The nation that inspired a worldwide modern hospice movement still woefully underfunds hospice care. Yesterday some short-term relief for children's hospices was announced by the health department. They faced a particular problem because a £48m lottery grant for children's palliative care - both at home and in hospices - is due to run out. Even with this funding stream, there was only one hospice bed for every six children in need of residential care. Hence the emergency approach which the association of children's hospices made to the prime minister 10 days ago. Hospices provide much wider help than just support in the last few days of life. They are an invaluable source of guidance and relief for families caring for terminally ill children. But numbering just 38 - with five more planned - hospices can only offer help to a minority of the 20,000 families with terminally ill children.
Yesterday's package will provide £27m over three years. This will bring short-term relief but something much more generous and long term is needed - for both adults and children, as well as for patients suffering from diseases other than cancer. There are now more than 230 British hospices following the principles laid down by Cicely Saunders, the founder of the movement, when she opened St Christopher's in Sydenham, south London, in 1967. As a former medical social worker, who later trained as a doctor, she recognised the terminally ill required a total different approach to conventional medicine. Unable to persuade mainstream hospital services to change, she launched her first hospice with the aim of addressing social and emotional needs as well as clinical. Equally important, she recognised the importance of dealing with pain and the early use of pain killers. Difficult though access is for terminally ill children, it is even more difficult for older people.
Full-time NHS hospices have emerged but by far the greatest proportion of hospice care is provided by voluntary-run hospices. Typically, they only receive one-third of their running costs from the NHS with children's hospices receiving much less. Yet this is a government that constantly urges voluntary organisations providing public services, to ensure their contracts reflect full costs. Even a Treasury review supported this principle. The health secretary was right to pay tribute to the teamwork between the NHS and hospices, but services would be even broader and better if the NHS pulled its proper weight. Let next year's 40th anniversary of hospices mark the change.
