Speeches by George.

“As well as the patient, there is also the family around them in the home. The expert panel identified that the value of unpaid carers is effectively about £29 billion, in terms of supporting those in need of end-of-life and palliative care. Is that going to be part of your MSF? Is your MSF going to be integrated with o…”

“Right.”

“You mean there is a gradual diminution of numbers and proportions that are admitted.”

“More so than a residential home? There would be admissions to hospital from there.”

“Looking more widely, I think the patient and family point of view is, yes, shift out to the community, but to a certain extent there is a fear of out of sight, out of mind, and they would feel safer in the hospital. There is not the 24/7 access to medication, advice and specialist palliative care when needed. Therefore…”

“Okay. The question was about the integration, rather than the funding.”

“Yes, it is. But Cornwall Hospice Care—St Julia’s, as was—has been hit by the national insurance increase, which cost it a quarter of a million a year on its turnover. There seems to be a balancing message at the moment, but certainly one that puts it under a lot of pressure.”

“But you are sending them two messages: on the one hand, they must work within their budgets; on the other hand, they must not engage in recruitment freezes. The two things do not add up at the moment, do they? You have left them in an impossible position.”

“Point taken. We have highlighted the issue. Shifting to capacity elsewhere, and particularly hospices, I do not want to tread on my colleagues’ toes and ask about the funding of them, but the NHS and hospices do not appear to be as integrated as they could be in providing a seamless care relationship. In my area, Cornw…”

“There has been a fall of 5% in community nurses in the last decade. Just coming down to the practicalities of providing palliative care in the home, setting up a syringe driver, the titration and so on cannot be done by a care worker. It has to be done by a qualified, competent registered nurse, or nurses working in ta…”

“It seems to me that specialist consultants are running at about 10 per 1 million of population. Is that the target? Is that the right ratio, or should it be higher than that?”

“Yes. You are putting on a brave face, but it is still not good, is it?”

“The Minister raised the issue of the administrative burden. I was referring to an occasion when an operator of the scheme was late in his submission to HMRC, in which case he was refused the rebate, which he had been taking. In such circumstances, he had to appeal. I was simply demonstrating the rigidity and lack of hu…”

“It is a pleasure to serve under you, Ms Furniss. I congratulate my hon. Friend the Member for North Devon (Ian Roome) on securing this debate and making a very strong case, of which I hope the Minister will take heed. I will return to some of the prehistory, because I have campaigned on this issue for so long. I congra…”

“There are 78 senior consultant vacancies, and 55 retirements are expected very soon.”

“Will the Minister give way one more time?”

“We have been through the model many times, and we understand it and the three shifts. But the workforce is not there; it has declined in the last decade. After all, 130 of the 168 hours in a week are out of hours. People needing palliative care need those specialist services delivered to them, whether it be hospice at …”

“On the question of geographical coverage, and given the Minister’s comment that he has not received representations about further areas for inclusion, I urge the Government to review the scheme and to take an objective measure themselves of where else it might extend to, rather than inviting us to form an orderly queue…”

“T6. Season’s greetings, Mr Speaker. In October, a Censuswide survey of 200 farms showed that 76% felt under financial pressure from supermarket buying practices, and seven in 10 thought that the buying relationship between supermarkets and farmers had worsened in the past two years. When will the Government publish the…”

“Until that happens, and until our own workers are prepared to take on these jobs—fundamentally, we are talking about jobs involving minimum wage and very hard work, in both social care and care work—we will still be dependent on migrant workers. What are you saying to the Home Secretary to make sure that that supply is…”