Improving palliative care: Words are welcome, now we need action

The new Scottish Government must turn promises into action to improve hospice and palliative care

The manifestos published before the Scottish election make one thing clear: cross-party support for hospice and palliative care has never been stronger. There is now recognition across the political spectrum that high-quality care for people approaching the end of life must be a fundamental part of the health and care system, not a niche issue. It is a core test of whether the system, and we as a society, can support people with dignity, equity and humanity where and when they need it most.

Political consensus is welcome, and vital, but it is not enough. Now we need action.

The new Scottish Government takes office at a moment when expectations for palliative care are rightly high. Manifesto commitments have been made. Scotland needs to do better for dying people and those closest to them. Hospice UK and Scottish hospices were clear before the election that one issue stands out as especially urgent: sustainable funding for hospice care.

Hospices are an essential part of Scotland’s health and care system. Every year, they support around 20,000 people and make 76,000 home visits. They care for people with complex needs, support families through some of the hardest days of their lives and help people spend time in the place that feels right for them, whether in their own home or in an inpatient unit.

But too often hospices are expected to provide this essential care while relying on funding arrangements that are short-term, uncertain and don’t reflect rising costs or rising demand. Sustainable funding is not just about organisational stability. It’s about what becomes possible when services can plan ahead: developing and innovating services, investing in care at home and reaching people earlier before they reach crisis point.

That matters for the whole system. Scotland spends around £1.3 billion on healthcare in the last year of life, with the vast majority, around £1.1 billion of that spent on hospital care. Too many people still end up in hospital because the support that could help them stay at home or in their community just isn’t there. Hospice and palliative care give people real choice and reduce avoidable reliance on hospital care. It can be part of the solution to the pressures the NHS is facing – waiting lists, delayed discharges, bed shortages – but only if it is funded properly and sustainably.

It also matters for equity. In rural and island Scotland, people receive too little help at home, especially overnight, and experience long journeys, delays getting medication, and support arriving too late. Good end of life care shouldn’t depend on postcode, diagnosis or how well local services can stretch limited resources. Sustainable funding is the foundation that makes wider reform possible.

Recent progress, including the previous Scottish Government’s funding to support hospices to pay their staff on a par with NHS, is a step in the right direction. But it must be the beginning of a longer-term shift, not the end of the conversation. What’s needed now is a funding model for hospice care that is long-term, sustainable and able to keep pace with growing need.

The new Government has a real opportunity. There is broad agreement across Parliament that hospice and palliative care must improve. The task now is to turn that consensus into delivery. The politics have moved. The funding now needs to follow.

Read more about Hospice UK and Scottish hospices’ priorities for the new Scottish Government

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