Hospice bosses from across Scotland have warned that the financial crisis engulfing the sector is now so perilous they will have to cut services and "turn people away".

In a letter published in the Herald today, the heads of 14 hospice charities say they are in the grip of an "insurmountable funding gap" as a result of recent hikes in NHS Scotland staff pay of 10.5% for consultants and 5.5% for nurses which they cannot afford to match, and the looming rise in national insurance contributions.

It comes of top of a surge in the costs of heating, transport, food, and maintenance.

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Hospices provide free end-of-life care to terminally patients and their families, but most of their running costs are covered by fundraising which is being squeezed by the cost-of-living.

CEOs say it is also "grossly unfair" that the funding they do receive from the public purse has not risen in line with NHS pay inflation, leaving them with ever-growing deficits and difficulties recruiting and retaining staff.

They are calling on MSPs and the Scottish Government to use the Budget on December 4 to move towards a "sustainable" funding model for the sector.

They write: "Hospice care is always free. There is now a risk that, for the first time ever, hospices will have to turn people away.

"Cutting services is the last thing any of us want to do. It would break our hearts.

"We promise to do everything we can to avoid that, but we also have to balance the books."

Health Secretary Wes Streeting said yesterday that the UK Government will "make sure we're protecting our hospices" by providing extra financial support to help with rising National Insurance contributions for employers.

Details will be announced "before Christmas".

Hospices are struggling to meet rising costs (Image: Getty) Rhona Baillie, chief executive of the Prince and Princess of Wales Hospice in Glasgow, said it had begun the year with a £500,000 deficit which they "worked very hard" to eliminate through cuts to day-to-day running costs, but that the recent combination of national insurance and pay hikes had added another £500,000 to its expenses.

The hospice costs £9 million a year to run, and gets around £2.4m from government - a sum Ms Baillie said had "not significantly changed" despite spiralling overheads.

She said: "I've been in this job 20 years and this is the worst position I've ever known us to be in.

"We've already made efficiencies in every single area we could apart from patient services and staff because we really don't want to do that, but there's nothing else left for us now.

"I can't emphasise enough that we really don't want to cut staff and services - that would be a last resort, but that's where we are headed."

Gillian Green, chief executive of St Vincent's hospice in Johnstone, Renfrewshire, said cutting services was a "very realistic possibility".

The eight-bed centre provides inpatient palliative care, symptom control, community nursing, day centre activities, bereavement support groups, and outpatient medical support.

It receives 32% of its funding from government but expects to rack up a £200,000 deficit this year.

UK Health Secretary Wes Streeting said hospices will get support to 'protect' them from National Insurance hikes, but details are not expected until 'before Christmas'UK Health Secretary Wes Streeting said hospices will get support to 'protect' them from National Insurance hikes, but details are not expected until 'before Christmas' Ms Green added: "We're losing staff because we can't maintain the level of lift that the NHS are getting, so that impacts on services. 

"Right now our care is free, it's always been free, and it should always be free and accessible to anyone who needs it.

"But the challenges we have now mean we could end up reducing down to a core service to cut costs which could mean turning patients away, and that is a terrible thought."

The issue is due to be raised today during First Minister's Questions at the Scottish Parliament by Scottish Conservative MSP Miles Briggs, who will ask what support the Scottish Government intends to make available to "fully fund and protect" hospice services. 

Strathcarron hospice, near Falkirk, provides palliative care at home to 400 people a week across Forth Valley and North Lanarkshire in addition to the 400 patients each year who receive end-of-life care in its main hospice site.  

Referrals are 76% higher now than they were in 2006, but the NHS has not funded the additional posts required and it relies on fundraising £116,459 a week to make up the shortfall.  

Its CEO, Mags McCarthy, said: "To match NHS rates of pay to recruit and retain our staff will significantly push up our wage bill.

"This could be devastating for the hospice and we are feeling enormous pressure.

"We are incredibly grateful to our generous supporters, without their donations, we just could not carry on”.

By 2040 it is expected that 95% of people dying in Scotland will require some form of palliative care (Image: Getty) Marie Curie Scotland runs two Scottish hospices as well as caring for 8000 people a year at home.

The charity has just launched a campaign to give people a right to palliative care.

Libby Milton, its associate director of strategic partnerships and services, said it is unfair that palliative care is fully funded as part of the NHS in some areas but not others. 

She said: “We are constantly juggling how we can afford to deliver the services we know are needed and in some places, through no fault of our own, we have had to reduce the care we can give.

“There is not a level playing field for the people of Scotland – some health and social care partnerships will offer us a small uplift, others have not, but none are keeping up with increasing costs, particularly staff costs."

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Dr Sandesh Gulhane, Scottish Conservative health spokesman, said the CEOs' letter was a "devastating warning", adding: “This letter must be the wake-up call for both SNP and Labour politicians to step up with greater support for a sector clearly at breaking point."

A Scottish Government spokesman said: “We are deeply concerned that many vital frontline services – including hospices – are facing uncertainty due to the impact of the UK Government’s increase to Employer National Insurance.

“We are aware that the UK Government has suggested that it will develop support for the hospice sector and we are seeking clarification as to what this might mean in practice.

“Independent hospices are highly valued and we understand the pressures they are facing, which is why Health Ministers continue to engage with the sector and hold open and honest discussions with hospice leaders, as well as continuing to work with the Integrated Joint board chiefs and independent hospices to support the longer-term sustainability of planning and commissioning.”