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Mr Calvin Bailey (Leyton and Wanstead) (Lab)
I beg to move,
That this House has considered therapeutic play and children’s healthcare.
It is a pleasure to serve under your chairmanship, Mrs Harris. I thank all colleagues who have joined us to support this debate, and in particular my hon. Friend the Member for Hitchin (Alistair Strathern), who I hope to hear from later. As all good stories begin, I was enjoying a beer at the Wanstead Tap during the Wanstead festival when I met one of my constituents, Sarah Owen. We spoke about our experiences of observing children suffering from cancer: I spoke about watching my teenage sister’s experience, and Sarah spoke about her experiences of her son, Hari. It is their story, and what it says about how the NHS can work better for children and their families, that I will highlight today. I am pleased to welcome Sarah and Hari, who are watching proceedings from the Public Gallery.
When we met, Sarah told me about the massive difference that play made to Hari’s care after he was diagnosed with leukaemia, aged just four. Suddenly he was plunged into a confusing whirlwind of surgery, blood transfusions, chemotherapy and, in between, separation and isolation. He was confined to a tiny room without much space and afraid to get out of his bed. A four-year-old’s life is centred around play. When their world is turned upside down after a diagnosis, play can be the only thing that removes the trauma from hospital treatment and makes it as smooth as possible. That was proven for Hari when the health play specialist arrived in that little dingy room, bringing a play mat, a tray of colourful Lego, a box of track and Thomas the Tank Engine.
Tom Hayes (Bournemouth East) (Lab)
My hon. Friend is describing some of the approaches that I have recently been honoured to see in action at Poole hospital. Does he agree that play professionals in our healthcare settings need proper support? Does he also agree that the Government should include health play professionals in the NHS workforce plan and make health play a registered allied health profession? I also note that the all-party parliamentary group on play, which I chair, is set to look at health and play.
Jim Shannon (Strangford) (DUP)
The Ulster hospital, which is near my constituency of Strangford in Northern Ireland, makes sure that there is no medical equipment in some of the rooms. That allows children to relax, play, read and draw, and helps to reduce the anxiety associated with hospital stays and treatment. The hospital also has a communal area for children and young people. Does the hon. Member agree that it should not be down to charitable donations to provide that; it should be down to the health trusts?
Mr Bailey
I thank the hon. Member for his powerful intervention. He is a massive champion for his local hospital. I agree that we should not rely simply on charity and that this issue should be looked at, which is the aim of the debate.
When the specialist invited Hari to play with her, Sarah told me that the change was immediate. She said:
“I saw my little Hari emerge again, play was bringing him back to us, in that dark tiny room I saw his light come back. This turning point became a moment that I held on to throughout the entirety of his childhood cancer journey.”
Sarah had to fight for that essential part of Hari’s care throughout the two and a half years of that journey. She understandably saw play as the most important therapeutic tool, but for many clinicians, medical treatments came first—even to the detriment of Hari’s mental health and wellbeing.
Adam Dance (Yeovil) (LD)
Play therapy services in Yeovil that support adopted children and those in kinship care are struggling due to cuts to the adoption and special guardianship support fund. Services have been reduced and therapists like Lilly have gone months without being paid. Does the hon. Member agree that that situation is unacceptable, and that more needs to be done to ensure funding models for play therapy services are sustainable, ethical and child centred?
Mr Bailey
I thank the hon. Member for his powerful intervention. I hope that we hear from the Minister how such services can be sustained, given some of the shortfalls that have been described.
In reality, medicine and play are not in competition. When clinicians took playful approaches or when health play specialists were involved, Hari was far more willing to engage with difficult treatments, helping them to go much more smoothly. The culmination of that was an MRI scan that Hari did, fully awake, at four years old, avoiding the need for general anaesthetic. The health play specialist prepared Hari for this potentially scary and challenging ordeal by playing with a Lego scan machine, and playing the sound of an MRI while talking him through that process.
Mr Richard Quigley (Isle of Wight West) (Lab)
I thank my hon. Friend for securing this debate and for the important work that he and Starlight have done so far on this issue. Does he agree that ensuring there is effective play within children’s healthcare not only helps create happier, calmer patients but delivers real benefits for the NHS by enabling quicker, smoother procedures and reducing overall costs?
Mr Bailey
I know that my hon. Friend has been raising this subject on behalf of his local community and I agree with his sentiment.
Sadly, after Hari was discharged from hospital, that same quality of play-centred care was not always there for him. He needed 130 blood tests, and the lack of play contributed to these often being traumatic experiences where Hari had to be held down, violating the safe space of his own home.
Alex Easton (North Down) (Ind)
Does the hon. Member agree that therapeutic play is most effective when embedded within healthcare teams, rather than treated in isolation, and that we need a shift away from seeing it as something that happens only in the playroom towards fully integrating it into children’s daily care?
Mr Bailey
The hon. Member is right, and he will hear more about how that impacted Sarah and Hari’s experiences. Those experiences have already had an influence on NHS policy in the way that the hon. Member would like through Sarah’s work with the charity Starlight, which co-produced the NHS Play Well toolkit that was published last year. The Government are rightly pushing forward with our new neighbourhood model, ensuring that more care takes place within the community. If we get that shift right, it will be truly beneficial to children who are in the same position that Hari was in, but doing so requires the toolkit to be implemented across the NHS—in new community services as well as our hospitals.
When I raised the issue with Whipps Cross, our local hospital, I am pleased to say that I got a very positive response. It has a dedicated play team based in the Acorn ward, alongside a garden space and a play space. The team includes a qualified play therapist, and it co-ordinates the offer for in-patient care, including for children in other wards, and helps with preparation for procedures such as blood tests, MRIs and surgery.
Lola McEvoy (Darlington) (Lab)
I thank my hon. Friend for the really interesting and informed speech he is giving—he is giving it quickly, so I will be quick with my intervention. Does he agree that just as play is essential in hospitals, it is also really important for parents? Therapeutic play can have a large impact on post-natal depression and parents’ mental health as they are taking their child through quite a difficult experience.
Mr Bailey
I thank my hon. Friend for her powerful and astute intervention. She will notice that I am speaking about not just Hari, but Sarah, because making sure that the parents are looked is a critical and fundamental part of making sure that the child is looked after.
Starlight has found that the situation in Whipps Cross is far from true around the country. In 2023/24, it found that 72% of NHS trusts had no budget for play resources and only 15% had play service policies or procedures. Only 520 registered health play specialists are employed by the NHS across the whole of England.
Uma Kumaran (Stratford and Bow) (Lab)
I thank my hon. Friend for sharing Sarah and Hari’s story, which is a powerful reminder of why play is important. My constituent Eleanor wrote to me last week following the unexpected withdrawal of funding for her level 7 play therapy apprenticeship. She is an experienced teacher who had taken it on as additional training. Does my hon. Friend agree that the Government must look again to ensure that there are accessible training options for play therapy, which is, as we have heard, an incredibly powerful tool for children’s emotional wellbeing?
Mr Bailey
I thank my hon. Friend and constituency neighbour, who raises a powerful point about specialist training. I know she has written to the Skills Minister and lobbied the Department for Work and Pensions directly to help the Minister who is responding today and close the skills gap on behalf of her constituent.
Those are the challenges and the situation that the toolkit is there to address and that its implementation must change. This is also a real opportunity for positive change as the Government’s NHS reform programmes move forward, because better play services for children in every part of England can not only reduce trauma and its long-term consequences, but save money through quicker procedures, lead to fewer cancellations, and reduce the need for anaesthetic.
Jen Craft (Thurrock) (Lab)
Much like my hon. Friend the Member for Stratford and Bow (Uma Kumaran), my constituent Ambia has written to me to highlight the fact that funding has been withdrawn for her level 7 apprenticeship in play therapy. Does my hon. Friend the Member for Leyton and Wanstead (Mr Bailey) agree that if the Government want to see the savings related to therapeutic play that he talks about, they need to invest up front?
Sarah Olney (Richmond Park) (LD)
I thank the hon. Member for securing this important debate. Last year, two important reports were produced: “Mental health inpatient settings: overarching report of investigations directed by the Secretary of State for Health and Social Care” and “Improving support for people with complex mental health difficulties”. They found that therapeutic input improves patient outcomes and results for adults with mental health difficulties. My constituency is home to the Cassel hospital, a tier 4 therapeutic community for adults with complex multiple-diagnosis presentations. Patients there tell me that the treatment is lifesaving and life-changing, but it is currently under a tier 4 review. Does the hon. Member agree that that review should consider the reports I mentioned? I would be grateful if the Minister could make reference to the tier 4 review in her summing up.
Mr Bailey
I thank the hon. Member for her powerful intervention; she is a massive advocate for her constituency. Her plea has been heard and I hope it will be answered.
Overall, the estimated financial benefit of the greater use of therapeutic play resources in NHS care is £3.2 million a year, at a cost of less than £700,000 a year. Surely, if we want the NHS to become more preventive, including through a higher uptake of childhood vaccinations and outreach programmes about exercise and health lifestyles, this is an opportunity we cannot miss.
I will close by asking the Minister a few questions. First, how is the Department working to ensure that the Play Well toolkit is implemented across every part of the NHS, including through delivering on training? How will the need for health play specialists be incorporated, as we have heard, into the NHS workforce plan? How will play specialists be included in the modelling of multidisciplinary teams for the new neighbourhood health service?
I was planning to ask whether the Minister would agree to meet with Starlight, but I am very pleased that she has already agreed to do so. I look forward to hearing the outcome of that meeting, which I know will be very valuable and will help us to deliver a more effective system that addresses the problems that we have raised today.
I want to close by thanking Hari and his mum Sarah for their determination to use their experiences to create better policy and help thousands of others. I look forward to our next Huddlestone street party and to hearing how Sarah and Starlight have moved this issue forward. It is a great pleasure to be able to use my position as their MP to highlight this issue.
Several hon. Members rose—
Carolyn Harris (in the Chair)
Order. I assume that all Members who are bobbing have sought permission from both the Minister and the Member in charge to make a speech. They will need to be very short speeches, or else we will not get a response from the Minister.
Dr Simon Opher (Stroud) (Lab)
I will be very brief. I thank my hon. Friend the Member for Leyton and Wanstead (Mr Bailey) for securing this fascinating debate.
All play is therapeutic, and I emphasise that the Government have put £18 million into new playgrounds. My constituent Tom Williams is a proponent of adventure play, which is incredibly good for kids. It reduces anxiety, it burns more calories than sport and, crucially, it provides a digital detox and improves community cohesion.
As a GP, I always had a big box of toys in my room. To examine a child, I had to play with the child; otherwise, they would scream their head off. Therapeutic play must be part of GP training in every way. The thing about therapeutic play is that it reduces the trauma, as we have heard; it actually results in fewer cancellations and, as my hon. Friend said, reduced need for anaesthetics and shorter procedure times because the child is enjoying themselves playing. I thank my hon. Friend for bringing this subject forward for debate—I will say no more.
Janet Daby (Lewisham East) (Lab)
I congratulate my hon. Friend the Member for Leyton and Wanstead (Mr Bailey) on securing this short but significant debate. I will not take up too much time.
It is vital that healthcare is fully accessible for children. I do not think anyone would disagree that therapeutic play can be instrumental in putting children at ease, as far as that is possible, when they are experiencing medical treatment. The Government must do all they can to prevent and reduce child trauma. I know from my time as Minister for Children and Families that work has already begun to evaluate the benefit of our therapeutic approaches, such as dyadic developmental psychotherapy. I think all of us in attendance would appreciate an update on the Government’s progress in this area. However, while it is important for the Government to evaluate new approaches to providing medical care, it is also critical that medical staff have the skills and knowledge to support children with complex needs, with adequate pay and conditions to retain them long term.
Before I conclude, I want to say how brave Hari sounds. I appreciate everything that the Minister has already shared in this Chamber, and I trust that the Government will keep all these things in mind as they develop their NHS workforce plan.
Alistair Strathern (Hitchin) (Lab)
I thank my hon. Friend the Member for Leyton and Wanstead (Mr Bailey) not just for securing the debate, but for continuing to live up to his true legend status by being so generous with interventions and speaking time.
Therapeutic play can all too often be seen as a nice-to-have in children’s healthcare, rather than as a fundamental part of doing paediatric care well. I had the privilege recently of joining fantastic play therapists such as Christina at my local hospital and seeing the transformative impact that therapeutic play, done well, can have on outcomes for young people. I spoke to young people who had had trauma eased that could easily have lasted far longer than the condition they were being treated for; to parents who, at some of the most difficult and traumatic moments of their child’s early life, were still able to find moments of joy and solace in the smiles they saw in the play area working with those fantastic therapists; and to wider health professionals who were able to deliver far more effective and often more cost-effective care because of the fantastic collaborative work they had with the therapeutic play provision team who are well embedded into the Lister hospital.
Those parents and families are really lucky. Working with Starlight, I know many other families across the country have got to be equally lucky, but far too often families face a postcode lottery in provision. It is fantastic to see the toolkit coming into effect. We now need to make it a reality for every family and every child with healthcare needs right across the country.
The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)
It is a pleasure to serve under your chairship, Mrs Harris. I thank my hon. Friend the Member for Leyton and Wanstead (Mr Bailey) for securing this debate on such an important topic. I am grateful to him for sharing Hari’s story, and to Hari and Sarah for making the trip to Parliament. I have always believed in bringing patient voices to the heart of what we do in Parliament, and I hope they both leave safe in the knowledge that this Government are listening.
I strongly agree with what hon. Friends have said about the relationship between play and medicine. I volunteered in a healthcare setting as a play worker many moons ago, but more than 30 years later, the important impact of that work has stayed with me. Play and medicine are not in competition, and it is disappointing that Sarah had to fight so hard for play to remain an essential part of Hari’s care. I am pleased that my hon. Friend the Member for Leyton and Wanstead got a constructive response from Whipps Cross, but he is right to say that coverage of play services varies across the country.
Investing in our children is not just a moral mission; it is a downpayment on a better future. Children do not stop being children when they enter a hospital or a GP clinic. It is important to treat children like children when they are at home, at school or in hospital. There is growing evidence that therapeutic play can mitigate risks of trauma. We recognise that play services are integral to paediatric care, not a nice-to-have. We published the NHS England and Starlight Play Well toolkit in June last year, and I am delighted to see representatives of Starlight in the Public Gallery today. That included the first national guidelines and standards for commissioning and delivering health play services in England. NHS England is making sure that every manager of health play services knows about the Play Well toolkit across a wide range of settings. We are promoting it in community clinics, emergency departments, children’s hospices and acute paediatric wards. A range of communication channels have been used to raise awareness, including engagement with services via professional bodies, messaging via the chief nursing officer, and ongoing promotion through operational delivery networks directly to trusts and with professional groups.
The NHS is also undertaking evidence-based initiatives such as the iSupport programme, which focuses on ensuring children’s rights and wellbeing. The iSupport checklist aims to help professionals deliver safe, compassionate and child-centred care. The programme is already being picked up by children’s wards across the country. I look forward to meeting Starlight. We have been trying to get this meeting in the diary for some time, and I am delighted that we have managed to do that. I look forward to working with Starlight to see where we can go further to help kids like Hari avoid childhood trauma.
Jen Craft
Recently, my daughter had an in-patient stay, and I saw a Starlight notice on the door of the playroom. Having met Starlight, it gave me quite a lot of confidence. In fact, thanks to the play therapist, the most traumatic thing about my daughter’s visit was when she had to leave, as she had such a good time. That was in an inner-city hospital; we also have a regional hospital that does not have the same resources. Can the Minister say how play therapy can be rolled out across the country so that every child can benefit?
Ashley Dalton
As I stated earlier, we are promoting the Play Well toolkit right across the country through a variety of communication methods. We look forward to a variety of healthcare settings using that toolkit to deliver in their local areas.
That moves me on to mental health. Under this Government, all children will have access to a mental health support team in their school or college by the end of this Parliament. We are also committed to opening 50 Young Futures hubs over the next four years, which will bring together services to help young people at a community level. There have been calls for us to go further on the children’s health workforce. The Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth), is absolutely committed to making sure that we have the right skills to care for patients, including children, when they need it. We are working through the changes and what they will mean for different professional groups. I know that mental health will be at the top of the agenda, not least for children.
Health play therapists are trained through foundation degrees. The toolkit that has been developed sets out clearly how services should support practical training of specialists. Games and active play build social and emotional skills and support children’s wellbeing. We want every child to feel safe from harm and for their families to feel supported. We know that the poorest children are more likely to develop long-term illnesses. That is why it is shameful that child poverty has increased by 700,000 since 2010.
With more than 4 million children now living in poverty in the UK and 800,000 children using food banks to eat, my right hon. Friend the Chancellor took the necessary decision to fund the biggest reduction in child poverty of any Budget this century. We are expanding free school meals to half a million kids whose parents are on low incomes, and lifting hundreds of thousands out of poverty by removing the two-child benefit cap.
In addition, there is a £126 million funding boost for the family hubs and Start for Life programme this financial year. Best Start family hubs will be rolled out to every local authority from April. We have kept our manifesto promise to restrict junk food advertising targeted at children. We have announced improvements to the soft drink industry levy, and we have invested £11 million in local authorities to deploy supervised toothbrushing for three to five-year-olds in schools and nurseries in the most deprived areas of England.
On neighbourhood health, my hon. Friend the Member for Leyton and Wanstead raised an important point about multidisciplinary teams for children and young people, which should take an holistic approach to looking after children. The aim is to embed general paediatricians in primary care to give specialist paediatric advice and reduce the need for out-patient paediatric referrals. Those discussions ideally bring together wider health, social care and educational specialists. The make-up of the teams is locally determined by integrated care boards, but play specialists could absolutely be involved as part of a neighbourhood team.
Ashley Dalton
As my hon. Friend will have noticed, I referred to the workforce plan. My hon. Friend the Minister for Secondary Care will consider all areas of the workforce and what should be included. Play specialists could be involved; their use is most appropriate in teams that give face-to-face patient care, for example when a GP and a paediatrician hold a joint clinic in a GP practice.
The majority of case discussions are held virtually, without the patient or family in attendance. There is probably less need for play specialists to support children in those circumstances, but we do encourage the use of the Play Well kit, to ensure that children’s needs are taken into consideration throughout the healthcare process. For the first time, in the recently published guidance, we require NHS providers to consider children in the roll-out of all services.
The Government are cutting waiting lists, giving children a healthier start in life and lifting half a million children out of poverty. This year—2026—will be critical, as we roll out the Best Start in Life hubs to every local authority in April, while rolling out neighbourhood health hubs and implementing the 10-year plan. The Government fundamentally believe in the importance of play. I am sure all my right hon. and hon. Friends would agree that we could do with a little bit more play in our lives, including in this place. As my hon. Friend the Member for Stroud (Dr Opher) pointed out, all play is therapeutic, and we would all benefit from a little more play. I stand ready to work with NHS England, my hon. Friend the Member for Leyton and Wanstead and Starlight to make this a decisive year for children’s health.
Question put and agreed to.