Palliative Care

Stuart Andrew Excerpts

Thursday 5th March 2026 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

May I begin by congratulating the hon. Member for York Central (Rachael Maskell) on securing this important debate, and the independent commission on palliative and end-of-life care on the amazing work that it has undertaken? Its report certainly provides an important contribution to the discussion about how we ensure that people receive compassionate and high-quality care at the end of life.

This debate is important. There is a saying that nothing is certain in life other than death and taxes, but it seems that we spend an awful lot of time in this place talking about taxes, and until recently we have not really talked about death. I agree with the hon. Member for Newcastle upon Tyne East and Wallsend (Mary Glindon), who said that we have gone into assisted dying but rather missed or leapfrogged the important debate around palliative care. I pay tribute to the hon. Member for Newcastle-under-Lyme (Adam Jogee) for his tribute to Dougie Mac, and to all colleagues who have made representations and congratulated hospices on the amazing work that they do around the country. We also heard moving contributions from the hon. Members for St Helens South and Whiston (Ms Rimmer), and for Worcester (Tom Collins). These debates are even more powerful when we talk about personal experiences that we have been through, and I thank them for sharing those.

For me, palliative care is about dignity, compassion and choice at the most difficult moments in people’s lives. When it works well, it relieves suffering, supports families, and allows people to spend their final days in the place and manner that they choose. Before coming to the House I had the privilege of working for 16 years in the hospice movement in both children and adult hospices, and with organisations supporting families whose loved ones were edging towards the end of their life. Many of those were supporting the families of children who had life-limiting conditions. That experience has stayed with me and informed how seriously I take this debate, because I saw first-hand the extraordinary compassion and professionalism of the people who provide such care, and the profound difference that it makes to families facing unimaginable circumstances.

When it comes to children, no parent expects to outlive their child. Often those parents would say to me that when they realised that their child was living with a life-limiting condition, it meant that their dreams and aspirations changed. Suddenly they were not thinking about their child’s first day at school or university, or their wedding day; they were changing their whole aspect and plan for that child’s life. That is why hospices and palliative care services are so important, and they support more than 300,000 people every year.

Much has been said about the wonderful Dame Cicely Saunders, but we should also pay tribute to Sister Frances Dominica, who set up the first children’s hospice in the UK. There was a wonderful saying in children’s hospices that I always used to relay: they cannot add days to their lives, but they can add life to their days. That shows how important hospices are to so many families.

Hospices are a vital part of our health system because they are relieving pressure on hospitals and providing specialist care in communities across the country. Hospices are not an optional extra in our health system—they are a core part of how our compassionate healthcare should work. Seeing adults and children get the care that they needed at the end of their lives, as I did at Hope House children’s hospice, East Lancashire adult hospice and Martin House children’s hospice, was phenomenal. It is no wonder that our hospice movement has been world-leading.

However, the sector is under increasing strain. Hospice leaders report rising costs, workforce shortages and growing demand for services at the very moment that they are struggling. Across the country, we are seeing reductions in services, bed closures and significant financial pressures. As many hon. Members have said, Hospice UK has warned that two in five hospices are now cutting or reducing services. I know that concerns every Member of the House.

The Government will point to recent announcements about capital funding for hospices and the continuation of the children’s hospice grant, and those investments are welcome. But capital investment and capital funding cannot pay for nurses, doctors or the day-to-day delivery of care. What the sector needs is sustainable revenue funding. As a former head of fundraising, I know that capital fundraising is often the easiest, because people want to buy a new building or a piece of equipment, and paying the wages is never as, dare I say, sexy.

As many hon. Members have said, children’s palliative care also faces challenges. Children with life-limiting conditions and their families require specialist care that supports them from diagnosis through to the end of life and beyond. I remember one parent saying to me that if he got up eight times in the night to his daughter, he would consider that he had had a good night’s sleep— I cannot imagine what that must be like. I also saw siblings having a different life from those of their school friends because their brother or sister needed extra, additional care. Children’s hospices offer wonderful bereavement support to families, which is another issue that many hon. Members have mentioned.

Access to that care remains inconsistent across the country. As my right hon. Friend the Member for New Forest East (Sir Julian Lewis) said, evidence suggests that fewer than one in five integrated care boards formally commission specialist children’s palliative care services that meet national standards. There are also serious workforce shortages. England has just over 1,000 community children’s nurses, when safe staffing estimates suggest that nearly 5,000 are required. Across the UK, there are only around 24 specialist paediatric palliative care consultants, when experts estimate between 40 and 60 are needed. For many families that means they cannot access the support they need at home, even when that is their preference.

The Government have indicated that they will publish a modern service framework for palliative and end-of-life care later this year, which I absolutely welcome and I commend the Government for that. That framework presents a really important opportunity to address the challenges facing the sector.

I would like to ask the Minister a couple of questions. I will not repeat the ones that my right hon. Friend the Member for New Forest East mentioned because we all had that briefing. What steps will be taken to address the workforce shortages facing palliative services, particularly community children’s nurses and specialist consultants? What plans do the Department have to ensure that hospices have the sustainable funding required to continue delivering these vital services and protect their independence? I get the call for us not to have so much reliance on fundraising, but there is a real danger that hospices lose that independence if they take that statutory funding. The thing I always noticed was how they were more able to respond very quickly to the needs of individual families than the NHS. It is really important that we safeguard that independence.

How will the Government ensure that this opportunity with the new plan seizes the chance to stop that postcode lottery? Will it see where we should firm up some of the guidance to ICBs around the country? Will Ministers look at the innovation that charities are doing in this work around palliative care? I think particularly of Sue Ryder, which is investing in add-on wards at the Airedale general hospital in Yorkshire. It is also focusing more on home services, rather than services in the building, and on getting to more and more patients. It is important that we engage with and learn from it so that we can see it evolving into best practice.

There is also a really important issue around transition, which is important for young adults. When I worked at Martin House, we had just opened the teenage unit, which enabled us to have a setting that was a bit more grown up but not old ladyish or old mannish, if I can put it that way; it was an environment suited to the needs of those young people. Thankfully, we now see that these young people are living longer. When I was working at Martin House, young boys with Duchenne muscular dystrophy would probably come to the end of their life at the age of 18. They are now living into their late 20s, 30s and sometimes even 40s.

There needs to be an appropriate environment for those people to have support, because palliative care is one of the most compassionate parts of our health system. The professionals, volunteers and charities that deliver that care do extraordinary work every day, and they deserve a system that supports them and ensures that every patient and family can access the care that they need at the end of life. I hope the Minister can tell us how the Government intend to achieve that.