Palliative Care

Tom Collins Excerpts

Thursday 5th March 2026 Commons Chamber

[Tom Collins (Worcester) (Lab)]

I thank my hon. Friend the Member for York Central (Rachael Maskell) for leading on this topic.

I have seen palliative care fail. My mum, Alison, had ovarian cancer. She died lonely and in dreadful indignity in a hospital ward intended for recovering liver and kidney patients. She felt a burden to a nursing team who were used to people getting better. She was waiting for a hospice bed, but, as it turned out, the waiting time was longer than she had.

In my constituency, we have hospices with superb facilities. Both Acorns children’s hospice and St Richard’s hospice are beloved institutions in our city, but they are struggling and it is vital that we support them. Clearly, we need more hospice capacity, but the deficiencies in palliative care are vast, and my lurking, uneasy suspicion is that many of them are not hospice-shaped, but reflect deeper deficits across our NHS.

[Ms Julie Minns (Carlisle) (Lab)]

My hon. Friend raises an important point about the NHS. In my limited but painful experience of hospices, one problem is that even when there is a hospice bed available, NHS staff do not refer end-of-life patients to the hospice because the palliative team is 9 to 5, Monday to Friday. Does he agree that we have to get to a point where palliative support in our NHS is available 24/7 so that those referrals can take place?

[Tom Collins]

My hon. Friend is entirely right. We need far better integration across those services. I was heartbroken to see that the palliative care that my mother was receiving seemed to have been outsourced to charities, and was not being provided by the NHS at all. That specialist care ought to be something that is native to our NHS.

I was recently talking to a couple of GPs in Worcester. Speaking with them is a refreshing change. While their work is in diagnosing and treating illness and, to a good extent, preventing it and promoting healthy lives, for them, palliative care is not an exception; it’s a Monday. With an ageing population, end-of-life care is really an emerging flavour in medical care. Bodies do not last forever, and the balance of benefits of treatment versus the very human costs of pain, inconvenience and indignity starts to change.

Medics dealing with palliative care understand that our bodies are intermingled, complex systems, and that they are one part of what we are: complex, intermingled physical, psychological, social and spiritual beings with rich tapestries of relationships, values, perspectives and experiences. “See the problem, name the problem, fix the problem” just does not cut it as an approach. We must treat the whole person, or we risk mistreating them. Sadly, our urgent and acute systems of diagnosis and treatment are simply not designed for this approach. Palliative care is by and large out of mind and out of scope. Care is siloed into specialties, patients become units of flow and relationships are substituted out for transactions.

This is reflected in the stories I hear from constituents in Worcester: stories from people with multiple complex conditions who are locked in the flip-flop between specialisms, where alternately one gets managed well and the other slips into neglect; stories of people who feel unheard, unvalued and anonymously shipped to different hospitals in different areas under different trusts; and stories of people who, when their wellness takes a dip, do everything they can to avoid calling an ambulance and the inevitable prodding, poking and a long, cold night in A&E corridors that follows. This has to change.

Addressing our gaps in palliative care demands a fundamental shift in the way our NHS thinks and works. Here and there, there will be a place for the cut-and-shut quick surgical procedure, a course of antibiotics, or a cast, a sling and a suggestion not to do it again, but the primary role of healthcare needs to be one that sees the human being and works in relationship for their wellbeing. In fact, best practice in palliative care is often remarkably similar to treatment for recovery: setting small, achievable goals and working with patients to fulfil them. An NHS informed by this approach would most likely be more effective across the board. With that foundation, the opportunities for a better, more holistic and properly resourced approach to palliative care can start to open up.

I would like to touch on the topic of assisted dying. I found debate on the Bill difficult to navigate, largely for the reasons I have discussed. The overwhelming message I have heard from medical professionals is that we need to improve the way we navigate the end of life as things stand today, break the taboo of death and develop care that meets the practical, physical, psychological, spiritual and social needs of patients and their families, and make that available to all.

As we do that, treatments that shorten but enhance life would undoubtedly play a role, but they must sit at the apex of a well-developed practice in end-of-life care that we do not yet have. This should be a major and urgent priority for us, not least because the drive towards excellent palliative care can only improve our systems and approaches overall, enabling us to deal better with complex needs, putting patients’ perspectives at the centre of system design, and plugging gaps so that patients are no longer able to fall through them. By taking proper ownership of palliative care, we can end experiences like my mum’s, and in doing so, we will also make a better NHS.