Children’s Hospices: South-east England

Motion made, and Question proposed, That this House do now adjourn—(Stephen Morgan.)

I wholeheartedly welcome the Government’s announcement this morning, in anticipation of this afternoon’s debate, of £80 million of support for children’s hospices over three years. I thank the Minister for listening to the calls of the children’s hospice sector and the Liberal Democrats.

The three-year settlement will enable hospices to plan and deliver services over a longer period. Above all, it will ensure that seriously ill children and their families can continue to access hospice care. However, providers tell me that this level of funding does not solve the children’s hospice funding crisis, nor does it put children’s hospices on a genuinely long-term, sustainable financial footing. Bluntly, this funding will only slow the rate at which children’s hospice services are being cut.

Across the south-east—indeed, across the whole of England—children’s hospices support thousands of seriously ill babies, children and young people, and the families who love and care for them. One such organisation is Shooting Star Children’s Hospices. A parent recent said:

“Without the support of the team at Shooting Star I believe our family would be under enormous strain and feel unable to know where to turn.”

They are places of compassion, expert medical care and human dignity. They provide everything from end-of-life care to vital symptom management and psychological support, but our children’s hospices are in crisis. Unless urgent action is taken, many may disappear.

Since 2019, the number of children and young people needing end-of-life care has doubled. The demand for symptom management has surged by 108%. Hospices are having to provide more care and support than ever before, yet they are struggling to keep their doors open. At the same time, inflation and rising costs, particularly in recruiting and retaining highly skilled staff, has driven hospice expenditure up by an average of 15% in the past year alone.

The Government’s disastrous national insurance hike has only exacerbated the existing pressures. For example, Southern Hospice Group is a local charity made up of three Sussex hospices: Chestnut Tree House children’s hospice near Arundel, Martlets in Hove and St Barnabas House in Worthing. The national insurance rise has collectively cost them £500,000. Yes, the Government have increased funding in cash terms, but it is simply not enough. Local NHS funding from integrated care boards remains 18% lower than it was three years ago, even as hospices stretch to meet rising demand. Children’s hospices are now dipping into their reserves to stay open. In 2024-25, 59% of them ended the year in deficit. In 2025-26, that figure is expected to rise to a staggering 91%. This is clearly not sustainable.

Meanwhile, a postcode lottery in funding continues. Recent freedom of information requests conducted by the charity Together for Short Lives showed that some integrated care boards in London spent over £400 per child needing palliative care, while others spent less than £25. We see that too in the south-east: one ICB spent over £260 per child, while another spent just over £100. Only 32% of ICBs could even say how many children accessed hospice care in their region. This gap in data must be filled.

The announcement this morning suggested that funding being distributed via ICBs would tackle the postcode lottery issue, but the results of these FOI requests suggest that there is an awfully long way to go. How will the Minister ensure that ICBs commission children’s hospice services equitably? What guidance will they be given to ensure that these vast variations in support are eliminated?

If I can emphasise one thing, it is that people are the beating heart of the hospice movement. Highly qualified specialists, passionate volunteers and generous donors all make the seemingly impossible happen, but the work- force is in crisis. Incredibly, there are only 24 full-time equivalent paediatric palliative medicine specialists serving the entire UK, when we know the need is for at least 40 to 60. If we followed the guidelines of the Royal College of Nursing, we would have nearly 5,000 community children’s nurses; right now, we have under 1,000. The professionals who care for our sickest children are being stretched to breaking point.

I urge the Minister and the Government to build on today’s announcement by first fixing the broken commissioning system. We must instruct NHS England and the Department to model what each local NHS body should be spending on palliative care and to hold them accountable. We must commission services at regional and national levels, where appropriate, to create economies of scale, and we must use the new pan-ICB commissioning offices to ensure consistent and equitable access to care across England.

Secondly, we must tackle workforce shortages and invest an additional £2.4 million per year in GRID and SPIN training for paediatric palliative medicine. We must fund and implement safe staffing ratios for nurses and aim to employ the 4,960 community nurses that England truly needs.

I congratulate my hon. Friend on securing this debate. An amazing children’s hospice that serves constituents in my patch is Demelza, which has an amazing array of staff, volunteers and the rest, including Queen’s nurses such as Donna Mole. Will my hon. Friend congratulate Donna on being a recipient of that award? Will she also congratulate the fabulous Fia, one of the children served by the hospice, on a book that she has written, and will she encourage the Minister to order a copy?

I thank my hon. Friend for celebrating the work of Queen’s nurses and fabulous Fia for what she has done in writing a book—I am not sure that I could do that. It is truly impressive, and I am happy to encourage the Minister to buy the book; it sounds like I had better buy it too.

This is about real children like fabulous Fia. It is about real families and real suffering that could be eased. Children’s hospices provide £3.32 of care for every £1 invested by the state, which is extraordinary value, so they deserve more support. These children deserve dignity, comfort and skilled care, and their families deserve the support that only children’s hospices can offer.

My hon. Friend has brought forward a critical debate on children’s hospices. While we are looking at children’s hospices, let me say that this issue is also critical for adult hospices. In South Cambridgeshire, we have the fabulous Arthur Rank hospice, which at the moment is looking toward the cutting of its adult hospice beds. The outcry from constituents and members is huge. Does my hon. Friend agree that the ICBs could look at strategic commissioning of that care across both adult and children’s hospice beds?

I thank my hon. Friend for the campaigning she is doing with her colleagues on Arthur Rank hospice in Cambridgeshire, and she is right. When I went to visit Chestnut Tree House in Sussex last week, I saw that it is talking to adult hospices in the area about where that more strategic view can happen.

These children deserve dignity, comfort and skilled care, and their families deserve the support that only children’s hospices can offer. Will this Government truly support the vision laid out in the NHS 10-year plan in which neighbourhood health centres, hospitals and hospices work together to deliver high-quality end-of-life care in the community, or will we continue to let these vital services be ignored, underfunded and unconnected? There is an opportunity for more action than that in this morning’s announcement and for a longer-term commitment. I urge the Minister to do what is necessary and right and ensure that no child is left without the care and dignity that they deserve.

I thank the hon. Member for Mid Sussex (Alison Bennett) for securing this vital debate. I also thank all those who work or volunteer in the palliative care and end-of-life care sector for their care and support—the compassion that they provide to patients, families and loved ones when they need it most.

This Government want a society in which every child receives high-quality, compassionate care from diagnosis through to the end of life, irrespective of condition or geographical location. In England, integrated care boards are responsible for the commissioning of palliative care and end-of-life care services to meet the needs of their local populations. To support ICBs in that duty, NHS England has published statutory guidance and service specifications. It has also developed a palliative care and end-of-life care dashboard, which brings together all relevant local data in one place. That dashboard helps commissioners to understand the palliative care and end-of-life care needs of their local population.

While the majority of palliative care and end-of-life care is provided by NHS staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at the end of life and their loved ones. In recognition of this, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children and young people’s hospices in England, to ensure they have the best physical environment for care. I am pleased that the first £25 million tranche of that funding, which Hospice UK kindly allocated and distributed to hospices throughout England, was fully spent by hospices on capital projects. An additional £75 million has been transferred to Hospice UK for onward allocation to individual hospices for use in the 2025-26 financial year, and I know that many hospices are already spending that funding this year.

Hospices in London and the south-east are receiving over £28 million of that £100 million capital funding. That includes over £4 million for children and young people’s hospices in London and the south-east. We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025-26. This is a continuation of the funding that, until recently, was known as the children and young people’s hospice grant. Children and young people’s hospices in London and the south-east are receiving almost £8.5 million of that £26 million of revenue funding.

I agree that increasing the time period covered by this grant to children’s hospices to three years will really help. Can the Minister comment on whether there are plans to do the same for the adult hospice sector?

The hon. Lady will know that children’s hospices are in a different situation from adult hospices: there has always been a centralised grant for children’s hospices, whereas the funding for adult hospices goes through ICBs and is part of the broader budgeting and commissioning process. Clearly, we will need to set an overall financial framework for adult hospices. We are currently going through the final stages of negotiations, both with the Treasury and within the Department of Health and Social Care, to finalise the financial envelopes and allocations for each part of my portfolio and the portfolios of my ministerial colleagues.

Although the investment is important, there are big opportunities around reform. A lot more needs to be done around the early identification of people in need of palliative care and people reaching the end of life. The interface between hospitals, hospices and primary care is nowhere near where it needs to be. A big part of our neighbourhood health strategy will therefore be about how we ensure that hospices have a strong voice at the table in the holistic integrated planning that is such an important part of the journey. The hon. Lady made some powerful points about that in her speech, and we are looking at the issue as we speak. I am meeting officials to determine how to reform the system. It is not just about the money, but about how the system works. We think that there is huge room for improvement.

I was truly inspired to visit Noah’s Ark children’s hospice in Barnet yesterday to understand the key issues that it is facing and see how our three-year funding commitment will support it to continue delivering essential palliative care and end-of-life care services to children and young people in its community. When I chatted to the chief executive yesterday, it was very clear how pleased she is to have some stability and certainty in planning the staffing and the services provided at Noah’s Ark. It is a wonderful place; I pay tribute to everybody who works there, and to the families.

We recognise the challenges facing the palliative care and end-of-life care sector, particularly hospices. The Department and NHS England are looking at how to improve the access, quality and sustainability of all-age palliative care and end-of-life care, in line with our 10-year health plan. The Government and the NHS will closely monitor the shift towards strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations. Officials will present further proposals to me over the coming months, outlining the drivers and incentives that are required in palliative care and end-of-life care to enable the shift from hospital to community, including as part of neighbourhood health teams.