Palliative Care

Mary Kelly Foy Excerpts

Thursday 5th March 2026 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab)]

Palliative and end-of-life care is one of the clearest tests of a health and care system. It is about whether people can live their final months, weeks or days with dignity, comfort and choice, and whether families are supported, rather than left to cope alone. It should never be a lottery, yet too often people still experience palliative care as something that arrives too late in a crisis and only after families have reached breaking point. Referrals are delayed, honest conversations are postponed and advance care plans are created at the point when somebody is already too unwell to meaningfully shape them. Families describe repeating the same story to multiple professionals, not knowing who to call at 10 pm on a Sunday evening, and watching distress escalate because there is no rapid response available. That is not what a compassionate system looks like.

I will make three substantive points. First, we must confront the reality of variation and fragmentation. Access to specialist palliative care, hospice-at-home services and community nursing support still vary widely between integrated care boards. In some areas, there is a reliable 24/7 advice line and rapid response within hours. In others, support is limited, particularly out of hours, and families are told to ring 111 or attend A&E.

Funding arrangements contribute to that variation. Adult hospices, which provide extraordinary care, still rely heavily on charitable fundraising, alongside NHS funding. The balance differs significantly between areas, which creates instability and inequity. Hospices such as St Cuthbert’s hospice in Durham do remarkable work supporting patients and families across our community, but like many hospices it remains heavily dependent on charitable fundraising. St Cuthbert’s has recently had to make difficult decisions, including on redundancies and reducing dementia services, as funding pressures grow. At the same time, much of the Government’s announced support has been directed towards buildings and capital investment, at a time when hospices and organisations such as Hospice UK have repeatedly warned that the real pressure is on staffing and day-to-day service delivery. If we are serious about reducing health inequalities, we cannot accept such stark differences in something as fundamental as end-of-life care.

Secondly, palliative care is not simply about the last days of life; it is about quality of life from the point of diagnosis of a life-limiting condition. Early specialist input can provide for symptom control, reduce unplanned hospital admissions and help people to make informed choices about where and how they wish to be cared for. That is why I welcome the emphasis in the NHS 10-year plan on shifting care away from hospitals and into the community, because for many people facing serious illness, the most compassionate and effective care is delivered at home or close to home, supported by community teams.

Thirdly, there are practical steps that the Government can and should take. We need a clear, fully articulated national strategy for palliative and end-of-life care, with measurable standards and transparent reporting. Every area should be required to demonstrate that it provides equitable access to specialist advice, rapid response and co-ordinated care planning, so that the ambitions set out in the 10-year plan to strengthen community-based care are genuinely realised for people at the end of life. We should move towards a model where every part of the country has guaranteed 24/7 access to specialist palliative care advice, backed by community capacity to respond quickly when symptoms escalate.

Workforce is central. Generalist staff in primary care, acute hospitals, community services and social care must feel confident in recognising when someone is deteriorating, in managing pain and other distressing symptoms, and in initiating compassionate conversations. That requires investment, training and protected time, not simply guidance on paper. We must also recognise that hospice and social care services rely on the contributions of migrant workers. Recent changes to visa rules and the right to remain are making recruitment and retention even more difficult, at a time when these services are already under immense pressure.

We must not forget the strain on hospice care for children, as the right hon. Member for New Forest East (Sir Julian Lewis) said. Provision in this area remains uneven, and the stakes are extraordinarily high. Recent campaigning on Hugh’s law has also highlighted the importance of ensuring that families caring for seriously ill children are properly supported and not left navigating complicated systems while dealing with unimaginable circumstances.

Debates on assisted dying are now taking place in this Parliament. I am clear in my opposition to that proposal. I believe that the foundation of a compassionate society must be strong, universal access to high-quality palliative care and end-of-life care. When people are properly supported, when pain is managed, when families are helped and when the highest standard of care is available close to home, the fear and desperation that often drive these debates are significantly reduced. If assisted dying were to become available on the NHS, it would raise important questions that are already being asked by professionals in palliative care and across the health system about our priorities for healthcare. Access to compassionate and properly resourced end-of-life care should never become the secondary option. I ask the Minister to set out how the Government will reduce the postcode variation, strengthen community and out-of-hours provision, provide stable funding frameworks—particularly for hospices—and ensure that workforce development is prioritised.

This is not an abstract policy area. It is about whether, at the most vulnerable point in someone’s life, the system is fragmented and reactive or calm, co-ordinated and compassionate. We owe it to patients and their families to get this right.