Palliative Care

Nusrat Ghani Excerpts

Thursday 5th March 2026 Commons Chamber

[Alison Bennett (Mid Sussex) (LD)]

I thank all hon. Members for their thoughtful and moving contributions this afternoon. The hon. Members for Worcester (Tom Collins) and for St Helens South and Whiston (Ms Rimmer) spoke so movingly about their own very personal loss. Of course, we would not be holding the debate were it not for the hon. Member for York Central (Rachael Maskell), who set out the frame of this debate so brilliantly and has done so much outside the Chamber to strive for better palliative care.

The hon. Member for York Central concluded her remarks by talking about bereavement support, and that is where I will begin mine. Last week, I was out in Burgess Hill. I saw an elderly gentleman who was standing by the edge of the pavement holding on to a walking frame. I got talking to him, and it turned out that he was waiting for a lift to St Peter and St James hospice, where he was going to a bereavement café. He told me that he had lost his wife two and a half years ago, but he had no recollection of the first two years following her loss—I think it had been a blur for him. For the past six months, he has been going back to St Peter and St James for the bereavement café, and he is beginning to feel a little better with that support each week. My thanks go to St Peter and St James, and to all the hospices that support our constituents, for what they do.

Our palliative care system is at tipping point, with a funding cliff edge approaching. Some 75% of hospices are running a deficit, two in five are planning reductions in clinical services in the year ahead, and 380 hospice beds across England lie empty, not because there is no need for them, but because there is no funding to staff hospices, as many hon. Members have said. Around 300,000 people are cared for by hospices every year, yet around 100,000 more need it. One in three of those who need hospice care miss out, and demand is rising sharply.

Over the next decade in England, just over 5.75 million people will die. Around 90% of them—an estimated 5.18 million people—will have palliative care needs. New research commissioned by Marie Curie and published earlier this month showed that nearly one in three dying people have both unaddressed symptoms and concerns and insufficient access to GP services at the end of life. That equates to nearly one person dying with unmet needs every three minutes. Without intervention, around 44,400 more people are projected to have unmet palliative care needs in 2050 compared with 2025. That is the scale of the challenge before us.

Hospices are essential pillars of our health and care system, especially at a time when the NHS is under such immense strain. The economic case for funding them properly is overwhelming. Approximately 15% of all emergency hospital admissions in England involve people in their last year of life—nearly 1 million admissions in 2023 alone. Those patients account for around 30% of all emergency hospital bed days. In the last six months of life, around 360,000 people spent a total of 8.4 million days in hospital. With the average acute bed day costing around £500, and with roughly 40% to 50% of the NHS budget concentrated in acute settings, the potential for a more appropriate allocation of resources is obvious.

Around 69% of people are admitted as in-patients in the final six months, with a median stay of 13 days, and 80% of those who die in hospital had an emergency admission in their final month of life. These are real people—people who, with better planning and properly resourced hospice, community nursing, GP, pharmacy and paramedic services, might have experienced a calmer, more dignified end of life and spared the NHS considerable cost. But the very sector that relieves this pressure is itself under extraordinary strain. Between 2022 and 2024, there was a £47 million real-terms cut in hospice funding. As the hon. Member for Cannock Chase (Josh Newbury) noted, the disastrous rise in employer national insurance contributions alone is costing hospices in England an estimated £34 million a year.

Hospices collectively raise about £1.4 billion themselves. Government funding amounts to just over £500 million—barely a quarter of the income—and in some areas, hospices receive as little as 8% of their funding from NHS grants. There is no robust national methodology underpinning these variations. It is a postcode lottery and, as the right hon. Member for New Forest East (Sir Julian Lewis) noted, the variation in funding for children’s hospices is even more acute than that in the adult hospice sector. Access to compassionate end-of-life care should not depend on geography, the strength of an area’s ability to raise funds or whether someone is an adult or a child.

Hospices, of course, welcome the capital funding from the Government, but it quite simply does not pay nurses’ salaries. Staff account for around 70% of hospice costs. Without revenue funding for core services, capital investment does not keep beds open or prevent service reductions. This is a national, structural problem, but it is also a very real one for all our areas across the country, particularly for my area in Sussex, where the Southern Hospice Group is consulting on how to cut its costs.

Marie Curie and others have warmly welcomed the Government’s commitment to developing a palliative care and end-of-life care modern service framework, with an interim report expected in the spring and a final report in the autumn. It will be the first national plan for palliative and end-of-life care since 2008. That is, of course, good news. The Government have rightly identified five core challenges: delays in early identification, inconsistent commissioning, workforce shortages, gaps in 24/7 provision, and limited uptake of personalised and advance care planning. But those are not new problems that need solving—we have known about them for some time—and if this framework is to succeed, it must go further.

My Liberal Democrat colleagues and I are campaigning to double the funding for bereavement support payments, reversing the last Conservative Government’s cuts since 2017. We would also reduce isolation following a bereavement, by improving access to social prescribing and through the work of a dedicated Minister for tackling loneliness. We would improve support for children who have lost a parent by appointing a Cabinet member for children and young children, and extend pupil premium plus funding to children in kinship care. The Government must provide stronger national leadership and oversight, and they must place palliative and end-of-life care at the heart of plans for a neighbourhood health service, looking beyond hospices. They must deliver a new funding and commissioning model that ends the postcode lottery. They must invest properly in the workforce, and scale up proven models of care that shift support from hospital to community, improving patient experience and delivering better value for taxpayers.

The Government seem happy to talk about moving care from hospitals to the community, but we need a material change. The Liberal Democrats believe that the Government have a choice: they can allow hospices to drift from crisis to crisis, with beds closed, staff lost, and unmet need rising year after year, all while still struggling to plug gaps left by the struggling NHS; or, they can seize the moment, through the modern service framework, to build a sustainable system that matches funding to need and delivers dignity for all. No one should face death in avoidable pain, no family should be left unsupported, and no responsible Government should ignore the evidence that properly funded palliative care is both the compassionate and the economically responsible choice.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Secretary of State.

--- Later in debate ---

[Rachael Maskell]

Will the Minister give way?

[Madam Deputy Speaker (Ms Nusrat Ghani)]

The Minister has finished speaking, but the hon. Member does get to wind up the debate.