Rachael Maskell MP: speeches

Speeches

• 13 Apr 2026 · Short-term Holiday Lets: Registration · Hansard source

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  11. What progress he has made on introducing a registration scheme for short-term holiday lets.

• 13 Apr 2026 · SEND Provision and Reform · Hansard source

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  We know the stories, the concerns, the trauma, and the battles and fights. Of course, we know the embedded inequality in the system, in which parents with little agency have little voice. But what is so important is that we recognise that the Children and Families Act 2014 ultimately never came with the funding, staffing, resourcing or culture change that were needed. I will focus on three things today: culture, resourcing and funding, and governance. On culture, although we have heard about rising attainment for so many children, we know that other children just never get that opportunity. Their right to an education is denied. We must change the pedagogy in the education system to make it an inclusive environment, and to ensure that the high-stakes behaviours approach is ended, because it denies neuroatypical children an education. We must address that clash, which is still being driven by a results-based system, and consider children and their long-term future more holistically. I certainly encourage the Minister to look at the work of Sir Ken Robinson, who understood that the system needs to be built around the child, as opposed to the child fitting into the system, and the importance of developing a nurturing environment. In York, we talk about belonging going beyond nurturing. We need to consider how we address the security that a child needs to thrive in any environment, putting that framing around the child and integrating it with a trauma-informed approach. We have heard about adoption today and the trauma that those children experience, but we know that so many children have adverse childhood experiences such as violence and neglect in the home and have challenging pasts that have intersected with their SEND needs, so we must ensure that that approach is put in place. On funding, if we can move resources in this place to fund our national security, we can move funding to secure children’s security as well. We need to resource the system, and not only financially—although without that, it will never succeed—but also, as many have said, with a workforce plan that is integrated with the NHS workforce plan, so that we know when resources will come on stream. That brings me to governance. Risk and responsibility sit in the wrong place in the system, which is why we must look at the impact of the academisation programme on where the lines of accountability are. It is almost impossible to hold those schools to account in the system we have now. I will certainly want to extend these discussions with the Minister when I get the opportunity.

• 13 Apr 2026 · Middle East · Hansard source

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  Resorting to violence does not achieve anything, but it has left 2,000 Lebanese dead and 1.2 million displaced. As the Prime Minister is demonstrating, bilateral and multilateral dialogue is the way forward to get progressive change. Instead of just looking at increasing the defence budget, will he also look at increasing investment in diplomacy and development, which is crucial in this increasingly destabilised world?

• 26 Mar 2026 · Local Bus Services · Hansard source

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  In York, we are ambitious to see modal shifts that get people out of their cars and on to buses, but we have an affordability problem. The mayor has a very generous transport budget, but only 6% can be spent on revenue. Will the Minister look at the ability to transfer capital funding into revenue, so that we can really boost our buses?

• 25 Mar 2026 · Proposed Visitor Levy · Hansard source

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  It is a pleasure to see you in the Chair, Mr Efford. I thank the right hon. Member for East Hampshire (Damian Hinds) for bringing forward this debate. I have long campaigned for a visitor levy. York itself sees 1.7 million overnight stays—6.2 million visitors to our city—and as a result we recognise the cost of tourism to our local authority. Whether it is about tidying our streets, putting infrastructure in place, cleaning our city or making additional provisions, the pressure of tourism on our public services is being paid for by local residents. There is an equation where local residents feel that they pay into the system and tourism gains, but that tourists are not making their contribution. I listened carefully to the right hon. Member; he talked about the money, the taxation and the benefit that goes into the national funding pot from the taxation system but is not being invested in local communities.

• 25 Mar 2026 · Proposed Visitor Levy · Hansard source

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  I was coming to the point the right hon. Member for Skipton and Ripon (Sir Julian Smith) raises, because I believe that the levy should be collected by local authorities. If the mayor collects it, it should be hypothecated to local areas so that they can determine the spend of that resource. Certainly I would propose that half the money be spent directly on tourism, through work with the industry, but there is also the opportunity to invest back into our communities and in local projects. I would put in place exemptions for children; I think that would be appropriate. I would exempt certain forms of accommodation, camping and hostel accommodation, because we know that those are used for budget holidays. Of course we need to respect the cultural need of Gypsy, Roma and Traveller people for overnight stays in different areas, but I certainly would include in a levy scheme short-term holiday lets. I just met the Minister to raise again the issue of short-term holiday lets, and the proper licensing system that we need in that respect. I believe that this should be a flat-rate levy. I have always said that the price of a cup of coffee could be the benchmark—people would not think twice about going and getting an extra coffee. If it were something like £4, we would bring £6.8 million into our city and that would help our local economy. We will struggle to support our tourism industry otherwise, so I would encourage that factor. We could use the money to promote the local tourism offer, from which the industry would gain, and could gain substantially. I am talking about putting on events, ensuring that we have better facilities and better infrastructure in our city, and supporting our bid to become a UNESCO world heritage site. All that would benefit not just York, but North Yorkshire and the wider region. It could include putting on projects such as Wild in Art and so on, to draw in even more tourism. I believe that a measure such as that could be seen as an investment in our future.

• 24 Mar 2026 · Middle East: Economic Update · Hansard source

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  I thank the Chancellor for her statement. I am sure she will agree that our biggest concern is the intersection between poverty and food and energy price hikes for our constituents. As she looks ahead, will she consider a warm homes prescription to protect people’s health by keeping their homes warm, which would also save money, and will she ensure sufficiency in the crisis and resilience fund, so that local authorities can invest in those in the greatest need?

• 23 Mar 2026 · Topical Questions · Hansard source

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  My constituent was just 13 months old when she came to this country. As a teenager, she was taken into care. She was then groomed and exploited in county lines and is now serving time in prison. Why are this Government deporting her, when she has only known this country? Will they instead look at giving her proper rehabilitation and getting her life back on track?

• 18 Mar 2026 · Royal Mail: Performance · Hansard source

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  Thank you Mr Twigg, for chairing today’s debate. What started with a pension deficit led to corporate excess, and then of course, the Lib Dem-Tory coalition escalating the risk to the Post Office with their Postal Services Act 2011. And now we see business failure with obscene consequences: a two-tier workforce, with wages below the real living wage, conditions falling, and the price of stamps increasing to the point of unaffordability. We know that the billionaire leader of the company is now striving to cut the universal service obligation. This is a failed business that the Government must pick up and drive forward. I commend York’s posties for the incredible work that they do. I met with them recently to hear their stories. One said to me: “I’m bringing to your attention the dire state we find ourselves in due to the business not caring about customers’ mail. Mail gets left every day in our office, birthday cards, hospital letters, everything. The staff here are exhausted as we keep getting unachievable work loads.” We know from the workforce that they have got the solutions in their hands. They know how to drive the business forward. The CWU and Unite, as their unions, will be able to work with the business and help the Minister to ensure that it thrives again. Recruitment challenges because of the unmanageable workloads have resulted in 27,000 staff leaving since 2022. As with rail, we know that the best efficiency and value would come from the Government bringing Royal Mail back into public hands for the public good, and keeping its public commitment. Let us be bold and brave, and let’s have it back.

• 17 Mar 2026 · Immigration Reforms · Hansard source

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  It is a pleasure to serve with you in the Chair, Mr Stringer. I congratulate the hon. Member for Perth and Kinross-shire (Pete Wishart) on securing the debate. I have to say to the right hon. Member for South Holland and The Deepings (Sir John Hayes): I do not know who he thinks is working in our NHS and in our care sector, providing the skills, or who he thinks the engineers are who are coming here and building our houses in order to support our economy, but we certainly need immigration to support our economy and public services, which have been so severely under-invested in over the past 14 years. We know our world is challenged. It is stretched and stressed, as we have seen with climate change displacing communities and war springing from that. We are seeing floods and famine across our planet, and as a result people are moving so that they can experience some dignity in their life. Some people come to our shores because they want dignity, and I have to say to the Government that the dehumanisation of fellow citizens of our planet is a complete disgrace and it is not in my name, and it is not in the values of our party. Our party was built on solidarity between communities. The responsibility of a Labour Government is to bring those communities together, as we always have in our tradition, through the trade unions and through our party, to ensure that we are investing in those communities and bringing fantastic integration, as we are seeing in York, where we recognise the dignity in one another and bring it to the fore. The Government seem to have lost their way, and as a result they are losing support. They have certainly lost their beating heart, which must be re-found. The draconian policies that are coming out of the Home Office are deeply damaging to our party and our future, as well as to our country, and I plead with the Government to change course. We know that Reform is not interested in the agenda—Reform Members just want power and have not even turned up for this debate today, so why follow them? Why not put a different stake in the ground with a different tune, which talks of different values—the values that we hold deep, the values that we place in those people, including the care workers who are serving our parents’ generation to ensure that they have dignity in later life? I say to the Government: change course. Change course, as well, on our universities. The policies that have been brought forward for our universities are forcing them into financial ruin. International students have choices, and they used to choose to come to British universities; they are now going overseas. I know from the two universities in my constituency the consequences of the policy. Remove the international student levy, which they should not be paying, and remove the NHS surcharge, which clinicians revile. Ensure that instead we give universities the opportunity to be more inclusive and to have more home students, which the policy clearly rails against. We have heard about already in this debate the impact of leaving the EU on migration levels. We need to recognise the risk-sharing opportunities of working with our European colleagues in a much more cohesive and comprehensive way. We used to be under the Dublin agreement, and we knew the rules. Since leaving the EU, we have not been part of that expression and working together with other countries. We cannot do this on our own, and we have seen the consequences of that. As imperfect as the asylum and migration management regulations are, at least they put risk-sharing at the heart of the agenda. We should be part of that too.

• 17 Mar 2026 · Topical Questions · Hansard source

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  I refer to my entry in the Register of Members’ Financial Interests. I have met the academics behind the University and College Union reports on the prison education service, which highlighted the real challenges around the wellbeing and mental health of educators, as well as their safety, especially with the racism they have been experiencing. Will my hon. Friend look at carrying out a complete review of the prison education service to ensure it is fit for purpose and able to do the job it was designed for?

• 16 Mar 2026 · Lord Mandelson: Response to Humble Address · Hansard source

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  It would be very useful to know what proportion of the documents we have already been able to set our eyes on, but also what proportion is being held back by the police, so that we can make a calculation of how much more is to come. But it all sounds too casual, not least when my right hon. Friend talks about WhatsApp messages. We need to ensure that there is proper due process across Government, not least when we are talking about the business associations of Peter Mandelson with the client of his own PR company, Global Counsel. How much more work is there to come that this House will see with regard to what was known about Peter Mandelson’s relationship with Palantir?

• 16 Mar 2026 · GP Contract · Hansard source

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  My hon. Friend the Minister mentioned the Carr-Hill formula. York had the lowest funding under the primary care groups, the primary care trusts and the clinical commissioning groups, and it now has the lowest funding under the integrated care boards. It is because it is not the most affluent place that it is really important that the new funding formula works for areas such as York. Could the Minister say a bit more about how that will be determined, so that my community gets the health spending that it deserves?

• 11 Mar 2026 · Lord Mandelson: Response to Humble Address Motion · Hansard source

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  Clearly, Peter Mandelson’s associations bring a real stench to the appointment process, but I want to know about the business associations, and how they are scrutinised in the process. We know that Peter Mandelson’s public relations company, Global Counsel, had as a client Palantir, which has won lucrative contracts from successive Governments. I want to understand whether the papers demonstrate those associations, and the associations that Peter Mandelson then brought into Government.

• 10 Mar 2026 · Courts and Tribunals Bill · Hansard source

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  When debating justice, I am first minded of the victim’s right to a process producing a fair and timely verdict and the defendant’s right to know that justice has been served fairly and without delay. There is much to commend in the Bill, including the removal of the presumption of parental involvement, protecting children from becoming the proxy target of a perpetrator’s abuse and the better handling of evidence. The listing backlog is not universal. York Crown court’s cases are being listed for 2026-27. The Government must learn from successful courts and think about instituting things like Nightingale courts to deal with the backlog. When I visited York Crown court, I was told about the dysfunctional IT system and how difficult it was to connect to achieving best evidence videos. I was told about the PECS contracts. I say to the Government that we should in-source that work to ensure that we do not see those delays. Estate improvements are also vital, not least in a Crown court built in 1777, like York. I want to focus on the removal of jury trials. We know that the judiciary lacks diversity, as we have heard, and I fear that is the result of unconscious bias, as academic papers have pointed out. We need to ensure that we have stronger deliberations of trials, and therefore to hand that to a jury would give more security. The final point I want to impress upon the Justice Secretary is a political one. When victims and defendants have lost confidence in the establishment and the elite, including the judiciary, a bridge to maintain confidence between them and their communities and the justice system is vital. As has been put to me, without that, a victim is less likely to have confidence in someone whose experiences are a million miles from their own. The same is true for a defendant, having been failed by the establishment time and again. Maintaining the bridge to justice with people who have walked in their shoes, grown up on their street and faced the same challenges enables the victim and the defendant to know that at least the court understands, even if it has not found in their favour. For someone to have their truth told to those from their community serving on a jury, and to know that the evidence has been deliberated well, upholds confidence in the courts and in justice, but to break that trust breaks justice and builds barriers. Justice must not only be done but be seen and felt to be done. It is easy for Ministers to get lost in the data and miss the purpose of justice, and I believe that it is this miscalculation that we wrestle with today. It is about who holds power and, ultimately, trusting that power.

• 10 Mar 2026 · Fur: Import and Sale · Hansard source

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  It is a pleasure to see you in the Chair, Ms Jardine. I congratulate my hon. Friend the Member for Newport West and Islwyn (Ruth Jones) for all the work that she does championing animal rights in this space. Whereas she spoke about the fur in a bobble hat, I am going to talk about King’s Guard caps and the use of black bear pelts, which the Government have committed to ending. This has been a commitment for decades, and yet we are still seeing the import of black bear fur. In the past, the Ministry of Defence believed that the black bear fur came from licensed culls; the Canadian authorities have denied that, both at federal and provincial government levels, saying that there is no such thing as licensed culls. We therefore know that trophy hunters are the source—something that this House has campaigned on time and again. We must ensure that, under this Labour Government, we see an end to trophy hunting. Coming back to the issue of the King’s Guard caps, we know that trade through the work of trophy hunters leads to bears—killed in a random way—often dying slowly and in much distress through blood loss, infection and starvation. The future is perilous for those cubs that lose their mums. We need to ensure that those pelts do not move on to the auction houses from which the MOD purchases them. Only part of the pelt is actually used—the bit with longer fur. The rest of the pelt is simply thrown away. It is costing us as taxpayers—this is what I find so repugnant: it has cost us £1 million over the past decade. One thousand bears have been killed to put on the heads of soldiers. What on earth is that all about? When there are faux fur alternatives available, which have been developed with great skill, we need to ensure that we use them. Faux fur mimics, and even outperforms, real fur with regard to waterproofing; it is lighter, it dries more quickly and it springs back into shape. The chemicals and water used in the making of faux fur are recycled, ensuring that it is environmentally friendly as well as ethical. Faux fur has uniformity of colour and fur length, and it can be developed from a bio-based fabric. The MOD must stop placing these pelts on the heads of soldiers. More than 75% of the public support that, so it is an obvious move. I call on all hon. Members present to sign early-day motion 2907 in my name to ensure that we end the use of this cruel method of both ceremonially parading these dead animals through our streets and having them standing outside Buckingham Palace. I find it shameful; it must end. What steps is the Minister taking to end the use of bearskins, and what discussions has she had with the MOD concerning that? Will the Minister halt the purchase of any further pelts from this point on, pending a review, and will she ensure that we use faux fur as an alternative to bearskin pelts? I am sure that nobody would disagree with such a move, and it would be such an improvement. Doing so would have no bearing on the safety of soldiers, but would restore safety to bears, so that we can take pride in knowing that animals are not being paraded on the heads of our soldiers.

• 10 Mar 2026 · High Street Businesses: Tax Changes · Hansard source

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  Property valuations in York are particularly high, making it very difficult for businesses, not least this year and certainly over the next three years. Will the Minister say exactly when he will launch his consultations on pubs, on hotels, on business rates and on high streets? Would he be willing to come and meet businesses in York to hear why they are struggling with the decisions made by this Government?

• 5 Mar 2026 · Energy Markets · Hansard source

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  I really thank the Secretary of State for all that he is doing, but at times like this, we think about our most vulnerable constituents. Although the energy price cap will protect them for now, we worry about the longer term, not least moving into next winter. Can my right hon. Friend say what he is doing on social prescriptions and social tariffs to ensure that we protect the most vulnerable constituents?

• 5 Mar 2026 · Topical Questions · Hansard source

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  The York Central 45-hectare development site will be the most powerful outside London. The Government have twice announced that they will have a government hub there. However, the Government Property Agency has not signed that off. The development is going to planning in May. Can the Minister give me an update on when we will hear the good news for York?

• 5 Mar 2026 · Consular Assistance · Hansard source

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  I am sure the Minister will agree that it is wrong for companies to profit out of this crisis. I have been hearing from constituents in the region who say exorbitant prices are being charged for airfares, which they cannot afford, and for hotels, which they cannot afford to stay in any longer. Can he put pressure on the industry to enable those constituents to come back, particularly as some of their travel insurance has run out?

• 5 Mar 2026 · Palliative Care · Hansard source

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  I thank all hon. Members for their contributions. We have had 20 contributions to the debate, with 12 excellent speeches from Back Benchers; I have to say that it has been a debate of the highest calibre. I heard so clearly such praise for the staff working in palliative medicine right across the country—in Scotland and in England—and I thank them myself, too. I particularly acknowledge the speeches made by my hon. Friends the Members for Worcester (Tom Collins) and for St Helens South and Whiston (Ms Rimmer), who talked about the loss of their mothers, with very contrasting experiences. That demonstrates the inequity across palliative medicine, and it cannot be right that people are not getting the care that they absolutely must get. I wanted to ask the Minister a follow-up question about how the transition takes place. If we do not frontload the funding, we will never see the development of community provision, because we will not be able to pull people out without the resourcing in the community. The challenge really arises from the whole model, which was the emphasis of my speech. I trust we will look very carefully at enabling the flow of patients into the community and getting care in the right place, but also at the sufficiency of funding, as so many hon. Members said, to ensure the excellence of the care itself. We also heard about the challenges that all hon. Members have had, whether for child or adult services, and we need to ensure that we train the workforce and have a sufficient workforce in the future. We need to get the commissioning right, and address those very pertinent issues. Above all, we must invest in the time and the compassion that is needed to give families and patients excellence in palliative care. As a clinician, I have witnessed working with people at the end of life. In such special moments, the whole workforce crowds around the patients, and supports them and their families. It is so moving, and today I also heard my hon. Friends’ moving reflections, which is what the debate is all about. It is about ensuring that we have those really special moments at the end of life, and we should really invest in that time so people can have those memories and cherish everything they possibly can. We have debated assisted dying so much in this place over the last year or so. I have heard so many examples of poor care, where I know that specialist palliative medicine could have made such a difference to the individuals. That is why today’s debate is not only timely, but necessary. We must really invest so that everyone has the opportunity to receive that amazing care, love and support at the end of life, and so they do not have to even contemplate assisted dying. I think we have a responsibility to put this front and centre. Let us move on from the debate on assisted dying to make sure we get care right for everyone. I want to close by saying a huge thank you to everyone here; I really do appreciate it. I should put on record that I am the co-chair, with Baroness Finlay, of the all-party parliamentary group on dying well. I invite all hon. Members to join us as we really try to advance this debate. Question put and agreed to. Resolved , That this House notes the findings of the Independent Palliative Care Commission; calls on the Government to implement its recommendations in full, including to establish a comprehensive and specialist palliative care service that is equally accessible to everyone and properly funded, as well as a new commissioning framework that secures a service across all settings and is available from the point of a terminal diagnosis, the advancement of a life-limiting illness or latter stages of a chronic condition; and further calls on the Government to have a focus on workforce planning and training, to provide a comprehensive palliative care service, and to ensure that patients are empowered through future care plans to articulate what they want to happen towards the end of their life, while also establishing bereavement services for all.

• 5 Mar 2026 · Palliative Care · Hansard source

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  I beg to move, That this House notes the findings of the Independent Palliative Care Commission; calls on the Government to implement its recommendations in full, including to establish a comprehensive and specialist palliative care service that is equally accessible to everyone and properly funded, as well as a new commissioning framework that secures a service across all settings and is available from the point of a terminal diagnosis, the advancement of a life-limiting illness or latter stages of a chronic condition; and further calls on the Government to have a focus on workforce planning and training, to provide a comprehensive palliative care service, and to ensure that patients are empowered through future care plans to articulate what they want to happen towards the end of their life, while also establishing bereavement services for all. I am grateful to you, Madam Deputy Speaker, and to the Backbench Business Committee for granting today’s debate on the future of palliative care. Although I applied for it last summer, it could not be more timely, as the Government consider their modern service framework. Dame Cicely Saunders said: “How people die remains in the memory of those who live on.” By addressing what she called “total pain”—physical, psychological, emotional, spiritual and social pain—palliative medicine could transform not only the way we approach death, but how we embrace life. Her legacy has since driven palliative medicine, with dedicated teams delivering care. Someone told me in York that they did not know “that such outstanding care was even possible.” Every complexity is embraced and addressed. In 2024, 532,000 people died in England. Marie Curie evidence published two weeks ago showed that one in three people fail to get the interventions they need. Despite requiring specialist palliative care, over 100,000 people received none. Demand is rising, and will grow by 42% in a decade. Where someone dies, on what day or at what time determines the care that they receive. Some 42% of all deaths occurred in hospital, 28% at home, 21% in care homes, 5% in hospices and 4% in other settings, such as prisons. According to Sue Ryder, just 50% died in the place of their choosing. I have had the sheer privilege of working with leading academics and clinicians, health leaders, international experts, charities and people with lived experience, in establishing, with Baroness Finley, the independent commission on palliative and end-of-life care, which is chaired by Professor Sir Mike Richards. We sought solutions to establish equitable access to high-quality palliative and specialist palliative care. I am beyond grateful; I have been inspired and I have learned much. I am also indebted to Professor Fliss Murtagh from the Wolfson Palliative Care Research Centre at the University of Hull. I make particular mention of Professors Katherine Sleeman and Irene Higginson of King’s College London; Oxford consultant Professor Bee Wee; Hospice UK; Marie Curie; Sue Ryder; the Association for Palliative Medicine; Together for Short Lives; my local hospice, St Leonard’s; and so many more. We held 10 evidence sessions and eight roundtables, received 506 written submissions from experts, and spoke to 129 witnesses. We then presented our report to the Minister. Now that the Government have progressed to the modern service framework, they must commission a single pathway across all settings, focused on excellence, crisis prevention and investing in the community. We found that early identification for access to high-quality specialist interventions was transformative for patients. At the point of terminal diagnosis or increasing frailty, a serious illness conversation undertaken by well-trained clinicians—as recommended by Professor Sir Chris Whitty—injects an honest understanding to ensure the best patient-centred care, while capturing the patient’s wider social needs, priorities and goals. It facilitates good clinical planning. Co-produced, personalised and optimal care is supported with palliative medicine. In York, the frailty hub brings all sectors, clinicians and services together. When that is intersected with palliative care, crisis admissions are avoided. Emergency services do not escalate without cause; rather, medicine integrates with the hospice at home team—one team, one set of records, one plan. Avoiding the need for crisis management avoids distress. In the last three months of life, however, almost half of people visited their emergency department, and one in eight spent more than 30 days in hospital. Placing palliative care professionals in emergency departments furthers the model, and allows patients to be triaged to the right service. Clinicians at the back door discharge into community palliative care teams. On the wards, hospital specialists connect with patients, introduce palliative care where appropriate, and seek to discharge to the community, hospice or special hospital unit, reducing hospital deaths and improving disease management. As our bodies fail, high-stakes interventions add little to the quality or quantity of life, yet they carry risk—as do hospital stays—through infection, deconditioning and disorientation. In a far cry from what happened on the Liverpool care pathway, the focus is on enhancing life, not hastening death. GPs have a significant role, and I ask the Minister to review the retiring of the palliative care register, which focuses GPs on identifying patients for palliation early, so that interventions can be considered. Can she set out how she will still achieve those aims? People are identified far too late for palliative support—just 56 days prior to death for cancer, and 27 days for non-malignant disease, like respiratory, neurological, renal or cardiac disease. Those with conditions like dementia are rarely ever referred. While there has been a move away from prognostication of life expectancy, due to its unreliability and often significant inaccuracy, recognition of palliative needs early is key. Marie Curie’s “Better End of Life 2024” report identified that 40% of families had no conversation about deterioration or possible death; 20% were alerted in the last three months of life, and 15% in the last week. Its report, “Measuring unmet need for palliative care”, highlighted that one in three people do not receive specialist care. Its post-bereavement survey in 2024 showed a doubling of unmet need, compared with the 2015 VOICES—views of informal carers: evaluation of services—post-bereavement survey by the Office for National Statistics, which should be reintroduced. That highlights the fact that there is higher demand and poorer access. Furthermore, we know that those from low socio- economic and ethnic minoritised communities are significantly disadvantaged, and face late identification of needs and poor palliative care access. Without agency and advocacy, outcomes are worse, and that is also the case for those with physical and intellectual disabilities. Such injustice demands change. Variation exists across integrated care boards. The responses to Hospice UK’s freedom of information requests showed that spend ranged from just 23p to £10.33 per person. The National Audit Office’s report on this subject shows the inequity, too; figures range from one hospice bed per 2,900 patients to one per 54,300, yet provision is mandated by the Health and Care Act 2022. At night and over weekends, 75% of the time, the availability of advice and interventions available to relieve distress, difficulties and discomfort is inconsistent, although 24/7 services are needed. By day, a single point of contact is essential, as the Association for Palliative Medicine has impressed upon me. Specialist palliative care from highly trained professionals must be commissioned to manage complex pain and symptoms through effective drug titration and interventions like palliative radiotherapy, nerve blocks and neuromodulation, which are often not available. The commission advised rapid escalation of complex cases to specialists, to improve outcomes across all settings. Psychological support is pivotal, yet only 19% of hospices can access clinical psychology. Early assessments can palliate depression or anxiety and their consequences. Young people with life-limiting and life-threatening illnesses must have equal access to care. Paediatric palliative care differs from adult care but is as ambitious in driving excellence. Tailored, age-appropriate care is needed, and expert parents need recognition for their advocacy, too. I particularly note the concerns about transition into adult services; special attention is needed to get that right. I turn to training. Family carers provide £28.7 billion-worth of care annually. They need training and support, to be listened to, and, above all, space to love, be and spend time. In addition to training and accreditation of the whole palliative health and social care workforce in domiciliary and residential settings, hospices and hospitals, we need a workforce plan for the whole pathway. All undergraduate programmes must have palliative care content. Specialist training to support GPs aspiring to consultant status needs dual accreditation, and the commission heard that overseas-trained staff need specific orientation to palliative medicine, as each jurisdiction approaches death differently. Across the whole service, we need high standards and united objectives. In 2024, the cost of dying in England was £24,222. The total for England was £12.8 billion, and 78% of that was spent in hospital settings. By contrast, just £1,017 is spent per person on specialist palliative provision, and £862 on community nursing. Research published today shows that specialist palliative care can save the NHS £7,908 per patient when delivered at home, and £6,480 per patient in hospital. That would save around 1.5 million bed days, or £817 million. Funding for hospice provision—essential healthcare—can no longer depend on bake sales and parachute jumps. Two in five hospices are making cuts, and 380 beds have been lost in a year, according to Hospice UK. Staff reductions and redundancies have occurred. Paediatric palliative care faces a £310 million shortfall, and there has been an overreliance on charitable funding, which is inherently inequitable.

• 5 Mar 2026 · Palliative Care · Hansard source

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  Will the Minister give way?

• 5 Mar 2026 · Palliative Care · Hansard source

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  I am grateful to the Minister for her speech, but we have heard throughout the debate that 100,000 people are not getting the care they need. One in three people needs additional support. By maintaining the financial cap, how are we going to build enough capacity to ensure that everybody has access to excellent care at the end of life?

• 5 Mar 2026 · Palliative Care · Hansard source

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  I am grateful to the hon. Member for raising 24/7 provision, and provision in the evenings and at weekends. Research shows that only a small proportion of services are available at those times and access to them is inequitable across the country. We need to ensure that a specialist is available at the end of the phone to support clinicians, family members and patients themselves, and that we have the workforce available to come out to deliver changes to medication or an escalation in care. It is crucial that this is not a nine-to-five service, but a 24/7 service. Finally, I want to mention bereavement. Bereavement support varies and is often underfunded, if funded at all. Grief costs the economy £23 billion a year, but it costs individuals far more. It can be complex and have a profound impact, especially on children. It is vital that we commission appropriate bereavement support, including counselling and, for some, social prescribing. In conclusion, palliative care affirms life and regards death as a normal process. It neither hastens nor postpones death. However, to date, access to palliative care has been inequitable. This debate must be a catalyst to providing outstanding care. Our ambition must go beyond the modern service framework. Our duty is to secure excellence in life, until the final breath is taken.