A baby, in Britain, in 2025, takes its stuttering final breaths. All deaths in infancy are harrowing. But the fact that this particular death might have been prevented – had neonatal care not depended so heavily on charity, had the NHS not failed to fund more than two-thirds of the healthcare babies need – is unforgivable.

Mercifully, the dystopian healthcare scenario I’ve just described does not exist in the UK today. Although paediatric care is undeniably overstretched, it is at least regarded as a core, bedrock NHS service.

We would never tolerate a government that chose to defund most neonatal services, gambling instead that charities would act to fill the gap. Yet this is exactly the situation faced by people needing end-of-life care. Remarkably, the famously “cradle to grave” NHS funds only about 30% of hospice care in the UK. The shortfall is made up from charitable donations: the goodwill of local individuals and businesses stepping in where the state has chosen to walk away.

As last month’s National Audit Office report demonstrated, the financial state of the hospice sector is dire. Two-thirds of adult hospices in England recorded a deficit in 2023-24. Across the country, hospices are being forced to cut staff, reduce their bed numbers and slash community services for dying people who wish to be cared for at home. The result is a postcode lottery of care in which your chances of receiving high-quality palliative care hinge on variables that include the level of deprivation where you live and the extent to which your local NHS management chooses to prioritise patients with terminal illnesses. A month ago,........

© The Guardian