Is Christmas cheer in children’s hospitals courageous?

When families weren’t made to feel welcome

As Christmas fast approaches, I found myself thinking of all the children who will be in hospital for the holidays. Over the past few weeks, there will have been parties in the wards. Santa will have visited. Sparkly lights and silly hats and boxes of chocolates will have appeared in abundance. All of this effort, expended by adults to help make sure children experience the cheer of this season.

I want to say thank you to those adults, unknown to most of us.

And I want to say thank you to the adults of the past whose campaigning made such hospital environments possible. They have been largely forgotten. Their efforts, though, implemented in the 1950s and 60s and 70s, have left a remarkable legacy for British children today.

What are children’s hospitals like today?

Earlier this year, I recorded a podcast conversation with Shelley Gray. She’s a mum who knows exactly what Christmas in hospital is like. Her little girl, Rosa, age 5 at the time, spent the holidays there. Shelley told me what that’s like.

“The hospital was designed as a welcoming place for children. On the ward, there was a play specialist nurse and a playroom. That was just brilliant. Even when Rosa was immobile and in bed, the play specialist would offer to come and support her and engage her. That was brilliant for Rosa. That’s the sort of normal stuff of being a child that she was missing while she was in hospital.”

“The design of a modern hospital makes it easy for parents to be there and to care for their child. There is a hotel in the grounds of the hospital. And on the ward, there is a pull-down bed for parents. It was right next to Rosa’s bed. You can come and go as you want. You can absolutely be with your child.”

And what about hospital at Christmas time? What’s that like? Shelley shared with me how an unexpected carol concert had helped to sustain her family’s spirit during this time of worry.

“One of our memories is of the Christmas. We were staying in the hospital’s hotel for families. Rosa’s brother, who was 8 at the time, came in to stay with us overnight. He had been staying with his grandparents most of the time, during all of this. We hadn’t realised they were lighting the Christmas tree. There was suddenly this Christmas music that we could hear. And we could see the tree from our hotel window. I remember my husband and our son, just standing and watching and listening to the songs. And, okay, Rosa wasn’t with us, but she was close by, because that was the point of the hotel. It is a nice memory for us, in the midst of all of it.”

This touching story was the spark that led me to write this article. I wanted to remind us that children’s hospitals didn’t always feel welcoming to families. I wanted to ensure we don’t take relational practice for granted. I wanted to push us to stop assuming that because a practice feels ‘obvious’, we can expect it will be quickly embraced by the system. Resistance to change turns out to be surprisingly common.

What were hospitals like in the past?

Pete Kinnear helps us to reflect on that resistance. He was the second guest included in my podcast conversation. Pete was a child in hospital too, albeit not recently and not at Christmas. In 1954, Pete was 7 years old, confined to an isolated room, on his own, for a period of three months. The story he tells of his hospital stay is very different from Rosa’s.

“In the whole three months I was there, only one person in my family was allowed to come to see me: my mother. She could come once a week, on a Saturday, for two hours. She brought sweets and colouring books. I think she chose those because I couldn’t read at that age. I didn’t see any of the rest of my family. The reason for that was [said to be] the possibility of infection. I never saw my brother or my sister or my father, in that whole period.”

“Toward the end of my stay, a new nurse was sent to attend me. The nurses were rotating all the time anyway, so I never knew the name of any particular nurse, even though they would give you bed baths once a day and such. This new nurse did not like me. She treated me roughly. I was so terrified of her that I learned how to, what I now know is called, ‘dissociate’. I told myself I was dead, so I couldn’t feel anything. That way I could endure whatever she said or did to me. It was very useful at the time. But I didn’t realise until much later that I had carried that ability right through my life – the ability to suddenly dissociate and not feel anything. I dissociated any time pressures were too great.”

Viewed from our perspective today, Pete’s story is shocking. That is part of the point of this Fierce Curiosity project. Stories like Pete’s help us to comprehend how good quality care of children comes about. It isn’t because systems naturally ‘do the right thing’ or the kind thing or the developmentally appropriate thing.

Change comes about because someone decides to make sure it does. Brave individuals decide to push for better care. The stunning children’s hospitals of modern Britain are grounded in the forgotten history of dedicated campaigners. Those agitators were working hard, even in 1954, to bring about the future we enjoy today. Unfortunately, their efforts had not yet reached the hospital Pete was staying in. As a consequence, he has suffered.

“In my life, I have been admitted to a psychiatric hospital six times. The first time I had a breakdown was in 1982, when I was 35. I deduced that first time that something had happened to me, even though I couldn’t figure out what it was.”

“Noone in psychiatric hospitals ever asked about or thought about or talked to me about what had happened to me. They were more interested in making a diagnosis and then giving me the appropriate pills. I was probably diagnosed with six different things by six different consultants. I began to think, myself, that all these different things were related, and probably to something in my childhood. But I was in my 60s before I understood what that was and that my hospitalisation could actually be called ‘traumatic’.”

Pete’s psychiatric challenges -- including his self-taught skills in dissociation because he felt scared by a nurse’s rough handling -- are a vivid reminder of our power as adults. The way we treat children has long-term impacts. Their minds and bodies carry lessons we never meant to deliver.

It takes courageous curiosity for us to face up to that idea. The science of relationships now makes clear that whenever the policies and practices of professional systems fail to prioritise children’s emotional needs, they will cause harm.

The rich conversation that took place between Pete and Shelley can be heard on this link:

“It sounds cruel”

In that conversation, we hear Shelley call Pete’s story “heartbreaking”. She says that she knew the modern approach to children’s hospital care was different from the past, but “until she heard Pete’s story, she had not realised just how different.” She then gets very honest and uses stronger language to describe her gut reaction to Pete’s experiences.

“What Pete describes actually sounds cruel. All of it -- like not being able to have your mum visit more than once a week for a couple of hours. That sounds cruel. Or, during his first hospital stay, when he was 4 years old, being separated from his sister but given no explanation for why. Yes, that does sound cruel.”

Is it really possible that well-intended professionals could unintentionally treat children in a way that is ‘cruel’? That’s an uncomfortable question. My answer is: Yes.¹

And it’s not just an historic consideration. That same question is being asked right now, in Britain today. Journalist Anna Fazackerley has been publishing a series of articles in the Observer newspaper about treatment of children in some academy schools in London. Staff are described as “screaming” in children’s faces, having completed training in the use of “healthy fear”. The controversy that has arisen in response to her articles is intense. The under-funding of children with special educational needs is also receiving furious attention. One in every 19 children in England (aged 5 – 15) now has a formal EHCP in place (i.e., Education, Health and Care Plan). Local councils, though, cannot afford to deliver the plans, so failure to meet children’s documented needs is becoming normalised. When children’s needs aren’t met, they suffer.

The framework of children’s rights

The framework which Shelley brings to her thinking about children’s needs is noteworthy. She spontaneously uses the language of ‘children’s rights’ to frame her expectations.

“I knew that the modern approach to children’s hospital is very different from how it used to be. I knew that maybe children of the past wouldn’t be listened to in the same way. People [back then] wouldn’t have thought: ‘How do we embed children’s rights? How do we get children’s views on designing a building?’ But it wouldn’t have occurred to me that children who were already in a scary situation would be treated cruelly.”

An alliance of Scottish organisations has campaigned for the past ten years to put children’s rights at the centre of Scottish law. Their recent success has been joyously celebrated, with the UNCRC (Scotland) Bill [United Nations Convention on the Rights of the Child] having been passed unanimously by the Scottish Parliament in December 2023 and the bill’s provisions brought into force in July 2024. I hope some of those campaigners will read this article and pause to appreciate the impact of their efforts. Shelley’s comments hint at how deeply their efforts have taken root in Scottish culture. As the mum of a child in hospital, she is confident that her daughter deserves to be treated with respect and tender care. The UNCRC is helping Scotland to guard against the unintended cruelties we adults too easily inflict on children. We can thank the Together alliance for this fundamental cultural mindshift.

Thank yous

I therefore want to end this piece with some other thank yous. That seems appropriate during this season of gift giving. Every single one of the following individuals and organisations has given a gift that features in this piece.

• Thank you to Pete for sharing your story publicly. You said this was the first time you have done so. You didn’t have to be quite so open with us. That took vulnerability and trust. Thank you.

• Thank you to Shelley for sharing your story.² I hope that, in future years, when Rosa hears your interview, she will be able to see in richer ways how very much she is loved.

• Thank you to Gary Robinson. It was only your willingness to share the hosting of your podcast series with me that allowed this conversation to happen. Keep telling the inspiring stories of care that you are featuring in your series, Amazing Strangers.

• Thank you to all the hospital campaigners of the past, including, amongst many others, psychoanalyst James Robertson, documentary maker Joyce Robertson, surgeon Harry Platt and nurse June Jolly. In the face of extreme opposition, you all carried on insisting that children do not settle quickly into hospital routines, that their emotions matter, that play is important and that children need their parents with them when they are scared. I wish you were here to behold your legacy.

• Thank you to HLM Architects. As lead architects for Edinburgh’s brand new Royal Hospital for Children and Young People, which opened in 2021, you designed the building that housed Shelley’s family during their time of uncertainty. The fact that your publicity material talks about children feeling “frightened, unsure or upset” shows how far we have come in our understanding of children’s needs. Architecture is not a profession that immediately comes to mind in relation to the trauma-informed movement. Your leadership makes it possible for other architects to join in your awareness.

• Thank you to Edinburgh City Council. Every year, you supply the Christmas tree that stands in the hospital grounds. Your kindness helped Shelley’s family to find a bit of peace. It will offer comfort to many other families battling uncertainty and sadness during December’s cheerfulness. In a time of financial cuts, you could have cut that gift. You didn’t. Thank you.

• Thank you to Edinburgh Children’s Hospital Charity. You host the party at which the Christmas tree’s lights are switched on. You ensure that the event feels fun and hopeful. You bring that same energy to your work throughout the year. I’m glad to call attention to your efforts, because most people will be unaware of them. Shelley’s story makes clear how much your care helped her family. Thank you.

The image at the top of this piece shows this year’s tree lighting ceremony, hosted by the ECH Charity on 24 November 2024. The many photos posted on social media make clear it was a day of festive cheer, even for families whose young children have never known any home other than the hospital setting. The Charity could not offer such care without the financial support of the public.

If readers wish, you can help by donating to Edinburgh Children’s Hospital Charity. That act of kindness builds on efforts that stretch back 75 years – back to the days when Pete was sitting up in his chair, looking out the window and down the drive, eagerly scanning for the arrival of his mum for her Saturday visit. Today’s children don’t have to pine all week. Their parents are cuddled up, right beside them. There will be many tired families who, like Shelley’s, draw unexpected comfort from looking out the window to find twinkling lights in the courtyard below.

I wish everyone a holiday season that includes the kindness of strangers.

1. In fact, I am quoted using the word ‘cruel’ in an interview with journalist Neil Mackay, published in The Herald newspaper in May 2024. That’s an uncomfortable headline for me – even though I stand by my comments.

2. If you like to hear more from Shelley, she has written of her experiences on the platform Medium.