The United Nations Convention on the Rights of the Child states that all children have the right to education, information, play and friendship. The internet plays a pre-eminent role in society today, with almost all older children using the internet for these activities.1 ,2

The quality of the hospital environment is important to well-being.3 Prolonged absence from school is acknowledged to affect social functioning and friendships along with education. Over the last few decades much has been done to improve and normalise the hospital environment. Internet access could improve this further, particularly for older children who form an increasingly large proportion of the inpatient population.4 However children must be protected from harmful materials. The EU study confirmed that internet access exposes children to risk, including access to pornography, sexual exploitation and bullying.1

We sent an email questionnaire exploring internet access to all 18 children's hospitals in the UK and to all 12 Welsh district general hospitals with paediatric beds. Any which did not reply were telephoned and interviewed orally. All 12 district general hospitals replied, with only one providing internet. Seventeen children's hospitals replied, with only one of these reporting no access. Of the others nine provided varying access for education, social networking and entertainment, and seven allowed access for education only; three of these 16 extended access on payment. Responses are shown in detail in table 1.

There were two reported events of concern. An 8-year-old boy trying to research his condition was found looking at a ‘scantily-clad woman running along the beach’. At another hospital a 15-year-old boy accessed pornography within an hour of their first providing wi-fi.

This is a simple study of hospital internet access, but we had an excellent response rate. Although most children's hospitals allowed internet access, this was inconsistent, with some providing internet for education alone, and varying restrictions found. There did not appear to be any justification for this lack of consistency. In three hospitals patients have to pay for play and socialising, which seems particularly inequitable.

Hospitals have a duty to protect their paediatric patients, so it was unsurprising that inappropriate use was a concern. This should be a problem to work around, not a reason to prevent access, as reported incidents were rare. It would seem reasonable for hospitals to share good practice, with safety advice combined with controls a pragmatic way forward. One children's hospital teaches safe use of the internet, a topic already compulsory within the national curriculum.5

By denying internet in hospital, we are compromising access to education, information, friends and play at a time when children are scared, anxious, isolated and often in pain. Providing safe internet access could help to normalise admissions and minimise the impact of hospitalisation on education and peer friendships. Hospitals need to respond to this change in children's cultural worlds and adapt the environment accordingly; we believe that enabling safe unrestricted internet access in the ward should be seen as essential as providing a playroom.