Thinktank says there are many questions still be be answered about how NHS might administer assisted dying
The Nuffield Trust, a health thinktank, says there are many questions to be answered as the bill progresses through parliament about how assisted dying might work. In a statement on today’s vote, Thea Stein, its chief executive, says:
As this bill progresses through parliament, MPs will need to carefully consider how such a change in the law would interact with the NHS and social care. There are large unanswered questions around funding, staffing and equity if this bill becomes law.
In particular, it is still unclear whether or not assisted dying would be fully publicly funded. If it is, it will sit alongside services like social care and hospice care which are not. Both of these services are financially on the brink and MPs will need to understand how current threadbare provision will interact with this new service, what implications this may have for people paying for social care, and how to fund assisted dying from a health budget that is already overstretched. If assisted dying is not publicly funded then it will be difficult for the bill to achieve its aim of improving choice for all patients. These are crucial questions to address in the next stage.MPs will also need to scrutinise and debate the staffing and regulatory questions this throws up. Will NHS trusts be able or expected to provide this service? Will medical professionals carry out this work privately or as part of their NHS contract? Who will regulate this service? And what changes will be needed to training and education to ensure staff have the skills and knowledge to deliver it?
Key events
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Afternoon summary
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Esther Rantzen says she’s ‘absolutely thrilled’ by Commons vote in favour of assisted dying
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How parliament first voted down assisted dying in 1936 (despite the Guardian being in favour)
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Thinktank says there are many questions still be be answered about how NHS might administer assisted dying
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Lammy says he voted against bill recalling his mum, and how she worried about being financial burden when terminally ill
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Rishi Sunak explains why he voted for assisted dying bill
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How MPs voted on assisted dying bill, by party affiliation
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MPs vote for assisted dying bill by majority of 55
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MPs vote on assisted dying bill
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Robert Jenrick claims bill will be changed ‘fundamentally’ by ‘activist judges in Strasbourg’ if it’s passed
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No 10 hints Louise Haigh’s resignation linked to breach of ministerial code
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David Davis backs bill, but says government should allocate four days for its report stage debate
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Heidi Alexander becomes transport secretary
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Badenoch says she’s against bill, citing teenager gender treatment as example of why NHS safeguards too weak
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Death, for many, is ‘misery, torture and degredation’, not something noble, says Kit Malthouse, backing bill
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Diane Abbott says she worries about people feeling they have to die because they’re burden,
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Kruger urges MPs not to back ‘state suicide service’ and ‘worse world, with different idea of human value’
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Danny Kruger urges MPs to vote down bill if they have reservations, as he gives opening speech from its opponents
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Leadbeater rejects claims bill will be ‘slippery slope’, leading to scope of assisted dying being expanded
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Leadbeater says she is open to toughening wording of bill to protect people with learning disabilities
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Kim Leadbeater opens debate on her assisted dying bill
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Speaker says MPs will not get vote on amendment that would have blocked bill to allow full policy review instead
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How the debate, and voting, will take place
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What is the real view on the assisted dying bill in Downing Street?
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MPs to start debating assisted dying bill at 9.30am
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Haigh says her conviction based on ‘genuine mistake’, and claims court accepted this
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Tories say Starmer’s decision to put Haigh in cabinet when he knew of her conviction ‘obvious failure of judgment’
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Starmer tells Haigh she has ‘huge contribution to make in future’ as he accepts her resignation
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Louise Haigh resigns as UK transport secretary after admitting phone offence
Afternoon summary
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MPs have taken a historic step toward legalising assisted dying in England and Wales after backing a bill that would give some terminally ill people the right to end their lives. As Jessica Elgot, Eleni Courea and Rowena Mason report, the Commons backed the bill by 330 votes in favour to 275 against, a majority of 55. Keir Starmer and the chancellor, Rachel Reeves, voted in favour while Angela Rayner, the deputy prime minister, and Wes Streeting, the health secretary, voted against. The private member’s bill, brought by the Labour MP Kim Leadbeater, would give terminally ill adults with less than six months to live the right to die once the request has been signed off by two doctors and a high court judge. Campaigners in favour of the change said the vote was a momentous step forward. Esther Rantzen, who galvanised the debate on assisted dying last December when she revealed she had terminal lung cancer, said the bill offered everyone “equal choice”. But some of the MPs who were voting for the bill said that, if they are not happy with what emerges after the bill gets revised in committee and at report stage, the could vote against. And Care Not Killing, the group campaigning against the bill, said it was “hugely encouraged that the more MPs hear about assisted suicide and euthanasia the more they turn against changing the law”. Here is a guide from the Institute for Government to what comes next in the parliamentary process. And here is a guide to what comes next from Kiran Stacey that focuses on the wider politics. (See 3.57pm.)
Photograph: Stefan Rousseau/PA
Luke Tryl, UK director for the More in Common campaign group, points out that it would only take 28 MPs supporting the bill today to change their mind for the bill to fall at third reading.
Reasonable majority, at top of what projected. But will only take 28 MPs to be dissatisfied with what emerges from committee/report stage for Bill to fall at 3rd reading. Debate continues & if/whether meeting public’s high expectations on safeguarding can be met will now be key.
Danny Kruger, the Tory MP who led opposition to the bill in the Commons today, said that while he was “disappointed” to lose the vote, he was encouraged by how many people have concerns about the bill. He told PA Media:
I was reassured that so many colleagues recognised that the bill is very dangerous, there’s lots of problems with it and they have said they want to improve it in committee.
I want to help them do that and I hope we can make substantial improvements before it comes back for third reading, and I hope that if it’s not good enough, if the safeguards are not strengthened, then colleagues will vote against it before it comes into law.
One of the striking features of what happened in the Commons today was the quality of the debate. Normally speeches in the chamber range between OK and dull/dire, partly because votes are whipped and MPs know what they say won’t make any difference. Today people were listening intently, and there were many very good speeches, often personal and moving. There was no party politics at all (which was a bonus). And there was a lot of passion, but with little or no rancour, bitterness or scorn, which is highly unusual.
The journalist and writer Ian Dunt has a good account in a blog on his Substack account. Here is an extract.
One after another, I saw MPs who I had not previously admired give some of the best parliamentary speeches I have ever seen. “The deathbed for far too many is a source of misery, torture and degradation,” Tory MP Kit Malthouse said. “A reign of blood and vomit and tears. I see no compassion and beauty in that, only profound human suffering.” He spoke of a man who had been reduced to committing suicide by walking in front of a train. He had waited until 2am so he could minimise the interference to commuters. For some reason I found this act so affecting I was temporarily overcome with emotion.
Esther Rantzen says she’s ‘absolutely thrilled’ by Commons vote in favour of assisted dying
Dame Esther Rantzen, who is terminally ill and who secured a promise from Keir Starmer before the election that he would allow a vote on assisted dying, has said she is “absolutely thrilled” with the result of the vote. She told PA Media:
I listened to the debate and it was very deeply felt. Members of Parliament, whether they opposed it or proposed it, had obviously given it a great deal of thought, and right up to the end of the debate, I had no idea whether it would be voted through or not.
And here is footage of Rantzen discussing the result in a call with her daughter, Rebecca Wilcox, and Paul Brand from ITV News.
‘We did it!’ Dame Esther Rantzen reacts to MPs voting in favour of the assisted dying bill
The broadcaster, who is terminally ill and has been a strong advocate for changing the law, and her daughter spoke to ITV News UK Editor @PaulBrandITV pic.twitter.com/wQ5p60SY1M
— ITV News (@itvnews) November 29, 2024
Charities have renewed their calls for better palliative care in the light of today’s vote on assisted dying.
This is from Matthew Reed, chief executive of Marie Curie, an end of life charity.
Marie Curie remains neutral on the matter of assisted dying, but what we are absolutely not neutral on is the need to urgently fix end of life care. In recent weeks, many MPs have acknowledged the importance of palliative care. The secretary of state for health and social care himself has even said that existing palliative care isn’t good enough.
But warm words won’t fix our broken end of life care system. The bill says nothing about the urgent need to improve existing provision. It says nothing about the postcode lottery for access to end of life care, nothing about the funding crisis, and nothing about people spending their final moments in A&E because our health system can’t offer them the care and support they need, in or out of hours …
As this bill progresses, we will be encouraging parliamentarians to amend the bill to ensure that it sets out the improvements that must be made to our palliative care system.
And this is from James Sanderson, chief executive of the palliative care and bereavement charity, Sue Ryder.
Ahead of the vote on assisted dying, the health secretary recognised the need to strengthen end-of-life care, and the prime minister said he would invest in it regardless of the result.
The government cannot now backtrack. It must fix end of life care.
As the terminally ill adults (end of life) bill progresses, MPs have a duty to ensure no one feels an assisted death is their only option simply because the care they need isn’t available. We found that 77% of people felt either a few, some or most terminally ill people would be put in this position.
Now is the time for change.
How parliament first voted down assisted dying in 1936 (despite the Guardian being in favour)
Polly Toynbee argues that it has taken the House of Commons too long to vote for assisted dying, saying previous bills have been voted down repeatedly since 2010. (See 4.09am.) In fact, the campaign goes back well beyond that. Here is an article from the Guardian archive about the formation of the Voluntary Euthanasia (Easy Death) Legalisation Society and plans for a bill. It was written in October 1935.
At the time the Guardian also published an editorial about the bill, which sounds remarkably similar to the Kim Leadbeater legislation. We were in favour (more or less). “No one who knows of the terrible suffering which incurable illness may bring in its train can doubt that this proposal deserves the most searching considering from every citizen,” the editorial said.
Sadly, as occasionally happens, a Guardian endorsement was not enough to persuade parliament. The bill was defeated in the Lords in 1936 by 35 votes to 14.
Here is Polly Toynbee’s column on today’s vote. She says the Commons has finally caught up with public opinion.
Here is an extract.
How long this has taken. Seven times since 2010, a Tory-dominated parliament voted down bill after bill on the right to die, regardless of public opinion. Almost all progressive social reforms have trailed behind the public in this way: parliament is very rarely the standard bearer. In fact, it is usually the foot-dragger, timid unless absolutely certain what its constituents think. Abortion had long been strongly supported before parliament finally caught up. Divorce law had become an absurd farce for decades – good business for private detectives who were hired to dash into a hotel bedroom to snap a husband in bed with a hired actor to prove his “fault” before a couple could legally part.
Banning capital punishment was the standout exception, when a new Labour government in 1965 dared to defy a public that was still in favour. Afterwards, the Commons held a vote in every parliament until 1997 calling to restore the death penalty, always defeated. Public opinion on this is now against restoration. Gay rights and civil partnerships broke through the barriers only with very strong public support. Here again, citizens were way out ahead.
And here is Polly’s full article.
Humanists UK have welcomed the result of the vote. This is from its chief executive, Andrew Copson.
Parliament has taken a historic first step to meet the aspirations of the public, who overwhelmingly support having choice, dignity, and compassion at the end of their lives. We welcome this and look forward to working further on the legislation.
As the bill goes through further stages and detail is debated, detailed questions of eligibility, process, and safeguards obviously remain on the table, but this is a historic bill which would give many suffering people the choice and dignity they desire and deserve.
The fact of the matter is that assisted dying is already happening in this country. Some are travelling to Switzerland, if they have the money and mobility to do so. Others are dying in traumatic circumstances by suicide, assisted or otherwise. Many more are suffering greatly, even while receiving the best possible care. This vote shows that MPs see the need to introduce real safeguards to our law where there are currently none.
Care Not Killing, which campaigns against assisted dying and in favour of better palliative care, says it is disappointed by the result of the vote, but encouraged by how many MPs are expressing reservations about the legislation. In a statement Gordon Macdonald, its chief executive, said:
We are naturally disappointed at the vote, but have been hugely encouraged that the more MPs hear about assisted suicide and euthanasia the more they turn against changing the law and rightly want the government to focus on fixing the UK’s broken palliative care system.
Thinktank says there are many questions still be be answered about how NHS might administer assisted dying
The Nuffield Trust, a health thinktank, says there are many questions to be answered as the bill progresses through parliament about how assisted dying might work. In a statement on today’s vote, Thea Stein, its chief executive, says:
As this bill progresses through parliament, MPs will need to carefully consider how such a change in the law would interact with the NHS and social care. There are large unanswered questions around funding, staffing and equity if this bill becomes law.
In particular, it is still unclear whether or not assisted dying would be fully publicly funded. If it is, it will sit alongside services like social care and hospice care which are not. Both of these services are financially on the brink and MPs will need to understand how current threadbare provision will interact with this new service, what implications this may have for people paying for social care, and how to fund assisted dying from a health budget that is already overstretched. If assisted dying is not publicly funded then it will be difficult for the bill to achieve its aim of improving choice for all patients. These are crucial questions to address in the next stage.MPs will also need to scrutinise and debate the staffing and regulatory questions this throws up. Will NHS trusts be able or expected to provide this service? Will medical professionals carry out this work privately or as part of their NHS contract? Who will regulate this service? And what changes will be needed to training and education to ensure staff have the skills and knowledge to deliver it?
Photograph: Neil Hall/EPA
Lammy says he voted against bill recalling his mum, and how she worried about being financial burden when terminally ill
David Lammy, the foreign secretary, has just released a letter to his constituents explaining why he voted against the assisted dying bill. He says he worries that, if assisted dying had been allowed when his mother was dying, she might have taken if as an option to avoid being a financial burden on her family in her final months.
Cabinet ministers were asked not to try to sway the debate on assisted dying before the vote today, because the government is meant to be neutral, and so presumably Lammy held back his comments until now in keeping with that guidance. Other cabinet ministers were more willing to get stuck in.
Here is video of the moment the result was announced.
Six cabinet ministers were among the Labour MPs voting against the bill: Angela Rayner, deputy PM; David Lammy, foreign secretary; Wes Streeting, health secretary; Shabana Mahmood, justice secretary; Bridget Phillipson, education secretary; and Jonathan Reynolds, business secretary.
Darren Jones, the chief secretary to the Treasury, and Anneliese Dodds, the development minister, also voted against. They both attend cabinet, but are not full cabinet ministers.
