The House Opinion Article | We can’t have assisted dying in a care crisis

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Hospice and palliative care face a severe funding problem. A National Audit Office report published at the end of last year found that nearly two-thirds of England’s independent hospices ran a financial deficit in 2023/24, with expenditures exceeding income by £78m. The hospice care provider, Marie Curie, revealed this year that around 170,000 people die annually in England with unaddressed symptoms, and unmet palliative care needs are expected to rise by 23 per cent in the next 25 years unless drastic measures are taken to fix the deficiencies.

Such a context is not one in which assisted suicide should be legalised. Individuals with unmet palliative care needs would not be given genuine choice at the end of their lives. Sufficient treatment would often not be an option, but a hastened death would be. Indeed, as health secretary, Wes Streeting warned that funding for palliative and end-of-life care would have to be reduced so funding could be diverted to set up assisted suicide services.

Lauren Edwards, the MP sponsoring the latest iteration of the assisted suicide bill, responded to the Prime Minister’s statement by making the claim that you don’t have to choose between fixing palliative care or having assisted suicide – it would be possible to have both. This has become a common refrain from supporters, but there cannot be a genuine choice if funding for care is so inadequate that some terminally ill people may feel forced into a premature death because their basic needs are not being met. The argument just doesn’t hold water.

Not only would there likely be less funding to fix palliative care if assisted suicide were to be introduced, which would bring its own costs, but the reforms needed to solve the deeply entrenched funding problems in the care sector are not a quick fix; they will take time.

The assisted suicide legislation includes an implementation period of a maximum of four years that would begin immediately after receiving Royal Assent and becoming law. This would mean that, after four years, assisted suicide would automatically be introduced regardless of the state of palliative care services at that time. I have every hope that the PM achieves his goal of fixing the funding issues in the care sector, but setting a hard limit of only a few years – less than the lifespan of one parliament – to fully address this monumental problem would be an irresponsible hostage to fortune.

Experts also agree that it is simply not feasible to attempt to do both at the same time. Professor Katherine Sleeman, Chair in Palliative Care at King’s College, London, has said that introducing assisted suicide when care services are so fragmented presents a “huge risk” that people may decide to end their lives “simply because of lack of high-quality care”. Professor Mumtaz Patel, President of the Royal College of Physicians, said something similar to the House of Lords Select Committee that considered the last assisted suicide bill: that people would certainly choose to end their lives “because of the lack of provision around good palliative care”. That, surely, is not what anyone wants.

Fixing palliative care is of enduring national importance, and it is welcome that the PM, along with both supporters and opponents of the assisted suicide legislation, recognises it as such. MPs must unite to implement the reforms needed to address these funding issues.

And yet, it seems irrefutable to me that care services cannot be fixed concurrently with the legalisation of assisted suicide, and that assisted suicide could not be introduced safely. Care services remain in a poor state. The obvious solution, as the PM has recognised, is to defer any talk of assisted suicide until we have fixed the issues with palliative care. Anything else would be irresponsible.

Mary Glindon is Labour MP for Newcastle upon Tyne East and Wallsend