It would be “foolish” for the government not to heed warnings from doctors about palliative care as MPs press ahead with assisted dying legislation for England and Wales, the chair of the health and social care committee has said.
The bill, which passed its first parliamentary hurdle in November, would give terminally ill adults with six months to live the right to end their lives. It will now be examined by a committee of MPs, who will hear public evidence, starting this month. It is likely to take a number of amendments before it returns to the Commons at the end of April.
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The health committee chair, Layla Moran, who voted in favour of the bill, said the government’s aim should be to ensure as few people used the assisted dying mechanism as possible if it passed into law. It is understood the committee will turn its attention to the state of palliative care later this year.
Moran, a Liberal Democrat, said she did not agree with some MPs who were pushing for changes to Kim Leadbeater’s private member’s bill to stop doctors being allowed to proactively offer an assisted death to patients.
“When I speak to doctors, they feel really strongly that if this is a course of treatment, which is a medicalised thing, then it would be wrong to not advise patients and families that this is an option. The question is, how do you do that?”.
Assisted dying bill brings critical state of palliative care into government’s focus
Moran said the government should not waste this moment to focus on the state of palliative care, or risk losing public confidence.
“I’ve always agreed with the principle [of assisted dying], but looking at the various pressures that are existing in the service as a whole, speaking to doctors, and in particular, palliative care doctors, we’d be foolish to not heed their warnings about the impact that this is potentially going to have on very vulnerable patients,” she said.
“I want to see an assisted dying bill pass, and then I want us to make it an aim of parliament to minimise the number of people who ever have to use it. I’m not convinced we would have had the focus on palliative care that we’ve had without this bill coming forward.”
Moran said she hoped the bill’s passage through parliament would be a motivation to keep the spotlight on palliative care. Last month the health secretary, Wes Streeting, announced a further £126m funding boost for hospices, many of which had said they were facing crippling costs, especially with the rise in national insurance contributions for employers.
Moran said she was unconvinced by the arguments from opponents of the bill that the state of palliative care was a reason not to proceed with assisted dying. “Palliative care in the UK is in a dire state,” she said. “The health and social care select committee are very keen to look at this in detail in due course.
“But if we try and fix palliative care via this bill, everything will go wrong. So I think we’ve just got to be really clear: the bill has precipitated the conversation, but it’s not for this bill to fix palliative care, that’s for the department and [the social care minister] Stephen Kinnock and everyone else in parliament to make sure that happens.”
Moran said that if the bill passed, she expected the committee would examine the practicalities and take evidence on implementing the legislation, including guidance for patients and medical professionals, subject to the agreement of all committee members.
“Nowhere in a bill do you ever get the specifics of how to implement policy – that is then down to the National Health Service and everyone else who’s involved. But that is where the select committee would then be able to look at the specifics of implementation,” she said.
Moran said that process would naturally come once the principle of an assisted death was passed into law. “I just don’t accept that it’s not receiving enough scrutiny. I think that parliament’s perfectly capable of providing the level of scrutiny to get this right,” she said.
“I think we often forget that we are, in our own right, legislators, we should be able to do this. And I don’t like the infantilisation of parliament that we can’t possibly do anything unless the government initiates it. I think that’s quite dangerous.”
She said the bill remained “vulnerable” because of the potential for private members’ bills to run out of parliamentary time.
“All it would take is a war or some other political crisis to distract everyone and parliament will run out of time. We’ve hit this milestone with a fairly decent majority. It’s just too important not to get right. If you don’t agree with it, engage with it,” she said.
