It can't stop here: Assisted dying bill must be complemented by restoring Britain's care networks

It would be grotesque if much-needed assisted dying ends up a more efficient service in the NHS than early-life care, geriatric care, or the hospice system.

Photo by Bret Kavanaugh on Unsplash

The debate on assisted dying - which saw the bill pass its second reading yesterday - was a rare sight in our politics: both passionate and compassionate, factual and emotive, respectful to the end. The manner of the vote, too, was a rarity at its own right. To the Westminster bubble (and honestly, only to the Westminster bubble and its professional connoisseurs), who sponsored a bill is almost invariably more important than what’s in it. Here, for once, nigh-fetishistic partisanship was suspended, and MPs were allowed to vote their conscience.

In consequence, the result doesn’t feel like victory for any particular set of Spitting Image characters, but one phase in a deliberative process of legislating policy for what all participants genuinely believe to be the public good. For once, we saw a vote over a contested issue being conducted in a manner that didn’t resemble spectator sport. It was a fitting tribute to the delicacy and seriousness of the topic, and one hopes it can be extended, somehow, to adjacent areas of legislation, without addressing which no assisted dying policy can be complete.

Assisted dying might be an entirely new area of care for both the NHS and the Treasury to get their heads around. Other provisions, not so much. We used to have pretty robust beginning of life services - Sure Start centres, to name one example. These are gone, and Labour’s promise to increase childcare allowance to 30 hours barely skimming the tip of the iceberg. Care at a much later stage of life, after retirement, has been so thoroughly and cruelly hollowed out that its underfunding is a key factor in the NHS crisis overall - with patients who should be in care homes being sent to in-patient wards in hospitals instead.

But the most glaring contrast to the sensibility, compassion and generosity of the assisted dying conversation is the silence, until very recently, around the evisceration of the most closely adjacent area - palliative care.

As with so many targets of senseless austerity, deliberate, political choices were made, accumulating to a shocking state of affairs across the sector. The Lead’s own Senior Editor

Natalie Morris

lost both her parents to cancer over the past four years. “Something fundamental had changed in the short period between my parents’ deaths,” she wrote this week in The Guardian. “The quality of end-of-life care has undergone a shocking and rapid decline.”

“In 2020 – despite the complications of Covid, restricted visiting and PPE – the hospice where my dad spent his final days felt like an oasis of calm. It was witnessing this experience that made my mum so certain of what she wanted… [but] for Mum, palliative care was fraught and stressful. There was a tense and time-pressured battle to get her a bed, and when we finally arrived at the North West hospice, she was given a bed on a shared ward – which felt no different to a hospital. It was hard to talk to each other with other patients close by, TVs blaring, and visitors running in and out. All we had was a paper curtain to pull around the bed.

I called the hospice every night and every morning before our visit, but on many occasions the phone rang out, or there was nobody available to give us an update. One evening, Mum messaged me asking for help – she couldn’t reach her call button in the dark and nobody had been to check on her or help her get ready for bed. The thought of her alone, unable to call for help, broke something in me permanently.”

As Natalie notes, this wasn’t the fault of the medical professionals concerned - but of the model imposed on them by successive conservative governments, where only 30% of a hospice’s budget is provided by the state, and the rest needs to be made up from elsewhere. The result is a £60 million deficit, redundancies, closures and agonising waits.

It would surely be a grotesque end result to the national debate on assisted dying if that would end up a more obtainable service than early infancy, geriatric or end-of-life care. Both proponents and opponents of the bill - like Layla Moran and Dame Diane Abbot, respectively - are recognising this discrepancy. Let’s hope it’s recognised both in the final version of the assisted dying bill and in the Budget’s NHS provisions, too - and that as many of us as possible tell the NHS to do just that, in their consultation on the next 10 years.

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ICYMI… Leigh Jones of the

The Teesside Lead

wrote for us about his life with a newly discovered chronic condition:

In the

The Calderdale Lead

, we hear why the MP for Calder Valley abstained from the vote despite supporting the bill in principle:

Calderdale MP backs assisted-dying principle but abstains on bill vote

And in the

The Lancashire Lead

, a 91-year-old pensioner makes food bank plea ahead of a tough winter:

Calderdale MP backs assisted-dying principle but abstains on bill vote

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Dimi’s recommendation this week is Say Nothing, the new series from FX on some of the most iconic figures of the Troubles - Dolours and Marian Price, Brendan Hughes, Gerry Adams - and their alleged roles in the fates of the Disappeared, the men and the woman abducted and murdered by the IRA. The series does an even better job than Patrick Radden Keefe’s book of bringing both perpetrators, survivors and victims to life (in some cases, the same person being all of the above); but it falls behind the book in one crucial area - explaining Adams’s rationale in moving from the bullet to the ballot. The series neglects to even to mention the crucial referendum clause in the Good Friday agreement, and ends up uncritically presenting the dissident Republican view that Adams sold their cause for a seat of power and an Armani suit. The peace process deserves far better, so we can but hope Season Two will be produced - perhaps with Peter Taylor’s Operation Chiffon as source material.

Enjoy your weekend,

The Lead

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