MPs’ opposition to assisted dying bill grows amid criticism of lack of debate
Jessica Elgot
Deputy political editor
THE GUARDIAN
Sun 27 October 2024
Rachael Maskell said a five-hour debate would not be enough to explore the potential effects on healthcare.
Sun 27 October 2024
Rachael Maskell said a five-hour debate would not be enough to explore the potential effects on healthcare.
Photograph: Parliament TV
Opposition to the assisted dying bill is growing in parliament after the interventions of the health and justice secretaries to call for caution – and a backlash among new MPs who are angered by the speed of the legislation.
Rachael Maskell, the former Labour shadow minister who chairs the Dying Well all-party parliamentary group against assisted dying, told the Guardian she and others had been meeting dozens of undecided MPs and hoped to persuade them to vote down the bill and push instead for a wide-ranging commission that would explore better palliative care.
The Guardian understands there is particular anger among new Labour MPs about the speed of the bill. The House of Commons will vote on the private member’s bill led by the MP Kim Leadbeater in five weeks’ time and there is growing concern that full details of the legislation are yet to be published.
Keir Starmer is known to be a keen supporter of the proposed change but has said there will be a free vote for MPs.
A number of senior politicians have expressed opposition to the bill in recent days. One key factor in the debate among MPs has been the decisions of the health secretary, Wes Streeting, and the justice secretary, Shabana Mahmood, to say they will vote against the bill.
Related: Should MPs legalise assisted dying? Our panel responds
Among those who are deeply torn there is a strong feeling that the vote should not take place until the government can show significant improvements to the state of the NHS – or risk sending a dangerous message. There are also grave doubts about the process of the private member’s bill, with just two Fridays to debate it. Several stressed, however, that they did not blame Leadbeater.
Maskell, who was part of a 14-month inquiry into assisted dying while she was on the Commons health select committee, said there were still key outstanding issues. She claimed there would be little time to press for clarity on issues such as whether doctors would have to opt out or opt in to carry out the procedure to end a life.
“It’s a very detailed, involved, complex area of healthcare and it’s got to be treated with that gravity, I think, and I just don’t get the sense that the five-hour parliamentary debate will even touch on that,” she said.
Maskell said MPs would be pushing for the government to instead announce a commission on palliative care, as a way to address many of the horror stories that have been raised as a reason to back assisted dying for those terminally ill and in great pain and distress.
Maskell said she and both of her former colleagues on the select committee who remained in parliament, Dr Caroline Johnson and Paulette Hamilton, were against the bill. “We’re the ones that have kind of really lived and breathed this for a significant amount of time,” she said.
Maskell, who is a religious Christian, denied that faith was the key factor for many opposed, saying there were many atheist MPs who were opposed and motivated by a human rights and equality perspective.
“Both Wes and Shabana are the two cabinet members that have the responsibility for implementing this, and when they’ve dug into the issue, they’ve expressed a concern,” Maskell said. “They really should be listened to.”
She said there was very little time for opponents to make their case. “The second reading on 29 November is really the day to defeat the bill and to say actually we don’t have to do this [in the] first six months of a Labour government. It isn’t the only vehicle in town, we can do something else.”
Streeting told MPs he had been persuaded because of the poor state of palliative care, despite having voted for assisted dying the last time around. Jonathan Reynolds, the business secretary, was also previously a member of the APPG against assisted dying. But other cabinet ministers have said they are in favour, including the work and pensions secretary, Liz Kendall, and the culture secretary, Lisa Nandy.
Among Conservative MPs, the issue is split down the middle. “I think that it’s very much a case of a core number of religious ones who are against it, a core number of people who through personal or constituency experience are very strongly in favour, and then a number who are very torn,” one senior Conservative said. “But I think there is a growing feeling of ‘is this the right way to do this?’.”
Ed Davey, the Liberal Democrat leader, who has a disabled son and whose wife has MS, has said he will vote against the bill.
Cabinet ministers are not expected to campaign on the issue. Earlier this month, the cabinet secretary, Simon Case, wrote to ministers to say they “should exercise discretion and should not take part in the public debate”.
Starmer’s support has been very influential for a number of MPs, however, and there are others in all the parties who are passionate supporters of the legal change, backed by three-quarters of the public, according to some polls.
Related: Doctor spared by Keir Starmer from assisted dying charges ‘is sure PM wants law change’
In a survey of MPs published earlier this month, just over half of those who responded backed legalisation in the case of terminal illness.
Esther Rantzen, the celebrity backer of the assisted dying law change, to whom Starmer promised he would hold a vote on the issue, wrote to Streeting late this week to say she was “deeply disappointed” in his decision and accused him of “ignoring the government’s request to stay neutral”.
She told the Express that Streeting should know “even the best palliative care cannot always protect patients from dying in agony, and their families and doctors watching helplessly”.
Maskell, a former physiotherapist, said taking part in the health and social care select committee inquiry into assisted dying had left her extremely concerned about the procedure. She said there were a significant number of her colleagues who remained undecided.
“We haven’t even seen the bill yet and we will have five weeks and then a five-hour debate – that feels like the process isn’t right for dealing with such a sensitive and challenging subject and complex subject,” she said.
“We’re in the context of a broken NHS. We know that social care is so fragmented and is just not functioning and massively under-resourced, and local authorities are climbing the wall around their finances. And we know that palliative care and the hospice service have been crying out for years about their underfunding.”
Maskell said for many MPs there was widespread support among their constituents for the change, and for those MPs who had their own doubts, they needed to explain an alternative to voting for the bill.
“We’ve got to think about end of life in a very different way if we are going to give people the very best of care,” she said. “There’ve been so many people who are just feeling they’re having to grab the first thing that comes along. I just think that lobby has been very successful and persuasive in trying to advance their agenda.”
Maskell said she had been having one-to-one discussions with MPs who were undecided. “I would say it’s certainly not the majority in favour yet. But the problem is that they don’t have an adequate response currently to give their constituents, to say: ‘I don’t want have to do this now, but I want to get palliative care right.’”
Hospices fear losing donations if they speak out on assisted dying
Opposition to the assisted dying bill is growing in parliament after the interventions of the health and justice secretaries to call for caution – and a backlash among new MPs who are angered by the speed of the legislation.
Rachael Maskell, the former Labour shadow minister who chairs the Dying Well all-party parliamentary group against assisted dying, told the Guardian she and others had been meeting dozens of undecided MPs and hoped to persuade them to vote down the bill and push instead for a wide-ranging commission that would explore better palliative care.
The Guardian understands there is particular anger among new Labour MPs about the speed of the bill. The House of Commons will vote on the private member’s bill led by the MP Kim Leadbeater in five weeks’ time and there is growing concern that full details of the legislation are yet to be published.
Keir Starmer is known to be a keen supporter of the proposed change but has said there will be a free vote for MPs.
A number of senior politicians have expressed opposition to the bill in recent days. One key factor in the debate among MPs has been the decisions of the health secretary, Wes Streeting, and the justice secretary, Shabana Mahmood, to say they will vote against the bill.
Related: Should MPs legalise assisted dying? Our panel responds
Among those who are deeply torn there is a strong feeling that the vote should not take place until the government can show significant improvements to the state of the NHS – or risk sending a dangerous message. There are also grave doubts about the process of the private member’s bill, with just two Fridays to debate it. Several stressed, however, that they did not blame Leadbeater.
Maskell, who was part of a 14-month inquiry into assisted dying while she was on the Commons health select committee, said there were still key outstanding issues. She claimed there would be little time to press for clarity on issues such as whether doctors would have to opt out or opt in to carry out the procedure to end a life.
“It’s a very detailed, involved, complex area of healthcare and it’s got to be treated with that gravity, I think, and I just don’t get the sense that the five-hour parliamentary debate will even touch on that,” she said.
Maskell said MPs would be pushing for the government to instead announce a commission on palliative care, as a way to address many of the horror stories that have been raised as a reason to back assisted dying for those terminally ill and in great pain and distress.
Maskell said she and both of her former colleagues on the select committee who remained in parliament, Dr Caroline Johnson and Paulette Hamilton, were against the bill. “We’re the ones that have kind of really lived and breathed this for a significant amount of time,” she said.
Maskell, who is a religious Christian, denied that faith was the key factor for many opposed, saying there were many atheist MPs who were opposed and motivated by a human rights and equality perspective.
“Both Wes and Shabana are the two cabinet members that have the responsibility for implementing this, and when they’ve dug into the issue, they’ve expressed a concern,” Maskell said. “They really should be listened to.”
She said there was very little time for opponents to make their case. “The second reading on 29 November is really the day to defeat the bill and to say actually we don’t have to do this [in the] first six months of a Labour government. It isn’t the only vehicle in town, we can do something else.”
Streeting told MPs he had been persuaded because of the poor state of palliative care, despite having voted for assisted dying the last time around. Jonathan Reynolds, the business secretary, was also previously a member of the APPG against assisted dying. But other cabinet ministers have said they are in favour, including the work and pensions secretary, Liz Kendall, and the culture secretary, Lisa Nandy.
Among Conservative MPs, the issue is split down the middle. “I think that it’s very much a case of a core number of religious ones who are against it, a core number of people who through personal or constituency experience are very strongly in favour, and then a number who are very torn,” one senior Conservative said. “But I think there is a growing feeling of ‘is this the right way to do this?’.”
Ed Davey, the Liberal Democrat leader, who has a disabled son and whose wife has MS, has said he will vote against the bill.
Cabinet ministers are not expected to campaign on the issue. Earlier this month, the cabinet secretary, Simon Case, wrote to ministers to say they “should exercise discretion and should not take part in the public debate”.
Starmer’s support has been very influential for a number of MPs, however, and there are others in all the parties who are passionate supporters of the legal change, backed by three-quarters of the public, according to some polls.
Related: Doctor spared by Keir Starmer from assisted dying charges ‘is sure PM wants law change’
In a survey of MPs published earlier this month, just over half of those who responded backed legalisation in the case of terminal illness.
Esther Rantzen, the celebrity backer of the assisted dying law change, to whom Starmer promised he would hold a vote on the issue, wrote to Streeting late this week to say she was “deeply disappointed” in his decision and accused him of “ignoring the government’s request to stay neutral”.
She told the Express that Streeting should know “even the best palliative care cannot always protect patients from dying in agony, and their families and doctors watching helplessly”.
Maskell, a former physiotherapist, said taking part in the health and social care select committee inquiry into assisted dying had left her extremely concerned about the procedure. She said there were a significant number of her colleagues who remained undecided.
“We haven’t even seen the bill yet and we will have five weeks and then a five-hour debate – that feels like the process isn’t right for dealing with such a sensitive and challenging subject and complex subject,” she said.
“We’re in the context of a broken NHS. We know that social care is so fragmented and is just not functioning and massively under-resourced, and local authorities are climbing the wall around their finances. And we know that palliative care and the hospice service have been crying out for years about their underfunding.”
Maskell said for many MPs there was widespread support among their constituents for the change, and for those MPs who had their own doubts, they needed to explain an alternative to voting for the bill.
“We’ve got to think about end of life in a very different way if we are going to give people the very best of care,” she said. “There’ve been so many people who are just feeling they’re having to grab the first thing that comes along. I just think that lobby has been very successful and persuasive in trying to advance their agenda.”
Maskell said she had been having one-to-one discussions with MPs who were undecided. “I would say it’s certainly not the majority in favour yet. But the problem is that they don’t have an adequate response currently to give their constituents, to say: ‘I don’t want have to do this now, but I want to get palliative care right.’”
Hospices fear losing donations if they speak out on assisted dying
Janet Eastham
Fri 25 October 2024 at 10:50 am GMT-6·5-min read
The hospice sector is accused of opting out of the controversial debate to protect their precarious revenue streams - RAFFI MAGHDESSIAN/CAVAN IMAGES
Hospices fear losing donations if they speak out on assisted dying, doctors have claimed.
Palliative care consultants have accused the sector of opting out of the controversial debate to protect their precarious revenue streams.
Hospice UK and Marie Curie, two major end-of-life charities which together represent more than 200 hospices across the UK, have both taken a “neutral” stance on legalisation, despite overwhelming opposition from clinical staff.
According to the Association of Palliative Medicine (APM), which represents 1,400 palliative care doctors and nurses, 4 per cent of clinicians are prepared to implement assisted dying.
Consultants working in the hospice sector, including two former APM presidents, told The Telegraph that the sector’s caution stems from its precarious financial position.
With only a third of its funding coming from the Government, hospices are forced to rely on charitable donations to stay afloat – a funding stream that could be jeopardised if they oppose legalisation.
Ahead of next month’s vote by MPs on whether the law on assisted dying should be changed, medics have warned that the hospice sector’s neutral stance impedes public debate.
Kim Leadbeater, the sister of murdered MP Jo Cox, introduced her private members’ Bill on Oct 16 to legalise assisted dying for terminally ill people.
A free vote is scheduled for Nov 29, the first time MPs have debated the issue since 2015.
Kim Leadbeater, the Labour MP, introduced her private members’ bill on Oct 16 in support of assisted dying for terminally ill people - Lucy North/PA
Clinicians have accused both Hospice UK and Marie Curie of refusing requests to survey their staff on the matter. They claim charities haven’t asked because they don’t want the answer.
A former president of APM said the profession has been “seriously compromised” by the hospice sector’s neutral stance and that “the majority of hospices will not want staff to speak out against assisted dying.”
According to the former president, the problem is that “there is good evidence in Canada that if you refuse to provide ‘medical assistance in dying’ in your hospice, then you lose funding. So the hospices are seeing that happening”.
Delta Hospice Society, a hospice organisation in British Columbia, lost $1.5 million (£1.8 million) in annual public funding over its refusal to offer assistive dying and was evicted from its 10-bed premises.
Dr Amy Proffitt, a palliative care consultant, said hospices “worry that if they oppose legalisation, and the general public wants it, then people won’t donate.”
A 2021 APM survey found that 11 per cent felt their organisation “actively encouraged” them to express their views on assisted dying.
Alex Schadenberg, the Canadian anti-assisted dying campaigner, said he was “disappointed” by the position taken by Marie Curie, having spoken to their policy team about the charity’s stance at the Conservative party conference in Birmingham last month.
He said: “I told them that this was a foolish thing to do, because, similar to Canada, the Canadian Medical Association went neutral ahead of time.
“They were always opposed, and then they went neutral, and their argument was, ‘Oh, well, this will give us a seat at the table.’ But in fact, it didn’t give them a seat at the table. It actually eliminated their argument.”
Mr Schadenberg added that Ms Leadbeater is going to “design a Bill that she thinks will get the majority of the members of the parliament to vote for it… So here’s the point. Do they need Marie Curie at the table? No, because they’re trying to create a Bill to get passed. They actually have lost their spot at the table”.
A Marie Curie spokesman told The Telegraph: “We remain neutral on assisted dying so that we can continue to focus on providing care and support to people that are at the end of their life as well as campaigning to improve palliative and end-of-life care.”
Hospice UK’s neutral stance has also been queried by doctors who pointed out the charity invited Liam McArthur, the Liberal Democrat MSP currently advancing a bill to legalise assisted dying in Scotland, to open their conference next month.
Hospice UK said in a statement: “It’s not our role to either support or oppose a change in the law on assisted dying. Rather, our aim is to make sure the experience and expertise of our members inform this important national conversation.”
They added: “There has not been a single concern or discussion within Hospice UK that our charity might lose donations over this issue.
“We are of course concerned that a sector already facing such a difficult financial situation might lose support over what could be a highly polarising debate and campaign.”
‘Public positioning may impact fundraising’
Slides used by Hospice UK when discussing assisted dying with hospices tell staff to “think carefully about how public positioning may impact fundraising” and stated there were “obvious risks of some loss of supporters of your hospice”.
Both charities acknowledged the particular complexities of the debate, with compelling arguments on both sides. Hospice UK said they “would not be reflecting the range of views that exist by taking anything other than a neutral position”.
Another former APM president said: “It’s incredulous that nobody with any ability to think does not have a view on this – it is risible.”
Hospice UK said they have spoken to staff and “don’t need a survey to know they have differing views”.
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