Assisted dying: What happens next?

Times

5 hours ago

Friday's Commons vote on assisted dying takes Britain one step closer to a historic change in the law that would allow terminally ill patients to end their lives at a time of their choosing.
But the legislation is still some way from entering the statute book and further still from coming into effect.
So what are the key hurdles that those supporting the move have to cross, what are the questions that remain and when is likely to come into effect?
The next stage for the legislation is the House of Lords, which will begin detailed consideration of the bill in the autumn.
The first stage will be the second reading where, unlike the Commons, there is not usually a vote and the bill is expected to pass to committee stage.
And here opponents of the bill have a dilemma. One option would be to flood the committee with amendments and demand that they are all considered individually rather than being grouped together, which is normal practice. This would ensure that the bill — which can only be debated on Fridays — runs out of time and falls when the current parliamentary session ends at some point in late spring next year.
• Assisted dying latest: MPs vote in favour of passing bill
However, it would not stop another MP from bringing back an identical version of the bill at the start of the next session and trying again.
The other option is not to try and kill off the bill but to use the Lords process to revise it and strengthen the safeguards within it. An opponent pointed out that only 12 of 133 amendments tabled to legislation came to a vote of all MPs, and argued that the Lords should scrutinise the legislation in a way that the Commons cannot, without killing it entirely.
Much will depend on the balance of views among those who have concerns about the legislation and whether they remain united. However, there is no way for supporters to force the bill through the Lords if opponents decide to sabotage it.
Ping pong is the process where a bill moves back and forth between the House of Commons and the House of Lords as they try to agree on amendments to the legislation. But private member's bills have limited time allotted to them — especially in the Commons — and if ping pong extends beyond the time available the bill falls.
Having tacitly supported the right of MPs to decide on the issue — by bringing forward the bill early in the session and allocating it government-controlled time — ministers might be expected to ensure that the bill does not fall at this last hurdle. But that decision may depend on what the final legislation looks like.
Wes Streeting, the health secretary, opposes assisted dying. But his department will be the one responsible for delivering it. Details of what this will look like remain vague, but in the next few months health officials will have to come up with a plan for helping NHS patients to die.
Rather than a dedicated NHS dying service, it is likely that separate assisted dying clinics would be set up by charities and organisations, which would then receive funding and contracts from the Department of Health and Social Care. This would mirror the system created after the Abortion Act 1967, with clinics run by charities such as MSI Reproductive Choices (formerly Marie Stopes) licensed to perform abortions.
The legislation has huge implications for the already stretched NHS workforce: hundreds of doctors and nurses will have to be trained and recruited to work in the new clinics. The Royal College of Psychiatrists has warned that 'there are not enough psychiatrists to do what the bill asks'.
There is an 'opt-out clause', which means no NHS staff or health professionals will be under any obligation to take part in the process of assisted dying. Professor Chris Whitty, the chief medical officer, has warned that only a minority of doctors will be 'happy to take part in the final stages'. New medical guidelines will also have to be issued to help doctors rule on when patients have less than six months to live — something that is notoriously difficult.
Even if the bill does become law, it will still be some years before terminally ill patients will be able to use it. The legislation makes clear that its provisions will not come into effect before 2029 at the earliest to give time for the health service to adapt to the changes and ensure robust legal safeguards are in place.