Hospices that oppose assisted dying ‘could be forced to shut'
Hospices that refuse to offer assisted dying services could be forced to shut if their funding is pulled, palliative care doctors have warned.
Almost 350 clinicians involved in end of life care have written to the Health Secretary urging him to promise not to revoke NHS funding for providers if they do not offer assisted dying.
They have warned that if hospices were to lose funding as a result of the choice to not provide assisted dying services, they would be at risk of closure.
The Terminally Ill Adults (End of Life) Bill will return to the House of Commons on Friday for further debate.
The proposed legislation would mean terminally ill adults in England and Wales with six months left to live could apply for assistance to end their lives, subject to the approval of two doctors and an expert panel.
Medical professionals, including doctors, pharmacists and social care workers, would have the right to refuse to take part in providing assisted dying services to patients.
However, the Bill as currently drafted does not allow employers, including hospices and care homes, the right to refuse to offer assisted dying on their premises.
The lack of protections for providers to opt out on religious or ethical grounds has prompted concerns from doctors in the sector about the risk of losing funding.
Campaigners have pointed to an example in Canada where a hospice in British Columbia was forced to close its doors after the Government pulled $1.5 million (£1.1 million) of funding when it refused to offer medical assistance in dying (MAID).
It comes as the Children's Commissioner for England warned that teenagers were worried about the future possibility of the Bill extending to 16 or 17 year olds.
In a letter to Wes Streeting, 347 working clinicians, including 124 consultants and doctors in palliative medicine, demanded clarity on protections available to hospices and care homes.
'Some hospices may be forced to close should they be denied NHS funding because they are unwilling to participate in the provision of assisted suicide,' the letter says.
'Our hospices provide expert, community based, specialist palliative care which is world-leading in our sector. We do not want to kill our patients, nor have them fearful that we may do just that. Let us do the job we are trained to do.'
They added: 'We urgently request clarity from the Government that no hospice will be denied public funding because they are unwilling to facilitate assisted suicide on their premises or be placed under a duty to provide such a service.'
'Conscientious objection'
A third of hospice funding is provided by the Government, with the other two thirds charitably funded.
During the Bill's committee stage Danny Kruger, a Conservative MP against the legalisation of assisted dying, said that he was concerned about the risk of institutions being 'defunded'.
He told the committee in March: 'I am concerned about the implication of that, which might be that institutions that did not wish to provide or facilitate assisted suicide but did receive public money, for instance care homes or hospices, would be at risk of losing that money – essentially being defunded – on the grounds of their conscientious objection to participating in assisted dying.'
Dr Gillian Wright, a spokesman for Our Duty of Care, warned that without stronger protections for hospices, doctors could leave the sector 'in their droves'.
'The palliative care and hospice sectors are already in crisis, massively underfunded and understaffed. Yet this Bill will compound the problem by failing to give hospices who do not support killing their patients an opt out.
'This will force many doctors, nurses and even volunteers to make a Hobbesian choice to stick to their clinical, ethical or moral objections against assisted suicide, or take part in ending someone's life. This is likely to see medical and ancillary staff leave the sector in their droves. Personnel who can't be easily replaced.'
She added: 'There are problems with the failure of MPs to give hospices the right to opt out. There may be pressure on hospices to provide assisted suicide or lose funding.'
Meanwhile, Dame Rachel De Souza, the Children's Commissioner, warned that teenagers had expressed concerns about the possibility of the eligibility of assisted dying later expanding to cover 16 and 17 year olds.
In a statement on Friday, she said: 'Even at this major stage of the Bill's passage through Parliament, children's views have at best been sidelined, at worst written off entirely simply because they would not fall within the scope of the current scope of legislation.
'They have spoken passionately about their worries that this Bill could be extended further. We need only to look to other models, such as Canada, where proposals for assisted death to be expanded to 'mature minors' – children – are a live issue, to understand the source of their concern'.
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