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New Statesman​

At what cost assisted dying?

David Smith MP (photo by House of Commons / Laurie Noble) and Blair McDougall MP (photo by House of Commons / Roger Harris) As the Assisted Dying Bill enters its final stage in Parliament, far too many unanswered questions remain about its final shape. What we feel certain of is that any new system will place significant costs on our NHS, whilst also creating a system of private provision that will profit financially from ending people's lives. We believe this nationalisation of cost alongside the privatisation of profit is deeply antithetical to the values of a Labour Government. What we do know is this bill seeks to profoundly alter the nature of the NHS and will change what we mean by the term 'health care' in this country: from 'Do No Harm' to 'Assist Death'. The ethical, practical and financial implications of this are essentially unquantifiable. Yet, despite this totemic shift in how our society cares for the vulnerable and dying, we have no meaningful understanding of how the system will be implemented beyond the vaguest of assessments. In the determination to pass the principle of assisted dying into law, supporters of the bill have swept aside well-founded concerns, such as the protection of children, and left current and future governments to work out the detail. Even minor amendments to improve the bill by strictly banning advertising in the same way we do for tobacco or cancer drugs have been rejected, leaving the door open for the marketisation of death for private profit. This introduction of the market into one of the most profound areas of our lives, how they end, has received little attention in the public debate. When the Labour Party first created the NHS, its architect Nye Bevan was concerned about the commodification of care. He worried about the role of the market in extending life, today our concern is about the potential role of the market in ending it. What has become clear in this process is that even minor changes or improved protections to any assisted dying regime would also impose massive, unfunded costs upon our NHS. Subscribe to The New Statesman today from only £8.99 per month Subscribe The Impact Assessment currently budgets for just two and half hours of online training on assisted dying for NHS staff, allows a junior doctor rather than an experienced consultant to lead on assisting someone in their death, and for that doctor to do it on their own, rather than being supported by a nurse. Increasing that training by just a couple of hours, insisting that a senior doctor oversees the process and that they are accompanied by a nurse would be reasonable and minor changes. Yet just these slight alterations alone would see the price of assisted dying to the NHS increase by tens if not hundreds of millions of pounds every year. We are repeatedly reminded that politics is about choices. These unfunded costs to the NHS will incentivise, even necessitate, private organisations to get involved in providing assisted dying. Private 'healthcare' companies delivering assisted suicide will have a duty to their shareholders to maximise 'sales' to the NHS for 'service delivery'. This will sit in sharp contrast to an effective, compassionate and yet underfunded hospice and palliative care sector which only receives 30 per cent of its funding from central government. All life seeks to avoid pain and suffering; it's at the heart of what influences many of our most basic decisions, and our desire not to allow other people to suffer is an essential part of our shared humanity. That's why for so many the assisted dying bill before Parliament feels like a compassionate choice. Given the country's stretched public services, its fragile finances and the inevitable commercial alternatives, an assisted dying regime will end up being not about compassion, but about the brutal logic of the balance sheet and the marketisation of death and dying. We risk creating a world in which, instead of supporting vulnerable people to live, a utilitarian choice will be made that weighs the cost of one life against the needs of the many, often finding that it is simpler and more efficient to support them to die. As new Labour MPs we were elected on the promise of change for our country, of rejuvenated public services, and a restored NHS alongside improved public finances. We would hope to have invested time debating how to properly fund the palliative care sector, rather than how to end people's lives. This is what a compassionate country does to stand in solidarity with those suffering at the end of their lives We were not elected to introduce a system that flies in the face of the principles enshrined in the NHS's foundations by the Labour Government of Bevan and Atlee, putting at risk their and our Labour Party's greatest achievement. Related