Commenting on the Terminally Ill Adults (End of Life) Bill
passing at Third Reading in the House of Commons, Nuffield Trust
Deputy Director of Research, Sarah Scobie, said:
“Now that assisted dying is likely to become a reality in England
and Wales, the debate on how that happens must begin: what
organisations and staff will deliver it, what systems will be
needed to ensure equal access, and how it can sit alongside
existing care at the end of life which, as MPs have recognised,
is all too uneven.
“How this is implemented could be crucial in addressing the
concerns raised by so many. We have looked at countries across
the world implementing assisted dying, including Australia,
Canada and the Netherlands. The differences are not just
procedural – they affect how individuals access and experience
services, and we must learn from them.
“Policy hasn't been static – it has changed over time in these
other countries, even once assisted dying has been passed into
law. It will be important to give the health and care system here
time to prepare for implementation, and to have clear processes
in place for how it will be monitored and compliance ensured.
“International evidence shows that assisted dying services tend
to be publicly funded and integrated into the health care system.
Successfully achieving that in England and Wales, with health and
care services under extraordinary pressure and hospices
struggling with a lack of comprehensive funding, will be no mean
feat.
“An amendment to the Bill will require the Secretary of State to
report on the state of end of life services. MPs were right to
see this as crucial context – and today, such a report would make
difficult reading. Too often people are identified as being at
the end of life at a late stage in their illness, and
opportunities to provide good quality care are missed. Public
spending on end of life care is also weighted far too heavily on
hospital care, even though most people prefer to die at home and
despite efforts to shift care into the community.
“Parliament has taken on the serious responsibility of voting
this Bill through. Now the government must shoulder the duty of
building a service that works alongside our health and care
systems.”
