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As someone who has had recent cause to think about the relationship mortality has with life, it’s my view that this Parliament is edging towards taking one of the most important decisions that it will ever make…
… and I am certain in the lifetime of an administration where the average age of MPs is hovering around 49yrs.
Assisted dying.
There will be a free vote in Parliament.
Our glorious leader, Empty-Street told the £walled Times;
'Assisted dying would be at expense of other services...
Proposed law change would carry ‘resource implications’ that would have to be offset by reductions elsewhere in the NHS.'
He has done a volte-face, first supporting it and now turned it into a political row, saying we shouldn’t be considering assisted dying because our end of life care is sooooo bad… and it’s all the Tories fault.
Is there no low, that he cannot stoop to in the name of ambition?
In so doing he has given a spurious lifeline to members of parliament who don’t have the intestinal fortitude to make a decision.
And, as usual Streeting is wrong.
Whilst it is true that like the rest of our public services the NHS has taken a hammering because of covid, Brexit, reorganisation and austerity funding, and
... the hospice movement screwed by inflation and now Labour’s budget increases in NI and working wages, the fact is, UK end-of-life care is the best rated service in the world.
Who says so? The Economist Quality of Death Index.
Before I quote some extracts, let me make it clear, the data is from 2015, the most recent edition of the index.
It is global data and Covid seems to be the reason there is not a more recent edition.
However, the UK was consistently top and so far ahead, in all classifications, it is impossible not to deduce… we know how to do end-of-life-care.
If there has been a decline, we know how and what to do to fix it… bring money.
Hospices receive about a third of their funding from the government. The rest they raise from you, running marathons and making jam.
However, the sector is facing a shortfall of around £60m in this financial year. Nearly all hospices (96%) are budgeting for a deficit in 2023/4.
Streeting is hiding behind small change funding failures to avoid a decision… sorry Wes, we can see you!
Back to the report;
‘The UK has the best quality of death… as in 2010 the UK ranks first in 2015… thanks to comprehensive national policies, the extensive integration of palliative care into [the] NHS and a strong hospice movement.
It also earns the top score in the quality of care…’
Having got the excuses out of the way, what are we to make of the Terminally Ill Adults (End of Life) Bill?
It is full of checks and balances and as far as the NHS is concerned,
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No registered medical practitioner is under any duty to raise the subject of the provision of assisted dying.
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No health professional is under any duty to participate in the provision of assistance.
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Guidance is to be developed by the Chief Medical Officer… after consultation.
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Where a person indicates to a doctor their wish to seek assistance to end their own life, the doctor is not required to do so.
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Relatives or beneficiaries are not able to participate as witnesses to any of the forms or formalities.
You may find all that reassuring… or not.
However, it seems there is a barn-door in the legislation…
... where will this final act take place?
Hospital boards may demur. Hospices with faith connections my not wish to. The International Association for Hospice and Palliative care, will oppose it.
So where?
At home? Maybe. The coordinating doctor does not have to be in the same room but must be ‘present’.
The inference is ‘NHS hospitals and GPs will do this’. They may not and given the sensitivities of the issue it would be wrong to oblige them to do it.
Does this create a problem about universality of access?
If we look to Switzerland for guidance, there are principally three organisations that offer assisted dying services.
Could we envisage companies or charities contracting with the DH+ to provide the service, somehow in parallel?
This is tricky, very tricky...
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