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.”
