Changes to the Assisted Dying Bill, including NHS provision and expert panels replacing High Court judge approval, have been defended by its lead MP, despite accusations of a flawed legislative process.
The Terminally Ill Adults (End of Life) Bill, which applies to England and Wales, is set to return to the House of Commons in the coming months after two months of committee scrutiny. MP Kim Leadbeater, who introduced the Bill, insists that it is now “safer, fairer, and more workable” following the revisions.
However, critics argue that the safeguards have been diluted, with Conservative MP Danny Kruger branding the scrutiny process “chaotic.” A key sticking point is the removal of the requirement for High Court judge approval, replaced by three-member expert panels comprising social workers, psychiatrists, and legal professionals. This change has led some MPs who originally backed the Bill in November’s Commons vote to reconsider their support.
Judicial safeguards and new provisions
At the conclusion of the committee’s final session, which ran until 12:30 am on Wednesday, members approved several significant amendments, including:
- The establishment of a Voluntary Assisted Dying Commissioner, who will oversee the implementation of the legislation.
- Expert panels replacing High Court judges in the approval process for assisted dying applications from terminally ill adults.
- The provision of assisted dying on the NHS, ensuring the service is available free of charge.
- A four-year implementation period, doubled from the original two-year timeline.
Ms Leadbeater defended the changes, stating:
“Support for a judge-led multi-disciplinary panel came from experts who gave evidence and has received strong backing across all parties. We are not removing judges from this process. Rather, we are adding the expertise and experience of psychiatrists and social workers to provide extra protections in the areas of assessing mental capacity and detecting coercion while retaining judicial oversight.”
Despite her reassurances, opponents argue that the changes represent a fundamental shift in the Bill’s original intent.
The NHS controversy
One of the most contentious amendments is the inclusion of assisted dying as an NHS service. Leadbeater maintains that this ensures equal access to all patients, stating:
“It is crucial that the option of a voluntary assisted death remains part of a holistic approach to end-of-life care.”
However, Danny Kruger strongly opposed this move, claiming it undermines the founding principles of the NHS:
“The NHS would, if the Bill passes into law, become the ‘National Health and Assisted Suicide Service.’ Those behind it are taking a red pen to Bevan’s legacy.”
The amendment places a duty on the Secretary of State for Health in England and grants devolved ministers in Wales the power to ensure voluntary assisted dying services are provided. While NHS Trusts and Integrated Care Boards (ICBs) will be able to use private providers in some cases, the same safeguards and regulations will apply across all services.
Concerns over legislative process
Labour MP Jess Asato, who voted against the Bill last year, was highly critical of how the amendments were introduced, describing the scrutiny process as “chaotic” and rushed. She noted:
“We’ve seen the NHS’s founding principles amended, the High Court protections ditched, and now the timeline for the whole process changed. This isn’t how good laws are made.”
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Supporters of the Bill argue that extending the implementation period from two years to four is necessary to ensure proper safeguards and training. Leadbeater admitted disappointment at the delay, acknowledging the “upset” of terminally ill patients who may not live to see the law come into effect, but she stressed that “it is more important to do this properly than to do it quickly.”
Wider developments on assisted dying
While the debate over assisted dying continues in Westminster, the Isle of Man’s parliament became the first part of the British Isles to pass assisted dying legislation on Tuesday. The Isle of Man Bill will now proceed to royal assent, with an assisted dying service potentially in place by 2027.
This development adds further pressure on the UK Government to re-evaluate its own approach, particularly as more jurisdictions globally move towards legalising assisted dying under strict regulations.
With the Bill set to return to the Commons for further debate and a crucial vote, both supporters and opponents will intensify their campaigns, with MPs likely facing pressure from constituents, medical professionals, and religious groups in the weeks ahead.
