Assisted dying set to be possible by 2027 after historic vote

Terminally ill patients could legally have the right to request medical help to die within two-and-a-half years after MPs voted overwhelmingly in favour of the assisted dying bill.

After five hours of impassioned and often emotional speeches on both sides of the debate, Labour MP Kim Leadbeater’s bill passed 330 votes to 275, with a majority of 55.

The historic result in favour was far higher than had been expected, with Prime Minister Sir Keir Starmer, Chancellor Rachel Reeves and former premier Rishi Sunak among those who supported it in the free vote.

The proposed legislation will now undergo six months of parliamentary scrutiny at committee stage before returning to the Commons for another vote, and possible Royal Assent by next May which means it officially becomes law.

If passed, there would then be a two-year implementation period before it takes effect. The Health Secretary could bring that forward, but this is thought unlikely in view of the concerns that any law is proof against abuse.

Supporters of assisted dying, including the broadcaster Dame Esther Rantzen, applauded the result and hailed Leadbeater a hero for navigating the bill over its first parliamentary hurdle.

But opponents warned that there were still not enough safeguards in the bill to stop vulnerable and disabled people being caught up in the law change and vowed to step up efforts to defeat it. There also remain concerns that the NHS and judiciary would need extra resources for it to be introduced.

Conservative MP Danny Kruger, a leading opponent of assisted dying, said he believed a portion of those who had backed the bill at second reading did so not because they were notionally in favour but in order to allow it to be strengthened or amended. He said he hoped it could still fall at third reading if those further safeguards were not added.

During the debate Kruger told the Commons: “We are the safeguard, this place, this parliament, you and me. We are the people who protect the most vulnerable in society from harm and yet we stand on the brink of abandoning that role.

“The Rubicon was a very small stream but on the other side lies a very different world, a worse world, with a very different idea of human value, the idea that our individual worth lies in our utility, valuable only for so long as we’re useful, not a burden, not a cost, not making a mess. Let’s not be the parliament that authorises that idea.”

But after the result Leadbeater told the BBC: “We have shown parliament in its best light today. Very respectful, very compassionate debate, irrespective of the different views that people hold.”

She pledged that the committee stage would be “thorough and robust”, adding: “There is plenty of time to get this right.”

Leadbeater, who will choose the make-up of the bill committee, said she would consider a number of concessions, including extending the planned two-year period before the bill takes effect, and toughening the language on doctors who “may” consult an expert if they have concerns about a person’s mental capacity to “must”.

The obstacles that MPs need to overcome in the assisted dying bill

Concerns about coercion
One of the issues most frequently raised during the debate was how doctors and judges would be able to identify if someone was coerced into pursuing assisted dying.
The bill would make it illegal to pressure somebody into the process, but questions remain about whether the bill has enough protections in place to ensure this doesn’t happen.
Veteran Labour MP Diane Abbott was among those raising this issue during the debate, telling MPs that coercion in a family context is often “not what you say but about what you don’t say”, making it impossible to identify.
She argued that the bill’s current safeguards are insufficient and voted against it on those grounds.

State of palliative care
Many MPs, both for and against the bill, have also raised the issue of the state of palliative care provisions in the UK.
Labour MP Rachael Maskell was among those to raise this, claiming the “focus should be on getting palliation right” rather than explore assisted dying, adding: “We can’t do both as there is simply not capacity.”
Maskell and fellow Labour MP Meg Hillier voted against the bill. Hillier told the Commons: “The time is not right now. We have not had the proper discussion about palliative care.”
But Tory MP Luke Evans argued that both palliative care and assisted dying should be considered, claiming the former “has limits” when it comes to alleviating suffering.

Impact on the NHS
Numerous MPs and campaign groups opposed to the bill have raised concerns about the impact assisted dying could have on the NHS both in terms of cost and the provision of other services.
Andrea Williams, chief executive of Christian Concern, warned that the bill would “create more suffering and chaos in the NHS”. This was echoed by the Church of England’s lead bishop for healthcare, Dame Sarah Mullally, who said the vote “still leaves the question of how this could be implemented in an overstretched and under-funded NHS”.
But Tory MP Kit Malthouse, a co-signatory of the bill, argued that those considering the bill should not be overly focused on cost.
He told MPs: “Even if you think there is an impact, are you seriously telling me that my death, my agony, is too much for the NHS to have time for?”

She also pledged to pass a highly unusual motion allowing for her bill committee to take written and oral evidence from all sides of the debate.

The result was announced to a hushed chamber and watched by several terminally ill patients and their families from the public gallery.

It had been the first vote on legally assisted dying since 2015, when the Commons voted 330 to 118 against.

Among those to vote against this time were Health Secretary Wes Streeting, who had previously expressed concerns that the new law would add extra burdens to an already under-pressure NHS, and Justice Secretary Shabana Mahmood, who had warned that it risked creating a “state death service”.

Streeting sat towards the end of the frontbench for the majority of the debate and was seen nodding avidly during several MP speeches discussing concerns over the bill’s impact on the NHS.

But The i Paper understands these two Cabinet ministers will not be involved in the parliamentary process to make the bill workable.

Instead junior ministers in the Department of Health and Ministry of Justice will oversee officials working with Leadbeater, under the umbrella of the Cabinet Office.

A source close to Streeting said he would “accept the vote whichever way it went and implement the will of parliament”.

Christian Concern said the result marks a “very Black Friday for the vulnerable in this country”.

While the size of the majority of 55 suggests the bill will pass at third reading, there are still potential obstacles for the legislation including amendments at committee stage and during the passage through the House of Lords.

One Tory MP opposed to the bill told The i Paper: “By convention, the Lords don’t touch PMBs [private members bills] much, so we only have a few months to make the case against this bill at third reading.

“I think those of us concerned about this bill will be galvanised now. MPs will be more willing to talk about it now their stance is out in the open, so we’ve got to make the case to them strongly about what is at stake if we pass this into law.”

Read Next

Labour MP Rachael Maskell, who sat on the 14-month health select committee inquiry on assisted dying, told The i Paper: “We know that many people voted today wanting to see a significant change in the bill, and some also voted because they wanted more debate on this issue.

“It’s hard to read what this vote actually means other than it will now proceed to committee, and we’ve got to make sure that committee holds the legislation to account.”

Maskell added: “My biggest concern is that the public needs to understand that the vast majority of deaths are very peaceful, and I’m concerned that people are hearing of all these horrible deaths which happen because we don’t have good palliative care.”

But Labour MP Dr Jeevun Sandher, an active member of the pro campaign, said: “Today, my colleagues gave us a strong mandate for this bill to proceed and help shorten agonising deaths for the terminally ill. Rightly, my colleagues will look for even more scrutiny and details on implementation in bill committee. And that is what will happen.”

Another supporter of assisted dying, Conservative MP Kit Malthouse, told Sky News: “The government has already said that if it passed second reading, which it has, it will engage with the legislation and work with the bill promoters to make sure that it is workable.

“And that means that during committee and report, there may be amendments and adjustments that the government wants to make, which is great, because we need to make sure that this lands well, not just for the people it’s going to affect but for the whole of society, and in particular for the NHS.”

Starmer did not appear in the Chamber during the debate, only taking his seat once he had cast his vote in favour of the legislation. While awaiting the results, he was seen crossing the floor for a brief conversation with Reform UK leader Nigel Farage.

There was a pin-drop silence as the results were read, and Leadbeater’s face showed a visible relief when it was confirmed that her bill had passed with a healthy majority.

Sunak said he voted for the bill because he believed it would help to “reduce suffering”.

Sunak described himself as a “religious person”, adding that he understood the “deep moral and philosophical concerns that many people have about this issue”.

He added: “So, it is important to stress that any medical practitioner who has moral, religious or philosophical objections to this change will have the right not to be involved in this aspect of care.”

Rantzen said she was “lost in admiration” at Leadbeater’s “complete mastery of the facts”, adding: “She’s an extraordinary person. I was also very moved by the various doctors who took part, who gave painful but important descriptions of the kinds of death people suffer, which cannot be eased by even the best palliative care, and I’m sure their interventions were crucial.”

Cabinet ministers for:
Keir Starmer, Prime Minister
Rachel Reeves, Chancellor of the Exchequer
Yvette Cooper, Home Secretary
Pat McFadden, Minister for the Cabinet Office
John Healey, Defence Secretary
Ed Miliband, Energy Secretary
Liz Kendall, Work and Pensions Secretary
Peter Kyle, Science Secretary
Lisa Nandy, Culture Secretary
Steve Reed, Environment Secretary
Heidi Alexander, Transport Secretary
Lucy Powell, Leader of the House of Commons
Hilary Benn, Northern Ireland Secretary
Jo Stevens, Wales Secretary
Alan Campbell, Chief Whip

Cabinet ministers against:
Angela Rayner, Deputy Prime Minister
David Lammy, Foreign Secretary
Shabana Mahmood, Justice Secretary
Wes Streeting, Health Secretary
Jonathan Reynolds, Business Secretary
Bridget Phillipson, Education Secretary
Darren Jones, Chief Secretary to the Treasury
Anneliese Dodds, Equalities Minister

Conservative Party leader Kemi Badenoch and Reform UK leader Nigel Farage voted against, while ex-Prime Minister Rishi Sunak voted in support.