Kim Leadbeater’s assisted suicide Bill has been hit by a further blow after the Royal College of Physicians (RCP) warned the Bill contains deficiencies that make it unsafe for both patients and doctors.
In a position statement released just days ahead of the debate at Report Stage last week, the RCP said that, after the completion of the Bill’s Committee Stage, “there currently remain deficiencies that would need addressing to achieve adequate protection of patients and professionals”.
The RCP outlined its concerns about the “under-provision of end of life care and palliative care in England and Wales”, saying “We are concerned that patients would not have equitable choice of services because of the inequity of availability, and under-provision of end of life care and palliative care in England and Wales”.
“These inequities of care are particularly present for more disadvantaged populations. There are widespread shortages in health and social care staff who provide these services, alongside increasing demand and very wide variation of where, when and how the services are delivered or available”.
“There is a risk that some patients may [choose] assisted dying because they fear their needs would not be met, by services that are currently not adequate”.
“Palliative care in our country is among the worst in the developed world”
The RCP’s concerns about the “under-provision of end of life care and palliative care” have been mentioned frequently, most recently in the debate at Report Stage, in which Iqbal Mohamed MP said “The current state of palliative care in our country is among the worst in the developed world. Without adequate palliative care, patients might feel pressure to go down the assisted dying route instead”. Rebecca Paul MP also shared her own concerns, saying “The key point is that we need to improve palliative care”.
Last November, prior to the Second Reading vote, a large group of medical professionals wrote an open letter to the Prime Minister, warning that the “NHS is broken, with health and social care in disarray. Palliative care is woefully underfunded and many lack access to specialist provision”.
Health Secretary Wes Streeting has previously shared his own concerns around palliative care, telling backbenchers in October that end-of-life care is not good enough for people to make a “genuine choice” about assisted suicide.
Mother of the House Diane Abbott drew attention to the fact that “If the Bill passes, we will have the NHS as a 100% funded suicide service, but palliative care will be funded only at 30% at best”.
“Limitations” of Mental Capacity Act criticised
The RCP said it “share[s] the concerns expressed by the Royal College of Psychiatrists on the limitations of the current Mental Capacity Act and its use in this situation”. Some of these concerns were highlighted by Daniel Francis MP during Report Stage, referring to his experience of being a parent of a child with complex disabilities, including a learning disability.
Francis said “The concern that haunts me every single day is, ‘Who will make, and how will they make, those decisions to support my daughter when my wife and I are gone?’”.
“That concern, shared by thousands of others, led me to the conclusion that the Mental Capacity Act 2005 was not written for this scenario”.
Referring to the second principle of the Mental Capacity Act, which states “A person is not to be treated as unable to make a decision unless all practicable steps to help him to do so have been taken without success”, Francis added “It was accepted in Committee that doctors would have to assist individuals in this scenario to make the decision about an assisted death. From my lived experience, I would query how some aspects of the Mental Capacity Act are being carried out, given that I often have to deal with professionals who deem that my daughter has less or more capacity than she actually does”.
RCP statement a “pretty damning verdict” on the Leadbeater Bill
Journalist Sonia Sodha described the RCP statement as “[a] pretty damning verdict” and asked “Will MPs listen to doctors?”.
Professor Allan House, Emeritus Professor of Liaison Psychiatry at the University of Leeds, queried the RCP’s claims of neutrality, saying “This isn’t a statement of neutrality to be quoted by supporters as meaning [the RCP] isn’t opposed. The opening sentence says the bill isn’t safe”.
After Kim Leadbeater dismissed the tactics of the Bill’s opponents as “scaremongering”, and labelled opposition to assisted suicide “state cruelty”, Sonia Sodha illustrated her disagreement by referring to the RCP statement, saying “Just today the Royal College of Physicians published a statement saying the bill’s deficiencies render it unsafe for patients and doctors. Are they just “scaremongering”?”.
Sodha added “The opposition to the bill isn’t ‘scaremongering’; many [including] professionals & experts [are] rightly concerned about people suffering state-sanctioned wrongful deaths. Regard for the vulnerable isn’t ‘state cruelty’”.
Leadbeater Bill is “nothing short of shambolic”
In a further blow to the Leadbeater Bill, the concerns shared by the RCP came as the Royal College of Psychiatrists (RCPsych) announced it “cannot support” the Bill, citing “many, many factors” that need addressing.
In a move described by journalist Dan Hitchens as “an absolute bombshell statement”, the RCPsych said “With too many unanswered questions about the safeguarding of people with mental illness, the College has concluded that it cannot support the Bill in its current form”.
Dr Lade Smith, President of the RCPsych, told BBC Newsnight that the RCPsych had “repeatedly” raised their concerns with parliamentarians but they had “yet to be addressed”.
Writer and political commentator Fleur Elizabeth Meston blasted the Leadbeater Bill as “nothing short of shambolic”, saying “Rushed scrutiny, biased hearings, rejected safeguards, and questionable claims have defined this bill’s journey. If we cannot trust Parliament to debate life-and-death decisions responsibly, how can we trust it to implement them?”.
Spokesperson for Right To Life UK, Catherine Robinson, said “The Royal College of Physicians has identified a range of issues and ‘deficiencies’ with Leadbeater’s dangerous Bill, joining many groups, MPs and publications who can see that this Bill is an absolute disaster. The Times is the latest to criticise the process of the assisted suicide Bill, calling it ‘ragged, chaotic, hasty and philosophically vacant’”.
“It is now time to consign this terrible Bill to the bin and to focus on putting resources into improving palliative care”.
