Officials are looking at the additional costs that assisted dying would bring to the NHS, amid a warning from Wes Streeting that some services could be cut to fund extended end-of-life care.
The Health Secretary has asked officials at the Department of Health and Social Care to analyze the potential “implications” for NHS services if the right to die is legalized in England and Wales.
Their work is ongoing amid increasing scrutiny over how the NHS would go about helping what the MP leading the push for assisted dying says would be hundreds of people a year who have only six months left or have less life to end their lives prematurely.
DHSC officials have already started to investigate the costs of the practicalities involved, for example by expanding the services of hospitals or community nurses.
The revelation comes after Streeting made clear his view that legalization could force the health care system to make tough decisions about funding some existing services.
“It would have an impact on resources if we did this. And those choices would come at the expense of other choices,” he told Times Radio earlier on Wednesday.
Asked whether he would have to find the money to fund an expansion of palliative care elsewhere in the NHS budget, Streeting said: “Yes. Governing is choosing. If Parliament decides to go ahead with assisted dying, it is making the choice that this is an area where investment should be prioritised.
“And we should process those implications.”
Later on Wednesday, speaking to the media at the NHS Providers conference in Liverpool, Streeting again emphasized his belief that legalization could put pressure on the NHS budget.
“I have asked my department to look at the costs” of providing more end-of-life care, he said.
“Now that we have published the bill, I have asked my department to look at the costs associated with providing a new service to enable assisted dying.
“That work is ongoing now, so I can’t give you an exact figure today. I have asked the department to look at the costs of implementing the bill as it is currently before parliament.”
Pressed about which services might lose money for improved palliative care, he declined to comment. But he added: “There are choices and trade-offs. Each new service comes at the expense of different competing pressures and priorities.”
Streeting – who plans to vote against assisted dying – also expressed fears that some people with a terminal diagnosis could choose to end their lives early as a way to save NHS money.
“You do touch on the slippery slope argument, which is the potential for cost savings if people choose to opt for assisted dying rather than remain in the care of healthcare providers or the NHS,” he said in response to a question.
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“I think this is a hair-raising slippery slope argument, and I would hate for people to choose assisted death because they think they are saving someone money, whether that’s relatives or the NHS. I think this is one of the issues that MPs struggle with when deciding how to cast their votes.”
MPs assessing their position on the Terminally Ill Adults (End of Life) Bill should not necessarily vote against it due to the potential competition for resources within the NHS, and should consider all arguments about assisted death, he added .
But citing the tightness of public finances, he again highlighted the potential dilemmas facing the NHS if legalization takes place, saying: “We do have to be concerned with making choices.”
In an interview on BBC Radio 4’s Today programme, Streeting said the NHS could ramp up the palliative care system so that it could take on the responsibilities that assisted dying would bring. He has previously stated that palliative care is not “the place it needs to be to give people a real choice.”
Streeting plans to vote against Labor MP Kim Leadbeater’s bill when it is introduced into Parliament on November 29, which will be the first House of Commons vote on the issue since 2015.
Downing Street would not be drawn into saying whether the Health Secretary was right when he raised the specter that the assisted dying bill would come at the expense of other NHS services.
Asked about Streeting’s comments, Dave Pares said: “Ultimately this is a matter for Parliament to decide and therefore it will be a free vote, and Parliament will debate the principles and merits of assisted death and the issues surrounding the Bill . .”