It was back in March that Keir Starmer first promised to hold a vote on legalising assisted dying. “I’m personally in favour of changing the law, I think we need time, we will make that commitment,” he told the terminally ill TV presenter Esther Rantzen (in a conversation filmed by ITV News). “Delay just prolongs the agony,” Starmer said, indicating that a vote could come early in the next parliament.
Yet the subject was almost entirely absent from the general election. This was partly because Labour made no reference to the issue in its manifesto – a conscious decision by the party to avoid an awkward debate (the Conservatives promised to “respect the will of parliament” on assisted dying; the Liberal Democrats pledged to hold a free vote). But MPs now face perhaps the most consequential decision they will make in this parliament.
Until recently, the consensus was that assisted dying would pass. Back in 2015, MPs voted by 330 to 118 against changing the law but the Commons now includes many more Labour and Liberal Democrat members (who have generally been sympathetic). A private members’ bill was brought forward by Kim Leadbeater – a well-liked Labour MP (she defeated George Galloway in 2021 in her late sister Jo Cox’s former seat of Batley and Spen). Comparisons were made with the social reforms of the Harold Wilson era when abortion and homosexuality were legalised through back-bench bills.
Yet the mood is changing fast. Last month, Wes Streeting told a Parliamentary Labour Party meeting that he intends to vote against assisted dying on the grounds that palliative care is too poor to allow people a genuine choice. Yesterday the Health Secretary went further, warning that a change in the law could force the NHS to cut services elsewhere. “There would be resource implications for doing it. And those choices would come at the expense of other choices,” he said (having ordered an analysis of the costs by civil servants).
For several reasons, Streeting’s voice carries weight in Labour. As Health Secretary he would be tasked with implementing the bill and he is popular among new MPs in particular (a crucial swing group), with some regarding him as a future party leader. Streeting also voted in favour of legalising assisted dying in 2015 – and converts are often the most persuasive advocates of a position.
His intervention angered supporters of the bill who believe that it contradicted the guidance issued by the Cabinet Secretary Simon Case last month (ministers, he wrote, “should exercise discretion and should not take part in the public debate”). At least three ministers in Streeting’s own department – including the social care minister Stephen Kinnock – are expected to vote for the bill. “Wes has approached this issue in a genuine, thoughtful and considerate way, setting out his own view while respecting others’ views,” an ally says.
What no one doubts is that opinion is shifting (one Labour supporter of the bill describes Streeting’s intervention as “a nightmare”). The Health Secretary is one of three cabinet ministers explicitly opposed to assisted dying, the others being Shabana Mahmood – who would be a central figure to the legislation as Justice Secretary – and Jonathan Reynolds, the Business Secretary. Angela Rayner, David Lammy and Darren Jones, the chief secretary to the Treasury, are also expected to vote against (three are publicly supportive: Ed Miliband, Lisa Nandy and Hilary Benn). Ed Davey, one of 72 Liberal Democrat MPs, is another notable opponent of the bill.
What of Starmer himself? The Prime Minister has a clear record on the issue: he voted in favour of legalising assisted dying in 2015 and, as director of public prosecutions, issued guidance stating that those who act out of compassion to help a terminally ill patient – with a “clear, settled and informed wish to die” – should not face the courts. His backing – so soon after Labour’s landslide victory – was expected by many to ensure the bill’s passage.
But this week Starmer revealed that he is undecided as to how he will vote. To the disappointment of assisted dying supporters, he also insisted that five hours was enough time for MPs to debate the bill on 29 November.
Those on both sides believe that the vote will be close (with a large number of abstentions expected). But faced with senior cabinet opposition and a lack of parliamentary time, the chance that MPs will decide it is simply too soon is rising.
[See also: Justin Welby’s resignation has not fixed the Church of England]
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