The Right to Die: A Failure of Political Leadership?

Perhaps there is no better example of the political naivety of this Labour government than its handling of the proposed right to die legislation. Whilst it is too early to confirm speculation that delays in the House of Lords (whether through purposeful obfuscation or through a genuine attempt to provide meaningful oversight and improvement to a private members’ bill) will lead to its demise, there are few people on either side of the argument who would claim that the Bill has been properly managed.

It is not 20/20health’s intention to start evaluating the merits or otherwise of the right to die; to do so would require substantially more study than can be provided by a blog. Rather, it is to illustrate the shortcoming in the government’s leadership and how this could be part of a wider issue affecting UK health policy formation.

The first, but often overlooked, issue is the legislation’s very nature as a private members’ bill. Given the media reporting and the (admittedly passive) support for it in Downing Street, it is easy to forget that the Bill is not official government policy. However, support is by no means universal; Darren Jones, Bridget Phillipson, Shabana Mahmood and Wes Streeting have all voted against the legislation, demonstrating the division at the very top of government.

Collective responsibility is irrelevant for this debate, a backbench Labour MP (Kim Leadbeater) proposed the legislation letting the government of the hook. Initially, this tactic was lauded by the Bill’s supporters as MPs could debate freely and vote each according to their conscience. But this misses one key aspect to introducing a right to die; regardless of whether or not they are outdated (as Esther Rantzen is keen to argue), social and healthcare beliefs if the UK have been founded upon the principle of the sanctity of life.

Such an overturn in societal values is worth more than the time afforded to a private members’ bill, especially as the policy did not feature in any party manifesto in the 2024 general election.

Why does the process matter, especially private members’ bills have been used by governments in the past to introduce “once in a generation” legislation which impacted society as much as the right to die would? A much-used example is the Sexual Offences Act 1967, introduced by Humphrey Berkeley, which decriminalised homosexuality.

However, there are subtle differences. Firstly, homosexuality was accepted by most of Britain, even if there was some resistance to the legalisation in some religious and conservative quarters. The right to die remains an incredibly divisive subject across all demographics. Secondly, whilst also a private members’ bill, the Sexual Offences Act 1967 followed the recommendations of the Wolfenden Report, a government led committee set up in the 1950s to help formulate government policy.

The right to die had no such lineage to call upon, nor has as much consideration gone into the drafting of the Bill.

This is the major problem with the Bill as it currently stands, regardless of which side of the debate you belong. Would it not have been much more sensible for the government (realising the amount of division surrounding the right to die) to have pulled the Bill and to have formed a committee to debate and investigate the issues? The committee could have been chaired by a former head of the NHS such as Amanda Pritchard, a former health secretary such Jeremy Hunt (who as a Tory as well as the longest serving health secretary could have helped bridge political divide) or a former religious leader such as John Sentamu.

Such a committee would have been tasked with forming the official government position and, in light of the urgency required, it could have been granted a year to present its findings. To help it formulate its report, the committee would have heard from campaigners, patients, HCPs, think tanks, lawyers and judges, religious leaders and any other relevant stakeholders.

The government would have been bound by the committee’s findings; if it recommended the right to die, then a properly formulated piece of legislation with meaningful safeguards could have been drafted. If the committee would have recommended maintaining the status quo, then at least its supporters could be satisfied that the matter had been properly debated for another generation, even if it was not the result they wanted.

As it is, the government has attempted to push through a momentous change of law using a mechanism which some supporters are concerned was poorly written and has been watered down sufficiently that it could now lack certain safeguards to protect vulnerable patients.

More alarmingly, the naivety of the government’s strategy has helped encourage division and has exacerbated the sense of grievance on whichever side was to lose. It is now too easy to believe that regardless of whether or not the Bill passes into legislation, there is the sense that there will be very few (if any) winners.

Most alarmingly of all is the perception of how policy decisions are now arrived at. As speculation grows into the longevity of the Stamer government and the manoeuvrings of the current health secretary, it is reasonable to question how long-term decisions are being made. As 20/20health has said before, there has been too much short-termism in successive governments.

Political naivety is failing to provide the meaningful health reforms required in England and Wales.