The succession of former British prime ministers who lined up in recent days to assert their compassion for the dying was quite something. David Cameron, Theresa May, Liz Truss, Boris Johnson — all of them wanting us to know just how much they cared. Imagine if this roll call of political powerhouses — each of whom was better placed than anyone to improve the fate of those with terminal diagnoses — had used that power, while in office, to do something concrete, tangible, to alleviate the terminal suffering that allegedly touched them so deeply. Imagine, in other words, if their actions then had matched their fine words now.
I do not doubt the strength of feeling behind this vote in favor of legalizing assisted dying in England and Wales, but as someone who has cared for thousands of people with terminal illnesses, I have to wonder at its sincerity, because every prime minister over the past 20 years — and every lawmaker for that matter — knows full well that much (though not all) of the pain and misery of dying can be alleviated with good palliative care. They also know how much suffering at the end of life is caused by basic National Health Service (NHS), social and palliative care simply not being there for patients.
Wes Streeting went one step further. The health secretary cited the threadbare realities of our underfunded, patchy, palliative care services as his primary reason for voting against the bill, stating (correctly) that the postcode lottery in care denies many patients a genuine choice at the end of life.
And he is absolutely right. I see them daily, the dying patients that British society fails. They arrive sometimes in the emergency room stricken with pain, desperate with fear, having begged for help and support that never materialized. After a few days of input from our team — the first palliative care they have ever received — their symptoms, their outlook and their hopes for the future can often be radically transformed.
So it is over to you, Streeting and British Prime Minister Keir Starmer. What will you do now about those anguished, frail, pain-racked patients who sit and quake in death’s proximity as they are failed by the NHS, social care and society at large? Surely you are not going to permit MPs to usher in a law that makes dying easier while failing to address the underfunding that forces people with terminal illnesses to conclude that death is their only option?
Surely you will now commit an immediate — and massive — injection of public funds into properly resourcing UK palliative care so that 100,000 people every year do not die without the care they need? Do not become the latest political powerhouses who, when push comes to shove, turn their backs on dying people.
I know dying people were not in the Labour manifesto. I know they have not been mentioned in the flagship speeches. I also know that this is not surprising, because an ugly truth underpins this vote — death and dying remain taboo in modern Britain. So I take immense heart from the fact that, thanks to Kim Leadbeater’s bill, a respectful national conversation has begun about the way we die in Britain. However, one issue, above all, has to remain at its center.
We cannot continue to fail dying people by grotesquely underfunding palliative care. The issue will not go away. Fund palliative care properly, once and for all, Starmer and Streeting. The nation is watching.
Rachel Clarke is a palliative care doctor and the author of Breathtaking: Inside the NHS in a Time of Pandemic.
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