Terminally Ill Adults (End of Life) Bill

Debate between Munira Wilson and Jeevun Sandher

Report stage
Friday 13th June 2025 Commons Chamber

[Munira Wilson (Twickenham) (LD)]

Even though I am not opposed to the principle of assisted dying, I have a number of deep concerns about the content of the Bill, the process by which we are legislating for such a monumental change and, importantly, the context in which it would be enacted, given the numerous challenges facing our health and care services. That is why I have tabled amendment 21 relating to palliative care and end-of-life needs, which has attracted cross-party support.

I am grateful to the hon. Member for Spen Valley (Kim Leadbeater) for supporting the amendment. I want to pay tribute to her today for kick-starting a debate about dying well and, in particular, about palliative care—a topic that has been neglected by many of us, myself included, for far too long.

Amendment 21 would require the Secretary of State to lay a report before Parliament a year after the Act has passed detailing the availability, quality and distribution of health services to those with palliative and end-of-life needs. Marie Curie estimates that one in four people who could benefit from specialist palliative end-of-life care do not receive it. People who are poorer, less educated and, yes, non-white are even less likely to receive it.

I was horrified, if I am honest, by the earlier speech from the hon. Member for Loughborough (Dr Sandher). All the data shows us that people from minority ethnic communities are less likely to access the healthcare services they deserve, in particular palliative care. There is a deep distrust of health services, and those of us who were in this place during the covid pandemic saw that played out in real time in hospitals and care settings up and down the country, with far more people from minority ethnic communities losing their lives and far more healthcare professionals from ethnic minorities not protected in the way that they should have been. If those people from minority ethnic and disadvantaged communities are less likely to access palliative care as a result of the Bill being passed, contrary to what its supporters say, my fear is that more people—rather than fewer—will die a terrible, horrendous, traumatic and painful death and they will be disproportionately from those communities.

[Dr Sandher]

The hon. Member raises a powerful and excellent point about the people from ethnic minorities who died during covid and their access to healthcare. As she will understand, that is of deep importance to me too. She is right about the need for greater palliative care and I am glad, as she says, that we are having that discussion.

If we look at assisted dying around the world and concern around ethnic minorities being more likely to access it, the stats show that it is the other way around and they are less likely to access it. However, that point is neither here nor there; rather, given that the safeguards are in place, the question is: is the process working well? Those are where the stats are going forward. I believe that the hon. Member raises the matter in good faith, and I thank her for doing so.

[Munira Wilson]

I actually think the stats the hon. Member cited undermine his own argument, because all the data shows us that the members of the communities I am talking about are less likely to access the healthcare services they need and therefore, less likely to end up accessing assisted dying. The hon. Member for Stroud (Dr Opher) gave the game away—he is acknowledging it—that wealthier people tend to access assisted dying more because they have the choice, as well as the services to have that meaningful choice. Those inequalities deeply concern me.

My grave concerns about the Bill becoming law are that the people I am talking about do not have the loudest voices or well-funded campaigns to support them. This whole debate about inequalities in access to palliative care should be the topic of a debate on a separate day and I hope there is the chance to have that debate.

Marie Curie also warns that there is

“no realistic national or local plan to address the scale of this challenge”,

and that the whole system is in “a perilous state” due to a

“lack of sustainable funding…and limited prioritisation of…end of life care”.

A 2023 survey of integrated care boards found that half had no plans to invest capital in palliative care services and 40% admitted that their services were inadequate for the needs of their population.