The UK Government has now announced how it will set about providing funding for assisted dying if Kim Leadbeater’s current Bill should become law.
Serious questions were being raised about whether the financial burden, estimated to be between £25 million and £35 million, should fall upon the NHS or upon the Judiciary. The VAD (Voluntary Assisted Dying) services will be provided by independent privately-run surgeries organised on the same basis as dentistry at the moment.
At first sight, this seems eminently sensible. It follows the models that exist in Canada and in most parts of Australia. Its separation from mainstream NHS services will enable such private surgeries to be run by doctors who really support the principle of the work they are doing.
However, this answer actually provokes more questions. Most strikingly, NHS dentistry itself does not receive from the Government anything like enough money to do its job properly. According to the British Dental Association, only 4% of people who tried to register with an NHS dentist in 2023 were successful in doing so. 11% stopped trying and chose to go private instead. 5% said they would have to rely upon the GP or local A&E Department. And 80% said there were going to do nothing.
In Canada, most VAD costs are covered by various form of insurance. In Australia the picture is rather confused, with many medical practitioners unsure whether or not they can claim for VAD work.
Unless the demand proves to be much greater than anticipated (most models assume that 2% of deaths will be by VAD) then the new VAD centres will probably only exist in the centres of big cities. Therefore, how will they be accessed by qualifying patients in smaller towns or in more remote hospices ?
At the moment, it seems difficult to avoid the conclusion that even in England and Wales, VAD services will only become sufficiently available if the patients themselves are prepared to pay for them.
