The UK government is considering outsourcing assisted dying to private companies if the law changes, aiming to prevent NHS waiting lists from spiralling out of control.
Officials believe contracting out the service could ease pressure on NHS resources while addressing doctors’ concerns that assisted dying requires a separate, specialist system.
How would it work?
Ministers insist that if assisted dying becomes legal, it should remain free at the point of use. However, they have “no in-principle objection” to involving private providers.
A model similar to NHS dentistry is under discussion. This would allow some clinics to offer NHS-funded assisted dying while also taking on private clients.
MPs weigh up the costs and challenges
The Terminally Ill Adults (End of Life) Bill, led by Kim Leadbeater, proposes allowing terminally ill patients with six months to live to seek medical help in ending their lives. MPs voted in favour last year, but now the practicalities are under review.
Government officials are carrying out an impact assessment to ensure the proposal is workable. NHS bosses remain cautious, worrying that setting up assisted dying services could be complex and costly.
Health Secretary Wes Streeting, who opposes changing the law, previously warned:
“There would be resource implications for doing [assisted dying]. And those choices would come at the expense of other choices.”
Would assisted dying specialists take over?
One suggestion is to follow models in Australia and the US, where a small group of doctors specialise in assisted dying.
A government source explained:
“You could end up with what you have in the States and Australia, where a cohort of doctors specialise in assisted dying and are passionate about it.”
Leadbeater is open to outsourcing, as long as there is still a free NHS option for patients who need it.
The ethical debate continues
Under the proposed law, two doctors must assess each request at least seven days apart. They must confirm the person has made a clear, settled, and informed decision, free from pressure.
However, Dr Andrew Green, chair of the British Medical Association’s ethics committee, argues that assisted dying should not be a standard medical role.
While the BMA remains neutral, Green believes:
“A separate service outside of existing pathways—though not necessarily outside the NHS—would provide reassurance both to doctors and patients.”
The Department of Health and Social Care has kept its distance, stating:
“This continues to be a matter for Parliament, not government.”
For now, the debate over who should provide assisted dying—and how—is far from settled.
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