EPAHealth Secretary Wes Streeting has said there is no budget for an assisted dying service, which MPs narrowly backed in a landmark vote on Friday.
Streeting, who was one of the most senior opponents of the legislation, posted a lengthy message on his Facebook page explaining why he voted against the legislation.
Among other reasons, he said there was already a lack of access to high quality end-of-life care on top of tightened finances within the NHS, which could add to the pressure faced by dying patients.
Streeting said he would “make sure that we do a good job with it for the country” if the legislation becomes law, but he worried MPs had made the wrong choice.
The government remains neutral on the bill, which cleared the Commons with a majority of 23 votes on Friday and will now be scrutinised by the House of Lords. MPs were given a free vote on Friday.
Campaigners in favour of the bill say it will give terminally ill adults the choice on how they want to die and prevent painful deaths, but critics argue it risks people being coerced into seeking an assisted death.
In his post, Streeting quoted former Labour prime minister Gordon Brown’s position that “there is no effective freedom to choose if the alternative option… is not available”, referring to sufficient end-of-life care provisions.
Streeting wrote: “The truth is that creating those conditions will take time and money.
“Even with the savings that might come from assisted dying if people take up the service – and it feels uncomfortable talking about savings in this context to be honest – setting up this service will also take time and money that is in short supply.
“There isn’t a budget for this. Politics is about prioritising. It is a daily series of choices and trade-offs. I fear we’ve made the wrong one.”
The MP for Ilford North pledged to work “constructively” on technical aspects of the legislation as it progresses through Parliament and stressed he had enormous respect for the bill’s supporters.
An impact assessment on the policy published in May provided a financial analysis of the costs and savings involved.
It said that in the first six months, savings for the NHS could range from around £919,000 to £10.3m.
That figure included hospital care, primary and community care, hospice, medicines and other care costs that someone choosing an assisted death would not need.
By the time the system had been running for ten years, savings could range from £5.84m to £59.6m.
The assessment found there would be costs too. Staffing an assisted dying service could cost in excess of £10m a year within a decade, while training costs in the first six months alone could be over £11m.
As peers prepare to examine the Terminally Ill Adults (End of Life) Bill, assisted dying campaigner Dame Esther Rantzen told Radio 4’s Today programme on Saturday that Lords had a duty to perform but that it should not extend to overturning the will of the Commons.
“Their job is to scrutinise, to ask questions, but not to oppose,” she said.
“So yes, people who are adamantly opposed to this Bill, and they have a perfect right to oppose it, will try and stop it going through the Lords, but the Lords themselves, their duty is to make sure that law is actually created by the elected chamber, which is the House of Commons who have voted this through.”
Dame Esther said she was resigned to the fact her own terminal cancer would probably progress to the point she will “buzz off to Zurich” to use the Dignitas clinic before the bill becomes law.
Crossbencher Baroness Tanni Grey-Thompson, a Paralympian and opponent of the plans, told Breakfast she hoped more safeguards could be introduced in the coming months.
“We’re getting ready for it to come to the Lords and from my personal point of view, about amending it to make it stronger,” she said.
“We’ve been told it’s the strongest bill in the world, but to be honest, it’s not a very high bar for other legislation, so I do think there are a lot more safeguards that could be put in.”
Another opponent, the Conservative peer and disability rights campaigner Lord Shinkwin, said he believed the bill needed “forensic scrutiny”.
“The margin yesterday was so close that many MPs would appreciate the opportunity to look at this again in respect of safeguards as they relate to those who feel vulnerable, whether that’s disabled people or older people,” he added.
The bill could still run out of parliamentary time if it is held up in the Lords, but the Labour MP who steered it through the Commons as a Private Member’s Bill, Kim Leadbeater, said: “I would be upset to think that anybody was playing games with such an important and such an emotional issue”.
