Up to 12 people a day could be using an assisted dying service a decade after it is introduced, and end-of-life care costs could be cut by millions, an official impact assessment has concluded.
The total number of people using the service in England and Wales is expected to rise from between 164 and 787 in the first year to between 1,042 and 4,559 in the 10th, according to the government’s estimates.
The central estimate is that 2,183 people would use the service in its 10th year.
The panels set up to approve procedures would cost about £2,000 a day, adding up to between £900,000 and £3.6m over a 10-year period. The total cost of running the panels – and employing a dedicated commissioner – would be between £10.9m and £13.6m a year, the Whitehall document said.
But the potential savings to the NHS of accelerating the deaths of terminally ill people were expected to range from between £919,000 and £10.3m in the first year to between £5.8m and £59.6m in the 10th.
The 149-page document, produced by the Department of Health and Social Care, calculated the potential savings as part of an overall impact assessment. This was ordered as part of a parliamentary bill sponsored by the Labour MP Kim Leadbeater, which is due to be voted on again on 16 May.
Leadbeater welcomed the impact assessment and said the proposed legislation was “effective and workable”. “By contrast, the law as it currently stands offers no protections, no oversight, and no support for people facing a painful and undignified death,” she said.
“Having the safest assisted dying law in the world inevitably has an impact in terms of cost and resources. Again, as the impact assessments point out, unlike in England and Wales, other countries do not have a voluntary assisted dying commissioner or multi-disciplinary panels to assess every application.”
But Gordon Macdonald, the chief executive of Care Not Killing, which is opposed to a change in the law, said the document “confirms that changing the law will save money … exactly as we have seen in other jurisdictions which have introduced state-assisted killing, placing pressure on vulnerable terminally ill people to end their lives”.
Tanni Grey-Thompson, a gold-medallist Paralympian and member of the House of Lords, said: “This impact assessment highlights how assisted dying would put disabled and other vulnerable people at grave risk by providing financial incentives to an already overburdened and underresourced NHS to offer assisted dying as a ‘treatment option’.”
The government is neutral on the legislation, which passed its first hurdle in the Commons last November. It would allow terminally ill adults in England and Wales who have fewer than six months to live to apply for an assisted death. This would be subject to approval by two doctors and a panel including a social worker, senior legal figure and psychiatrist.
The bill has undergone significant changes since that initial vote. A high court safeguard has been dropped and replaced by expert panels, while the implementation period has been doubled from a maximum of two to four years.
It has been suggested some MPs who supported the bill last year could change their stance when it returns for a further vote, after the change to the high court safeguard.
The impact assessment said it had “not been possible” to estimate the overall costs of implementing an assisted dying service at this stage of the process.
A spokesperson for the health department said it “has a responsibility to make sure any legislation that passes through parliament is workable, effective and enforceable” and that the publication of the impact assessment was done “in order to help parliamentarians in their consideration of the bill”.
The health secretary, Wes Streeting, who confirmed last month that he still planned to oppose the legislation at the next vote, said last year that there were “choices and trade-offs”, adding “any new service comes at the expense of other competing pressures and priorities”.
Andrew Copson, the chief executive of Humanists UK, said the government had done a “thorough job” on the impact assessment. “Assisted dying isn’t untested. Legislation is already working in over 31 jurisdictions across the world, where implementation in Australia, New Zealand, the US, and Europe has shown it to be safe, compassionate, and practical. It’s time for parliament to grant people the dignity and autonomy they deserve at the end of life.”
Liz Carr, the actor, activist and author of the BBC documentary Better Off Dead?, said: “The conclusion of the impact assessment that assisted suicide would save the NHS money only confirms the fears of many disabled people that our lives will be seen as expendable and a burden on public services should this dangerous law be implemented … Lives should never be measured on the basis of financial worth.”
While it remains illegal in most of the world, more than 300 million people now live in countries that have legalised assisted dying. Canada, Australia, New Zealand, Spain and Austria have all introduced assisted dying laws since 2015, when UK MPs last voted on the issue.
