This can be a very short post. Those reading Fit for the Future: 10 Year Health Plan for England published on 3 July 2025 with an eye to understanding how the Terminally Ill Adults (End of Life) Bill will impact upon it will do so in vain. That is for a very simple reason. The Bill is not Government policy, and the Government is neutral upon it. Just as the Impact Assessment published on the Bill is unusual in its (necessary) caveats around its ability to forecast key details, the 10 Year Plan cannot take account of what will – if passed – be one of the most substantial changes to the the NHS since its foundation (potentially requiring, in fact, a change to the very definition of what the NHS is there to do contained in what is currently clause 41((4) of the Bill).
The Plan does make (brief) reference to palliative care, noting that:
People nearing the end of their lives often do not have the support they need for a good death, in the place of their choosing – which for most people is their home. Community-based advice and support will help more people die in their home, while community teams will work closely with care homes and paramedics to share care plans to avoid people being taken to A&E by default. Teams will include hospice outreach staff and palliative care professionals. Rapid response teams will help symptom management, including pain (page 35)
In this regard, if the Bill is passed in its current form, the ‘mission statement’ contained here will need to be modified to make it possible for the coordinating doctor to be present at the person’s own home under what is currently clause 25, which requires that:
(11) The coordinating doctor must remain with the person until—
(a) the person has self-administered the approved substance and—
(i) the person has died, or
(ii) it is determined by the coordinating doctor that the procedure has failed [a word which is not otherwise defined in the Bill], or
(b) the person has decided not to self-administer the approved substance.
(12) For the purposes of subsection (11), the coordinating doctor need not be in the same room as the person to whom the assistance is provided
The 10 Year Plan also makes reference to suicide in two places, noting (at page 86) that it will be through the NHS’s quality agenda:
that we achieve our Plan for Change commitment to reduce the number of lives lost to the biggest killers, including cancer, cardiovascular disease (CVD), and suicide.
And at page 112 that:
New digital tools, digitised therapies and real-time suicide surveillance will improve mental health and reduce suicide rates.
Again, if the Bill is passed in its current form, the ‘mission statement’ contained here will need to address how its implementation interacts with suicide prevention.
At the risk of sounding like a stuck record, the simple fact of the disjunct between the publication of such a major piece of work in relation to the priorities of the NHS and the fact that a Bill is before Parliament that would significantly impact those priorities, but which is not Government policy, just shows the complexity of seeking to introduce such major change through the vehicle of a Private Members’ Bill.
Resources and Disclaimer
For more resources on the Bill, see here. For the avoidance of any doubt, any views I have set out on this page, or on pages linked to it which express views on the Bill, are mine alone, and do not represent the views of organisations I am affiliated with or working with an ongoing basis.
