It’s a bit late in the day, but the cost to the public of legalising assisted suicide has finally been spelt out. Wes Streeting’s headline-grabbing admission that there’s no money to fund the “service” for which MPs voted last week means that something else will have to be cut.

“There isn’t a budget for this,” the Health Secretary wrote in a message to constituents at the weekend. “Politics is about prioritising. It is a daily series of choices and trade-offs. I fear we’ve made the wrong one.” Helping people to kill themselves, in other words, will damage the NHS’s ability to treat the living. It would have been helpful for MPs to understand this before they voted in favour of assisted suicide in England and Wales on Friday, but at least Streeting has made it clear before the bill arrives in the House of Lords.

The estimated cost of running the “service” is between £10.9 million and £13.6 million a year, which may not sound significant in terms of the overall NHS budget. But the prospect of reducing the money available for knee operations, each of which costs the NHS around £7,600, won’t be much comfort to patients who have already been waiting for months.

Additionally, there are the problems created by diverting resources from other areas of the NHS. The Government’s impact assessment suggests that the panels set up to approve an assisted suicide would cost about £2,000 a day, but that’s assuming sufficient qualified professionals can be found to sit on them. There is already a shortage of psychiatrists in the UK, amounting to 15% of the workforce according to figures published two ago.

Since 2023, the number of people waiting for mental health care has risen by 29%, with some waiting for two years or more, according to the Royal College of Psychiatrists. Assessing terminally ill people who have expressed a wish for assisted suicide would add an entire new cohort of patients, including tricky questions such as having to establish whether coercion is involved.

The idea of having to make trade-offs between the living and patients who want to die is repellent. But it underlines the difference between the fantasy promoted by supporters of the bill, in which no one but an individual patient is affected by a decision to die, and real life. It’s always been clear that friends and family could be devastated by the suicide of a loved one, yet until now the impact on other patients — complete strangers, desperately in need of treatment to improve mobility or save sight — has barely been considered.

After almost a year in office, this Labour government has become notorious for pitting vulnerable people against each other. If there isn’t money available to provide much-needed hospice care, how do MPs who voted for Kim Leadbeater’s bill think assisted suicide will be funded? Passing legislation with insufficient safeguards seems especially cynical when anxiety about money is acute and cuts to welfare benefits are in the pipeline.

Streeting’s intervention should at least encourage peers to scrutinise the bill line by line. They also need to ask hard questions about resources. After all, it would be beyond parody if patients with non-fatal conditions were expected to pay the price of setting up a National Death Service.

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Joan Smith is a novelist and columnist. She was previously Chair of the Mayor of London’s Violence Against Women and Girls Board, and is on the advisory group for Sex Matters. Her book Unfortunately, She Was A Nymphomaniac: A New History of Rome’s Imperial Women was published in November 2024.

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