Ben Troke, Partner at law firm Weightmans, discusses what the rejection of the assisted dying bill means for the future of palliative care in the UK.
The death of Dame Esther Rantzen, who spent her final months campaigning publicly for a change in the law following her terminal cancer diagnosis, has brought renewed poignancy to the assisted dying debate. It comes as the campaign reaches what appears to be the end of the road in this Parliament.
MPs rejected the Terminally Ill Adults (End of Life) Bill on 11 September, by 286 votes to 270, and with no obvious parliamentary route forward, it looks unlikely legislation of this kind will return to the Commons before the next general election.
That wider conversation must continue, even if assisted dying isn’t to become UK law in the foreseeable future. Palliative care is an essential part of our healthcare system, and one that has too often struggled to win political attention. The debate brought the issue of palliative care to the fore. The challenge now is keeping it there, and with the autumn budget on 28 October, timing matters.
The reality behind the figures
According to Hospice UK’s financial benchmarking data, published in March 2026, nearly six in 10 English hospices have made or are considering cuts to frontline services. A Marie Curie survey of bereaved family carers across England and Wales in 2023 found nearly one in three people died with unmet palliative care needs, meaning unaddressed symptoms and insufficient GP support at the end of life.
For healthcare providers already managing rising demand and workforce pressures, gaps in palliative and end-of-life care have consequences across the system. When appropriate support is not available in the community, patients with life-limiting conditions may be more likely to rely on GPs, community nursing teams, urgent care and hospitals – including at times when their preference would be to remain at home or receive specialist hospice care.
This can add pressure at several points in the patient pathway. Hospital teams may be caring for patients whose needs could be better met in another setting, while difficulties arranging appropriate community support can complicate discharge. GPs, district nurses and other community services can face greater responsibility for managing complex symptoms and supporting families, often alongside already demanding caseloads.
Behind those statistics are individuals and families at one of the hardest points in their lives. For someone living with a life-limiting condition, good palliative care means pain control alongside emotional and practical support. For their families, it means guidance on what to expect and how best to support someone they love. Without it, patients can end up in hospital when they would rather be at home or in a hospice, and families are left to find their way through the system alone, often while exhausted and already grieving.
The budget should be part of a longer-term answer
On 28 October 2026, the government has its first real opportunity to show the attention on palliative care was more than a passing interest. Hospices are making difficult decisions now, and many rely heavily on charitable income to keep their doors open. For them, this budget really matters.
But a one-off injection of cash, welcome as it would be, isn’t the whole answer. The system needs sustained investment, and joined up, longer-term planning. Short-term relief doesn’t give hospices or NHS organisations the certainty to plan, hold on to specialist staff or build up the community and out-of-hours services that let people be cared for where they want to be. And dealing with it piecemeal, rather than holistically, risks entrenching all the problems of the current fragmentation.
Funding guarantees that last beyond a single year would make a difference, allowing services to plan around need rather than the next shortfall. Greater clarity about responsibilities across the system is also needed, so integrated care boards, NHS providers, local authorities and hospices aren’t left looking to one another to fill the gaps.
The government’s plans for a National Care Service recognise that care outside of hospital and the pressures facing the NHS are intertwined. Palliative care needs to be part of that same thinking. When people can access the right support at home, in the community or through a hospice, it can help them receive care in the setting that is right for them, while also avoiding unnecessary hospital stays and supporting smoother transitions between services.
For many people, palliative care comes too late, and earlier support with managing symptoms and maintaining their quality of life while living with serious illness is often needed. Getting that right means planning the NHS, hospices and social care as one system rather than three separate budgets.
The conversation can’t end with the vote
There is now a real risk that attention moves on. The pressures on hospices won’t ease because the parliamentary debate on assisted dying has finished, and neither will the needs of people approaching the end of life or the families supporting them.
So, the questions for policymakers are simple. Will care reform include a deeper look at how palliative care is funded and delivered? Will it prompt a closer look at the gaps between services and the people who need them?
It seems likely the issue of assisted dying will return to Parliament, even if not for a few years. When it does, will MPs still be saying that the law shouldn’t change until palliative care is ‘fixed first’?
Images: Ben Troke and Shutterstock
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