Brexit and the waning days of the United Kingdom

[Duque de Bragança]

Do other European countries have this problem with deportation?
I know nothing but am dubious.

Going by Sheilbh's example, replace Pakistan by Algeria, and the UK by France. 

Also, Sheilbh agrees with Zemmour, RN and the right of the right, regarding visas. 

[Tamas]

Another assisted dying rant, on something from this article: https://www.theguardian.com/society/2025/jun/19/uk-behind-curve-on-assisted-dying-among-progressive-nations-says-kim-leadbeater

Carden, who leads the Blue Labour group of MPs, told the Guardian he would vote against, having previously abstained. "Legalising assisted suicide will normalise the choice of death over life, care, respect and love," the MP for Liverpool Walton said. "I draw on my own family experience, caring for my dad who died from lung cancer three years ago.

"I genuinely fear the legislation will take us in the wrong direction. The values of family, social bonds, responsibilities, time and community will be diminished, with isolation, atomisation and individualism winning again."

Gallantly ignoring the point that individualism is something to frown upon, apparently, his argument is infuriatingly the exact opposite of what he is trying to say.

Suicide is not illegal. Assisting it is. Responsibility, community, family, social bonds are arguments FOR the fucking bill, not against it. It is about helping those in dire need to end their life being spared suffering, and to preserve a modicum of their humanity.


I believe at the core of this opposition is people refusing to face death as a concept, in particular the certainty of it. That no matter what that's the end for everyone.

[Grey Fox]

What does he mean by atomisation? 

[Sheilbh]

I'm not sure there's much point in me getting into it as we disagree quite profoundly on this.

But I look at the groups that have come out against this bill or expressed very severe reservations and I don't think it's because they can't face death. It includes basically all disabilities and palliative care groups in the country, including the Association for Palliative Medicine of Great Britain and Ireland, the Royal College of Psychiatrists, the Royal College of GPs, the Royal College of Physicians, the National Bereavement Alliance, the British Association of Social Workers, the Centre for Women's Justice, various race equality groups in healthcare.

I don't think these associations, or their members, refuse to face death - I think they often are people who face it more than most. I've mentioned before that the MPs with most exposure to caring - like Sir Ed Davey, leader of the Lib Dems who was carer for his mother for five years as a teenager while she died as well as caring, with his wife, for their severely disabled son, or Angela Rayner (who I like a lot generally), whose professional background was in caring.

They are all raising very significant concerns about this legislation and its sponsors voted down every single amendment to address them. And, frankly, Kim Leadbetter in Parliament and in the press for the final push either doesn't understand her bill or is lying about it. But I think the big problem is that people who support have not been able (or, perhaps, willing) to understand why anyone could or would have concerns.

To my mind, as it is at the minute, there will be coercion and social pressure. There will be probably be an over-eager NHS Trust. I expect it'll disproportionately affect the poor and the disabled and quite probably Black Britons. And we'll end up in 10-20 years with a national scandal followed by an inquiry no doubt repeating what Baroness Casey wrote in her report last week: "blindness, ignorance, prejudice, defensiveness and even good, but misdirected intentions, all played a part in this collective failure".

I mean a huge part of addressing my concerns would be, as Gordon Brown argued over the weekend, simply doing the palliative care and social care reforms first. I think starting to provide assisted dying when the palliative and social care systems are still broken is going to have predictable consequences.

[HVC]

I once more pledge my support for Tamas but I'm tired* so I'll leave it at that


*insomnia sucks.

[crazy canuck]

I mean a huge part of addressing my concerns would be, as Gordon Brown argued over the weekend, simply doing the palliative care and social care reforms first. I think starting to provide assisted dying when the palliative and social care systems are still broken is going to have predictable consequences.

What do you mean by social care systems, and what is broken in palliative care?

[Sheilbh]

What do you mean by social care systems, a

Adult social care is broadly personal care for adults who need it - mainly through old age, disabilities, mental health problems. Some of it is provided in the home (I have a 90+ year old uncle who has daily visits from a nurse to help for example) but for those with most need it will be through the provision of residence in a care home.

It is a system under huge pressure because we have an ageing population. It's largely provided by private sector care homes (often in re-purposed B&Bs or hotels) but is broadly funded by the state, particularly local government. Broadly if you've got assets over £100,000 then you need to pay for your own care, everyone under that receives a sliding scale of local authority support until £20,000 at which point you don't have to contribute anything and it's fully funded and there's also a on what individuals will ever have to pay - so you'll never have to pay more than about £85,000 for care.

It's hugely broken. So in some local authorities adult and children's social care is now taking up to 60-80% of their budget. There's funding issues and systemic problems. There have been multiple reports commissioned by various governments since 2005 that have not been acted on. And both parties have proposed some reforms to inheritance tax nationally to fund some form of social care service (or insurance) - Labour under Gordon Brown and the Tories under Theresa May. Obviously both of those parties did poorly in their elections and their care proposals were attacked by the other side as a "dementia tax" - which I think has made it a political third rail. Everyone knows it's a problem, no-one really wants to deal with it.

I'd add there's also been specific issues with care homes in covid. They were the epicentre of covid deaths especially in the first wave. And one of the worst decisions made was Matt Hancock as Health Secretary basically trying to create space in hospitals in the first wave by moving people from hospitals into care homes without adequate testing. It was a disaster.

and what is broken in palliative care?

There's just been a report on it - referred to by Brown:
https://palliativecarecommission.uk/

But key points from Brown's piece:

Every year, more than 600,000 people die in the UK. It is estimated that between 75% and 90% of them should have the benefit of palliative care, and that 100,000 terminally ill people do not receive the palliative care that they need. The charity Cicely Saunders International estimates that demand for this type of care is expected to rise by 42% by 2040. Access to such care is perhaps the country's worst and least defensible "postcode lottery", a person's fate depending on whether there is hospice help nearby and whether places or home care are available.

[...]

Better end-of-life care is surely the priority. Last year Hospice UK, which represents more than 200 hospices, said that one in five were warning of cuts to services, and this year the position seems worse. Just last month, for example, the Kirkwood hospice in Huddersfield announced it has been forced to cut its beds from 16 to 12, as well as reducing home support, with the result it will serve 800 fewer patients each year. This is now a pattern – from St Giles in Lichfield, St Catherine's in Crawley, to Birmingham Hospice and Hospiscare in Exeter. Late last year, Hospice UK estimated that 300 beds in England are out of use because of insufficient funding. And with integrated care boards required to manage their expenditure within funding constraints set nationally, only about 60% of NHS hospitals provide seven-day on-site specialist palliative care, and only a third of localities have out-of-hours access.

We don't yet know whether, and for whom, the government will be prepared to cover 100% of the costs of assisted dying. What we do know, however, is that, on average, a hospice patient is publicly funded for barely a third of his or her costs. And so MPs are being asked to pass a bill in the full knowledge that, whenever it is implemented, the services available to all those who would prefer assisted living to assisted dying are inadequate. "The lack of a cohesive national strategy for effective palliative care delivery has resulted in fragmentation of specialist palliative care services," said the recently published commission on end-of-life care, "with inequity of provision, confusion over who takes responsibility for each patient, and lack of advice and support to the public and to staff in all services."

[Tamas]

I consider concerns from disabled people valid as in something to pay attention to and consider even if misguided and incorrect. Palliative care companies / organisations I dismiss as organisations with financial interest in not letting people choose graceful death.

[Sheilbh]

I consider concerns from disabled people valid as in something to pay attention to and consider even if misguided and incorrect. Palliative care companies / organisations I dismiss as organisations with financial interest in not letting people choose graceful death.

So I think to turn your comment on you - I think maybe you've got a particular view on facing death, which is perhaps not shared by everyone. Not that they're not facing it but having done that would still choose to live if help and support were available to them.

[Tamas]

I consider concerns from disabled people valid as in something to pay attention to and consider even if misguided and incorrect. Palliative care companies / organisations I dismiss as organisations with financial interest in not letting people choose graceful death.

So I think to turn your comment on you - I think maybe you've got a particular view on facing death, which is perhaps not shared by everyone. Not that they're not facing it but having done that would still choose to live if help and support were available to them.

Yes and they will be free to do so. The coercing argument is an extremely weak one when compared against the suffering people are coerced (by law) to endure just so a drastically smaller number of people do not run the risk of being coerced into choosing assisted dying and then actually managing to fall through all the fail safe mechanisms.

It is the opponents of assisted dying who forcefully remove agency, not the supporters of it.

[Sheilbh]

Yeah I think that's the philosophical debate to an extent.

On the on hand agency, which I'd say is advanced by those who are used to exercising agency and autonomy and have a liberal subjectivity, for example many MPs or Esther Rantzen and her daughter. On the other hand I think there's people who are concerned that many people in our society do not meaningfully exercise agency or autonomy.

There is coercive control (particularly by men in relationships with women), there is social and racial inequality (especially in healthcare) and not everyone has access to good palliative or hospice care - certainly not if they can't pay for it. If you live in one of the two-thirds of NHS regions without out-of-hours palliative care, or in the 40% without seven day care - how is that a choice for someone? If they need that care it will not be available, but assisted dying will (indeed one of the amendments they rejected was allowing hospices to opt out of providing assisted dying).

Obviously I sympathise more with that side. My entire point would be questioning who it is agency for. So I think it is a trade off of whether the ability for some to exercise agency outweighs the risk for others to go into assisted dying.

I'm not opposed to assisted dying in principle but I think it needs to be a legitimately free and equal choice for all - a positive freedom, not just decriminalising. And as I say I am very dismayed that the sponsors of the bill have rejected literally every amendment proposed to help address those concerns (e.g. anorexia is not excluded from assisted dying, the assessment of coercive control is a 50%+1 assessment of mental capacity - not coercion) - or saying proposals for assisted dying will follow implementing the recommendations of the cross-party End of Life Commission. I'd also add that at the first reading they said that the flaws in the bill can be addressed at the second reading, then at the third reading, now in the House of Lords (who don't really amend private member's legislation) - it's really not good enough for something this important and part of the problem is precisely that they've refused to consider any amendments that would help fix those flaws (and in my view they want those flaws because it makes the bill a bit looser - but they're won't make that argument because they need to big up the safeguards).

[crazy canuck]

Sheilbh, thank you for describing those matters.  That is a troubling context in which the legislation is being passed. 

[Sheilbh]

Totally separately - pleased to see my local MP has resigned from her ministerial role in order to vote against the whip against the governments proposed cuts to disability benefits.

[Tamas]

If the person has to have less than 6 months to live, how can anorexia qualify without being explicitly banned?

[crazy canuck]

Somewhat related, Runciman"s series on the history of bad ideas examined austerity

https://podcasts.apple.com/ca/podcast/past-present-future/id1682047968?i=1000712932913