The first vote on the assisted dying bill is not only hugely consequential, it’s also hugely unpredictable and even as the vote draws near it still feels like it could go either way.
MPs will debate the bill, brought forward by Labour MP Kim Leadbeater, in parliament today before they get a free vote on the legislation.
There are a few reasons why the potential outcome of the vote is difficult to predict. Firstly, the last Commons vote on this issue was back in 2015. It was also a Private Members’ Bill and a free vote, that was defeated by 331 to 119 – 199 MPs didn’t vote and one abstained.
That may seem like a useful starting point to predict future results but there has been an unprecedented turnover of MPs since then.
It was less than a decade ago but over two-thirds of those MPs from 2015 are no longer in parliament. This means there’s no voting record that can help us out this time round.
Secondly, it’s a free vote so we can’t, as we usually would, look to the political parties to work out the numbers.
Every single one of the 650 MPs must make up their minds for themselves and they have all taken a slightly different approach to the process.
Image: How MPs have told Sky News they will vote on assisted dying
Some came out straight away and declared their position publicly. Some took their time and have only decided in the last few days, putting out statements on social media platforms.
There are also those who prefer to keep it to themselves, and some who are genuinely still undecided and will be until they walk through the voting lobbies.
So, to get a sense of what could happen, at Sky News we have been monitoring declarations as well as reaching out to every MP personally.
This has given us, on the eve of the second reading, an informative but still incomplete picture.
So far we have confirmed that 181 MPs will vote for the bill, while 148 say they will vote against, and 300 are either undecided or haven’t revealed their decision.
There are also 20 MPs that won’t vote – the SNP because the changes won’t apply in Scotland, Sinn Fein who don’t sit in Westminster, and the Speaker and Deputy Speakers.
Of those who will vote but whose position is still unknown, about two-thirds are Labour MPs – a big chunk of those are brand new.
This is the deciding cohort, who just a few months into their roles will make a life-or-death decision that will influence generations to come – no pressure.
Ms Leadbeater has said she hopes parliament will “show itself at its best” by voting in favour of the bill.
In a statement on Thursday night, she said: “I hope this parliament will also be remembered for this major social reform that gives people autonomy over the end of their lives and puts right an injustice that has been left on the statute books for far too long.
“People will be looking in on parliament as it debates this important change to the law – a change that, when we most need it, could bring comfort to any one of us or to somebody we love.”
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2:24
Lord Cameron to support assisted dying bill
What could make the difference?
Most MPs tell us they have been poring over the legislation line-by-line and listening intently to their constituents.
But beyond that, there are external factors that will no doubt have influenced their thinking.
Public opinion will be high on the list, with the latest YouGov poll – one of many – showing an overwhelming majority (73%) of the public are in favour of a change in the law.
The other will be how Cabinet ministers vote, with many high profile and respected names, Ed Miliband and Hilary Benn among them, coming out in favour.
Image: MPs will vote in the House of Commons on the bill
More controversial though are those who oppose the bill.
In particular, the Health Secretary Wes Streeting and the Justice Secretary Shabana Mahmood have made the news with their views.
They will both have to take a leading role in implementing the legislation if it passes.
He also ruffled feathers among colleagues when he appeared to breach the etiquette around free votes, by repeatedly raising concerns around extra pressures on the NHS and making the case for improving palliative care instead.
Image: Health Secretary Wes Streeting changed his mind on the issue. Pic: PA
Mr Streeting’s position and approach have made the bill’s supporters nervous that new MPs will fall in behind him.
In contrast, other big beasts – the prime minister, the chancellor and the foreign secretary – remain silent on which way they will go, aware that their opinions could sway the result.
As it stands, after all the number crunching, it looks likely that this landmark legislation will pass the second reading.
But with so many unknowns, both sides will feel that even at this late stage, it’s still impossible to call.
They were former classmates who both died after receiving care from the same mental health hospital three years apart.
Warning: This article contains reference to suicide
Multiple failings led to the death of 22-year-old Alice Figueiredo – who took her own life in July 2015 – and the NHS trust responsible for her care was charged with corporate manslaughter.
Last week, following a months-long trial, the trust was found not guilty of that charge but was convicted of serious health and safety failings.
Karis Braithwate, who had gone to school with Alice, also died in 2018, having been treated by the same NHS trust.
Reports seen by Sky News detail a decade of deaths at North East London NHS Foundation Trust (NELFT), with coroners repeatedly raising concerns about the mental health services provided by the trust – in particular at Goodmayes Hospital in Ilford.
Rushed assessments and neglect were often cited. One patient was marked as alive and well, even though he had taken his own life inside the hospital the previous day.
Another patient told staff he was hearing voices telling him to kill himself, yet staff did not remove crucial items from his possession – items he would later use to take his own life.
Karis, 24, was sent to Goodmayes Hospital after she tried to take her own life at a train station in October 2018. The next day, staff spent 27 minutes assessing her and a further two minutes confirming their conclusion.
Image: Alice Figueiredo (L) and Karis Braithwaite (R) died in 2015 and 2018 respectively
She was discharged from hospital in the afternoon. She then went to a nearby railway station and took her own life. Her death came less than an hour after she had left the hospital.
Karis had been friends with Alice, her mother said. The pair had been classmates at the same school.
Karis told her mother she was upset at being put on the same ward where Alice had taken her own life three years earlier.
Her stepfather Mark Bambridge called Karis sweet and kind and said she often “struggled with life”. He felt relief when she was taken to hospital, saying: “She was in a place where she would be taken care of.”
Image: Mark Bambridge said Karis was a sweet and kind girl
Karis’s mother – who asked not to be named – said her daughter confided in her about the neglect she endured at the hospital.
Karis told her mother that her carer would sleep when they were supposed to be watching over her and said she never felt safe.
“She spoke of her belongings going missing, of being treated with indifference and disrespect, and of staff who showed little concern for her wellbeing,” her mother said.
Karis’s mother said her daughter was failed by the hospital and the family was offered only a “hollow, superficial and indifferent ‘apology’ from the administration team of those who were meant to protect her”.
In the wake of the verdict in Alice’s case, Karis’s mother said: “I am holding Alice’s family in my thoughts and praying they receive the justice they – and we – so clearly need and deserve.”
A spokesperson for NELFT called Karis’s death a “profound tragedy” and said the trust had conducted an in-depth review of patient safety since 2018, “resulting in significant changes in the way we assess risk of suicide”.
“We train our staff to consider the trauma in a patient’s history, rather than focusing solely on their current crisis,” the spokesperson added.
“This approach allows us to see the person behind the diagnosis, making it easier to identify warning signs and support safe recovery.”
The trust said it had also improved record-keeping and communication between emergency workers and mental health practitioners.
The man marked as alive after he’d died
Sky News looked at more than 20 prevention of future death reports, which are written by a coroner to draw attention to a matter in which they think action could be taken to prevent future deaths.
Behind each report is a different person, but there are some strikingly similar themes – failure to carry out adequate risk assessments; issues sharing and recording information; neglect.
One report said staff at Goodmayes Hospital “panicked and did not follow policy” in the wake of a man’s death in 2021, instead writing that he was still alive when he had died the day before.
Speaking in response at the time, the trust said it had written a “detailed action plan” to address concerns raised.
Another report said one woman developed deep vein thrombosis after she was left to sit motionless in her room. She had not eaten or drunk anything in the two days before her death, and the trust was criticised for failing to record her food intake.
Responding to the report at the time, the trust said it had implemented new policies to learn from her death.
Issues stretched beyond Goodmayes Hospital and spanned the entire NHS trust.
One man was not given any community support and overdosed after his access to medication was not limited.
Another man, a father of three, was detained under the Mental Health Act but released from Goodmayes after just a few hours. The 39-year-old was found dead two weeks later after being reported missing by his family.
At his inquest, a coroner raised concerns about the lack of a detailed assessment around him, with a junior doctor saying he was the only doctor available for 11 wards and 200 patients.
‘Don’t kill yourself on my shift’
It has been 10 years since Alice took her own life inside the walls of Goodmayes Hospital. But current patients say the issues haven’t gone away.
Teresa Whitbread said her 18-year-old granddaughter Chantelle was a high suicide risk but she still managed to escape from the hospital “20 times”.
“I walked in one day and said, ‘Where is Chantelle?’, and no one could tell me,” she told Sky News.
Image: Teresa Whitbread does not want her granddaughter to return to Goodmayes Hospital
On another occasion, Chantelle managed to get into the medical room and stabbed herself and a nurse with a needle.
She said one nurse told her granddaughter: “Don’t kill yourself on my shift. Wait until you go home and kill yourself.”
Teresa grew emotional as she talked about her granddaughter, once a vibrant young girl and avid boxer, whose treatment is now managed by community services.
“It’s made her worse,” Teresa said of Chantelle’s experience at Goodmayes Hospital. “There’s no care, there’s no care plan, there’s no treatment.”
The NEFLT said it could not comment on specific cases but added that “patient safety is our absolute priority, and we work closely with our patients and their families to ensure we provide compassionate care tailored to their needs”.
Chantelle’s family say she is a shell of her former self and have begged mental health services not send her back to Goodmayes.
“Something has to change, and if it doesn’t change, [the hospital] needs to be closed down,” Teresa said.
“Because people are not safe in there.”
Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK
Labour MP Kim Leadbeater, who proposed the legislation, was seen crying in the chamber as it went through.
Campaign group Dignity in Dying hailed the result as “a landmark moment for choice, compassion and dignity at the end of life”.
“MPs have listened to dying people, to bereaved families and to the public, and have voted decisively for the reform that our country needs and deserves,” said Sarah Wootton, its chief executive.
The bill will now go to the House of Lords, where it will face further scrutiny before becoming law.
Due to a four-year “backstop” added to the bill, it could be 2029 before assisted dying is actually offered, potentially coinciding with the end of this government’s parliament.
The bill would allow terminally ill adults with fewer than six months to live to apply for an assisted death, subject to approval by two doctors and a panel featuring a social worker, senior legal figure and psychiatrist.
Image: Campaigners with Dignity in Dying protest in favour of the assisted dying bill. Pic: PA
Ms Leadbeater has always insisted her legislation would have the most robust safeguards of any assisted dying laws in the world.
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3:35
MP: ‘Surreal’ moment as assisted dying passes Commons
Opening the debate on Friday she said that opposing the bill “is not a neutral act. It is a vote for the status quo”.
She warned that if her plan was rejected, MPs would be asked to vote on it again in 10 years and “that fills me with despair”.
MPs have brought about historic societal change
A chain of events that started with the brutal murder of an MP almost 10 years ago has today led to historic societal change – the like of which many of us will never see again.
Assisted dying will be legalised in England and Wales. In four years’ time adults with six months or less to live and who can prove their mental capacity will be allowed to choose to die.
Kim Leadbeater, the MP who has made this possible, never held political aspirations. Previously a lecturer in health, Ms Leadbeater reluctantly stood for election after her sister Jo Cox was fatally stabbed and shot to death in a politically motivated attack in 2016.
And this is when, Ms Leadbeater says, she was forced to engage with the assisted dying debate. Because of the sheer volume of correspondence from constituents asking her to champion the cause.
Polls have consistently shown some 70% of people support assisted dying. And ultimately, it is this seismic shift in public opinion that has carried the vote. Britain now follows Canada, the USA, Belgium, Switzerland, the Netherlands and Australia. All countries with sophisticated health systems. Nowhere has assisted dying been reversed once introduced.
The relationship between doctor and patient will now also change. The question is being asked: Is an assisted death a treatment? There is no decisive answer. But it is a conversation that will now take place. The final answer could have significant consequences, especially in mental health settings.
There are still many unknowns. Who will be responsible for providing the service? The NHS? There is a strong emotional connection to the health service and many would oppose the move. But others will argue that patients trust the institution and would want to die in its arms.
The challenge for health leaders will be to try and reconcile the bitter divisions that now exist within the medical community. The Royal Colleges have tried to remain neutral on the issue, but continued to challenge Ms Leadbeater until the very end.
Their arguments of a failure of safeguards and scrutiny did not resonate with MPs. And nor did concerns over the further erosion of palliative care. Ms Leadbeater’s much-repeated insistence that “this is the most scrutinised legislation anywhere in the world” carried the most weight.
Her argument that patients should not have to fear prolonged, agonising deaths or plan trips to a Dignitas clinic to die scared and alone, or be forced to take their own lives and have their bodies discovered by sons, daughters, husbands and wives because they could not endure the pain any longer was compelling.
The country believed her.
The assisted dying debate was last heard in the Commons in 2015, when it was defeated by 330 votes to 118.
There have been calls for a change in the law for decades, with a campaign by broadcaster Dame Esther Rantzengiving the issue renewed attention in recent years.
Supporters have described the current law as not being fit for purpose, with desperate terminally ill people feeling the need to end their lives in secret or go abroad alone, for fear loved ones will be prosecuted for helping them.
Ahead of the vote, an hours-long emotionally charged debate heard MPs tell personal stories about their friends and family.
Maureen Burke, the Labour MP for Glasgow North East, spoke about how her terminally ill brother David was in so much pain from advanced pancreatic cancer that one of the last things he told her was that “if there was a pill that he could take to end his life, he would very much like to take that”.
She said she was “doing right by her brother” in voting for it.
How did MPs vote?
MPs were given a free vote, meaning they could vote with their conscience and not along party lines.
The division list shows Prime Minister Sir Keir Starmer voted in favour of the bill, but Conservative leader Kemi Badenoch voted against.
Health Secretary Wes Streeting and Justice Secretary Shabana Mahmood, who will have to deliver the bill, also voted no.
Opponents have raised both practical and ethical concerns, including that people could be coerced into seeking an assisted death and that the bill has been rushed through.
Veteran Labour MP Diane Abbott said she was not opposed to the principle of assisted dying but called the legislation “poorly drafted”.
Former foreign secretary James Cleverly echoed those concerns, saying he is “struck by the number of professional bodies which are neutral on the topic of assisted dying in general, but all are opposed to the provisions of this bill”.
Recently, the Royal College of Psychiatrists, the Royal College of Pathologists and the Royal College of Physicians have raised concerns about the bill, including that there is a shortage of staff to take part in assisted dying panels.
However, public support for a change in the law remains high, according to a YouGov poll published on the eve of the vote.
The survey of 2,003 adults in Great Britain suggested 73% of those asked last month were supportive of the bill, while the proportion of people who feel assisted dying should be legal in principle stood at 75%.
In November, the bill passed its second reading by a majority of 55, more than twice as large as today. It then went to “committee stage”, during which the wording and implications were examined in detail, and tweaked with input from experts, stakeholders and the public.
That amended bill will now be passed on to the House of Lords, where it will go through a similar process before being either passed back to the Commons with further amendments, or sent to the King for Royal Assent.
Only after both houses agree on the exact wording of the bill does it become law.
Who changed their vote since November?
A total of 56 MPs voted a different way today, compared to how they did in November. There were 11 who changed to yes, while 24 changed to no. There were also 21 MPs who voted last time who chose to abstain today.
Among those who chose to change their vote were foreign secretary David Lammy and culture secretary Lisa Nandy. Mr Lammy had voted against the bill in November, while Ms Nandy voted in favour. Both chose not to vote today.
Only one MP, Labour’s Jack Abbott, voted in favour today after voting against at the second reading.
Prime Minister Sir Keir Starmer has voted in favour of the bill on both occasions, as has Chancellor Rachel Reeves and former prime minister Rishi Sunak.
The health secretary, Wes Streeting, who will have a crucial role in implementing the legislation if it becomes law, has voted against the bill both times, as has Angela Rayner, the deputy prime minister, and opposition party leaders Kemi Badenoch and Nigel Farage.
Lib Dem leader Ed Davey voted against the second reading, but chose not to vote today.
They were among 43 MPs in total who did not vote this time, including the Speaker and his Deputies. That’s slightly lower than the 46 MPs who abstained during the second reading vote in November.
Overall, a clear majority of Labour MPs supported the bill, while most Conservatives voted against it.
What do the public think?
Pollsters YouGov asked people if they were in favour of assisted dying or against, before November’s second reading and again last month.
On both occasions, a majority said they approved of the policy becoming legal, both in principle and in practice.
The Data and Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done.