Meeting of the Parliament 06 November 2025
I thank Paul Sweeney for lodging the motion and so, for the second year running, leading this debate in Parliament. It has become a significant annual debate about an important annual report published by Marie Curie—and this year once again produced in collaboration with Loughborough University. The report is above all else about the way we live with terminal illness, and I say “we” because it could happen to any of us at any time—and I say “we” because we do not live as individuals or as consumers in a market; we live as citizens in a society, in a community where we look out for each other.
The preliminary findings also compel us to examine the world in which the Assisted Dying for Terminally Ill Adults (Scotland) Bill, which has been back before Parliament again just this week, is conducted. I cannot help thinking about the inverse care law—that those in the most need of support are oftentimes the ones least likely to receive it—and about how poverty and deprivation fuel conditions like clinical depression, how the suicide rate in our most deprived communities is two and a half times that of our least deprived communities and how, as the Association for Palliative Medicine has warned,
“palliative care is underfunded and unevenly available.”
Assisted dying, it concludes,
“risks deepening inequalities for vulnerable groups”.
That is why its members overwhelmingly oppose it, as do I.
Replying to the debate on the 2024 report by Marie Curie last December, the Minister for Public Health and Women’s Health told us that
“The Scottish Government is assessing the report and looking at where we can make changes.”
But the preliminary findings from this year’s report are absolutely clear—that end-of-life poverty has stagnated and has not improved between 2019 and 2024, despite some policy efforts, and in some areas, it has worsened. In the local authority areas that I am elected to represent in this Parliament—North Lanarkshire, South Lanarkshire and Falkirk—it has stagnated, with an average of one in four people of working age and one out of six people of pensionable age still dying in poverty. As we know from the findings of previous years’ reports, if you are from a black, Asian or minority ethnic background and living in Scotland, you are twice as likely to die in poverty than if you are white.
Last year in the debate, the minister also proclaimed:
“I believe that we have to approach the issue from a very non-political perspective and work together to get the best results for the people of Scotland.”—[Official Report, 5 December 2024; c 45, 47.]
Now, I am happy to work together, but this is highly political. We have grotesque poverty in the midst of obscene wealth.
These findings are not just about poverty; they are about inequality—a sordid inequality of not just income and not just wealth but a sordid inequality of power, which is class based. As long as we have an economy largely driven by the market and primarily run for the accumulation of wealth, and as long as we have a society that is self-evidently riven with class divisions, we will never end poverty.
That is why we need not just welfare interventions as amelioration; what we need is a decisive, an irreversible and a permanent shift in the balance of wealth and power, because these inequalities are structural. So we need radical action and fundamental change—economic as well as political change—with a change in economic relations and so power relations. We need a new equilibrium. That is the only way we will change the material conditions, the quality of life and the fate of the people we are sent here to represent.
17:22