Meeting of the Parliament 12 March 2026 [Draft]
That is not what I am saying, and perhaps I will be able to clarify that a bit more as I go on.
By creating a specialised opt-in service, we allow clinicians who feel able and willing to participate to develop the expertise, training and professional resilience required for that sensitive work. That answers Ross Greer’s question—they can opt in. Concentrating the experience in that way ensures that patients are supported by professionals who are confident, well prepared and equipped to manage the clinical and ethical complexity involved.
It is important to emphasise that a specialised service does not mean creating something outside the NHS, nor does it necessarily require new buildings or separate facilities. Such services could—and, in my opinion, should—be community-based and delivered either in or close to the patient’s own home. What distinguishes a service is not the building that it sits in but the dedicated teams that provide it. Those teams could bring together a multidisciplinary group of professionals who are capable of supporting the whole person—their physical needs or emotional and psychological wellbeing, their social circumstances and the needs of their family.
The reality is that any assisted dying provision would be a deeply human process that would affect patients, loved ones and professionals alike. Families may require support before the process, during it and afterwards, through bereavement. Patients need time to explore their choices, fears and circumstances. That level of care requires co-ordination, continuity and expertise, and a specialised service allows for exactly that. It would enable dedicated teams to support patients through the entirety of their journey, ensuring consistency, trust and a continuity of care. At the same time, a patient’s own GP could continue to provide all other aspects of care, ensuring that their existing relationship with primary care remains intact.
Such a model would also protect the workforce. The emotional weight and time commitment associated with assisted dying must not be underestimated. A dedicated service would allow for protected time and the provision of mandatory training and appropriate psychological support for the professionals involved. That is far more difficult to guarantee if the responsibility is dispersed across thousands of GP practices. I think that such a set-up would go a long way towards addressing many of the concerns that members have shared over the past couple of days. I will not go over all of them again, but some of them could be addressed by a single service.
There is also the question of expertise. Based on current estimates—I think that this has been highlighted already—most GPs would only rarely encounter an assisted dying request. That makes it extremely difficult to build the experience and confidence that are needed to navigate such a complex process. In this chamber, we regularly hear about the importance of enabling healthcare professionals to gain experience in relation to specialist work rather than distributing that work thinly across the system. The same principle should apply here.
To answer Jeremy Balfour’s point, it is true that a specialist service might require greater investment. I do not know what those figures might be, but I believe that, when we are legislating for something that would have such profound implications for individuals and families, cost alone cannot be the deciding factor. Safety, expertise and dignity must come first. However, on the issue of cost, I would say to Jeremy Balfour that I do not see such a system being set up separately from what health boards have just now.
My amendment would also allow assisted dying services to sit as a delegated responsibility within Scotland’s integration authorities and our health and social care partnerships, strengthening links with palliative care, social services and community support. That approach would not only improve co-ordination but also ensure that multidisciplinary expertise is built into the system from the outset.
Members may wish to note that my amendment 250 is supported by the Association of Palliative Care Social Workers, the Royal College of General Practitioners, the Royal College of Nursing, the Scottish Association of Social Work and Social Work Scotland. It has good and credible support from many organisations representing the people who would be working in such a system.