The decision to provide assisted dying through the Welsh NHS will rest with the Senedd, Wales’ Health Secretary has confirmed, though services may still be available privately if the law changes.
Speaking to the Senedd’s Health and Social Care Committee on 16 July, Welsh Health Secretary Jeremy Miles clarified the Welsh Government’s role in implementing the proposed Terminally Ill Adults (End of Life) Bill, which would legalise assisted dying for mentally competent adults with a terminal illness and is currently progressing through Parliament and is due to be debated in the House of Lords on 12 September. If approved, it would become law in England and Wales.
Although the power to enact the Bill rests with Westminster, decisions about service provision in Wales, such as whether NHS Wales can offer assisted dying, fall within devolved health powers. As a result, the Welsh Government would only be able to implement assisted dying through the NHS if the Senedd agrees.
“If the [Welsh] Government wanted to [implement it], and the Senedd didn’t want to approve it – the Senedd would have that ability as well,” Mr Miles said.
Conservative MS Peter Fox, Chair of the Health Committee, sought clarity on whether assisted dying services could be offered through NHS Wales if ministers chose not to lay the necessary regulations.
“If they are not made by the Welsh Government and consequently approved by this Senedd, the NHS in Wales will not be able to provide assisted dying services – is that the case?”
“That is correct,” Mr Miles replied.
He also indicated that decisions about NHS provision would likely be made after the next Senedd election, scheduled for May 2026.
However, the Health Secretary suggested that even without NHS provision, assisted dying could become available in Wales through the private sector, as is the case in other jurisdictions around the world.
This distinction between the legal framework and public service provision has prompted renewed questions about how equitable access will be ensured across the UK.
The former Welsh First Minister, Mark Drakeford, recently raised his own concerns about ensuring assisted dying is accessible in all parts of the UK. Speaking at the Humanists UK convention in Cardiff, he said “I would much rather [assisted dying] was one of those things that we did on a UK-wide basis”. He went on to warn of “the unintended consequences there would be if assisted dying was available in Wrexham but not available in Chester.”
Graham Winyard, Director of My Death, My Decision, says:
“It would be deeply unjust for people in Wales to be denied access to assisted dying through the NHS while people in England are supported to die on their own terms. Without NHS provision, those who cannot afford private services ,or who are too unwell to travel, may be left without any meaningful choice at the end of life.
Right now, some people are forced to make the traumatic and expensive journey to Switzerland to have the dignified death they deserve. It would be no fairer and no less cruel if people in Wales were forced to travel across the border to England instead.
We hope that whoever is in Government in Wales after the May election will ensure that everyone facing a terminal illness, regardless of where they live or what they earn, is treated with the compassion, dignity, and respect they deserve.”
Before the election, Members of the Senedd will have a say on a Legislative Consent Motion (LCM), a formal vote used when Westminster legislates on devolved matters. Although not legally binding, such motions carry significant political weight under the Sewel Convention, which states that the UK Parliament will “not normally” legislate on devolved matters without consent.
Mr Miles confirmed that the outcome of this vote would influence the Welsh Government’s next steps.
The Senedd has previously voted against the principle of assisted dying — most recently in 2023, by 26 votes to 19, with 9 abstentions. A similar motion was rejected in 2014. However, the current Bill is more narrowly drawn, applying only to mentally competent adults with a terminal illness, and includes a clear legal framework and strict safeguards.
Notes:
Members of the MDMD team, as well as individuals affected by the current law on assisted dying, are available for interview upon request
For further comment or information, media should contact Nathan Stilwell at nathan.stilwell@mydeath-mydecision.org.uk or phone 07456200033.
Media can use the following press images and videos, as long as they are attributed to “My Death, My Decision”.
My Death, My Decision is a grassroots campaign group that wants the law in England and Wales to allow mentally competent adults who are terminally ill or intolerably suffering from an incurable condition the option of a legal, safe, and compassionate assisted death. With the support of over 3,000 members and supporters, we advocate for an evidence-based law that would balance individual choice alongside robust safeguards and finally give the people of England and Wales choice at the end of their lives.
