Top psychiatrists warn staff shortages could render Leadbeater Bill unworkable

A shortage of NHS psychiatrists seriously undermines Kim Leadbeater’s latest attempt to rescue her assisted suicide Bill, two eminent members of the profession have warned.

In a raft of hastily introduced amendments, the backbench MP sought to fix her controversial Bill by replacing her ‘ultimate safeguard’, of a High Court judge’s approval of a person’s request to be killed, with the decision of a three-member panel, comprising a social worker, lawyer and psychiatrist.

But Professor Allan House, Emeritus Professor of Liaison Psychiatry at the University of Leeds, and Professor Gareth Owen, Honorary Consultant Psychiatrist at King’s College London, have argued that there are too few psychiatrists to make it work.

Dispute

Drawing on the results of a Royal College of Psychiatrists’ membership survey on assisted suicide, Leadbeater claimed that there are “several thousand psychiatrists” ready to serve on panels – a claim disputed by Prof House.

He said that the survey’s ten per cent response rate made it impossible to “extrapolate”, and that there is likely to be “an order of magnitude” difference between those who support assisted suicide in principle, and those ready to help a patient kill themselves.

He explained: “In areas where studies have looked at how many doctors in general take part once assisted dying is legalised, such as in Oregon and Victoria, the figure is usually 1 to 2 per cent of all registered doctors.

“So, if we assume 1 per cent, we’re talking about 30 people across England and Wales. I am assuming the expectation is they are working at consultant level.”

Insufficient capacity

Prof House told The Daily Telegraph: “Does psychiatry have the capacity for this? Well, one of the other things that the Royal College census shows is that, across the UK, 28 per cent of all consultant jobs are either vacant or filled by non-substantive staff.

“So you are asking a profession that can’t fill a quarter of its consultant jobs with full-time consultants if they want to release 30 people to do this work… [I]s there sufficient capacity? It is not at all clear that there is.”

Prof Owen agreed, saying: “there is a difference between being open to this work in theory and the capacity to take it on: consultants have busy NHS job plans already and there are going to be new workforce demands, including the increased role for consultants in the revised Mental Health Act”.

The Royal College of Psychiatrist’s President, Dr Lade Smith, added: “We hope for further engagement with Parliamentarians on this Bill in the coming months as there are still a number of outstanding issues that need to be considered, including workforce shortages.”

Expertise ignored

Prof House and Prof Owen both gave evidence before the Committee selected by Leadbeater to examine her Terminally Ill Adults (End of Life) Bill.

In a letter to The Guardian, Prof House reflected that despite his “expertise in the interaction between severe physical illness and mental health”, his session “was interrupted by Leadbeater explaining to the committee that I and other witnesses didn’t understand the nature of suicide in life-limiting physical illness”.

He added: “the committee went on to ignore the advice of all three experts that the bill’s proposed medical assessment was inadequate”.

Lives not worth living

Prof House concluded: “The latest twist is Leadbeater’s proposal that a psychiatrist will be part of a panel that will review decisions made by two doctors whose assessment does not meet the standards recommended by her psychiatric witnesses.

“The rationale for this approach seems to be that the last months of life are so self-evidently not worthwhile that there is no need to ask about, or offer help with, possibly modifiable influences on the decision to seek assisted suicide.

“Therein lies the danger of the bill and the real reason for much opposition to it.”