Seòmar agus comataidhean

My amendments 255, 313 and 314 would require the preparation and publication of an independent review of the bill’s financial implications. I lodged versions of the amendments at stage 2, and I have lodged them at stage 3 because I do not believe that a satisfactory answer has been provided on the issues that they raise. Indeed, more information has been provided by the Government in the interim, since stage 2.

In my view, there is far too much that we do not know. We have discussed the fact that the bill lacks a financial model. Tonight and tomorrow, we will make decisions, as we have done in previous days, that will affect the overall costs.

As deputy convener of the Finance and Public Administration Committee, I was involved in scrutinising the original financial memorandum for the bill, which was found to be full of holes and significant underestimates. It was also found to be largely silent on key financial implications of assisted dying.

The Royal Pharmaceutical Society Scotland described the estimated cost of £80 per dose to end life as

“a huge underestimate of the actual cost”,

while the Royal College of Nursing said that the financial memorandum was

“largely silent on the resourcing implications for nursing, despite the Bill establishing a key role for registered nurses in the process.”

Compared with the number of people who had an assisted death in places such as Queensland, the financial memorandum appeared to the committee to vastly underestimate the number of people who would seek assistance to end their life in Scotland. In addition, we found that it did not take account of Scotland’s poor health record, which could lead to higher eligibility for assisted dying. Finally, and most critically—

I will be brief. What is Liam McArthur’s reaction to the letter from the cabinet secretary that came subsequent to stage 2, which clearly set out that putting the bill in place will require cuts to other NHS services?

Audrey Nicoll makes the fair point that any expansion of that service will come with more than the direct cost of providing care and that any scaling up of palliative care would take both time and resource. We all share an aspiration in that regard, but must consider the bill on the basis of what is in front of us when no money has been allocated for any of that—none.

No one here, whatever their political views, would question the considerable strain that our NHS is under or the fact that health budgets look set to be tight in the coming years, given the rising demand across Scotland. The Scottish Fiscal Commission is clear about that trajectory. We know that the money to pay for the bill will come from those resources, so Parliament would be neglecting its duties if it did not ensure robust financial oversight and scrutiny before the legislation is implemented.

My amendments would require Parliament and Government to acknowledge the significant costs that would be involved, to put that on the record, to approve spending and to say where that money should come from. I urge all members to support the amendments.

Turning briefly to other amendments in the group, I am happy to support the amendments from Audrey Nicoll, Douglas Ross, Bob Doris, Jackie Baillie, Sue Webber, Jeremy Balfour, Stephen Kerr and Miles Briggs because they all, in various ways, aim to increase data collection, which I think is essential. I urge members to vote against the amendment from Stuart McMillan.

Can Liam McArthur confirm whether a post-death review will be required in every case following the recording of a death and who, in those circumstances, will conduct the review? I ask that because, as the member may be aware, in the case of the Isle of Man bill, the lack of compulsory post-death reviews has been raised by the UK Ministry of Justice as being potentially non-compliant with human rights obligations under article 2 of the European convention on human rights. I would appreciate the member’s response on that.

Jackie Baillie might want to recognise that, in the 2026-27 budget, there is an increase in resource funding for palliative care, but it is to pay staff more money. The point that I made in my speech was that there is no resource to expand capacity in palliative care. Does Jackie Baillie recognise that?

I confirm that there was no such discussion, because that particular remedy was not known at the time that the financial memorandum was scrutinised by the Finance and Public Administration Committee. The implications have developed quite significantly in recent weeks—we heard the discussion last night about who knew what, where and when—but, certainly, the Finance and Public Administration Committee knew none of that information, as it was not available to us at that point in time.

I will come to members in a moment.

Despite Liam McArthur’s insistence that the bill should be accompanied by improvements in palliative care so that people would have a genuine choice, not a penny was identified in the financial memorandum for palliative care.

I will take an intervention from the Deputy First Minister.

Of course, my colleague Mr Mason, as a member of the committee, raised those issues at the time. I understand that there is a real sensitivity in how the issue is discussed and how that might imply something about motivations on one side of the debate or the other. I do not take a position on that. However, I understand that Mr Mason has strong feelings on the issue, and he is right to put on the record the concerns that he has at this time.

In my view, the report should be laid before the Parliament for scrutiny, and a vote should be taken on whether it would be approved as a recommendation on the system. That is my view on the amendment, as it was drafted.

A motion could be lodged and a vote taken on whether the Parliament accepted the conclusions of the review. That would give some kind of legitimacy to the system and its cost. I take Mr Hepburn’s point on that, however.

I will make some progress. The Scottish Government’s response to the revised financial memorandum gives me little confidence that many of the issues that I am raising have actually been addressed. Those issues were set out recently in a letter from the Cabinet Secretary for Health and Social Care to the Health, Social Care and Sport Committee on 26 February. As the delivery model for the bill remains unclear, the Government is warning us that

“any discussions around costs are, at this point, purely illustrative.”

The Scottish Government disagrees with many of the assumptions that have been made in the revised financial memorandum, such as that the provision of assisted dying would be “absorbed” into “existing budgets”. That is not the case, says the Government. The financial memorandum says that the bill would have “minimal” cost implications. That is not the case, says the Government. The memorandum says that data collection from Public Health Scotland would be

“minimal and covered by existing budgets”.

Again, the Government says that that is not the case.

It is abundantly clear that, even with a revised financial memorandum, Parliament has no idea how much the legislation would cost. The letter from Mr Gray also states that funding the costs would require “a degree of reprioritisation” and that negative impacts would be kept “to a minimum”. That would mean cuts to other parts of our NHS to pay the costs of this service—that is absolutely clear.

I will also comment on the fact that there is no mention of assisted dying in the budget for 2026-27, and nor is there in the Scottish spending review, which covers the next three years. In the discussion that we have just had, Mr Doris pointed out that he would like to see more funding for palliative care. Again, there is no additional money for the expansion of palliative care in the 2026-27 budget, and no money is earmarked for the expansion of palliative care in the Scottish spending review, which sets out the spending plans for this Government and the trajectory of spending for the next three years for whoever forms the Government after the election.

21:00

Promises have been made by both sides of the argument. People who are in favour of assisted dying say that we should have enhanced palliative care as an alternative to assisted dying, but there is no allocation of money. People who are opposed to assisted dying wish to see more and improved palliative care as a true alternative, but, again, no money has been offered. We should be fundamentally honest that there is no money. Of course, future Governments can change that position, but the spending plans of this Government are set and no additional money has been allocated for palliative care.