The shift in parliament from driving access to health and care to shaping it around needs, values and lives

Last week, Parliament passed two major votes on abortion and assisted dying – one a Private Member’s Bill, the other an amendment to Government legislation – within the space of four days.  

MPs voted 379 to 137 in favour of decriminalising abortion in England and Wales, supporting an amendment tabled by Tonia Antoniazzi to the Government’s Criminal Justice Bill. Three days later, they backed Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill, creating a statutory route to assisted dying for patients with fewer than six months to live.  

These votes have captured widespread attention, prompting debate across the health sector and beyond. They reflect a broader shift in Parliament’s willingness to legislate on personal autonomy and the right to healthcare, with a growing appetite for rights-based reform being driven from the backbenches.  

So what does this mean for the debate around our health and policy development moving forwards? 

With the largest ever intake of first-time MPs, many of them younger and drawn from more diverse professional and social backgrounds, this Parliament appears to be more willing to engage on socially complex issues and challenge long-standing policy taboos. This could have long term implications for health and care services and how we design policy accordingly. 

Until recently, health policy discussions have largely centred on access: who gets care, how quickly, and at what cost. But these two votes mark a shift away from just access to services, towards agency over how and when those services intervene. One empowers women by removing the threat of criminal prosecution from those ending a pregnancy. The other seeks to give patients with terminal diagnoses greater control and dignity in relation to the end of their life. Together, the two reforms bookend the life course – framing healthcare decisions in terms of choice and trust. 

Polling has shown public support for these reforms, particularly for the decriminalisation of abortion, which is less of a radical leap than an overdue modernisation. The fact that Parliament has caught up says as much about changing political culture as it does about the issue itself. 

Still, last week’s votes have reignited an important question around what autonomy really means in practice, and whether our legislative and health system processes are set up in a way to deliver this effectively. Disability rights campaigners have raised concerns that legalising assisted dying without stronger safeguards or proper investment in end-of-life and social care could, in fact, reduce choice. Wes Streeting, who has made his position clear, has argued that without properly funded palliative care and social support some may feel pressure to consider assisted dying not out of autonomy, but out of a lack of a better option.  

A similar tension has played out in abortion policy. Northern Ireland decriminalised abortion in 2019, yet gaps in service provision continue to undermine access. Many women still face significant barriers due to patchy commissioning, limited local provision and the absence of clear regional care pathways. Across the UK, debates continue over the 24-week gestational limit, access to later-gestation care, and the future of telemedicine – particularly in rural and under-resourced areas.  

Legal reform clearly only has teeth when it is backed by the infrastructure needed to deliver it safely, equitably and consistently. 

If passed, these reforms will raise questions about how services are delivered, who delivers them, and whether the system is equipped to meet increased or more complex demand. And this comes at a time when the health system is already in flux – from cuts to ICBs, to the abolition of NHS England, and the prospect of new targets under the forthcoming Ten-Year Health Plan.  

Streeting is in the final weeks of preparing to launch the Government’s 10-Year Plan for Health, promising a shift toward prevention, community-based care and digital transformation. These votes show that both Parliament and the public are increasingly concerned not just with whether people can access care, but whether they can shape it around their own needs, values and lives. Can and will the Plan reflect that?  

And if introduced into the system successfully, do these policies open the door for more innovative approaches to health delivery in the future or will implementation challenges put this at risk? 

While the focus over the next few months will be on responding to Government policy, there is a growing need to recognise where and how the next assertion of the right to health and care might emerge.  

If you’re interested in hearing more about WA Communication’s work in the UK, get in touch with a member of the team.