Avote on assisted dying was supposed to be one of the easiest reforms for Keir Starmer’s government. To many, including the Prime Minister himself, a law allowing terminally ill patients to choose to die would be a self-evidently progressive and historically significant change. It would mean Britain could transcend the objections of a religious minority and join Canada, the Netherlands and other countries in a modern, more enlightened era.
In the assisted dying debate, the PM appears a mere onlooker, while Streeting is taking the lead
Starmer didn’t want to have to order his MPs to vote for assisted dying. The strategy instead was to use a private members’ bill, brought by the Labour backbencher Kim Leadbeater. This ploy didn’t work because, according to a senior party figure, ‘everyone thinks the bill is being brought with No. 10’s backing’. However, with the vote due next week, opposition has emerged, and there is no guarantee that the bill will pass. To make matters worse for Starmer, its main critic is not from the opposition benches but his own side – the Health Secretary, Wes Streeting.
Since it’s a free vote, ministers may vote as they wish, but the Cabinet Secretary Simon Case ordered them to stay out of the public debate. Starmer’s own views are well known (as recently as last year he said ‘there are grounds for changing the law’ on assisted dying), but since the bill was introduced he has followed protocol so closely that he has only recently confirmed he would even vote and has refused to say which way. ‘This is Keir down to a tee,’ says a Downing Street aide. ‘He made a rule so he will stick to it.’
In contrast, Streeting has not only said that he will be voting against but that he is doing so because he fears the bill could harm existing health services. He highlighted a huge flaw in the plan: there has been no impact assessment, so MPs cannot be confident about the implications. While there may be a Commons majority in favour of the concept of assisted dying, Streeting voiced the concerns of many MPs that the practicalities have not been thought through. ‘[The government] thought all these new MPs would just vote for it,’ says one member of the 2024 intake. ‘But that hasn’t happened at all. We are all thinking about it for ourselves.’
Streeting’s critique is a source of irritation in No. 10 – Starmer even took him aside last week to voice his annoyance. Leadbeater has also spoken of her ‘disappointment’, while Harriet Harman has criticised the Health Secretary for making the argument about ‘money’. Streeting’s cabinet colleagues complain that his interventions mean they are now being asked to give their own views in detail.
Some in the party have also accused Streeting of having ulterior motives. In July he narrowly held on to his seat by 528 votes against a pro-Gaza independent, so coming out against assisted dying could play well with religious voters. ‘He’s doing God’s work,’ jokes one MP.
Yet there is another narrative forming – one discussed privately in Labour circles. Is Streeting simply doing what Starmer ought to be by showing leadership? As home secretary in the 1960s, Roy Jenkins also opted for free vote reforms through private members’ bills, but he was vocal in his support. He allowed more parliamentary time on legalising abortion, spoke from the despatch box in favour of decriminalising homosexuality and defended his vision of the ‘civilised’ society.
In the assisted dying debate, Starmer appears a mere onlooker in a historic vote, while Streeting is taking the lead. ‘He’s very straightforward – it’s refreshing,’ says a supportive colleague. ‘He thinks hard about problems and comes up with solutions. Why are you in politics if not to make your argument?’
Now Starmer’s seemingly elegant plan to allow others to make the case for assisted dying is backfiring. Across government, doubts are being raised about the wisdom of allowing the vote just as Downing Street attempts to shake off its disastrous first 100 days. ‘Everyone knows the government needs to get on the front foot after a bad start – to have a narrative around tax rises and to explain what we’re here for,’ says a regular visitor to No. 10. ‘Instead, we’ve had three weeks of rolling death.’ A government aide tells me: ‘At this point I hope [the bill] fails so we can stop talking about it.’
If it fails, there will be plenty around Starmer who will blame Streeting for the defeat more than anyone else. ‘If it doesn’t pass, I think MPs will look back and see Wes showed leadership on it,’ says a colleague.
No one is suggesting that Starmer is in danger, but succession chat is a popular pastime for MPs of all persuasions. Streeting has long been talked up as a future leader. Several Labour MPs dismissively refer to Starmer as merely part of ‘The Project’, the idea being that some of his backers are interested in keeping the right wing of the Labour party in power, rather than him personally.
On these grounds, Streeting, an ambitious Blairite who is well liked by the new intake, is regarded as the heir apparent. To the annoyance of some of his colleagues, he is often sent out on the media round and in the last Budget managed to secure an extra £22 billion for his department. ‘Of the two most likely eventual successors to Starmer, one [Rachel Reeves] is having a torrid time, in trouble for editing her CV and facing a farmer mutiny. The other is Wes and he’s doing well, even if you don’t like what he’s saying,’ says a party figure. ‘It’s noticeable.’
Beyond the gossip about succession, since Streeting is faring well, could the beleaguered Starmer learn from him more generally? So far, the government’s reform agenda has been lacking, but the Department of Health is where the most action is happening. On his first day in the job, Streeting told staff in a private meeting that he was in a hurry: ‘I’ve had two brushes with death – one with cancer and one at the ballot box,’ referring to his 2021 cancer diagnosis. He was the first in government to turn to the old Blairites for help, bringing Alan Milburn into his department to work on NHS reform. Since then, No. 10 has brought in its own Blairite recruits – Jonathan Powell and Liz Lloyd.
No one is suggesting that Starmer is in danger, but succession chat is a popular pastime for all MPs
Starmer’s supporters play down the idea that there is any long-lasting animosity between the Prime Minister and the Health Secretary. One No. 10 ally says Starmer is relaxed about tall poppies in his cabinet. ‘He takes the opposite view to Boris Johnson, who wanted old lions,’ says a confidant. Starmer has even spoken positively to aides about ministers writing him letters (which are usually designed to be leaked) complaining about proposed Budget cuts, on the grounds that they were prioritising their department over slavish loyalty.
After a difficult Budget, which featured many spending announcements but few plans for reform, the Prime Minister needs a course correction. Both Starmer and his chief of staff Morgan McSweeney regularly tell colleagues that they came into government to achieve more than ‘managing things a little better’. That means having to make big decisions on welfare and health. At next year’s spending review, which is now expected in the early summer, ministers who come forward with any requests will also be expected to bring their plans for reform.
How ministers present their plans will be telling. So far, Streeting’s reform agenda has stood out for his controversial suggestion that there should be a hospital trust league table and that under-performing hospital managers should be eased out. In contrast, other departments, including Education, are taking a more conciliatory approach.
If Starmer can turn reform into more than just a buzzword, his government and premiership will benefit. If he fails, the risk is that the Prime Minister will continue to be compared unfavourably with the tall poppy across the cabinet table.
Hear more from Katy Balls on the Edition podcast, where she was joined by Labour MP Steve Race to discuss her article:
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