Kit Malthouse (North West Hampshire) (Con)

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As co-sponsor of the Bill once again, I am acutely conscious that there is more at stake today than merely the fate of those who are facing their end, because the conduct of the other place means that our democracy is also on trial today. I sat in the Chamber at the other end of this building on a number of occasions when it was debating the Bill, and I saw more of the debate on television, and I watched with unfolding horror the game that was being played there—a game that was marked in homes across the country with dismay, misery and agony. I contemplated the Lords effectively putting up the pretence of scrutiny, but at the same time tabling 1,000 amendments—

Kit Malthouse

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I will not. The Lords tabled 1,000 amendments, many of which were cruel or absurd; they were effectively designed to be sand in the engine, and to slow up what should have been proper parliamentary process—a process that the dying deserve to see operate correctly.

We have to be aware in this House that expectations are high, and the people who send us here should be able to rely on decisions made in this House proceeding into law. I am afraid that what is at stake today is our democracy. If this Bill falls today, one of the biggest losers will be the standing of this House and this institution as a whole.

Kit Malthouse

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I respect my right hon. and learned Friend’s expertise in this matter, but, as he has already heard on the Floor of the House, it is perfectly possible for this House to suggest amendments, negotiate them with the promoters of the Bill, place them against the legislation in the House of Lords and then have them come back to this House for approval. We would much rather that had happened in the first place.

This House now faces an invidious choice: if we amend and pass the Bill in this House, it will just be talked out again. I am afraid I have no faith that the small group that dedicated themselves to holding up the Bill to deny dying people what they seek, because of their own—

Kit Malthouse

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I will not.

Some of those Members had just a few months before been specifically rejected by the electorate and replaced in this House by others, and I am afraid that they cannot be trusted not to do the same thing again. I grant my right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright) that this is a less than ideal situation. However, I know that the sponsor in the House of Lords is willing to entertain amendments being tabled in the Lords, which will come back to the House for conclusion.

Before I conclude, I want to deal with a couple of other issues. The first point is about the notion of palliative care, which we discussed extensively on Second Reading. I am pleased that this legislation has stimulated a strong debate about palliative care. The Health and Social Care Committee of the House of Lords found that in territories that have assisted dying, palliative care generally improves, because people become less afraid of talking about death. But we must be careful not to say that perfection is a precondition for those who are dying; perfection has to be an objective for those of us who will carry on living. We cannot delay and indulge the dying in their agony because we are not satisfied with the state of palliative care. We have to deal with the choice that those people are facing at the point of their death, and give them the choice that so many of them seek.

The second point is about coercion. The Father of the House, my right hon. Friend the Member for Gainsborough (Sir Edward Leigh), talked about love. One of the most affecting people I have met over the last 11 years of campaigning on this issue is Warwick Jackson, who came to our party conference a couple of years ago. Warwick’s wife, Ann, was diagnosed with terminal peritoneal cancer. She basically knew that she was going to die a slow, suffocating death at the end. As Warwick watched her dying and heard her begging her palliative nurse to end it all for her, he contemplated smothering her with a pillow. The only thing that stopped him was that he did not want her dying thought to be that her loving husband had brought her life to an end. That is the conflict of love that we pose to people by perpetuating this appalling status quo. We have heard time and time again that the situation that thousands of our constituents live with every single day is so horrific and appalling that even the best palliative care cannot alleviate their pain.

I urge colleagues to consider what their vote may mean today. As we said on Second Reading previously, a vote against this Bill is not a passive act. It is not something neutral; it is a vote for a status quo of misery, degradation and cruelty for so many. We know that the British people support this measure. We know that there are lots of territories around the world that we respect and admire that have assisted dying and have operated it for many years successfully. It is not beyond us to get our democracy operating as it should and to design something that will work for the British people. We cannot give dying people more time, but we can give them mercy and love. I urge Members to vote for the Bill today.

The Minister for Social Care (Alison McGovern)

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Not for the first time this week, I find myself wholeheartedly agreeing with the right hon. Member for East Hampshire (Damian Hinds). He and I agree that we will all act according to our conscience and respect others if they come to a different conclusion.

I thank Members on both sides of the debate across the House for their consideration of this legislation and their thoughtful contributions to the debate. By my count, 40 Members have spoken in the debate; I have listened to all that they have said with great interest, and I thank each and every one of them. It has been a difficult debate to speak in at times. We have heard of people’s own family and private experiences, and that is hard to bring to this House. I really thank all colleagues across every corner of this House for doing so.

The issue of assisted dying has been subject to extensive and detailed consideration over a number of years, most recently in this House and the other place in the previous Session, as well as outside Parliament. We think today of all those who feel strongly on both sides of this debate and what they are thinking about as they listen to our discussions. We send our care to all those who are struggling with grief.

Let me reiterate that the Government are neutral on the question of assisted dying and on the passage of the Bill. As the Prime Minister has said, this is an incredibly important and personal debate, and it is right that it is a matter for Parliament, not Government, to decide whether the Bill should become law. However, the Government have a duty to the statute book. It is on that basis that I am speaking at the Dispatch Box today as the Minister responsible for helping to ensure that the Bill, if passed, is workable and effective.

I must explain to Members that in the interests of time, I am going to keep my remarks purposefully brief, and I will not be taking any interventions; I apologise to Members wholeheartedly for that, as I would normally take interventions. I am happy to discuss with Members any issues that they have.

I have listened to the entire debate today and heard Members’ views, questions and many interventions, and I want to turn briefly to a couple of important issues. On procedure, like any private Member’s Bill, this Bill will proceed through the usual parliamentary stages, subject to Parliament’s will. With respect to questions to the Government on the Parliament Acts, I refer Members to the Acts themselves, which set out conditions under which legislation may pass without requiring the consent of the House of Lords. That is a matter for Parliament, and it is not for the Government to decide whether to pass this Bill. As is usual with any constitutional questions, Members may approach the Clerks for further advice, as I am sure you would agree, Madam Deputy Speaker.

Alison McGovern

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I have said that I am not going to take any interventions. I am sorry to be discourteous to the hon. Member, but I am going to stick to that.

I want to make a few comments on the matter of social care and palliative care, having recently taken over responsibility for these most important issues. In my opinion, social care has been ignored for far too long—both the 1.5 million people, mainly women, who work in it and the families who need it. We have heard that across the House today. The Prime Minister has made social care a personal priority, and I am working with my right hon. Friend the Secretary of State to deliver changes now, alongside the work being done by the Casey commission, which we have expedited by a year.

Building a national care service will mean that people know where to turn when they need help and that care workers are given the status and the respect they deserve. We are pushing ahead with workforce changes, including career progression, training and job security, and we have made £4.6 billion of additional funding available for adult social care by the end of this Parliament, including £500 million for the first fair pay agreement for care workers. We will strengthen social care now—we are not just waiting for the Casey commission—and provide greater choice and independence as we do so.

Turning to palliative care—

Alison McGovern

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I also respect my hon. Friend and, though it was not a point of order, the House will have heard what she said. I am attempting to address the points that have been raised in the debate, particularly on procedural matters, on social care and palliative care, which I turn to now.

Palliative care is extremely important and has been raised many times within the debate. As the Chair of the Select Committee set out, we are developing a modern service framework for palliative and end-of-life care. The framework is clinically led and evidence-based, to support sustained improvements in outcomes for patients and carers, including by systematically identifying, measuring and reducing health inequalities and reducing unwarranted variation in access, in experience and in outcomes. As part of that work, we expect all integrated care boards to complete a needs assessment so that we can get a detailed understanding of their current and future population, including people of all ages with palliative care and end-of-life needs. That is vital in order to commission services that best meet the need while providing value for money. Many hon. Members raised the importance of doing that, and particularly of reducing unwanted variation. I acknowledge that and I will be working with Members across the House to deliver that modern service framework.

Members quite rightly mentioned the hospice sector. We provided a £125 million capital boost to funding for adult and children and young people’s hospices. I say to hon. Members that I have heard the points that they have made, and I know we have more to do. Many hon. Members and friends will know that in July, I lost my own mum, so I had a very practical education in this topic, and that experience will shape how I take this work forward.

To conclude, I thank all hon. Members once again for all they have said. They will understand how difficult it is when we are sharing personal experience, as many of them have done today, and I am really proud of everybody who has done so, difficult and challenging though this issue is. I thank all Members who have given me their sympathy over recent months and weeks. It has been so appreciated.

The Government remain neutral on whether the Bill should become law, but it is our serious responsibility, should Parliament pass it, to ensure effective implementation within the framework provided by the legislation. On that basis, we would provide technical support to the promoter if Parliament chooses to progress the Bill.

That said, I will repeat the comments made by the right hon. Member for East Hampshire from the Opposition Dispatch Box, which I now say on behalf of the Government. This is a deeply challenging issue for us all, for the public and for the constituents we represent. In discussing this issue, we must model the best behaviour of this House—having respectful, thoughtful, careful debate, listening to one another and understanding our very different perspectives. I think that we have done that today. I hope that, whatever happens in the Division, we will be able to continue to show those behaviours and give this serious subject the deep respect it deserves.

Kit Malthouse

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claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.