(1 day, 7 hours ago)
Lords ChamberRead Hansard Text Read Debate Ministerial Extracts
Lord Falconer of Thoroton
That the House do now resolve itself into Committee.
Amendment to the Motion
Lord Falconer of Thoroton
At end insert “and takes note of the progress of its scrutiny of the Bill during the current session”.
Lord Falconer of Thoroton (Lab)
My Lords, today is our final day scheduled for the Terminally Ill Adults (End of Life) Bill. I am despondent that this Bill, so important to so many, has failed not on its merits but as a result of procedural wrangling. There is no prospect that the Bill can get through this House today or before Prorogation ahead of the King’s Speech on 13 May. Consequently, we cannot complete the Committee stage, let alone have a Report stage, when we could have tested the House’s views on the amendments proposed and then had a Third Reading debate.
If the elected Chamber decides to return this Bill to us in the next Session, as I very much hope it will, there will be ample time for us to pick up where we left off and complete the proper task assigned to us as a revising Chamber. We are not a democratically elected House, but we are rightly held to account for what we do here, or, in this case, what we have not done. Members of the public, who support assisted dying by a very large margin, will be asking themselves why Parliament has failed to enact a measure that they believed would and should become law after Members of Parliament voted in favour of it in the other place. That is why I believe it is not only right but imperative that we take some time today to consider why we find ourselves in this position.
I remain as committed to this Bill as I have been throughout the whole process, and so, I believe, do a majority in this House. We know that a majority of the Commons do, as do a majority of the public, as demonstrated in survey after survey by reputable polling organisations over a long period of time. The assisted dying Bill commands strong views. In those circumstances, it is for us in your Lordships’ House to debate with civility and patience. We need to set an example, in the way we conduct this debate, to everybody else engaged in the debate. I have kept that important point in my mind at all times in the course of this debate.
The public have had an eye on our proceedings on this matter in a way that they rarely do. Our constitutional role is to revise and propose amendments, not to block. I know, because many noble Lords have said so, that it is not just supporters of this Bill who believe that we have let ourselves and Parliament down. Much more importantly, we have let down those terminally ill people, and those who love them, who were depending on us at least to reach conclusions on the Bill. Although this House has debated assisted dying on several occasions over the past two decades, for the first time we have had before us a Bill sent from the other place following unprecedented scrutiny and with clear majorities there at both Second and Third Reading. The suggestion that Members of Parliament did not deeply interrogate this Bill in the other place and that the issues it raised were not properly dealt with is profoundly mistaken.
The Bill passed its Third Reading in the Commons in June after more than 100 hours of debate, including 29 sittings in Bill Committee, two full days of debate on Report on the Floor of the House, and a full day’s debate at both Second Reading and Third Reading, with no whipping and no guillotines. That is almost double the time given to scrutiny in the other place of, for example, the Children’s Wellbeing and Schools Bill that we have been debating. Altogether, the Bill Committee in the other place considered and debated over 600 amendments, accepting around a quarter of them. Over 100 amendments were made in the sponsor’s name and more than 30 amendments were tabled by MPs and passed by MPs who had voted against the Bill.
Baroness Coffey
At end insert “, recognising the reports and recommendations of the Delegated Powers and Regulatory Reform Committee and the Constitution Committee.”
Baroness Coffey (Con)
My Lords, “The Lord moves in mysterious ways” is a well-known phrase. But today perhaps it is better to say, “The Lords move in mysterious ways”. I came back from the Council of Europe specifically to continue debate on the Bill, because I believe that scrutiny is necessary. I thought that the purpose of a sitting Friday on the Bill was to debate the legislation before us, not to debate process.
I tabled this amendment to the amendment of the noble and learned Lord, Lord Falconer of Thoroton, in response to the letter circulated by the Bill’s sponsors to MPs this week, which I consider was actually somewhat misleading. I make specific reference in my amendment to the excellent reports prepared by respected cross-party Select Committees of this House: the Constitution Committee and, in particular, the Delegated Powers and Regulatory Reform Committee.
The continuing claim that this Bill is the safest in the world and was largely good to go in this House—perhaps with a few tweaks—just does not hold true. The reports and recommendations therein of the two committees to which I have referred were pretty damning about the unprecedented use of Henry VIII powers, the number of issues to be left to regulations, and so on. If I were the sponsor of the Bill, I would have been embarrassed by the outcome of these reports. It was embarrassing to read for Peers who also support the principle of the Bill, but those reports confirmed that this was a poor and flawed Bill.
At Second Reading I raised my main issue, which was about guarding against indirect coercion—a topic that came up from the Royal College of Psychiatrists in particular. For certain, safety is not secure in this Bill. Nevertheless, I suggested that while I would try to make improvements to the way the Bill worked, I felt then that the Commons might need to start again and come up with a better Bill.
For what it is worth, I wish the Government had been more open about the discussions they were having with the Bill’s sponsors. I respect the Government’s neutrality, but it was particularly important to see how the Bill might work in practice. Time after time, parliamentary routes proved fruitless. Freedom of information requests were turned down repeatedly and consistently, if the departments even bothered to reply. They certainly have not replied to lots of the appeals that were made. The ongoing response was that it would not be in the public interest to reveal the discussions on what had happened or on how this might work.
Lord Falconer of Thoroton (Lab)
The noble Baroness will be aware, and I am sure she will agree, that if the Bill comes back a second time to the Commons, it will come back here. The effect of the Parliament Act is not to stop further debate but simply to prevent the House blocking the Bill and not returning it to the Commons.
Baroness Coffey (Con)
Yes, I completely agree. That is why I say that I respect the right of MPs to decide to use the Parliament Act process. But I would rather that we did not have to go through all this again, having to change what has been a flawed Bill at this end. I appreciate and am aware of the Parliament Act process.
I completely understand the passion of people who want assisted dying to happen in this country. A variety of amendments have been rejected when talking about pain or other things being key criteria, or about autonomy versus the risk of coercion, and I think they should come up with a better Bill.
I am conscious that I have spoken for somewhat longer than I had intended. I could have said a lot more in response to what the noble and learned Lord said. The two Houses are different in their processes. I could have given examples of popular PMBs; one in particular had a majority of 304 in the Commons and then never made it through this House. I am conscious that others want to speak and, for what it is worth, I do want us to go into Committee at some point today. With that, I beg to move.
The Senior Deputy Speaker (Lord Gardiner of Kimble)
My Lords, the noble Baroness, Lady Campbell of Surbiton, will be taking part remotely, and it has been agreed that she will be called as the third speaker in the debate on the amendment.
Lord Markham (Con)
My Lords, I begin on a personal note. As I have mentioned in previous debates, my mother was a Marie Curie nurse who supported terminally ill people through their final days. In 2007, she was diagnosed with late-stage womb cancer. When she was in pain at the end of her life, she was helped by hospice staff—in my words—to take an earlier train home.
That experience changed how I see the debate. I consider myself broadly in favour of assisted dying, because I believe in choice and in personal autonomy, but what I witnessed, and what I have learned since, is that what happened to my mother happens quietly all the time across the country, informally and inconsistently, with no upfront oversight and no safeguards. The current ban does not prevent assisted dying; it simply makes it unregulated, unequal and unsafe. It forces some people to travel to Dignitas, often alone, dying earlier than they need to because the law has given them no other way. It leaves their relatives looking over their shoulders, concerned that they might face prosecution for helping their loved ones have their dying wish. It forces others to take their own lives, frightened and alone, or perhaps with assistance but with no way to protect against abuse. We heard evidence in the Select Committee that 650 terminally ill people commit suicide every year with no controls, no safeguards and no protections under the current legislation. Others, without the ability or resources to take control, risk dying terribly or without dignity, in pain and with suffering.
So I came to this Bill believing in the principle of assisted dying to allow choice and autonomy, but believing that it needed the skills of your Lordships’ House to make assisted dying the best and safest process in the world. I was in favour of setting up the special committee to take evidence; I even sat on it. I was in favour of giving the Bill extra time to allow additional scrutiny. It was fitting that we had a similar number of sittings on this Bill as on the current Crime and Policing Bill.
However, as the noble and learned Lord, Lord Falconer, set out, this Bill has had plenty of time compared with other Bills; we have just not chosen to use that time wisely. It has taken 20 times longer—20 times more per page of legislation—than other Bills, such as the Crime and Policing Bill, such as welfare, health and security Bills, or the levelling-up Bill, so I believe that it has had plenty of time for scrutiny. As I say, we have just not chosen to use that time wisely. I believe that the whole Bill, and the reputation of the Lords, is the poorer for it. I know that many Lords will state that the noble and learned Lord, Lord Falconer, has not been responsive to suggested amendments. He has pointed to the many examples where he has been.
For me, our failure to get to the end of this process and discuss all clauses has made us all the poorer. Let me give an example. On an earlier clause, the noble Baroness, Lady Monckton of Dallington Forest, spoke eloquently and movingly about the dangers of people with learning disabilities being inadvertently coerced into assisted dying through their wanting to crowd please. The whole Committee was moved and educated that day by the noble Baroness, and the noble and learned Lord immediately agreed to make the necessary amendments to safeguard against this. This was the Lords at its best—into the detail, understanding the full consequences and then acting to protect. To me, the real missed opportunity here is that, by spending so much time on the early clauses and not getting through the Bill, we did not have the benefit of this House’s wisdom, experience and expertise to go through, make the points and understand them in the very clear way that the noble Baroness did that day, and the way that the noble and learned Lord reacted.
That is my true regret in this, and that we let down the 70% of the British population who support assisted dying, saw the House of Commons pass the Bill and do not understand how the Lords can block it without even a vote. Most of all, I am sorry to those people who are currently terminally ill, for whom the Bill held out a safe, humane and pain-free death of their own choosing.
I finish by remembering some of those people who passed away during the passage of the Bill, for whom we are too late. Antony Shackleton, aged 59, was diagnosed with motor neurone disease. He battled for six years and travelled, in the end, to Dignitas in December 2024. He said to his wife Louise, “Look at my options. I could go there and die peacefully, with grace, without pain, or be laid in a bed, not even able to look at anything unless you move my head”. He spent his final four days laughing and, in his wife’s words,
“ at total peace with his decision”.
For accompanying her husband so that he could die with dignity, Louise spent 10 months under police investigation. What he wanted, as she put it, was
“nothing more than a good death”.
The Lord Bishop of Newcastle
My Lords, I speak as one of the Lords spiritual and as a member of the Select Committee that examined the Bill. I do so with a deep sense of responsibility for the integrity of our legislative process and for the dignity and protection of those whose lives may be most directly affected by what we decide. I have been deeply moved by the personal stories that have been shared by noble Lords in recent months and wish to acknowledge the stories that my noble friend shared with us just now. My own dear cousin died earlier this week from a condition that could at many stages have been described as terminal. She continued resolutely to live life to its fullness, and her sudden death is a matter of great sadness to me.
In our context, where questions of life, death, care and conscience are so closely intertwined, the quality of our scrutiny is not a procedural detail. It is a moral necessity. Some may dismiss my contribution as one grounded in a faith, but this is as legitimate and significant as any other viewpoint, whether grounded in faith, belief or none. While my faith informs my alarm at our designation of dignity or the lack of it, it is from my experience on the Select Committee that I have found that, the more closely we have examined this Bill, the more concerns have come into focus, not fewer. For a Bill of this magnitude in terms of societal change, the highest level of scrutiny is imperative. Within our proceedings, there has been an acknowledgement, even from those closely involved in the Bill, that it is not yet in a settled or satisfactory form. When such admissions are made, it is incumbent on us to listen with care.
The Select Committee heard evidence that raised a number of unresolved and deeply serious questions. These questions were practical as well as deeply principled: whether the state should be obligated to address unmet need before assisting someone to die, even if in doing so the person’s mind might be changed; how we ensure that we continue to uphold our duty to suicide prevention for those who are terminally ill; how such a significant change in the law would be delivered in a way that does not put vulnerable people at further risk; and how this would work for extremely vulnerable populations who do not have the same choice, such as prisoners. These are not marginal concerns. They go to the heart of how we understand protection, vulnerability and moral responsibility.
Across this House, Peers from many different perspectives have expressed concern. That breadth of unease ought not to be dismissed lightly, yet I share the concern that the time afforded for debate has often been limited in ways that do not reflect the gravity of the subject. When the Bill was first introduced, it contained a number of delegated powers of a kind that, as noble Lords have already pointed out, rightly attracted concern. While some adjustments may have been made, the underlying issue remains—whether too much is being left unresolved, to be determined later rather than clarified now. There must be opportunity for a deliberative process as these are examined. Moreover, the committee and the House more broadly have raised a number of detailed questions to which clear answers have not always been forthcoming from the Government or their advisers. That lack of clarity makes it difficult for us to discharge our duty with the confidence that is required.
In my ministry, I am often reminded that how we care for those at the end of life is a measure of our common life together. That care must be marked by compassion, clarity and a steadfast commitment to protect the most vulnerable. For that reason, I believe we must continue to proceed with great caution. Until the questions that have been raised are answered more fully and until this Bill has received the depth of scrutiny it requires, it would be irresponsible to allow it to move forward. This is not about resisting change. It is about ensuring that any change we make is just, humane and worthy of the trust that is placed in us.
The Senior Deputy Speaker (Lord Gardiner of Kimble)
My Lords, the noble Baroness, Lady Campbell of Surbiton, is taking part remotely. I invite the noble Baroness to speak.
Baroness Campbell of Surbiton (CB) [V]
My Lords, as requested by the noble and learned Lord, Lord Falconer, I have reflected on the progress we have made on the Terminally Ill Adults (End of Life) Bill to date. I know that we have engaged in vital scrutiny work and made progress, although for the supporters of the Bill it seems agonisingly slow.
I am acutely conscious that the role of this House is not to rubber-stamp legislation. It demands that we draw on our knowledge, our experience and research evidence to demonstrate why revision is necessary and, most importantly, to insist firmly that a Bill is made safe before it leaves us. That is our constitutional duty and it is what we have been doing over the past 14 days in Committee. Yet our work has been dismissed as filibustering or worse. That is simply not true. The breadth of participation in this House reflects deep and genuine concerns shared by NHS doctors, human rights bodies and disability organisations about the risks this legislation may pose to the most vulnerable.
I have spent over two decades studying similar laws internationally. I have long supported autonomy for disabled people, but autonomy without protection is not freedom—it is risk. When the outcome is irreversible, that risk must be treated with the utmost seriousness. Public opinion is given to reflect that caution, despite the high-profile celebrities fronting the campaign for assisted dying. Of course, they get the headlines. Actor Miriam Margolyes’s recent outburst against “a cohort of rabid Catholic privileged Lords out to sabotage the Bill” was heard loud and clear. But please do not be mistaken; this is not a reflection of public opinion.
The latest polling by Whitestone Insight shows that there is no clear or informed public mandate for this Bill. Around four in 10 people do not understand that assisted dying involves administering lethal drugs—when voters are better informed, support falls away; nor is this a public priority, with far greater concern focused on NHS pressures and social care. Importantly, the same polling shows strong support for the role of this House. A clear majority of the public believe that the House of Lords has a duty to amend or block legislation if it risks harm. That is not a call for us to step aside. It is a call for us to do our job.
Without significant amendment, this Bill cannot guarantee protection for those in vulnerable situations or outside its intended scope; nor can it ensure that decisions are made entirely free from pressure. These concerns are shared by, for example, the Royal College of Psychiatrists, the Royal College of General Practitioners, the Equality and Human Rights Commission and disability organisations. Even Liberty, an organisation long associated with defending individual freedoms, cannot support this Bill. It warned Parliament at Second Reading that the risk to those whose rights are fragile must also be protected. As it put it, the autonomy of one group cannot override the rights of another. Rights must be carefully and proportionately balanced. This Bill fails that test.
I also struggle to understand why the Bill’s sponsor appears unwilling to recognise the weight of expert evidence. I welcomed the noble and learned Lord’s open-door policy to engage with our concerns and I sought to assist him to understand the nature of a terminal prognosis. I arranged for two eminent intensive care consultants from St Thomas’ Hospital to meet him and provide a clear tutorial on prognostication. They demonstrated that a six-month prognosis cannot provide a reliable foundation for legislation of this kind. But has he returned with amendments of his own to address this deficit in the Bill? No.
Much of the chatter around the debate inside and outside this Chamber focuses on motives; it should not. Our role is to examine all available evidence, test safeguards and make revisions. Disabled people who have contacted me are very clear: this Bill frightens them, and they want me to explain to your Lordships why it is dangerous for them. They fear unequal access to care shaping their choices, subtle coercion that cannot be easily detected, error in prognosis, persistent assumptions about the value of their lives and a system already under strain being asked to deliver decisions of the utmost gravity. These are real and repeated concerns. I have contributed to amendments that have sought to strengthen safeguards to that end. That is not obstruction; it is our duty.
Lord Carlile of Berriew (CB)
My Lords, I express my agreement with the concern of the noble and learned Lord, Lord Falconer, that the Committee stage of the Bill should have been completed. I wanted to be part of a process that amended the Bill so that we could reach Report and have some meaningful votes on certain parts of the Bill with which I disagree profoundly. I thank the noble and learned Lord for his acknowledgement of my part in some discussions we had, to which I will refer in a moment.
What a singular privilege it is to speak shortly after the noble Lord, Lord Markham, who made a moving, personal and brave speech. He illustrated that, when we debate difficult issues such as this, we should, as Members of the House of Lords, seek to embrace an agreement in the final analysis, not raise our fists in disagreement. We should have reached a conclusion on this process. It raises some questions, which I hope the Leader of the House and the Chief Whip will take into account, about the suitability of the Committee stage in your Lordships’ House for Private Members’ Bills of this general kind—major conscience issues—coming from the House of Commons.
In the technical language of this House, the noble and learned Lord is not my noble friend, but he is my learned friend of many decades. That phrase, “my learned friend”, which I use for many others in this House, reflects a bond of friendship, however we disagree. Although a number of the lawyers here have disagreed about issues, we have all been trying, I think, to find a consensus for the Bill.
If he will allow me to tease him slightly, the noble and learned Lord, Lord Falconer, has shown in this House his barrister’s skills and the skills that made him such a distinguished Lord Chancellor: his powers of preparation, knowledge of the law and facility with competing conceptual issues. He is a fine advocate, but I will let noble Lords into a trade secret, for there are dangers of brilliance among advocates. It is a fact that the very best advocates are the ones who lose the most cases, because they are given the most difficult cases to argue. I fear that this has been an example. It would perhaps be unkind to say that the noble and learned Lord has demonstrated his powers to make a silk— or Silk’s—purse out of a sow’s ear, but the Bill has many imperfections.
Not the least of those imperfections is its failure to safeguard the most vulnerable. I absolutely agree that the noble and learned Lord has made some concessions, which he mentioned, and some of them are important. He kindly mentioned the attempt that he and I made together, as I thought it, to try to bring back what was in the original version of the Bill when it started its course in the House of Commons: that the ultimate governance of the process of assisted dying should be with the courts rather than the largely unaccountable panels set up under an untested system introduced by amendments in the House of Commons. The Bill’s promoters made a serious mistake doing that. A former Lord Chief Justice, my noble and learned friend Lord Burnett, was made a Knight of the Garter this week. There is a reason why we have such confidence in senior judges: they are able to ensure ultimate governance of the laws passed by these Houses of Parliament.
I was disappointed and surprised that the noble and learned Lord, Lord Falconer, did not agree to the process available to us to meet officials and parliamentary draftsmen to try to produce an acceptable and mutually agreeable version of my Amendment 150, which was debated on the first day in Committee and would have introduced ultimate governance by the courts. I heard him say this morning that we could have achieved that on Report. Perhaps we could have, but he did not take advantage of going through that process when it was available during Committee. I believe that if we had reached an agreement—a formula was available, which we talked about—we might have shortened quite a lot of the debate on the Bill in your Lordships’ House.
I say as kindly as I can to the noble and learned Lord that it is rather hyperbolic to allege that the Bill has been delayed illegitimately by this House. It has indeed been delayed by this House, but the question is about the legitimacy of that delay. We heard earlier from the noble Baroness, Lady Coffey, who moved the amendment to the amendment to the Motion. I remind the noble and learned Lord that much of the opposition has not come from old fogies like me—I am now a veteran of this House; I have been here 26 years, after 14 in the other place. Much of the opposition has come from a group of—if they will forgive me—newbies to this House but not to Parliament: noble Lords and Baronesses who were recently Cabinet Ministers and who have the spirit and intent of the House of Commons very much in their minds in the work they do in the House of Lords. We are, in general terms, very grateful for having them here.
They did not come here as newbies to obstruct the House of which they had been Members for many years, even if they had lost their seats—which I did not, by the way. I think they came here to do exactly what it says on the tin, as it were: to amend draft legislation so that it is fit for purpose and, as I stated earlier, to try to do so by agreement, not disagreement. Although I wish that they had at times been quicker and put down fewer amendments, they have been doing what we are here for: to make draft legislation fit for purpose. If there is a further Bill, we should, as a House, be less obdurate, as should the noble and learned Lord or whoever is the Bill’s sponsor. We should have a stronger critical faculty and an ambition to complete the process of the House.
My final words are to remind your Lordships of what this Bill does: it is intended to give a citizen the power deliberately to bring about the death of another citizen—something that, since the end of capital punishment, has not been available to citizens of this country except in a legitimate war. Let us not forget the importance of what is being asked for.
Lord Baker of Dorking (Con)
My Lords, this House has debated assisted dying this century on nine occasions, first in 2003 and then in 2005. There are very few members in the House today who spoke in those debates, with the possible exception of the noble Baroness, Lady Finlay of Llandaff. She was a very devoted opponent of the Bill of those days, just as I was a devoted supporter of it. But all those debates were about Private Members’ Bills that originated in this House. What we have now is a Bill coming from the House of Commons; it is not a government Bill, but it received a great deal of debate, amendment and improvement, and then it was sent to us.
However, we do not exist as a House to frustrate the determined will of the House of Commons. Our task is to examine Bills—which they do not do themselves in a measured way today—to improve them and send them back. This has been frustrated by a relatively small group of people; just seven noble Lords has tabled nearly over 1,000 amendments. That is a tiny minority by any standard. I believe that the prolonged filibuster they embarked upon is a constitutional farrago. It is a denial of democracy and an attempt to give this House the wrecking powers that were taken away in 1912.
I congratulate the noble and learned Lord, Lord Falconer, for the very patient way he dealt with the repetitive speeches that were full of absurd exaggerations and extravagant fantasies. He did not lose his cool, and that is quite remarkable. I also thank the noble Lord, Lord Carlile, for his effective contributions towards improving the Bill. He came forward with several proposals, but he too is frustrated from implementing them currently as a result of us returning the Bill to the House of Commons in the way we received it.
I support this Bill for two reasons. First, it will reduce the suffering of many elderly people who are experiencing a prolonged death, and nothing was more eloquent than the speech that my noble friend Lord Markham made about that. We are particularly well suited in this House to debate this sort of measure because, on the whole, we are rather older than most MPs and we have experienced the deaths of friends, colleagues and relatives. Just this week, one of my closest friends, who was a Cross-Bench Peer in this House, died. I had tea with him the previous week. Robert Skidelsky was my close friend. We lived close to each other. He was a brilliant economist, but he was also a very good bridge player, and I shall miss him enormously. He is one of the lucky ones, as it were.
As I said, one reason I support the Bill is that it reduces the suffering of people when they slowly begin to lose control of their own bodies. It was very interesting to hear what the right reverend Prelate the Bishop of Newcastle said, because in previous debates the main argument was about the sanctity of life. It is only the Bishops who continue to make that argument; no one else will make the argument because what we are concerned with are the safeguards, and this Bill will reduce the suffering of people. As we slowly lose control over our own bodies, people can no longer get up and dress, wash or feed themselves, or prepare their food, or walk or run, or engage in any life whatever; they then lose control of their bowels and bladders, and it is a very unpleasant way to die. If you can get palliative care, you can anaesthetise pain, but you cannot anaesthetise indignity. This Bill allows people to die in a dignified, and sensible, way in their own homes.
Baroness Scotland of Asthal (Lab)
My Lords, I hesitate to interrupt the noble Lord, Lord Baker, but I am sure he would want the House to be aware that the Attorney-General’s guidelines have assisted in enabling prosecutors to make decisions which would obviate the need for prosecution where there is no evidence that the person assisting did it other than for love. The fact that there are so few prosecutions is something we should celebrate as opposed to criticise, because those 10 that go forward are because there is evidence that that which was done was not well done and should be prosecuted.
Lord Baker of Dorking (Con)
I understand what the noble and learned Baroness is saying, but the police have decided very clearly what their position is. Between 2009 and 2025, 199 cases were referred to the Director of Public Prosecutions by the police for assisted suicide. Of those 199 cases, 131 were not proceeded with by the Director of Public Prosecutions and were withdrawn; the police then withdrew 39 other cases. Therefore, this not a law that is operating today because juries will not convict. I would—
Baroness Scotland of Asthal (Lab)
I do not want to interrupt the noble Lord again, but I think it is right for him to know that this matter came before the Attorney-General, myself, to determine how we should address this problem. How could we make it better? How could we differentiate between those who should validly be prosecuted and those who should not? The Director of Public Prosecutions then has a duty to implement the Attorney-General’s guidelines when making a decision as to whether to prosecute or not, and they have duly done so.
Lord Baker of Dorking (Con)
I recognise that there is that power, but it is very rarely used. That is the point I have been making all the time. Juries will not convict.
This has happened before in our history. There was a time when the law decided that youngsters as young as 10 or 12 could be hanged for stealing a pocket handkerchief. That fell away because juries would not convict. Similarly, I do not believe that the present law on suicide can in fact operate effectively, and therefore it should be changed.
Lord Barber of Ainsdale (Lab)
My Lords, I have spoken only once previously in the many long hours of debate on the Bill. That was at Second Reading, when I told the story of Daniel, the much-loved son of my noble friend Lord Monks, who, in the absence of any form of assisted dying in this country and faced with intolerable suffering, starved himself to death in 2024.
Like many others around our country, I had strong hopes that the Bill would have given, for the first time, people very close to the end of their lives some choice on how to leave this world. While remaining silent in the Chamber, it quickly became very clear to me that an additional voice was certainly not needed. I have been distressed and disturbed by what I have witnessed here.
As I was coming into this place a little over a year ago now, I was given to understand that we had two central responsibilities. Our job was not to seek to displace or overturn the elected House, but to act as a scrutinising and revising Chamber. So, how well have we carried out those responsibilities? As my noble and learned friend Lord Falconer reminded us, this is a Bill of 59 clauses. In Committee, after 120 hours of debate we have managed to scrutinise only seven of those clauses. The rest of the Bill, 52 clauses, has received no scrutiny whatsoever. As to our responsibility to propose revisions for the elected House to consider, there have been a handful of entirely non-contentious matters to which revisions have been made in Committee. Of course, substantive revisions would fall to be considered and voted on Report, and we have never come even close to reaching that point. In sum, we have abjectly failed in our responsibilities as a scrutinising and revising Chamber.
It became apparent very early on in Committee that the rate of progress was utterly glacial. My noble and learned friend proposed a Motion to the House, seeking additional time if necessary, and committing the House to completing consideration of the Bill in good order to return it to the Commons. Nobody voted against it, but nobody changed the form or the length of their contributions to these debates, even by a tiny amount, to make its objective achievable. All efforts by my noble and learned friend, as he reminded us, to establish more streamlined processes, came to naught.
There has been a catch-all justification that we have heard again today, offered by some of the Bill’s opponents, that it has always been a bad Bill in need of fundamental root-and-branch reworking from top to bottom as a result of insufficient earlier work and insufficiently detailed scrutiny. I reject that view, and I regard it as deeply disrespectful and an insulting slur on the sponsors of the Bill and all those highly expert advisers who have supported the sponsors at every stage of the Bill’s preparation. It rather ignores the very detailed consideration the Bill received in the elected Chamber, in many cases, with honourable Members—
Lord Barber of Ainsdale (Lab)
With great respect, I would like to conclude my remarks.
There were many cases of honourable Members weighing their positions after close consultation with deeply interested constituents. Noble Lords may disagree with the Bill and oppose its objectives, but please do not claim that there is some grave technical deficiency in it to justify that position.
I have used, throughout these remarks, the word “we” in describing the House’s handling of the Bill, but this is not about the House as a whole, because what has become abundantly clear to me—and I suspect to many people in the wider community—is how a relatively small number of people in this place have been able to use its procedures, not to scrutinise or revise a Bill supported by the elected House, but simply to seek to block it. In my younger days, I attended a number of lively demonstrations, led by the chant, “kill the Bill”. The message and intent of some colleagues may have been less brutally expressed in this House, but the objective has been clear.
Many noble Lords have had grave reservations on particular points in the Bill but have seen it as their duty to seek what they consider would be improvements. They too have been thwarted by the actions of those determined to block its passage. Indeed, the whole House has been denied any meaningful opportunity to express its view on the Bill as a whole and what it was seeking to achieve. This may now prompt a wider debate about the role of this House, the privileges it confers on noble Lords, and whether its procedures are justifiable when they can be used so blatantly to overturn the expressed will of the elected Chamber.
I recognise that many noble Lords have genuine, deeply felt objections to the Bill, perhaps as a result of their faith or just a strong personal conviction that this Bill can never build in enough safeguards to satisfy their conscience. I recognise and respect that, but is it right, on that basis, to use the privileged position that this House gives to each of us to impose that personal view on the membership of the House as a whole? I think not.
That is a matter of interest to those of us concerned with constitutional issues in our democracy and institutions. I would not run a local trade union branch meeting with a difficult decision to make in this self-regulated way that so many Lords take great pride in. As we lay this Bill to rest and pronounce the last rites over it, at least for now, I think first of all of those ordinary, decent people, perhaps with deeply loved ones in circumstances such as those that faced Daniel, yearning to see this change enacted. They will be bewildered and outraged to understand how it has foundered in this place. On this matter, the House has not served our nation well.
Baroness Hollins (CB)
My Lords, I thank the noble and learned Lord for an opportunity to reflect on this debate. Nearly 250 Members have spoken in the debate, not the minority that have been spoken about. I remind the House that I am a past president of the Royal College of Psychiatrists and a fellow of three other royal colleges.
When my husband was diagnosed with motor neurone disease, he read that motor neurone disease was the most feared illness. He took a different view. He joked that he was just fading away. He had good care. I wish everybody did. He died naturally and peacefully at home with a smile on his face. Fear is infectious. Please let us not feed on fear.
The Bill’s aim was to provide patients with a choice at the end of their lives. For that to be meaningful, it needs to be a real choice. I have introduced amendments to try to address the other side of choice: the lack of palliative care and the gaps in services that underlie so many of the distressing stories that we have heard; the lack of clarity about the actual means by which someone would be assisted to end their own life; and the risk of implicit institutional coercion, when new processes and procedures change the culture in the NHS.
Lord Lansley (Con)
With the greatest respect to a number of noble Lords, I think what we are hearing is, in a sense, what we would have heard had we taken the Bill to Third Reading. We are hearing debates about the principle of the Bill, whereas this debate should be about where we have reached and either how we should have dealt with it or how we should deal with another Bill if we are presented with one like it in a future Session. I will focus on that point. I am very glad to follow the noble Lord, Lord Carlile, because he made some very important and substantial points about how we should do that.
Some noble Lords might remember that, several weeks ago, I said that I thought our responsibility was to proceed with the Bill to the point where, on Report, we would consider and improve it by amendment and vote on it. I said that we should therefore take the Bill to Third Reading and that it was my expectation that we would send it back, in an improved form, to the other place. To achieve that, I said that I would withdraw the amendments in my name—and I did so. I was very grateful to the noble Lords, Lord Goodman of Wycombe and Lord Hunt of Kings Heath, and the right reverend Prelate the Bishop of Southwark for assisting in withdrawing those amendments. No other noble Lords did that, to my knowledge.
What I want to say, in a sentence, is: we are a self-regulatory House. If we wish that to work, we have to regulate ourselves, because we cannot rely on someone else doing it for us. We did not do that. We have to think very carefully about any future Bill that we receive and seek to do that. We should do it through our normal procedures. Perhaps, as the noble Lord, Lord Carlile, said, we should think again and differently about how we conduct Committee procedures in relation to a Bill of this kind, but we definitely should do it substantively on Report with votes.
When we see a new Bill—I do not know what the proposals will be in another place—we definitely should not see the same Bill presented back to us by way of the Parliament Act procedure. The sponsors of the Bill should recognise that the debates we have had—and the amendments that we have seen but not necessarily debated, of which several are mine—should be incorporated into substantial revisions of any Bill. I draw attention to just two areas. First, having just listened to the noble Baroness, Lady Hollins, I agree with her that we need more by way of safeguards in relation to the availability of high standards of palliative and end-of-life care built into the Bill—one of my amendments was to that effect.
Secondly and in particular, I draw noble Lords’ attentions to the two speeches made in earlier debates by the noble Lord, Lord Stevens of Birmingham, on the relationship between the structure of this Bill and the National Health Service: it will not work as it is presently structured. We have to go back to thinking about an assisted dying service, if we wish there to be one, which operates independently from the NHS but, of course, with the participation of all the willing clinicians and others who are professionally needed to support it. It will not work if it is put into the structure of the NHS as we presently have it.
I hope that, if the sponsors of this Bill wish to bring back another Bill, it will be a different Bill. For my part, I hope that those who have been opposed to this Bill would be willing to put aside the fact that they are opposed in principle and leave that to the Third Reading debate, when, if they are opposed in principle, they can vote against it. At least give those who are in favour of the Bill—and those in another place, if they send it back to us—the opportunity to see what the Bill would look like with the amendments that we think need to be made to it. At the moment, on this procedure, we have not accomplished that responsibility.
Baroness Butler-Sloss (CB)
My Lords, I put down one amendment and did not speak to it. I do not like the Bill—everyone knows that—but I was working, and trying very hard, to get it to Third Reading. I am grateful to the noble and learned Lord, Lord Falconer, for recognising that. I want to say to your Lordships something about the future. It is inevitable that there will be another Bill. I implore the other House, assisted by us, that we must have pre-legislative scrutiny at that point, because if we have pre-legislative scrutiny then we really should be putting it through this House.
Lord Mohammed of Tinsley (LD)
My Lords, I am one of the newbies the noble Lord, Lord Carlile, referred to, although I have not spent time in government—I have spent a lot of time in local government and a brief time in the European Parliament. Noble Lords will note that I have spoken only twice during the debate—I made one substantial speech at the start and then one intervention—but I have sat through the many Fridays we have spent on the Bill. I pay tribute to the moving and personal speech from the noble Lord, Lord Markham, earlier.
Last night, I was with some friends who asked me whether I was going back home to Sheffield or staying. I said that I was going to stay and that I was going to listen, and that I did not have a pre-prepared speech but was going to speak from the heart. There have been occasions during our deliberations on which noble Lords have raised important points, whether on learning disabilities or prisoners. The noble and learned Lord, Lord Falconer, and the other sponsor have listened, but my frustration has been this: just because I have 10 minutes to speak, as I do today, does not mean I need to take 10 minutes to get to the point. Noble Lords need to reflect on that. Had we made the points we wanted to make quicker, we may well have got through many more topics. I pay tribute to the efforts of the noble Lord, Lord Carlile, in trying to narrow our debates into topics. I thought that we had found a way forward.
On Wednesday, when I was making my way to the Public Services Committee, I set off one and a half hours earlier than usual, due to the Tube strike, not realising that the Jubilee line was still running, and so I got here an hour and 15 minutes early. There were many people outside Parliament who were deeply frustrated by what is happening in your Lordships’ House. I have to say, there are issues here around confidence and trust. Our reputation is at stake. Our duty is to revise and scrutinise legislation. That is what we do best.
For me, one of the key points has always been about choice. I made it very clear to your Lordships’ House in my first speech on this topic that this is not something I would like to exercise, nor would any members of my family or anyone else I know from my faith. However, who am I to stop others? That is why I have said that I will play an active role in helping revise and improve this legislation where I can, but I do not intend to block it.
I really hope that the sponsors of the Bill, the noble and learned Lord, Lord Falconer, and my friend from the other place—I am not sure what terminology to use—who are here, are listening, because I see this issue coming back to us. This is not going to go away just because we are not able to conclude our deliberations. As the noble and learned Baroness, Lady Butler-Sloss, said earlier, we may have to do some pre-legislative scrutiny on this, because, ultimately, as I see it, this is half-time for this issue. There will be a second half in the next Session. I hope that all noble Lords on both sides of the argument will reflect on how we have conducted ourselves on the many Fridays we have sat, as well as on how we can improve both how we operate and the public’s perception. With that, I will sit down—after three minutes.
Baroness Smith of Newnham (LD)
My Lords, like the noble Lord, Lord Markham, I am one of the members of your Lordships’ Select Committee. We came to the Bill from different perspectives. As noble Lords know, I am not in favour of the principle of assisted dying. However, my view has always been that the role of your Lordships’ House is clear: it is to scrutinise and amend legislation. I have at no point sought to delay the legislation, because it is crucial that we send a message to the other House.
If my views had prevailed, my preference would have been to say that we do not want this legislation at all, but that does not appear to be the will of your Lordships’ House, and the view of the country seems to be a general preference for legislation on assisted dying. As I said at Second Reading, we as legislators are not legislating for ourselves or our own preferences; we must be legislating for the most vulnerable in society.
Lord Falconer of Thoroton (Lab)
I apologise for intervening but I completely agree with what the noble Baroness has just said. The way in which that would happen is that the Bill would come back from the Commons and we would agree here to put in the amendments that I put in as a result of the power of the noble Baroness’s speeches. We would then send it back to the Commons, where it would be agreed, so as to not let it be caught again in a procedural thicket.
Baroness O’Loan (CB)
My Lords, as we all know, this is a Private Member’s Bill. There was no manifesto commitment to it, nor was it in the King’s Speech.
Baroness O’Loan (CB)
The noble and learned Lord is interrupting me but I am not going to give way.
As the Constitution Committee of your Lordships’ House said, it is our duty to scrutinise, approve, amend or reject any Bill. Constitutionally, we are under no duty to pass a Bill simply because the other place did so. No constitutional crisis will ensue when this Bill fails, as it probably will do today. A majority of MPs now agree that that is the case.
Government Ministers have told the House that the Government are not responsible for ensuring that safety is considered and provided for in legislation —that it is a matter for the noble and learned Lord, Lord Falconer, and, ultimately, a duty of this House to scrutinise draft legislation in order to ensure that what we pass is safe. Yet what has happened is that, although the noble and learned Lord has made multiple commitments to table amendments to remedy problems, he has not done so. Indeed, some of the amendments that he has tabled have reduced the safeguards contained in the Bill, such as those inserted by Daniel Francis MP and Jess Asato MP, which relate to people with learning disabilities and domestic abuse. We know that it has been said that MPs expected this House to scrutinise the Bill and improve it, but, as The Parliament Politics reports:
“New data has emerged suggesting that the initial support for the bill was not an endorsement of its specific mechanics, but rather a tentative nod toward a concept that many MPs now believe is fundamentally unsafe”.
Now, only 40% of them would vote for the Bill, while 45% would not.
As has been said, there was no pre-legislative scrutiny, consultation or proper impact assessment before the Bill was introduced. The result was widespread concern, not least among the professional organisations. The short Lords Select Committee that took evidence received very specific, detailed criticisms and concerns from stakeholders. Most of those concerns have not been addressed by the Bill’s sponsor, including concerns articulated by the Royal College of Psychiatrists, the Royal College of General Practitioners, the Royal College of Pathologists, the Royal College of Nursing, the Royal College of Physicians, the British Geriatrics Society, the Law Society, the Royal Pharmaceutical Society and the organisation Standing Together Against Domestic Abuse. These are very real concerns about the safety of the Bill, its impact and its effect on professionals and ordinary people.
The debates at Second Reading and in Committee have enabled very extensive and necessary discussion on much of the Bill—but because it was so deficient when it came to your Lordships’ House, much remains to be considered. At least 244 Peers have been directly involved in scrutiny of the Bill in Committee. The average speech has lasted less than seven minutes. It has been said that only a handful of Peers tabled amendments. In fact, 92 Peers tabled or supported amendments. The noble and learned Lord, Lord Falconer, tabled 76 amendments. The noble Lords, Lord Birt and Lord Pannick, tabled 35 amendments jointly. Apart from that, the supporters of the Bill did not table any amendments and nor, for the most part, was there any constructive contribution to improving the Bill.
We have now debated more than 800 amendments. In the course of that debate, we have considered not just seven clauses, as has been asserted. Rather, we have considered Clauses 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 34, 35, 36, 37, 39, 41, 42, 43, 47, 49, 50, 51, 56, 57, 58 and 59, and Schedules 1, 2 and 3, in whole or in part.
Lord Falconer of Thoroton (Lab)
Is the noble Baroness’s position that we have completed our scrutiny in Committee of all clauses beyond the seven that she has mentioned? If not, I am not quite sure what point she is making. We certainly mentioned those clauses, but the idea that we completed our scrutiny is nonsense.
Baroness O'Loan (CB)
My Lords, to be accused of nonsense is slightly unsettling. I do not accept the accusation. The reality is that we have considered in depth a number of issues—
Baroness O'Loan (CB)
This Bill seeks to provide for individuals to be provided by doctors with fatal drugs to kill themselves. Where those patients cannot self-administer, Clause 25(8) says that
“the coordinating doctor may … assist that person to ingest or otherwise self-administer”
the drug. We have not yet debated this clause at length, but it does raise the spectre of Dr Shipman. What protection is there against a Dr Shipman in these circumstances? What protection exists for those who may be subject to coercion, which will not be identified because of virtual assessments—for example, where the assessing doctor is not in the room with the patient or has no way of knowing who else is there or what is going on? These things had to be identified and discussed and amendments tabled to address them.
In the course of our debates and through the submission of evidence to the Committee, we have identified multiple other serious problems. On many of them there was no engagement by the sponsor, as the noble Baroness, Lady Hollins, said. Following clearly argued criticisms, the noble and learned Lord has accepted a long number of problems with the Bill. However, there are virtually no amendments to address those issues. The legal definition of persons exerting pressure must expressly include bodies corporate, to uncover institutional or organisational abuse. Think of the pressures of bed-blocking and budgets in the NHS.
Regrettably, many of the amendments that the noble and learned Lord tabled weaken safeguards for which the MPs voted—such as explicit domestic abuse training or the mandatory independent advocate presence—under the guise of tidying up the Bill. Often these would save the Government money. The Government’s impact assessment reveals that it almost halves the cost of the assisted dying process if independent advocates or translators do not have to be present. There was provision for independent advocates to assist those who have substantial difficulty in understanding the process. Under the noble and learned Lord’s amendments, the advocate does not have to be physically present during medical assessments—and a person is allowed to entirely waive their right to an advocate.
It is perhaps paradoxical and dangerous to expect someone who qualifies for an advocate, precisely because they struggle to understand information, to independently decide to waive that very protection at the outset. The advocate is introduced only after key clinical and eligibility assessments have been completed, rendering them a box-ticking process. Think of the more than 100 languages spoken in England and Wales and of the problems of people with hearing difficulties, articulated by the noble Baroness, Lady Nicholson, and other communication difficulties.
Doctor-shopping possibilities have expanded as a consequence of the noble and learned Lord’s amendments. Let us be very clear. As is appropriate, our debates have ranged over a large number of issues. We have considered the effect on the NHS, the necessity to revise the NHS constitution, and the effect on practitioners who did not join their professions to kill people and who need protection against involvement. We have yet to debate the existing conscience protection provisions, but we know that they are inadequate. The BMA and the royal colleges asked for an explicit opt-in model, which was rebuffed multiple times in the Commons. The noble and learned Lord finally acknowledged the concern, but his Amendment 669A introduces an opt-in requirement only for training, not for assisted dying as a whole.
The Bill provides some protection for professionals but not for all the other people who enable our NHS to work—the administrators, the porters, the cleaners. The current option of going to an employment tribunal if facing disciplinary action in the context of an unwillingness to engage in any way in assisted dying is just not satisfactory. People need their jobs to pay their rent or mortgage, to feed their children. A system-wide opt-in model is the only way to protect staff from institutional pressure, yet the noble and learned Lord drew the line at protecting administrative staff, to ensure that the NHS runs properly.
Too many issues that should be debated fully in this House are to be left to secondary legislation, which Parliament can only accept or reject but not amend—for example, the approval of lethal drugs and the provision of assisted suicide services in England and Wales, which the DPRRC has said should be removed.
We talk of democracy, yet there is nothing democratic about handing sweeping powers to Ministers rather than to Parliament. There are those who, like me, believe that all life is sacred and to be protected, from conception to natural death. That has not been the subject of our debates over these months. As legislators, some with a religious faith and some with humanist beliefs or maybe no beliefs, we have been through this Bill word by word and clause by clause to see whether it can be improved. We have identified the massive inadequacy in the provision of specialist palliative care and the consequences of that inadequacy; the disparity of access to hospice care; the unique identity of hospices in providing a safe place to live and die without pain and at peace; the huge trust that is fundamental to the doctor-patient relationship in places in which people live and die; and the potential consequences if the Bill is passed for private and public funding arrangements for hospitals and the NHS.
Lord in Waiting/Government Whip (Lord Wilson of Sedgefield) (Lab)
The noble Baroness has spoken for over 11 minutes and it is supposed to be 10 minutes. Can she bring her comments to an end?
Baroness O'Loan (CB)
I am bringing my comments to an end.
We have tabled amendments to provide some protection for the vulnerable, the weak, the poor, the disabled, the sick, those with suicidal ideation, those with mental health problems and all those whom we have identified. Many of us have concluded that this Bill is not safe and have worked to try to make it safer. As I conclude, I pay tribute to those living with serious illness and disabilities; people such as Pete and George, who have attended every day of our debates and who sit behind me; and all those—
Lord Wilson of Sedgefield (Lab)
Can the noble Baroness please bring her remarks to an end now? It is nearly 12 minutes and other noble Lords want to speak.
Baroness O'Loan (CB)
The 12 minutes include the interruptions I have suffered.
I pay tribute to all those who have written to encourage us as we fulfil our duties as legislators in your Lordships’ House in scrutinising this flawed and very dangerous Bill.
Baroness Prentis of Banbury (Con)
My Lords, I regret that I was not here this winter during the discussions on the Bill. But watching it on television has been a key part of the rhythm of the weeks that I have spent at home. During my chemo-induced cognitive dysfunction, the plot of “Midsomer Murders” was often beyond me, and the steroid frenzy I felt meant that I often could not settle to a book. But during 13 bouts of chemo and an operation, I kept returning Friday after Friday to this debate. Noble Lords may ask themselves, why? It may be because, as a government lawyer, the constitution is in me like the writing in a stick of rock. But it is also, of course, that as your normal procedures and love of friends, work, food and drink are taken from you because you have to remain isolated, the issues of life and death come sharply into focus.
What I watched, from a unique perspective, with my telly newly installed in my bedroom—shockingly, some might say—was impressive. It was the calm, quiet scrutiny of legislation. Far from few voices were heard, as some have said. I frequently had to consult the booklet to see who was speaking. I saw the former heads of royal colleges explain why no royal college can support the Bill. I saw lawyers worried that coroners are not able to feel that there are sufficient safeguards in the Bill. I saw former NHS managers worried about the effects on the service and staff that they care for so deeply. I saw experts on devolution get into the details. I was impressed by the deep experience of the Bishops, often speaking from their time as parish priests, who, frankly, have held more hands of the dying than the rest of us put together.
As I watched from the coalface of trying not to die, I felt huge sympathy for the very ill people who think that this Bill might be the answer to their problems. Illness leaves you with few options and little control. The systems can seem unyielding and, as a result, uncaring. In my experience, that is worse than pain.
Of course, you are exhausted, miserable and sick. You look awful, you are often smelly, and some symptoms are, frankly, revolting. Of course, you worry very deeply about your family watching you go through all this and what it is doing to them. Even with my excellent care and good prognosis, I have definitely at times felt that death would be much easier. Whenever my treatment has not been as speedy as it might be because of capacity issues—I am currently waiting longer than I want to for radiotherapy, which is due to start the week after next—or when I have been waiting literally on the floor, having fainted in a less than perfectly clean NHS corridor, I have had a vision in my head of crisp white sheets and the certainty that would come from knowing that you were instantly going to die. For me, and I suspect for most vulnerable people, that vision passes and life becomes worth living and good again. But I do not think for one minute that we should deny that that vision is briefly an attractive one.
We owe the dying better than this Bill. We owe them the best death that we can manage and real effort and enthusiasm put into palliative care and all facilities, including temporary nursing where necessary, to help people die at home surrounded by their families. We need to really integrate physical and mental care and not just talk about it. We owe the dying love, care and respect. We hope that crisp white sheets and some control over treatment dates may become part of the normal system of palliative care and not just reserved for people who engineer some form of assisted dying. We owe the vulnerable legislative protection.
Baroness Hayman (CB)
My Lords, it is an absolute privilege to follow the very moving and focused speech of the noble and learned Baroness, Lady Prentis. Perhaps the one good thing about the last year that has been a real revelation, and something that I respect enormously, is the number of people who have shared their experiences of death, dying and illness and their views about the best way forward. No one can pretend that there is unanimity on this issue. We have to respect all those views and listen to them.
Twenty years ago, I was a member of the Select Committee on Joel Joffe’s assisted dying Bill. That experience, the visits that we made and the evidence that we heard, convinced me that it was possible to frame legislation that safeguarded against coercion and did not compromise but rather complemented palliative care. For me, as the noble Lord, Lord Markham, said, it made the argument for regulation.
So, I was surprised to hear the noble Baroness, Lady O’Loan, describe what could go so badly wrong in an unregulated system—Shipman, coercion and no one knowing what happens. I simply do not accept that a tightly regulated Bill with the sorts of safeguards that are in this Bill is not better than the wholly unregulated system we have at the moment.
On that Select Committee, the visit to Oregon in particular made me very aware of another issue: that having legislation for assisted dying would directly affect only a small number of people who took up the option. The percentage of people who investigated the option and got a prescription—as that system required—but never used it, and who instead found that they could cope with the situation in which they found themselves, was about 30% across jurisdictions. But the very existence of legislation, and a system that they knew they could access if things became intolerable in the end, gave huge reassurance to the hundreds of people who would die under assisted dying legislation. There are thousands who would feel more secure and be reassured by the fact that there was an option. I put myself absolutely in that category and I suspect that many others in the House would do so too.
I participated in the debates. The noble Lord, Lord Baker, is in his place. I went head to head with the noble Baroness, Lady Finlay, on all those debates as well. I participated in all of them. I have been disappointed before and I have seen Bills fail before, but nothing has made me feel, in the words of the noble and learned Lord, Lord Falconer, “despondent” in quite the way that the process we have gone through in the last year has done. So, it is important that we reflect in today’s proceedings, because they should be a reflection on what I consider to be a collective failure.
I think we have failed those people who came to us with experiences, either through families or their own experiences, of the inability of palliative care, however good, to meet what they actually need at the end of life. We have failed those repeated campaigners who knew that the legislation would be too late for them but did not want others to go through what they had. We have failed to respect the consistent weight of public opinion on this issue that we ought to have a different, regulated and safe system, and we have failed to respect the elected House’s request to us to do the job that was described so clearly by the noble Lord, Lord Lansley.
We have to reflect, because all those failures have damaged the reputation of this House and they have damaged what many of us have respected and felt to be very much part of the House’s DNA—self-regulation. We have not fulfilled our duty to use our procedures on a Bill that has been passed by the House of Commons to focus either on the issue of principle by a vote at Second or Third Reading, or on specific detail where we need to calibrate the strength of opinion in this House—to vote—and send our conclusions to the Commons for its response. Instead, we have had the prolonged and painful process described by the noble and learned Lord, Lord Falconer. It has been a protracted, repetitive debate which, ironically, has led to us failing properly to address issues, such as those about the Delegated Powers Committee, which we have to take seriously. I find it disingenuous that the amendment to the amendment states that we have not taken proper account of this committee, when the reason we have not been able to is that we have not got to that bit of the Bill yet, because we have spent so much time on other bits.
There has been criticism of the noble and learned Lord, Lord Falconer, for not moving enough. I think he described the processes that he has been through. I have been present at many of those meetings, and attempts have been made to find a serious process to identify the issues that are most important to try to reach either consensus or a point where we can vote on them and decide what we want to tell the other place. Instead, we have spent hours focusing elsewhere. A very brave woman dying of stage 4 breast cancer said to me, “I’ve listened to you, and what you have been doing is focusing all the time on hypothetical harms, some of them bizarre—the pregnancy test and those sorts of issues. What you have done is ignore the actual and profound suffering that is before your eyes”. That is a serious accusation to us.
Of course, as legislators, we have a responsibility to scrutinise legislation like this for safety, but we also have a responsibility to have a full debate and reach conclusions. We have not discharged that responsibility, and we should all reflect very seriously on that.
Baroness Harding of Winscombe (Con)
My Lords, my mother-in-law died from motor neurone disease a couple of years ago. She was a primary school headmistress, and she took firm control of her life throughout it. Three weeks before she died, she called a multidisciplinary team meeting of all the various clinicians, including the palliative care team, and her family to express her wishes very clearly. She had reached the point where she could not move other than her face. She could not breathe without a CPAP mask for more than a few minutes, and life was intolerable. She told us that she intended to die in three weeks’ time.
That was an assisted death to the layman. It was completely legal because she could still speak. Three weeks later she told her nurse to take her mask off, she asked the nurse to give her a sedative and she passed away completely peacefully. That has completely shaped my view. As my noble friend Lord Markham set out so much more eloquently than I could throughout the course of this Bill, we have an unregulated system that is scary and unfair, so I am in favour of this Bill.
Baroness Mattinson (Lab)
My Lords, it is important that we, as an unelected Chamber, focus on what the public think. Over the last few months, we have heard opponents of the Bill suggest that it lacks public support; I want to correct the record on that. The most recent British Social Attitudes survey—which is, by the way, the highly-regarded bible that tracks longitudinal public attitudes—was published in March, and it shows that an overwhelming eight out of 10 of us support changing the law to enable assisted dying. This powerful evidence is consistent across respected public polling and across age, gender, region and political attitudes. It is also consistent among those with disabilities, those who profess a religion and those who work in the medical professions.
Data modelling by the polling organisation More in Common reveals that support far outweighs opposition in every constituency in Britain. But do not take my word for this. Polling guru Professor Sir John Curtice observed recently that the picture of public support for assisted dying was
“one of remarkable stability and near consensus in public attitudes”,
while another senior and highly respected pollster, Peter Kellner, says:
“Having reported, commissioned and conducted polls for more than half a century, I cannot think of another major social controversy where the public mood has been so settled and so emphatic”.
Both pollsters, in my experience, place the very highest value on presenting an objective and truthful representation of people’s views. Those views are not just widespread and consistently held in favour of assisted dying; they are also heartfelt. They are not theoretical but drawn from painful personal experience, and many of those stories—
Baroness Mattinson (Lab)
I am speaking very briefly so, if the noble Baroness does not mind, I will continue. Many of those stories have been told very movingly here today.
The point is that 52% of us have cared for or witnessed a family member who was terminally ill and suffering at the end of their life. Unsurprisingly, experience of this rises with age, up to 66% in the 50 to 64 year-old age group, and higher as you get beyond that. Research—for example, England’s first ever citizens’ jury, so more qualitative and deliberative research—tells us that support for law change grows the more that people understand the issue and hear about it.
Meanwhile, the backdrop to this debate is that trust in our democracy has never been lower. Too often, the public do not feel listened to. Confidence in this unelected Chamber is at its lowest ever: a desultory one in five has confidence in the House of Lords to do its job. At the end of last year, YouGov found that just 2% had a lot of confidence in the House of Lords and only 17% had some confidence. Some noble Lords have quoted a poll that suggests that the public would like to see us doing better scrutiny. Yes, in abstract, they absolutely would, but, with reference to this particular Bill, a YouGov poll recently found that 58% disagreed with the way the Lords has dismissed the Bill while only 17% found it acceptable. Again, public opposition rises, as you would expect, with greater experience by age, consistent with the lived experience of the impact and pain of the alternative.
As this debate draws to its close, we should all be aware that the way the Bill has been treated by this Chamber risks having profound implications for the Chamber itself and its reputation, as well as the absolute tragedy of ignoring the passionately held public view for assisted dying.
Captain of the King’s Bodyguard of the Yeomen of the Guard and Deputy Chief Whip (Baroness Wheeler) (Lab)
My Lords, we will hear from the Cross Benches.
Baroness Gerada (CB)
My Lords, I remind the House that Harold Shipman was a murderer convicted of 15 life sentences plus four years. He did not provide an assisted death. I would like that to be on the record.
I stand here as a general practitioner with over 40 years’ experience and, as I have said many times, as president and chair of the Royal College of GPs. Over the decades, I have had the privilege, though not always an easy one, to care for patients at the end of their lives. For some, I have been present at the moment when life passes to death. It is an extraordinary moment—not, as it is often portrayed, bleak or clinical or purely tragic, but something far different. When death is well supported, when it is anticipated and when it is held by family and those who care, it can be a moment of stillness, connection and a sense of peace that feels unexpectedly profound. It is one of the most powerful experiences I have ever had as a doctor. In those moments, one thing is always clear: the patient is at the centre. Their wishes, relationships and dignity all shape how that final phase of care unfolds when it goes well.
However, that is not the whole truth. I have also cared for many patients whose deaths have not gone well: patients who have refused treatments or have starved themselves rather than endure what lies ahead; patients who, sadly, have ended their own lives, unable to bear the weight of their diagnosis; and patients whose illnesses have taken away from them the ability to make their own decisions, and whose deaths have been placed into the hands of others—families, clinicians and the systems acting in their place.
That brings me to the heart of this debate. The question is simply, though uncomfortably: whose death is it? For decades, medicine has placed patient autonomy at the centre, bounded by capacity, consent, clinical judgment and protection from coercion. We speak of choice, dignity and the individual’s right to determine what happens to their own bodies; we have built systems, laws, safeguards and languages all around that. Yet, at the moment when autonomy might matter most—the manner and timing of one’s own death— it is withdrawn. At that point where a patient is dying, we say, “Not here. Not you”. To my mind, that is not just a tension but an inconsistency that demands reflection, which is what I have been doing over the last few months.
I say with respect that much of what I have heard in this House has strongly focused on risk, even today, but risk is not unfamiliar territory in medicine. It is our daily working environment. We do not eliminate uncertainty; we manage it. We make complex decisions every day about treatment, capacity and withdrawal of care under conditions of imperfect knowledge, guided by safeguards, judgment and professional accountability.
Alongside this focus on risk, there has been a tendency, again as I have heard today, to imagine worst-case scenarios and to construct arguments at their point of failure rather than their point of function— the “what if?”—and to build in increasing complexity to cover every possible scenario that might come up to manage these hypothetical fears. We have even heard today about the 100 languages that are spoken. How do we manage learning disability? How do we manage people who are disabled? We do this every single day, a million times per day.
Even the Chief Medical Officer, Sir Chris Whitty, warned in his oral evidence that we are
“layering layer upon layer of complex bureaucracy on top of one another”,
and, in my mind, expecting the dying patient to jump through endless hoops, be that having to see their GP six times in six months, living at the same address for 12 months or having repeated assessments. We have heard powerful testimonies about relatives who have died. Can you imagine, at the moment of their death, asking them to do repeated serial sevens—that is, counting backwards from 100 in sevens—or to draw a clock face to assess capacity?
Let me take my own profession: general practice. Listening to some of the debates here, one might think that when a patient receives a terminal diagnosis general practice fades away—that we retreat or that care fragments. This is not my experience, nor that of many of my colleagues. When a patient enters their final phase of life, general practice leans in. We intensify care; we place patients on dedicated pathways; we ensure rapid access to benefits; and we maintain continuity with a named clinician, who is more likely than not a GP. We co-ordinate care with community teams, palliative care specialists and families and we ensure that we do our best to provide continuity in and out of hours. We organise ourselves around the patient. We do not move away. Instead, we gather more closely. Are there failures? Yes, of course—no system is without them—but end-of-life clinicians across disciplines try, often beyond expectation, as I have, to keep the patient at the centre and to get it right.
Captain of the Honourable Corps of Gentlemen-at-Arms and Chief Whip (Lord Kennedy of Southwark) (Lab Co-op)
My Lords, I am conscious that many noble Lords wish to speak in this debate. If we work together, everybody standing up will get the chance to speak. If we follow the wise words of the noble Baroness, Lady Harding—we can make our points in four to six minutes very easily—we will all get a chance to speak. The next contribution will come from the noble Baroness, Lady Grey-Thompson, whom a number of noble Lords have called for. Please all work together—we will all get to speak.
Baroness Grey-Thompson (CB)
My Lords, I thank the Chief Whip for recognising my inability to bob. I apologise that my noble friend Lady Finlay of Llandaff is not able to be here today. She is attending the funeral of one of her patients, whom she spoke about in your Lordships’ Chamber in this very debate. Four doctors diagnosed that patient with a terminal condition and told him he had three months to live. My noble friend has known him for 35 years.
It does not give me any sense of satisfaction that we are where we are today. This is a complex Bill, and there is a whole range of emotions on all sides of the debate. But people are angry and scared. Where we have got to in the debate does not address many of the issues of death—the good death—or palliative care. I am one of the Peers who have been targeted in the press for the number of amendments they have tabled. My amendments came about in different ways. I wrote many of them. Some were tabled at the request of organisations and charities of and for disabled people, as well as disabled individuals who are very worried about the reality of the Bill. We have been criticised for the length of our speeches and the way we have worded things. I am very happy to show anyone my speech outside the Chamber, although I am not allowed to do so in the Chamber. We edit and rewrite as we go along in order not to be repetitive. But our role is to bring our experience and knowledge to the Chamber.
It is hard to argue with the principle of two doctors’ settled wish and a six-month diagnosis, but Committee in the House of Lords is about detail. Committee has raised many issues of detail that we have explored, but it is not possible to put this into simple soundbites. A letter was circulated yesterday about the role of the House of Lords and mentioned that we have completed only seven clauses. But I agree with my noble friend Lady O’Loan: we have debated other parts of the Bill. I have made numerous attempts to get answers to my questions about Clause 22, and they have not been forthcoming. Where the noble and learned Lord and I probably agree is on some of my amendments around advertising. I understand why it took weeks for him to table his amendments, but what has been tabled is a much weaker version of what I originally put down.
We are continually told that this Bill is the safest in the world, but in a meeting with the noble and learned Lord and the honourable Member for Spen Valley, I asked who said that. I was told that doctors from all around the world did, but that does not make it the safest Bill in the world—it is not a very high bar. I have a frustration with the understanding of people outside the Chamber of how Parliament works. The Bill we have been presented with is very different from the Bill that started in the Commons. Two-thirds of the time there was spent with a High Court judge as part of the Bill, and that was then removed. On Report in the House of Commons, 121 amendments were tabled— 44 by the sponsors. Of the remaining 77 amendments, MPs were allowed to vote on only seven, so I disagree that there has been detailed scrutiny.
This Bill has failed because there are too many gaps in it. The recent Bill in Scotland failed because there were severe concerns at the third stage about safety. The Delegated Powers Committee, royal colleges, organisations of and for disabled people, charities and individuals have all raised multiple concerns about this Bill, not the principle. Although many people have written to me about not wanting to die in pain and suffering, this is not in the Bill. There is a lot of misunderstanding about what people might get. I really worry that people on the outside have been promised something that they were never going to get.
Some think this is about euthanasia. It is not one pill. Assisted death does not mean that the death is painless or that it will be quick, and it is not for some of the groups who think they will get it: it is not for people with motor neurone disease, but it could be for people with bulimia. It certainly will not be available at a place of people’s choosing. Most of the emails I get say, “I want to choose the time and place of my death”, but, without proper licensing, that will not happen.
There is a challenge in this being a Private Member’s Bill, in that those who oppose it have not had access to the team to be able to finesse our amendments. Yes, we have been asked several times to think about what groups we might like to debate, but I have not seen a suggested groupings list. We are not one single group of people; in this debate, I have been working alongside people whom I never thought I would agree with on anything. It shows the strangeness of this debate. Many of my amendments are drafting amendments—just simply to get the correct language around disabled people and to think about the impact the Bill might have on those groups.
I have had a lot of pushback on my amendments. Certainly, pregnancy seems to have attracted a lot of attention. I made it clear in the debate that it was not about who could get pregnant. It was not a debate about gender recognition, nor about the age of the individual; this is set out in NHS guidance. It seems a shame that those who are willing to take umbrage with me do not appear to have listened to what I said in the Chamber.
What have we learned? We have learned that being pregnant, homeless, poor or disabled should not be a barrier. That is why the Bill’s progress has been slow: those comments have made people nervous. If you are homeless, poor or disabled, you do not have equal access to society, so it is not a level playing field to start off with and you have significant disadvantage. Why are disabled people scared? A couple of weeks ago, I had my name on an amendment to the English devolution Bill, which was simply to enact legislation that passed 30 years ago. It was to make sure that taxis were accessible for disabled people. There was a three-line Whip against me and the vote was lost. This Chamber voted against something as simple as making taxis accessible for disabled people. So why do disabled people have little trust in this Bill?
It is not just seven of us who have opposed this Bill. There are many who have spoken in the debates. The noble and learned Lord himself has tabled 76 amendments. He now comes fifth highest on the ranking list. To me, that shows that there is not the confidence that this Bill is safe.
I have received many emails, many of which asked whether I have watched someone who I love die. Yes, I have. I sat beside my father’s bedside for weeks while he died slowly, having multiple amputations. I held his hand for the last 24 hours before he died, and I constantly think about what I could have done differently. My father was instrumental in making me the person I am and for all my strengths and weaknesses. I seriously questioned myself on whether this Bill, if it had passed, would have made his death better. No, it absolutely would not.
We talk about choice and free will, but there are many people who have no choice or free will, and this Bill does not operate in a vacuum. We cannot forget the significant amount of discrimination that many people face. I myself have experienced ableism within the health service, and the point that my treatment changed was not when I became an expert patient and it was not when I argued for my rights; it was when they realised that I had a red stripy badge and that I sat in the House of Lords. We have to recognise the privilege that we have.
I have had thousands of emails on this issue, including two this morning, one of which was from someone who has emailed me many times, who finds my cruelty unforgivable and is disgusted with me. Another was sent to Ms Leadbeater and I was copied in. The individual said:
“I am someone with no one. Little in the way of family. There will be no one there with me when I die. I know that I will be manipulated to not waste inheritance money on care homes, and to end my life for the sake of others. I’ve been in hospital dozens of times the last few years as my health declines. Each time by taxi, no one to look after me, not allowed sedation because there’s no one at home to look after me the following 24 hours. I don’t think I’ll be someone who lives a long life. It’s embarrassing to admit you have no family to care about you, who would look after you in old age or when you are ill, or to hold your hand in your last moments. So I believe we are the silent majority”.
We have heard much debate today about the damage to your Lordships’ House, but I have had thousands of emails to thank us for what we are doing here to unpack the danger that is in the Bill. I am very clear on my role. It has not been pleasant to sit here and be targeted by so many people who say that we are doing a bad job. But our job is to protect everyone in British society, and this Bill does not do that.
Lord Farmer (Con)
My Lords, this is a Private Member’s Bill, finally passed in the Commons with a shrinking majority of 26. I have spoken to a number of Labour MPs since, and what is possibly not known is that there was considerable pressure from No. 10 to pass the Bill. It was known that the Prime Minister, Sir Keir Starmer, supported it, and indeed there were government party Bill supporters standing at the entrance to the Lobbies taking note of who was going through. I am just passing on what Labour MPs have said to me: that they felt intimidated.
There have been and still are considerable concerns about such an important matter as assisted suicide coming on the statute book through a Private Member’s Bill. It has not had pre-legislative parliamentary scrutiny, as we have heard. Committee stage in the other place was chaired by its sponsor and appeared to some to be unbalanced, and there has been no publicly available impact assessment or cost analysis by the Government.
Lord Falconer of Thoroton (Lab)
The noble Lord says that there has been no publicly available impact assessment; that is wrong. There is a publicly available impact assessment, published not by the sponsors but by the Department of Health and Social Care.
Lord Farmer (Con)
I will continue. Almost 250 Members of this House have been involved in a massive and sustained effort to try to make the Bill safe and workable. The House staff, as we have heard, have been outstanding in their service to us all and I am sure we are extremely thankful and grateful to them for that. Much has been imputed, particularly in the press, about our motivation in closely scrutinising the Bill, including that we are cruel. At no time have we been unaware of the suffering that the Bill’s supporters have wanted to alleviate. However, it is not compassionate to pass a Bill without addressing the many concerns raised by royal colleges, three committees of this House, myriad disability groups and others: that would be cruel to the poor and the vulnerable. Yet we, and by extension they, have been shown not a little contempt at times when we have taken time to lay out how the Bill would affect them. We need to be wary of contempt when courtesy, as we were reminded at the beginning, is the currency of this House.
I continue to have a quiet concern about the language used. Orwell described political language as
“designed to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind”.
First, we talk about “assisted dying”, when we surely mean “assisted suicide”. Assisted dying is what Dame Cicely Saunders said hospices and palliative care would provide. She said:
“You matter to the last moment of your life, and we will do all we can to help you not only to die peacefully, but also to live until you die.”
I urge this Government to do what no previous Government have done and make high-quality palliative care sustainable and universally available.
Secondly, the legal qualifier for assistance is terminal illness within six months to live. As we have heard already, when that prognosis has at least a 20% to 30% unreliability, according to evidence given to the Select Committee, we should not pretend that legal solidity exists where actually there might be pure wind. Thirdly, any notion that noble Lords are filibustering rather than legitimately scrutinising the Bill is unsustainable, given both the length of the Bill and the proceedings in the Commons, and the fact that the mean length of speeches in this House has actually been under five minutes.
Finally, I detect an assumption that anyone who is religiously motivated should not be heard or impose their views on anyone else. We do not impose our views, but we do echo a very substantial number of people outside this Chamber whose faith is partly why the Bill evokes deep concern. In contrast, every day of our lives, secular humanism is imposed on us, with its assumptions about the primacy of individual autonomy and the irrationality of belief. Such assumptions deny that human existence is inherently relational, deny the loneliness of hyperindividualism and deny that it takes more faith to believe that this incredible world in which we live came from nothing than to believe that there is something or someone behind it:
“Does he who make the eye not see?”
Finally, there are very many ethical, medical and practical reasons why this Bill has needed robust and lengthy scrutiny from a very diverse group of Peers. The process in this House and evidence from other countries have profoundly challenged the assumption that the service that the Bill attempts to provide can be safe. Many here say that this is based not on faith, but on evidence. To return to what I said at the beginning, this House has a premier global reputation for its thoroughness of scrutiny. When I was in Brussels, I talked to an Italian lawyer working for the European Commission who said that the work received from this House was second to that from no other secondary Chamber in the world. I believe that we have lived up to that reputation over the course of this Bill.
Baroness Rafferty (Lab)
My Lords, I speak for the first time in this debate as a nurse and former dean of the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s College London. Our patron saints include Florence Nightingale and Cicely Saunders. It would be hard to imagine two more rigorous and formidable expert witnesses to comment on the debates that we have been having these past few weeks. Both were deeply committed Christians, driven by the alleviation of human suffering and providing the practical means to do so through nursing and palliative care. Both were accomplished scientists, Nightingale being hugely influential in public health, epidemiology, statistics and social science, as Cicely Saunders was in physiology and the psychology of pain, coining the concept of total pain to convey the holistic sense of suffering.
But both had more speculative sides to their characters. In the case of Nightingale, it was a fascination with Thomas à Kempis, Teresa of Ávila and the medieval mystics. She committed some of her thoughts to paper, consulting Benjamin Jowett, regius professor of Greek and theology at Balliol College, Oxford, who became her spiritual confessor. Cicely Saunders’s library reveals a similar quest to understand Christian ethics and the existential nature of the human condition. Both were deeply interested in, as well as troubled and possibly tormented by, the challenge of squaring the existence of a benign God with the dark side of the soul and human suffering. Perhaps the ultimate question in their minds was an eschatological one. How will it all end? How will life end and what will death be like?
In a sense, that is what we have been wrestling with over the past months, struggling to reconcile very different perspectives on how it will end for ourselves, loved ones, patients and relatives. Some of us believe in enabling people to exercise autonomy over the end of life and the nature of their deaths—to have agency over the end. We have heard testimony from people who have chosen this path, as well as from relatives and loved ones. They have spoken powerfully of the sense of freedom and relief it has provided and the physical, emotional and spiritual sense of peace for all concerned.
There are those who do not agree that this should be possible. Such views are profoundly personal. I happen to have witnessed some very difficult deaths of patients and close family members. That has convinced me that assisted dying is a positive step in easing people through to a good ending. Denying that option to people who would like to avail themselves of it, when we can offer it and international evidence demonstrates that it is safe to do so, seems not only cruel but unethical. When seen in the context of a Bill that has passed in the elected Chamber and is supported by public opinion, it seems like a dereliction of duty. It is not our job to defy or block the democratic process. I implore noble Lords: it is time to dissolve our differences and do the right thing by finding a way to pass this Bill.
The Archbishop of Canterbury
My Lords, I shall briefly make some reflections. It is a great privilege to follow my friend, the noble Baroness, Lady Rafferty; I thank her for her contribution. I recognise the enormous amount of work that has gone into this Committee stage. I am grateful to the noble and learned Lord, Lord Falconer, for meeting me; I thank him for the time that he has given me.
Noble Lords will know that I oppose the Bill in principle, both as a priest and as a nurse, but it is clear that some things unify us. Whether we support the Bill or oppose it, we are unified by the fact that we want people to die in a dignified, pain-free and compassionate way, with the least possible fear. I also believe that we are unified in the belief that there needs to be investment in palliative care now. I welcome the new modern framework for palliative care that the Government have introduced, but recognise that financial investment still needs to occur.
We are also unified around the fact that if this Bill or topic comes back in some form, we need to do our work differently. There is no doubt in my mind that this is one of the biggest societal shifts that we are seeing or will see. Therefore, we need to take our role seriously, as we have done. There is something about our learning for this process and looking forward to how we do it differently when it comes back. I was very taken by the view of the noble and learned Baroness, Lady Butler-Sloss, of pre-legislative scrutiny, although I do not know the details. We should look seriously at that.
We are also united in knowing that this touches some of our deepest emotions. I am grateful to those who have shared their own experiences and stories; I have felt very humbled listening to them. For me, as a Christian, this is clearly an eschatological question, as my friend, the noble Baroness, Lady Rafferty, said. Of course, for me, as a Christian, death is not the end. There is hope in death and life everlasting. As we talk about these things that touch us deeply, we need to look after each other and ourselves and recognise that this process will have impacted us, as well as those listening.
Lord Pannick (CB)
My Lords, I assure my friend, the noble Lord, Lord Farmer, that I shall seek to avoid pure wind. I share the disappointment of so many in this House, and indeed so many outside it, that we have not completed our task of scrutinising this important Bill. Scrutiny means not just debating seven clauses of a 59-clause Bill over 13 days; it means completing Committee and Report, going to Third Reading and voting on our differences.
There are profound differences of opinion that people can quite properly and reasonably hold, but there has to be a choice as to which side you are on. Our failure—and it is a real failure, for whatever reason—is a stain on the reputation of this House, because the issues raised by the Bill are profound. They are important to people—people who are worried about death and those who are worried that they may be coerced into agreeing to assisted dying. The issues are highly contentious, and the Bill has been passed by the other place—the democratically elected place. That does not mean that we have to agree with it, but it certainly means that we have to come to a view and vote on these matters.
I, incidentally, have no doubt whatever that if we had reached Report and Third Reading, and if we had voted on this Bill, the overwhelming majority of this House would have voted in support of the Bill, thereby rejecting the destructive amendments that were put forward. I think the opponents of the Bill know that as well.
Lord Deben (Con)
My Lords, as a fellow Catholic, I make a confession. I have learned an enormous amount from listening to almost every moment of the Bill. The argument that most distresses me is that which suggests that this has been subject to a filibuster. I have learned a great deal, and I am the better for it, although not the happier for it. I want, therefore, to explain something that I find extremely difficult and that we have not really faced. The problem is not the problem that the noble Lord, Lord Pannick, has raised; the problem is the nature of the process right from the beginning.
The noble and learned Lord, Lord Falconer, said that this could not be a government Bill. It is perfectly possible for the Government to have said in their manifesto that a Bill would be prepared, but people would be able to vote on it as they believed to be right. That would have meant that we had a Bill that answered the fundamental problems that many of us have.
The noble and learned Lord knows that, in principle, I disagree with the Bill, but my fundamental problem with it is that I cannot ask about or understand a whole range of things, because they are not in the Bill and are left to a Government to decide how they shall be done. That is why the Minister, with commendable and continuous patience, has had to say, “I cannot answer that, because that depends on what the Houses say, and we will have to answer that afterwards”.
This is not a satisfactory way to proceed and nor is blaming the House of Lords in our debates, when the fundamental issue is that what really happened—and we know what happened—was that the Prime Minister made a promise and then did not do it in the way it should have been done. He arranged for a Private Member’s Bill to be produced. That Bill has been produced. Now, we are told, it is a very good, robust and safe Bill. Well, a robust and safe Bill would not be the only Bill I can remember in 50 years in politics that is opposed by every representative of the disabled movement. What other Bill would we bring forward, saying that it is a suitable Bill, even though every disability organisation is opposed to it?
Lord Weir of Ballyholme (DUP)
I thank the noble Lord for giving way. As he indicated, over 300 disability groups have expressed concerns about this. I do not think that a single disability group has come out in favour of it. That has led, in part, to the problems that we have faced. There has been a wide range of amendments, particularly those put down by the noble Baroness, Lady Grey-Thompson, as well as those put down by me and others, on disability issues, which have been either directly inspired or suggested by a disability group. In virtually all those cases, the answer that has come back was no. It is perhaps not surprising that there is still a level of concern and opposition from disability groups.
Lord Deben (Con)
My concern is merely to say that, whatever your views are, I do not know of a previous occasion when such concerted concerns have been, frankly, not faced up to.
The second thing that I find very difficult is for it to be said that this is a robust and safe Bill, when, so far, it has not actually met the concerns of all the royal colleges. I entirely agree with the correction made by my noble friend: some of them are opposed to it for particularities, some want particular changes and one, I believe, is opposed to it in principle. However, the point is that we are seeking to make a fundamental change, and that is this other issue that I find so difficult. I think the phrase used by the most reverend Primate the Archbishop of Canterbury was societal change. This is not like the other Bills with which it has been compared; this would make a change to something that we have held as a society for hundreds of years. We have never thought it proper for the state to take life, except when we believed that it was all right for capital punishment, and we certainly believe it to be right in the case of a just war.
We have to face the fact that this would be a fundamental change. Some of the comments that have been made have been really concerning. When it is said, as it was, that this was about nitpicking changes, you realise that there was no understanding of the fundamental change that we are proposing. There are many who take a different view from me about that fundamental change, but we should all accept that this is not a passing issue that can be discussed easily.
When the noble Lord, Lord Pannick, says that we ought to get through it all, I say that we can do that only if we do not do the job properly. The problem here is that much of the job that we have had to do— I say this directly to the noble Baroness, Lady Jay, with whom I have had discussions in the past—ought to have been done before the Bill came to this House. It should have been done by a royal commission. We should have had a proper Bill, which was a government Bill, and we should then have been able to use both our ability to debate and our right to decide at the end of it.
I hope that the noble and learned Lord will not bring back this Bill, unamended or even amended with the bits of amendments that he has so far been prepared to do, for which I thank him—I do not mean “bits” in an unpleasant way; I mean the pieces that he has done. I wish he would do something quite different. I very much believe in my cause, and I want this to be properly carried through a proper parliamentary system. I want to uphold what Parliament is about. I want, therefore, to have a proper commission. I want to have a proper Bill, produced by the Government, and then I want people to be able to vote on that as a matter of conscience. If he does that, he will have the respect of all of us.
Lord Moore of Etchingham (Non-Afl)
I begin by making apology to the most reverend Primate the Archbishop of Canterbury. When I was shouting to be heard, I did not realise that she was standing. I apologise for that.
I would like to bring the debate back to the question of the process and remind us that the noble and learned Lord, Lord Falconer, when moving his amendment, began by talking about the pressure of public opinion. It is obviously a very important subject—and it has been in relation to that that much of this debate has taken place. I took part in a debate with the noble and learned Lord before the Bill came to this House, which was published in the Spectator. At the time he said that
“opinion polls shouldn’t determine whether or not parliament passes this. People should look at the details of how the thing works and say whether or not we can improve it”.
That is what we have been doing. It is not right to say that everybody has just kept on expressing their own views.
Lord Falconer of Thoroton (Lab)
The point that has been made repeatedly in this House is that public opinion is in favour of this Bill and the Commons has passed it. Therefore, we have a duty to get through our business. Does the noble Lord agree?
Lord Moore of Etchingham (Non-Afl)
I accept that that is the argument made by the noble and learned Lord. However, the argument I am trying to make here in a limited time is about public opinion and its effect and how we should regard it. When the noble Lord, Lord Barber, said that we have a privilege here, he was right, but I think that he was criticising the privilege in the wrong way. We must exercise that privilege because, unlike most people in this country, we have been able to consider the Bill at great length. We owe it to those people to consider it seriously and to consider all its elements and effects.
I can just testify for myself—because I am not an expert on the subject—but I have learned a tremendous amount in these discussions. I understood the broad arguments of principle before these discussions, but I have just re-read the Explanatory Notes that the noble and learned Lord and others issued about the Bill when it began. The three words “National Health Service” hardly appear in them. This was the big revelation to me and, I think, to many people. It is a matter not just of what you deeply believe about this very important issue—choice versus wider sanctity of life and so on—but of what will happen to the most important public service in this country and all the ramifications of that.
It is quite wrong to speak of a small minority of people who have been constantly agitating within the House. I do not know who those people are, but I know that many noble Lords on both sides, certainly on the side that is critical of the Bill, are very learned people on the subject of the effects on the National Health Service—for example, the noble Lord, Lord Stevens, and the noble Baronesses, Lady Cass and Lady Hollins. It is very important that they be heard and understood.
I sometimes think the Bill would be clearer if it were entitled the Terminally Ill Adults National Health Service (Assisted Suicide) Bill, because it is not just about assisted suicide. It is about how it would be carried out. It would be carried out by the National Health Service in almost all cases, so we need to debate its costs, its professional conflicts and all the difficult questions that arise. We have been doing that.
I come back, therefore, in justification of what we have all, on both sides, been trying to do. This is described accurately as a conscience Bill. If you have a conscience about something, you must be confident that the result will be safe. If it is not, how could you possibly not object to it? How could you just say, “Oh, well, there we are”? I do not think you can. In his opening remarks, the noble and learned Lord, Lord Falconer, said that the Bill has not failed on its merits, and I agree with him. It has failed on its demerits, and it is those that many of us cannot in conscience support.
Baroness Andrews (Lab)
My Lords, this is a very difficult day for this House. It is a profound day, and that has been reflected in extraordinary speeches, but it is a devastating day for people who invested hope that this House would follow the democratic lead of the other place and improve and vote for this Bill.
I am grateful to follow the noble Lord, Lord Moore of Etchingham, because there is one thing on which I want to take issue with him. On 27 March, he said there was “a big moral gulf” in this House between the two sides. I could not disagree more. We disagree on many aspects of the Bill—for example, I disagree with my dear friend, the noble Lord, Lord Deben, that it should have been a government Bill; I think there would have been an outcry if it had been a government Bill—but we are not divided on morality. We find different ways to approach grace. I am particularly glad that we have the most reverend Primate with us today and have listened to her words of reconciliation, because that is what this House has always been about.
Noble Lords will forgive me for a bit of history, but I was the responding Minister on the first Bill on assisted dying in this House in 2005. I remember very well what the noble Lord, Lord Baker, said—several people who are still in this House were there. It was the first time we had ever debated it. What marked that debate in 2005 was a generosity of spirit and a gentleness of approach that took every single view of this House into respectful consideration. That was true of the two other Bills we had in 2014 and 2016. We have never had a debate in this House that has been contested, where views have been challenged for the reasons that they have been held. This Bill has been different in so many ways. The tone of our debate has been pretty awful at times. We have not paid the respect we should have paid to what we have heard—and we have all learned a lot.
I also disagree with the noble Lord, Lord Deben, because I think this Bill is the best Bill we have ever had, not least because it has embedded legislation that has become tried and tested over the years—the Mental Capacity Act, for example. We have listened to the patient voice. We know more about patient safety than we did 20 years ago. We have the experience of many other countries.
When I stood at that Dispatch Box, hardly any of the medical colleges supported that Bill. They were sceptical and some were hostile. Public opinion was very ambivalent; it has moved. Medical opinion has moved to a position of more neutrality.
Baroness Andrews (Lab)
I would prefer not to give way. I have hardly spoken in this debate and I would like to make a coherent case.
Public opinion has moved, medical opinion has moved, and I think the House has moved. Many countries have taken the decision, and millions of people now have the right to choose to die without fear and pain. That of course includes people near to home in Jersey and the Isle of Man. The major critical difference is that this House has listened to the other place make up its own mind—but we have come to the decision that we must not do that.
It is not a bad Bill. It was in the process of improvement. One of the first things that the noble and learned Lord, Lord Falconer, said was that he would have accepted many of the amendments that came out of the Delegated Powers Committee report, and it is hardly surprising that that committee found the emphasis on delegation something to comment on. Private Members’ legislation sometimes does not have government rigour, so there is always a sense that you have to put things into implementation. Let us have that debate. We have not had that debate and the House has not been able to vote on it.
I have not had the experience that others across the House have had, which we have heard in extraordinarily personal and powerful statements, not least this morning from the noble Lord, Lord Markham, which was so moving. But in the past few weeks, I have heard the testimonies of people who are living with the reality of what it means to know that they are dying. One of the things they have found so difficult, as has been so well said by many people this afternoon, is the disconnect with reality that they have heard as we have wrestled with arcane elements and bureaucratic and technocratic issues that they do not recognise in their experience of dealing with, say, a multiple team of medics rather than a single practitioner, or with residence qualifications. I will not rehearse any of those arguments.
We would have done better to listen more rather than, in some instances, pontificate. We should have listened to Chris Whitty, who said: do not overengineer a process that is already extremely complicated. I really wish more noble Lords had taken advantage of listening to the Australian practitioners who told us how they manage in the most humane and effective ways to implement the Act in Australia.
I am sorry that the noble Lord, Lord Moore, is not in his place. I want the House to listen for a moment to the words of a real expert, a terminally ill lady in a wheelchair who we heard on Wednesday:
“I am a lay preacher in the Church of England. I am deeply grateful for the excellent care and treatment I receive … I do not want to die. Not now. I want to live. But alongside that desire to live I carry something else, fear, a deep, persistent fear and how my life may end. And while palliative care is often excellent it is not all powerful. It has limits … I am not alone … too many terminally ill people are living not only with pain but with fear; fear of losing control … Fear of being forced to continue when all sense of dignity and meaning has gone. That fear shapes our days. For some that fear leads to impossible choices”.
She said that she may die
“sooner than I would choose … And yet instead of confronting reality we have seen repeated delay in the House of Lords … Delay is not neutral. It is a choice. A choice that risks overriding the will of the Commons and the wishes of the majority of the public”.
Lord Sandhurst (Con)
My Lords, the law should be changed. The current law on aiding and abetting suicide does not address the issues the promoters of the Bill undoubtedly seek to address.
The structure and detail of the Bill before the House are deeply flawed. It required restructuring and the debate we have had in the past six months. It is not a safe Bill, when you get down in the weeds. We have to remember that the original process was to be overseen and managed by the judges of the Family Division. Had that still been the case then it would have been obvious that many of the safeguards that had to be written into this Bill, in the absence of such judicial oversight and control, would not have needed to be put expressly in it. We rightly trust our judges on such delicate matters. They are used to dealing with whether to end life support, and so on.
The Family Division judges were removed from the scene. That required a proper rethink. Instead, we got this Bill. It was not the product of a royal commission. There had been no Green Paper. It has not received pre-legislative scrutiny. There was no formal consultation process on a draft or outline proposals. That is why, I am afraid, it is not fit for the very important purpose and aims which it has. Length does not mean quality.
Lord Falconer of Thoroton (Lab)
This is a most interesting speech. On the basis of what the noble Lord, Lord Sandhurst, is saying, if the judge was still there then the Bill would be okay. Why could we not have got to Report and voted on that to make a decision on it?
Lord Sandhurst (Con)
There were grave problems with having the judges. As the noble and learned Lord knows, it would have occupied far too much court time. It simply was not practicable to put it into the courts. If it was to be dealt with properly by a judge it would have been at least half a day, sometimes a day. If you had 1,000 cases a year, that would be 1,000 court days. A High Court judge has 240 sitting days a year, as the noble and learned Lord, a former Lord Chancellor, should jolly well know. Is he saying that four High Court judges should have been taken out of business permanently? The answer must be noted.
Lord Sandhurst (Con)
I am sorry; I want to finish this and I shall be short.
It is, as I have said, a deeply flawed Bill on this grave issue of the administration of death—something completely new to our society. Such a policy must be carried out properly, with safeguards from the outset. We must have proper safeguards. Because it has had a flawed genesis, it is a Bill that needs great changes. We have had the reports of the Delegated Powers and Constitution Committees, which highlighted flaws and identified that we simply do not know the detail. We are talking about people dying: to leave the detail of the process to statutory instruments, without even providing draft statutory instruments, is simply not acceptable in this area. It may be all right for other things—regulation of food or something—but it is not appropriate here.
This has been a big factor in causing so many amendments to be laid. The Bill has been justifiably criticised by a large number of responsible, independent, professional and expert bodies, the great royal medical colleges among them. That is why I put forward a large number of detailed amendments. As I have explained, these were drafted by two independent bodies of distinction. One was the Law Society of England and Wales. Coming at this as lawyers, it does not have a view on the merits but it wanted to make the Bill safe. It sent me a great bundle that I then put down, having looked at them.
The other group that provided me with amendments that I have identified was the Complex Life and Death Decisions group at King’s College London. As I have explained, that is a group of multidisciplinary experts in the fields of mental health, capacity and decision-making. They know all about the Official Solicitor, the Court of Protection and everything else. Both these bodies are concerned with making the Bill safe. They are not saying no to assisted dying; they are saying that it must be managed properly. What I put forward was, I hoped, a means of avoiding risks identified by experts in the field to make the Bill effective and safe—not to obstruct but to improve.
Too little heed has been paid to those concerns to ensure that the Bill is safe. The speeches to date and many amendments identified and promoted remedies. By last Christmas, it was clear to anyone with eyes to see that the Bill needed major correction. I thought, naively perhaps, that after our Christmas break the noble and learned Lord might return with outline proposals for constructive amendments and perhaps invite discussions outside the Chamber, having heeded what the royal colleges, the lawyers—the Law Society—and others were going to say. I remind people that I am actually a barrister, not even a solicitor, so I do not have a vested interest in that.
This was a golden opportunity for review. By then, our Committee’s detailed processes had identified the many gaps that any serious person would wish to see filled before proceeding with assisted dying. As I have made clear, I am not a dyed in the wool supporter of assisted dying—I say yes to autonomy, but not regardless. My long experience in the law and medical matters has led me to know that there are many risks in this area. The Committee identified the many gaps that have to be filled. The dangers cannot just be brushed aside.
We who are concerned with the Bill do not feel we have had the open engagement that it merited. Too many serious questions remain unaddressed. There must be a complete rethink—because a Bill is bound to come back—in which those who promote the Bill look seriously at the objections that have come from this side, or from people like me, to make certain that we really have a proper Bill that starts cautiously, because this will be a major change in our lives. That is all I will say about this Bill. I have spoken for only seven minutes.
Before I end, however, may I say one more thing? I anticipate that this is my last speech in this Chamber before compulsory departure, so I just want to digress from the tumbril on one matter. What I have learned in this House is the great depth of learning and wisdom that is deployed all the time, sometimes from quite surprising sources. Speaking frankly, I had concluded well before 1999 that the time for hereditary Peers was well past. However, I believed, again naively, that our continued process would spur proper reform. That opportunity has now been lost. To me, that is a pity, because it must be apparent to any thinking person that we cannot continue on the basis of appointments for life at the whim—I emphasise “whim”, because it sometimes is—of the Prime Minister of the day. How change is to be achieved is a matter for those who remain in this House, but I suggest it might be a mixture of elected Members and others appointed from bodies such as the royal colleges and great professions for fixed terms, whether five years, 10 years or whatever, to ensure the expertise and breadth that we have in this House. Something must be done: it cannot stay in the “too difficult” box any more.
Baroness Hunter of Auchenreoch (Lab)
My Lords, I spoke at Second Reading to support my noble and learned friend Lord Falconer’s Bill, and I have been here throughout Committee. I am honoured to speak in the same debate as the most reverend Primate the Archbishop of Canterbury and also to follow the noble Lord, Lord Sandhurst, in one of his last speeches here. As a relative newcomer to your Lordships’ House—one of the newbies mentioned by the noble Lord, Lord Carlile—I am in awe, and will always remain so, of the great variety of expertise and experience of noble Lords. These last months have been proof of that writ large: powerful and persuasive arguments from some of the most eminent physicians, lawyers and other professionals in the country, as well as many noble Lords with a long history with the subject and a deep knowledge of this Bill.
I genuinely respect the views of opponents and have followed closely noble Lords’ many amendments and speeches. Indeed, there are among your Lordships long-standing and personal friends of mine, and noble Lords have made their arguments, some at great length. That is why I imposed a self-denying ordinance on speaking myself—until now. I speak up because the other aspect of this House that has so impressed me is the way in which we conduct ourselves: self-regulating, courteous, disciplined; scrutinising and improving legislation in order to fulfil our time-honoured duty of returning Bills to the other place, to our elected representatives. I am proud of our reputation and my role, but something irregular and troubling has gone on, and we all know this. There has been an atmosphere in the House on occasion, despite my noble and learned friend’s extraordinary good temper, which is not what I had hitherto known.
There have been more than 1,000 amendments, with just seven noble Lords tabling half of them. We have spent more than 100 hours—16 days—scrutinising and improving this Bill. That is on top of the 110 hours in the other place. Despite extra time for these Friday sittings and my noble and learned friend’s sincere attempts to reach agreement, here we are, on our last day, having debated less than half of the groups of amendments, never more than four a day—a snail’s pace. I welcome careful scrutiny, but I believe that what I have witnessed is procedural obstruction, as the noble Lord, Lord Baker, so eloquently pointed out too. I have been baffled, dismayed and, ultimately, embarrassed that these tactics mean the Bill will fall today, before this House can even vote on the principle of assisted dying, let alone pass it back for final consideration by this country’s elected representatives, who have already supported it.
Lord Dobbs (Con)
My Lords, this debate has become very personal at times, and perhaps I might indulge in that. First, I apologise to my noble friend Lord Sandhurst for trying to get in the way of his valedictory speech. He is a friend of mine and will remain so, and I shall miss him very much. There are many other opponents of the Bill, which I so fervently support, who are dear friends of mine, for whom I have and will continue to have great respect. That includes, for instance, a previous Chief Whip who I can see, and who am I to argue with the wiles of a Chief Whip?
Five years ago, when I was diagnosed with the cancer that had killed my father and my brother, one of the first people to come to me to say, “Michael, come and have a cup of tea”, and to give me a hug, support, sympathy and advice was the noble Baroness, Lady Finlay of Llandaff. I am very sad that she is not in her place today because I would have liked to express my affection for her and my gratitude to her in this House to her face.
This has been a Bill of passions and disagreements. I will continue to respect all those of my friends who disagree with me on this, but—there is always a “but” in life, is there not?—while this has not been a filibuster, I was silly and went and looked up how a filibuster is defined, and it is “to talk something to death”. There is a certain irony in that definition, is there not? Look, it is not a filibuster, but if something looks, sounds and smells like an elephant and it is standing on your bloody foot, you can be forgiven for believing that it is indeed an elephant—but, of course, it is not a filibuster, is it?
It is not the job of this House, as we have heard so many times, to bury a Bill in distractions, which is what so much of the last few weeks and months have been about. I believe that we as a House have let ourselves down by failing to come to a conclusion on this Bill. We have harmed our future by failing to do our duty. There are people out there, opponents of this House, who would bring this House down and use this debate and our failure to deal with this Bill properly as a reason for doing so.
No one wants a bad law, but we already have a bad law. It is a law which is cruel. It is a law which is callous. It is the law of Dignitas, whereby people are forced—only if they can afford it—to go off to a strange land and die there. We have a law of suffering and excruciating pain. It is the law of humiliation and degradation, which far too many people have to endure, totally unnecessarily. I fail to understand how anyone can suggest that the current law in this country is acceptable. We must find an alternative. We should not be made, as individuals, to go on that longest journey we will ever take, to our deaths, racked with pain and stumbling in fear.
To know that you can and may die in peace is to live in glory. This Bill will fail, but it will be resurrected. It will return and it will succeed—and I personally will rejoice.
Baroness Berger (Lab)
My Lords, I am dismayed at the decision to spend some time today on process instead of continuing to consider the raft of outstanding issues that we otherwise would have considered, so that the substantive challenges could be addressed in any future legislation. Today we would have considered how an assisted death would interact with the NHS constitution.
As we take note of the overall progress that has been made in this House, I will respond to a number of the claims that we have heard today, in some cases more or less from the moment the Bill arrived before us last summer. The claim today has been that the scrutiny that has taken place has been unnecessary or unusual and that in any event, the elected House had already undertaken sufficient scrutiny before we began. The Bill was first published in the way any Private Member’s Bill is. We have heard in this Chamber today some attempt to equate it with government Bills such as the Crime and Policing Bill and the welfare rights Bill, but there was no prior public consultation on this Bill. There was no pre-legislative scrutiny, no Green Paper, no White Paper, no international comparison. Even at the earliest stage, when the Bill was first presented, it was several times longer than any other Private Member’s Bill, weighing in at 43 clauses. It has now been expanded to 59 clauses and three schedules. The House of Lords Library tells us that this is the longest Private Member’s Bill ever.
This is in stark contrast to previous well-known Private Members’ legislation on issues of conscience that supporters have sought to use as precedents, such as the seven-clause-long Abortion Act and the four-clause-long Murder (Abolition of Death Penalty) Act. Both benefited from a commission which fulfilled the pre-legislative scrutiny role that this Bill has sorely lacked.
After Second Reading, the amending stages in the other place began in Committee with the overwhelming majority of amendments being rejected by a Committee made up of 14 Members who supported the sponsor, in contrast to nine MPs who raised concerns about the Bill. Two-thirds of the way through Committee in the Commons, about 62 hours in, the most significant safeguard in the original Bill—the High Court stage at the end of the process, involving a judge—was removed. It was replaced by the new untrialled process, involving non-judicial panels overseen by a new, tsar-like figure, the voluntary assisted dying commissioner.
This seismic change was made without any input from the 627 Members of the other place who were not on the Bill Committee. Significantly, no evidence was taken on that totally new process. On Report in the Commons, scrutiny was limited to just over two days, and of 77 amendments tabled—
Lord Falconer of Thoroton (Lab)
My understanding is that Sir Nicholas Mostyn and Sir Max Hill gave evidence to the Bill Committee about the role of the judges and the possibility of a panel. Am I wrong?
Baroness Berger (Lab)
My point is that the change to the Bill was introduced after 62 hours. No evidence was taken on the new process. On Report, of the 77 amendments tabled by Members other than the sponsor, only seven were selected for a separate decision.
Lord Winston (Lab)
The noble Baroness and I are relatively unique in that we were two of the 12 members of the Lords Select Committee panel that looked at the Bill. One issue that we found on our side was that the people against the Bill refused to take the evidence that we were trying to propose from other countries that had been successful with this type of Bill, including Australia, New Zealand and many other countries—some 30 sovereignties. We had great difficulty getting any chance of a proper hearing until the very end, by which time it was too late.
Baroness Berger (Lab)
Forgive me; I am unclear exactly what the noble Lord is referring to. I can tell the House, for clarity and for the record, that only one vote was taken at the Select Committee of this place: a vote not to accept written evidence. We all would have benefited from accepting the greatest number of representations. I voted in support of written evidence, and it is a shame that we did not have it. It meant that, because of the time limitations, we did not get to hear from more people. That was in large part determined by the clerks who supported us on the Bill.
It was therefore not surprising that the Bill cleared the Commons by just 23 votes—less than half of its already moderate majority at Second Reading. The assertion repeated today is that the Commons carried out thorough scrutiny and addressed the most important issues, but I attest that that does not mirror the facts. This is not a criticism of the efforts made by our colleagues in the other place; it is an acknowledgement that the process for Private Members’ Bills is completely inadequate for the task of scrutinising a Bill of this length, magnitude and complexity that has not been preceded by any consultation or other pre-legislative scrutiny.
It was therefore no surprise that, when the Bill arrived in this House, not one but two Select Committees in this place, the Constitution Committee and the Delegated Powers and Regulatory Reform Committee, were scathing about the state in which we received it—specifically about the 42 Henry VIII powers that the Bill now conferred. It was exactly for that reason that an agreement was reached with my noble and learned friend to hold a time-limited Select Committee, which did not delay the timetable for the Bill. It ensured that we maintained the four protected Friday Committee sessions before the Christmas break at the end of last year but allowed us to take evidence on the Bill as we received it in this place and to hear from the professional bodies whose members will be responsible for delivering on the Bill.
We heard evidence from organisations such as the Royal College of Psychiatrists, the Royal College of Physicians and the Royal College of Nursing, and from GPs and medical examiners—organisations and groups that are neutral on the principle of assisted dying but have legitimate and significant concerns about the efficacy, workability and safety of the Bill. I was seeking to make an intervention earlier on my noble friend Lady Andrews. Not a single royal college in this country will attest to the safety of the Bill. Why is it that noble Lords in this place believe that they know better than the people, organisations and professions that will have to deliver on the Bill? The Equality and Human Rights Commission, disability organisations, mental health organisations and domestic abuse experts talked about the Bill’s practical issues: its gaps and lack of safeguards or guardrails.
I have to express my significant disappointment that virtually none of that evidence presented to us has been taken on by my noble and learned friend the sponsor. What should have been an opportunity to strengthen and improve the Bill seems to have been treated instead as a mere hurdle to be jumped over to get this legislation over the finish line. That rich body of authoritative evidence, imparted over 13 panel sessions, has been largely ignored in the sponsor’s own amendments—the only amendments that have so far been accepted, save for one amendment to an amendment from my noble and learned friend Lady Scotland.
As for the comments that have been made about Committee, I attended every sitting and I do not believe that the depth and seriousness of this scrutiny can be captured in mere numbers and statistics. However, since supporters of the Bill have repeatedly referred to the number of amendments tabled, I will point out only that it is not clear what a normal number of amendments is for a Private Member’s Bill of this length and complexity that has not benefited from any pre-legislative scrutiny, because there has never been any attempt to pass a Bill like this before. It is a wholly spurious criticism.
Lord Falconer of Thoroton (Lab)
The letter of 31 January 2026, which was sent to every Peer, said that.
Baroness Berger (Lab)
Forgive me, but I have seen that letter about amendments that would be forthcoming and looked at it very closely. There was a letter that said, for example, that my noble and learned friend would bring forward alternatives on the issue of 18 to 25 year-olds. We are still waiting for those alternative amendments.
Lord Falconer of Thoroton (Lab)
I am slightly surprised that the noble Baroness, Lady Berger, says that I did not indicate which of the coming amendments I would accept, because I indicated in detail which I would accept. I set out a whole number of amendments. The suggestion that the House did not know what I was willing to agree to is, if I may say so, not correct, and I am really surprised that she is saying it.
Baroness Berger (Lab)
I can reiterate only what I said in previous meetings about having specifics. I do not know which, if any, of the 1,000 amendments—some of which were tabled just the night before and we had to understand them in detail—my noble and learned friend was prepared to accept. I have looked very closely at the communications that I have received, and there have been some indications on two of the measures, but on everything else we have not received that.
I have taken a number of interventions. In conclusion, I will just address one issue that has been raised. The accusation has been repeatedly made, last weekend and this morning, that religion has been driving opposition to this legislation. There are Peers of all faiths and none who have participated in your Lordships’ House and raised concerns. The objections that I and many others have to the Bill are not doctrinal; they are rooted in the real-world consequences the Bill may have for those whom we have spent years striving to represent—in my case, drawn from my direct experience as a Member of Parliament for almost 10 years—including people who do not have the same amount of agency or resources that all in this place are fortunate to enjoy.
I conclude by saying that to insist that we should have glossed over this legislation that will hand the state the ability to end the lives of some of its most vulnerable citizens, ignoring the evidence that we have heard, and a Bill that no professional medical royal college in this country today says is safe, has been a misguided approach.
Baroness Burt of Solihull (LD)
My Lords, I cannot tell you how disappointed I am to see this important Bill come down to this. I feel very strongly for the sponsors, as well, over some of the accusations that have been made here. I am not a medical or a legal specialist, but I am going to take just two minutes to make one point.
Despite being given the extra time that we have had, we are faced with a Bill that has not now been properly considered. A great opportunity has been wasted for a very small number of noble Lords to go to the extreme point. I am no stranger to this: I have had several Private Member’s Bills on schools lost for the only reason that they ran out of time.
It is clear to me that the Private Members’ Bill is not suitable for purpose, and this is better highlighted nowhere than here today. The difference is that this started in and passed the House of Commons, so it already has the approval of the House, and not just this House but the proportion of the British public who support it. They can see that the tactic of delay and manipulation is wrong, so I suggest that the Member system should be revised; it is not allowed to play with a Bill that has the clear will of the House—and I believe the collective House, although we never had the opportunity to test that.
However, looking past the non-passage of this Bill, those who took part in its fall have taken away the opportunity, and surely the right, of a painless death if that is a patient’s wish. I hope that the elected House will involve the Parliament Act and stop making the perfect the enemy of the good.
Baroness Cass (CB)
My Lords, this debate seems to have characterised everyone in the House as being either supporters or opponents of the Bill. I declare myself somewhere in the middle, and I suspect that there are many others who fall into that category who may have been quieter.
Following the views of the noble Baroness, Lady Harding, I have tried to keep my contributions to two or three minutes every time I have spoken—except once, when I spoke at a greater length to describe what I felt would be a more efficient, effective and safe medical model for delivering what this Bill promises. I have tried to engage in good faith with the sponsors of the Bill, both here and in the other place, to work with them and look at how a shorter and less onerous but safer process might work. This is difficult to do by amendment, however, when one starts from the point of having to make changes to a process which does not seem to fit with the natural patient journey.
When a Bill comes back to the House, I hope it may be possible that it starts from something we talk quite a lot about in the NHS: co-production. That is where we build the blocks upwards, with medical professionals and service users getting together to think about how a viable process might work in the NHS, and lawyers getting together to look at how this could proceed in an effective legal model, and so on for other experts. Rather than starting with pre-legislative scrutiny, as suggested by my noble and learned friend Lady Butler-Sloss and the most reverend Primate the Archbishop of Canterbury, we could start before it with building blocks to create legislation to which people with experience have contributed. That would gain the confidence of all the relevant professional bodies and, most importantly, the people who will benefit from it as patients.
Baroness Fox of Buckley (Non-Afl)
My Lords, I will give way. I am sure that the noble Baroness will do the same for me in a moment.
Baroness Blackstone (Lab)
My Lords, I am very grateful to the noble Baroness for letting me get in. I have sat through 13 days of Committee on this Bill and I have hardly spoken at all. I will cut what I intended to say, as I know we are beginning to run out of time, to allow others who still want to come in to have a chance of doing so. Moreover, much of what I wanted to say has already been said by others and I want to avoid what has happened during Committee—endless repetition. However, I will endorse two or three important things that have been said.
I endorse what has been said about the effect of the failure to scrutinise the Bill in a fair, considered and disciplined way, so that voting on possible improvements could have taken place, on the thousands of people who have experienced agony, loss of dignity and a desperate wish to die peacefully and as soon as possible. These people and their close friends and relatives, who feel their pain too, have been let down, I am afraid to say, by a relatively small number of Members of this House who have been determined to block the Bill. I know it has been said already, but I endorse that.
I also strongly endorse the criticism that the opponents of the Bill in this House have refused to take into account the overwhelming support for it from the general public, including from the minority of people in this country of religious faith and from individual disabled people. In both cases, most of them want to see a change in the law and something along the lines of what the Bill is trying to do. Its opponents have damaged the reputation of the Lords, not just by the number of amendments tabled—some of them absurd—and the repetition entailed, but by the lack of accuracy and rigour in making their arguments. That we have not talked about today, and I want to do so in a particular area.
There are many examples I could cite, but I will concentrate on the presentation of the medical profession as being opposed to the Bill. I am not a doctor, but I declare an interest as chair of the trust board of the Royal College of Obstetricians and Gynaecologists, which, like virtually all the royal colleges, has taken a neutral position on the Bill. The noble Baroness, Lady Berger, has just given, in my view, a really misleading impression about this. I regret that she felt the need to do that.
It is absolutely true that, when assisted dying was debated in the House in 2014 and 2015, the medical professional organisations were opposed and there was justification in referring to it at that time. But those who are still implying this have simply not caught up with the changes in medical opinion over that decade. This is reflected in the view of 50 senior clinicians, including 13 former presidents of the royal colleges and the BMA. They said:
“The status quo in this country is not working; the blanket prohibition of assisted dying has made the way we deliver end-of-life care in this country more cruel and more dangerous. You now have an opportunity to vote for legislation that will give people in England and Wales choice and control at the end of life. In our view this choice will come to be seen as a compassionate and integral part of our National Health Service, of immense comfort to dying people and their loved ones. Changing the law will send a clear message to all in society that we will respect their wishes. We believe it is time for Westminster to show compassion by giving … people choice”.
That is very important.
Baroness Blackstone (Lab)
My Lords, I am not going to give way because time is short.
Baroness Blackstone (Lab)
I am sorry, but I am not giving way. I do not think it is appropriate for me to do so, and many others have not. I am happy to discuss it with the noble Baroness afterwards.
The largest survey of medical opinion in the UK by the BMA found doctors more likely to support than to oppose assisted dying. Organisations that represent them have worked closely with my noble and learned friend Lord Falconer and Kim Leadbeater MP, the sponsor of the Bill in the House of Commons. I had intended to turn to several examples of blatant misrepresentation that have taken place in Committee, but in the interests of giving other people an opportunity to express their views, I will leave them out. I am afraid to say that it was a failure—
Baroness Blackstone (Lab)
I have already said that I am not giving way. I turn to my conclusion. The debate on the Bill would have been of a higher quality and met the expectations of high standards in this House if those who oppose it had acknowledged the constructive co-operation of the medical profession and if the position of medical stakeholders generally were not misrepresented by opponents of the Bill.
We must return to the Bill in the next Session of Parliament, but we must do so in a rigorous and honest way, where we do not misrepresent the position of the medical profession. We have to complete it as well, to be sure that those who continue to suffer terrible deaths because of the cruel unfairness of the present law no longer have to do so.
Baroness Smith of Newnham (LD)
Is the noble Baroness aware that, in the evidence from the royal colleges given to the Select Committee appointed by your Lordships’ House, everyone expressed their concern about the safety of the Bill? Individual letters and so on, even from 50 people, are not the same as the evidence received by our Select Committee.
Baroness Blackstone (Lab)
My Lords, I will answer that briefly. I did not, in what I have just said, in any way imply that the medical colleges did not have some suggestions for improvements to the Bill. Many people have suggestions for improvements to the Bill, including my noble and learned friend Lord Falconer of Thoroton. What I am saying is that it is misleading to suggest that they are opposed to the Bill in principle as a profession—they are not; they have been neutral.
Baroness Berger (Lab)
Before my noble friend sits down, I say that I have been accused of dishonesty in my representations. I will just repeat what I said. I was very clear that, while the overwhelming majority—bar one, I think—of the royal medical colleges take a neutral position on the principle of assisted dying, there is not a single medical royal college in this country that will attest to the safety of the Bill. I reiterate that that should concern us all.
Baroness Fox of Buckley (Non-Afl)
My Lords, I acknowledge that those who have been campaigning for the Bill, inside and outside here, are well motivated. Many have watched a loved one die in great discomfort, even agony, and are informed by grief. Understandably, they do not want that for their loved ones or themselves. I also acknowledge that they are often driven by choice and autonomy, which are honourable virtues. Facing death, when illness threatens to remove bodily or cognitive control, can be daunting. As the noble and learned Baroness, Lady Prentis, so vividly and movingly described earlier, you can feel how people would therefore want to assert control at the end of their life.
I acknowledge that absolutely, but I want to refute something that keeps being thrown out regularly: the accusation that those of us who raise concerns about the Bill do not care about those campaigners and that we have never listened, or are not listening, to the terminally ill. To note, the terminally ill are not an undifferentiated identity group with a fixed view. Sadly, we will all know people who are terminally ill now. I can tell the House that those I know find that politicians’ enthusiasm for assisted dying—in preference to energy going into palliative care or hospices—makes them feel like a burden, and they are demoralised and dispirited.
It seems that some people are determined to undermine the motivations of those of us who tabled amendments, as though we are all part of some malign Machiavellian plot. Media reports this week—by the way, I must give credit to Dignity in Dying for its good comms and PR; its media work is second to none—have said that we in the Lords should hang our heads in shame. Actually, we should hold our heads up high. At the moment, it is fashionable in politics to look the other way—to see no evil, hear no evil, and so on—but we were charged with a huge task and a heavy responsibility. If there was to be a law that would mean that the state and doctors could help end the lives of the terminally ill, how could we pass that law without creating recklessly unsafe legislation?
This has not been some tactical coup, as the noble Baroness, Lady Hunter, implied. The task was to scrutinise the longest Private Member’s Bill on record—all without any guidance from Government Ministers beyond narrow, technical comments on legal and operational workability, not safety. Also, we were charged with the task of scrutiny not just because of our intrinsic role here but because MPs in the elected House told us that they were relying on our House to fix a flawed Bill.
Contrary to the point made earlier by the noble Baroness, Lady Gerada, what has become obvious is that the people who are not grounded in reality are those who support the abstract ideals of the sponsors. Once amendments try to pin down the practical, specific mechanisms of the Bill about how an assisted dying service would operate on the ground, worrying implications and unintended consequences are exposed. When the Health Minister, Stephen Kinnock, admits that the Government would need to reprioritise spending from NHS budgets to fund assisted dying, it is our duty not to stay shtum. We should not talk it out but we should be talking about it, because we should ask: which health services will be cut? Could palliative care get even less money? When the Royal College of Psychiatrists warns that the requirement for members to sit on AD panels would mean taking them away from overstretched, front-line mental health services, our job is not to ignore that but to ask: would that mean even longer waiting lists for those who are mentally distressed, or a reduction in people at the coalface of suicide prevention because they have been diverted into okaying the state assisting individuals in taking their own lives—that is, not suicide prevention? Such moral dilemmas hint at the fundamental shift in the—
Lord Pannick (CB)
No one in this House is suggesting that, as the noble Baroness puts it, we should keep shtum. We have had 14 days of debate on the Bill.
Baroness Fox of Buckley (Non-Afl)
Such moral dilemmas hint at the fundamental shift in the raison d’être of medicine that is required. A systemic shift will be needed to change the NHS constitution and redefine “medical treatment”. So I am grateful to this House, whether or not it has taken 14 days, that we heard the noble Lord, Lord Stevens, warn that the Bill’s open-ended Clause 41 would be a Trojan horse clause for fundamental change to the NHS by the back door, yet amendments to it have been sneeringly described as trivial, overly cruel and absurd.
Having sat through hours—days, even—on the Employment Rights Bill in this place, I thought that it was my responsibility to look at this Bill’s impact on workers’ rights. When I asked about two-tier conscience clauses that could leave out junior staff and ancillary workers such as porters and care workers if there were no system-wide opt-in model, the noble and learned Lord, Lord Falconer, batted my worries away. However, since my speech on that topic, I have talked to people, including prison officers, care staff and even a real-life porter—they were all trade union members, by the way—who thanked me for raising it and said that they had changed their minds after the debate because it had made them understand and reconsider the Bill’s broader impact. It seems a credit to the Committee that it has allowed people outside this Chamber to think about lawmaking beyond soundbites and emotive headlines.
My final words are to comment on who we, the alleged filibusterers, are. No disrespect, but we are a bit of a ragbag and not an organised ideological collective. I am in awe of my temporary comrades in arms, who have treated this process with diligence and moral seriousness. It is lazy and insulting to hear people being discussed in the media so disparagingly, or the suggestion that all the amendments were some conspiratorial plot. That is cynical misinformation and an undignified smear. So when—probably—or if any version of assisted dying legislation returns here, I hope that all sides will continue to read the small print, line by line, and that we will stop smearing each other and maybe work together on bringing through safe and workable legislation, if we must have the legislation at all.
Lord Kennedy of Southwark (Lab Co-op)
My Lords, we can all get all Members who are standing in if their speeches are kept short, sharp and to the point. We will hear from my noble friend Lady Hayter, then we will go to the noble Baroness, Lady Berridge.
Baroness Hayter of Kentish Town (Lab)
My Lords, the House of Commons and the public want the Bill, but the number of amendments and the length of the speeches mean that we have run out of time, so it cannot go back to the Commons. This is bad for democracy. Even more seriously, it is bad for the terminally ill—those mentally competent adults with fewer than six months to live. The Bill would offer them the choice of a more peaceful way out of this life, a way under their control, with friends and family around them, rather than an isolated and often risky suicide. A particular mum of three asked, “How dare a handful of Peers look society in the face and say they care about dying people? How dare they put their particular beliefs above the care and compassion that should be due to those facing an agonising death?”
Of course, we never heard from those affected. As my noble friend Lady Hunter said, we on the committee, where we were outnumbered by the opponents to the Bill, were denied the opportunity to hear from those facing deaths or from those bereaved, who had to watch their partner die without this help. As we just heard from my noble friend Lady Blackstone, we heard from the royal colleges, organised groups, professional bodies, social workers, the church, palliative care experts and lawyers—everyone except for whom the Bill was designed.
We have heard in the debates that the amendments are actually about improving the Bill. But I know, and I think that we all know, that some people would never have supported the Bill, even if we had accepted a thousand amendments. The most reverend Primate the Archbishop of Canterbury—although she was a Prelate at the time—admitted this at Second Reading, saying that she was going to propose a vote against the Bill at Third Reading. We heard her say today that she is against it in principle, so for some these amendments were not about improving the Bill but because they opposed it in principle.
Had we just been interested in trying to make assisted dying safer for the vulnerable groups, we would not have had to have those amendments referred to—that everyone, including a man, should have to have a negative pregnancy test before they could apply for assisted dying. We would not have had to consider the idea that some of the very people who needed this—such as those in care homes—would be denied it; that anyone being treated in an NHS hospital would have to leave for a private place with different doctors and carers if they wanted an assisted death; or, indeed, that the intimate private discussions with the panel should take place in public, so that the public can watch people talking about why they wanted to bring their deaths forward. We would not have been told in the amendments that this all costs too much, even though the estimate is the same as what the NHS spends a year after accidents caused by people wearing flip-flops—I kid you not. The cost—
The Archbishop of Canterbury
Will the noble Baroness confirm that while I have said very clearly that I oppose the Bill and that I would bring it to a vote on principle at Third Reading, I have not in fact tabled any amendments?
Baroness Hayter of Kentish Town (Lab)
It was the in principle issue that I was discussing rather than amendments, but I take the most reverend Primate’s point completely.
I have jumped now to costs. The cost is about the same as the cost of accidents caused by wearing flip-flops. My estimate is, and I have had some better economists than I check, that the cost estimated for this is about two hours of NHS spending time. Would we say that NHS is not going to spend money on people who have had accidents wearing flip-flops,going skiing or horseracing or doing dangerous sports, that we would not come to their aid because it was too expensive? So how can we put costs in over this?
Progress could have been faster, it could have been more focused, it could have even been forensic had we concentrated on the big issues. I apologise to those affected, some of whom are with us today, because we have failed in what we should have done.
Baroness Berridge (Con)
My Lords, I recognise that this is a day of disappointment. I am keenly aware of those who viewed this law as the solution to their plight, but also of those for whom the clear failure of proper provision of palliative services will not be solved any time soon and for those living with disabilities or with children with disabilities who struggle to access healthcare today. I also recognise that there is disappointment for many in their perception of their Parliament. I have, in my 15 years here, witnessed the best of parliamentary legislating as I sat on the Joint Committee scrutinising the Mental Health Bill after an independent review, a White Paper and a government response, but in my 15 years, this is not the best. I have said numerous times in Committee that the Private Member’s Bill process is being asked to replace pre-legislative scrutiny, and it cannot do that, so there is no surprise that huge concerns remain.
I will speak briefly of just two examples—it was going to be three, but I am mindful of time—that could have been dealt with if there had been pre-legislative scrutiny. First, the consultative palliative care expert Jamilla Hussain said in the Guardian on 18 May 2025:
“I am deeply concerned about the provision that there is no requirement to inform family or next of kin until after the assisted death has occurred”.
This led me to think that children could be that next of the kin who would be the first informed and then to the question of children as interpreters, so I tabled amendments in that regard. The latter amendment about interpreters was the subject of enormous criticism on social media, but it was not, in the words of the noble Baroness, Lady Andrews, a “bureaucratic” amendment. It was not “procedural obstruction”, as the noble Baroness, Lady Hunter, said. It was an important amendment, and it was not until the Select Committee of your Lordships’ House that Parliament first heard from the Children’s Commissioners about the impact on children, although outside the scope of the Bill, of the societal change we were going to introduce.
My second instance, or expert, is the noble and learned Lord, Lord Falconer. I have enjoyed the intellectual engagement in those meetings, and I am grateful for them, particularly the meeting that was held with Professor Alex Ruck Keene KC on the nuances of the Mental Capacity Act, down to the detail of decided case law. However, when the discussion came to the Mental Health Act, we got back to the basic outline principle that the Mental Health Act is not based on capacity. You can be detained repeatedly under the Mental Health Act but still have capacity. It was clear to me when leaving that meeting that we had gone from nuanced detail to basic principle and that we needed to have a look at the interconnection of the Mental Health Act and this Bill before we started.
I will conclude where I began, with the different views of the world—which was also the subject of a meeting with the noble and learned Lord. He came from a place of individual autonomy and choice when beginning to legislate. But as I outlined at Second Reading, that is an anathema to many people who live in close community—whether that is geographical, in the north-east, or within a faith community. As other noble Lords have outlined, I think there is disappointment among some people of faith that their motivations and views have been used so casually and negatively in the media campaign—although, I note, never by the noble and learned Lord in my meetings.
It is interesting that Professor John Lennox, emeritus professor of mathematics at Oxford, quoted an unusual source in Westminster Hall in June last year. He said:
“Polly Toynbee was spot on when she wrote in The Guardian: ‘Every day in Parliament, fundamentally different worldviews do battle. Politics is all about the clash of moral universes’”.
Atheistic, materialistic, secular, humanist, Judaeo-Christian, liberal and now neoliberal viewpoints are all welcome. I would hate to think what William Wilberforce or Martin Luther King would think if it were otherwise.
I have two final practical points. Away from your Lordships’ House, the noble and learned Baroness, Lady Hale, and Lord Williams of Oystermouth are going to have a debate on the principle of this Bill on “Intelligence Squared”. If this view of the involvement of religious motivations is shared by the noble and learned Baroness, I would love to see her on a platform of that scale to discuss her views and intellectually engage properly on that issue, which is key to our liberal, democratic society.
My second point is to reiterate to the noble Lord, Lord Carlile, and the noble and learned Baroness, Lady Butler-Sloss, that the Private Member’s Bill process has not served us well. I am sad to see the polarisation and the polemic nature of many of our debates. I hope we can find a way to look at what has happened with this Bill to prevent it happening ever again.
My final point is to do generally with the law. I hear the comments from my noble friend Lord Dobbs, but for the parents of disabled children, we have not spoken sufficiently of whether the law will protect their children when they are gone.
Lord Kennedy of Southwark (Lab Co-op)
My Lords, we have now been debating this issue for just short of four and a half hours. It is my intention to bring proceedings to a close at around 3 pm. Both the Government and Opposition Front Benches have indicated to me that they wish to make contributions, so after the noble Baroness, Lady Lawlor, we should be looking to bring proceedings to a close. Maybe we will have one more speech after her—but then we want to hear from the Front Benches. Then we need to hear from the noble Baroness, Lady Coffey, and my noble and learned friend Lord Falconer before adjourning around 3 pm.
Baroness Lawlor (Con)
My Lords, the amendment this morning from the noble Baroness, Lady Coffey, to the noble and learned Lord’s amendment asks us, when we note the progress of scrutiny today, to recognise the recommendations and findings of both House of Lords Committees: the Constitution Committee and the Delegated Powers and Regulatory Reform Committee.
The Constitution Committee is very concerned that, as a Private Member’s Bill, this Bill has not had the same kind of pre-legislative scrutiny and debate. It has not been in a manifesto and has not had the discussion or attention that a government Bill would have. Indeed, the committee points out—and we know this to be the case—that the impact assessments, which have been mentioned this morning, reached the House of Commons only after the Committee stage was concluded, on the first day on Report, 16 May 2025, after which it had two more days on Report. That is just over a month before the Third Reading in the Commons, which took place on 20 June.
In the words of the House of Lords Constitution Committee:
“The degree of deliberation, assessment and scrutiny is therefore significantly less than we would expect to see for an equivalent government bill”.
That is especially concerning given the subject matter of the Bill.
I point out, in response to the many people who have drawn attention to the fact that we have spent a lot of time scrutinising, that one of the bold print recommendations in the Constitution Committee’s report is that not only does the House of Lords play an important role in the legislative process but it is
“constitutionally appropriate for the House to scrutinise the Bill and, if so minded, vote to amend, or reject it”.
I shall not go into that point any more, but it is therefore wrong of the protagonists of the Bill to denounce the process of scrutiny that we have been doing and to accuse people who are trying to amend the Bill to make it better and safer, and indeed constitutionally to bring it up to the standard of a government Bill that has, as has been said, had all that time. I do not like the fact that reports have been given to the media suggesting that. In my experience in the House of Lords—I have not been here very long—people have been given a lot of time, including on government Bills, and Governments of both complexions have bent over backwards to be polite and take account of what Members have tried to do.
Apart from that, I will mention only one other point: delegated powers. There are many of them—we have heard today that there are 42 in the Bill, which is a particular problem. I will mention just one instance of a Henry VIII power that is worrying. It is just a technical one, but I was glad to support the amendment of the noble Baroness, Lady Hollins, on Clause 27, and later I had my own on Clause 37. These are to protect and regulate the supply of drugs that are designed to bring about death. They are called “approved substances” in Clause 27. We are not given any detail about the substances—no list or anything else—but are given just the meaning of an “approved substance”, without any details other than the meaning of a drug or other substance specified in the regulations in Clause 27, referred to again in Clause 37 with more about the powers to make provision on these.
These substances, as the Delegated Powers and Regulatory Reform Committee notes, will be
“inherently dangerous and indeed necessarily lethal”.
What happens if someone has taken the substance but changes their mind? How rapidly would it work? Is it reversible, and how? What would the side-effects be? Bringing up such points as these may seem to protagonists of the Bill a matter of time-wasting and obstruction. But they should remember that this Bill will give Ministers—and often officials, as advisers—power to make very serious laws about regulation and determining safety, which we debate every day of the week in every other Bill that comes our way. We take a great deal of time on them, whether on the environment or anything else.
So it is very important that these matters be debated and gone into. It is important that there are answers in the Bill, as both committees want. With that, I beg the noble and learned Lord to regard the good faith with which people have tried to make his Bill better.
Lord Kennedy of Southwark (Lab Co-op)
My Lords, we have had over four and a half hours of debate, and I want to begin to close as soon as we can after 3 pm. I will call three more speakers from the Back Benches and then move to the Opposition Front Bench. We will have three more brief contributions: the noble Lord, Lord Cashman, the noble Baroness, Lady Falkner, and my noble friend Lady Jay, former Leader of the House of Lords. Then we will move to the Front Benches.
Lord Cashman (Non-Afl)
My Lords, I thank the Chief Whip for the opportunity to speak. I will speak briefly. I spoke at Second Reading and in Committee. I did not mention then, but I will mention now, that 12 years ago I watched my husband of 31 years die a slow and agonising death. When death came, it made absolute sense to him and gave him peace. To me, death makes no sense, but when I face it, I want to have the death of my choosing, as indeed my friend Elise Burns does, who is facing stage 4 cancer and is in your Lordships’ House this afternoon.
I also remember my dear friend June Brown, who implored me to get her to a country where she could die with dignity and have the death that she wanted. I deeply regret that we have not passed this necessary and important Bill. We have not fulfilled the humane wishes of those who seek the right to choose how they die. But I honestly believe that we have fulfilled the wishes of those who believe that this House should be radically and drastically reformed.
Baroness Falkner of Margravine (CB)
My Lords, I declare an interest, as past chair of the Equality and Human Rights Commission, which ended on 1 December last year. I say that because it is pertinent to the remarks I will make. I gave evidence to the Select Committee in the other place as long ago as 2024. While the Equality and Human Rights Commission took a neutral position on the principle of assisted dying, it found several flaws with this particular Bill.
After we started proceedings on the Bill on 22 January this year, I, with the support of 60 or so other Peers, wrote to the noble Baroness, Lady Merron, asking for a revised equality impact assessment, because the original one was by then so out of date and so much new information had come to light during our deliberations. The Bill itself had changed so enormously from when it was first tabled, so we thought it was important to get more up-to-date assessments of what the Government thought the impact of the Bill would be.
The noble Baroness, Lady Merron, very generously wrote back to me very quickly on 29 January. She recognised that these were important considerations but declined a revised impact assessment. However, she promised that, once the Bill became an Act, the Government would review all the impacts of the Bill. In other words, we were being asked to legislate blind—to move amendments without knowledge of what the impacts might be. That is an essential requirement of an Act of Parliament or primary legislation. We were asked to legislate blind. While I understood the Government’s position and their neutrality, that has been the effect of where we have been. It may be one of the reasons we have had so many amendments that some noble Lords find time-wasting.
I want to turn to one important thing in my final observation. I will not speak for long, but I want to impress upon the House the responsibility that we have when the state is asked to sanction—indeed, assist in—the taking of life rather than saving it. This is particularly so when so many other jurisdictions appear today to have stretched the ethics of where that balance should lie. That may not have been where they started out, but that is where they find themselves decades later. I believe that it is right that we in the UK, with our particular constitutional arrangements, take care and apply the due diligence that careful scrutiny seeks.
If we have people who find that the level of their suffering is so intolerable, I completely accept that perhaps we should think of a way of death for those people. I say that only to re-emphasise what the noble Baroness, Lady Campbell, said what seems an aeon ago but was only a few hours earlier: autonomy without protection is not freedom; it is a risk. I will go further: it is a risk that we as legislators should not in good conscience allow to pass to be exploited by the unscrupulous. I believe we have discharged our duties, but that is not to say that this should be the final word on this most difficult and contested ethical issue. I hope that the proposers will take note of the good faith that we have all employed and try better next time, as I believe they may well be entitled to.
Baroness Jay of Paddington (Lab)
My Lords, like the noble Baroness, Lady Hayman, I was a Member of the House when we looked at the original Bill introduced by the late Lord Joffe in 2004. I have also been Leader of this House and, over the decades, I have never experienced quite the extraordinary exploitation of the procedures—one could almost say the sometimes rather relaxed procedures—of this House as on this Bill. Today, for example, I thought we were perhaps going to start again dealing with the House of Lords Act 1999. I have been through all the convolutions of Brexit, but never—I repeat “never” and, indeed, “exploitation”—have I seen the relaxed procedures of this House so negatively exploited. That is something we need to return to, and I echo the concluding remarks of the noble Lord, Lord Cashman.
I have a very big concern about the content and quality of some of the topics of the hundreds of amendments we have seen. It is about the way in which, as many noble Lords have referred to today, they have ignored the concerns of the people for whom the Bill is directed: terminally ill adults. My noble friend Lady Berger asked for examples of the way in which our lack of compassion had been demonstrated. In the interests of time, I will not go into any in particular, but I refer her to the 27 February discussion in Committee, when we spoke for some hours about the composition and the structures of the commission assessing people’s ability to take assisted dying. There was enormous emphasis on the activities of the commissioners and their convenience, et cetera, but scant regard was paid to the concerns of those people for whom this service was being offered: those who might be frail, bed-bound or concerned about their personal and emotional situation. We dealt almost exclusively with bureaucracy and administration. That, frankly, has been the tone of so much of the debate.
I am aware of the Chief Whip sitting there with his stopwatch, but I want to refer briefly to the other major and concerning omission from our discussions, which is the lack of any sort of detailed discussion about the international evidence and experience of assisted dying. I remind the House that more than 30 jurisdictions in the world have now satisfactorily introduced ways to give their citizens the choice of an assisted death. These places include our close neighbours in western Europe, major Commonwealth countries and American states, as well as the capital city of Washington and the District of Columbia. Some of those jurisdictions have voted very recently to establish new systems. In the western state of Oregon—which the Select Committee on which the noble Baroness, Lady Hayman, and I sat some years ago visited to establish the realities of the situation—assisted dying has been in place for nearly 30 years. I have no doubt that there have been some difficulties and some mistakes as these different places have developed their own plans—there always are when major changes in social policy are introduced on anything—but no assisted dying laws have been repealed. None of them has been challenged at that level. There has been no collapse in palliative care. Indeed, with proper choice at the end of life, palliative care has often been improved. That is certainly the case in the state of Oregon. To disregard or distort international experience, as the debates in this House have done recently, or to suggest that only the Westminster Parliament can produce a legally proper system is, in my view, a dangerous form of arrogance.
In conclusion, this is the fourth assisted dying Bill that I have taken part in and there have always been profound differences of principle, but in none of the others was there the atmosphere of unpleasant tension and antagonism at a personal level that has characterised recent sessions. Indeed, 10 years ago, when my noble and learned friend Lord Falconer introduced his similar Bill, the Times reported our proceedings extolling the serious, calm authority of the debate and congratulating the House of Lords on its deliberations as a demonstration of Parliament at its best.
I very much regret that we have today to take note that the current proceedings have greatly damaged the reputation of the House. I can only hope, like other noble Lords, that when a future assisted dying Bill returns—and it most certainly will—the issue of choice for the terminal ill will be both constitutionally and compassionately considered by this unelected second Chamber.
Lord Wolfson of Tredegar (Con)
My Lords, this has, I can say without qualification, proven to be one of the most contentious Bills that has come before your Lordships’ House in this Session and perhaps, indeed, in any Session. One of the reasons why it has been so contentious is that it is so important. No one can deny that the Bill, if passed, would result in a profound change in the relationship between the individual and the state. It is therefore, obviously, a very important Bill.
The fact that it is such an important Bill has meant that noble Lords across the House, whether for or against the principle of assisted dying, have taken the scrutiny of the Bill very seriously, as they rightly should. I suggest that there is both a general and a specific reason for that. The general reason is obvious— it is part of our unique constitutional role to scrutinise legislation in detail. That is why we are here. It is why our procedures are both substantively and essentially different from those of the House of Commons; I will not get into whether they are better or worse, but they are certainly different. The specific reason is that many MPs voted for the Bill not only in the knowledge but also on the express basis that it would be properly scrutinised here. Indeed, it was noted by several noble Lords at Second Reading, including in my own speech, that some Members of the House of Commons voted in favour of the legislation because they supported the underlying principle of the Bill trusting that this House would undertake the heavy task of detailed scrutiny in due course.
Detailed scrutiny is separate from the question of the principle underlying the Bill. You can be for or against the principle of assisted dying and you can be for or against the Bill, but they are not the same thing. I know that there are some noble Lords who are and will always be against assisted dying on principle. Some of them have made that clear in their speeches. They would therefore be against any legislation that legalised assisted dying. But there will be others, and perhaps many, who are not against the principle of the Bill but are none the less anxious to ensure that we pass a Bill that is safe, contains proper protections and, importantly, is workable in practice.
Whether one is for or against this Bill, it is regrettable that your Lordships’ House has not been able to reach a conclusion on it one way or the other. I feel uncomfortable that the Bill has run into the sand rather than being either sent back to the House of Commons in an amended form or voted down. I would have preferred either of those options to where we have ended up, where the Bill will simply be lost when the Session ends.
The primary reason for the large number of amendments, many will say, is the large number of questions that the Bill, as drafted, left open. Many amendments raised complex issues, as those of us who have been at all the Committee days will know. It is understandable that there was a large number of amendments; some were designed to effect change and some were probing amendments designed to introduce greater clarity. However, regardless of how many amendments there have been, whether or not to legalise assisted dying is clearly a question that the public would like Parliament to answer.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, as noble Lords are very aware, the Government remain neutral on the Bill and on the principle of assisted dying. This is a Private Member’s Bill, not government legislation. On issues of societal change, as we have discussed, Private Members’ Bills have long been a vehicle to handle matters of sensitivity and important matters of conscience, as in this case.
As I made clear during my remarks at Second Reading and throughout Committee, my role, alongside that of my noble friend Lady Levitt, has been to help to ensure that, if passed, the Bill would be technically and legally workable. Sixteen sitting Fridays were allocated for debate on the Bill and, as my noble friend the Chief Whip has said consistently, it was for the sponsor of the Bill and your Lordships’ House to determine how to use that time.
We know that assisted dying is an emotive topic, and we recognise that there are deeply held views on all sides of the debate. We have spent many hours debating this important matter and, while noble Lords across the House have often differed on matters of principle and policy, I believe that there is a desire in the House to do the best for people at the end of their lives, at their most vulnerable.
Baroness Coffey (Con)
My Lords, this has been a really helpful debate. I am quite sad that we did not get to Committee at all, but never mind. I am conscious that we are in a Session where eight Private Members’ Bills have become Acts of Parliament, and I place on record my thanks to the Ministers, in particular the noble Baroness, Lady Blake of Leeds, who has often stepped in for Ministers. I am grateful to her for that.
According to information provided by the House of Lords to me—it could give me information covering only to the end of February—651 Peers have turned up on one of the Fridays we have spent considering this Bill, 87 of us have turned up for every single Friday and 16 of them have spoken today. Some 516 Peers attended at least one day at Second Reading, while 327 turned up for both. There has certainly been interest in this Bill but, I am sure and appreciate, there have also been frustrations on both sides that we could not make more progress in that time, particularly during the 13 days in Committee—recognising that the House did not go into Committee today.
One of the things that it is important to consider is how we address things more quickly. I do not just mean looking at the brevity of speeches. In fact, on the first day in Committee, the noble and learned Lord, Lord Falconer of Thoroton, thanked me for the brevity of my speech. We need to see how we can more quickly address things such as DPRRC reports, particularly when we debate Private Members’ Bills. I am conscious that the noble Lord, Lord Pannick, referred to several things in that report, and I know that the noble and learned Lord, Lord Falconer, has acted on some of them—although perhaps not to the committee’s satisfaction. However, in the committee’s second report, there remain three clauses that it felt should be removed from the Bill. The noble Baroness, Lady Finlay, the noble Lords, Lord Goodman and Lord Rooker, and I had done quite a lot of work trying to address the DPRRC’s recommendations, including coming up with potential for others in that regard.
There has been only one point today when I thought Standing Order 31 might need to be invoked. We should reflect that we have been able to do this, even when it has got a bit tense. I assure the House that I have been working on spreadsheets and trying to get more groups together to try to get through this. I have actually been surprised that we have not got through that many groups on a Friday when I have been encouraging people to make progress, because I believe it is important we do so. As I say, however, I have no doubt that a lot of this has been done with great sincerity. With that, I beg leave to withdraw my amendment.
Lord Falconer of Thoroton (Lab)
My Lords, I give special thanks to those who shared personal experiences with us, in particular the noble Lords, Lord Markham and Lord Dobbs, the right reverend Prelate the Bishop of Newcastle, the noble Baronesses, Lady Hollins and Lady Grey-Thompson, the noble and learned Baroness, Lady Prentis, and my noble friend Lord Cashman. I will single out the speech made by the noble and learned Baroness, Lady Prentis, in particular, as it was—for everybody—incredibly impressive and moving. I will say how welcome she is back here, and she has the warmest possible embrace from the House.
There was a moment when we heard from the noble Baroness, Lady Rafferty, who had been the president of the Royal College of Nursing; we then heard from the most reverend Primate the Archbishop of Canterbury, who had been the chief nurse of England and Wales; and sitting on the Woolsack we had the noble Baroness, Lady Watkins, who was a distinguished professor of nursing. That is an indication of the depth of knowledge we have in this House.
I am not going to say the normal thing about what a great debate it has been. Honestly, it has been a horrible debate. Unlike almost every other debate I have ever participated in, there has been quite an edge, particularly from the opponents of the Bill.
I am not going to say that it is we who should end this debate; the views of the people outside the House should be taken into account. I quote the much-missed Lord Williams of Mostyn, who, whenever we behaved badly, always said, “Remember, there are people out there who are watching”.
I will finish with three voices. The first is that of Elise Burns, who is in the Gallery today. She has terminal cancer. She said that she would love Peers
“to look me in the eye and tell me why me and my friends, and anyone with terminal illness, don’t deserve to die with dignity and to have the choice to die as they choose, without pain”.
Nat Dye, whom noble Lords on both sides of the House met regularly during the course of the Bill, died a few weeks ago. His sister Becky said:
“I feel betrayed by the system really, that people are kind of able to serve their own agendas rather than being representative of the people in the general population”.
Finally, I quote Dan Tuckley’s sister, Kate. Dan got a very aggressive form of cancer and at the very end of his life went, in conditions of quite considerable distress, to Dignitas in Switzerland. Kate said: “This Bill running out of time is a complete travesty for the people of the UK. It will mean that the views of the people of England are not being properly represented by the people trusted to do so. It means the British people have been let down”.
I beg leave to withdraw my amendment.