Lords Chamber

Friday 30th January 2026

(began 1 hour, 45 minutes ago)

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Lord Bach Portrait Lord Bach (Labour)
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The question is that this bill be now. The question is that this bill be now. Read a third time. As many of that opinion will say, content contrary, not content. The

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contents have it. To move that this bill do now pass. My Lords, I only intend to say a few words on the motion. say a few words on the motion. Really? To thank those who have been closely involved with this bill as it passed through bill as it passed through Parliament. I start with my hon. Friend Emma Foudy, Member of Parliament for Cramlington and Killingworth, who carefully guided this bill through the other place. I'd also like to thank my noble friend, the Minister, the noble Lady, Lady Levitt, for her assistance and of course, her officials and others at the Ministry of Justice who have made this task easier.

I'd also like to thank all noble Lords who spoke at the Second Reading of this Bill in this House, and to thank the frontbenchers of all parties who have given the Bill the support it needed to become law. In short, this bill will allow us to continue to transform how we detain children and young people in custody by delivering education and intensive support in secure schools. This bill and the establishment of secure schools, has had the support around the house within the with of secure schools within the custodial estate represents, I believe, a pivotal step in reducing offending for some of our most vulnerable children and young people.

And I am delighted, as I hope the House is, that it will soon be on the statute book. I beg to move.
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Earl of Effingham Portrait The Earl of Effingham (Conservative)
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The question is that this bill do now pass. do now pass. >> My Lords. Please let me thank the noble Lord Lord Bach for his efforts to take this Bill through efforts to take this Bill through your Lordships House and for his past work on the Back Commission, which strive to improve the legal aid situation within the UK justice system. As I outlined that Second Reading, Secure 16 to 19 Academies Bill conceptualised in Charlie Taylor's review of the Youth Justice System published in 2016, then agreed upon and adopted by His Majesty's Loyal Opposition when we were in government, and will now be made more practicable and effective as a result of this bill.

Secure schools are an ideal founded upon the principle of rehabilitative justice for our youth, with the vision of improving behaviour, mental health and educational attainment. The nature of this aim means that every offender who enters a secure academy will have different requirements, and the academies must therefore be both flexible and adaptable. The bill reduces expenditure funding for the academies from a seven year to a two year horizon. It removes the requirement that the Secretary of State must take into account local schools before accepting the academy, as pupil intake will largely not, if at all, overlap.

And finally, it requires a consultation with local partners instead of local schools, bringing process in line with purpose. My Lords, it is in everyone's interests that secure academies work. Young offenders will be given a second chance and with a fair wind, they will join the workforce and have every chance to succeed. That is why when in government, we supported the proposals and why we continue to do so now, we need more secure academies and this bill will help deliver that goal.
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Lord Kennedy of Southwark Portrait Lord Kennedy of Southwark (Labour)
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proceedings today. I will keep it short to enable debate to start as soon as possible. I would, however, like to thank noble Lords again for their kind words and constructive discussions during the past week. I continue to do my best to strive to find ways to assist the House in its scrutiny, balancing some difficult and often opposing positions. As I set out last week, following the House is clear indication that he wants more time to consider the bill. I will not seek to adjourn the House at 3 p.m.

but rather at around 6 p.m. noble Lords will not be surprised to hear me say that ultimately, it remains in the hands of the House and other colleagues. Noble Lords may seek to adjourn earlier by moving the motion. The House be now resumed, as we did last week. We will adjourn the committee at a convenient point around 1 p.m. for a 40 minute break, to give those participating a chance to eat. I would hope noble Lords can make more progress than on previous days, and trust that noble Lord will continue in the debate with respect for each other's and different views, remembering that opposing views are just as sincerely held as your views are.

We do not take interventions on interventions, and interventions are the opportunity to ask a short question, not to give another speech. And I've asked this particularly to intervene. That happens. Finally, I place on record, on record, on behalf of the whole House, our thanks to the staff of the House for the usual courtesy, professionalism and excellent service that they provide to members, not only today, but every day. With that, my Lords, I think we should move on to the substance of the Bill and continue our debates.
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Lord Ahmad of Wimbledon Portrait Lord Ahmad of Wimbledon (Conservative)
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Before the Chief Whip sits down, and I have. I thank him for the and I have. I thank him for the time he gave me yesterday. There were three very brief points I wanted to make. There has been much speculation and indeed discussion outside your Lordship chamber on both procedure principle and the workings of your Lordships' House. Very briefly on procedure. There has been this week, regrettably, much discussion about the use of the Parliament Act when it comes to the workings of this Bill.

I would ask the noble Lord, the Chief Whip, who I know holds the House in great esteem, and fight the cause, that to clarify the fact that the private member's bill that we have in front of us, it would be unprecedented indeed, if the Parliament Act was to be used in this regard, the last time it was utilised, as all noble Lords know, was in 2004 when the Hunting Act, and indeed that was a government bill. So we would be setting a very different precedent if that was to happen.

The second point is on procedure. If this bill was not to pass, and indeed the Parliament Act was invoked, it is not for the proponents of this bill, the supporters of this bill, to actually make that call. That would be, as my understanding is a matter for. Mr. Speaker, after careful consideration. Equally, on reading the two acts, it is also very clear that the House of Lords would still have a role. And let us not forget, if this was to be presented again in the next session, there's still the small issue of the private members ballot in the other place, and I would again ask the noble Lord to clarify the issues of procedure to allow for the effective debate in your Lordships House.

And thirdly, about the House of Lords itself, in terms of who we are and what we are, as many noble Lords will know, I was on the receiving end for a very long time as 12 years in government across communities, the Home Office, transport and indeed with the Sembler Bill and indeed discussions around the EU and Brexit at the Foreign Office. But everything was, as the noble Lord, the Chief Whip, has said, done in a reasoned way. But one thing, and I say this to someone who I respect personally, greatly, the proposer of this bill, the noble and learned Lord.

We listened and he and I joked recently, I've certainly been doing my part in listening during the Committee stage. I've been here for a large part of it, but I'm yet to intervene. Though I'd warn the noble and learned Lord, that doesn't mean I will not. That said, the value of your Lordships House, I think I recall correctly, the noble Lord Carlile said this, that as we're discussing this, the amendments which are being proposed, and I really pay tribute to the noble Lady Baroness Finlay and the noble Lady Baroness Grey-Thompson, amongst others.

It's being done that if this legislation was to become law, that the duty of care that the government has, and I respect what the Minister has said repeatedly and my noble friends on my frontbench, that this is a position on which both the His Majesty's Government and His Majesty's Official Opposition are neutral, that the protection and security of our citizens is paramount. And that's after listening in your Lordships House, is what I've heard from most, if not many, of the amendments which have been proposed.

Therefore, I ask the good offices of the noble Lord, the Chief Whip, and indeed of the Lord Privy Seal, that in any discussions that take place, as I know they will, there will continue to protect the traditions, the conventions and the procedures of your Lordships House.
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Lord Kennedy of Southwark Portrait Lord Kennedy of Southwark (Labour)
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Yeah, right. >> David. >> My Lords, can I firstly say that

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My Lords, can I firstly say that I, I love the house very much and I've been here for 16 years. An absolute privilege to be here every absolute privilege to be here every day, both in opposition and in government. And I know the many. We all come here today, every day, to

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work with the best intentions and with the best interests. Of the. House. And the house itself, over many, many years, has always assisted the other place in improving legislation, scrutinising it, making better bills. And we've it, making better bills. And we've all done that. All of us in opposition in government. And I think we should get that on the think we should get that on the record. First of all, can I thank the honourable Lord for his question and other Lords, particularly for coming to see me yesterday.

So I've had a chance to yesterday. So I've had a chance to to go away and look at some of this stuff. And I'm going to put a statement here to read out to colleagues if you let me get to the end of it and then we'll I think then hopefully I've found a way to hopefully assist colleagues. I think it's fair to say that, you know, that this is. Go on the record that I'm not an expert on the Parliament Act 1949, and it probably not surprised how say it is complicated.

OK. I cannot and will not give you whether or not the bill that can be applied to this bill or any other bill, if noble Lords are interested in the detail, I can refer them to paragraphs 30.49 to 30.56 of Erskine May sets out some very helpful background, as does the note from the House of Commons Library published in February 2016. Ultimately, though, my Lords decisions on the application of the act are for the House of Commons, Erskine May makes it clear in paragraph 30.55 that any final decision must be endorsed by Mr Speaker.

I do not advise the House on a complex procedure to avoid that, and to assist all noble Lords. My office has spoken to the clerk assistant soon to our new clerk of the parliaments, and I'm pleased to announce to the House that the House the clerks will arrange a factual briefing on the details of the Parliament Act and this general application. What the briefing will do is not a discussion about this bill. And what if, what if, what if, but actually how how the Parliament works and how it can be applied to legislation.

But I can confirm for the record that the Parliament Act 1911, as amended by the Parliament Act in 1940 1945, applies to all public bills other than money. Bills and bills extended the maximum duration of a Parliament so it can be applied to private members Bills. The act provides that any bill introduced originally in the House of Commons and passed by the Commons in two successive sessions, with at least one year between the first Commons Second Reading and the Commons. Third Reading in the second session can be presented for Royal Assent to the Commons.

Many of the conditions underlying are open for interpretation and what constitutes rejection by the House of Lords. It has not, though, been applied to a Private Member's Bill to date. It has then been used for several Acts of Parliament. Under the 1911 act, it was used for the Government of Ireland Act 2014, the Welsh Church Act 2014 and interestingly, the Parliament Act 1949 and since 1949 it's been used for the War Crimes Act 1911, the European Parliament Elections Act 1999, the Sexual Offences Amendment Act 2020 and the Hunting Act 2004.

So that's where we are. I will arrange for a proper factual briefing to understand how the Act operates, and I will probably attend the briefing myself. But actually, to be clear, it is a matter for the other place. For Mr. Speaker, it has never been used on

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the Prime Minister up to date. And my Lords, I'm very grateful to the noble. I'm very grateful to to the noble. I'm very grateful to the noble Lord Biggar Chief Whip for his, as always, very kind and for his, as always, very kind and helpful explanations. Could I raise a further point, because I think it affects the proceedings of of your affects the proceedings of of your Lordships' House, as we now go on from today? Of course I would defend to the death the noble and defend to the death the noble and learned Lord Lord Fowler right to appear on the today programme.

But I do think that what he said there made it very difficult for the proceedings that are about to ensue, because he said that he threatened, though I don't think it's in his power. He threatened the Parliament Act, he threatened us with the Parliament Act, but more particularly he said that what was going on in all these proceedings was just a filibuster. And it's not just that that is quite untrue, my Lords, as you will witness through these many, many hours of detailed
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Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-affiliated)
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worried about the bill. But everybody seems to think that that's what's happening. And it's been done by media briefings. And been done by media briefings. And it's quite demoralising to be in a situation where you're told you're situation where you're told you're effectively wasting your time. In answer to the noble Lord, Lord Blunkett, I'd just like to say that Blunkett, I'd just like to say that in preparing for worrying about getting the wording right on the getting the wording right on the amendments, I want to speak on that.

I have read this bill a number of times, understatement, and have tried to take seriously the role that we are given here. In terms of scrutiny, I have not where it's been impossible to speak and not know anything about it. I just haven't said anything I've done, as has been suggested. Listen. But this is not about an imagined bill. It's about the bill we have before us and gaps in it that some of us are worried about what is not said, what will happen if those gaps aren't filled? I just think it's very important, whatever side we're on in this, to treat each other as though we're acting in good faith, because we are acting in good faith.

And what's discrediting to the House a media briefing suggesting that there's some cynical plot of outside forces that somehow are all influenced by hidden religious views, I think was one phrase that was used. Can I just point out, I think this bill requires us to be deeply moral and ethical, whatever side we're on, because we're talking about life and death issues. We're talking about a change in the constitution of the NHS and so on. I won't go on.

And but we have to assume that we are in good faith because we are in good faith. It's nerve wracking enough taking on an issue like this without then having the media basically being told by the media, as I was last night on Newsnight in the gap, where they said, oh well, you lot are just all being manipulated by forces anyway, I finished.
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Lord Kennedy of Southwark Portrait Lord Kennedy of Southwark (Labour)
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Can I firstly say that if I >> Can I firstly say that if I don't cover all the points that my door is open at all times, and I door is open at all times, and I will and generally please come and see me, you know, because I genuinely want to be helpful to the house and to help all members here. A couple of things. I firstly say that the Baroness Coffey I first met Lord Spellar when I was 16, and that's a very good advice.

I've he's been a friend of mine since then, so he's a thoroughly good, noble Lord. I always listened very, very carefully. Can I say just going around the house a few things. The Royal commission, that is not for me, that, you know, that would be a matter for the government to look at in terms of protecting the House's procedures. That is obviously one of my roles, and I try and do that as best as I can to defend the house, defend the house of all members in the House to to have their say.

We are called self-regulated and we all actually treasure our self regulating status. I do also though of course to be self regulating you have to show some self regulation then. So and be mindful of that. Because the alternative, of course, is that we do end up with a House of Commons type procedures, which of course no one would want to see. So we do actually need to think when we are speaking what we are doing or not doing things that we have to ourselves regulate and ensure that that carries on.

In terms of the PM being brought back by the government. The government has no intention of bringing this. This will remain a private member's bill. There'll be no change to the government bringing this in the next session. I'm going to say to the House, I have enough problems getting the government's programme through at the moment, let alone trying to deal with this bill. So I promise you, it's not going to come back as a government bill. At the end of the day, if this bill and this is why I don't want to get into lots of what if, what if, what ifs, you know, if this this bill falls, it may get come back through the house, it may get through.

And then then the parliament may be applied. But that's a matter for the other house. And it's not a matter for me, for any other member of the House to determine what the other House does or what Mr. Speaker does. So that'll be a matter for them if it happens at all. So that's all I can say there. I didn't listen to my friend on the today programme. I'm sorry. I usually do listen, but I actually missed that one. I must get catch on catch up, I think, and see what was said, because clearly it actually has a lot of bearing, a lot of members today.

What I would say at the end of the day, lots of things get get around the media, lots of speculation. There's been pages written in newspapers about this. At the end of the day, this House will decide what he does with this bill, and no one else will decide that it's up to this House now. I think we should make more progress. I think, you know, and as I said earlier, if the Parliament Act would be applied, there are many conditions that would be applied to make that happen.

And they would look at I would suspect they would look at how the House of Lords has dealt with the Bill, but that is a matter for the other place, not for me or any other member here. I think I've covered most issues there, right. You know, but please come and see me if you if you. Oh, sorry.
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Lord Kennedy of Southwark Portrait Lord Kennedy of Southwark (Labour)
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Yeah. >> Yeah. >> The all I can say briefly and I we've now been here 30 minutes, so maybe we can get on to the bill fairly shortly. Is that obviously this is not a government bill. It's not going to become a government bill. I think my friend, my noble friend always deals with the House courteously when he deals stuff with his amendments and he sees the House and has got great stamina to stay here. Not always do to deal with all these matters.

Amendments before the House I think that it is an unprecedented number of amendments, but I do think that we can all work together. We can make more progress on this bill going forward, and that's what we should be seeking to do. I think that all members are put down in good faith and we should accept that. But actually, we then should seriously deal with the issues and all members should, you know, work on that basis. And I don't believe anyone is acting in bad faith here.

I would never suggest that. But I do think we do need to work together to make more progress. We have a quite a number of days in committee now and not much progress. And if I was if this was a government bill, I would be very agitated that we were making so little progress on a government bill. So but it's not just I accept that and it won't become a government bill. But I do think at this stage now having 30, nearly 32 minutes now on questions, we actually do need to move on to the substance and try and make more

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progress today. Yeah, yeah. House, do we again in committee on the terminally ill adults end of

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on the terminally ill adults end of life. Bill, Lord Falconer of Thoroton. Beg to me. I, my Lords, I beg

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Beg to me. I, my Lords, I beg leave to move that the House do now resolve itself into a committee on the bill. The question is that the House

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The question is that the House do now again resolve itself into a committee upon the bill, as many of that have been so content, contrary,
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Baroness Grey-Thompson Portrait Baroness Grey-Thompson (Crossbench)
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believe we'll have an impact on the groupings that we are about to groupings that we are about to debate today. And I did notify the Chief Whip and the clerks of my intention to raise this, and also intention to raise this, and also the noble Lord, Lord Falconer, the noble Lord, Lord Falconer explained in his letter this week which has in his letter this week which has been raised. The recognises the concerns raised about independent advocates and that following discussions with the sponsoring discussions with the sponsoring Another place and their amendments, he has tabled changes.

And the reason I'm raising this now is, I think, the sense of frustration that we aren't getting answers to the amendments that we are tabling in good faith, and I hope he will be able to answer these questions so that we can move a bit more pace. So I would like to propose those changes that he suggested relate to what was agreed in another place. The amendments in the comments were understood to introduce independent advocates as a mandatory safeguard, and this is an area that many of us are concerned about, and reflecting the fact the individuals in scope may have substantial difficulty in understanding the process or communicating their wishes.

And under the noble Lord, Lord Falconer. Amendments, however, a person is treated as having an independent advocate, even if the advocate is not present or involved in the decision making process. The amendments do not require an advocate to be present. When the coordinating or independent doctor meets with the patient, nor when the panel considers the case. Advocacy is therefore satisfied by instruction alone rather than active participation, and in addition, advocacy is made conditional on request. The preliminary discussion may proceed without an advocate and a qualifying person may refuse one.

So could the noble and learned Lord please explain whether he considered this framework to preserve the substance of the Commons concession, or whether he accepts that it represents a shift away from a mandatory safeguard towards a more discretionary model? And in particular, how does the noble and learned Lord address the concern that people who qualify precisely because they struggle to understand are required, unaided, to decide whether to waive one of the bill's central protections at the very outset of the process?
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None Portrait Legislation: Terminally Ill Adults (End of Life) Bill - committee stage (day 8)
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In clause one, amendment 60 Baroness Coffey.
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None Portrait AMDT: 60 Baroness Coffey (Conservative)
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amendment 60 in my name. I'm grateful to the noble Lords Lord Harper and MP for signing that. I'll also be speaking to amendment 65 that I've tabled, as well as consideration, consideration of an amendment put forward by the Shadow Front Bench. My Lords, it's slightly disappointing that the Justice Minister has not in her place on the front bench today, because part of what I want to discuss by these amendments is important about the assessments and in consideration of whether or not somebody has capacity, that is actually an act under the basis of which actually the Ministry of Justice is responsible.

And indeed several other aspects of what I prepared to say. My Lords, we are only at clause one on subsection three, but I feel that this is a key element to consider carefully. Basically, what and where do the all these issues have to happen and whether it has to happen face to face. Now, as the Bill reads currently, it suggests that it's only the initial request for assistance. The first declaration, the doctor's assessment, and the second doctor's assessment, and indeed, then the second declaration has to happen while the person requests making all these requests is in the country, no other part of this bill, including preliminary discussions, actually the act itself.

But all these other things don't have to happen in this country, or the person doesn't have to be here. And I think I've made it clear in a series of elements that I've made to the House, my concern about how this becomes not something that just gets decided on the papers, but there's real interaction in trying to understand how this bill will work in practice. And that's why I've added a series of that, of whether or not the person who's making the request, the terminally ill person, has to be in the country.

But we should get into other aspects of whether or not things like the panel has to be here. Now, one of the things that I've put this in place to try and make sure we had a debate earlier in, in the committee's considerations, where I tried a clumsy attempt of how to have people actually in this country, because as I made the point before, you can be ordinarily resident in more than one country at the same time. So that's why I wanted to continue to focus on this.

Being a person patient, I don't really like calling it a patient because I don't consider this to be a health treatment, but a person based process. And for me, a lot of that is about where somebody is and whether or not there is that face to face link. Now, the government in a different policy has recently rightly wants to accelerate and increase substantially the number of face to face assessments being done for consideration of basically eligibility for sickness benefits. A lot of that was changed during Covid because, frankly, it was not practical to undertake that sort of process, and it has been gradually being brought back and needs to be accelerated.

But I think that thinking that is going alongside that policy is critical to the application of this bill. Now, the other, as far as I can see, the way I've interpreted three B is that it's only sections ten and 11 have to be done by persons in England and Wales, and that is the initial assessments. And I put it to the committee, to your Lordships, that a lot more of this should be done face to face.

As Jake the late James Munby pointed out, it's absolutely right that the panel should be considering this process. Looking into this, I'm conscious there'll be medics here who have perhaps even greater understanding of I, of how the variety of assessments should be done face to face. What happens when people making a declaration? Are we sure that somebody isn't in the room giving them the eyes that they'll do the right answers, as opposed to understanding whether coercion can happen or not? And indeed, in a documentary undertaken by ITV, it I think it was the bill's promoter, Kim Leadbeater expressed concern when she saw what happens in Oregon, where a lot of this is done by video.

Link expressed her concerns and indeed I believe considered that she would was uncomfortable and would consider adding an amendment to make clear that consultations with doctors could not be done by video call, and that they should be done in person. Now, that hasn't happened so far by the bill promoters and no explanation has been given. But that's why I've tabled these amendments, because I think they're a very important way of making sure safeguards are there, so that as we go through this novel process to us, I appreciate not novel to the world, but that we have every confidence that a lot of the safeguards on which people are concerned about are going to be appropriately applied.

So one of the things that we started discussing in a different group, brought forward by the nobles, noble Lord Birt, last week gave us a picture of how this could start to look. And indeed, the noble and learned Lord McInnes amendments, I think, have started to touch on aspects of this about how Commissioner can happen. But I can see very quickly, especially bearing in mind some of the amendments last week, which I appreciate, the noble and learned Lord Coaker did not accept.

But this is where almost every day a panel could be meeting. Right now, it could be somebody on holiday in Tenerife, it could be somebody else elsewhere, meeting in a video, a zoom, a teams meeting, whatever. And that feels to me like it could become quite a routine tick box exercise. And the very reason the late Sir James Munby pointed out why this should not be given to judges is to avoid. What is the point of having the judge if it's just going to be tick box exercise? And I think we need to be careful that we do not end up in that situation here.

In terms of specifically, I've suggested what needs to be done face to face. That's in amendment 65. It is the preliminary discussion. It is the request is is in the bill. It is actually the witness. The witness should be there face to face. I think that's seems sensible. We've got the first and second assessment already as, as their I think we could go further. What about the interaction with the independent advocate. Is that just going to be done down the phone.

These are the serious things which I think we need to consider. Should the panel be meeting face to face with the person applying or. I appreciate that, as in the amendment. 320 A the assumption is it should be face to face, but perhaps by exceptions by video link. But again, I think when I initially started observing this at the other end, I did think this would happen. And actually what seems to evolve is a lot of this will just be done remotely.

About the only thing which is in the I haven't included in amendment 65, is that the actual doctor being there and the assessment hopefully happening in this country, although that isn't specified in this bill, I appreciate, but the 25 three does actually say the coordinating doctor has to be there and provide in person, although actually in the following clause that can all be delegated to somebody else. So, my Lords, I don't want to overly labour the point at in consideration, but I hope it does give some thoughts to noble Lords on how they want to see this Bill work in practice.

It may be that people are very happy for this. All just happen in video. When why are we getting in the way? Isn't this just about autonomy? I think this would be sensible amendments to consider in order to make sure that while no Minister yet has said there's a safe bill, but make it as safe as possible, that we need to look at the operation of it, it's certainly the case in other parts of the health system that this a lot of this would not be acceptable.

A lot of this would have to be done face to face. And I don't think it is a case of overengineering this bill or leaving it to regulations. I think we should be clear in Parliament that this is what we are going to do. I am conscious of thinking of amendment 320 A, and I appreciate that. My noble friend Lord Evans of Rainow in 376 has particularly singled out in person for for parts of Paul's 12. I do get it that some people may be so terminally ill.

Perhaps a video link may be there, but I don't. I think that should be exceptionally rare if we are going to go down that route at all. So I'll be looking forward to hearing my noble friend explain why that is the case and how it can be administered. But with that, I beg to move.

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Amendment. Proposed clause one, page one. Line 21. Leave out eight, page one. Line 21. Leave out eight, ten, 11 and 19 and insert as ten, 11 and 19 and insert as printed on the Marshalled List. As having put money into some of these having put money into some of these amendments. In the spirit of what the chief have said are not repeat what Baroness Coffey had to say, what Baroness Coffey had to say, but just gently remind the House that this private member's bill is not normal insofar as most private member's bills are five, six, 7 or
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Lord Empey Portrait Lord Empey (Ulster Unionist Party)
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8 pages, this one is 51 pages with 59 clauses. So it's a very different animal to what we're used different animal to what we're used to as private members. Bill, I think the amendments in these think the amendments in these groups are there because in many respects, I find this aspect of the respects, I find this aspect of the process deeply disturbing. We're talking here life and death. We're talking here life and death. We're talking about making assessments of a person who is making an application for an assisted death.

You'll be aware that in the committee select committee of this House, Professor Martin J. Vernon, chair of the British Geriatric Society Ethics and Law Special Interest Group. On the 29th of October, said assessing somebody remotely digitally without a face to face assessment, particularly if they have complex health and social care needs, is nigh on impossible. Now I would have thought, to assess somebody's state of mind, to have any sense of judging whether they're being coerced or not coerced.

One of the most obvious things is to see them in front of you, to get the feel for that. How can a psychiatrist judge? The other point I would make, the practicalities. Depending on where you are in this country, you may or may not have the equipment. You may or may not have the capacity to use it. Signals drop off. Inevitably, if somebody is in a very frail and unstable condition, they'll have to be other people present to operate this.

Now, does that mean that a team from the hospital would have to go out to some remote location, or even worse, are we doing stuff on the phone? Can you imagine how people would react? Dial a death. This would be the sort of way people would describe it. I, I find that exceptionally objectionable that somebody in those conditions can be effectively provided. The state can provide a service to assist them to kill themselves on the phone. That's what we're talking about here.

So I have to say that trying to assess people remotely, it's conceivable, I suppose, that there are special circumstances. But like everything else, if we work this thing out properly, we'd have covered a lot of this. I think this part of the bill is fundamentally unsafe. So I take the view that to assess some of these state of mind, what they're settled will, is how a team can do that without seeing them face to face, in the room or in their home.

I find difficulty, we know we do use video links for legal proceedings, but there's a big difference between somebody who's been held on remand for robbery, appearing in court on video, and somebody who's seeking assistance to end their lives. We're not talking in the same sphere of influence or effect at all. So I have to say, very unhappy about the proposals in the bill on this. And I have put my name to some of these amendments and support the comments by the noble Baroness Coffey speak.
11:02
Lord Evans of Rainow Portrait Lord Evans of Rainow (Conservative)
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My amendment. >> To hear. >> The noble Lord, Lord MP I last Friday, like many of your Lordships, I sat here all day and didn't say a I sat here all day and didn't say a word and my amendment was in the following group, but sadly we didn't get to it. But there was an excellent discussion. I want to pay tribute to some of the contributors, Lord Deben and Lord Mawson and indeed the noble Lord, Lord, Lord, Lord Falconer. Lord Falconer said something that rang a bell and he referred to study, diligence and how healthcare professionals and the whole system will study how best to conduct these assessments.

And my Lords, when he said study diligence, it reminded me of some experience that I had as a member of Parliament and helping people in very distressing circumstances with healthcare of of loved ones and trying to navigate the system. And the the thing that struck me was studied neglect, now studied neglect is quite difficult to detect because it's not always obvious. Now, many of us in this house have a routine. That's what makes us get up every day.

And as the older you get, that routine is very important. So you have a good night's sleep. You wake up in the morning, you shower, you clean your teeth, you exercise, you go to work, or you go to functions in the community. You eat well, you eat healthily, you lead a normal life and you can leave that lead, that normal life, as many as many of us do in this House. But something may happen to you may have a fall, slip, trip and fall, and you may find yourself in hospital.

And that, my Lords, is where things can can go wrong. Because if you're out of that routine of a good night's sleep, getting up in the morning for every week that you lie in bed, you lose 10% of your muscle strength. You don't get up, you don't do your routine, you don't shower. You don't clean your teeth. Things start happening to you go downhill very, very, very quickly. And those things can happen through daily life. But the thing that really concerns me about this bill and the reason why I tabled this particular amendment, insisting on face to face diagnosis with the healthcare professionals having to make this decision is based on experience, as I said, as a as an MP, because close family and friends can have a malign influence by slowly but surely.

And this is why I refer to it as studied neglect. Not encouraging a loved one to get out of bed in the morning. That routine so it declines. They stop showering in the morning. They don't go for manicure or pedicure their hair. They start to decline. So people who we always regarded as very, very smart for their age declined very quickly and the loved ones so around them can engineer this, so that when social workers and healthcare professionals meet with these people, it's not obvious what is what is happening.

They're not sleeping properly, they're not looking after themselves properly, they're not eating properly and therefore it declines. The nutrition is very important. You have medication, there's no clear care plan. As one grows older, we take lots more medication and that medication can be increased when it doesn't need to be increased and indeed not given at all. So this is why I'm using the phrase studied neglect to the noble and learned Lord Fuller study diligence. We really do have to look very carefully at these malign forces that I'm afraid, are out there in society, that looks at granny and there's Lord Deben says, the £2 million house sitting there, and slowly but surely, but relatively quickly, they can see the demise of of granny and realise those capital assets.

And that's the reason why I put this amendment forward. Crucial steps in assisted dying process should be undertaken with direct in-person interaction, to increase the likelihood that the individual's request is truly voluntary, informed and free from coercion. The necessity for direct interaction with a person, particularly face to face contact, is driven by the importance of rigorous safeguards and scrutiny, and upholding patient autonomy in a process that culminates in an irreversible outcome called death. I could use many, many more examples, but the interest of time I beg to move this, this amendment.
11:06
Lord Blencathra Portrait Lord Blencathra (Conservative)
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Alliance. I write. >> Alliance. I write. >> To speak to amendment 320 B and three others in my name in this group, because the first clinical group, because the first clinical gateway in this bill is the most important moment any of us will ever legislate for. That is the moment a doctor begins the process that can lead to a life being ended. That gateway must be treated with the utmost care. It should not be reduced to a convenience driven video call. My amendment is simple and proportionate.

It creates a presumption that the coordinating doctors first assessment takes place in person, and it asks only that if the presumption is displaced, the doctor requires records. Why an in-person meeting was not possible for medical reasons. That is not micromanagement. It is common sense. It is the minimum standard of human contact we should expect before opening a pathway that is irreversible. Why does this matter, my Lords? Well, first, capacity and voluntariness are relative, are relational judgements. Clinicians do not assess capacity from words alone.

They read the faces, they notice the hesitation. They observe the environment and see who else is present. They pick up the small, telling signs of distress or coercion that a screen can hide, a hand hovering off the camera, a whispered instruction, a look that does not match the words. Remote consultations blunt those senses. If we are serious about preventing coercion, the law should make face to face the default, not the exception. Second, this is a narrow safeguard, not a prohibition. The amendment allows remote assessment where it is genuinely impossible for medical reasons.

It recognises that it will be rare cases when a patient is too frail to be seen in person. In those cases, the coordinating doctor must set out the reasons that requirement creates an audit trail and accountability. It deters the normalisation of remote practice for administrative convenience and gives panels the commissioner and, if necessary, later reviewers, a clear record of why the presumption was set aside. Thirdly, the evidence is clear leading geriatricians and psychiatrists have told committees that assessing capacity remotely for complex patients is nigh on impossible.

Telemedicine studies and experience and course show the limits of video for detecting vulnerability. We should legislate to reflect clinical reality, not hope that guidance will be followed uniformly across hundreds of clinicians and thousands of cases. Now, some will say this will delay access or overengineer the process. I disagree, my Lords. A single in-person assessment at the outset is a modest investment of time that dramatically reduces the risk of error. If the system is robust, it will absorb that step without undue delay.

If the system cannot, then speed has been prioritised over safety and that would be a real problem. Finally, on this amendment, my Lords, I put it to noble and learned Lord Lord Falconer of Thoroton will he accept that a life ending pathway should begin with human contact with a clinician who has seen the person in the flesh smell the room, so to speak, and observe the context in which that wish has arisen? Or will he prefer a default of pixels on a screen? My Lords, when the outcome is death, convenience must never trump clinical rigour.

I urge the House to support my amendment 320 be my amendment three four, seven eight ensures that the second assessment, the final medical safeguard, is conducted in person. The bill currently allows the independent doctor to assess the patient entirely by video. That is extraordinary for a life ending decision. Experts told the House of Lords select committee that assessing capacity remotely is, as I said before, nigh on impossible for complex patients. The subtle signs of confusion, fear, coercion or cognitive impairment are often visible only in person.

Remote assessment hides the environment. Who is in the room? Who is influencing the patient, what pressure they are under. I think Kim Leadbeater MP herself said she was uncomfortable watching Oregon's remote assessments, describing them as tick box. If the sponsor is uncomfortable with death by zoom, Parliament should not legislate for it. This amendment of mine is modest, proportionate and essential for safeguarding my amendment. If remote assessments are permitted at all, then my amendment 406 introduces the bare minimum safeguards. The doctor must verify that the patient is alone and speaking freely.

Coercion, as we know, is often silent. Abusers consider off camera patients are coached and Michigan prosecutor famously spotted a domestic abuse victim being coerced during a zoom hearing. If trained lawyers and judges can miss coercion on video, how can a doctor reliably detect it in a single remote consultation? This amendment of mine does not ban remote assessment. It simply prevents the most obvious and dangerous form of abuse. Without it, the bill's coercion safeguards are meaningless. And finally, turning to my amendment 415B.

This ensures that remote assessments are tightly controlled. Use only when appropriate and subject to independent oversight. The bill currently allows remote and even pre-recorded assessments without any statutory framework. A protocol approved by the Commissioner ensures consistency, transparency and accountability. It prevents remote assessment becoming the default due to NHS pressures or simple convenience. Without this amendment, I suggest the bill creates a system where lethal decisions can be made based on pre-recorded video clips. That is indefensible. So, my Lords, in summary, these four amendments of mine from a single focussed package of safeguards to ensure human judgement, not administrative convenience, governs a life ending pathway.

320 B makes the first assessment face to face. By default, the minimum human contact needed to test capacity and support coercion. 347 A extends that presumption to the independent second assessment, so the final clinical check is equally robust. 406 A requires a simple verification when assessments are remote and recorded, confirmation that the patient is alone and speaking freely, and 45B demands a statutory protocol for remote or pre-recorded assessments. So exceptions are tightly controlled and independently verified. My Lords, these are modest, proportionate measures.

They do not block access where an in-person assessment is genuinely impossible, but they stop convenience becoming the norm when the consequences. I put this to the noble and learned Lord, the Lord Falconer of Thoroton. If this bill is to be the safest system in the world, will he accept these targeted protections so that speed and convenience never replace clinical judgement and human scrutiny? I urge the House to support my amendments.
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