Live Debate: Commons Chamber

Commons Chamber

Friday 11th September 2026

(began 9 hours, 41 minutes ago)

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09:35

None

All. All. Before All. Before we All. Before we begin. All. Before we begin. As All. Before we begin. As Mr All. Before we begin. As Mr Speaker said in his statement yesterday, today marks the 25th anniversary of the 9/11 attacks on the United States. It's also the subject of today's adjournment debate. I, too have seen the site of the attacks and it is a harrowing reminder. Remember the 2977 innocent lives lost, including 67 British citizens? That also impacted family members in my constituency in Sussex Weald, we pay tribute to the extraordinary bravery of everyone that and who risked their lives and their own safety and ran towards the danger in order to save others.

I am sure that colleagues from across the House will wish to remember the victims of those terrible events

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and their loved ones. Point of order. Madam Speaker.

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Point of order. Madam Speaker. Point of order. Kit Malthouse. I beg to move this house to sit in private.

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in private. The question is that this house sit in private. As many as that sit in private. As many as that opinion, say I. Of the contrary. Of opinion, say I. Of the contrary. Of the contrary? No. The noes have it.

09:36

Private Members' Bills: Terminally Ill Adults (End of Life) Bill: Second Reading

09:39

Lauren Edwards MP (Rochester and Strood, Labour)

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10:05

Rt Hon Dame Karen Bradley MP (Staffordshire Moorlands, Conservative)

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Yeah. >> Very much, Madam Deputy Speaker. This is a very difficult day. No one could fail to be moved by the grief of campaigners, by deeply personal stories, whether born of their own experience or of the experience of those they have lost. And those voices deserve to be heard. And it is important in this place that we respect all views, whether we agree or disagree. But as we deliberate today, I go back to the words of the hon. Member for Bradford, who spoke in the previous time we debated this and she asked us to remember the quiet ones, those who may be less organised or not as powerful, but who are nonetheless equally, if not more important, the voiceless.

Now, those words resonated particularly strongly with me because I had the privilege of serving ten years ago as the Minister for Preventing Abuse, Exploitation and Crime. The first time that that safeguarding brief had been brought under one Minister, it was so often the quiet voices that needed to be heard. It was the time I spent with victims that persuaded me that modern slavery was something we needed to legislate for. It was the time I spent with the victims of domestic violence, some of whom didn't even want to admit that they were victims.

That persuaded me we needed to do more. We needed to legislate in this area. And when I took the coercive control offence through Parliament, it was incredibly important, a very difficult offence. Coercive control is not easy to prove. It's not easy to find the evidence for. But it was so important that we did this. And I remember speaking at events not long after the legislation had gone through, and I explained that coercive control offence and what we were trying to do in Parliament, and afterwards a woman came up to me privately and she was in tears.

She told me that what I described had been her life some 30 years earlier. She had recognised eventually that she was a victim. And so often victims don't recognise they are. But she did recognise she was a victim. She'd gone to the police, but because the the offences weren't violent, they weren't physical. The police said there was nothing they could do. They even said, lock the door and hope that he beats the door down because then we could arrest him on criminal.

A criminal violence that was. That was all they had. There was nothing they could do to help this woman. And that encounter stayed with me. And it reminds me time and again that abuse is not always a single act. It can be the gradual erosion of somebody's confidence, independence, and sense of what choices are really theirs, and coercion to end one's life may not come as an explicit threat. It may be the repeated suggestion that someone is becoming a burden.

It may be I will. I will not be giving away much because I Madam Deputy

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Speaker, but I will give way to the hon. Lady. I thank her very much for giving way and for sharing that really difficult story. But would she not agree with me that the current system has absolutely no safeguards

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system has absolutely no safeguards at all against coercion? And that's exactly why we need this bill. Yeah.

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Yeah. So so coercion is something that we absolutely need to tackle and we need to understand as a society. I don't think this bill has the safeguards that are needed, because I will give way that and then I'll

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give way to the previous sponsor and then I will. Can I thank the honourable for giving way? And I quote the story giving way? And I quote the story of of one of my constituents and a man d sufferer. He said if he had the option to two years ago for the option to two years ago for this, he probably would have taken it. But instead his words I would have missed out in the most fulfilling two years of my life and fulfilling two years of my life and the knowledge that I can have more moments like this ahead of me.

His words is please don't do this. Life

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words is please don't do this. Life is worth living. Does she agree? Thank you. The hon. Gentleman makes a very important point. I now

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give way to the previous sponsor. Thank you for. Giving way. Would she agree with me? And she's making a very me? And she's making a very important point. And I consider this at length, obviously during the last two years. And that's why so many amendments were made to the so many amendments were made to the bill around coercive control, to ensure that all professionals involved have to have training. There are multiple checks for coercion throughout, which don't coercion throughout, which don't exist now.

We now check for coercion when someone is dead.

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coercion when someone is dead. But I accept what the hon. Lady says, and I know she speaks with great sincerity. But but this is still the case that under this bill, somebody could be seen remotely without a face to face appointment, without them being alone where the the coercive perpetrator may be forcing them. And yes, final, final intervention.

10:09

Claire Hazelgrove MP (Filton and Bradley Stoke, Labour)

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I thank the hon. Lady what she >> I thank the hon. Lady what she is describing. Suicide currently outstrips homicide of women in our outstrips homicide of women in our country as the reason for the deaths of. In cases of domestic abuse and coercive control that she is talking about. So what she outlines is currently happening today. So arguing for the status quo is not something that I feel comfortable with, and I feel considerably stronger about the safeguards which I worked with my hon.

Friend to make sure we're in

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the bill. I have enormous respect for the previous Minister and I, and we previous Minister and I, and we have worked closely together. But the point she's making around suicide of women who are victims of domestic abuse, etc. is a separate matter. We need to tackle that. Absolutely. And we need to make Absolutely. And we need to make sure that those women in particular, who feel that they have nowhere else to go other than to commit suicide, I mean, that is just the most outrageous and horrendous situation.

And we absolutely have to tackle it and we have to work on this. But this bill is not the solution to that problem. And as I referenced her, I better had I.

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Thank the hon. Member for giving way. She's been very generous with her time as a as a survivor of her time as a as a survivor of domestic violence, as a survivor of an attempted suicide many years ago whilst campaigning about domestic violence, would she agree with me that coercion is not always that coercion is not always external? Coercion can always also be internal? AM I a burden on my be internal? AM I a burden on my family? Can they afford to look after me? Coercion that coercion isn't picked up in training because it comes from deep inside.

When you are vulnerable and at your at your

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worst end. Yeah. The hon. Lady makes the case so powerfully and I'm going to disappoint. Now. There won't be any further interventions for some time because my fear, as hers is, is not because my fear, as hers is, is not principally for those who are confident, articulate and able to insist upon what they want. It's for that person who doesn't want to for that person who doesn't want to make a fuss, the person accustomed to putting everybody else's needs before their own, the person who before their own, the person who internalises that coercion, the person who feels guilty about the care they require or have simply been deprived of it.

And recognising abuse is a really difficult thing. I'm struck there's those who have the misfortune of watching daytime TV making notice that there are currently adverts

10:27

Rt Hon Sir Edward Leigh MP (Gainsborough, Conservative)

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10:32

Dr Zubir Ahmed MP (Glasgow South West, Labour)

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10:46

Rt Hon Kit Malthouse MP (North West Hampshire, Conservative)

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and I'm pleased that this debate has stimulated a strong debate about palliative care. The Health and Social Care Committee of the and Social Care Committee of the House of Lords found that in territories that have assisted dying, palliative care generally improves because people become less afraid of talking about death. But we must be careful. We must be we must be careful. We must be careful not to say that perfection is something is a precondition for is something is a precondition for those who are dying.

Perfection has to be an objective for those of us who will carry on living. We can't delay and indulge them the dying in their agony, because we're not satisfied with the state of palliative care. We have to deal with the choice that those people are facing at the point of their death, and give them the choice that so many of them are seeking. The second is, is about coercion. And as the Father of the House said about love, one of the most affecting people I've met over the last 11 years of campaigning on this.

This issue was Warwick Jackson, who came to our party conference a couple of years ago. Warwick's wife, Ann, was diagnosed with a terminal peritoneal cancer. She knew basically she was going to die. The slow, suffocating death at the end. And as he watched her dying, he heard her begging her palliative nurse to end it all for her. He contemplated smothering her with a pillow, and the only thing that stopped him was because he didn't want her dying thought to be her loving husband, having brought her life to an end.

And that is the conflict of love that we pose to people by perpetuating this appalling status quo. We've heard time and time again that the situation millions, thousands of our constituents live with every single day is so horrific, so appalling, that even the best palliative care cannot alleviate their pain. And so I urge you, colleagues, to consider what your vote may mean today, because, as we said at Second Reading, a vote against this bill is not a passive act.

It's not something neutral. It is a vote for a status quo that is status quo of misery and degradation and cruelty for so many. We know that the British people support this measure. We know that there are lots of territories around the world that we respect and admire, who have assisted dying and have operated it for many years successfully. It's not beyond us to get our democracy operating as it should do, and to design something that will work for the British people.

We can't give dying people more time, but we can give them mercy and love. Urge you to vote for the bill today.

10:49

Ashley Dalton MP (West Lancashire, Labour)

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Ashley Dalton. And the last time this. second. >> Reading, I was keeping a secret.

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Reading, I was keeping a secret. Whilst Honourable and right hon. Members were debating the issue, I was grappling with my own terminal diagnosis. I was told I have stage four incurable metastatic breast cancer. I was overwhelmed with grief, fear and anxiety. I was scared of what was to come and I was fearful of how it would impact my family and my loved ones. I was scared that I was going to get really poorly and thinking, how will I cope? How will my family cope? How will I be cared for? How will I afford it? How badly will it hurt? How long will it last? When you hear those words depression, anxiety, grief, fear, shame and guilt come in bounds.

Suicide risk is highest immediately after diagnosis, and it usually falls quickly. Within 3 to 6 months. I would be lying if I said that when thinking about all that was to come, I didn't consider that it might just be fairer and easier on everyone if I just got the dying over with as soon as possible. Having treatable depression, however, will not exclude anyone from an assisted death within this bill, and depression is common among people with terminal illness, but it is often treatable.

Clinicians are trained to prevent suicide in people suffering from depression. But where would the line be drawn? This bill makes no provision to support this difficult transition or to create safeguards around it. A person can also be suicidal and have unmet mental health needs prior to developing a terminal illness, and then ask the state to kill them without any assessment of their psychological health, just their mental capacity. Because mental capacity and mental health are not the same thing.

The Royal College of Psychiatrists recommends a holistic, multidisciplinary assessment of every applicant. The three person panel at the end of the assessment process in this bill is not what most NHS clinicians recognise as a multidisciplinary team. It certainly does not allow for meaningful, multidisciplinary decision making. The assessment needs to happen at the beginning of the process, not the end, and each team member should be independently assessing the patient in person. This is not what has been included in this bill.

Now, I don't know how long I will live. I will be on treatment for life, however long or short that may be. I at the moment, live between scans in 9 to 12 week blocks of time. The last scan may show the disease is stable, but the next scan might show that it is growing again. If the disease is stable, the drugs working and we can carry on. Eventually the drug will stop working, the cancer will grow and we'll have to try another drug and see if that works.

At some point, we'll either run out of drugs to try or I'll be too poorly to tolerate them. Then I die. It could be months. It could be years. No one really knows. Prognosis is notoriously difficult to predict. Palliative care professionals and oncologists tell me that whilst they can more or less give me an indication of when I'll die, when I'm a few days or weeks off, anything beyond that is the flip of a coin. The six month prognosis in this bill is something no one can ever be really sure of, but what the palliative care professionals have told me is that palliative care can help me when I die.

But in the campaign around this bill, it seems to me that it's being implied that without that, a person with a terminal illness will have a dreadful, painful death unless they have access to assisted dying. And it's simply not true. Palliative care in the UK is excellent. Far too many people do not have access to palliative care that they need, but the idea that it is not possible to alleviate pain and discomfort is false. People. I have been terrorised with tales of people vomiting up their own faeces, as though this is commonplace during death.

It is vanishingly rare and, you know, bowel obstructions are more common, but they are treatable. I know I've had one. It's nothing short of irresponsible to scaremonger people like me into believing our deaths will be horrific, when all the evidence suggests that with access to good palliative care, deaths are, on the whole, gentle. The answer is not to terrify people and their families. It's to sort out palliative care and social care first, because none of this takes place in a vacuum.

Until we can say that everyone that needs it has access to high quality palliative care, then we're offering nobody a choice, a terrible death or an assisted death is not a choice. It's a threat. Whilst I speak today from the position of someone with a terminal illness, I am acutely aware that this is not about me. This debate is also not about an abstract concept or a position of principle. The question that will be put at the end of this debate will not be that this House has considered the question of assisted dying.

It won't even be that this House agrees with the principle of assisted dying. The question will be that this House agrees that this bill be read for a second time. This bill, not the bill it might have been not the bill members might have hoped it would be, not the bill. It could be this bill. It is the only thing before us today. And incidentally, it says absolutely nothing about the House of Lords. That is not the question that we are being asked.

And whatever honourable or right hon. Members think about the principle of assisted dying. Surely our first and foremost responsibility is to write law that is safe and workable, not one of the professional bodies that would be tasked with delivering the bill are willing to attest that, as it stands, it is either safe or workable. Not one. The Royal College of Psychiatrists, the Association of Palliative Medicine, the Royal College of Physicians all say the bill is seriously inadequate. They aren't opposed to assisted dying in principle, but they cannot support this bill.

And instead of bringing a bill identical to the last so that the Parliament acts could be used and it can be forced unamended onto the statute books, why didn't the proposers spend the summer working with the Royal Medical Colleges, professional bodies and organisations to build a bill that they could also support? If they had done that, it would have been very difficult for anyone opposed to the principle to argue against the bill, but they didn't. But this is not about sides.

This House is not a debating society. It's about making the law. Whilst we may be campaigners out there in here, we are all legislators. It is our responsibility not to pick a side and dig in, but to work together to build the best laws that we can. And that is never truer than with a private member's bill. On a matter of conscience. This bill does. No I won't. This bill does not protect the most vulnerable. It does not commit against the poor, the old people with disabilities, all black and minority ethnic people being disproportionately affected.

It does not protect people who are mentally ill. It does not recognise that not everyone has the same level of agency, control or influence over their decision making, and what the clinicians we would ask to deliver this bill are saying is that it isn't even workable, that there is every expectation. It wouldn't even work for the terminally ill people that want an assisted death either, and there's no stopping it. Or to commencement in the bill means, if it's passed by the Commons, pushed through the Parliament Act, and even if the government or the NHS is not ready, it has to happen on the strike of four years from it being passed, even if there's no funding, even if palliative care is still broken, even if it is known to be dangerous, flawed or unworkable, it is happening.

Ready or not, this is not a last chance saloon. This debate has been going on for years. It's not a once in a generation opportunity. It could come back again at the next Parliament. My days may be numbered, but that doesn't mean that I want this chamber to rush through bad law just so I might have a chance to see it or use it. It's a huge importance. If honourable and right hon. Members have any doubt that the bill before us today is not the best it could be, is anything less than excellent, well thought out and robustly drafted legislation that protects the vulnerable and recognises the expertise of our world class clinicians, and a bill that I and other terminally ill people deserve.

Then I vote. I urge them to vote no or vote abstain. Pippa Heylings thank. begin.

10:58

Pippa Heylings MP (South Cambridgeshire, Liberal Democrat)

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By thanking. and Strood for her courage and compassion in bringing this bill back before Parliament. The debate in this House, the other House and across the country is profoundly important. We need to get better at talking more openly about death and what dying well means. These were the words of the end of life care clinical lead during my last week's visit to the new, dedicated palliative and end of life care ward at Addenbrooke's Hospital in my constituency of South Cambridgeshire.

It's something my own father said to me many, many times over 40 years ago. He was a family doctor in Hull, in the deprived communities, witnessing family births and deaths of many patients at home and in hospital. Love life, live life as much as possible and have a good death. The last time this bill came before the House, it encouraged that conversation. There was respectful debate. Evidence was examined, safeguards were strengthened, the Commons voted in favour and the Bill was sent to the House of Lords for further scrutiny.

What we are doing today is allowing due process to continue by sending the Bill back to the Lords so it can complete its passage here. I am grateful to the many constituents who have written to me on all sides of this debate, sharing deeply personal experiences that have shaped their views and informed my own thinking. Having listened carefully over all of our debates, the bill committee, the witnesses, the evidence, I continue to support this bill. There is a need to change the status quo.

Receiving a terminal diagnosis, as we have heard, is devastating. It brings a loss of control of the future that many people find deeply frightening. One of those people is my constituent, Jodie, who is living with a terminal grade four astrocytoma brain tumour following life saving surgery. She continues treatment aimed at preserving the best quality of life possible. Fiercely independent, she is living every single day. Yet, in her own words, the prospect of the disease eventually taking over her brain, leaving her unable to think clearly, communicate or make decisions frightens her more than she can express, she said.

None of us know what the future holds, but knowing that the option of assisted death would be available should I ever reach that point, would provide me with enormous comfort and reassurance. As we've heard today, what we don't talk enough about is the current status quo. It's almost as if there's a taboo, and that, for some terminally ill people, is an unsafe and cruel status quo, with hundreds of people already taking matters into their own hands. And I want to share the story of my constituent, Kath Shepherd.

Her sister, Emma Windrush, was a keen and active outdoors woman who loved life. Facing the end of that life, she chose the only legally defensible and medically suported route available to her, voluntarily stopping eating and drinking. We know that many medical practitioners feel that this is a grey area, and much more guidance is needed. This area that should not be the only option. Emma felt robbed of the death she wanted, and she campaigned for the law to change until her end came after Emma's death.

Kath has continued that campaign so that others might have the option of the gentle and dignified death her sister believed she was denied. Now, again, as we've heard today, too often assisted dying and palliative care are presented as competing alternatives. They are not. Both are rooted in the same aim, ensuring that people approaching the end of life are treated with dignity, compassion and respect. I'm fortunate that Arthur Rank Hospice serves my constituency and the wider region. It provides

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outstanding care and support to patients and families at some of lives. Its staff.

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Its staff. Volunteers do extraordinary work, yet like many hospices around the country, it faces huge cuts. The country, it faces huge cuts. The loss of beds something that many and I and others are campaigning to stop happening. We all know there stop happening. We all know there is a disgraceful crisis in adult social care, hospices, hospitals, social care, hospices, hospitals, home services, district nursing, community palliative care are all desperately underfunded. Therefore, I welcome, as we all do, as liberal Democrats welcome the Prime Minister's call for cross-party talks on social care.

But Madam Deputy Speaker, I do not share the premise that assisted dying legislation must wait until palliative care is fully funded and available everywhere. This is not an either or. This is not a before until. These are not and should not be competing priorities. My support for this bill is matched by my belief that we must equally strengthen palliative and end of life care. Dog dying with dignity means access both to outstanding palliative care, compassionate every stage of life, and the ability to have choice, agency and dignity for those very final days.

And this bill will not make choice for anyone. It will simply allow terminally ill people to make choice for themselves, safely challenging the status quo and with

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the loved ones around them if they so wish. Thank you.

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Thank you. Josh Fenton-Glynn Madam Deputy Speaker, I've. Struggled with this vote,

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Struggled with this vote, perhaps more than any other in Parliament, because if you'd asked me at any time in my life if I was me at any time in my life if I was for or against assisted dying, I'd say I'm in favour of it. I believe people have autonomy over their own bodies as a fundamental liberal principle, but we do not vote on principles here. We vote on legislation. And this bill at this

11:05

Josh Fenton-Glynn MP (Calder Valley, Labour)

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time is not one I can support. I don't believe it's safe. I don't believe it addresses very legitimate concerns of disabled voices, and I do not believe it's come at the right time. In my speech, I'm going to cover the state of palliative care and fears of coercion. But first, I'd like to of coercion. But first, I'd like to thank my constituents for the role that they've played in this coming to meetings, speaking to me at to meetings, speaking to me at surgeries, writing me emails in a respectful way, the way that we should conduct our politics in all things, but particularly things this seriously, I bring professional and personal experience to this.

I've been a council Cabinet member for social care, sitting on a safeguarding board. I've worked for the General Medical Council, and for the past two years I've sat on the Health and Social Care Select Committee. And like many people, I've sat with a loved one as they've died. Ultimately, my experience mean that I don't for one minute believe that this is simple. I know that if we don't pass this bill, then some number of people will die in preventable pain and a painful death.

I also know that if we do pass any bill, there will be some number of people who are coerced into taking their own lives. If you have moral certainty, not just now, thank you. If you have moral certainty on this, I honestly envy you. But on the state of palliative care, we are told that this bill is about giving our constituents more options of choice between good palliative care or an assisted death. But in a world where there are such gaping holes in our health, social care and palliative care system, that is simply not the case.

Not just now. My committee asked our independent expert panel to look into the quality and availability of palliative care, and the results should give everyone in this room a pause for thought, because we do not have a universal offer of palliative care in this country. The report points to a postcode lottery of provision. Hospices are largely funded through charitable donations, which means in better off areas, there is better care. On my committee, we constantly hear about the social determinants of health.

Let's not have one of them be that those in wealthy areas have the choice of a comfortable death, while the poor must choose an early one here. Furthermore, there is a workforce crisis in palliative care. There are 700 palliative care doctor posts, but 70 vacancies add to that 130 doctors expected to leave the profession in the next five years. And to make matters worse, training bottlenecks mean there won't be specialist doctors trained to replace them. This is in a landscape where, in the current decade, we expect demand for palliative care to increase by 55%.

I want a safe bill and taking all of these things into account. A safe bill would give some discretion to the Health Secretary as to when they implement it. This bill does not. I'm sorry, I won't just now. It has an auto commencement clause, which means that within four years of the passage of this bill, whatever the state of our health service, whatever the state of our social care, whatever the state of our palliative care, even if there's been another pandemic, this bill will come into force.

And that brings me to our safeguards. I cannot vote for a bill that does not sufficiently guard against coercion. That is what my constituents with disabilities say they fear the most. And having been in charge of social care, I know what that looks like. And let me be clear the safeguarding this bill are not enough. If the bill in its current form passes, a patient would be subject to more scrutiny to give up a kidney than to give up their life.

The ultimate weakness of this bill is that the question being asked when a patient goes to the panel is a medical and legal one, not a social and psychological one. The main judgement will be will, will, will be an assessment of whether they're likely to die in the next six months, not why they've chosen to die, or whether there is a risk of coercion. And coercion isn't always committed by the traditional villain. It's not who wants money. It is often committed by a loved one.

At the end of their tether, a support falls away and money drains options narrow and people's sense of what choices they have. Narrow, too. Without improving palliative care, we will put far too many people in this heartbreaking position. Now, as MPs, we are used to being forthright in our opinions. We are used to advocating for ourselves and our constituents. Madam Deputy Speaker, I am coming to the end, but on our Select Committee, I'm constantly hearing from vulnerable patients who say that they are frequently ignored, talked about or talked over by medical professionals.

They feel talked at, not talked to. And when considering this legislation, I do not ask whether it will work for people like me. I ask whether it will work for the most vulnerable, those whose voices are rarely heard, those whose voices are most dependent on the state for protection. They rely on us to be their voice. This bill comes from a place of compassion, but it could lead to a place where a disabled person feels they are less. It could lead to a place where poor social care means people don't feel they have a choice between a comfortable life and an early death.

So that is why I say with a heavy heart, not this bill and not at this time.

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Thank you, Mr. Bernard Jenkin. Thank you, Madam Deputy Speaker, and I welcome the hon. Member for Calder Valley speech, because he is an example of what we have seen throughout this whole debate, which throughout this whole debate, which actually goes back to the early 2000, that people have been peeling 2000, that people have been peeling off from supporting assisted dying in principle, and certainly peeling off supporting this bill. And I am a case in point. I came into the chamber to listen to the Falconer bill, the Lords bill, I think it was in 2014, absolutely determined I was going to vote for assisted dying.

And I sat through the debate

11:11

Sir Bernard Jenkin MP (Harwich and North Essex, Conservative)

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and ended up voting against, because I thought the arguments were not made in favour of this bill of of any bill. And the second bill of of any bill. And the second reason I think we should throw this out today is the bill keeps changing. Even now, this bill is changing. Even now, this bill is not settled. Even now, the advocates of this bill want changes advocates of this bill want changes to this bill, and they are stuck with the reality that if the Parliament Act is invoked, they will only be able to invoke the Parliament.

The Bill, as it stands today, they will not be able to have their changes. So if in doubt today, the House must vote no. Yeah. Third point I want to make. This is a far bigger question, it turns out, than just a matter of conscience or a matter to be decided that is isolated. It's a massive question that affects public policy. And with major public expenditure consequences. And that has convinced me that we really shouldn't see another bill like this one until we have a government bill that has been through the process of proper scrutiny within government, with all the consequences laid out and dealt with, so that a responsible and accountable Secretary of State presents a Bill that it is not a backbench Bill, and maybe there should perhaps be a citizens Assembly on this question.

It is a. It is a subject that would lend itself to a citizens assembly. Well, it doesn't take away any power from this House. This House would still be able to decide, but it would inform the debate in a way that the debate debate is still not informed. Finally, I would just say my mother and my father passed away in recent years. I'm so grateful that my mother never had to confront this question. She often said, oh, I just want to die.

I am just a burden on the family. And though she would never have qualified for this bill, I'm so grateful. There were never any circumstances possible that would have confronted her with this question. And I just also advert to another conversation a very dear friend, someone who's become a mentor, a very, very interesting, clever, intellectual, determined, courageous lady. And she has scoliosis of the spine. And the last time I went to see her there, she was hardly able to sit up in constant pain.

And I asked her, because we have open conversations, if assisted dying was available to you, would you take it? And without hesitation she said, oh yes. And I said, why? Because I'm a burden to my family. And I said, well, I've been voting against assisted dying. I'm going to have to rethink my position. And she said without hesitation, oh, I don't advocate it because she understands the complexity of this. And she knows that it opens a can of worms that we really haven't understood fully.

So I do urge colleagues in this House today to

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vote against this bill. Jess Phillips thank you, Madam Deputy Speaker. I want to start my Deputy Speaker. I want to start my remarks by paying tribute to the. remarks by paying tribute to the. My hon. Friend from Filton and Bradley Stoke, I mainly because I'm a bit lazy, I very rarely prepare a bit lazy, I very rarely prepare to speak in debates, don't have copious notes ever. And her remarks copious notes ever. And her remarks have led me to where my remarks will go, and that is, I will cover the issue of corruption that people have mentioned today.

But like her, I will talk about my mother, who also died when she was 61 years old.

11:15

Jess Phillips MP (Birmingham Yardley, Labour)

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And unfortunately for. And it was much, much nearer in my hon. much, much nearer in my hon. Friend's life. My mother died when Friend's life. My mother died when I was 28 years old, and so many years ago now, and she had a years ago now, and she had a leiomyosarcoma and suffered with it for around three years. The for around three years. The prognosis did change. So I hear those arguments that are being made in this House, but towards the end of her life, my she.

She felt she was going to die. At one particular point she. It was coming to the end. She was in a wheelchair. She was completely paralysed. She was like Dudley incontinence by this point. And just to give you an idea of the kind of woman my mother was, my mother was an absolute titan. She was like Erin Brockovich, but with a bad perm. In the 1980s. She. She can put claim now to giving a job and being able to spot talent because she gave a job to the current Prime Minister, who worked for her for some time and is often teary eyed whenever I talk to him about her.

And when she got to this stage, my. My brothers live in different parts of the world and country I. I live 20 minutes from where I was born and where she lived, and we all went back to be with her because we believed this was it, that she was going to be taken, that she was going to die. And she didn't die on that occasion. And so my brother, who lives in France, went back home. And then when it came to the point where a doctor gives you the call and says, your mom is about to die, my brother couldn't come back.

It was about four weeks later. And so it was me who was with my mum when she died. Not all of her children, not all of her grandchildren. And I am eternally grateful for that. But she definitely. This was a woman who had written every part of her funeral. She. She knew exactly what she wanted us to feel. She had planned within an nth degree what would happen after she was gone. I found the other day a recipe for Christmas puddings and the pin number for her credit card in an old.

In an old bag, because she was like, your dad might not be able to get money. She had thought about everything. She wasn't gifted with the ability to think about this. She would have. When my brothers were surrounding her, she would have taken the choice. On that day, and I feel that it. She didn't die in terrible pain and I. I recognise what the hon. Lady is saying and we shouldn't. We shouldn't. She wasn't writhing. It wasn't awful. However, she should have been able to choose to have her family with her.

I will, I won't, and so I, I will vote for this bill. She raised me to believe she was. I went to Women's Liberation Play group, which she set up with a load of women. She raised me to believe in a right to choose. My gosh, more so than anything else in life. And so she would tell me what to do today. But I just to the point of coercion that many people have mentioned, I am a scholar of coercion, and I want to just say it to everybody today.

Don't rest on the laurels that if we do nothing, people today won't be coerced to death, that that will happen today. That will literally happen today. And so the, the idea that if we just do nothing, I'm not going to because the Madam Deputy Speaker is, is, is clear. But the idea that we are going to walk out of here, if we do not pass this today, and women in our in our country are any safer, is an absolute is an absolute myth, doing nothing, doing nothing is not the

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same as acting. Layla Moran thank you, Madam Deputy Speaker. Can I start by Deputy Speaker. Can I start by paying tribute to all the members who have shared their story and the Member for Birmingham Yardley? I Member for Birmingham Yardley? I feel like we've learned a bit more about how she became, how she is about how she became, how she is today, and we've heard so many heartbreaking stories, I'm sure, from our own constituents. I want from our own constituents.

I want to thank all of them who have contacted me. Whether or not we agree or not, because sharing these stories are profoundly difficult for people. One constituent with incurable cancer contacted me, asking for the freedom to choose when to give up their battle. Her own brother had incurable, incurable melanoma spreading down his neck, which left him barely

11:20

Layla Moran MP (Oxford West and Abingdon, Liberal Democrat)

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able to speak to his loved ones. He went out at 2 a.m. in his dressing went out at 2 a.m. in his dressing gown. He climbed onto a bridge and he jumped onto a motorway below. he jumped onto a motorway below. But this was witnessed by two girls who were walking home from a party. who were walking home from a party. My constituent asks how many more need to take their own lives in need to take their own lives in horrific ways, because they simply cannot bear the pain, discomfort and hopelessness anymore.

And she wants the right to decide when is enough. Enough is enough for herself. And then there is Joelle, whose sister went abroad to access assisted dying. 84 year old Joelle sang to her sister. She ended her life peacefully with her family around her. She said it was a painless, peaceful and dignified death at a time of her own choosing, together with giving birth to my own children, it was one of the most beautiful experiences of my long life. I don't believe that only families with means should be able to have this experience.

It should be open to everyone. Now let me turn to the issue of palliative care. I pay tribute to my colleague from Calder Valley, where we share the committee, and we both wrote the reports together. I come to a different conclusion and with great respect it is true. And frankly, it is a stain on successive governments. The state that palliative care is in our investigations and our findings were stark commissioning, variation and postcode lotteries, bereavement support frequently inaccessible services, a fragmented workforce and skill shortages are widespread and systemic inequalities persist.

It's also worth noting that it's also worth noting that the NHS hasn't been meeting its own standards on palliative care for decades. The then Minister appeared before us in the spring and he mentioned the importance of workforce. I say again, and I'll say it again, I hope. Where is that workforce plan? We need it, but that won't be the whole answer. We also need better data, early identification, clearer guidance, and joined up working with adult social care and local authorities. Now, the government have said that they are going to publish a modern standard framework, and I think it is very positive that the interim MSF is now published.

But let me tell you where I see it. As chair of this committee, I genuinely do not believe that palliative care would have been included in the early batches of MSF if it wasn't for this bill forcing it to. And I further don't believe that the NHS, with all of its issues and competing priorities, let alone the competing political priorities that this government has and any other government that may come after it in the next four years, that palliative care, without the pressure of a bill like this, is going to improve as fast as we want it to.

And so I say to members this I do not believe that this is an either or proposition. I want palliative care to improve.

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this. Bill. And I will have to end with one

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And I will have to end with one more constituent story. And that's the story of Robert. His two the story of Robert. His two parents actually had different views on this. His father didn't views on this. His father didn't agree with assisted dying, but his mother did. We are lucky in Oxfordshire that we have some of Oxfordshire that we have some of the best palliative care in the country. And he described how her care was absolutely exemplary. She died in a way where she was without pain and well looked after, but she.

He felt that her wishes were not respected while his father's were. And there were consequences to her not being able to access assisted dying, which was that her brother couldn't be there at her bedside when she passed. So for those constituents who want a real choice at the end of life, I will tirelessly continue to want to improve palliative care. But I will also be supporting this bill today.

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Andrew Lewin thank you, Madam Deputy Speaker, and I mean that sincerely. On a day when so many colleagues want to speak, I promise colleagues want to speak, I promise you my remarks will be brief. Our debate today is about who has debate today is about who has choice and agency in our society in respect of the authority of this respect of the authority of this elected House of Commons, and what limits should exist on the role of the other place, and, more the other place, and, more fundamentally, the right of a terminally ill person to exercise choice at the end of their life, or whether the state should be able to override it? We are back here today for a Second Reading of the Terminally Ill Adults Bill, not because the question before us, before us has changed since November 2024, but due to the actions of a very small number of

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members of the other place. That point won't give way. I'll happily give way. Would he confirm to the House

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Would he confirm to the House how many amendments were accepted in the House of Lords, and that it

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was about 90 peers who were involved in supporting the amendments that were laid down? Yeah.

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Yeah. Grateful for hon. Friends intervention. I don't have the number of amendments that were approved. What I do have is that approved. What I do have is that the number that were proposed, 1286 wrecking amendments. Now there are. Madam Deputy Speaker, there are many thoughtful and compassionate critics of this bill who I respect deeply and I want to put on record my. I won't at this moment my admiration for the Member for West Lancashire, for her astonishingly brave speech this afternoon, but what I can't condone are the actions of members of the other place whose motivation in the last session of Parliament appeared to be to block the democratic process.

I will give.

11:26

Andrew Lewin MP (Welwyn Hatfield, Labour)

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11:31

Rt Hon Dr Andrew Murrison MP (South West Wiltshire, Conservative)

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difficult matter that will affect a relatively small number of people relatively small number of people at the end of their life. Now, I don't agree with the Prime Minister don't agree with the Prime Minister on much, but I do agree with him on that. And happily, the hon. Member, the Member for Glasgow South West, the Member for Glasgow South West, is no longer in his place, agrees with it too. And if I may with it too. And if I may paraphrase the Prime Minister, I want good palliative care to be available in every postcode.

I think the criticism we have of it in this country right now is it is not universally available to all. I believe that if it is, then many of the considerations that we are deliberating on today would be profoundly altered. And that is one of the reasons that I will not be

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supporting this bill today. I will very briefly. I'm grateful because I undertook the Independent Commission on Palliative Care, and we know that the data now shows a worsening of the data now shows a worsening of palliative care. 170,000 people not having access to the care they need, but also specialist techniques like but also specialist techniques like neuromodulation, palliative, radiotherapy and nerve blocks not available to those even able to available to those even able to access palliative care. Does he not recognise we need to look at the skills available as well as the

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access points. I suspect those sort of things were on the mind of the Prime Minister when he made his remarks recently, but the first reason I will not be supporting this bill will not be supporting this bill today is I seriously do not want to live in the kind of society in which we see the frail, elderly and vulnerable feel coerced into doing the right thing. Yeah, we can set the right thing. Yeah, we can set up panels and judges in chambers and social workers and all the rest of it, but we as humans know how humans work.

We know the light side and we know the dark, often the currency that passes between vulnerable adults and their influences are things that are not said. And some of the contributions today have touched upon that, and none of it is captured in clause 34. We know that certain groups particularly like to please to acquiesce, to oblige. We all know constituents like that, and we also know that they are often amongst the most vulnerable people with down syndrome. For example, people like the lady that was cited by my right hon.

Friend the Member for Staffordshire Moorlands, who featured in the Simply Cream advert. People like that, quiet people, if you like. They are among the vulnerable and they are among the people that I do not believe are adequately protected by this bill. Can we genuinely say that there would be a level playing field for them? Our first mission in this place must be, must be to protect the most vulnerable and on the vulnerable. Canada has seen the most appalling mission creep, particularly into mental health.

And that's probably why the Royal College of Psychiatrists, in company with the most impressive array of medical, disability and charity groups, is so wary of this bill. Count them off. Do not turn a tin ear to them. Now, I do not want the tone and texture of my profession or of any other to be changed irrevocably by its involvement in termination. Nor do I want others in the NHS or elsewhere in our care system, unprotected by codes of ethics and opt outs, and explicitly protected in this bill to feel obliged to be involved involved in it.

Clause 31 is all very well, but if this bill passes the pressure on those in the palliative care sector, particularly to facilitate assisted dying, will be substantial. Early in my career, I considered being an obstetrician and I was very attracted to it, and one of the reasons I didn't do it, because I did not feel comfortable being involved with a very large part of that practice, which is termination of pregnancy. I feel this will irrevocably change the nature of palliative services in this country.

The previous health secretary pointed out the tedious business of opportunity costs. 5% of deaths in Canada, where the law we are now debating has been in place for a decade and now assisted. I won't because of time. I'll get the evil. Sir. Madam Deputy Speaker. Persistent cough that is 1 in 20. Madam Deputy Speaker translated to this country, that would mean a huge extra cost that would have to be found from other front line services, which services likely be found from government support for hospices already reeling from national national Insurance increases that have yet to be fully offset? In my view, the moral, ethical, legal and practical issues that we are discussing today, complex as they are, are well beyond the scope of a private member's bill.

The only way to achieve a halfway safe and competent act is to make it a government bill contained in a manifesto, and so far, no major political party has wanted to engage with that. It is true that each day lives are shortened by interventions aimed at easing pain or suffering. That's what the caring professions do. That is quite different from a deliberate and systematic, state sanctioned and delivered program to end the lives of people approaching death. At the end of the day, we can rationalise the pros and cons of assisted dying, but most of us will go with what we feel in our guts.

My instincts tell me that giving the state or its agents leave to end life in this way is wrong. They tell me that however well intentioned, it will lead in one direction, it will over time, leave a grisly trail of unintended and unforeseen consequences. And that's why I oppose this bill.

11:38

Sarah Champion MP (Rotherham, Labour)

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Yes, champion. watched the assisted. Dying debate for many years since it started in Oregon. Many countries across the world now have it in place, including some of our crown dependencies. And I am pleased that dependencies. And I am pleased that this legislation in front of us is building on the good of that and rejecting the bad that it has seen. I'm also assured that there has been hundreds of hours of debate and scrutiny, which has built on the bill, which is in front of us now, and so I am very comfortable supporting it.

I know that people have extremely strong views on that, on this bill, and I respect them for that. I wanted to really speak to the people who are undecided, because there are a lot of myths that have attracted themselves to this bill, and I hope to knock some of them out. I'm not sure if members are aware, but before I came to this place, I ran a children's hospice, and I can tell you the palliative care system is amazing. The end of life care that is given is absolutely incredible.

But everything everybody has said about it being a postcode lottery, if it's in your area, if they have space, if it has the funding, it's true. And we need more funding and we need universal palliative care. But that's not what this debate is about. I was also deeply shocked when the debate was first raised about the number of disability groups and disabled people who thought that this was targeted at them, and I was shocked because I hadn't realised how vulnerable they felt in our society, and that they could believe that this bill might be an attack on them.

I'm not going to, because we're really pushing the time. What I want to say to them is this bill is tightly drafted. It is specific. It is for people of sound mind in the. Who have a terminal diagnosis of six months or less. That has to be verified by two clinicians. And then there is a panel to make sure that you. I'm still not giving way. I'm sorry that you are of sound mind. And this is something that you want to do, because a lot of debate has been taken up about coercive control.

And I have to defer to the powerful speech given by my very amazing hon. Friend from Birmingham Yardley, whose entire career has been spent fighting against coercive control. As she said, there are not robust measures in place for those generally women who are suffering domestic violence, coercive control. But in this bill, there is some measure to try and make sure that coercion is not applied to people taking forward this measure. What is this debate about? It's about choice.

It's about giving

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Adults of sound mind. The choice in the last six months of their life. My hon. Friend. Give way. Currently, the only choice available is if you have a lot of money and you're physically able to money and you're physically able to go to Dignitas or as so powerfully and emotionally outlined by my hon. Friend from Filton and Bradley Stoke to take your own life. Neither of those are an acceptable position for us to continue with. And it's not just about pain.

But let me say from my experience that there is some pain that is unmanageable, and not everybody gets the dignified death that they want. So for adults who are able to make an informed choice, I would like them to have that responsibility. I would like them to choose the time. But let's also look at what's happened internationally. Many people who go through the process who get the certification don't actually use it. It is a comfort blanket to them. It is an insurance policy for them.

So let us not have this illusion that as soon as you know you get the certificate, that's it, you're marched off. That's absolute nonsense. The choice is there all the way through. So when I say to you in a couple of hours, when you walk through one chamber or the other, please think about your constituents. Think about their ability to have an informed choice. And I genuinely believe this legislation does that. Bonnie. Roger.

11:42

Shivani Raja MP (Leicester East, Conservative)

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Thank you. Madam Deputy Speaker. As members of this House, our fundamental obligation, above all political considerations, is to political considerations, is to protect those who are most exposed, most vulnerable and least able to advocate for themselves. I acknowledge that colleagues from all sides view this bill as a measure of compassion. But if compassion is to truly serve the public interest, then it must be paired with rigorous scrutiny and an examination of all consequences of the intended legislation.

Madam Deputy Speaker, I voted against this bill both at its Second Reading in 2024 and its Third Reading in 2025, and I intend to do so again today. I believe that government should assist people to live, not to die. Our focus should be on providing hope and support to all those who feel death is the only way out of a dark situation. That is the purpose of humanity to preserve life. We should prioritise the improvement of palliative care and end of life care, as opposed to directing taxpayer money away from these services into assisted suicide.

Around 60% of the public agree that we should first fix our NHS, before even considering whether to introduce assisted suicide into law. I note also the right hon. Member for Ilford North, during his tenure as Health Secretary, concurred with this majority in June 25th, describing how it would take time and money that is already in short supply. And in addition, our new Prime Minister has outlined his commitment to a new National Care service and to implementing reforms to strengthen our existing services.

I welcome the fact that this Prime Minister is acting to protect the function of our health and care networks, to support our constituents in life, because ultimately the NHS should be saving lives, not taking lives. Our palliative and end of life care services are are an essential part of our NHS and wider health care system across the country. I want to pay tribute specifically to Laurel's Hospice, who provide free and high quality care to terminally ill and adult patients across Leicester, Leicestershire and Rutland.

They care for around 2500 people and play an important role in our community in Leicester East, not only in their direct support of patients but also through their provisions to wider families and friends that are affected by such situations. In their evidence to the public Bill Committee, they highlighted that there should be one specialist palliative care bed for every 12000 people, but with just 22 beds, they had one for every 55000. How can I turn around to my constituents and say they'll have a choice other than assisted death? Against that backdrop, I am respectfully.

I will not be taking interventions. Many colleagues wish to speak and I am mindful of time, so please forgive me. I am disappointed and concerned that the hon. Member for Rochester and Strood has reintroduced this identical bill to the House, ignoring all of the issues revealed, even the ones admitted by the noble and learned Lord Falconer in the other place. This bill's failure is not just a sign of how inadequate the private member's bill process is for a bill of this magnitude, but also the alarm over the lack of safeguards for vulnerable people.

The very demographic that we in this House are supposed to protect and support. Madam Deputy Speaker, the purpose of this House is to legislate well. We are here to advocate for our constituents, to share our differing opinions and to use our privileged positions of influence to impact the outcome of legislation. But the methods and attitude of the Member for Rochester and Strood completely discounts the hours of debate that took place on the assisted suicide legislation in the last session. The amendments tabled in the other place were not unreasonable, but were legitimate safeguards to protect those who are vulnerable in our society.

Many from external organisations and 26 from the Law Society alone. Amendments that would ensure the safety of those with eating disorders and down syndrome. Amendments to increase the chance of catching abusive situations where the individual is being pressured to end their life. Amendments from trade unions to protect the compensation rights of families of workers suffering from occupational or industrial diseases who seek an assisted death, the Leader of the House told MPs before summer that lessons needed to be learned about how you take the public with you, how you build consensus, not to just keep ploughing on and that they should consider if the PM route is really appropriate.

His words fell on deaf ears. It seems we stand here in the Mother of Parliaments as representatives of the millions of British citizens throughout our constituencies, and we have the right to debate issues because generations before us fought tirelessly to secure it. The threat of the use of the Parliament Act to drive through this legislation completely disregards safeguards for vulnerable people. It requires us not to care if no further changes are made to this bill. I am well aware that this subject of debate is not one that is easy and straightforward, but is painful for a lot of our constituents and distressing for members across this House.

Madam Deputy Speaker, if I can just come to my last point, one of my many concerns with the concern with the concept of assisted suicide relates to coercion. This can come in many forms, as we've heard in the House. Members across this House will know that my constituency of Leicester East has one of the highest concentrations of non-white, British and multi-ethnic populations in the country. And I will say again, again, I'm enormously proud of that, but I will not support any bill that leaves them vulnerable to coercion.

Legal experts gave evidence to the Bill committee during the previous parliament, stating that in some cultures, and I quote, decision making is a collective process involving family and community members. We cannot allow the fear and distress of people experiencing palliative care, end of life care, or simply struggling with the prospect of living another day to be taken advantage of. It is dangerous that this House would consider creating legislation that would allow space for people to be encouraged, and, in some instances, forced to take a decision at their most vulnerable to end their life.

My. Madam Deputy Speaker, allow me to conclude on this point by reminding the hon. Member for Rochester and Strood that 59% of voters in her very own constituency agreed that this bill should not be the priority for this government. I ask her now whether she sits here today to truly represent her constituents, and if she does, and if she takes into account the situations of those within her constituency who are vulnerable, she will acknowledge that it would be morally void to support this

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bill any further. Members can help each other by keeping their speeches to five

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minutes. Noah Law. Alongside that, my support for this private member's bill is contingent on a commitment to contingent on a commitment to improving, not sidelining the palliative care system. And may I start by paying tribute to the start by paying tribute to the courageous and dedicated palliative care workers of our country, care workers of our country, including in my constituency. Mount Edgcumbe Hospice and despite being seen as charitable organisations working alongside the NHS Hospitals Hospices vitally provide vital line of support and reduce in fact the cost of care in our NHS itself, which is something I think should be considered.

And each year these independent hospices are very briefly give way. I'd like to thank the hon. Member for giving way. Does he acknowledge that actually, even with excellent palliative care, there's very similar rates of people demanding assisted dying. And in fact, even in 2010, when we had probably the best palliative care in the world, still people went to Dignitas or took their own lives.

11:50

Noah Law MP (St Austell and Newquay, Labour)

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Yes.

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Very important point raised by my by my right. My hon. Friend. And and each year, these independent and each year, these independent hospices help around 220 000 people spend their final days outside of hospital settings, and this saves the NHS an estimated 1.5 million bed days and more than £800 million annually. Our Prime Minister is right. We must fix palliative care, and I greatly welcome that commitment to work cross-party to end the decades of political drift on social care to ballooning budgets that have hit not just the NHS but local authorities too, and particularly those in Cornwall.

They've really hard. We need to fix that system so that it gives people dignity. I will keep going so that everyone has a chance to speak. We must give people dignity, security and support when they need it the most. And at present, palliative care remains lovingly, but to an embarrassing degree, funded by the donations of those supporters who run the marathons, the charity shops and fundraising events for hospice charities across the UK. The National Audit Office concluded that in 2023 to 24, around two thirds of independent adult hospice sector's total income was generated from those charitable sources.

And whilst around 29% of total income was government funded primarily through Icbs. Now I'm all for social enterprises and charities using their assets to generating income, but the reliance on this model has to stop. So why not have a system where government provides consistent, central centralised support frameworks for hospices, reflecting the consistent and vital services that they provide to our NHS and people at the end of life? It is in our government's gift to fix this. If we believe that high quality palliative care is a fundamental service at the end of life, that's and that that system currently depends on commissioning the decisions, commissioning decisions from integrated care boards, ad hoc grants, and the fundraising of local hospices.

Is that really fit for purpose? We must ensure a consistent national minimum standard of provision to be delivered by every integrated care

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board to the end to end. The end of life postcode lottery. Again.

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Again. Thank you, Madam Deputy Speaker. Palliative and social care need fixing, and that is a concern that fixing, and that is a concern that unites us as a house because it is a scandal that how well you divide depends on where you live. But to depends on where you live. But to suggest that this bill should wait until palliative care is improved is a fallacy for two reasons. Firstly, this bill gives us an opportunity to improve palliative care. It plays a statutory duty on the Secretary of State to tell this House what the state of palliative care in this country is, whether people can even access it.

No government has ever been required to answer that question. And under this bill it would be. Now, I would go further and say that this assessment should come into place before the act comes into force and

11:54

Alicia Kearns MP (Rutland and Stamford, Conservative)

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should be an annual update to Parliament. But that amendment cannot be made to a bill that does cannot be made to a bill that does not exist. So if we vote down this bill today, we delay and deny the bill today, we delay and deny the possibility of mandating a genuine assessment of the state of palliative care in this country. palliative care in this country. The second reason is that it is a fallacy, is that Hospice UK has told us repeatedly that it would be told us repeatedly that it would be inappropriate to even imply that hospice and palliative care can address pain in all circumstances.

We know it does not, and honestly, it cannot. So when we say we will fix palliative care first, we are promising something that no palliative care system has ever delivered or will ever be able to deliver. And we are asking for people to die in pain, waiting for something that cannot be given. Vote this down and we are no closer to understanding the state of palliative care. I would also add that we already have in this country do not resuscitate orders.

Doctors suggest them. Families agree, and a person who could have been revived dies often without their voice featuring in any way. I have that this in my own personal circumstances where I had to run across to Guy's and St Thomas's and tell them to lift a do not resuscitate that they had put in place without consulting me. So let's not pretend that this line is sacred, because no one in this place seems to be saying, well, while we're at it, let's scrap, do not resuscitate.

And it is on the same continuum. Let me turn to the other place and procedure. A great many peers were doing precisely their job. Others were laying siege to the bill. And if anyone does not want to accept, both of those are true. I ask you to look at your own bias and on some issues they were right. On treating depression, on eating disorders and whether a hospice can decline to take part. When this House passed the bill, we expect it to be debated and come back with amendments in the ordinary way.

Erskine May provides that where a Bill proceeds under the Parliament Act, that this House may suggest amendments to the other House without inserting them into the Bill. That power does not sit with the Bill's sponsor. It sits with anyone sat in this chamber, and if the Lords agree to that amendment, they are treated as Lords amendments already accepted by the Commons. They don't even need to come back to us. There is precedent from the hunting bill in 2004 and the Trade Union Labour Relations Bill, 1976.

So the choice before us is not between an unamended bill and no bill. So I am not asking the House to accept the bill as it stands, and I will press amendments myself through that process, particularly around the audit of palliative care and treatable depression. So to members, this process can be improved. As a conservative individual, freedom, choice and personal responsibility shape my decision making. Until those freedoms cause harm to others. For years, I have listened to debates on this issue, waiting for the harm in the principle of giving us autonomy over our own bodies and our own deaths materialise.

There is no harm in the principle of assisted dying, and I am yet to hear an argument that exposes it. This bill applies to those who have six months left to live. No one else. And I'm arguing for a freedom that harms no third party, but will relieve a great deal of suffering. In our last debate, I told the House my mother's last words were, I cannot go on like this, and she died a few days later, and that was a great kindness to her, even if it was a great cruelty to me and my children.

But too many in this country, this great compassionate country, go to sleep at night, desperate for the pain to end and wake the next morning, knowing they must endure another day of it. A body that betrays them all Wrexham where no medication will soothe it. And another day where this house has denied them to bring an end with their families on their own terms. I'm going to keep going. Members have spoken often about unexpected recoveries and how this has brought them to oppose the legislation.

This is the news we wish for every person we love and for every love person you have. Last year I was told twice that I would die, almost likely potentially with a with complications I had that I will not speak at the moment of. So I know what it is to want to survive. I know what it is to fight. But for many, that day is not coming. There is no reprieve on that way, and we cannot write laws around the dying for hope of a miracle that will not come for most.

So I will vote for this bill, because living in a perpetual state of torture cannot be right, and we cannot allow people to wait for longer. If you are undecided, vote for the bill. Do not end the argument. Continue it and I will stand with you. In laying suggested amendments to the Other place women's.

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Thank you. Madam Deputy Speaker. The last time this matter was debated in time this matter was debated in this House, I was sitting at the hospital bedside of my dying mother. Consequently, I was unable to speak in that debate and unable to cast a vote. I am therefore grateful for vote. I am therefore grateful for the opportunity to speak and vote today, and I urge colleagues and the sponsor of this bill to ensure

11:59

Ms Julie Minns MP (Carlisle, Labour)

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the sponsor of this bill to ensure that this House has the opportunity to scrutinise, amend and make it safe. Accompanying someone you love through the final days of their life is one of the most profound experiences any of us can have. It confronts us with suffering, vulnerability, fear, and also with the importance of care, compassion and human dignity. That experience did not make me indifferent to the arguments for this bill. Quite the opposite. It made me determined that before we offer people assistance to end their lives, we as individuals, and especially as legislators, have a responsibility, a duty to ensure they have access to every possible form of support to live their remaining days well.

As the friend to a mother whose child was failed time and time again by the inadequacy of our mental health service, whose child, by some miracle, survived the swallowing of razor blades, anorexia, overdoses and self-harm. I know that access to every form of support was not there for them. As the relative who saw the inadequacy of social care eat away at the self-respect of a once fiercely independent woman, leaving her to conclude she was a burden and would be better off dead.

I know that that access to every possible form of support was not there for them. And as the daughter who sat at a hospital bedside having agreed to the withdrawal of invasive treatment only to watch my semi-conscious mother scream for water that was wrongly withheld and writhe in agony because specialist palliative care was only available 9 to 5 Monday to Friday. I know that access to every form of support was not there for her. So I ask colleagues why, when we know that every possible form of support is not there for our constituents, when we know that mental health care is inadequate, when we know that social care is threadbare, when we know that palliative care is an unfunded lottery, when we know that there is no going back, when we vote for this, how? How can we prioritise and fund the resource, the care and the support for those choosing an assisted death, but deny it to the mentally ill, deny it to the elderly and deny it to those who wish a pain free natural death.

We hear much of choice in the context of this debate, but choice is only meaningful when people have genuine alternatives. And in too many parts of our country, those alternatives simply do not exist. Therefore, before, before, not after, not over the next four years, but before we vote to facilitate death, we have a duty as legislators to ensure that the resource, the funding and the support is there so that we can no, no today, no.

Before we take this vote, that every possible effort has been made to treat suffering. This bill does not do that. Madam Deputy Speaker, once we are over the edge, there is no going back. We know that in every country that has introduced assisted dying, its scope has subsequently expanded, sometimes without further legislative approval. And yet I will not give way. And yet, despite knowing this, we stand once more on the edge. We stand on the edge. Knowing all of this bill's flaws.

So I ask colleagues to pause, not step over the edge, and instead ask ourselves, are we certain that this bill definitively safeguards against coercion, including self coercion? Are we certain about mental capacity assessments? Are we certain about terminal prognosis? Are we certain that the safeguards and review mechanisms will be in place? Are we certain that we have ensured our constituents have access to every possible form of support to live their remaining days well? Because if the answer to just one of those questions is no, then we should not.

We must not step over the edge. Madam Deputy Speaker, let me conclude with the words of the friend I spoke of whose child was was failed by our mental health service. She said, my daughter had a history of serious mental health problems from the age of 13. At 22, she went to university and quickly realised she needed more support to manage the change. Despite her history, referrals from her GP, multiple self-harm instances that required A&E admission, community services kept saying she did not meet their thresholds.

It ultimately led to total deterioration and two years as an inpatient on a secure ward. During this time, she repeatedly said her life was not worth living and that she was in so much pain. She wanted to die. After much fighting with inadequate and unsafe services, she is now living in the community back at university and has plans for the future. But in countries such as the Netherlands, her wish to die would have been granted under their assisted dying rules.

She says I have my daughter today because we don't have assisted dying here. Please, please don't change that. Monica Harding. This bill is not safe and as of today, the responsibility for this bill falls on us and only us. If we vote yes today, then unless the movers who accepted no critical amendments at the Committee stage last time, unless they have a 180 degree change of heart, then we can expect this bill to become law. As it stands, and despite hon.

Members saying that they will press their own amendments, we have no assurance from the government that government time will be allocated to that. So the only question we are left with is not whether we are in favour of the principle of assisted dying. It is are we 100%

12:06

Monica Harding MP (Esher and Walton, Liberal Democrat)

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content with this bill because we no longer have the prospect of the second chamber making it any safer? second chamber making it any safer? And as somebody who is against an unelected second chamber, then that is a responsibility that I am is a responsibility that I am determined to accept that it is a daunting prospect, far more daunting than when we debated this the last time, because the responsibility is now ours and ours responsibility is now ours and ours alone. We cannot ignore the fact that none of the expert witnesses at the Lords Select Committee could confirm that the bill was safe.

None. And of the warnings, the one that resonated most from me, from the Royal College of Psychiatrics when they stated currently needs can be identified but not necessarily met. Somebody could proceed to an assisted death where they may have made a different decision had those needs been met. During the passage of this bill. Two of my siblings, who suffered with poor mental health throughout their lives, have died. I witnessed their struggle. The terrible fear and pain of cancer while their mental health worsened.

In both cases, the medical staff couldn't get their mental health medication right because of poor handover between practitioners. A service design issue because of the difficulties in assessing the mental health of patients in a palliative state, a clinical issue and because the psychiatry resource was not available, a resource issue. None of these issues will have been resolved when this bill becomes law. This bill is not contingent on making palliative care provision better or mental health provision better, and there is no provision in this bill to assess unmet psychological medical needs at any stage, nor consult others involved in the patient's care historically or involved through their life.

Family members like me, who had seen them failed by systems and processes throughout their life, and was desperately concerned that those systems and processes might also fail them at the end of their life. It is our duty to design the systems and processes which are safe for people like my brother and sister, and on this occasion, I don't think that we have done so many professional bodies are clearly warning us that we haven't. There will be no amendments to protect people like my brother and sister.

I would have wanted them protected. It's down to us now. The Other place can't help us or hinder us. The responsibility sits squarely on our shoulders, and this is no longer about the principle. We have had that debate. It is about the practice of this bill, which the movers have shown time and time again that they will not permit to be amended. The experts, the clinicians, the groups asking for the most vulnerable in our society are overwhelmingly telling us that this bill is not safe.

The offer of assisted dying to people

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in the position of my siblings is the very opposite of autonomy. Yes.

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Yes. Today we must accept our responsibility as MPs grave responsibility as MPs grave responsibilities to those most at risk today. This is not about the risk today. This is not about the principle. This is about the practice. And the bill is not safe

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today. We must vote no here. Sadik Al-Hassan.

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Thank you, Madam Deputy Speaker, and may I pay tribute to the my honourable colleague from Filton honourable colleague from Filton and Bradley Stoke Birmingham Yardley and Rutland Stafford for Yardley and Rutland Stafford for sharing really heartfelt stories and showing a strength that I wouldn't be able to show. My mum wouldn't be able to show. My mum passed away in November last year and their stories and what they and their stories and what they shared with us today are inspiring.

And like many across this house, I've spent a great deal of time thinking about this debate, reading constituent stories, many of them heartbreaking, and reflecting on what this bill means to me personally, as well as what it means to the people of North Somerset who sent me here. At the heart of this debate is autonomy, dignity and humanity. The question of whether someone who is terminally ill can choose the manner of their death is fundamentally a question about agency. These people did not choose their illness.

They did not choose the suffering that came with it. They did not choose the impact it has on those who love them. But they might be able to have some say in how their story ends. And that, I believe, restores some measure of dignity and control that illness

12:11

Sadik Al-Hassan MP (North Somerset, Labour)

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has taken from them. Many of you will know that I practised as a pharmacist for nearly 20 years before my election. That means I've seen the faces behind this debate. seen the faces behind this debate. I've watched people collect prescriptions that offer nothing more than a sticking plaster over more than a sticking plaster over terminal illness. Pain managed but suffering not ended a safe and suffering not ended a safe and legal route at the end of life would not replace good palliative care.

It would sit alongside it, offering the small mercy of choice to those who want it. And another element of this debate I had to consider is, as a Muslim, this question sat alongside my faith in a way I had to think through carefully, and I've concluded that while I personally may not choose to make use of this provision, my faith guides my own life. It is not my place to let it dictate someone else's final chapter. This debate is at its core, about whether people have the right to choose, and it's worth remembering that choice is itself central to faith.

Belief only has meaning because it is freely chosen. If I were to use religion as a basis for stripping others of their choice, it would turn faith against one of its own foundations. My faith guides me to live my life and make my choices. That right to choose, I believe, should not be denied by any one of our beliefs, however sincerely held. I won't thank you. Like so many North Somerset residents who have written to me on this issue, I believe that those who are suffering, often for long, unimaginable stretches of time,

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deserve to be offered a choice. Mims Davies. Thank you, Deputy Speaker, for

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Thank you, Deputy Speaker, for calling me. There is no conscience issue more capable of dividing constituents, family or indeed this House, than that of assisted dying. House, than that of assisted dying. And we can all agree no one wants to suffer unnecessarily at the end to suffer unnecessarily at the end of their life, and no one wants to witness their loved ones suffering. We are all here in this place, doing what we believe is best to achieve that end.

This debate means the subject of death as a process, again, is out of the shadows. Where we are as a society have thrust it over the many years, unwilling to confront our own mortality, avoiding difficult discussions even with our own families, until reality finally hits us as it does.

12:14

Mims Davies MP (East Grinstead and Uckfield, Conservative)

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We just don't know how. It is a truth that the death of a loved one truth that the death of a loved one and our own inevitable decline can sometimes arrive with real fear, sometimes arrive with real fear, real pain, and sadly, with too much unnecessary and unsupported suffering. But it does come to us suffering. But it does come to us all, and it would be wiser for us to be ready to face it, to prepare for it, and to be able to live with it as individuals, as family, as society.

And for those of us here today, as lawmakers, in reality, a change can happen in all our lives. Whether a bolt from the blue accident incident, tragedy, a violent attack, a diagnosis, or simply being in the wrong place at the wrong time can mean life changes in an instant, and who you are and what you are capable of and what your life is now and onwards comes into focus. And my dad and our lives changed in an instant.

He was attacked at work, punches thrown, fell and hit his head on the kerb. Saved by passing man on his lunch break with first aid training. I was 11, he didn't recognise us for several months and as a result the financial impact we eventually lost our home, our family business and the surety that his hard work had given us. So disablement can begin at birth, it can be acquired. It can come as a health condition, all depicting what happens next. Yet we are legislating and potentially fundamentally changing every person in this country's relationship today with the state, with their doctor, with the NHS, depending on their health, their preparedness for what is next and the support they may not have.

Over the past two years, I've listened to carefully to my colleagues on all sides of the House who've made personal arguments for and against. I've read the many briefings sent to me by charities, organisations and groups, and representatives from right across our society, and I've heard two from 1000 or so of my constituents who I deeply thank for sharing their own stories and thoughts, and I've reflected back on my own experience, my father's and other friends and loved ones, as it does when you witness accident, incident or health condition, or eventually that death of a loved one.

And we know that many people are fighting and come to this place for better lives, for better treatment, for updated drugs and better knowledge and empathy, often living and pushing for living longer after an initial prognosis they have been given. And my father lived a longer life than in fact. My mum, who became his main carer. She previously worked with disabled young adults, helping them into work and helping them to thrive. And as someone who was previously having the honour of being the Minister for Disabled people, Health and Work, I roundly appreciate that some of our most vulnerable, often to feel under acknowledged, undervalued, unheard and screened out of life and work and wider society.

And in this role, I had to learn and be ready not to base policy making on my own thoughts and my own family experiences, but to put good law making at the heart of what I did. People must not feel pressured, worthless, or subject to coercion defined solely about what they can't do. My dad too often felt worthless long term. He felt less of a man, no longer a provider, a business owner, and went back to his farming roots. But a head and neck injury and injury meant this wasn't sustainable.

An unseen disability saw him succumbing to early onset dementia, with trauma induced epilepsy and diabetes. He far too often felt he was worth more to us dead than he was alive. This was long before the realm of social media and the additional pressures that all of that entails. So I do believe this process is completely wrong. Sadly, for a vehicle of this bill to bring forward such societal conscience, consequence and change, to change the relationship between a patient and doctor, individual and state, and change significantly all of our connections with the NHS.

I will do

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lady for giving way. Is she not like me? Then puzzled that the sponsor brought back the same bill, despite there being many same bill, despite there being many amendments that the sponsor in the Lords agreed needed to be made and, as the sponsor today acknowledged,

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as the sponsor today acknowledged, absolutely. We are here to make good laws.

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We are here to make good laws. And today's vote, as we've heard, is not simply on the principle of the bill, but on the detail or the bill, but on the detail or frankly, the lack of detail. Good intentions are not good enough. We are voting not for what we want to happen. Because of this bill. We are voting for what will happen and we cannot continue to divorce this from reality. It will impact right across government, our communities and intertwine us swiftly into new challenges.

Too often in this place we have had good intentions but no delivery plan. We cannot continue with that. The bill signed sponsoring the Other place felt his own need to bring forward 70 new amendments. Let me just make some progress. I have four main concerns funding, assessment process, lack of institutional opt outs and, crucially, the auto commencement clause. Can we all look at our local NHS teams and know that we are ultimately taking more resources from them? The impact of the equality Impact Assessment explicitly acknowledges disabled people and those from ethnic minorities, often who we speak about in this place with prevalence because we can do it for them.

This puts this at odds with this bill. There is much more, I would like to say, but I need to conclude this bill, although well intentioned, is simply a mixture of naivety, idealism and wishful thinking. No delivery plan, and it greatly raises the hopes, the great hopes in the hour of need for care and good support and understanding of our constituents. We are being asked to send this bill back to the other place and perhaps use the Parliament Act to force it through, regardless of fitness, for purpose.

With all knowledge of its flaws and its lack of workability, to just get it done. But that means that we are not listening, even to the doctors who have spoken in this place today. I cannot subscribe to this type of lawmaking. Madam Deputy Speaker, no matter how well intentioned, I am grateful we are talking about life and death and end of life care, and what value we put on people and loved ones. We are fighting for better palliative care, and we are doing what we can for people to give them all they need as death approaches.

But I cannot, in good faith, support an unsafe private member's bill and support this process. We today are undertaking. Hilary Benn.

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Indeed, Madam Deputy Speaker, this is a very difficult moral and this is a very difficult moral and practical question, but for me, it is fundamentally about whether we is fundamentally about whether we can act to relieve human suffering. Now, we've heard a number of really profoundly moving speeches in the debate today. I would highlight in debate today. I would highlight in particular the speech of my hon. Friend for West Lancashire, my hon. Friend the Member for Filton and Bradley Stoke, because we are talking here about people who fear or face unbearable pain, choking or gasping for breath or loss of control at the end of their lives.

Are they not vulnerable too? So really, I think for me, a really important point and the question is, can we really look them in the eye at that moment and say, I'm very sorry, but I am not prepared to vote to support you being given the means to remove that fear. Not everyone will take advantage of it, but for them it is an assurance or to relieve that suffering, even though that is what you wish. And are we going to say, I'm sorry, but I will not give you the means of determining the manner of your passing from this world, surrounded by those whom you love.

I'm not going to give way because of the constraints of time, and I don't

12:23

Rt Hon Hilary Benn MP (Leeds South, Labour)

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think we can any longer justify the contradiction that is at the heart of this debate. We know people with of this debate. We know people with terminal illnesses already killing themselves. That happens not at all themselves. That happens not at all covered by the protections that are contained in the bill that my hon. Friend has moved. And, you know, Friend has moved. And, you know, the biggest contradiction of all for me is the fact that there are for me is the fact that there are those who travel abroad.

We know this is happening. And I think it's a very uncomfortable fact for those who oppose the bill. For this reason, I think it's a gaping hole in the argument against the bill, because the truth is that the Crown Prosecution Service was faced with a terrible dilemma. They could see the number of people going to Switzerland, and they had to ask themselves, are we actually going to prosecute mums, dads, spouses, lovers, friends, brothers and sisters for going with those, with those that they love to be with them at the end? And that is how they came to draw up their guidelines.

And if you read them for me, they're full of common sense because they say in these circumstances, it's not in the public interest to prosecute someone. And if you look at the figures, the vast majority of family members who've accompanied their loved ones to Switzerland have not, quite rightly, in my view, been prosecuted for what I would regard as a final act of love. Indeed, it would be an outrage to prosecute them. But, you know, despite those guidelines, some people are fearful because they get questioned when they come back and some have not gone to Switzerland with their loved ones to hold their hands at the last, for fear of what might happen to them.

So the question I put to the House is this if we have in effect, legalised assisted dying for British citizens who have the money and the means to do it abroad. And we have, and I've heard no one in the debate so far criticised that. Then why are we not prepared to provide the same means to people to bring their lives to an end who are terminally ill here in the United Kingdom? And, Madam Deputy Speaker, coming to terms with our own mortality is about the final journey that we will make.

We we talk about awe and wonder. I never fully understood what war and wonder meant until I was present at the death of those I loved most dearly. And you know, when the bill was given its Second Reading, when the result was declared, there was this extraordinary moment because there was complete silence in the House, complete silence. And why do I think that was the case? Because we understood the significance of what we had just done and the consequence of the bill that we had voted to eventually send to the other place.

And today we're called upon to make once again our choice. I have made mine, and I will cast my vote to enable those who are terminally ill, who want to take control of the moment of their death, who want to be able to relieve their suffering, who want to feel that they do not have to fear what is coming to take that decision. If that is their choice. And I would urge the House not to deny those people.

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Madam Chair Rosie Duffield thank. You, Madam Deputy Speaker. Rarely do we debate. Legislation that represents

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Legislation that represents quite such a seismic shift in the relationships between individuals, the state health providers and civil society, and there is so much at stake when members believe at stake when members believe strongly that a bill is flawed and can be abused, resulting in serious harm, we have an absolute duty to harm, we have an absolute duty to implore others not to simply let it pass and hope for the best, but to consider it fully, deeply, and to accept that our duty is first and foremost to protect lives.

The potential consequences of poorly drafted legislation without robust safeguards are ultimately the responsibility of every single member in this room. I come to this debate wearing several hats as the representative for Canterbury, the home of this country's Christian faith. Rather than removing that aspect in this debate, as others may have chosen to do, I must consider the views of the church, and the Archbishop has made her view very clear again this week, as well as representations from our sizeable mosque and that community.

As a daughter who this week, last year, was sitting at my father's bedside as he was dying from the early onset Alzheimer's that so cruelly began when he wasn't very much older than I am now. And as the partner of a filmmaker who directed the BBC documentary Better Off Dead, led by Liz Carr and based on her decades of disability rights activism, I was already aware of Liz's work through her better her Not Dead Yet campaign, but the opportunity to learn much, much more by discussing this subject at home in depth as so many months was invaluable.

Lifelong campaigner Baroness Jane Campbell has seen off so many attempts to pass assisted suicide legislation in the other place that she likens it to Groundhog Day. In the documentary, she says people are decent, kind. They think they're doing us a great favour by giving us this choice. But what they don't realise is how deadly this choice can be. And it is worth repeating that not a single disabled rights organisation or professional body supports this legislation. And if this place were truly representative of the UK's population, there would be almost 100 physically disabled members of Parliament.

But we are nowhere near

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then. Thank you, Madam Deputy. Speaker, and I want to thank my

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Speaker, and I want to thank my hon. Friend for what is a very powerful speech that she is giving, and she truly sets the tone when and she truly sets the tone when she talks about disabled people. Will she agree with me? There was a poll that was out this morning that poll that was out this morning that polled thousands of disabled people, where many of them said and rightly said, they need assistance to live. said, they need assistance to live. In fact, we have to get our palliative care and also social care right before the right investment, before we could even begin to engage in a discussion or begin to engage in a discussion or debate around assisted death and assisted suicide.

So does she agree with me that these are the with me that these are the priorities that we should be taking, not trying to push through legislation that is flawed and not fit for purpose?

12:30

Rosie Duffield MP (Canterbury, Independent)

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12:37

Sarah Smith MP (Hyndburn, Labour)

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people die without good palliative care, and during these debates we have heard so many horrific stories of death, which, of course, we must do all we can to avoid. I spoke with one of the most highly regarded palliative care nurses in regarded palliative care nurses in the world, who has spent most of her career in South Africa with children who have Aids and who die children who have Aids and who die far too young. She told me in her decades of practice and thousands decades of practice and thousands of patients, there were only two patients she could bring to mind when she was unable to offer them a good death.

With the right treatment and care, assisted dying is not a choice. If palliative care is not provided as an alternative. As it stands, the cost of assisted dying are supposed to come within the existing health Budget. Research carried out by Sue Ryder found that to offer a consistent palliative care to every patient who needed it would. We would need to double the levels of funding from the NHS, costing around an extra £300 million a year. We have to be clear about the priorities and honest about what is possible.

This Bill intends to force the NHS to implement a assisted dying within four years. It is just not realistic to say, with Budget constraints and capacity limitations, that both palliative care can be improved and assisted dying can be introduced simultaneously. We are taking ten years to implement the Senedd reforms that we are proposing, and yet we expect to do this within four. What this law should do is provide that assisted dying is not introduced until palliative care is fixed first, and this bill fails to do this.

Furthermore, the evidence from other countries is overwhelming. Introducing assisted dying leads to a decrease in the investment in palliative care. I will close to say that a Labour government, it was a Labour government that introduced the National Health Service with the aim, and, I quote, to secure improvement in the physical and mental health of the people in England and in the prevention, diagnosis and treatment of physical and mental illness. And it is this mission that staff in the NHS have signed up to deliver.

Let this Labour government not be the one that brings in a bill that effectively, entirely undermines and changes this former purpose of

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the NHS. And let's instead vote today to kill this bill. To Tom Gordon.

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Thank you. I'd like to start. By paying tribute to the Member for Rochester and Strood, and also for Rochester and Strood, and also to the Member for Spen Valley, for their hard work, not just on this bill, but the one in the last Parliament that I sat on the Bill Parliament that I sat on the Bill committee and tabled many amendments, sometimes much to the frustration of the hon. Member for Spen Valley. In the last Parliament, Spen Valley. In the last Parliament, I want to talk about a number of people who died without dignity and without choice today.

The first one of which was a story I remember as a teenager. My mum told me about her uncle, who was terminally ill, and she cared for him during the end of his life. She went round to his house to check on him, knowing that the end was getting near and tragically stumbled upon him. He'd collapsed on the floor and died. That was something that stuck with

12:40

Tom Gordon MP (Harrogate and Knaresborough, Liberal Democrat)

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her to this day and informs her views and my views on assisted dying. The reason I say he stumbled and collapsed on the floor is my and collapsed on the floor is my mum was led to believe he was making his way in his final moments across the room to pick up the across the room to pick up the shotgun on the back of a door to end his life. That is the reality for people like my mum and my mum's uncle and many other people.

A number of years ago, I also ended number of years ago, I also ended up dealing with a situation not too dissimilar myself. I was lived back. I was living back home with my mum and nipped next door to where my grandma lives and heard a loud bang. I ran across the road with my gran and we found the neighbour John, a pig farmer who was suffering unbearably with a chronic and life ending condition, who decided to take matters into his own hands. That is the status quo.

That is the reality for people today who are in pain, who have unbearable suffering, who are terminally ill, and we do nothing to protect them. That is why I am in favour of a change in the law, and it is one of the things that drives me to this place with the conviction that something, a law like this has to be better than what we currently have, which offers no safeguards and no protections for people in those final moments. No one wants to die.

It is not a choice they make, but we can give people that choice about their end of life and how they may see the end. And it's not just a choice for terminally ill people, but also people who are in remission. Like my mum a number of years ago, my mum had breast cancer. She had a stage one and a stage three breast tumour, both independent in the same breast. In my mid 20s I faced having to have a conversation with my mum about what would happen if she, a single parent, was to pass away and leave me with my then 5 or 6 year old sister.

That is not a conversation that I ever forget, and it's one of the things that motivates me to talk about this issue as prominently and as much as I do for my mum. She's made it clear that if she was to end up with secondary breast cancer and it coming back, she wouldn't want to go through the ordeal and the trauma of the surgery and chemotherapy that she faced. She's got lasting nerve damage and a quality of life that is poorer and reduced as a result of that original cancer.

It is something that causes her great concern every single day. And every time I've come to this chamber or to the chambers where we had the conversations for the Bill committee, I ring her first and ask for her advice. She has routinely said that when she goes to her breast cancer support meetings with other friends who are in remission, time and again, they say that having that choice, even if they seek not to use it, would bring them great comfort. That is why I come to this place with such clarity on this issue.

It is those people who are living in those circumstances, or those people who didn't have a choice, that guide my views on this situation. I think for me, if we were in that situation, I would fight tooth and nail for my mum to go through with having surgery and having chemotherapy or radiotherapy or whatever it may be, but I respect it would be her decision, even if I would not like the consequences of it. And today that is why when we're revisiting this conversation, when we're revisiting this piece of legislation, I don't see this as a final say on this bill.

It is restarting that process, which was abruptly ended by members in the other place. We've heard a lot of information today about all amendments wouldn't be accepted. And with the greatest respect to the Member for Rochester and Strood and the Member for Spen Valley Spen Valley in the last Parliament, despite being a supporter of this bill, I consistently put down amendments to make it a bill which I thought better reflected the realities for people people who might have neurodegenerative diseases and other criteria. We know that when we look across the globe that this bill is the most restrictive, the most narrow.

To suggest that this is a bill that would somehow be a new frontier that has never been delved into before is simply untrue. We are lagging behind international comparators. We are lagging behind giving people that choice. We know people who have the means or the money can have that right now by travelling abroad. We know that all too often people who don't have the money have to take those circumstances and actions tragically into their own hands and are robbed of a good death. So today, I would encourage all members and those who are genuinely undecided or wavering as we sit in this place, that a vote at Second Reading will continue this debate, it will allow a continuation, and it will allow the members to table amendments at Report stage.

And importantly, one of the things that people keep ignoring in this debate is if the Lords operate in good faith and they send us sensible suggestions, we will end in ping pong. We will be able to pick up amendments that would further allay those fears, that would strengthen this bill. And the idea that that's something that can't happen is one that is simply untrue. So I would encourage all members today to make sure that they continue this debate and give opportunity and choice to

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people at end of life. Ruth Cadbury thank you, Madam Deputy Speaker. I supported this Deputy Speaker. I supported this bill in 2015, and I will again, as this bill goes through its this bill goes through its processes. I am truly grateful for all of the work that so many all of the work that so many members here and in the other House have done to work on the detail of have done to work on the detail of this bill, and I am confident that we have.

It has been improved significantly and learned from the experiences of jurisdictions across the world, many of whom have had assisted dying for many years. And let's remember, in most of those jurisdictions, only about a third of people who choose the option of assisted dying actually go ahead and need to use it. My resolve has been strengthened, Madam Deputy Speaker, by those I have heard from with direct experience. And I will mention just two experiences told to people told to me by people I know well.

One is a constituent who asked me to support the change in the legislation. His brother was diagnosed with cancer and after an operation that proved unsuccessful, was admitted to a hospice for end of life care. He said about his brother he was very philosophical about what was going to happen. His one request and hope was that his death was not going to be prolonged and painful. He received excellent care from an amazing team at the hospice, but sadly, when the time came, he suffered in a way no human should have to.

We don't. My constituent went on. We don't allow our pets to suffer the way he did. His acute suffering and pain lasted for days. When he was able to. He pleaded for help, for the pain to stop. The hospice did everything possible to help. But there are legal limits to what they can do. If he could only have received a life ending intervention five days before he died as he wanted, he would not have had to suffer the indignity and agony of a painful and long, drawn out, horrific death.

The second experience is that described in several occasions in this House by Paul Blomfield, former MP for Sheffield Central, about his father's death. And Paul continues to be a powerful advocate for the right to choose, and his full speeches are preserved in Hansard. So I'm just going to quote

12:48

Ruth Cadbury MP (Brentford and Isleworth, Labour)

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a small part about the experience. After Paul received a phone call that his father had been found dead that his father had been found dead in his garage after receiving a terminal diagnosis of inoperable lung cancer, from Paul's words, he had faced various health problems positively until the diagnosis positively until the diagnosis clearly led to his decision to take his life. He could not talk to me or his partner about it because he or his partner about it because he would have made us complicit.

The current law forced my father into a lonely decision and a lonely death, and he died prematurely. Because I'm sure that what drove him to end his life at that point was the fear that if he did not act when he was still able to, he would lose the opportunity to act at all. Madam Deputy Speaker, those potentially facing unimaginable pain or suffering at their after their terminal diagnosis, despite the best palliative care, have options now that are unbearably lonely, like Paul's father, or involve an arduous and costly journey by going to Switzerland.

Or they have no choice, such as that of my constituents brother, I won't. The many people who have shared their experiences of facing death soon have told us they want to die on their own terms, and we also know through various credible polls, that the majority of people in this country want that choice for themselves. I don't want to deny them the right to be able to make

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that choice. Martin Vickers thank you. Madam Deputy. Speaker.

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Speaker. For giving me the opportunity to. Speak in this. Important debate. Understandably.

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Understandably. We have. Heard some passionate contributions and courageous ones,

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such as the from the hon. Lady for longer. In her place. But she gave a remarkable

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But she gave a remarkable contribution to the debate in the House. We discuss a whole range of issues week in, week out, many of them rather mundane. But nothing, of course, is more important than these issues that affect life and death. I would have thought, to be honest. Madam Deputy Speaker, that the mountain of briefings, reports, individual letters, particularly from a number of clinicians, would have been sufficient to persuade

12:50

Martin Vickers MP (Brigg and Immingham, Conservative)

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most people that this is an unsafe bill. But my conclusion is that I bill. But my conclusion is that I want to speak about the the wider implications. Other members have mentioned the impact on society. I claim no particular insight. Indeed, I see through a glass darkly. Some I see through a glass darkly. Some of us will believe that life is God given, others not. But what I'm given, others not. But what I'm sure we can all agree is that it is uniquely precious and that we should do all we can to preserve it.

I do not in any way question the motives of those members, or the members of the public who take a different view. Many of will have reached those conclusions, as we've heard today, having witnessed the slow and sometimes painful death of a loved one. I have a firm view that if assisted dying is legalised, we will be poorer as a society. We will have crossed a line. We will have accepted that. To adapt the phrase I used earlier, life is not uniquely precious and importantly, we will have changed the relationship between doctor and patient.

That relationship is crucial and it could be compromised if the patient was anything other than 100% certain that the doctor or clinician was striving to maintain life. When we are old, weak and seriously ill, we need compassion and support, not the nagging doubt that the treatment that we are receiving is not entirely. No, I can't give it. There's no time for interventions. As society has evolved and civilisation has advanced care of the vulnerable, those who are sick and those who need comfort nearing the end of their lives has become a higher priority, and rightly so.

In preparation for this debate, I reread an article that the former Supreme Judge, Lord Sumption, published in The Sunday Times in November 2024. We cannot produce legislation that that meets every circumstance. The Lord Sumption has stated that the decision to allow doctors to help bring about the death of a human being crosses a major moral threshold. I think that is sufficient warning that we should. Be very, very confident that this bill safeguards that. I don't believe it does.

As I say, we can't produce legislation for every individual circumstance, so we are left with the alternative, including sufficient safeguards. Even if you support the Bill in principle, this does not have those safeguards. If one is old, frail, weak and seriously ill, one needs help, support and compassion, not the added worry and the nagging doubt over whether everything possible is being done to preserve one's life. Both my parents died of cancer and suffered in their final months. I well remember the telephone call from the consultant after the tests on my father, when he said, we must hope that God is merciful and does not allow him to suffer for too long.

Although he did suffer, he lived for a further six months after I received that fateful call, and in that six months I saw him enjoying life, sharing time with his then four year old granddaughter. In his final weeks, he spent time in Saint Andrew's Hospice in Grimsby. I saw then what comfort could be offered through palliative care. No longer did he suffer the periods of pain that he had had in earlier weeks, and that happened as long ago as 1988.

Things have improved dramatically since that time, my

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friend. Give way. Well, one one intervention. Yeah. I'm very grateful to. My friend for giving way. Quite rightly, when we entered this life, the NHS, the state supports us through obstetrics, gynaecology, through obstetrics, gynaecology, maternal health, neonatology and paediatrics. But at the other end of our life, when we leave this of our life, when we leave this world, the charitable sector picks it up. The majority is delivered outside the NHS. Surely that can't outside the NHS. Surely that can't be right.

As a society, surely we have to fix that and sort palliative care before we go

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anywhere near this bill. I thank my hon. Friend for that intervention, and he makes an intervention, and he makes an important point going back to Saint Andrew's Hospice in Grimsby. My Andrew's Hospice in Grimsby. My mother actually died in hospital on the day that she was due to be moved into that hospice. And how I moved into that hospice. And how I wish that only a day or two earlier she had been able to do that and she had been able to do that and receive the care that I know from subsequent visits that they have provided.

We all have to cope with the loss of loved ones and such experience. Raise in the mind of any right thinking person the question of how we minimise suffering. If someone has previously indicated their wish to hasten their death, I acknowledge it's extremely difficult to say sorry, that's not possible. However, I believe moves to legislate for assisted dying would be yet another step that lessened the value of human life that we, as a society place on it. I suggest to the House that though that of the expert opinions and personal thought, the stories we've all received must.

Even if you print in principle favour assisted dying, make you think seriously about whether or not this bill is the right vehicle to introduce it. In my view, it is not. There are too many safeguards that are lacking. It must be rejected. Life is precious and we should recognise that.

12:56

Ms Abena Oppong-Asare MP (Erith and Thamesmead, Labour)

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Yes. >> Thank you, Madam. >> Deputy Speaker. Before I begin, I'd like to declare an interest as I'd like to declare an interest as patron of my local hospice in my constituency community hospice. I want to be clear from the outset that I'm not opposed to assisted dying principle, and I understand why many people support a change in law, and I recognise compassion that motivates those views. However, today I want to set out why I remain unable to support this particular bill.

This debate evokes deeply held views across the House. I respect my colleagues who have reached a different conclusion, but the question that has troubled me throughout this debate remains the same. Can a choice ever be truly free? If the support, care and dignity people deserve are not equally available to all? Through my work with my local hospice, I've seen first hand what excellent end of life care can achieve. I've seen dignity, comfort and compassion, and I've seen how much those final months, weeks and days can mean to individuals and families.

That experience leaves me convinced. One thing dignity at the end of life is possible, and it's our challenge to make it available to everyone. I've also listened carefully to constituents on all sides of this debate. One constituent wrote to me about caring for both her husband and her former partner after they were diagnosed with terminal cancer. Both were told they had no more than six months to live. Both lived for more than a year beyond that prediction. During that time, they were able to reconnect with family, spend precious time with loved ones, and continue living meaningful lives.

Her message was simple. Prognosis. Prognosis. Prognosis is not certainty and diagnosis. Diagnosis is not the end of the journey. That does not mean doctors are wrong, but it does mean that when Parliament is considering legislation built around predictions of life expectancy, we must take that uncertainty seriously. I won't give way. That's why I believe the concerns raised by organisations such as the Royal College of Physicians and the British Geriatrics Society about the end of life uncertainty, safeguarding and the definition of terminal illness deserve careful consideration.

Madam Deputy Speaker, I cannot separate this debate from my own experiences either. Members of my family have experienced discrimination within the healthcare system. These experiences leave a lasting impression. They remind you that trust, access and outcomes in healthcare are not always experienced equally by everyone, and those in inequality. In a moment. In those inequalities, they do not disappear when people

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seriously become ill. And they are giving way. And what we're now saying to those what we're now saying to those clinicians is, we want you to do much, much more. We want you to gauge whether people have been gauge whether people have been coerced. We want you to make a definitive judgement about how long definitive judgement about how long someone has to live. This is an unbearable pressure on those who are mission to save lives, not to

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take lives. Yeah. My hon. Friend, for his intervention, I also want to talk about data from the King's Fund, which shows that in 2023, 24 local authorities received over 2 million requests for social care support from new clients, but only 859,000 of those received public, publicly funded, long term social care, nearly two thirds of them older people. That means 58% received no support. That. Furthermore, the government's equality Impact assessment gives me pause.

It acknowledges concerns that people from ethnic minority backgrounds may face higher risks because of poorer access to health care, poverty, lower quality of care and higher levels of abuse, disabled people and disability organisations have also spoken powerfully throughout this debate about their concerns and the risks they believe this legislation could pose. Pose. We should listen carefully to those voices because for many people, the question is not simply whether someone has been coerced, it is whether they are making this choice in circumstances none of us would

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want for ourselves. I will give way. Thank you, and I thank.

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My hon. Friend and my constituency neighbour for giving way this week. We've seen evidence from Kingston University which reinforces the experience of people with learning disabilities, that with learning disabilities, that they see advice from a doctor, not as advice but as a recommendation. as advice but as a recommendation. And we know from their experience in Covid, they were five times more likely to have a do not resuscitate order placed on them. So does she share my views that those issues in the Equality Impact assessment

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reinforce the view that for people with learning disabilities, this legislation would remain unsafe? Yeah.

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Yeah. I'd like to thank my hon. Friend from Bexleyheath and Crayford. I do share those concerns. I've met with share those concerns. I've met with constituents who have also been impacted, and I've seen it in the equality impact assessment. So I equality impact assessment. So I want to go back to the point. It is whether we are making this choice in circumstances none of us would in circumstances none of us would want for ourselves. So the person unable to access the social care they need, the person worried about the financial consequences of their illness, the person who feels like a burden to those they love, and the person feeling loneliness and dependency or abuse.

Where evidence identifies greater risks for particular groups and where respected voices continue to raise concerns about whether existing safeguards are sufficient. I believe Parliament has a duty to take those concerns seriously and test whether more can be done, because access to death should never be easier than access to dignity in life. Madam Deputy Speaker, I want every person approaching the end of life to receive the dignity, support and compassion that I've seen provided by our hospices across the country.

But having considered the evidence before us, I am not persuaded that these serious concerns around inequality, disability, safeguarding and end of life uncertainty have been adequately resolved. Until I can feel confident that these safeguards are strong enough to protect the most vulnerable. I do not believe Parliament should create a legal route to an assisted death. Thank

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you, Madam Deputy Christine Jardine. Thank you very much, Madam Deputy Speaker, and I'd like to thank the hon. Member for bringing thank the hon. Member for bringing this back and giving us another chance to debate this. Although part of me regrets, and I'll part of me regrets, and I'll explain why, that we are having that other chance. And I respect everyone who has taken the everyone who has taken the responsibility of coming here today to do this again. And I particularly respect those who have particularly respect those who have shared their very moving personal stories with us all.

But most of all, I respect and I would like to apologise to those who are going through the trauma again, of waiting to find out if they will have the choice. I have huge sympathy for them because they believed when we originally passed this bill and sent it to the other place, that if they needed it in four years time, they would have the choice. It would be in their hands, but that has been snatched away from them. That hope has been taken away, not by us.

We fulfilled our responsibility to the electorate. We spent hundreds of hours in committee, in private discussions, in debates, in the Report stage, going over this bill in minute detail until we could, in confidence, send to the other place the best bill we thought possible. Of course, we thought they'll amend it, they'll bring things back, but

13:04

Christine Jardine MP (Edinburgh West, Liberal Democrat)

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13:08

Rt Hon Liz Kendall MP (Leicester West, Labour)

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And I do think of all of the people who have suffered unbearable pain and loneliness since that first and loneliness since that first debate took place. Now I'm going to make three brief points and forgive me if I don't take interventions. I me if I don't take interventions. I know there are so many people who want to speak. The first is why I support a change in the law. In support a change in the law. In principle, I have always believed that so long as it does no harm to others, people should have as much control, say, and choice over their lives and the decisions that matter to them as possible, no matter what their background or situation.

That power should be in people's hands to live or die as they choose, not as anybody else thinks they should or tells them they should, and that this shouldn't only be the privilege of those with money, knowledge or resources. For me, this applies as much to the end of your life as it does throughout the rest of your life, and arguably more so to choose as best we can, how we leave this mortal coil on our own terms, in as little pain as possible with grace, humanity, and dignity, surrounded by the people we love and who we love in return here.

And that is not the case at present. As my hon. Friend, for the Member for Filton and Bradley Stoke so bravely and movingly set out, the principle of choice is deeply important to the people and families who have suffered unbearable deaths and who are worried about unbearable deaths. Whether or not they use that choice. Many have talked about having that option as a kind of insurance policy, or as a comfort for them when they're going through those difficult times.

And that principle of choice and how important that is leads me to my second point, which is about the argument that we need better palliative care and social care before any change in the law. The truth is, if you genuinely believe in choice, it's not either better care, palliative care or social care, or the option of assisted dying. It is both. Because even with the best quality universal palliative care, it will not achieve unbearable suffering. For some people.

We know that from respected research institutions, from hospices and from patients themselves, and we should listen to their voices. Now, back in 2000, the year 2000, the then editor of the British Medical Journal, Richard Smith, wrote a powerful article entitled A Good Death. And I remember reading it and how how amazing I thought this this article was at the time. And in it he argued that medicine in particular, but also society as a whole, does not give the attention we should to helping people die a good death.

But our ageing population and the increase in long term chronic conditions. So sudden death is no longer the norm, means we need a new approach to look across the broad spectrum of support that is needed to provide a good death based on clear principles, including being able to retain control of what happens to be afforded dignity and privacy, to have control over pain relief and other symptom control. To have choice and control over where death occurs, who is present, who shares the end, and to be able to leave when it is time to go and not to have life prolonged pointlessly.

I see today's debate very much within that context on what makes for a good death. So alongside a change in the law on assisted dying, we must also improve palliative care and social care for families. I have campaigned for that for years. For more beds in my local hospice Loros for for free social care and choice at the end of life. And so that, as Richard Smith argued all those years ago, we as a country and society bring death more into life.

And that is entirely within the power of this government and this House. And I know my honourable and very dear friend on the frontbench will care passionately about those issues. My third and final point is about trust in our democratic process, and I want to pay tribute to the right hon. Member for North West Hampshire for the very powerful speech he gave earlier on this point. I have the greatest respect for many knowledgeable, experienced, highly principled members of the House of Lords.

But it is not right, and it is not acceptable that a tiny minority should be able to talk the bill out with hundreds and hundreds of amendments for the sole purpose of scuppering this bill, a bill that, may I say to hon. Members, has been far more highly scrutinised than many government bills, the most scrutinised in my 16 years in Parliament, and a bill that was passed by this House of elected members. The Lords should vote on this bill, amend it if they see fit, send it back to us just like we do with all other bills.

We have done our job. Now the House of Lords needs to do theirs to give people the dignity, respect, choice and control over how, where and when they die that so many hundreds of people have not had in the decade since we last faced this issue.

13:13

Dr Kieran Mullan MP (Bexhill and Battle, Conservative)

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A doctor. >> Madam Deputy Speaker now be able to give my personal views on this bill, as colleagues in health have taken over responsibility for it. I spent most of my life as someone that was highly sympathetic to the cause of assisted dying and and imagined that I would support it if imagined that I would support it if I ever was an MP. But that changed in 2018. That changed when I read the Gosport Memorial Hospital independent panel report published in that year.

That is a report that should be more widely read, and I often wonder why it didn't get the attention it deserved, because it found between 1987 and 2001, more than 450 NHS patients had their lives prematurely shortened by healthcare staff. There were mainly elderly, the average age of 81 but as young as 61, and more than 70% of them had been admitted to hospital, not needing palliative care or at the end of their lives. And the report describes what happened to some of them.

One patient was admitted for respite care but deteriorated and became confused. During his stay. Staff asked permission to give him diamorphine but his daughter refused as he was not in pain. However, his wife later agreed and he was started on diamorphine via syringe driver. He died the same day a man admitted for dementia was started on diamorphine syringe driver. Staff asked his son for permission and he gave it, but he felt there was no explanation of what it meant to be given diamorphine. The dose was doubled and his father died five days later.

His son felt that the diamorphine had effectively killed him. Why did that happen? It happened because the staff in that hospital, in that ward, had developed a culture of prioritising the convenience of looking after patients over the value of their lives. And it speaks to something we often don't like to talk about and we might feel guilty about, and that is that looking after people is not only just challenging, it can sometimes be deeply unpleasant. As a doctor, I've helped look after people that when you approach them to give them care, they scratch at you or hit out at you.

I've helped look after patients who refuse to stay in bed, even though it's in their best interests, and continually wander the wards and need to be monitored all the time, and perhaps in what might seem benign but is actually very challenging. Sometimes patients who continually call out for help again and again and again and again, perhaps asking for a medicine they've already been given, or a meal they've already been given and refuse to be consoled. And that brings out perhaps what we would want most of the time, the best in us, the best in our nature to be kind and caring and compassionate.

But it can also sometimes bring out the worst of our nature, our impatience, our intolerance, and even our cruelty. I'm also, I've seen that happen in hospitals. I know that goes on in private homes, up and down the country every day. I won't, not time. And whilst I don't seek to say that this bill will be used in that same way to deliberately bring about the end of the lives of confused or elderly patients, my worry is how it inserts itself in that battle in our country, between the best and worst of our nature, in families and in conversations and settings where people, as much as we don't like to believe it, actually actively, for selfish reasons, wish their relatives were dead, and that those relatives know that their family wish that they were dead.

I don't want a bill or a message from this Parliament to go out to the wider country to say that actually not just Parliament, but through the mechanism of the NHS, a wing of the state, we will sometimes support and help you to end your lives. I remain deeply sympathetic to the scenarios and circumstances that people have described, and I can personally foresee a situation where I would want to make use of this bill and feel it would benefit me, but we shouldn't legislate for what we might want.

We have to legislate for what is the broader interests of our constituents and our country, not least because of many has articulated this bill in itself has some serious flaws, particularly the arbitrary decision to implement it in four years time, regardless of what might be happening to the situation in our palliative care situation, palliative care services, where we've seen even recently them facing very new and real challenges when it comes to to funding. So while I understand why people will see this will bring benefit for some people, and I acknowledge that it will, I think the price we're asking some of the most vulnerable in need people in our society, the risk that we're asking them to face, the price we might be asking them to pay is simply too high.

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Mary Kelly Foy. Thank you. Deputy Speaker.

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We've heard. Much today about the. The legal and the medical and ethical questions being raised by ethical questions being raised by this bill, and for me to ignore the warnings of the the medical warnings of the the medical professions is absolutely baffling. But my remarks today will focus on poverty, inequality and what poverty, inequality and what dignity really means at the end of life. And my daughter Maria has been in my mind throughout my considerations. Maria lived with severe cerebral palsy.

She was non-verbal and required round the clock care. And from the day she was born, we were told that she might just have six months to live. But she defied this and lived for

13:18

Mary Kelly Foy MP (City of Durham, Labour)

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13:24

Carla Lockhart MP (Upper Bann, Democratic Unionist Party)

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the soft language of assisted dying is misleading the public because it is misleading the public because it obscures the stark and very, very dark reality of what is actually being proposed. We should have always have the courage to call things for what they are. Of course, things for what they are. Of course, we all want assistance when we are dying, but that's not what this dying, but that's not what this bill does. It's not an extra shot of morphine to ease someone on their way.

It is a bill that allows doctors to provide lethal drugs for a patient to end their life. Let the reality of that sink in. Our great NHS, the principles of which are to protect and save lives, will be responsible for state sponsored suicide. And that's what it is. Madam Deputy Speaker, yesterday was World Suicide Prevention Day, and the irony should not be lost on any member of this House. Healthcare professionals and charities work tirelessly to prevent suicide. They seek to reassure people in despair that their life has value, that help is available, and that hope remains.

But what does this bill do? It weakens the principles that underpin our suicide prevention strategies. So I ask supporters of this bill what message does a system of state sanctioned death send to those already wrestling with suicidal thoughts? How can we genuinely regard suicide as a tragedy to be prevented, while at the same time allowing it to become a medical intervention to be facilitated by the state? One of the deepest concerns is that this bill does not require proper exploration of why a patient wishes to end their life.

What if it is driven by financial worries, or poor access to care, or fear of being a burden on family members? Sometimes a desire to die is actually a cry for help. Yet under this legislation, death will be presented as an acceptable response to hardship. The lines get particularly blurry when it comes to certain manageable conditions, such as type one diabetes. If a person decides to refuse treatment, these conditions could end up meeting the bill's definition of terminal illness.

When the definition is this broad, it is easy to see how the law will expand over time. And I know the opposite to my view will hate the words slippery slope. But that's the reality in every country where this legislation has been approved. Oregon, similar to our bill now diabetes and arthritis. Belgium children, people with autism. Spain. A lady who was gang raped ultimately went on to end her own life. I also have really grave concerns about those who may be quietly pressured into choosing assisted suicide.

This bill allows doctors to discuss assisted suicide with patients, but it makes no exception for those who may be

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especially vulnerable. These people include. I will give way. The hon. Lady.

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For giving way. The very definition of coercive control is that it is insidious, and we don't that it is insidious, and we don't find out about it until years later. Maybe the victim themselves wasn't even aware of it until years later.

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A victim of coercive control, assisted dying. There would be no years later, would there? I couldn't agree more with my

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I couldn't agree more with my hon. Friend. These include people with learning difficulties, those with a history of suicidal feelings, or those detained for their own safety under the Mental Health Act. To give just one example, people with down syndrome rely heavily on parents and carers to help navigate complex decisions. They are deserving of every possible safeguard and this bill does not provide it. Instead, according to the National Down Syndrome Policy Group, the bill presumes the ref the best.

The bill presumes the best rather than legislates for the worst. That's not good legislation. As one member of the group said, I worry that I and others with down syndrome and our families and supporters might be pressured to consider ending our lives when we face the effects of ageing. Haven't we enough stigma to deal with already? The Bill will also know a lot give way. This bill will also fundamentally alter the patient doctor relationship. For generations, people have looked to health care professionals for treatment and care.

That trust is precious. It should never be diluted and this bill deserved drives a coach and horses. Through that relationship. The role of our health service should be to do no harm and to stand alongside patients in their darkest moments. And I'm not standing here with rose tinted glasses on. I know that too many people struggle to access end of life care Death more available. The answer is to make care more available instead. We should be focusing our energy and resources on strengthening palliative care services and ensuring that nobody faces their final days without proper support.

Madam Deputy Speaker, my opposition to this bill is not only practical but moral. Life is precious, and it deserves protection from its beginning to its natural end. That is what my Christian faith teaches me, and that belief is shared by many of my constituents and by countless people across this great United Kingdom. This House was founded on Christian principles. This legislation is so far removed from those Christian principles. The true measure of a compassionate society is not how easily, easily to facilitate death, but how faithfully, faithfully.

It cares for those who are suffering. As I watched my dad take his last breath on this earth, tears rolled down his face. His pain had often been unbearable, but our NHS stepped up. His consultants paid nurse and those caring for him rallied around him because he wanted and deserved to live. He did not need help to die. He needed help to live and when death came naturally, he needed care, compassion and dignity. That is what every vulnerable person deserves. I cannot support a law that would allow the state to be involved in ending human life, and that is why I and my colleagues

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on this bench will be voting against this bill today. Janet Davey, thank you, Madam Deputy Speaker. And surprisingly, I'm not trying to persuade hon. Members how to vote one way or the other during this assisted dying debate. And this is because I think hon. Members know by now how hon. Members know by now how they're going to vote and why they're going to vote the way that they do. However, I feel I need to they do. However, I feel I need to share my thoughts and my views with my constituents of Lewisham East, why I'm voting the way I am today.

And I say this because there is a significant change as to how I voted previously. Now, if hon. Members are influenced by my contribution, then indeed, so be it.

13:31

Janet Daby MP (Lewisham East, Labour)

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Madam Deputy Speaker, I will get right to the point. I previously voted for assisted dying. I voted for assisted dying. I recognised then, as I do now, the deep turmoil that family members experience when they know or indeed experience when they know or indeed see their loved ones dying, the agonising distress or pain they experience is something no one experience is something no one wants for themselves or indeed their loved ones. However, I cannot shake from my mind a conversation I had with someone some time ago about assisted dying.

They've been diagnosed with HIV and Aids, and this was before the time of advanced medication for this illness. Their body was breaking down and there had been informed that their prognosis was bleak. They said had assisted dying been an option for them, then they would have taken it. However, it wasn't an option and after some time they have since been stabilised on medication. They're in full time work and although they do have a side effects and they do feel tired, they are living a meaningful life and they are no longer, as you can imagine, an advocate for assisted dying.

When I previously voted for assisted dying, and my voting on the different amendments at that time was varied, as I was trying to navigate my way through this issue, ensuring I was considered in my approach, but on my mind was always the questions of inequalities, how this would impact poorer communities, isolated individuals, people with mental and physical disability, as well as those in control. And as we've already heard and discussed, coercive relationships and how this system would work in our society now, and how it will change in years to come.

And also, of course, how this would impact black and minority ethnic communities who already experience deep inequalities within health services, as shown by years of impact assessments and reports on this issue. As chair of the Sickle Cell and Thalassemia APPG, I'm constantly reminded of the health inequalities and suffering that people with this disorder continue to experience. They are constantly undermined, ignored and their disorder is grossly lacking in research funding. Part of this new evidence has also been the government's own impact assessment on the effective.

On the effectiveness of assisted dying on the health service. This recent report suggests that people from ethnic minority backgrounds may be more susceptible to coercion. Coercion due to structural pressures such as poverty, lower care quality or domestic abuse. As a result of these pressures, the impact assessment states that ethnic minority people could disproportionately choose to have an assisted death to avoid financial hardship or escape abuse. This relates to broader concerns regarding the availability and quality of social and palliative care, particularly for already disadvantaged communities.

Earlier this year, up to 60% of hospitals hospices reported that they were having to make cuts to frontline services as a result of financial pressures. And while the government has increased funding for the sector, it is clear that far more work is needed before those in need of support at the end of life receive the dignified care and choice of treatment they deserve. Alongside this, there is the additional pressures on the broader health service and the legal legal sector resulting from this bill, which reinforces my decision to vote against it.

Now, I implore the government to invest in hospice and palliative care across the country to make it the best it can be for all postcodes. Now, following my vote in favour of assisted dying for the following two nights, I had nightmares about dying and death. I had to wrestle with myself, knowing that I was not entirely comfortable with the decision I had made and my conscience was not at peace, and I cannot in good conscience vote for the bill. In fact, I wish there was a bill before this chamber that we could have all gotten behind, as there is so much that needs to be done in our society.

I decided that if the opportunity should arise again, I'd be voting against assisted dying. Now, I do not judge the conclusions that others, my hon. Members and hon. Friends from across this chamber reach, but I ask that we respect each other and we do that in a respectful way. Yeah. Andrew. George.

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Mr. Speaker, we be asked to speak in this debate. Indeed, this is the first time that I have, and indeed, I'm a sponsor of the bill indeed, I'm a sponsor of the bill and a member of the Health Select Committee. I congratulate the hon. Committee. I congratulate the hon. Member for Rochester and Strood in the way that she she introduced this this debate and the this this debate and the outstanding work of the hon. Member for for Spen Valley in the way that for for Spen Valley in the way that she.

She has championed this this over over all this time. If we if this bill is defeated today, it will leave us with a significantly unsatisfactory and dangerous status

13:36

Andrew George MP (St Ives, Liberal Democrat)

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quo where all of the legitimate concerns raised by those who oppose the bill in respect of safeguards the bill in respect of safeguards and coercion will simply continue, but probably be increasingly driven but probably be increasingly driven behind closed doors as things I fear will will only get worse. And fear will will only get worse. And also, it will reward the worst and most reprehensible behavior by by those in another place to block this bill last last time. If the purpose of the shocking behaviour of a small minority of peers towards this Bill earlier this year was simply to make a powerful case for their own abolition, then they've certainly hit the jackpot on this occasion.

And if we reward them with with victory today, we weaken the relationship between the the two houses and cede more power and influence over our democracy than is healthy or indeed or indeed wise. There is a concern, a theme which has been running through the debate today that implies that that that the bill is insufficiently perfect, that indeed perfect being the enemy of the good syndrome that runs through this. And indeed a lot of other debates and other legislation, the concept that there is a 100%, as I think, my hon.

Friend for for Asia described it, 100% perfect bill is simply in the minds of those who who believe that it is possible to to get to that to that point, when when have we ever had a perfect piece of legislation? If the hon. Member wants. I'm sorry, because of time, I don't think you can. They can they can they can answer this one with a postcard to me rather than an intervention. When we when, when have we ever had a perfect piece of legislation? We we end up perpetually restrained.

We would end up being being perpetually restrained from making progress because we only produce compromises and not the utopian perfection which we all want. If we were all sent off at the beginning of this process two years ago, in terms of in terms of how best to handle end of life considerations, and everyone was given a pen and paper and go off into a darkened room without their mobile phones. And to draft a piece of legislation, we'd have 650 perfect bills, all written according to the opinions of everyone in this chamber.

All bills are are inevitably a compromise. I can't because because of the the time constraints, all bills are necessarily a compromise. And that and that doesn't mean to say that we simply have to make, make do with, with, with bad legislation. And indeed, this is the bill that was was sent down to the other place was in fact, a very, very good compromise, an excellent compromise which actually achieved all of the matters which which will I'm I'm sorry to be stirring people up at this stage of the debate, particularly as as time is, is indeed very short.

The other the other theme which runs through this is that somehow people believe that that that the issue of, of, of, of palliative care is one, as if there were a binary choice available to us. So that indeed either either we have 100% palliative care or we can go down the route of, of backing this bill or that we shouldn't support a bill like this until we have 100% perfect wraparound universal palliative care around the country. I mean, having being a member of the of the Health Select Committee, we produced a report on this, and it's quite clear that that that it is possible, indeed, it will actually help the case for improvements in palliative care, if this option is also is also available, as a number of other members have made the.

The point in relation to the the limitations of of palliative care, I think that that that point has been made very strongly by by others. And indeed, the points around coercion and safeguarding, because, after all, the current situation is. That is that both in terms of coercion and safeguarding the environment at the moment is is certainly not satisfactory. The Bill provides safeguards where presently there are none. It is irresponsible and scandalous that some people promote scare stories about risks to disabled people, to anorexic children, to Down's Down's syndrome, children to the vulnerable, when in fact, actually those those those risks currently exist.

And indeed, this bill actually provides the safeguards which I think many people want. So last time we we had a vote on this issue at Third Reading. I thought it was this chamber at his very best. There was no no choreographing of the response. You could hear a pin drop when the result was announced. It was the a a very good debate, followed by followed by MPs coming together in silence following that debate, and indeed people from both sides of that, of the debate embraced behind the chair in tears because they understood the gravity of the decision before them.

And that, I don't think, was respected by the way in which the laws have treated this bill. And that's why I think it's vitally important that we send this bill back to the Lords and don't allow them to have the victory that they seek. Thank you.

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Doctor Peter Prinsley.

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Thank you, Madam Deputy Speaker. So I have cared for patients with advanced cancers of the head and advanced cancers of the head and neck, and I've seen patients at the end of their lives. And it is this experience, above all, that convinces me that we must introduce this humane and dignified option to this humane and dignified option to assist those who are dying in peace at a time of their choosing, and to avoid the loss of autonomy and dignity that so many people fear.

I fear it. Perhaps other hon. Members will so fear it, for none of us can

13:42

Dr Peter Prinsley MP (Bury St Edmunds and Stowmarket, Labour)

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know when we will die, and not until we are dying ourselves. For until we are dying ourselves. For this is not a measure that chooses between life and death, only between death and death, between between death and death, between dying and dying. And that is the truth of the matter. Now, I did not always think like this, but I've always think like this, but I've seen the limits of even the most skilful palliative care, and I have skilful palliative care, and I have seen the look in the eyes of the patient, reconciled with the end of their days, and the pleading expression of the poor soul to put an end to suffering.

For that is what we are debating. Suffering, assisted dying is complementary to palliative care. It is not an alternative. Now, others will say that this is unconscionable and I respect that. I am asking the House to vote to support choice. That is all I am asking. We voted for it before, and hon. Members in the other place sought to prevent the passage of the Bill. But we are not misled or deceived by such a parliamentary device. Neither the public who will not forget this moment.

So I urge members across the House to support choice. That is all I am asking for.

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Sean Berry Madam Deputy Speaker, I'm here because we do need to change the law so that dying people have a choice for a better death have a choice for a better death than too many horrible progressive terminal diseases allow. For now, I'm here because of my own conscience. I'm a humanist and a patron of humanists UK, and I'm also here with the support of so many of our citizens who desperately want to see a change in

13:44

Siân Berry MP (Brighton Pavilion, Green Party)

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the law, and a very many of my own constituents who've written to me to tell me their own personal to tell me their own personal stories of losing people under the worst circumstances, because the worst circumstances, because the status quo did not allow them another choice. Two weeks ago, I heard from my constituent Julia, heard from my constituent Julia, who told me about her mother, Jane, and asked me to speak about her case. Faced with a progressive terminal neurological diagnosis at 92 and unable to travel alone for help, Julia's mother decided in secret to end her life in a very distressing way I cannot bring myself to describe today, Julia says.

I had no idea that she was going to act on her off stated desire, although in retrospect, I realized that a phone call we had in the morning of that day, she said goodbye in her own way, and she also made sure that it would be her friend and carer who would find her. This was instead of Julia herself. The next morning Julia says, well, I miss her terribly. I'm proud of her for her determination and grateful that the manner of her death apart, she has left me with positive memories of her, rather than the gradual eroding of herself that she and I, to be honest, were both dreading.

She adds, now that I'm coming out of the weeds of my grief at her loss, I am determined to make her legacy the right for people in her situation. When they are faced with losing all agency. To have the choice to take the ultimate act of agency over their life. That is what we're here for. We're here to make something more humane than that situation that Julia and her mum Jane faced. Examples like these are real people, brave for telling us their stories, who have demonstrably being harmed by the law.

As it stands, people are raising concern about potential harms if we change things. We have debated this so many times, and now in the Bill, for every concern I've heard expressed that this new law being used by someone ineligible or by someone who is not choosing freely the way their terminal illness will play out, I believe we can see real safeguards in the bill before us. They are very, very strict. For some dying people, these requirements on them will be too much, in fact.

So some people will be denied the service in this bill today. But people will benefit and there is a clear moral case and duty for Parliament as a whole to act to progress this issue. But now, Madam Deputy Speaker, there is not just the moral case for this bill. We have debated before. There is a Democratic case to the serious, careful work we started here must be completed in the normal way in our upper house, too, for the democratic process to be complete.

Last year we voted and voted again on the principle in the Bill committee at Report stage. The earlier proposer of the bill listened and proposed over 100 of her own amendments and accepted more than 30 from opponents who wanted to go maybe further than than she or I would have liked. She worked with civil servants to make its workability crystal clear, and the Minister reported back to us previously that the bill was workable. Other amendments were voted on here in this House at Third Reading, we debated what we had designed and voted again.

We passed on a sound piece of legislation last year. I believe we sent the Lords a good bill, a safe bill, a compassionate and workable change in the law for the Lords to refine if they wished. And we must now say to the Lords they must collectively now do as MPs did. Consider the Bill with the seriousness it deserves. Vote just as we did our duty in putting our votes on the record and bring it to a conclusion in that place.

Honourable, I say to my hon. Friends, Madam Deputy Speaker, please vote for this Bill to continue so its progress and all the work we've done so far to build something better than the status

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quo for dying people does not end today. Doctor Marie Tidball, thank you,

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Doctor Marie Tidball, thank you, Madam Deputy Speaker. This week death has felt rather too close to death has felt rather too close to home for me. My dad, John, my constituents, my great political constituents, my great political hero and indeed hero in life had surgery for lung cancer, followed surgery for lung cancer, followed by a cardiac arrest the next day. Thanks to our wonderful NHS and its outstanding care, CPR and treatment performed on him was successful and

13:49

Dr Marie Tidball MP (Penistone and Stocksbridge, Labour)

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he is now in the process of recovery to such an extent that I recovery to such an extent that I was able to have a detailed conversation with him at his bedside, where he insisted that I come here to this place to speak come here to this place to speak and vote. In this debate, my dad is determined to live. Nevertheless, he told me that if circumstances were different, where his condition condition was terminal, with six months left to live and had capacity to make that choice, he would want to have the option to choose an assisted death, to give him dignity, access to the choice of assisted dying.

As tightly drawn in the bill today enables the terminally ill adult who chooses it to live a good death. In the Second Reading of this bill, previously brought by the Member for Spen Valley, I said my support was conditional on further safeguards being embedded in it, because too

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often control is taken away from disabled people and clarity. On that point.

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I continue. She doesn't mind. And for clarity, I wanted to say, Madam Deputy Speaker, that clause two, subsection four of the bill before us today says, for the avoidance of doubt, a person is not to be considered to be terminally to be considered to be terminally ill only because they are a person with a disability or mental disorder, or indeed both. Yes. Further, Madam Deputy Speaker, as a member of the Bill Committee, I worked for over 90 hours to ensure all those changes that I requested were made, and they are now on the face of the bill brought by the Member for Rochester and Strood.

Yes, my amendments include, including to introduce two new clauses were unanimously supported by that committee. The first clause 48, establishes a disability advisory board made up of disabled people and our organisations to embed a long term and iterative structure in law to report on the bill's implementation and impact upon disabled people. The second clause 22 sets out provisions to put in place independent advocates for people with autism and mental health conditions, enabling them to effectively understand their options around end of life care.

Further, Madam Deputy Speaker, I also ensured the bill provides for specific up to date training for registered practitioners on reasonable adjustments and safeguards for autistic people and people with learning disabilities. In clause eight, further, I secured an expanded duty in clause 28 to collect additional information about whether immediately before death, the person seeking assistance had a disability, as defined under section six of the Equality Act. Other than a disability amounting to terminal illness as defined in this bill.

Together, all these measures create a solid foundation to enable disabled people to have a strong voice when advocating for themselves about their choices on end of life care and importantly, a seat at the table scrutinising and monitoring the implementation of this bill. After spending nearly two years thinking about death in relation to this bill has been life changing for me because the thing about considering choice in death, understanding what dignity in dying involves, and what living a good death really means, is that it makes you think deeply about the meaning of living a good life to to love ferociously, to live passionately, experiencing every single moment as if suspended, like a vignette woven from Charlotte's Web.

After all, what's a life, anyway? We're born. We live a little while. We die. As E.B. Webb's eponymous character points out, each of these stages of human life requires us to treat ourselves and fellow humans with dignity, to value ourself, to enable us to feel and perceive our own worth. This bill not only anchors that dignity at this final stage, but in doing so, compels us to embed dignity at each and every other stage of our lives as well.

This bill lays a counterweight alongside the government's plans to raise the quality of and access to palliative care, and to drive urgent reform on social care, to build a new system that gives people the dignity, security and support they deserve. Driving quality in these areas together can and must be done contemporaneously. My friend, an incredible assisted dying campaigner, Nathaniel Day, passed away this year. He squeezed every single drop of joy out of life and taught me so much about why living a good death matters for setting the bar high for dignity in death.

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We set the bar even higher for dignity in life. Here.

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Doctor Ben Spencer. You, Madam Deputy Speaker, as a former mental health doctor and someone who's done research in decision making capacity today, in my brief time I have I want to talk my brief time I have I want to talk about stigma. I've looked after many hundreds, perhaps thousands of people who've self-harmed or

13:55

Dr Ben Spencer MP (Runnymede and Weybridge, Conservative)

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people who've self-harmed or attempted suicide. And of course, a desire to one's life to end can be entirely reasonable and understandable. Wish. But it's often a manifestation of a treatable mental disorder, a treatable mental disorder. With the right intervention, care and support, people get better with a person looking back and saying, what was that about? I'm so thankful I didn't succeed. When they got the care and treatment I needed. But the bill refuses to acknowledge this framing to debate the intervention as shortening the death process or some form of assisted dying rather than what it is.

Physician assisted suicide. It is designed to take at face value, an expression of a wish to die as an absolute fact, an expression of autonomy, not a possible manifestation of mental illness. This is its blind spot. This is its most tragic flaw, where I believe all problems from the bill derived from mental disorder can be very tricky to detect. There is nothing stigmatizing about mental disorder. If someone in hospital expressed a wish to die, if someone in a care home or an outpatient clinic expressed a wish to die, if someone here in this chamber expressed a wish to die, if a loved one expressed a wish to die, the first person I want them to see is a psychiatrist, not an assisted dying practitioner.

Yeah,

13:57

Dr Simon Opher MP (Stroud, Labour)

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To Simon Offer. >> To Simon Offer. >> Thank you very much, Madam Deputy Speaker. And can I just praise the House all round for some fantastic speeches? The Member for fantastic speeches? The Member for West Lancashire, the Member for Filton, Bradley Stoke, and indeed just now from Penicillin and just now from Penicillin and Weybridge. So I'm very proud of our house and the way we've we've debated this. I've been involved in delivering palliative care and end of life care. These are actually quite different.

For over 34 years I continue to do so as a GP. I will cut this speech short. But this is really about choice. Choice exists for people in France, in Spain, in the Netherlands, in Belgium, in Australia, in US and Canada, and indeed in Jersey and the Isle of Man. And it also exists for people in this country. If you've got 15 grand. However, we haven't got access to this at the moment. And what I would say is to all these doubters, this is the safest assisted dying bill in the world, full stop.

That is a fact, because it's got so many safeguards, many more safeguards than the ones in Australia or in any other place. Now I will just carry on if that's OK. So it's a good thing to offer. It's a great thing to offer end of life care and palliative care. And in 2010, the UK system palliative care was was levelled at the best in the world. And yet still people went to Dignitas. Still, 600 people who were suffering from terminal diagnosis killed themselves.

And indeed, in Oregon, 92% of patients who opted for assisted dying were receiving good palliative care. They are different. So I'm just going to carry on and be very brief. One other thing I would say there's been a lot of concern, quite rightly, about disabled people and people from the black and Asian minorities about whether they'll be harshly dealt with. In fact, the evidence is from other jurisdictions is that these people do not go for assisted dying. It's actually a white, middle class, able bodied thing that tends to go, and in a way, we have the opposite problem that we need to deal with.

Can I also say, can I also say, can I also say that in some studies, just to answer your question, there's some studies in California where they treated depression in people with terminal illness, and it made no difference to their choice around assisted dying. Assisted dying is different because as my friend, the sorry, the my the Member for Norfolk. No, I can't remember where you're from, I'm afraid. But what he said, it's not a choice between life and death.

It's death. A death from natural causes or death on your control. And all I would say to all these people, all of us here, is that we have a choice. We have a choice right now in about five, ten minutes. And then. But we must give other people that choice. And is it our right to deny those people that choice? So I will now sit down because the speaker is giving me some black looks. Thank you very much.

14:00

Rt Hon Damian Hinds MP (East Hampshire, Conservative)

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14:10

Alison McGovern MP, Minister of State (Department of Health and Social Care) (Birkenhead, Labour)

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We are pushing ahead with workforce changes, including career progression, progression, training progression, progression, training and job security, and we've made £4.6 billion of additional funding available for adult social care by the end of this parliament, the end of this parliament, including £500 million for the first fair pay agreement for care first fair pay agreement for care workers, and we will strengthen social care now, not just waiting for the Casey Commission providing for the Casey Commission providing greater choice and independence as we do so.

Let me turn to palliative care. Madam Deputy Speaker, that many, many members have raised. Thank you, Madam Deputy Speaker, and I have huge respect for the Minister. But she said today she's not taking any intervention. She's a very good Minister, and I trust that she will be answering in detail the points that have been raised in the House today, because having discussions with her and the government after the debate is too late for today's vote. Now, I know she's a thorough and assiduous Minister.

I'm sure she'll do her best to do that, but it would be. I think it is important to make the

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point to the House, Madam Deputy Speaker. As the right honourable and very experienced member. Will know.

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Will know. That was not a point of order and not a matter for the chair, but I'm sure the Minister has heard her. Minister.

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Minister. Thank you, madam. Madam Deputy Speaker, and I also respect my hon. Friend and though it was not a point of order, the House will have heard what she said. I am attempting to address the points that have been raised in the debate, particularly on procedural matters, on social care, and I'll turn now to palliative care, which I think is extremely important and has been raised very many times within the debate now on palliative care. We're developing, as the chair of the Select Committee set out, we're developing a modern service framework for palliative care and end of life care.

This framework is clinically led and evidence based to support sustained improvements in outcomes for patients and carers, including by systematically identifying, measuring and reducing health inequalities and reducing unwarranted variation in access and experience and outcomes. And as part of this work, we expect all integrated care boards to complete a needs assessment to get a detailed understanding of their current and future population, including people of all ages with palliative care and end of life needs. And I think that this is vital in order to commission services that best meet the need whilst providing value for money.

Many members raised how important this is, particularly reducing unwanted variation, and I want to acknowledge that and say that I will be working with members across this House to deliver this modern service framework. Members mentioned the hospice sector quite rightly. We provided 125 million capital boost funding for adult and children and young people's hospices. But I just want to say to members, I've heard the points that they've made, and I know we have more to do, and many members and friends will know that in July.

I lost my own mum, so I had a very practical education in this topic, and that experience will shape how I take this work forward. So. I'm sorry, Madam Deputy Speaker. To conclude, I would just like to thank all hon. Members once again for all they have said members will understand how difficult it is when we're sharing personal experience, and many of them have done today, and I'm really proud of everybody who has done so.

Difficult and challenging though this issue is. Thank you. I'd just like to also thank all members who've given me their sympathy over recent months and weeks. It has been so appreciated. The government remains neutral on whether this bill becomes law, but it is our serious responsibility. Should Parliament pass this legislation to ensure effective implementation within the framework provided by the legislation? And on that basis, we would provide technical support to the sponsor if Parliament chooses to progress the bill.

That said, I would just repeat again the comments that the right hon. Member made from the opposition despatch box, which I will now say on behalf of the government. This is a deeply challenging issue for us all and for the public and for our constituents that we represent. In discussing this issue, we must model the best behaviour of this House respectful, thoughtful, careful debate, listening to each other and understanding those very different perspectives that we come from. I think that we have done that today, and I hope, Madam Deputy Speaker, that whatever happens in the division, that we will be able to continue to show those behaviours and give this

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deserves. The.

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The. Point of order Kit Malthouse. Madam Deputy. Speaker, I beg to move that the

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motion now be put. Question. The question is that the

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The question is that the

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The question is that the question be now put. As many as are of that opinion say aye. Of the contrary, no. no. Division. Clear The The question The question is The question is that The question is that the question be now put. As many as of that opinion, say I of the contrary. No, no. The Tellers for the ayes are Geoff Smith and Bambos Charalambous, the tellers for the

14:18

14:29

Terminally Ill Adults (End of Life) Bill: Second Reading:Closure Motion Division

>> >> For >> For the >> For the order.

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For the order.

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For the order. The ayes to the right 293. The

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noes to the left 218. The ayes to the right were 293. The noes to the left 218. So the ayes have it. The ayes have it. Unlock. The question is that the bill be. Now read a second time. As many as are of that opinion, say I. Of the contrary. No, no. Division.

14:31

Terminally Ill Adults (End of Life) Bill: Second Reading: Division

14:48

>> Ago today, on a clear. Tuesday morning, 19 terrorists four passenger planes. Two were flown

14:48

Alan Mak MP (Havant, Conservative)

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15:04

Kirsty McNeill MP, Minister of State (Foreign, Commonwealth and Development Office) (Midlothian, Labour )

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25 years on, it can be tempting to think of 9/11 as a moment in history an event, perhaps for a text book or museum or a documentary. And those, of course, are important. I will come to them later, but I begin by saying that for thousands of families, 9/11 is not history at all. It is a memory deeply felt of someone who left home that morning and never returned. So today we begin with them. We remember the nearly 3000 people killed in New York, at the Pentagon and in Pennsylvania.

We remember the victims for more from more than 90 countries. We remember the 67 British citizens who lost their lives they loved, and those who have carried that loss for a quarter of a century. The hon. Member for having spoke very movingly about his constituent, Sally Taber, and the loss of her godson, Ollie Bennett. And I want to pay tribute to Ollie and offer my deepest sympathies to Sally, to all his family and to all those who knew and loved him.

The charitable work established in his memory is a truly powerful example of how a life can continue to inspire hope and opportunity for others. And we should also remember and honor the extraordinary courage that was shown that day by the firefighters who climbed the stairs of the World Trade Centre, while thousands of people were trying to escape from the police officers, the paramedics and ordinary members of the public who did extraordinary things, putting the safety of others before their own. Passengers aboard flight 93 acted with remarkable bravery and, as my hon.

Friend the Member for Edinburgh South West has told us, many first responders, many first responders, lost their lives, but others have lived with the physical and mental effects of what they experienced. So their courage deserves more than our admiration. It deserves our lasting remembrance. The courage we remember today was individual, but the response that followed was truly collective. As the hon. Gentleman from Christchurch has told us, and the hon. Gentleman, the Member for Strangford, for 25 years, the United Kingdom, the United States, have indeed stood together in remembrance.

And we do so again as we mark this anniversary. The hon. Member for Havant has also asked about closer educational and commemorative links with the national September 11th Memorial and Museum. Our diplomatic network in the United States has worked closely with American partners and other stakeholders in support of this anniversary, and will continue to look for opportunities to deepen US UK cooperation in this regard. My hon. Friend the Minister for the Americas represents His Majesty's Government at commemorative events in New York today, including at the National September 11th Memorial at Ground Zero and a special memorial at the Queen Elizabeth II September 11th gardens.

There, he will join victims, families, survivors, first responders, American representatives and international partners. While here in the United Kingdom. The anniversary was this morning marked with a special changing of the guard ceremony at Buckingham Palace. It echoed the special programme of music played there on 13th September 2001, when the British and American national anthems were played as a clear signal of our unity and our support. The Royal Highnesses, the Duke and Duchess of Gloucester and my right hon. Friend the Foreign Secretary, stood alongside the United States Ambassador to the United Kingdom, Warren Stevens, to remember.

They were joined by representatives of victims families and UK emergency services. Now, these events cannot undo the pain of the past, but they are a way of us saying that all lives that were lost still matter. Their sacrifices still matter, and they will never forget what happened. The hon. Member for Havant has rightly focused on our responsibility to pass the memory of 9/11 on to a new generation. Many of us remember where we were when we heard the news and the hon. My hon.

Friend from Watford has reflected on that powerfully, but many young people, as has been mentioned, have no memory of that day. Many were not yet born. Future generations should understand what happened and why it mattered. Education should explain clearly the harm caused by terrorism. It should tell the stories of the victims, and it should recognise the courage of the first responders. The National September 11th Memorial Museum plays a vital role in preserving such stories and helping new generations understand both the scale of the attacks and the individual lives affected.

Wider digital archives allow people around the world to hear testimony, see photographs and explore historical records, and the UK is playing its part too, through institutions such as the National Archives, records connected to September 11th are being preserved so that future generations can continue to learn from them. The hon. Member from Havant has asked about how 911 is taught and remembered in schools, and I will make sure that his points are drawn to the attention of my right hon. Friend the Education Secretary and the Minister for the Americas.

The attacks of September 11th, of course, demonstrated with truly tragic clarity why our collective security matters. Following 911, NATO invoked article five for the first time in its history because our allies recognise that an attack on one was an attack on all. In the years that followed, British and American service personnel would stand side by side once again in Afghanistan. Many never returned home, and we remember them today, too, and recognize the lasting impact on veterans and on military families.

So today, this House has come together to remember those who lost their lives, to honour the courage shown that day, and to stand with the families and communities whose lives were changed forever. As we mark the 25th anniversary, let us remember that behind every single statistic was a person. Behind every headline was a family. And behind every act

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of remembrance is a promise you'll never be forgotten. The question is that this House

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The question is that this House do now adjourn. As many as are of that opinion, say I, I.

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I.

09:00

Deputy Speaker

This debate has concluded

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