Terminally Ill Adults (End of Life) Bill

Debate between Baroness Keeley and Lord Harper

Committee stage
Friday 27th March 2026 Lords Chamber

[Baroness Keeley (Lab)]

My Lords, on the same principle of making it safe, I will speak to my Amendment 219, which would open an extra channel of communication. It would require the person’s GP to disclose relevant information about the person’s eligibility for assisted dying. That information would be disclosed, first, to the doctor who conducts the preliminary discussion; secondly, to the co-ordinating doctor making the assessment; and, thirdly, if the GP believes that the person may not be eligible, to the commissioner.

The principle behind the amendment is simple. The doctors and the panel need to be as informed as possible about the applicant in those circumstances. A GP may well have crucial information and, at the moment, the Bill does not give a clear opportunity for that information to be shared. The GP’s only role in the Bill, as has been said previously, is to receive notifications. As my noble and learned friend Lord Falconer put it,

“the GP, in the structure of the Bill, is not somebody who has to be involved … the GP is somebody who is receiving information”.—[Official Report, 12/12/25; col. 478.]

This seems to be a missed opportunity. It is not hard to think of cases where a GP might have relevant knowledge. There are instances of fluctuating capacity, where a GP might well know more about the person and their mental capacity than the assessing doctors and the panel. There are cases of coercion, where the assessing doctors might miss the signs. Where there is doubt over the person’s illness and their six-month prognosis, a GP’s input could be essential.

The Bill requires the assessing doctor to make such inquiries of professionals who are providing, or who have recently provided, health or social care to the person, as the assessing doctor considers appropriate, but that is quite a broad provision. Crucially, it is a one-way process. The assessing doctor can make an inquiry with a person’s GP, but the GP is not supposed to offer helpful information unless they are specifically asked for it. That seems an obvious gap.

In a previous group, we discussed amendments that would give a greater role to the GP, but those amendments were criticised as being unrealistic. This amendment, by contrast, would make a small change, which would enhance the protections already in the Bill.

The report of the Demos commission, chaired by my noble and learned friend, said that a key element in the assisted dying regime was

“a doctor who, where possible, knows the person well”.

That doctor could be the patient’s general practitioner. The Bill does not guarantee that, but my amendment would ensure that, if the GP has significant, first-hand knowledge, that knowledge will be taken into account and not overlooked.

[Lord Harper (Con)]

My Lords, I will be very brief. I will speak to my Amendments 354A and 432A, which are both about making sure that relevant information from the preliminary discussion is made available to the commissioner and the panel. The reason why I can be brief is that they are similar in what they are trying to achieve to the amendments tabled by the noble Lord, Lord Rook. He set out clearly the rationale for doing so, and I can simply agree with what he said in support of my amendments.

I will comment on the amendments in the names of the noble Lord, Lord Shinkwin, and the noble Baroness, Lady Grey-Thompson. The theme behind all of them is to ensure that there is timeliness in reporting and sufficient clarity about what is recorded to give people confidence that the process has been carried out properly. The noble and learned Lord, Lord Falconer, has been very clear that there is a clear process set out in the Bill, but it is important to give people confidence that it is documented, comprehensively and on a timely basis. There is clearly a debate to be had about being too specific about the timeframe or what is recorded. However, ensuring that there is sufficient detail, and that it is done sufficiently quickly, is important. I commend those other amendments to the Committee.

Social Care

Debate between Baroness Keeley and Lord Harper

Wednesday 25th October 2017 Commons Chamber

[Barbara Keeley]

I will come on later to discuss how we should proceed and whether we should proceed on a cross-party basis. The hon. Gentleman’s point about carers and family carers is important. The plain fact of the matter is that there was nothing for carers in his party’s manifesto. We had announced that we were going to lift carer’s allowance at least to the level of jobseeker’s allowance. That is the only improvement that was discussed during the general election. He should turn to his own Minister and his own party and ask them what they will do for carers.

[Mr Mark Harper (Forest of Dean) (Con)]

I welcome the hon. Lady’s tone in this debate. It is very valuable. I know that she has taken an enormous interest in this subject, even when it has not fallen within her Front-Bench responsibilities. These debates are very helpful in educating people about difficult issues. I am happy to accept that we did not handle this issue well in the general election. The mistake that we made was not being clear about the current system, which is why her reference in the motion to our proposal without setting out the current system in which people can potentially lose all but £23,000 of their assets is disappointing. Such information would have helped to contribute to the public debate.

[Barbara Keeley]

We will come on to that. If the right hon. Gentleman wants to get into the mess that his party made, the truth is that we legislated a number of years ago to lift the asset floor to £118,000. What his party did during the election was drop that to £100,000. At the weekend, we learned that there was an intention to make it only £50,000. He should be clear about what his Front-Bench colleagues were trying to do. Since then, all we have heard is a deafening silence.

We need to focus on the crisis in social care now. We on the Labour Benches have raised many times just how fragile the care sector is after years of swingeing budget cuts by the Government. A survey by the Association of Directors of Adult Social Services reported that more than two thirds of councils had reported closures of care providers in the first five months of the financial year. Nearly half those councils had had homecare providers handing back contracts.

Housing Benefit (Abolition of Social Sector Size Criteria)

Debate between Baroness Keeley and Lord Harper

Wednesday 17th December 2014 Commons Chamber

[Mr Harper]

Let me make a little more progress.

It is also worth putting on the record that, when Labour Members were in power, they increased spending on a broken welfare system by 60%. They have rejected every welfare reform that we have implemented. They are seeking immediate abolition of this policy, which restores fairness. As my right hon. Friend the Member for Banbury (Sir Tony Baldry), who is no longer in his place, said, it brings the social sector into line with a policy that Labour Members themselves advocated for the private rented sector, and it ends the unfairness of 820,000 spare rooms being paid for by taxpayers when 250,000 people were living in overcrowded homes and 1.7 million were on waiting lists, as was the case when this reform was implemented. The Government are determined to help those families as well. Numbers on waiting lists have now fallen by a fifth to 1.4 million—the lowest for a decade.

[Barbara Keeley]

rose—

[Mr Harper]

I am sure that the hon. Lady will welcome that.

[Barbara Keeley]

I hate to disappoint the Minister, but I will not welcome the figures he has quoted. He is making a point about fairness. Does he think it is fair that 60,000 carers should have to pay the bedroom tax? They do not have spare rooms; they are essential rooms that they need to sleep in so that they can carry on their caring. It is cruel to keep on repeating that when 60,000 people who are struggling, unpaid, to care, and saving the state a lot of money, are not exempt from this cruel tax. Is that fair?

[Mr Harper]

Someone who has an overnight resident carer is exempt from the policy. To deal with particular circumstances, we have given local authorities the ability to use discretionary housing payments in what they judge to be appropriate cases. I am sorry that the hon. Lady would not welcome the news that waiting lists have fallen by a fifth to 1.4 million. That is a very welcome statistic, showing that fewer families are waiting for homes because we are now using the housing stock in the social sector more efficiently.

Oral Answers to Questions

Debate between Baroness Keeley and Lord Harper

Monday 8th December 2014 Commons Chamber

[Mr Harper]

No, I will not. I have talked to disability organisations about this matter, and they agree with the Government. More than 1 million people get social care through the mainstream social care system. The Government are not making any savings by moving the ILF to local authorities and devolved Administrations, and we are working closely with each local authority to ensure that the amount of money being transferred at the point of closure next year will be exactly what is needed and what is being spent by the ILF, meaning that disabled people will be protected.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Some £4.3 billion has been taken out of adult social care budgets over the past four years because of the Government’s cuts. If that funding transfers across, as is planned, it will plug only a very small part of the gap. If they will not rethink this policy, as my right hon. Friend the Member for Wentworth and Dearne (John Healey) just suggested, will Ministers require that the funding be ring-fenced to ensure that 70 people in Salford and 18,000 people across the country with disabilities can look forward to keeping their independence and to this continuing support?

[Mr Harper]

Of course local government has had to play its part in the savings, but local authorities can make choices. My local authority in Gloucestershire has protected the value of social care because it thinks that protecting older people—[Interruption.] No, my local authority has faced cuts, like all local authorities, but it has chosen to—[Interruption.] If Opposition Members want me to answer their hon. Friend’s question, they should stop yelling. My local authority has prioritised funding for older people and people of working age. Clearly, the hon. Lady’s local authority has made different decisions. If those on her local authority want to ring-fence the money transferred from the ILF, they are absolutely free to do so, so I suggest she take that up with them.

Oral Answers to Questions

Debate between Baroness Keeley and Lord Harper

Monday 1st September 2014 Commons Chamber

[The Minister of State, Department for Work and Pensions (Mr Mark Harper)]

My hon. Friend will know from earlier answers the priority that we attach to this. As well as ensuring that the assessment can take place faster, we are also ensuring that the DWP decision makers will be able to cope with the increased number of cases as those cases move through the system, so that, once we have got the assessment process sorted out, those decisions will be made in a timely way which will benefit her constituents and mine.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

T4. Ministers have talked about bedroom tax exemptions, but in reality these do not protect unpaid family carers. In fact, 60,000 carers are hit by the tax, and Carers UK has found that 75% of the carers it surveyed were cutting back on food and heating to make up the shortfall. Will the Minister now accept how cruel and unfair it is to make unpaid family carers pay the bedroom tax?

[Mr Harper]

The hon. Lady will know that the spare room subsidy is about making sure that people have the size of home that they are entitled to, and that if people regularly need carers to stay overnight, that is considered an acceptable reason for having an extra bedroom. She will also know that we have made considerable funds available to local authorities through the discretionary housing payments, many of which have not even been spent.

Oral Answers to Questions

Debate between Baroness Keeley and Lord Harper

Monday 25th March 2013 Commons Chamber

[Mr Harper]

My hon. Friend is right that when the UKBA makes decisions, people in settlement cases frequently have a right of appeal. Some of those processes can often be very lengthy, so we will keep on considering whether there are ways of making the system smoother and more streamlined.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

11. What steps she is taking to increase the use of CCTV in communities where it is wanted.