Terminally Ill Adults (End of Life) Bill

Baroness Blackstone Excerpts

Friday 30th January 2026 Lords Chamber

In the absence of amendments such as these, how can the Minister ensure that Parliament is discharging its most important responsibilities to the people of this country? If he does not accept the need for these amendments, will the noble and learned Lord, Lord Falconer, introduce amendments to address the very serious problems which have been identified in this group?

[Baroness Blackstone (Lab)]

My Lords, I declare an interest as the chair of one of the medical royal college’s trusts. I want to speak to this group of amendments, taking into account the medical profession. I entirely agree, and I am sure that the vast majority of doctors will also entirely agree, that it is better to have face-to-face consultations in these circumstances. However, nearly all those who have spoken in favour of face-to-face consultations have admitted or agreed that there will be exceptions, and there will be quite a lot of exceptions. We have to remember that many people who are terminally ill are bed-bound; they are not able to get up and go to a face-to-face consultation, even if it is quite near to where they live. The vast majority of doctors would want to discuss with their patients whether a face-to-face appointment is acceptable, possible and desirable and, if not, to have an online consultation with them. That seems to me the right approach.

Moreover, I really wonder whether we should be putting in the Bill a clause that would constrain doctors in a way that I think is unacceptable. We must accept that the vast majority of doctors will go into this work with utter commitment to doing the best possible job they can. I find it a bit disconcerting that there is constant reference to a tick-box approach; you can have a tick-box approach face-to-face, or you can have a tick box approach in a consultation online. It does not seem to me a relevant and important point to make. I suggest that, rather than putting this in the Bill, given that I am sure that there is a very strong case for face-to-face consultations normally, it should instead be part of a code of practice for the medical profession that will certainly have to be developed if and when this Bill is enacted.

[Lord Birt (CB)]

My Lords, we are discussing one of the most important decisions that any individual might make in their lives. It is important for the individual and for the state. I think that it is appropriate to ask that the critical meetings with the medical practitioners should be face-to-face, because that allows a degree of intimacy and nuance which, frankly, the world of Teams, however valuable it is, does not. There are three doctors involved in the process set out in the Bill and, at the very least, for the second doctor who is going to co-ordinate the process, it is reasonable to require that that meeting be face to face.

--- Later in debate ---

[Baroness Blackstone (Lab)]

My Lords, it is far easier to develop a code of practice over time and change it in the context of changes in the environment. It is much more difficult to change a law by statute, which means it has to be brought back into both Houses of Parliament, so I do not really think that the point the noble Baroness just made is valid.

[Lord Harper (Con)]

My Lords, having listened to this debate, I am struck that there seems to be a fair bit of consensus. Thinking back to the arrangement of business discussion we had about the pace before this debate, I have listened to the number of people who quoted Kim Leadbeater and her uncomfortableness about making these decisions on Zoom. It strikes me that if she had followed through on that uncomfortableness and put into the Bill a clear presumption that these decisions should be taken face to face, with some exceptions that I will elaborate on in a minute, we would not have needed this debate and we would be moving at a faster pace. There is perhaps a lesson there for the noble and learned Lord: if more cognisance had been taken about some of these concerns at an earlier stage, we would have moved at a faster pace.

The only reason why these amendments exists, why we have debated them and why the noble Lord, Lord Birt, referenced how important a decision this is to get right is that this issue has not already been addressed. I will just leave that there as a possible reason why there are as many amendments as there are to this lengthy Bill and why the debate is necessary: it is because it has not already been done. I will leave that for noble Lords to think about.