Terminally Ill Adults (End of Life) Bill

Baroness Crawley Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Baroness Crawley (Lab)]

My Lords, in a House packed to the gunwales with legal, medical and moral experts, it feels almost impertinent to intervene. However, along with many noble Lords, I have experienced unprecedented lobbying on this Bill. It is only respectful to those who have contacted me to say a few words in one of the most significant Second Readings in my 27 years in this House.

We have watched loved ones die, sometimes peacefully and sometimes in a drawn-out struggle. Like many noble Lords, I am conflicted on this end-of-life Bill. I voted against the last Bill to come before us some years ago. However, in the intervening years, I have tried to see the arguments for self-determination at the end of one’s life and to acknowledge the current, totally inadequate, position of the law in this area. After all, in nearly every other aspect of our lives, we are able to practise autonomy in our decision-making—well, those of us with agency are—so why should we not have self-determination in death if that is our wish and if life has become unbearable?

Yet still, I cannot dismiss my misgivings about my noble and learned friend’s Bill: not religious misgivings—I am afraid I am a collapsed Catholic—but misgivings about the Bill underestimating the coercive factors in society that could affect people at their most vulnerable time, be they personal or financial, and the Bill overestimating people’s ability not to feel a burden on their families and caregivers.

I know that in Clause 11, regulations are to be set out to avoid this happening, but the whole issue of the Bill relying so much on regulations yet to be seen has been rehearsed in the report of the Delegated Powers and Regulatory Reform Committee, which has a point. I worry that we have not yet had time to listen to those professional bodies that are hesitant about the Bill and to ask them about the reliability of a six-month diagnosis. I worry about the lack of learning from other countries where assisted dying is already the law, which provide examples of assisted dying being offered too quickly to those who simply need greater support.

I worry too about the economics of healthcare under the Bill—that assisted dying will be fully funded in our overstretched NHS, while palliative care is only partly funded, as the noble Lord, Lord Stevens of Birmingham, highlighted last week. Choice is squeezed out in such a scenario. I do not wish to see a future where palliative care withers on the vine while assisted dying becomes the default and cheaper option.

Having said all that, the Commons has spoken and sent us the Bill, and it is our responsibility now to take it and make it as workable as possible for our most vulnerable citizens, as seen in the compromise reached between my noble and learned friend Lord Falconer of Thoroton and my noble friend Lady Berger. We have a job to do in the coming months, and the whole country is watching—not something you often hear about your Lordships’ House.

National Health Service: 75th Anniversary

Baroness Crawley Excerpts

Thursday 30th November 2023 Lords Chamber

[Baroness Crawley (Lab)]

My Lords, I too thank my noble friend Lord Hunt of Kings Heath for introducing this debate. Few are more qualified to discuss the significance of the 75th anniversary of the NHS than he is.

It was a sometime Conservative Chancellor who once described the NHS as a “national religion”. It must pain some of my colleagues on the Government Benches to see the extent to which the Government appear to have lost faith in that service and that religion. Anyone who read the recent Autumn Statement could reach no other conclusion. What is the old lyric? “They are only putting in a nickel, but they want a dollar song”.

Let us deal with the realities. As we have heard from noble friends and others in this debate, according to the BMA, some 7.8 million people are currently on NHS waiting lists. Over 3 million of these patients are waiting over 18 weeks. People who can ill afford it are pursuing private health provision instead of risking the long wait, as we saw last weeks in the figures that came out from the eye care sector. There are millions of people living in constant pain and worry, with no immediate alleviation to hand, including older people and their families waiting in bewilderment for dementia diagnosis and support. As a Dementia Friends ambassador, I know that support is so ad hoc and threadbare across different health authorities that the national infrastructure is just not there to implement any future medical advances in Alzheimer’s and dementia. Young people who cannot find peace of mind wait far, far too long for mental health services.

What does the Chancellor say to all this in the Autumn Statement? He says:

“That is why I want the public sector to increase productivity growth by at least half a percent a year—the level at which the size of our state starts to reduce as a proportion of GDP”.—[Official Report, Commons, 22/11/23; col. 328.]


What is he saying? “Let’s not worry about the industrial action of recent times. Let’s not be troubled by the healthcare buildings infected by crumbling RAAC. Let’s not be dismayed about the Government’s vanishing new hospital-building commitments. Let’s not fret about the stresses on beleaguered staff. Let’s just make nurses and doctors work so much harder in order to achieve our ideological goals”. As my noble friend Lord Hunt said, you could not make it up.

I invite the Minister to share this pledge: that nobody, in any part of this country, should ever be treated in a hospital corridor. If that is not a government objective by now, we certainly need a new Government. Meanwhile, I have to agree with Professor Ranger of the Royal College of Nursing when she commented on the Autumn Statement, saying:

“The NHS faces a multi-billion pound deficit—giving away at least £5 billion in tax cuts in place of health spending confirms the NHS is no longer a priority for the government”.


Let those words sink in: “no longer a priority”. A fit for purpose NHS seemingly does not fit with the Government’s ideological scheme of things. Even the NHS Confederation, hardly His Majesty’s Government’s greatest critic, had this to say about the Statement:

“There were no new major funding announcements for healthcare and existing settlements will stay the same in cash terms”.


This is despite the Nuffield Trust estimating that the NHS faces £1.7 billion deficit. Let us face it, a Conservative Secretary of State for Health—and there have been a few—is about as welcome to health professionals at the moment as James Cleverly would be today in Stockton North.

It is, we are told, the Chancellor’s stated goal to boost productivity in the UK—and so say all of us. Can one think of a faster route to increase productivity, as noble Lords have said, than a healthy workforce with few anxieties about seeing a consultant or getting treatment for a loved one?

The NHS is now 75 years old and remains probably our most stirring national achievement, the envy of the free world. This septuagenarian should invite both respect and support—and it does not appear to be getting either from this Government at the moment.

Health: Dementia

Baroness Crawley Excerpts

Monday 5th July 2021 Lords Chamber

[Baroness Crawley (Lab) [V]]

My Lords, is it not the case that there are just not enough diagnostic consultants and memory service nurses to reduce the waiting list that the noble Baroness, Lady Couttie, referred to? Given the number of people with dementia who, sadly, have passed away during Covid, when will the Government change the law to enshrine the rights of care home residents to have family visits?

[Lord Bethell (Con)]

My Lords, the focus on diagnosis is critically important. That is why Challenge on Dementia 2020 set a target of two-thirds of people living with dementia receiving a formal diagnosis. At the end of May 2021, DDRs were 68.8%, compared with 61.7% at the end of April. We are working hard to get these numbers back up, and the £17 million fund which I referred to is one contribution to that. But the noble Baroness is entirely right that this is an important area, and we are focused on it.

Health Protection (Coronavirus, Local COVID-19 Alert Level) (High) (England) Regulations 2020

Baroness Crawley Excerpts

Wednesday 14th October 2020 Lords Chamber

[Baroness Crawley (Lab) [V]]

My Lords, I thank the Minister. While I will support the measure, as I supported my noble friend Lady Thornton, I want to ask the noble Lord a few questions about why we are where we are.

Will the Minister update us on the 25 used test kits mistakenly handed out last night in Selly Oak, Birmingham? More generally, why is test and trace still not running at all effectively, having been launched way back in May? These lockdown restrictions will be of benefit to people only if test results come back quickly, enough people are tested and, if positive, they properly isolate. There needs to be a complete reset on a system that is only marginally useful at best and throws up mistakes such as the possibility of cross-contamination in Selly Oak at worst.

Why is it also, as several noble Lords have said, that financial support for areas in the new high-alert level, especially for the hospitality sector, is still not generous enough to cover people’s needs over the coming months? As my noble friend Lord Hunt said, if we take a city such as Birmingham, the leader of the council, Ian Ward, has said that 135,000 hospitality jobs and livelihoods are now at risk. Without even going into the argument about whether pubs are safer than people’s homes, as far as transmission is concerned, the fact remains that in high-alert level areas, some businesses—indeed, many businesses—and jobs will be lost in the coming months. Can the Minister give some comfort to those people whose jobs, especially in hospitality, are now at risk?

Unless national and local government morph into some 21st-century version of the old East German Stasi, there is no way that people can be continually spied on in their own homes, but the Government can regulate public venues such as pubs and restaurants, which is why, I suspect, hospitality is being targeted. It is a decision to tackle transmission where it can be enforced, but it will still leave many people jobless.

Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations 2020

Baroness Crawley Excerpts

Thursday 3rd September 2020 Lords Chamber

[Baroness Crawley (Lab) [V]]

My Lords, I have a couple of questions arising from these regulations. In asking the Minister, I acknowledge the work that he is undertaking personally in these very challenging times despite his Government’s best efforts to sow chaos and uncertainty all around him.

Can the Minister say a little about the particular support being given to BAME communities during local restrictions and lockdowns, as we are all aware of the disproportionate effect of Covid-19 on these communities? How is clarity and transparency in official communications being addressed when focusing on BAME communities?

In the case of Birmingham, a city that I used to represent and which is now, as he knows, an area of enhanced support—meaning that it is one step away from intervention—does it really make sense for us to see the city’s drive-through testing facility close? I am aware that there are other facilities outside the city boundaries, such as at West Bromwich and Solihull, but this must be the most convenient facility for people to access. Has there been any more progress in looking at alternatives as far as drive-through testing sites in Birmingham are concerned?

Covid-19: Cancelled Medical Operations

Baroness Crawley Excerpts

Wednesday 10th June 2020 Lords Chamber

[Baroness Crawley (Lab) [V]]

My Lords, which NHS trusts, following Sir Simon Stevens’ letter to them of 29 April, have made full use of all contracted independent sector hospital capacity, and will the contract between NHS England and the private healthcare sector be renewed at the end of June?

[Lord Bethell [V]]

The noble Baroness has asked for a very specific figure, which I am afraid I do not have to hand. However, I can assure her that the private healthcare contract has provided us with incredibly valuable surge capacity and we will be looking at how to use that kind of capacity to protect the NHS from a potential surge in the wintertime.

Covid-19: Response

Baroness Crawley Excerpts

Tuesday 19th May 2020 Lords Chamber

[Lord Bethell]

I first pay tribute to the devolved nations for working so closely together, as characterised by the very close work of the four CMOs. The noble and learned Lord is entirely right that different parts of the country move at different paces—the disease does not respect national boundaries in any way—but public health messages have to be clear to be effective. It is difficult to speak in terms of one region or another being in different phases of the disease, but I completely accept his point that local variations may well be necessary. When they are, and if it is possible, we will have to shape our communications to that cause.

[Baroness Crawley (Lab)]

My Lords, if, as the Statement says, we in England are now in the second phase of the fight against coronavirus, and given the need to turn our attention to the huge backlog of operations and procedures for those non-Covid NHS patients on waiting lists, will the Minister inform the House if and when NHS England will renew its current important contract for capacity and diagnostics with independent hospitals? I understand that the contract is coming to a close at the end of June.

[Lord Bethell]

The noble Baroness is entirely right: the backlog of operations and procedures will be a daunting task for the NHS to tackle. We have prioritised it. Simon Stevens has told the NHS to throw the doors open to try to get through this backlog. As a result, we will live with the effects of Covid for months to come. I am not fully aware of the contract of which she speaks, but I will try to find out its status and will write to her with additional information.

NHS: Targets

Baroness Crawley Excerpts

Thursday 6th February 2020 Lords Chamber

[Baroness Crawley (Lab)]

My Lords, it is good to take part in this debate secured by my noble friend Lord Hunt of Kings Heath, whose commitment to and leadership in the NHS is known to us all. I am also delighted to follow the inspirational maiden speech of my noble friend Lady Wilcox, who I think has cheered us all up.

Speeches about the NHS are inevitably a cross between a love letter and a post-it note. The love letter bit is revisiting everything in one’s life that makes one grateful to the NHS, despite all its faults. For me, it is the safe birth of my three beautiful children, two of them twins, born in the brand new John Radcliffe Hospital in Oxford in the 1970s, the restoration to rude health of my husband from leukaemia 10 years ago and my mother’s care in her final years of dementia.

We all have our personal love letter to the NHS, but we also have the post-it note reminder: never to be complacent about this amazing national service; always to hold the Government to account; and to ask the awkward questions, as my noble friend has asked in his debate today, on performance, safe staffing, budgets and future prospects.

This year, 2020, is Florence Nightingale’s bicentenary and has been designated the Year of the Nurse and Midwife by the World Health Organization. In this year, it is right that, in response to the NHS long-term plan, we highlight, as has the Health Foundation, the real difficulty of growing pressure on our services and the widespread pressure of staff shortages.

In our local campaign in Banbury, Oxfordshire, which has been going on for years now, to keep the Horton hospital general and functioning across many departments, time and again the question of not being able to recruit staff—from the UK, Europe or the Commonwealth—has been cited for closing services. How will workplace shortages in both the NHS and the social care system be handled post Brexit under the Government’s new immigration strategy?

When it comes to staff pay, the social care sector in this country, in particular, as noble Lords have said, has nothing to be proud of. We cannot continue to run a care system on the cheap with an ageing population, the rising incidence of dementia and the prospect of AI just around the corner—benign or otherwise.

The excellent House of Lords Library briefing for this debate reminds us of the facts when it comes to the targets spoken of by my noble friend. NHS England’s performance against the four-hour A&E waiting time target in November 2019 was the worst since the figures started being collected in 2010. The 62-day maximum waiting time target between an urgent GP referral and the first cancer treatment was last met, astonishingly, in 2013-14. Also in November 2019, NHS England was below its operational standards for elective referrals, cancer referrals and treatment waiting times. Had those figures been owned by a Labour Government over the past 10 years, the media would have hounded us out of office. All those targets are now under review, and in that review, the House of Commons Public Accounts Committee has called on NHS England not to reduce current standards to make them easier to meet. That is a forlorn hope, I fear, but again we call for it today.

I was proud to be a member of a Labour Government who invested record sums in our NHS and the social care system. However, we did not grasp the issue of long-term social care funding and it is now for the Government to step up and turn the Prime Minister’s rhetoric into the reality of a properly funded NHS and social care system for the future, free from the threat of a trade deal with the United States and free at the point of use well into this century.

Organ Donation (Deemed Consent) Bill

Baroness Crawley Excerpts

2nd reading (Hansard): House of Lords
Friday 23rd November 2018 Lords Chamber

[Baroness Crawley (Lab)]

My Lords, I too congratulate my noble friend Lord Hunt on his important work in bringing the Bill before us today, and of course on his new appointment—we are very proud of him.

In so many ways, the business of politics should be to minimise unnecessary pain and marginalise premature death, as the noble Lord, Lord Lansley, said. According to the latest NHS figures for the year ending March 2018, the total number of patients whose lives were saved or improved by an organ transplant increased by 7% to 5,090, as the noble Lord, Lord Patel, said. It is a mercy that we live in a time when, thanks to science and innovation, sick children can be given new hearts—but really they are old hearts. This is the most wonderful form of recycling we can ever hope to see. Like all good recycling schemes, the more people who get involved and take action and tell their kids about it, the stronger and the healthier our society becomes.

The statistics show that the incidence of every kind of organ transplant is rising, from donors both living and deceased. But hundreds still die every year while waiting on the list, hoping for a donor who does not appear. We are told of the 426 patients who died last year on the waiting list for new organs; of those, 17 were children. There can be nothing more gruesome for their families—all those loved ones who know that the science is in place and the doctors are ready, but the phone never rings. Their souls must be truly sealed up with tears.

Everyone knows a relative or a friend—I certainly do—whose lifespan has been extended by the good will of a fellow human being whom he or she will most likely never meet. The silent solidarity of one particular young man who has bone marrow drawn out of his pelvis so that an older man can defeat blood cancer is the most precious human currency we can ever store. The kidney, the pancreas, the liver, the heart and the lung can all be used more than once. A thousand tons of relief and joy must pour into families every year because of this modern, scientific and miraculous reality.

I congratulate Dan Jarvis and all those from all sides of the House in another place who have pushed so hard to make Max and Keira’s law not merely a step forward but, with this opt-out provision, a turn of the ratchet. The Mirror’s campaigning activity, sustained over several years, is a credit to the editor and the journalists concerned, as well as to all the brave families who told and retold their stories in its pages. Such a sustained campaign has been needed because, although 80% of people said they would be willing to donate their organs when asked last year, only 37% had recorded that decision on the NHS organ donor register. The gap is important.

Finally, as the noble Lord, Lord Patel, mentioned, we are surely all glad that, where in the past there have been cultural and religious inhibitions about post-mortem transplants, that now seems to be something of a losing force. I hope that continues. We have to hope that the whole of England, in all its glorious diversity, absorbs the message of deemed consent and that every community teaches its young that organ donation is one of the highest forms of good.

Sustainability and Transformation Plans

Baroness Crawley Excerpts

Thursday 26th January 2017 Lords Chamber

[Lord O'Shaughnessy]

All 44 sustainability and transformation plans have now been published and are being scrutinised by NHS England, which is helping to ensure that they are as successful as possible. Operational plans will then come forward from April 2017 onwards.

[Baroness Crawley (Lab)]

My Lords, the sustainability and transformation plans have been widely criticised for not yet allowing adequate public or parliamentary scrutiny. Does the Minister agree with me that any future rationing of cancer drug treatment, for example, should receive the public scrutiny it deserves? In particular, will he intervene with NICE and the pharmaceutical company Roche to demand a rethink on the proposal to stop from next week the effective secondary breast cancer drug, Kadcyla, being available to women on the NHS?

[Lord O'Shaughnessy]

On public scrutiny, all the sustainability and transformation plans have had public involvement. They were published and consulted on. I do not recognise the picture that the noble Baroness paints in relation to cancer drugs. This Government created the cancer drugs fund in order specifically to fund innovative cancer drugs and bring them to market more quickly. She will know that decisions on availability and funding of drugs are properly taken by NICE on a clinical basis.