Terminally Ill Adults (End of Life) Bill

Debate between Baroness Finlay of Llandaff and Lord Farmer

Committee stage
Friday 27th February 2026 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

I am coming to my amendments later.

[Lord Farmer (Con)]

I speak in support of amendments on behalf of my noble friend Lady Maclean of Redditch, who unfortunately cannot be in her place at this hour on a Friday afternoon. I refer to Amendments 445, 483A, 495B and 941A. First, Amendment 445 would require the panel to consider signs of fluctuating capacity. That issue has been addressed in previous groups but needs raising again briefly here. As Professor Martin Vernon told the Lords Select Committee,

“fluctuating capacity is an extraordinarily common issue, but none the less somebody may retain capacity at some point during their dementia diagnosis sufficient to make a determination as to whether they wish to end their life”.

As has been stated, about two-thirds of people with dementia have never received a formal diagnosis, so it is incumbent on the panel to consider that possibility and take evidence on whether it could be the case. Given that the co-ordinating doctor is not required to be in the room at the actual moment of administration, fluctuating capacity could raise vital issues of consent.

Amendment 483A probes whether the panels have sufficient powers to gather all necessary evidence to decide on eligibility. It ensures that a panel can refer the patient for any further assessments that it considers necessary. Can the noble and learned Lord who is the sponsor explain why the panel does not sit within the usual tribunal structures, as doing so would give it more expansive powers to request further evidence where necessary? For example, the tribunal procedure rules for the First-tier Tribunal, in the Health, Education and Social Care Chamber, empowers the tribunal without restriction to give direction to matters such as,

“issues on which it requires evidence or submissions … the nature of the evidence or submissions it requires … whether the parties are permitted or required to provide expert evidence, and if so whether the parties must jointly appoint a single expert to provide such evidence … and the time at which any evidence or submissions are to be provided”.

It would be helpful if the Minister could confirm whether the powers given to the panel in Clause 17(4)(d) and (e) are as extensive.

Finally, my noble friend’s connected Amendments 495B and 941A would require the panel to provide a report to the person containing recommendations to address any unmet social and palliative care needs, in addition to determining whether an eligibility certificate should be granted. More fundamentally, these amendments probe what the panel is intended to be. The Bill’s sponsors previously have tried to argue that the panel is akin to a multidisciplinary team. My understanding is that on this point they have been rebuffed. After the noble and learned Lord cited the Association for Palliative Medicine’s Dr Sarah Cox in his defence on 9 January, the APM responded in a letter that the Bill’s sponsor had misrepresented Dr Cox’s position, saying:

“This panel fails to replicate a true multidisciplinary model and essential protection”.


Further, it says that the Bill’s current provisions render

“the panel a mere administrative review, stripping it of the very nuance and human understanding that defines robust, compassionate decision-making at the end of life”.

My noble friend’s amendments are intended to help the noble and learned Lord by providing ways for his panel process to be strengthened so that it operates more like a multidisciplinary team. An important first step would be to expand the panel’s scope so that it includes explicitly the ability to provide assessments of or treatments for unmet health and social care needs. This would enable each panel member to assess, individually and then together, the holistic needs of the patient and contextualise their decision around assisted suicide. My noble friend’s Amendments 495B and 941A build on this and a recommendation of the Royal College of Psychiatrists that the panel should be able to recommend interventions addressing potential drivers of a desire to hasten death, such as depression, social isolation or difficult physical symptoms.

It should be remembered that the Bill does not guarantee that the person will ever have met a psychiatrist or social worker before this stage in the process. We cannot deny the patient the benefit of their holistic experience and expertise in favour of a rubber stamp. My noble friend would also tie her amendments to the sponsor’s commitment to consider a requirement for the co-ordinating and independent doctors, although not the panel, to ask why a person has requested assisted suicide. Ultimately, what is the point of exploring motivation unless the intent is to establish whether drivers can be addressed in another way?

To conclude, the heart of the problem is that, due to the way it was added to the Bill in the other place, the panel process suffers from a fundamental identity crisis. Are the members trying to be a kind of tribunal, or are they designed to be a kind of multidisciplinary team? It would be helpful if the sponsor could enlighten us, because currently they fall short of both.

Covid-19: Social Care Services

Debate between Baroness Finlay of Llandaff and Lord Farmer

Thursday 23rd April 2020 Lords Chamber

[Lord Farmer (Con)]

My Lords, I, too, congratulate the noble Baroness, Lady Wheeler, on initiating this important and well-timed debate. I will speak today about children’s social care and how supporting those on the edge of it can prevent this crisis from being the tipping point when they become looked after by the state. First, however, we should acknowledge the families who are flourishing now that they are no longer in the time famine of normal life, even though money and space are tight. Many children are enjoying being with their fathers, for example.

On those in social care, the Government are consulting on reforms to the use of unregulated care homes which include banning this provision for under-16s and introducing national quality standards. In these strange times, young people currently in such accommodation are out of the sight of social workers and others, who have high case loads. I have heard that these professionals are seeing only the highest-need families face to face. Some have adapted well and are catching up with young people directly, for example through WhatsApp, but such flexibility might be patchy. Can the Minister inform me whether a national assessment has been made of the welfare of those in unregulated accommodation during this crisis?

More broadly, the Government have committed to reviewing the care system. For the system to be sustainable going forwards, this review requires what I call the prevention pipeline. It should establish how we can best prevent, first, children from coming into care in the first place and, secondly, the care system from being a runway into educational underachievement, unemployment, criminality and prison, early parenthood, addiction and poor physical and mental health.

Early family support is essential to prevent children from tipping across care thresholds. Many local authorities have set up family hubs where families with children of any age can access help. I have set up the Family Hubs Network, which has held several virtual round tables with providers, who report that hubs have come into their own in this pandemic. They are offering food, maternity appointments, a rich programme of online family support and more. I understand that the DfE is leading on family hubs, but can the Minister inform me whether and how it is supporting their spread?

[The Deputy Speaker]

I call the noble Baroness, Lady Blower. She is not here. We will move on to the noble Lord, Lord Addington.