Tobacco and Vapes Bill

Baroness Fox of Buckley Excerpts

Report stage
Tuesday 3rd March 2026 Lords Chamber

[Lord Dodds of Duncairn (DUP)]

My Lords, I am grateful to follow the noble Baroness, Lady Ritchie, but say gently to her that Brexit has allowed the UK Government to pursue this legislation. As we have seen in the cases of Denmark and the Irish Republic, both Governments, whatever they might decide to do in the future, are deciding now that they are unable to proceed with this type of legislation because of the tobacco directive. The noble Baroness needs to be careful of the actuality and the legal position that prevails.

Noble Lords who are in favour of this intergenerational ban and are confident that the Windsor Framework does not provide any legal impediment should have no difficulty with these amendments. Amendment 201 in my name and that of the noble Baroness, Lady Hoey, makes it explicit that Section 7A of the European Union (Withdrawal) Act 2018 provides that European Union law is supreme in Northern Ireland. It is a conduit for the implementation of the Windsor Framework protocol. It says that if there is any doubt, the courts must say that UK law will be operative and cannot be set aside by any consideration of Section 7A. There should be no concern that these amendments are trying to impede the implementation of the inter- generational ban. They are trying to ensure that it will happen, despite the Windsor Framework.

I heard the noble Lord, Lord Forbes of Newcastle, talk about the legal opinion of the Tobacco Manufacturers’ Association. I have no doubt that it has produced a legal opinion, but many others have as well. The courts in Northern Ireland have ruled on this as well. We need to be clear that those of us who are concerned about this issue are looking at it from the point of view of ensuring that Northern Ireland does not lose out and that we are not prevented from benefiting from what should be a UK-wide, four-nations approach.

The former Attorney-General of Northern Ireland, John Larkin KC, has said that the Tobacco and Vapes Bill

“serves almost as a textbook example of how a measure advanced by a Government commanding a large majority in the House of Commons can run aground, as respects its Northern Ireland component, on provisions contained in the Windsor Framework … Parliament is simply not free to legislate effectively in those policy areas in which EU law still prevails through the Windsor Framework in Northern Ireland”.

We can look at other examples. On legacy legislation, the courts of Northern Ireland have said that Section 7A of the European Union (Withdrawal) Act means that an Act of Parliament is not just incompatible with the European Convention on Human Rights and therefore needs to be rectified but is actually disapplied and made of nil effect, because of Section 7A and the fact that European law overrides. We have seen it also in the case of migration law.

This is not some kind of novel concept, subtly dreamt up by a few people in the interests of the tobacco industry; this is a real concern about the application of European Union law—in this case, the tobacco directive—that has the potential and almost certainly the effect of disapplying this law for Northern Ireland. Anyone who is concerned about reducing smoking and the effects of smoking in Northern Ireland, where over 2,000 people die every year from illnesses associated with smoking, should be concerned about this issue and should want to do something about it.

The Government are relying on assertion. They keep asserting that this will apply throughout the United Kingdom. We have heard other speakers in this debate just provide assertions but ignore the clear approach that the courts in Northern Ireland have taken on these matters. Why do the Government not publish their advice, as the noble Baroness, Lady Hoey, said? They have published advice in other areas recently, so why do they not publish the advice and let us know what the particular argument is that says, in this particular instance of the tobacco directive, this will not apply in Northern Ireland? There is no logic; there is no analysis by any lawyer that I know of who has looked at this matter and who has dealt with the other cases that have come before the courts of Northern Ireland, and who believes that is the case. So why will the advice not be published?

We are told that this is just a normal age of sale restriction. The fact of the matter, of course, is that it is not just a normal age of sale restriction and therefore exempt; it is a rolling ban, and that cannot be got round. That is why the Irish Republic and Denmark took the position that they did, after getting very serious legal advice from those European Union law experts within their own Governments and the European Commission.

I say very respectfully to noble Lords who have spoken: do not rely on assertions. Do not rely on a view that this will be all right on the night and that there will not be any challenge. The fact of the matter is these things will be challenged. We are trying to build a protection into this Bill that will ensure that Northern Ireland benefits, along with the rest of the United Kingdom, in moving forward with this inter- generational ban. That is entirely reasonable. It is entirely sensible. Why not take the opportunity to ensure that guarantee is in place?

[Baroness Fox of Buckley (Non-Afl)]

My Lords, following on from that very useful contribution from the noble Lord, Lord Dodds, it goes without saying that the amendments in this group on the tensions between the Bill and the Windsor Framework are crucial. I want to commend the noble Baroness, Lady Hoey, for leading on this issue, because she has brought to light something that we need to understand.

It gets to a general concern about the Bill that I have, which is a worry about its workability—legally and when it comes into contact with reality—because I fear a rude awakening. A part of that will be the unintended consequences of the Bill, which a lot of us have tried to draw attention to in Committee and so on. That is why I have added my name to Amendment 206, which calls for periodic reviews of the Act in terms of its operation as well as its effects. I have also tabled my own amendments on the impact of the Act on domestic production and supply chains, which I will discuss later.

Just before I explain why, I am of course glad to see that the Government also recognise the need for a review, and that is very positive. With all due respect to the Minister, I am afraid that Amendment 205 is just not extensive enough. I was particularly disappointed that the consultation is limited to the Welsh Ministers, the Scottish Ministers and the Department of Health in Northern Ireland—what about all those other stakeholders who would be affected and what about the research? I would really urge the noble Baroness, Lady Merron, to incorporate parts of my own amendment and that of the noble Lords, Lord Lansley and Lord Norton of Louth, into her amendment to make it have some substance and not just be written down for the sake of it.

Amendment 206 gives a concrete shape to what should be reviewed. I appreciate its focus on independently conducted research, particularly now that there have been complaints that, “You cannot trust that research because it is by the Tobacco Manufacturers’ Association”. I have similar views when I read research by ASH. The noble Lord who cited it, as though he was a kind of neutral observer, is part of another lobbying group. I would rather have neither as my trustworthy go-to. But I feel that quite a lot of important information is missed if we do not have research, so that is why I like it.

I felt frustrated during our deliberations in Committee that so much information had been overlooked. For example, many neutral academics who have researched the health impacts of vaping, in particular its efficacy in helping people quit smoking and the epidemiology of vaping versus smoking, had been overlooked by the Government. These would be invaluable sources and insights had they been consulted.

In Committee, I also suggested that the Government should look at research coming out of assessing the impact of the single-use vape ban that came into force last June. My amendment was rejected, but, interestingly, early evidence and research, as well as market indicators, show that the majority of adult vapers have transitioned to compliant reusable products. I did not think they would, but they have. That is interesting, because it goes against what I intuitively thought.

However, recent evidence shows that 9% of daily vapers admit purchasing illegal single-use vapes and, more worrying, 15% of former single-use vapers report that they have returned to smoking and/or increased their tobacco use. This sort of research and information is important for us to understand why we need careful monitoring, and with this Bill, we are going to need a lot of careful monitoring.

That is why I commend the amendment from the noble Lord, Lord Lansley, which asks all the right questions to review evidence to discover whether the Act will actually reduce rates of smoking. Will it reduce rates of vaping among young people and children? Will the legislation reduce the use of vaping products for adults? That is not a good outcome, but will that be what happens? What will the economic impact of the law change be on small and micro-businesses? That is something I am really worried about in terms of family-run convenience stores and so on.

The amendment also usefully differentiates between tobacco, nicotine and vape use, which are too frequently in discussions elided without distinction. The suggestion of assessing

“the behavioural responses to the regulatory regimes introduced under this Act”

is key, as the Bill makes a number of suppositions based on the idea that everything in this Bill will have a certain impact on the behaviour of consumers, retailers and other parties. But as this is a novel policy that nobody else has done before, there is no evidence from anywhere else in the world that it will work. We are yet to see whether behaviour will change in the way the Government allege and the supporters of this Bill imagine, so the review will check reality.

My Amendment 207 is more focused on an aspect of the Bill’s impact that we have not really talked about before now. It seeks a structured parliamentary scrutiny of the Act’s practical effects on domestic production, supply chains and market behaviour and enforcement in relation to nicotine products. There is a whole new industry that has grown up domestically around nicotine products, and it is going to be hit by the Bill.

The Bill represents a significant regulatory intervention in a rapidly evolving market. Regulator interventions on this scale can produce structural consequences beyond their primary intent. Often, when Bills are passed, we see problematic effects afterwards, such as compliance costs altering competitive balance, enforcement capacity not being aligned with legislative ambition, lawful operators facing disproportionate burdens and illicit, dodgy suppliers adapting more quickly outside the law than lawful businesses striving and straining to comply with law changes. One area of concern is whether the relatively new, innovative, domestic industry associated with nicotine products will be strangled almost before it gets off the ground.

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[Lord Darzi of Denham (Non-Afl)]

If I have not, then I apologise. I still believe it is not clear on paper. I feel it is the flavour that is being bound, but if the noble Lord’s amendment is correcting that, that is fine. Narrowing the powers before the science is settled is another issue. There is very little scientific evidence on the impact of the taste or whatever the inhaler contains. This has not been utilised before, so we do not know the dangers of the substance that is being inhaled. The prudent course is to retain the widest possible powers and to act on evidence as it emerges. To do otherwise will leave our children exposed to risks we could have prevented. I urge the House to at least look at these amendments or reject them.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I shall be brief, because the noble Lord, Lord Moylan, has explained what his amendment is trying to do. I just want to query whether narrowing the powers before the science is settled is an admirable aspiration. That gives authoritarian power to the Government to do anything they want because there is no science and it is not settled. How is that evidence-based policy? It is the opposite and I think that is very dangerous.

I want to more accurately emphasise that flavours are part of smoking cessation, but I am only going to do that briefly. The reason why I want to do that is to quote ASH, because—guess what?—ASH says that flavours are a very important way in which adults vape and therefore give up smoking. So, for once, I am quoting ASH in a positive way to say that flavours cannot be demonised and we have to be very careful what we wish for.

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I believe that the Government should consider accepting this amendment, which is designed to facilitate good policy-making and mitigate any of the unintended consequences that the powers in the Bill might have on the hospitality industry.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, the explanation for the amendments has been well made. I have added my name to a number of amendments, including Amendments 149 and 151 in the name of the noble Lord, Lord Udny-Lister, which would exclude vapes and nicotine products from prohibitions regarding advertising, and he has explained why.

It is genuinely shocking how many misconceptions there are about vaping and smoking among the public. There is a real job of communication that the Government have an obligation to do. If 50% of adults now believe that vaping is as harmful as smoking, that is not a good thing. If only 30% believe vaping is less harmful, that is not positive.

Conflicting messaging about vaping can discourage smokers from switching to lower-risk products and therefore widen health inequalities—all the things we keep talking about. Misrepresentation is a real problem and I think we have got to tackle it. Banning advertising would reinforce the false perception that vaping is just as harmful as smoking.

As we are coming to the end, I will make my final declaration. As somebody who smoked 40 cigarettes every day for 40 years—can you imagine?—I want to put on record in Hansard that I am grateful to the vaping industry, and particularly to flavoured vapes, because I stopped smoking as a consequence of flavoured vapes. That is what I thought that everybody wanted us smokers to do, only to find that vaping and smoking are being treated as though they are almost the same. I am very keen that we do not do anything that will make vaping less visible or erase it from the public square.

The Government have sort of acknowledged that by allowing public authorities to run mass media campaigns encouraging adults who smoke to “Swap to Stop”. Dare I suggest that official public health adverts, even if they go on TikTok, might be a little bit dry and less appealing than seeing some adverts for vapes in a nightclub? Tens of thousands of people gather for a night out at hospitality venues, so that seems to be something that the Government would want to encourage. Although I know that the amendments do not make the Government do anything, I suggest that it would be very positive if, in venues where you have thousands of adult smokers, they saw adverts for less harmful alternatives to smoking. That is a clever way to encourage switch-and-quit.

That is one of the reasons why I have added my name to Amendment 168 in the names of the noble Lords, Lord Sharpe of Epsom, Lord Brady of Altrincham and Lord Naseby. The emphasis on adverts for vapes and products that do not contain tobacco is well made. It is also important for us to consider the hospitality sector; that has been explained very well. Hospitality venues rely on marketing and sponsorship as part of their income. As I say, it would be a public service, rather than doing anything damaging, to allow them to carry on.

Many of us are worried about the fatal damage that the Bill will do to the retail sector. It seems ridiculous that another industry could be put in jeopardy by the Bill; that would not be good for the Government’s growth strategy. When UKHospitality stresses that the industry has

“absolutely no more capacity to absorb additional costs”,

we should listen. When the CEO of Whitbread, one of the largest hospitality operators in the country, says that the hospitality industry

“finds itself on the receiving end of a series of government interventions which together will significantly hold back our ability to contribute to growth”,

we should listen. We could, rather carelessly, be in a situation where we do not take that into consideration when we bring in some of these advertising restrictions. These amendments are proportionate; they suggest that we should hold back a little and at least organise a consultation.

Another industry that the Bill imperils is the design industry. That is why I have added my name to Amendment 152, which would exempt designers from having committed an offence if they had “reason to suspect” that a design or imagery contains these kinds of products. The problem for designers is that they may be criminalised for designing something that includes products that the Bill is trying to eradicate from the public space. That is a serious attack on artistic freedom. This amendment should be incorporated into the Bill. I do not think that anyone intended for the Bill to criminalise designers—but this is a Bill that will do all sorts of things that were not intended. These amendments are very moderate and allow the Government to hold back the tide of that.

[Lord Strathcarron (Non-Afl)]

My Lords, very briefly, I support Amendment 168 in the name of the noble Lord, Lord Sharpe, and of other noble Lords, because it seems so reasonable. Surely there is no harm done if the advertisement is in a licensed premises; is not visible, except from inside the venue; is not for a tobacco product; mentions a smoke- or vape-free area; and is age-restricted to adults only. I cannot see what there is to object to, unless we are saying that the age restrictions do not work—in which case, why are we pressing ahead with a generational ban in the first place? Do we really want to get into this overreaching, overregulated situation where the compulsory cure is worse than the voluntary disease—one entered into willingly and knowingly by consenting adults?

I particularly support subsection (3) of the proposed new clause. It asks for further investigation into the effects on the hospitality industry, which is already suffering the devastating consequences of other policies. It would be good to hear what losing these marketing revenue streams will mean for those who have to run a business to make a profit in order to employ people, especially bearing in mind that recent policies have cost nearly 100,000 jobs and are responsible for nearly 50% of all job losses.

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The request that I would make is for the Minister to confirm that any designations of premises that are made under the powers in this clause will be based strictly on published evidence of risk to health and not, for example, on the precautionary principle or a desire for regulatory symmetry with tobacco. I beg to move.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I thank the noble Earl, Lord Howe, for introducing those amendments so well and explaining some of the concerns. I am particularly pleased that he brought back the point about artistic freedom because it was very well made.

I will talk more broadly about the amendments in this group, which sum up the dangers of mission creep inherent in the Bill and highlight the pitfalls in allowing the Secretary of State to have such leeway, away from democratic scrutiny, to move the goalposts. Granting Ministers the power to extend smoke-free areas, including outdoors, to include vaping and heated-tobacco use, should not just be nodded through. It would mean the use of secondary legislation to allow the banning of, for example, smoking or vaping outside in the beer garden of a pub and the ring-fencing of whole swathes of outdoor uncovered spaces, such as outside health and social care facilities or education settings.

It is worth remembering that this would mean that for front-line workers, from teachers to care workers, never mind patients or residents, it could be illegal to go and have a vape outside their workplace. Is that reasonable? Is that proportionate? It is one thing for the workplace to designate that they should not, but for the law to intervene is more dangerous. This again, in effect, conflates smoking with vaping, undermining the perception that vaping is relatively safer, as I have endlessly, boringly, repeated.

I want to say something about smokers because, in this relentless bid to banish smoking, there is a danger that we end up demonising smokers—millions of our citizens who can be punished for indulging in a risky but legal habit—and saying that we do not want to see them anywhere in the public sphere. I do not know that this is the kind of society that the Government have in mind. Even Cancer Research UK warns that

“it will be important to consider how to avoid stigma or accidentally risk pushing people into smoking in their homes, which would increase second-hand smoke exposure to those living with them”.

There again are those unintended consequences.

Part of the justification for many of these outdoor bans is the notion of modelling and normalisation theories that are so popular in academia, which say that we need to protect children so that they never see adults smoking or vaping and therefore do not copy them and it is never normalised. I want us to think about what that would mean if that was why we could never have adults vaping outside where children might see them. If we are saying that children might copy adults who vape or smoke, is that not a green light for the state to start seizing children from their parents and leading public health home invasions to rescue children from their vaping parents? I am frightened to say that because it might give the Minister some ideas.

The amendments in this group that I have put my name to are again largely those in the name of the noble Lord, Lord Udny-Lister, because he tabled some brilliant amendments. They seem to me to be entirely proportionate and sensible, seeking to keep the Bill on track and focused on its stated aims instead of being a vehicle for outlandish overreach that is not evidence-based. The arguments in favour of restricting vaping and smoking outside venues seem to hinge on a prohibitionist personal distaste for the habit rather than evidence-based policy.

That is why the issue around passive vaping and the lack of evidence in relation to it is worth highlighting. Cancer Research UK supports the Bill but keeps putting out warnings in its briefings that you must be careful not to go too far. It says:

“Further research is needed to understand the health effects of vaping, however the current evidence does not suggest that breathing in second hand vapour is harmful. Given that evidence indicates that vaping is far less harmful than smoking, it’s likely that second-hand vapour would be less harmful than second-hand smoke”.


Meanwhile, Dr Sarah Jackson, principal research fellow at UCL’s tobacco and alcohol research group, explains:

“Second-hand exposure also differs: smoke comes both from the burning tip of the cigarette and exhaled smoke, whereas e-cigarettes release aerosol only when exhaled, resulting in far lower bystander exposure. Research led by UCL found that people exposed to second-hand vapour absorb around 84% less nicotine than those exposed to second-hand smoke. While not zero, exposure from vaping is far lower than from smoking, and levels of other toxicants are likely to be lower still”.


They are basically saying, “Hold on, keep a sense of proportion”, and that is all that we are talking about here.

I hope that the Government will seek out such voices in their consultation on smoke-free, heated tobacco-free and vape-free places in England, which was announced on the first day of Recess on Friday 13 February. Of course, these free places will be anything but free, as they will deny individuals personal freedoms and impinge on the freedoms of a great many private and public venues.

I urge the Minister and her department to widely and loudly advertise that consultation so that a diverse group of respondents can be encouraged to feed in beyond the usual suspects, NGOs and lobbyists. I especially hope she will encourage the hospitality industry and individual venues to respond because, as we have already heard, the hospitality industry is under the cosh.

The British Institute of Innkeeping has warned that 62% of its members fear that these kinds of bans will negatively impact their trade and 20% believe it would lead to the closure of their pubs. Sometimes when we discuss issues in the Bill, we view all aspects of society only through the prism of public health. It can be a rather joyless, arid and sanitised version of “The Good Life”, in my opinion. For those unfamiliar with the world of pubs, pub gardens, nightclubs, or eating or music venues, overregulation will kill them off; it will kill off the atmosphere, never mind kill them off financially.

The truth is that if one looks at the research, 49% of regular pub-goers are smokers—shock horror—even though smokers account for less than 15% of the UK population. More and more, of course, are vapers. That is not a crime nor a problem. Funnily enough, a lot of people who go to pubs also like to have a drink. Yet, bizarrely, they are in trouble for that too. Many in hospitality worry that the Bill will be used as a blueprint for alcohol, as well as anything else. Indeed, the Department of Health is considering preventing under-18s from purchasing no-alcohol or alcohol-free drinks in pubs, because they say it would encourage alcohol uptake in the future. Then there is a discussion about adding health warnings and imagery and plain packaging to alcohol bottles.

It is no wonder that all those different hospitality organisations that the noble Lord, Lord Sharpe, quoted are saying that they are worried about the impact of the Bill and its provisions on trade, customers’ behaviour and operating costs. To be honest, it is no wonder that many publicans have banned Labour MPs from their locals, if one considers everything that has been added on.

Presently, hospitality venues put up their own restrictions. In other words, they ban people they do not want; they have rules. That is because they deal with their clientele with absolute common sense. But there is a fear that such proportionate self-regulation by the sensible people who run the hospitality industry in this country will be trampled on by the Bill.

Finally, sadly, trusting small SMEs in hospitality to act responsibly is not a feature of Amendment 199 in the names of the noble Baronesses, Lady Northover and Lady Walmsley. It seems apt to note, in my final speech on this Bill, how shocked I am—shocked, I tell you—that the Liberal Democrat Benches are neither liberal nor democratic on this issue. Through Amendment 199, they want to inveigle local councils into compliance by using this law to issue future pavement licences only as smoke-free. So much for localism, encouraging a thriving high street or cafe society, or supporting local autonomy. It is a step too far; I think a few things are, but that really is the limit. I hope the Minister can reassure me that the Government are not as illiberal as the Liberal Democrats. I will not necessarily hold my breath.

[Lord Udny-Lister (Con)]

My Lords, it is really hard to follow the noble Baroness, Lady Fox, when she gives a speech like that. Amendments 193, 194, 197 and 198 hope to address the powers to designate vape-free and heated tobacco-free places. The argument, really, is that it is all a bit over the top. There is limited evidence of harm from passive vaping compared with that of inhaling second-hand smoke. It is my fear that, as currently drafted, the Bill could inadvertently force ex-smokers to have relapses if they are using alternatives alongside smokers. That is what is going to happen. They are all going to be pushed into the same area, and that, I suggest, is the worst of all outcomes.

I further push the point that age-gated venues should be able to retain the discretion that they already have. Our hospitality and pub sectors need these safeguards.

Of course I agree with everybody that we must protect children but, in doing so, we must not inadvertently drive adults back to cigarettes and destroy our pubs in the process. That, I am afraid, is exactly what we run the risk of doing.

Tobacco and Vapes Bill

Baroness Fox of Buckley Excerpts

Report stage
Tuesday 24th February 2026 Lords Chamber

[Lord Udny-Lister (Con)]

My Lords, the purpose of my amendment to Clause 10 is simply to ensure that heated tobacco products are explicitly addressed within the age of sale framework. I am strongly of the view that, when Parliament seeks to regulate a product, it must define it clearly. As other noble Lords have repeatedly mentioned, there is still a high level of inconsistency and ambiguity in this Bill, which renders it fundamentally flawed unless many of these amendments are supported over the next few days. Both retailers and trading standards officers require certainty when it comes to product classification, and a clear statutory definition would avoid later confusion, reduce the overall risk of litigation and strengthen accountability, which must remain the overriding purpose of this Bill if it is to stand any chance of delivering what I believe is the Government’s intended result. In the interest of making the Bill workable on the ground, I hope that this minor change will have your Lordships’ support.

My amendment to Clause 11 mirrors the approach that I have taken concerning Clause 10. I am again asking for consistency so that, where vaping products are referenced, heated tobacco products are dealt with explicitly. We cannot pass legislation through this House where there is ambiguity. I fear that, if these points are ignored, the Bill will lack the clarity required to make it practically enforceable. As such, we in this House will be placing a grave, unfair burden upon those in enforcement. Furthermore, we will be creating unfairness for compliant businesses, which comes with the not inconceivable risk of pushing retailers towards the temptation of rogue and illicit trading. We need to legislate coherently across product categories rather than allow voids to undermine the objectives that the Government are seeking to achieve.

I will speak now to Amendments 87, 89, 90, 101, 113, 189 and 190 in my name. I wish to ensure that the phrase “or consumed in any other way” is removed and that a clear definition of heated tobacco is inserted. It is important to note that heated tobacco does not burn tobacco; it heats it. This is important as evidence indicates lower toxicant exposure compared with that of most cigarettes. If future adult access is to be prohibited, this decision must be based on proper assessment and evidence, which is lacking at this time. The purpose of Amendments 189 and 190 specifically is simply to insert some precision into the Bill. These amendments replace “consumed” with “smoked” and remove reference to heated tobacco devices. I put it to your Lordships that “consumed” is excessively broad. Through slightly better drafting, we can protect businesses, enable better enforcement and protect the courts from uncertainty. I beg to move.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I commend the noble Lord, Lord Udny-Lister, for helping to differentiate products and for having some precision in the way we discuss these issues. I have been concerned throughout about a one-size-fits-all approach. I do not think it helps anyone. It certainly does not help in relation to health, let alone retailers and so on, as has been described.

Heated tobacco should not be conflated with vapes, but it should also not be conflated with smoking cigarettes or tobacco in that sense. As the noble Lord explained, heated tobacco products are heated, not combusted. That means that, although they might have some degree of harm, there is a body of evidence that shows that there is a huge reduction in harmful products from heating tobacco rather than smoking tobacco. This matters to me because a lot of people use heated tobacco as a smoking cessation tool, as a form of giving up smoking.

When I have raised issues concerning the evidence on heated tobacco, I have been told that the problem with that evidence is that it is based on research produced by the tobacco industry rather than by independent researchers. I point out that, none the less, it is scientific evidence and can be tested as such, whoever pays for it. But if there is some concern about the evidence, I encourage the Government to consider how they can fund research into the very different types of product we are talking about, rather than simply dismissing any evidence they do not like the look of because of who funds it. We need to have a sense of proportion and should not treat all products the same. As I say, I therefore reject the one-size-fits-all approach. We will have much better legislation if these things are clarified on the face of the Bill and we all know what we are talking about, and do not just lump things under the single heading of “harmful and dangerous”.

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[Lord Udny-Lister (Con)]

I shall talk about the two amendments in my name. First, the Bill does not provide a deterrent; the proposed fixed penalty of £200 is nothing to those involved in this illicit trading and organised criminal activity. It is obvious that the unscrupulous retailers will simply absorb the costs and just continue with what they are doing.

It is worth mentioning at this point—and I have seen this—that when people are selling illegal tobacco it is not under the counter. You can have a nice card with all the different brands laid out for you to pick and choose from. It is very professional: a serious bit of criminality out there. I might add that I do not smoke, but I have seen it with others. That is why I am seeking through this amendment support to introduce a stepped penalty regime, escalating for repeat offenders and enabling referral to national and enforcement bodies where organised criminality may be involved. If we want to stand any chance of cutting down this illicit trade and the sale of tobacco and vapes, enforcement must have real teeth. Without a stepped penalty regime and referral powers, the Bill and the generational ban will be nothing more than symbolic.

Amendment 63 is on the points I have just made about having a more robust and stepped approach to penalty notices. I want to strengthen enforcement further by introducing a new statutory referral duty where a fixed penalty notice is issued. If the Bill does not confront the organised criminal network, it will just continue. We want local authorities to issue fixed penalties, and then to refer the matter to the National Crime Agency and relevant police forces and to share intelligence, which is key. It is further my intention that this amendment place a statutory duty on the NCA and police to investigate whether organised crime, excise or VAT evasion is at scale or other serious offences are involved.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I wanted to speak to two amendments in this group that are about the opposite ends of the retail spectrum. On the one hand, there are law-abiding shopkeepers who need to be given a certain leeway if they mess up at the start of this legislation. At the other end of the spectrum are those open lawbreakers who hide in plain sight.

I added my name to Amendment 63 in the name of the noble Lord, Lord Udny-Lister, which is about giving relevant authorities the discretion to issue a warning notice to first-time offenders. Because this is totally novel and internationally unique legislation, enforcement will be important; but because this is a bit of an experiment, some leeway has to be given to allow it to settle in without criminalising people unnecessarily.

Fixed penalty notices are precisely designed to enable offenders to avoid criminal prosecution and reduce the burden on the courts. That is how they are usually used. I am just worried about the overcriminalisation of shopkeepers via this Bill; it is important to be proportionate and allow that discretion. Allowing trading standards officers to issue warnings to first-time offenders would promote the idea that shopkeepers can learn what the rules are and find out that they have had their warning. I am sure that many initial breaches are likely to be unintentional, and a warning will help a business to understand the rules and allow them not to repeat the mistake, and so on. Therefore, fines are reserved for repeat or serious offences; that is an important way in which to approach this.

In relation to an earlier amendment about communicating what the Bill will do, although I do not necessarily agree with it, it is obviously important that people understand the implications of the Bill when it becomes law. If it passes, which it will, there will have to be quite a steep learning curve for all sorts of different parts of society.

I want to draw attention to something called Local Vape Action, which has just been launched in Maidstone in Kent. It is a local partnership involving retail shops working with the local community and doing education, engagement and enforcement. There are initiatives happening locally where people are trying to say, “We are the good guys; we are the people who are compliant; we’re trying to keep to the rules”. They are trying, for example, to improve the appearance of high streets, making sure that legitimate vape retailers—not the ones that the noble Lord, Lord Moylan, described—want to take some responsibility for not being the rogue traders. I think that is to be commended.

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[Baroness Merron (Lab)]

My Lords, this has been a helpful debate on an issue that concerns us all in this Chamber.

On Amendment 17 tabled by the noble Lord, Lord Moylan, I agree with his desire to take robust action against counterfeit products—I am sure we all do—but I cannot accept the amendment simply because I do not believe it is necessary, not because of specific objections. I heard his invitation for me to continue as I started, but, unfortunately, I cannot do so for this amendment. We believe it is not necessary, as referred to by the noble Baroness, Lady Northover, because protections against trademark infringement are already a matter for existing legislation.

On the point about necessary legislation addressing counterfeit products, which I accept, I say to the noble Lord and the noble Baroness, Lady Fox, that the Trade Marks Act 1994, as we have heard, already provides significant penalties for breaching these rules. They include: on summary conviction, imprisonment for a term not exceeding six months or a fine not exceeding the statutory maximum, or both; or, on conviction on indictment, a fine or imprisonment for a term not exceeding 10 years, or both. These are significant penalties.

[Baroness Fox of Buckley (Non-Afl)]

In terms of duplication, I argued on the Crime and Policing Bill that it was probably not necessary to legislate for assaulting a shop worker to be against the law, as assaulting anyone is. I asked why there was a specific point about shop and retail workers and was told that this would make a special case of shop workers to emphasise their vulnerability. The point about duplicating laws has never held the Government back before, because they keep doing it.

[Baroness Merron (Lab)]

I must admit that I have a different view. Where we already have legislation covering the specific points we are talking about, as we have here with the Trade Marks Act 1994, there is no reason to go further. The legislation is already working. It is fair to raise the example that the noble Baroness gave, but I do not share her view on that duplication, as it was important specifically to identify shop workers. Maybe we just need to disagree on the duplication or otherwise of legislation.

While trademark protection is not a matter for the Bill, powers in Part 5 will enable the Government to introduce regulations relating to packaging, product safety and product registration. Those who breach these regulations following their implementation may face significant penalties of up to two years’ imprisonment, a fine or both. The penalties broadly mirror the penalties provided by the noble Lord’s amendment, albeit I accept he proposes a slightly higher maximum term of imprisonment of three years instead of two.

The noble Lord, Lord Moylan, raised legitimate points about the scale of the illicit market and also potential connections to other illegal activities. On that point, HMRC and Border Force’s joint illicit tobacco strategy sets out the continued commitment to tackle and disrupt the organised crime groups behind the illicit tobacco trade, a commitment supported by over £100 million of new funding.

Tobacco and Vapes Bill

Baroness Fox of Buckley Excerpts

Report stage
Tuesday 24th February 2026 Lords Chamber

[Baroness Gerada (CB)]

My Lords, I am also against these amendments. I will disclose a conflict of interest: I started smoking when I was 16—and 33 years later, like many of us who start to smoke at that age, because it is a childhood disease, I gave up.

We know and have heard about all the health effects of smoking, but we also have to realise that smoking is an easy addiction to start. I have looked after every addiction—heroin, cocaine, alcohol—and smoking is the easiest. You need only two cigarettes for 80% of people to be addicted, like me, for 33 years, and many people, like me, try to give up.

It is not just addiction that is the problem. It is not even about death, although death is a bad outcome to have. It is also about all the other complications. Like many smokers, I have lost many of my teeth. Our eyesight goes. We have skin problems. Smoking causes all sorts of things.

As a GP for nearly 30 years, I am pleased that I have seen a massive reduction in people with smoking-related diseases. My surgeries used to be full of what we call blue bloaters and pink puffers and full of people with premature heart disease. It is not an accident that I no longer see that in my consulting room; it is because of the hard work of our Chief Medical Officers, the Department of Health, ASH and many others to stop normalising smoking.

On the issue of the black market, there is of course a price differential. Wherever there is a price differential you will get a black market, whether it is diesel, cigarettes, alcohol or whatever. But the Bill is about stopping people starting—as the noble Lord said, preventing the next generation that has not even been born from starting. We have to focus on prevention, which is what the Bill is about.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, the noble Lord, Lord Rennard, called this a world-leading policy. It is world-leading, because no one else in the world has chosen this policy. One wants to know why. At least the noble Lord, Lord Stevens of Birmingham, admitted that this was novel and therefore untested. Can we at least have a little humility by admitting that the Bill is an experiment? It is a risk.

How you do age verification, as rather wittily described by the noble Lord, Lord Clarke of Nottingham, is a bit untested. How will we cope with the 84 year-old versus the 85 year-old—will there be a scrap? It is said that it is not going to happen for many years, but I thought the idea of legislators was that you were meant to think about the future, not just tomorrow, and the long- term implications of policies that pass.

Let us be honest: there is no good practice to copy with this Bill. There is no evidence about exactly how it will work or whether it will work. The claims on its behalf are largely based on modelling and speculation, and that is not evidence; it is not scientific. Therefore, the moral high ground and the sense of certainty deployed by those who are enthusiastic about the Bill, and the disdain towards those of us who are sceptical about it, are just a little misplaced.

I therefore request that, as we go through the very short Report stage, because a lot of us have been through a longer Committee stage, we are honest about things such as cost-benefit analysis—what is lost, what is gained—and, rather than moral righteousness, consider whether this is actually fit for purpose, even the purpose of those people who are putting the Bill forward. Whatever the intentions of those promoting the Bill, many of the clauses in it are counterproductive.

I know we are not on this section yet, but as an ex-smoker who started vaping, I am utterly distraught that we now have a Bill that, to all intents and purposes, treats vaping and tobacco as interchangeable, despite a denial by the Government. I do not think that there will be the health gain that is claimed.

My final point at this time—because I will be back —is that it is a little rich to sneer about freedom. Saying the word “libertarian” gives certain people a thrill; they can feel as though they are morally virtuous. I do not consider myself to be a libertarian, despite what Wikipedia says. However, I fully embrace living in a free society. I do not think that freedom is something I should be embarrassed about, nor that saying that people should be given choices about their lifestyles makes you to the right of Genghis Khan, or whatever it is that people are implying—or, worse, in the pay of big tobacco, which is the inference of many of the contributions. At some stage relatively soon, lots of adults—the 84 and 85 year-olds, because these kids do grow up to be adults—will be denied a choice. This Bill affects adults.

People can make choices about whether they take risks in their health. I suspect that practically everyone I know is using those weight-loss injections. To me they are a bit risky—I think, “Are they safe?”—but I am not mounting a campaign yet, because half this House would be out. People say it is worth the risk. A lot of people do daft things such as going skiing—mad; too risky for me. There are all sorts of things. People have been known to have the odd extra pint or eat the odd greasy breakfast. People take risks and make choices about their health all the time.

I do not want more people to smoke, but I also think that, in a free society, we have to give a certain degree of room for people to make choices—even the wrong choices. We live in a free society. Deciding the right and wrong choice is what happens in authoritarian regimes, but in a free society we say, “I don’t think you should do that, but I’m not necessarily going to legislate so that you can’t do everything I personally disapprove of”. We should not even say, “You shouldn’t do that, because I know best for your health what you should and shouldn’t do”. In medical ethics, there are times when you go to your doctor, who says, “Take this”, and you say, “I decline to take that medication; I do not want that intervention”. In a free society, a doctor cannot force you to do what you do not want to do—even the virtuous health professional who we are all meant to revere.

As we carry on this Report stage, can we all show a bit of humility? Living in a free society puts before us difficult moral decisions. There is no necessarily right or wrong. We are allowed to scrutinise a Bill that is put before us without being accused of somehow being evil because we do not go along with the Bill. Just because the Conservative Government, when they were in, and the Labour Government now agree—if that is the basis on which we should not scrutinise, we might as well all go home. I am sad to say that, for some of us, the Conservative Party has had far too much agreement with the Labour Party over recent decades.

[Lord Brady of Altrincham (Con)]

I am a Conservative Member who, in the other House, voted against this proposition. Does the noble Baroness not share my concern that one of the unspoken nonsenses of this legislation is that far too many young people are already choosing to smoke cannabis, instead of cigarettes that they might legally obtain? That proves that, however we try to legislate or regulate this market, people will do what they choose to do. Virtually no effort is made to clamp down on the illegal smoking of cannabis.

[Baroness Fox of Buckley (Non-Afl)]

I am allowed to come back on that. All I want to say is that I do not want it to go down in Hansard that I am such a libertarian that I support the smoking of cannabis: I am not Zack Polanski. It is also the case that we have to think of the unintended consequences and the real world and real young people, rather than imaginary ones.

--- Later in debate ---

[Lord Udny-Lister (Con)]

I will briefly speak to Amendment 26, which is in my name, about the cost implications for small retailers and convenience stores. It is really a plea to the Minister to make some money available and introduce a grant system which can assist them. Age-verification technology is not cheap. They need to invest in a robust IT system. We need to build up a market for age verification. We also need one that protects consumers’ data and strengthens enforcement without penalising shopkeepers.

I think we all acknowledge that small shopkeepers are already in difficulty; it is not an easy time for them. We should look at anything we can do to help, and I think this would help. A simple act such as this would make it that much easier to ask the difficult question about age verification.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I half support Amendment 26. I would also like to congratulate the noble Lord, Lord Moylan.

The introduction of this regressive and untested generational ban on tobacco sales obviously raises the thorny issue of how it will be implemented in terms of retailers checking ages. Following the discussion on the first group, it is worth noting that this is very different from standardised age checks, which we already have, where there can be challenges at 18 or 21 and over.

I would like to quote Trading Standards Wales, which described it as creating

“a two-tier age system for tobacco whereby someone born in 2008 would be legally able to purchase tobacco products whilst someone born in 2009 would not”.

It seems that, for this Bill to work in its own terms, enforcement is key, but it is not clear how that will be practical. Again, to quote Trading Standards Wales:

“Having a two-tier age system means that young people could still obtain cigarettes from older friends or family members that smoke and, it is unlikely that any parties would report each other to the authorities as both would face legal consequences in doing so”.

--- Later in debate ---

[Baroness Bennett of Manor Castle (GP)]

My Lords, I rise to welcome government Amendments 14 and 15, and I look forward to hearing from the Minister. I will not go through them in detail, as I am sure she will, but I note that this is a lovely practical example, and all credit to the Government that their campaigning has worked. We heard in Committee from both Action on Smoking and Health and the Mental Health and Smoking Partnership about the need for an exemption in in-patient mental health settings for vaping vending machines. The Government have clearly listened, and this is an example of how this all should work, so let us applaud and highlight that.

I support Amendment 16, which the noble Earl, Lord Russell, has just introduced. The ban on disposable vapes is clearly being widely, almost universally, got around. The noble Earl spoke about producer responsibility. Well, we have a profoundly irresponsible industry that is behaving in ways that have serious health and environmental impacts. I spent most of this afternoon hosting an event for the National Association of Local Councils. As soon as I said I was leaving to do the Tobacco and Vapes Bill, the reaction was, “Waste!” That is understandable. Let us look at some figures from Biffa on three recycling facilities, in Suffolk, Teesside and London. Before the ban on single-use vapes came in, they saw an average of 200,000 vapes mixed in with general waste; after the ban came in, that went up by about 3%. There was perhaps a rush of material being sold in that immediate period, but from everything we are hearing, the waste problem is still enormous, and the risk of these lithium batteries exploding and catching fire in waste lorries and recycling centres is absolutely enormous.

We need more action on public health, too. I spoke to a young person today who said, “Well, I’m a bit confused about how vaping relates to health and cigarettes”. Young people are not getting a clear message, and they are being sold these things everywhere. This amendment is saying we need to keep a watch on this and be ready to catch whatever the industry does next, because we know big tobacco is profoundly irresponsible. As the noble Earl said, this is perhaps not the exact way to do it, but we need to make sure we hear from the Government that they are prepared to take action against big tobacco at any time.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I, too, warmly welcome government Amendments 14 and 15, which create an exemption for vape vending machines in mental health hospitals. This was really good to see: it is a humane step and will be very beneficial to patients. It proves that the Government can listen and amend, and I hope there might be more listening and amending, and exemptions, even at this late Report stage. It makes our debates feel as though they can get somewhere. This was an important concession for the Government to make, so I am really pleased to see that.

I have grave concerns about Amendment 7 in the names of the noble Earl, Lord Russell, and the noble Baroness, Lady Walmsley. There is a real danger here that we end up seeing this Bill as a vehicle for a relentless attack on anything to do with nicotine. Unless I am much mistaken, the Bill does not intend—even though this is its effect—to treat all nicotine products in an undifferentiated way. It is aware of Cancer Research’s statement that vaping is “far less harmful” than tobacco and is the most popular tool to help people quit smoking.

But, following on from the remarks of the noble Earl, Lord Russell, I do not want to say simply that vaping can be considered positive only if it is used as a smoking cessation tool, because people will then undoubtedly—and they do undoubtedly—vape as a recreational habit. Is the Government’s aim, or this amendment’s aim, to tackle dependence on any substance whatever? Nicotine is the one that is named, but will caffeine be next? Where do we draw the line? As far as I am concerned, that should not be what this Bill tries to do.

I worry that this will lead to mission creep in the Bill, which will create a kind of pre-crime. I listened to the noble Baroness and I do not think that we should have a moral panic about vaping: that is the main thing. It is not appropriate for this Bill to start doing a pre-crime anticipation of all the things that might or might not go wrong in relation to vaping. That would be a disastrous outcome of this Bill. So I urge the noble Baroness to avoid the siren voices of those urging her to take it even further down the line of prohibition. I urge her to hold firm to the notion that, although there will be some suggested regulation of vaping, we should not and must not make vaping indistinguishable from tobacco in the public’s eye by treating them as equally problematic through the course of the Bill.

[Baroness Northover (LD)]

I very much support my noble friend Lord Russell’s amendments, which seek to address the abuse of vapes and other nicotine products. When you go into any local shop or see adverts, you must mentally think that those promoting these should hang their heads in shame. I mentioned in Committee the example from my own extended family, where vaping has been the route for teenage relatives to become addicted to nicotine and, from there, to smoking. So I fully support everything that we are doing to reduce nicotine dependency, and I support my noble friend’s amendments here.

Despite that, we welcome the Government’s amendments that create an exemption for mental health settings, allowing the continued use of vape vending machines. Written evidence submitted to the Bill Committee by, for example, the Cambridgeshire and Peterborough NHS Foundation Trust and others made it clear that vape vending machines located in mental health wards are currently a crucial part of delivering effective smoking cessation services. Several trusts using these machines have reported that they provide a safe and straightforward way of ensuring that patients can access vapes when they need them. It is therefore welcome that the Government have listened to this evidence and made this concession.

In England, vapes are now the most commonly used smoking cessation aid, and it is awful that they have been exploited for other purposes. Nevertheless, vaping is recommended by NICE as the first-line smoking cessation tool and is more effective than traditional nicotine replacement therapies. Smoking prevalence in in-patient mental health settings remains extremely high, with estimates of about 50% overall and some studies reporting rates as high as 80% in individual hospitals, so I see why the Government have decided to take this particular measure forward.

Although it is technically possible for vending machines to be stocked with other forms of nicotine replacement therapy, this would not reflect patient preference, and we need to be guided by what works to support smokers to quit. As my noble friend Lord Russell said, that is what vapes should be about. The risks associated with proxy purchasing would seem to be low, particularly in closed wards, but I would be interested to hear from the Minister further on this point and to have clarification on how she envisages these machines operating within the new licensing scheme.

Therefore, although we accept the Government’s amendments in relation to mental health settings, we think that they need to do more to tackle the awful spread of nicotine addiction that we now see among young people. I look forward to the Minister’s response.

Terminally Ill Adults (End of Life) Bill

Baroness Fox of Buckley Excerpts

Committee stage
Friday 6th February 2026 Lords Chamber

[Lord Empey (UUP)]

My Lords, I will speak to Amendment 89. I think that everybody in the Committee is more or less on the same page in what we are trying to achieve here. This amendment would add,

“or withdrawing medication, hydration, or life-sustaining devices”

to Clause 2(2). This has perhaps been forgotten about, but people sometimes rely on ventilators and other equipment to sustain their lives, so it is not a big leap forward to add this to the legislation. It is simple and straightforward, and amending Clause 2(2) seems to make sense. I cannot think of any reason why the noble and learned Lord should not adopt the amendment as a sensible way forward. It indicates—we have had this conversation a number of times, but we have to bear it in mind—that there are still significant weaknesses. We have to make the Bill safe.

On the hostile reaction to what we are trying to do here, I gently remind the Committee that when we last discussed this subject on 22 October 2021, at the Second Reading of the Assisted Dying Bill that Baroness Meacher brought forward, her Private Member’s Bill had 10 pages and 13 clauses. The Bill before us has 51 pages and 59 clauses. People have to understand that this is a massive Private Member’s Bill and is not normal in terms of how we deal with such Bills—it is much bigger. With that, I hope that the noble and learned Lord will have no difficulty in accepting Amendment 89.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I will speak to my Amendment 103. I thank the noble Baroness, Lady Hollins, for adding her name to it. It is a modest amendment simply seeking to ensure that a person is not categorised as terminally ill if they have refused life-saving treatment because they are influenced by a mental disorder. The noble Baroness, Lady Keeley, was perceptive in addressing some of the issues that concern me and are why I tabled this amendment.

We are talking about any individual who, in effect, voluntarily brings themselves within the definition of terminal illness as defined in the Bill. As we heard on the previous group, supporters of the Bill often present the six-month prognosis as clear-cut and argue that we all know what we mean by terminal illness. In public discussions, the example given is usually cancer, which again seems fairly clear-cut. But we heard on the previous group that life and death and diseases are rather more complicated. The noble Lord, Lord Moylan, raised some very thought-provoking issues around that.

I want to make a bit more concrete what terminal illness would mean in the examples that I talk about. I have noted that the noble Baroness, Lady Coffey, started this theme in the previous group, and I was very affected by the moving speech made by the noble Lord, Lord Farmer, which also pertains to this. Where someone suffers a serious depressive episode, perhaps related to a debilitating physical illness that is difficult but none the less treatable, what would happen if, in a temporary period of despair, they refuse treatments such as dialysis or HIV antivirals, therefore potentially leading them to a terminally ill prognosis? Would they be eligible for assisted death in that instance?

Or let us take the case of a suicidal person, perhaps a prisoner suffering mental distress, who has attempted to take his own life several times before but suicide prevention policies have saved him. I think in particular of prisoners I have long campaigned for who are on IPP sentences. Tragically, suicide figures among that group of prisoners are very high and suicidal ideation is a real factor for those prisoners. Our imagined prisoner is not just mentally disturbed but physically dependent on insulin for diabetes and needs to take it to remain alive. If that person refuses to take that treatment and becomes seriously ill, bringing upon himself the inevitability of having a progressive disease and it becoming terminal, would he be eligible for assisted death under this Bill?

This example would seem to contradict the slogan of many of the Bill’s supporters, which we frequently hear: “They’re dying anyway”. As it happens, it is a phrase that I find particularly chilling, but, in this instance, they would not be “dying anyway”; they would be dying in a self-induced way. How will the idea of terminal illness in such instances be weighed up? In the case of our IPP prisoner refusing to take treatment such as insulin—perhaps even refusing to eat or drink—this could lead to an inevitable assisted death, because he would meet the physical criteria of terminal illness when, actually, the root cause was not inevitably progressive.

I like to imagine that we as parliamentarians, along with campaigners, will be successful in ensuring that IPP prisoners are freed from the hopelessness of an abolished prison sentence that psychiatrists uniformly and consistently say is a major factor in making people suffer mental illness in prison. If the IPP was ended, that prisoner could resume their medical treatment and their mental ill-health would have changed because the social circumstances would have changed. Therefore, they could resume their treatment, start engaging again, feel that they have a reason to live and become treatable, with recovery possible—but not if it is too late as they have already had an assisted death. In other words, terminal prognosis is not inevitable in that instance but self-induced, driven by a disturbance of the mind.

The noble and learned Lord, Lord Falconer, has some insight into the issues in this amendment, as he has explained. He has tabled an amendment and talked about any disease caused by a person not eating or drinking when that occurs as a result of mental disorder. Obviously, the focus there is on anorexia and eating disorders, but is this not a similar example?

I raise these issues because this is a loophole that has been nagging at me. I cannot see anywhere in the Bill where safeguards exist to prevent such undoubted unintended outcomes. Without those safeguards, the drafting of the Bill could inadvertently incentivise self-destructive choices about treatments for illnesses that are treatable, and lead to irreversible early death facilitated by state medical services when life-saving medical treatments could have ensured that people lived and were not categorised as terminally ill. It is this confusion—about who defines terminal if you put yourself into that category—that I would like the noble and learned Lord to reassure me about and clarify.

--- Later in debate ---

[Baroness Hayman (CB)]

My Lords, the noble Lord says that we should understand the ordinary meaning of words, and I agree with him. I must say to him, however, that my own mother—who turned her face to the door and stopped eating and drinking—did not commit suicide. We did not feel that. She was at the end of her life, she was terminally ill and she decided that she had had enough. She did not want the next blood transfusion, and she did not want any more time. I find it really offensive to be told that she committed suicide.

[Baroness Fox of Buckley (Non-Afl)]

I also want to respond to the noble Baroness, Lady Gerada. Words do matter, which is why plain speaking matters. Being told that you cannot say certain words because they might offend someone is unhelpful. Can the noble Baronesses respond to the fact that, in opinion polling, if people are asked whether they support assisted dying, many will say yes? If they are asked whether they support assisted suicide, they say no. In other words, calling something what it is—namely, suicide—is not necessarily something that the noble Baronesses should be frightened of. They cannot instruct us as legislators to do the job of spin doctors in trying to make something more palatable by using kind words. We have to be honest with the public and then they will decide; it is up to them.

[Baroness Whitaker (Lab)]

Does the noble Baroness, Lady Gerada, agree that the cardinal difference between suicide and voluntary assisted death is that voluntary assisted death applies to people who are already dying? There is no way that they are going to survive, and that seems to make the whole difference. What we seek in this Bill—and I very much support the safeguard proposed by my noble and learned friend in Amendment 87—is that the process of dying should be free from terror, pain and humiliation. It will not stop the person dying. Therefore, it is not suicide.

--- Later in debate ---

[Baroness Smith of Newnham (LD)]

I can see a point to that, but the message I was given by the mental health practitioner who rang me from the mental health team—I think he was a psychiatrist—was basically that once somebody is in a home, these tests become much more difficult because of the nature of the environment. That may differ from home to home—and yes, when my father had pneumonia and was clearly delirious, he was at home. If there are concerns, we should surely make sure, if people have a cognitive impairment, that we know that is the case, but if somebody does not—if there are the short-term issues that are being discussed in the amendments, in particular Amendments 111 and 112—then surely those people who want an assisted death would want it ruled out that they had some sort of cognitive impairment if it were temporary and reversible. That is the sort of thing we really need to get right, not only for those people who have an impairment but for those who actually do not have one but would not then be able to have the assisted death that the noble Baroness, Lady Hayter, and others might wish them to be able to avail themselves of.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, this small group, which I did not expect there to be so much rich conversation about, indicates why care homes really are an important focus for the Bill. I absolutely want to echo the points made by the noble Baroness, Lady Finlay, about care home workers: they have not been consulted. Might the noble and learned Lord make a commitment to meet up with representatives of the care sector to discuss the very real issues that the Bill will create for them if it passes? We can recognise that many of the people in society who will, at some point, be eligible for assisted death if the Bill passes will probably be in care homes, because that is where elderly people are, who might well get terminal diagnoses—rather than 14 year-olds. We are talking about a different cohort; that has at least to be considered. Some of the previous contributions have therefore been very helpful. I really thank the noble Lord, Lord Blencathra, for laying out so clearly why this should matter to us all.

I am somewhere between the noble Lord, Lord Deben, and the noble Baroness, Lady Hayter, on care homes because, for the purposes of this discussion, I would rather not go down the care home horror story route. However, even if you accept care homes as positive places in general, there are still huge challenges in the Bill in relation to them. I will lay out some of these challenges.

Despite the horror stories, in most instances, care homes are incredibly important to society’s care of the elderly and frail. Although they are too often neglected—understatement of the year—by state support, they are fulfilling an incredibly important public service. By and large, the care workers I know and have encountered—far too many of them, for a variety of reasons—are heroic. They are poorly paid, underappreciated and overworked, and we know there is a massive turnover of staff. These things have been well covered in different discussion. I also find that many care workers are amazingly generous and creative in their care of our older citizens who are in need of residential care.

Despite all that, we must be realistic. There are difficult, challenging circumstances in care homes, and we have a social care crisis, which we talk about all the time. This is the living example of that crisis. There is not enough space in care homes, and they can be chaotic—not because of the staff. In a day-to-day sense in care homes, standard mental capacity assessments are done by overworked care workers who are not clinical professionals. I worry that these assessments used for treatments might bleed, in some way, into the future as a way of signing off a new medical treatment on the block: assisted dying. We must recognise that as a possible concern.

I am slightly contradicting myself now, but we must recognise the kind of pressure that people are under. Many elderly people in care homes have had things like do not resuscitate orders or inappropriate diagnoses. I think it was the noble Baroness, Lady O’Loan, who made a point that I too can relate to, where an elderly person was given their meal and drink, and it was ticked off by care staff as having been eaten and drunk but it was not; the elderly person did not even know what it was, but it was ticked off anyway. That was not cruelty, on behalf of the staff; it was rushing around. They did not feed that elderly person, but they were not starving them; they simply did not have time to sit down and do anything about it.

This matters because a large number of people who may fall into eligibility because they are terminally ill will be people whose capacity needs to be assessed, and they will live in care homes. The problem is that care homes are a gathering of people who have fluctuating cognition. The main thing that goes on in care homes, beyond care, is that cognition changes all the time. The idea that a firm, autonomous decision will be made in those circumstances needs to be, at the very least, queried slightly.

We are talking about UTIs, dehydration, infection or the effects of medication, but the big one, of course, is undiagnosed dementia or early dementia that no one has yet noticed. Alzheimer’s Society data shows that only two-thirds of those with dementia have received a formal diagnosis. Sadly, there are massive waiting lists, so the diagnosis rate is low—and in Wales, inevitably, it is sadly even lower. There is also hidden dementia, where no one is trying to get the people assessed but it is there none the less. Due to the heightened risks of cognitive impairment issues and the instability of cognition, we definitely need to take these amendments seriously. We need to have specialist clinical assessments to ensure that capacity means capacity and is not part of a “good days, bad days” scenario.

Anyone who has had relatives in care homes, or spent any time in one, will know all about the “good days, bad days” situation. You can go in one day and chat away to a coherent and articulate older person, but the next time you see them they are completely incoherent and confused. You then go back and they are chatting away again.

Terminally Ill Adults (End of Life) Bill

Baroness Fox of Buckley Excerpts

Committee stage
Friday 30th January 2026 Lords Chamber

[Baroness Pidgeon (LD)]

I am coming to the end of my speech; I do not think I have to take an intervention, so I would like to finish my point.

It seems to me that this is about making the choice of an assisted death difficult or impossible. We need to think carefully about the checks that we are putting in place for people in the last six months of their lives. We need to make sure that the system really will work for them.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, we should thank the noble Baronesses, Lady Gerada and Lady Pidgeon, for raising important counters to a lot of these contributions, because it is important that we do not fetishise face-to-face communication as infallible. It offers no guarantee that comprehension happens, that people listen and that there is no misunderstanding. We should know that because we sit face to face in this Committee every Friday and goodness knows it has not guaranteed much of that.

I have put my name to several of the amendments in this group because, despite what the noble Baroness, Lady Pidgeon, just said about how we must make this as easy as possible for people with six months to live, the Bill’s sponsors have rightly built the need for eligibility into the Bill. You cannot just wander in and say, “I’ve got six months to live, get rid of me”; you have to pass the eligibility assessment. We are trying to work out whether face to face as the default would be a better way of guaranteeing that there is no abuse, which is reasonable.

I remember the ITV documentary referenced by the noble Baroness, Lady Coffey, in which I heard the Bill’s sponsor in the other place, Kim Leadbeater, admit that she was uncomfortable with what has been labelled “death by Zoom”—the model that she was watching in Oregon. Despite what the noble Baroness, Lady Gerada, said, it was actually Kim Leadbeater who rightly noted that it looked too much like a tick-box exercise. We need to be wary of anything that goes in that direction, but, because this is what I saw in that documentary, I expected a basic requirement in the Bill for face-to-face assessment, except in exceptional circumstances. So I ask the noble and learned Lord, Lord Falconer, to respond on why the Bill still permits so many encounters with doctors, including the panel, to be conducted remotely, meaning that somebody may access assisted death without having seen a doctor face to face. One might pause on that, at least.

Despite the virtues of telemedicine, of which there are many—we can all see the reasons why, on occasion, it is important, just as we all use Zoom for meetings and so on—this is a question of whether it is superior and whether it can be relied on. The noble Baroness, Lady Smith of Newnham, gave a vivid example in response to the contribution from the noble Baroness, Lady Jay, in which she said, “At least the noble Baroness, Lady Gerada, knows what it is like to be the doctor doing the consultation”. Well, some of us know what it is like to be the patient on the other end of it. To be honest, it is not always a case of “trust the expert” and all that, because there absolutely may be crossed wires, hanging around, frustration and all sorts of things going wrong.

Professor Martin Vernon, who chairs the ethics and law special interest group at the British Geriatrics Society, said:

“Assessing somebody remotely, digitally, without a face-to-face assessment, particularly if they have complex health and social care needs, is nigh-on impossible”.


There is something in that, too, which we should consider. Non-face-to-face Zoom or phone encounters are particularly challenging for certain groups, such as people with communication difficulties. The noble Baroness, Lady Nicholson, reminded us of the issues for people with hearing difficulties in our debate on a previous group. We all know that there are difficulties of language.

Of course, older people are likely to make up the majority of those being assessed for assisted dying. Without wanting to caricature oldies as being technically illiterate—although there is a smidgen of truth there—there is something else to consider. Older people sometimes present their best selves on the phone. They put on their best voice. There is nothing wrong with that, but they chat away as though everything is fine and, even on Zoom, they sit there looking their best.

However, when you see them face to face—I am not now talking about a doctor assessing them—they are dishevelled, pale and frail. Something else happens. Because the assisted dying decision involves highly emotional and existential issues, purely remote assessments potentially undermine the relational aspects of care that will help ensure that decisions are well considered and autonomously made. We have to think about those direct, personal interactions. The noble Baroness, Lady Jay, is right: these are the last six months of your life—allegedly; that is what you have been told. People are vulnerable, distressed and not quite sure. All these amendments are suggesting is that it would possibly be better to see the doctor. If you cannot get there, that is all fine, nobody is being inhumane; but the doctor sees you and assesses what is going on. It is a necessary if not sufficient way of establishing the eligibility criteria.

Finally, the noble Lord, Lord Empey, talked about how this might be appropriate for online legal proceedings. I am sure that the noble and learned Lord is aware of the evidence on the use of video links in court proceedings and trials. In Transform Justice’s survey of court users, 70% of respondents said that it was difficult to recognise whether someone who was on video had a disability, while 74% believed that those who had no legal representation were disadvantaged by appearing on video; in other words, the vulnerable always suffer in those instances.

The report similarly found that there were significant issues in assessing evidence and character. We can learn from other areas, but the main thing is that the default should be face to face. That should be in the Bill. I agree with Kim Leadbeater on that one—that is a headline. I do not understand why, Kim Leadbeater having noted that, it is not in the Bill. There should be exceptions if people are too ill, too far away or having a ball in Tenerife for their last six months. Yes, we get all that, but the default point is: face to face, where possible, as much as possible.

[Baroness Coussins (CB)]

My Lords, if we are to have remote assessments, it is very important that we have an exception for one group of people who might be seeking assisted dying: those who require the services of a public service interpreter. Elsewhere in the Bill, the provision of interpreters is acknowledged and provided for. This is one situation where face-to-face consultations are essential. During Covid, there was a huge rise in remote interpreting in the criminal justice system. A number of studies, including a very robust piece of research by the Magistrates’ Association, showed that there were problems with remote interpreting, for reasons ranging from dodgy technology to missed cues because of missed body language.

In these circumstances, more than anything else, a face-to-face consultation or assessment is right and appropriate, where the services of a public service interpreter are needed for the benefit of the person seeking help.

--- Later in debate ---

[Baroness Finlay of Llandaff (CB)]

My Lords, in the previous debate we had an interesting discussion about the importance of face to face. I think the conclusion was that the noble and learned Lord, Lord Falconer, should bring forward amendments that would make face to face the default mechanism, while accepting that there would be exceptions. At that point, I raised the question of recorded statements made by someone who then could not speak. It is important to remember that speech can now be faked and can sound exactly like the person. I hope that, in drawing up those amendments, the noble and learned Lord will be able to encompass some protection to ensure that, when a presentation is made of a recording that seems to be in somebody’s voice and in their words, we are still protecting against abuse and coercion and against those with malintent who may have faked that. Unfortunately, we are already hearing stories of criminal activity where such fake voice recordings are used, and we find that people believe them as being from the person, when actually they have been part of a criminal activity. This amendment has been important—although I accept, of course, that it is only a probing amendment—because it has actually made us think on a much wider scale.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, the Government’s 10-year health plan for England seeks to

“make the NHS the most AI-enabled health system in the world”.

Like others, I think that is an incredibly exciting prospect. I do not want it to be dystopian. I think that the right reverend Prelate the Bishop of Hereford makes an important point in warning us against going completely over the top. I think it is important that this amendment has been tabled, because it makes us think about what the possible problems are, which have been well expressed by others. Despite my excitement about what AI might do, even in terms of treatments—there are wonderful possibilities in terms of helping people to walk, what is happening with the brain, and so on—we do not want to be naive.

The question for the noble and learned Lord, Lord Falconer, is: as the NHS digitises and doctors become increasingly reliant on AI for notes and diagnostics, given that the diagnosis is so important in a life-or-death situation in this instance, how can we ensure that a time-poor doctor does not use AI as an assessment tool or a shortcut? We would be naive to imagine that that does not happen elsewhere; we would only have to think of politics. People now use AI to avoid doing research, in a wide range of instances, and I do not want that to be translated over.

As for the patients, algorithms are supremely impressive and can take things that have happened on Facebook or TikTok, from when you have been on a Teams meeting or Zoom—all sorts of indications—and detect chronic illness conversations. The algorithms can then push pro-assisted dying content such as the Switzerland adverts or positive end-of-life options. Interestingly, when discussing banning social media for under-16s, which I completely disapprove of, or bringing in the Online Safety Act, which I argued against, everybody kept saying, “Algorithms, oh my goodness, they can do all these things”. We should consider not that chatbots are malevolent but that AI tends to agree with people via the algorithms; to quote the title of a piece in Psychology Today, “When Everyone Has a Yes-Man in Their Pocket”. If you say that you are interested in something, they will just say, “Yes, here are your options”. That is something to be concerned about, and it will come up when we discuss advertising.

I finish with that BBC story from August of a Californian couple suing OpenAI over the death of their teenage son. They allege that ChatGPT encouraged him to take his own life, and they have produced the chat logs between Adam, who died last April, and ChatGPT that show him explaining his suicidal thoughts. They argue that the programme validated his most harmful and self-destructive thoughts. I am just saying that AI is a wonderful, man-made solution to many problems, but if we pass a Bill such as this without considering the potential negative possible outcomes, we would be being irresponsible.

[Lord Hamilton of Epsom (Con)]

My Lords, I have supported AI for as long as I can remember, and I think it is the future for this country. If we are looking for improvements in productivity, there is no doubt that we should look to the National Health Service and the public sector, where we can see AI having its greatest effect and improving the health of the economy of this country.

However, we are in early days with AI, although it has been with us for some time. We must be very careful not to rely on it for too many things which should be done by human beings. The noble Lord, Lord Stevens, has already referred to the appalling rate of misdiagnosis. We can look at these statistics and say, “Well, it is only a small number who are misdiagnosed”. Yes, but my noble friend Lord Polack was misdiagnosed as only having six months to live and he is still with us 32 years later. You must think about this, because if you get the situation with misdiagnosis badly wrong, it undermines the basis of this Bill. Therefore, we must be very careful that AI does not contribute to that as well.

I pay tribute to the right reverend Prelate. AI is having a tremendous effect in the health service and helping a large number of people to get better, and it may well be that AI introduces cures for people who are being written off by their doctors—perhaps wrongly. We must not dismiss AI, but we must be very wary about where it leads us. There will be an awful lot of bumps in the road before AI is something in which we can all have complete confidence and believe will deliver better outcomes than human beings.

Terminally Ill Adults (End of Life) Bill

Baroness Fox of Buckley Excerpts

Committee stage
Friday 16th January 2026 Lords Chamber

[Baroness Monckton of Dallington Forest (Con)]

My Lords, all these amendments address motivation, one of the areas that the noble and learned Lord, Lord Falconer, identified as a key area in his email sent to some noble Lords on Wednesday. This therefore feels an appropriate moment to make some short observations on general matters arising from that email. My amendments focus on risks to people with learning disabilities and autism, and there is also an amendment to exclude hospices that provide palliative care, which is, I believe, true assisted dying.

As I understand it, the email’s proposal has two parts: first, that we move away from this House’s established line-by-line scrutiny and condense 74 groups into 13 areas; and, secondly, that any concessions will be limited to those areas. My question is straightforward and has been asked in various ways by my noble friends Lord Harper, Lord Deben and Lord Blencathra. When will we see the detail? What amendments will the noble and learned Lord make to address each of the areas of concern he has identified as key in the Bill? What are the terms of the noble and learned Lord’s proposals to address the concerns raised by the Delegated Powers and Constitution Committees?

We are told that amendments will be brought forward on Report to address a limited number of these concerns: advertising, independent advocates and some regulation-making powers, but we have not been told which ones. There are now 42 such powers and a further seven Henry VIII powers, but no detail has been provided. Commitments to respond to these reports were made months ago. We need to know.

The email identifies only three further changes: on the position of those aged 18 to 25, those deprived of their liberty through the Court of Protection, and the role of multidisciplinary teams. These are important but they do not go very far. Nor is there any reference to excluding hospices, as suggested in the email from the noble and learned Baroness, Lady Butler-Sloss. Finally, there is no mention at all of the serious concerns raised by five major royal colleges. They were flagged as long ago as May.

To conclude, we need answers long before Report so that all Members of this House can properly consider what is proposed.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I thank the noble Baroness, Lady Monckton of Dallington Forest, for that excellently clear way of expressing some of the discomfort and what we would like to see. I would be much happier and feel that I did not have to speak too much if I was getting reassurance and seeing on paper what exactly will address our concerns. At the moment, we are not getting that. We wish the noble Lord, Lord Shinkwin, were here. The fact that he is not is a real shame for the quality of this debate.

Inside and outside this House, I know plenty of people who support assisted dying and this Bill, inasmuch as they know the broad sense of what it is about. I try to avoid living in echo chambers. Whenever we discuss why they support the Bill, and potentially have a bit of an argument, they invariably say, in a very humane and compassionate way, that they think it will help people who are suffering, and that anyone who says they are suffering should have access to assisted dying. It is assumed, therefore, that the motivation of illness-induced suffering is at the heart of the Bill. That is what most people think. It has come up a lot in this Chamber but, ironically, suffering is not mentioned in the Bill, and neither is there any reference to motivations in the way that one would imagine. That bothers me, because the Bill checks on capacity, prognosis and residence, but it does not enforce a check on motivation. It seems to me that we should ask somebody who says that they want assisted dying, “Why?” It is a crucial absence in the Bill, and I hope that the noble and learned Lord, Lord Falconer, might rectify that or explain exactly why the Bill does not think that doctors should ask, “Why do you want assisted dying?” I think it would throw up a whole range of red flags in relation to coercion.

I have added my name to two amendments in this group, Amendment 30 in the name of the noble Baroness, Lady Foster, so ably moved by the noble Lord, Lord Weir of Ballyholme, and Amendment 56 in the name of the noble Baroness, Lady Coffey. To save time,I will concentrate on Amendment 30, which seeks to ensure that those who seek assisted dying are not substantially motivated by a number of factors. I will focus on two of those—not wanting to be a burden on others or public services, and not being motivated by mental disorder, including depression.

This week was the 29th anniversary of the death of my father, John Fox. He was only 66. He was diagnosed with cancer and given three months to live, although he actually made it for four and a half months. When he was told, the whole family was devastated, as anyone would be. The one thing that really shocked me to the core, and stays with me, was that when I had that initial, very emotional father to eldest daughter conversation, my father kept apologising. Believe me, that was not usual. In our relationship, he did not say, “Sorry, Claire” lots of times. He was so distraught. He was convinced that he would be a burden on us, and that his daughters and my mother, in looking after him, would all have to miss work and all the rest of it. He kept saying, “I’m really, really sorry”. He was worried about how we would cope. He did not want to distress others—a point that the noble Baroness, Lady Lawlor, was making on her amendment to this amendment.

I also noticed that he kept saying sorry to the nurses and the doctors. To everybody, he kept saying, “I’m really sorry for taking up your time. I’m really sorry that you’re having to give me so much attention”. There were stories in the media at the time about bed blocking. He was a vociferous reader of newspapers, and I was hiding the newspapers because I thought he would say sorry even more, convinced that he was taking up NHS resources. It took some time and determination for the family to reassure him, but I kept thinking afterwards how sad it would have been if he had been on his own or in a care home or whatever. To be honest, if a GP had suggested that assisted death was a medical option, in today’s circumstances, I think my father would have said yes—not because he wanted it but because he felt he was a burden on the family. It would not be the GP’s fault, as it is an internal feeling of being a burden. That is not the same as choice.

I was struck by a letter from Lord Sumption in the Times that is worth reflecting on. He says:

“The current bill contains a number of provisions designed to ensure that patients are not ‘pressured by any other person’ into taking their own lives”—

that was in relation to something else. He continues:

“The real problem, however, is not the pressure applied by ‘other persons’. It is assumptions which many old and ill people spontaneously make about the attitudes of the society around them. They are afraid of being an emotional or financial burden”.

That is very important.

By the way, I had better say that, in the four and a half months following his diagnosis that my father lived, we had some of the most meaningful time of our lives with him. It was through a veil of tears, but there was love, joy and reconciliation, there were conversations that would never have otherwise happened, and so on and so forth. It was a time that was important to him and to us as a family in a way that I cannot really describe.

Another motivation that I feel strongly we need to explore is on the part of those with a mental disorder. As many noble Lords have noted, a number of mental health conditions have suicidality as a feature. Again, I am sorry to do the personal stuff, but the first time I encountered that was as a young mental health community worker. I met a young man who was bipolar. I and others—psychiatric medics and social workers—worked hard not just to prevent his suicide but, using all our skills in pharmacological and psychological interventions, to alleviate the terrible “black dog” of depression and the horror of the obsessive suicide ideation that that young man had. I have to ask, then, whether the Bill would allow such a suicidal person’s depression-induced desire for death, and whether all those who had worked with him would suddenly be expected not just to welcome it if this young man made the choice of an assisted suicide but to say, “Oh, look, a perfect exemplar of autonomy and choice”.

I was therefore a little taken aback that the noble and learned Lord, in his summation of the last group on eligibility, said in relation to those with a mental disorder that it is their choice, and that if they want it and they have capacity then that is all right. I point out that, for anyone who wants to commit suicide, it is their choice and they want it, but some of us spend a lot of time asking them please not to do it, not saying, “Yippee!” I cannot think that, in that situation, if that young man had said, “I’ve got a terrible story. I’ve got a terminal illness in addition to my bipolar depression, and I want your support and help in assisted dying”, I would say that it is all perfectly fine and he should get on with it, and be delighted for him being able to show that he is a free, autonomous individual. I would say, “Please don’t”. The four and a half months that we had with my father was the kind of quality time that I would want to ensure that young man had, every day of his life, even if he was terminally ill and dying. I would want to make sure that he was not depressed or suicidal during the time he lived.

[Lord Empey (UUP)]

My Lords, I am associated with some of these amendments. I do not think we want to get completely hung up on the minutiae of each particular line, because there are variations that one could make. I guess that when one is drafting a Bill there are choices to be made and language can be better if one gets professional assistance.

The fundamental point, as has been outlined by the noble Lord, Lord Weir, and the noble Baroness, Lady Fox, is that anyone here who has represented an inner-city, working-class constituency will know that the approach that a lot of people have towards doctors and the medical profession is perhaps different from the approach that we have. If we want medical assistance, I guess most people in this room can pay for it if they so wish. That is not an option that other people have.

--- Later in debate ---

[Lord Falconer of Thoroton (Lab)]

It is very difficult and would be inappropriate to try to examine exactly why people make particular choices. Look at the first Amendment 30 proposal:

“not wanting to be a burden on others or on public services”.

Why does the thought that they are going to be a burden on their children become an unbearable thing for some people to go through? They might make that choice because of what has gone on in their lives, but it is totally inappropriate, impossible and wrong in a Bill such as this to say that we have to ask why they are in that position.

The next proposal refers to a mental disorder—

[Baroness Fox of Buckley (Non-Afl)]

If the doctor was required to ask what someone’s motivation was, and the patient said, “I just really don’t want to be a burden on my family; it’s too intolerable”, but they have been told they are terminally ill relatively recently, is it not possible that there could be an intervention that would say, “Maybe you won’t be a burden” and to go and talk to their family? One of the problems is that it is assumed the endpoint is there already, whereas if you ask the question, there is a possibility that you could offer an alternative. If somebody says, “I can’t face the pain”, you can tell them there is pain relief available. This is not trying to undermine the Bill totally, but it is possible that if the doctor responds with some options, the patient would be on their way. Why not ask for the motivation? That would surely be positive.

[Lord Falconer of Thoroton (Lab)]

That is a very important question. There is a difference between excluding certain motivations, which is what Amendment 30 would do, and asking why, which the noble Baroness, Lady Smith of Newnham, raised. I see force in the proposition that somewhere in the Bill, somebody has to ask why—for two reasons. First, as was raised previously, if you ask why, it might throw some light on circumstances that suggest classic coercion. Secondly, and separately, it might deal with exactly what the noble Baroness, Lady Fox, is referring to.

Take an utterly absurd example: someone says, “I want an assisted death because I cannot deal with the noise that’s going on in my head”. The doctor could then reply, “Well, actually, that’s a building site that will stop tomorrow”. If it is something like that, one should know.

I am attracted by the idea of something in the Bill that says why. That has to be asked somewhere down the line. This also connects with our previous discussions about the multidisciplinary team engaged in looking after the person, which might well have a much better view about why.

--- Later in debate ---

[Lord Falconer of Thoroton (Lab)]

I am saying that everybody should have the choice. The way that one makes the choice is inevitably determined by how one got to the point where one had to make it. It is an impossible question. Why do we all make choices? They are all affected. Some people make them because they are richer or poorer than others, but I am not in favour of drawing financial distinctions. I hope that, in the light of my remarks, the noble Baroness— I cannot remember who started this—will withdraw her amendment.

[Baroness Fox of Buckley (Non-Afl)]

I blame myself for this, but the noble and learned Lord was about to say something about the mental health issue when I made a point, and we have not gone back to it. That is a very distinct question, so will he reflect on it?

[Lord Falconer of Thoroton (Lab)]

This is not a technical point, but the way the amendment is drafted is very confusing. If your mental illness makes you come to this conclusion, that may well go to capacity. I am not clear what is being got at in relation to the mental health issue. However, if the position is that you may have a mental health condition but are perfectly capable of making a decision, you should be allowed to make it.

--- Later in debate ---

[Lord Shinkwin (Con) [V]]

My Lords, I begin by quickly welcoming back the noble Baroness, Lady Campbell of Surbiton, and thank her for reminding us so eloquently why we have missed her contributions.

I rise to speak to Amendment 34, and I thank my noble friend Lord Frost for tabling it and for his excellent speech. I also thank the noble and learned Lord, Lord Falconer of Thoroton, for his past commitment to ensuring the law is communicated as clearly as possible by removing the Latin names of the prerogative writs through the Civil Procedure (Modification of Supreme Court Act 1981) Order 2004. Can he explain in his closing remarks why, 22 years later, he appears to have changed his mind on the guiding principle, which I assume informed his earlier decision, that the law should be accessible and unambiguous? Perhaps, and maybe he could clarify this in his closing remarks, he now believes it should be accessible only to some, and that for others it is fine for it to be clouded—or shrouded might be more appropriate, given the fatal consequences of an ill-informed decision on assisted death—in euphemism, nuance and even deceit.

After all, those with a learning disability or Down’s syndrome, for example, are only disabled people, are they not? What does it matter if their disability means they cannot quite grasp the enormity, finality and irreversibility of the decision to seek, as my noble friend’s amendment states,

“help to commit suicide by provision of lethal drugs”?

We know that language matters, but do we know how much it matters to those whose disabilities make them understand less or make comprehension challenging, and, in the case of Down’s syndrome, those whose innate desire to please makes them more prone to agreeing with the question, especially when its implications are not fully grasped?

I hope the noble and learned Lord will accept this amendment and thereby protect not only those whose disabilities make full comprehension difficult but the reputation of your Lordships’ House. Let it never be thought that we do not care if those whose disability-related need for the clarity provided in my noble friend’s amendment are somehow misled to death because of nuance. I hope the noble and learned Lord will show, by accepting this amendment, that those whose disabilities make them particularly vulnerable to ambiguity must not be treated as unfortunate collateral damage.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I signed the amendments from the noble Lord, Lord Frost, which seek to probe the ways that we can make this Bill more transparent to the public. That is my main driver—I believe in plain speaking. The public deserve to know what this Bill involves.

As it happens, I think the noble Lord’s wording would add clarity. His proposal is to replace

“assistance to end their own life”

with

“medical help to commit suicide by provision of lethal drugs”.

That wording is factually accurate, even if it makes you gulp. The reason it makes one gulp is because it is factually accurate, and we do not often recognise what is being advocated here. There is a danger that the Bill’s terminology creates ambiguity rather than clarity, and it is important that we are frank and open.

Why use the word “suicide”? As has already been explained, the Bill needs to amend the Suicide Act precisely to carve out the legal space to allow this type of assisted suicide, as mentioned in the Bill, to be within the law. That is accurate. But I am wary of having a culture war over the word “suicide”—I use the term “assisted dying” all the time, so I do not want to be called out for hypocrisy here—because I am aware of the fact that suicide as an issue is far too serious and tragic to be glib about or to have verbal ping-pong over.

On the other hand, I am worried that avoiding the word “suicide” in this debate, and making it verboten, might desensitise public debate. Let us be honest, language choice can influence opinion. “Assisted dying” sounds softer, palatable and more sympathetic. It is interesting that evidence shows that support for assisted dying changes if you call it “assisted suicide”; it drops significantly when the terms are plainly defined.

Some may flinch at the proposed words used by the noble Lord, Lord Frost—

“medical help to commit suicide by … lethal drugs”.

As I have said, it is hard to accept that. It makes you think. Is there going to be a complete change in the way medicine is operated, so that medics could hand you poison and lethal drugs? The answer is yes. When people hear that phrase, it might hit them what a fundamental shift this will be for medical professionals and so on. That is exactly why a number of us are not prepared to nod this Bill through. It is perfectly reasonable to completely disagree with what I have just said, but I want everyone to know what the Bill is about and why it is a very big change in our society, causing all sorts of ethical discussions. The public deserve to know that, and therefore we should be as clear as possible.

I recall that, on the first day in Committee—and subsequently, but particularly on the first day—there was a lot of tut-tutting and reprimands, with a lot of people being shouted at when Peers used the term “assisted suicide”. A lot of people stood up, saying, “You can’t say that. You’re just being emotional, manipulative and so on”. But clear language promotes public and patient understanding. In a way, I advocate a patient-centric approach rather than a euphemistic approach, which could, arguably, be seen as an act of misinformation in some instances.

Terminally Ill Adults (End of Life) Bill

Baroness Fox of Buckley Excerpts

Committee stage
Friday 12th December 2025 Lords Chamber

[Baroness O’Loan (CB)]

My Lords, it is very regrettable that the noble Lord had a patient in an abortion situation. We are not, in this group, discussing the doctor’s wishes or otherwise and his views about abortion. I ask the Minister, because I can hear mutterings here, what provision says that you cannot intervene in a debate where you have not been present, perhaps, at the very first moment of the debate? What is the section in the Companion that provides for that?

[Baroness Fox of Buckley (Non-Afl)]

My Lords, returning to the amendments that we are discussing, I want to commend the sponsors of the Bill in the sense that, when I read the Bill, multiples clauses referred to the applicant’s GP. There is an assumption, however, of an ongoing relationship with that GP. If there is not, we can come back to that. I had assumed that there is an ongoing relationship. The noble Lord, Lord Rook, has raised some of the real challenges to why that might not be realistic.

The problem is that, if there is no assumption of an ongoing relationship but simply a visit to a GP, it seems to me completely meaningless. You go in for a 10-minute meeting with a GP, which is transient and patchy at best, as they are unlikely to be able to make any clinical assessment of great merit. The noble and learned Baroness, Lady Butler-Sloss, referred to the real-life situation of not seeing a GP but how pleasant it was.

--- Later in debate ---

[Baroness Lawlor (Con)]

My Lords—

[Baroness Fox of Buckley (Non-Afl)]

I will just finish, because it relates to this. I appreciate that, once given a terminal diagnosis, that might be true, but not necessarily. That is the honest reality of the situation.

We have a moral dilemma here. GPs are being called on as though they are important to this Bill, but if they are just passing and you do not have continuity of care, they are actually being treated with contempt. On the other hand, in truth, the demand that you have to have continuity of care before you can ever be offered assisted dying seems unrealistic in today’s modern health service.

[Baroness Lawlor (Con)]

My Lords, I will speak to Amendments 30B, 220 and 265A in my name. They share the aim of other amendments in this group to ensure that the GP knows and has looked after the person who wants to end his or her life, but go beyond them in proposing the extent and length of the relationship needed and in requiring a letter from the GP to provide important additional safeguards. I will explain the amendments.

First, I propose that the patient be known personally to a doctor for two years through having been seen for at least six appointments. Secondly, I propose that the doctor submits a letter to the assessment panel on the patient’s physical and mental health during that period, and a prognosis. Thirdly, I stress that the doctor, as we see their involvement in this Bill, may be the patient’s GP, but that is not required; the doctor may be the first doctor, but, given Clause 11(8), this is unlikely, and it will probably not be the second doctor. The important point is that a medically qualified practitioner knows the patient over time and can write an assessment for them.

Why does this matter? Advocates of and those concerned about the current arrangements in the Bill want adequate safeguards. We all do. We want to protect the weak, the elderly and people with physical or mental health conditions from being influenced, pressured or coerced into wanting to end their own life. But if the request for assisted suicide can be accepted without a doctor who knows the patient personally over time, there will be no such safeguards. “Knows” does not mean a fleeting acquaintance but a professional knowledge of the patient built up over years. That is the aim of my amendments. By contrast—

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[Baroness O'Loan (CB)]

I thank the noble Baroness for her intervention. I also want to raise the risk of domestic abuse, which is much higher during pregnancy. The Maternal Mental Health Alliance says that up to 30% of domestic abuse cases begin during pregnancy.

Ending someone’s life with lethal drugs while they are pregnant raises additional layers of moral, legal and medical concern—for example, consent, the viability of the baby, conflicts of interest, et cetera. Pregnancy causes drugs to be processed differently. The rate of absorption is affected by physiological changes. That could mean a slower or more prolonged death from the approved substances for both mother and child. Women are particularly vulnerable, and the safeguards just do not seem to be in the Bill at present.

The amendments from the noble Baroness, Lady Berridge, in this group relate also to those up to the age of 25 who have an EHCP, which may be provided to vulnerable children, including those with special educational needs and mental health concerns.

Finally, the noble Baroness, Lady Hollins, has told us that young people with complex needs may be at a higher risk of internalising negative societal values about their disabilities. The National Down Syndrome Policy Group states that people with learning disabilities can be highly suggestible and prone to acquiescence bias, agreeing with authority figures to please them.

There may also be diagnostic overshadowing, the risk that a young person’s desire to die might be as a consequence. In this context, a young person with an EHCP, for example, might request assisted dying not because their condition is intolerable but because the social care and support legally promised to them has failed to materialise, making their daily life situation unbearable. That could be misinterpreted by clinicians as a rational choice due to their disability. It is therefore the case that special provisions, such as those identified in these amendments, are necessary to ensure proper support, and that the various vulnerable groups of people do not feel that they have no choice.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I want to speak specifically to Amendment 22, about why prisoners should not be eligible for assisted dying. The amendments from the noble Lord, Lord Farmer, are also pertinent here.

The right reverend Prelate the Bishop of Gloucester raised the real and specific safeguard issues from the lack of medical records of prisoners, and I am sure we will hear more about the problems of medical care for prisoners. The terrible terminal diagnosis that one might get as a prisoner would be particularly frightening, I would think, because of the lack of medical care.

That is actually not my concern. Regardless of where one stands on assisted dying in general, I really hope that, when it comes to this Bill, noble Lords will consider the very particular circumstances of those incarcerated by the state. I hope the sponsors of the Bill will still be open to excluding prisoners and keeping them out of the Bill, on the basis, if nothing else, of their lack of autonomy.

I have to confess that I was rather taken aback when I heard Minister Stephen Kinnock in the other place state that excluding prisoners from this Bill would lead to a difference in treatment between prisoners and non-prisoners, an inequality, citing Article 8, private life, and Article 14, discrimination, of the ECHR. He noted that differential treatment would require objective and reasonable justification. It seems a bit shocking to me to have to explain this to a Minister, but my objective and reasonable justification is that, if you are in prison, you do not have the same rights as if you are not in prison. I did not make that up—although I know the Sentencing Bill has gone a bit liberal.

Actually, I think that, you know, you are deprived of your liberty. Many of the arguments made by the advocates of the Bill about autonomy and giving people choice towards the end of life, in particular circumstances —which I completely understand, philosophically and politically—are entirely appropriate for free people. But when you are not free and do not have autonomy, it brings with it a whole new range of ethical dilemmas.

The purpose of prison is, as I have said, to suspend certain rights from people to protect the public, to ensure deterrence and to uphold a sense of justice in society—I could go on. When the state has deprived an individual of so much autonomy, for all the criminal justice reasons we know, offering the option of an assisted death does not increase their autonomy in a meaningful way. It is saying, “Oh, well, we’re giving them choice”—but their real choice would be being able to leave. In other words, we have limited their choices.

Why does this matter? It is because, when the state decides to deprive somebody of their liberty, it is a very serious decision. For me, it is the worst possible punishment you could give: you are limited in being free, which I obviously consider to be very important. Prisoners, inevitably, are depressed: and often they are vulnerable in the first place. That is why they are prone to suicidal ideation.

Those of us who have had the privilege of doing some work with prisoners will know that we spend a lot of time tackling self-harm, with people hating themselves and the circumstances they are in. We do a lot of work on that. I and many others have worked on IPP prisoners, who are, ridiculously unfairly, still in prison indefinitely based on an abolished sentence, often for minor breaches of the law in the past. It is always shocking when you hear of another IPP prisoner who has taken their life. It is particularly horrible, as many noble Lords here have articulated far better than I can, because it is almost like it is on the state’s conscience. That is the reason why coroners make such a fuss about it. Those prisoners should not be there; they are in prison because the state made a mistake with the sentencing regime that it will not resolve and then they take their life. The state is somehow implicated in those suicides and we make a particular point of that.

Those of us who have worked in prisons will also know that suicide prevention is something we take very seriously. It does not matter how heinous the prisoner’s crime is. They could be a child abuser, a rapist or a murderer, but, if there is even a hint that they might commit suicide, there is suicide watch. We do all sorts of suicide prevention. The reason is that, as a humane society, we do not think that people should be allowed to take their own life, if at all possible. We have suicide watch in prison because the state has somebody incarcerated. Therefore, as a humane society, you take seriously not letting them kill themselves: otherwise, you could just say, “Carry on boys, it doesn’t matter”. We do not do that because we think that we have to protect those prisoners in the state’s care.

Right, I will finish. Letting prisoners have access to and be eligible for assisted death would be very close to reckless state abandonment of those prisoners to something very deeply dark. Philosophically, if a penal sentence in Britain ends up with the state effectively putting a prisoner to death via lethal drugs—I do not want to go on, but that is what would have to happen: they would be locked up in a prison, in the state’s care, the state would then make them eligible to ask for assisted dying, with limited autonomy, and would then hand them lethal drugs—that is far too like capital punishment, which I have long opposed and do not approve of. Therefore, even if you do not agree with me on the rest of the Bill being a completely difficult challenge to humanity, which I think it is, I none the less suggest that, if we pass it, we should absolutely exempt prisoners from it.

[Lord Moore of Etchingham (Non-Afl)]

My Lords, I support these amendments, particularly those relating to prisoners and, indeed, what the noble Baroness, Lady Fox, so eloquently expressed. Just before I do, I will also support something that the noble Lord, Lord Blencathra, who is now not in his place, said earlier, when he complained about some of the exterior noise around those of us who are debating this Bill.

I declare an interest as a general practitioner, not of medicine but of journalism. I know very well what happens and how to recognise when we are being pushed to do a story. In the past two weeks, all the British media have been pressed very hard by lobbyists in favour of this Bill to produce a series of highly contentious arguments that attack anybody who tries to debate the Bill fully. This is very much at odds with the spirit of legislation of this sort, and with what the noble and learned Lord, Lord Falconer, keeps trying to do. He says at the end of each group what a valuable debate it has been. He does not say, “What a waste of time this debate has been”; he says it has been valuable, which it has been. I have learned a lot today, for example, about GPs and their difficulties, and we are learning more about prisoners. There was a virulent article in the Times by Nicholas Boles, who was an informal—

Terminally Ill Adults (End of Life) Bill

Baroness Fox of Buckley Excerpts

Committee stage
Friday 5th December 2025 Lords Chamber

[Baroness Hollins (CB)]

My Lords, I have an amendment in this group and I support the noble Baroness, Lady Berger, in this. I just want to add to earlier comments. The transition from children’s to adult services at 18 is well known to be a very confusing and destabilising period during which key clinical relationships are lost and important elements of a young person’s history may not be carried forward. These factors are directly relevant to assessing decision-making capacity and identifying safeguarding concerns for individuals aged 18 and above who may seek assisted dying. I think that raising the minimum age would allow for any medical advances—for example, with emerging new treatments that might change a young person’s prognosis. It is important not to be too hasty.

I also want to comment on the Scottish Sentencing Council and to add that, again, there is something about the developmental process which is still under way which can increase susceptibility to influence, vulnerability to risk-taking and the likelihood of short-term, emotionally driven decision-making. We have only to think about the fact that in that age group, the biggest cause of death is actually accidental death. Research done by the Sentencing Council and other research shows that maturity may be delayed by adverse childhood experiences. It is therefore reasonable to assume that some young adults with serious illness may carry such developmental vulnerabilities into their decision-making around the end of life. The Sentencing Council guideline suggesting lower culpability and a greater capacity for change than in older adults endorses the suggestion that we should change the minimum age to 25. This is an irreversible decision. We need enhanced safeguards for this age group, and I support the amendments.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, let me just state that, for very different reasons, although I have a great deal of respect for both the noble Baronesses, Lady Lawlor and Lady Berger, in this instance I have serious qualms about these amendments in relation to raising the minimum age for receiving assistance to end one’s own life to either 21 or 25. I think we need to hold on to the standard age where we consider adult responsibility to begin—that is 18—as the Bill does. I worry that we are already getting ourselves into a tangle on age issues. For example, the proposal is now to lower the voting age to 16. I wonder how the sponsor of the Bill will hold the line at 18 when those newly enfranchised 16 to 18 year-olds start demanding equal entitlements from 16. Logically, those teens will have a point when they argue, “If you trust us to decide on the future of our country, why not trust us to decide on the future of our own fate if we fit the other eligibility criteria?” I would like some reassurances from the noble and learned Lord, Lord Falconer, that this age slippage will not happen, but also that 18 is a watertight age in terms of eligibility, and there are other amendments later on.

Conversely, I ask the noble Baronesses whether there is a danger of unintended consequences in using the argument that the young brain has not developed sufficiently at 18 to make such important decisions. It makes me anxious when neurodevelopment research is cited about cognitive development and a lack of maturity about anyone under the age of 25. That is used to challenge the decision-making capacity of anyone below the ages of 21 or 25. I fear that it could be used regressively. How can we trust 18 to 25 year-olds to vote, or be asked to take on any adult responsibilities, if their brain is still developing? Where are we going to end up? I think we need to avoid unintentionally institutionalising state paternalism that robs young adults of their individual rights and limits the choices on their own fate in various ways. The cultural shift to infantilise the post-18 cohort, which is a broader problem, is, in my opinion, regressive.

Finally, I am very sympathetic to the concerns that have been raised here already. It might be worth considering some kind of carve-out for 18 to 25 year-olds on EHCPs, but that would be an exception, not a rule. Viscerally, the idea of any young person of 19 or 20 having a terminal diagnosis and then being offered the choice of an even earlier death fills me with horror, gives me the chills and is tragic. But I still think that 18—if tightly protected by the sponsors of the Bill—is adequate in relation to age safeguards. There are plenty of other safeguards that I am worried about without adding to them.

I also think that there is a problem of the Bill creating a culture, for the young in general, of suicidal ideation. However, these amendments do not resolve those broader problems.

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[Lord Falconer of Thoroton (Lab)]

On the comments that the noble Lord refers to, in relation to whether you should impose a whole-life term on somebody under 21, I recognise, as the Sentencing Council does, that issues of immaturity might make that inappropriate in certain cases. However, on this position, the question is: what is the age at which you might be capable of taking a settled decision? The concerns that the Committee has expressed about people aged between 18 and 25 make me think that the right course is to consider whether there are ways to deal with that that the House would feel are satisfactory on Report. I think that is the right course.

[Baroness Fox of Buckley (Non-Afl)]

Could I have some reassurance that with changing the franchise to 16, there will not be any slippage in relation to this Bill from 18 downwards? That is a reasonable question because, according to some people, 16 is now mature enough and adult enough to decide the fate of the country and decisions made here. Is there not a danger? Can he guarantee that this will not happen?

[Lord Falconer of Thoroton (Lab)]

I guarantee to the noble Baroness that the age is not going to go down from 18 as far as this Bill is concerned. The future is not in my gift, unfortunately. However, as far as the future is concerned, it is extremely unlikely that a subsequent Parliament is going to reduce that age.

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If those under the age of 18—or better, a higher age—are to be properly protected, will the Bill not state unambiguously that no discussion involving the revelation of assisted dying is permitted, even if those people raise the subject, on pain of practitioners being made ineligible under the Bill?

[Baroness Fox of Buckley (Non-Afl)]

My Lords, the noble Baroness, Lady Keeley, explained some of my concerns, which I found very helpful. I have a couple of questions for the noble and learned Lord, Lord Falconer.

Why does an independent doctor’s report no longer have to say why there was a refusal? I do not understand why the words “reason for refusal” have been omitted; could that be clarified? One of the things that will be very important in reassuring those of us with concerns about safeguarding being taken seriously is having as much transparency as possible in the process and ensuring the constant recording of information.

I am troubled by Amendment 418 and the word “unwillingness”, and not understanding, probing or having any way of finding out why somebody is unwilling. I understand that unwillingness might well refer to not being available or not being able to be so. However, if a doctor steps away, maybe because they feel uncomfortable about family members, undue influence or some kind of coercion taking place—all the things we have heard about—it seems relevant that that information be recorded somewhere, because it is a red flag and an early warning. That doctor’s opinion is only an opinion—the second doctor does not need to take any notice of it—but it would at least say that something is wrong; whereas, if the information just says that the doctor is not doing it because he is unwilling, we do not know anything.

In this process, there surely has to be a way of checking all the time that everybody knows that things are being done in good faith. I am afraid that some of these drafting amendments seem unintentionally to make things more obscure. The wording does not help to give us more information; rather, it removes information. Therefore, I would like the noble and learned Lord to look at redrafting his redrafting, so that we can have a bit of clarity.

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[Baroness Fox of Buckley (Non-Afl)]

I think I understand what has been said there but, for clarification, is the withdrawal explicitly queried anywhere? I am under the impression that there is nowhere where you say, “Why are you withdrawing? Is it for this reason or that reason?”. I am delighted that the noble and learned Lord agrees with me that certain withdrawals suggest something that should be noted down. Where in the Bill—forgive my ignorance—does that happen? I do not see it anywhere and I would be grateful if he could refer me to it.

Tobacco and Vapes Bill

Baroness Fox of Buckley Excerpts

Committee stage
Wednesday 26th November 2025 Grand Committee

[Lord Howard of Rising (Con)]

My Lords, my Amendment 200A touches on a different theme from the other amendments that I have tabled. As my noble friend Lord Howe commented, it is a probing amendment to test the Government’s attitude to small shops and the burdens that they face. I endorse the remarks made by my noble friend about shoplifting because it no longer seems to be a crime—you just go in and help yourself to what you want.

This amendment is focused on the burden placed on businesses by their need for age-verification technology. The businesses that will have to comply with this Bill are not just major supermarkets or established tobacco specialists; they are also corner shops and convenience stores up and down the country. These are small businesses on which local communities rely. They are run by local businessmen who provide employment in our villages and towns. They are a place where essential services, such as postal services and phone or bill payment services, can be accessed.

Any additional burden on our corner shops must be considered in that context. Can the Minister please set out what assessment the Government have made of the impact of this Bill on small businesses, especially convenience stores? Can she assure us that, if the impact on these businesses is shown to be overly burdensome following the passage of this Bill, Ministers will look closely at how to support convenience stores further by reducing the regulatory burden that they face? I should declare an interest in that I own a convenience store, although I do not run it.

It is essential that we do not proceed blindly without a proper understanding of the impact that this Bill will have on small businesses, so I hope that the Minister will be able to address my concerns fully in her closing remarks.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I am very much in favour of these three amendments. As we come to the end of Committee, it is important that we consider some of the unintended consequences of this Bill, particularly in relation to retailers. In relation to Amendment 188 from the noble Lord, Lord Kamall, and the noble Earl, Lord Howe, I stress in particular proposed new subsection (4)(a) and (b) on the need to consult retailers of relevant products and representatives of retailers of relevant products. This is key and would help to inform the guidance on implementation for retailers that is called for in Amendment 191.

I want to say something on consultation because, throughout Committee, whenever the word “consultation” has come up, the Minister has assured us that retailers have been consulted. I am not impugning her at all, but I do not think that the notion of widespread retail consultation is strictly accurate. Twenty witnesses were invited to give oral evidence to the Public Bill Committee, but the solitary witness from retail, the British Retail Consortium, represented large retailers. More broadly, a wide range of organisations representing independent shopkeepers and related stakeholders such as pubs and hospitality supplied written evidence. Nineteen of the witnesses called to give oral testimony represented health charities, public health practices, health regulation and local government officials. That is a distorting set of witnesses in relation to what will have a big impact on different sectors such as retail and hospitality. It distorts the evidence base and the information that the Government are working with, and it shapes the narrative away from one of the sectors that is affected by this legislation.

The sort of retailers that are caught up in and detrimentally affected by the Bill are thousands of small retail outlets, mini marts and convenience stores, often family businesses with up to half run by British Asians—the sort of shops that are the heart and soul of so many communities and are especially important in rural areas. They are a vital part of local economies, especially in areas where large corporate retail companies do not have much of a presence. I have been talking to a number of these retailers, and I think that it would be useful for the Government to talk to them to get an accurate picture of their fears and concerns and, indeed, to listen to some very imaginative and creative solutions they have to the challenges presented by the Bill. I recommend to the Minister that her department and officials start by reading a useful academic essay by Maged Ali, reader at Essex Business School, University of Essex, entitled The Backbone of the UK Under Attack: The Economic Effects of Tobacco Generational Sales Ban on Retail SMEs because it provides a lot of rich detail.

The economic effects are very important for Amendment 200A in the name of the noble Lord, Lord Howard of Rising, on the need to provide financial assistance and grants for the acquisition of age-verification technology. I stress how important this is. The sector is largely driven, as I have indicated, by independent retailers who run 71% of convenience stores. They are self-financing individuals who will have to invest their own money to enforce policies that, as we have heard from the noble Earl, Lord Howe, will mean them receiving potentially more abuse, intimidation and violence in terms of ID checks. They certainly need some help in dealing with all this.

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[Baroness Walmsley (LD)]

My Lords, I agree with the noble Earl, Lord Howe, about how important it is that retailers of all kinds feel supported as we move into the transition to a smoke-free generation. Those who operate legally and who will obtain a licence to operate under the new rules will want to see the Government doing everything that they can to attack the illicit trade that undermines the profits of law-abiding businesses.

They also need protection from the wave of shoplifting, which the noble Earl, Lord Howe, talked about, which eats into their profits and sometimes puts them in physical danger. It is quite possible that progress towards gradually raising the age below which the retailers may not sell tobacco products could exacerbate this situation unless action is taken. Age verification could be seen as a problem or a solution. However, the need for age verification is already quite common and it falls upon the consumer, not the retailer. I have to verify my own age when I buy a senior railcard to use on the train, although my grey hair means that I am not challenged when I want to buy a bottle of wine. However, the fact remains that, when I have alcohol in my basket at the checkout, a member of staff is entitled to verify that I am over 18—in fact, they take one look, and they click on the terminal. They do not ask for my birth certificate, but of course they might if I looked under 18, which I do not.

However, the situation will soon change for young people only a year apart in age. Having said that, young people are already quite used to having to verify that they are over 18 when buying a drink or a packet of cigarettes or vapes. What do they do now? They use a digital age-verification tool already, and some bars issue their own card once they have verified the age of their regular customers. It therefore would not be unreasonable, and would be helpful to the retailers, if a range of age-verification mechanisms could be available to customers who would then have to show one of them in order to protect the retailers from inadvertently committing an offence. They have to show that they are over 18 now, so why not that they are 19 a year after Royal Assent or 20 the year after that?

It may be a very good idea for the Government to carry out more research on this and publish a strategy, as the noble Earl, Lord Howe, has proposed in Amendment 188. But the public are not the only ones who need guidance and information about the law well before it comes into operation; how much more important is it for retailers? We have already debated my noble friend Lady Northover’s amendment about the need for a communications strategy, so I am not sure how much Amendment 191 would add to that, but it is a useful probe.

Like the noble Baroness, Lady Bennett of Manor Castle, I do not support Amendment 200A from the noble Lord, Lord Howard of Rising. I do not see why taxpayers should foot the bill for creating age-verification mechanisms. I suspect that individual customers will obtain their own digital age-verification mechanism and that inventive companies will produce them and make them readily available. Of course, the vape manufacturers may also produce age-gated products, so perhaps it should be the tobacco industry that foots the bill because of its very large profit margins. I look forward to hearing the Minister’s views on this issue.

[Baroness Fox of Buckley (Non-Afl)]

If the Committee will allow me, I want to come back on the point about retail organisations. I am more than happy to acknowledge that all sorts of organisations are not quite as independent as they seem. In fact, many health charities over the years feel more like Astroturfed organisations, because most of their money comes from government, one way or another. All I am pointing out is that the idea of a kind of neutral body of representative organisations is something that could be queried.

It is fair enough about trade associations, but my general point—rather than trying to imply that there is something dodgy about the associations I mentioned because of any association with tobacco—is that tens of thousands of small retailers are tearing their hair out about the implications of this legislation. That is reflected in a wide range of ways, not just by briefings I have had from trade associations, of which I have not actually had very many. I have investigated this myself; I have talked to quite a number of them and met others, and I have read around. That is why doing research for a piece of legislation matters.

There is a danger of saying, “We can’t talk to the trade associations for small convenience stores, because the ones we know of have some association with or get some funding from big tobacco”, but maybe that is because they are often sidelined and ignored by other organisations, and they should not be. The Government could actually take them seriously and not have them treated as though they were a kind of pariah one can ignore. These are the small players; this is your local corner shop. How do they get a voice here? I thought I would try to give them a voice, and it is not appropriate to imply that somehow giving them a voice is something to do with representing big tobacco. It is completely unrelated to the general point I was making and, as I have pointed out, organisations such as ASH get their funding from somewhere. That is not necessarily big tobacco, but it is big government.

[Baroness Walmsley (LD)]

Having said that, does the noble Baroness agree that it would be unfortunate to see any organisations fearmongering among small businesses that already have a lot of concerns, and a lot to face when this Bill comes into operation?

[Baroness Fox of Buckley (Non-Afl)]

It would also seem that misrepresenting them in the pages of the Grocer by saying that they absolutely love this legislation is the opposite of fearmongering. That is called misinformation; it is illegitimate and not fair. I do not think any fearmongering needed to happen. As it goes, the Government recognise that small retailers are under pressure, which is why they are trying to bring in legislation so that there will be a special offence if you assault or attack a retail worker. I always hoped the law would do that anyway and that we would not need an extra law, so it makes me nervous that we would do it.

That is not because of fearmongering but because on the ground, in small shops up and down high streets throughout the land, things are pretty grim. The BBC report I recently mentioned about the illegal shops that are springing up was also an indication that a lot of these small shops are saying, “We don’t even mind being licensed. We don’t want to be part of a world that’s ignored”. All I am saying is that they have not had consultation with the Government; they do not know how to do it, and they cannot afford the big bucks—perhaps they get a bit of sponsorship, I do not know—but somebody should listen to them. They should go out and talk to them; go round with a billboard and just chat to them. I am suggesting that we do not pass this legislation without having a chat with them. I get annoyed when people say that we have already consulted retail, yet nobody has had a chat with the people who will be really affected by this.

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With those thoughts about this, I hope that we return to this on Report with a view to trying to work collectively on designing a way of delivering improved public awareness of the benefits of this vaping product regime and confidence in the way the system is being used, relative to the evidence that is being derived and adopted. I beg to move.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I have not always historically been an enthusiast for experts dictating policy, but I am enthusiastic about this amendment from the noble Lord, Lord Lansley.

Particularly in relation to policy or legislation related to public health, there is an awful lot of evidence swapping, people citing data, and so on and so forth, then accusations of not being able to trust that data. It would be very helpful to have a genuine independent academic body looking at some of these things, that we could maybe all trust a little—or even look sceptically at—but which actually digs into the evidence. Many of my friends are academics; any research can be advocacy research. None the less, it has to be there in the public arena for us to examine it. It is not just data and numbers.

This is important because earlier today, the Minister rightly said that we are going to follow the evidence, yet we had a serious conversation about whether there should be regulation to ban second-hand vaping fumes. The explanation for the fact there is no evidence of that being harmful was that it is evolving evidence, evolving evidence being the unknown, unknown approach, as far as I can see. I want to Cancer Research here because this is what you do when you are not quite sure how to counter somebody saying this is evidence. It said:

“Further research is needed to understand the health effects of vaping”,


which I accept,

“however”,

there is currently no good

“evidence”,

that

“second hand vapour is harmful”.

However, we have managed to have a conversation as though, even though there is no evidence, it probably is, or it could be. I think that discredits the notion of evidence-based policy. There are also different kinds of academic studies. I was pleased to hear the idea of behavioural studies. At Queen Mary University, for example, they have done a lot of work on vaping, and all their studies suggest that vaping is not a gateway to smoking. I think that the Government need to consider such things. There are a large number of qualified specialist academics who are researching not just the health impacts of vaping but a whole range of how vaping is used. I would like that somehow to be acknowledged in the Bill and for that group of people not to be ignored.

As we are at the end of Committee, sometimes in this Bill I have argued in defence of vaping as a smoking cessation tool, because that is how I have used it. However, I have felt a little uncomfortable about the way that it is assumed that, unless it is a smoking cessation tool, there is something wrong with it. I wanted to query whether that is true. Have the Government got a view of a recreational habit? Why would the Government choose to try to overregulate something that is just a recreational choice? Some people might start vaping who have not smoked. It might be that, by vaping, they will not start smoking.

[Baroness Bennett of Manor Castle (GP)]

I thank the noble Baroness for giving way. I just think we must not lose sight of the fact that we are talking about a highly addictive product and there is a role for the Government in ensuring protection from giant multinational companies trying to hook people on highly addictive products that we know do them harm.

[Baroness Fox of Buckley (Non-Afl)]

I want to say that I understand some of the addiction points in relation to young people in particular. I asked in an earlier group in Committee if this Bill was tackling addiction per se as a problem. There are things that we know are addictive—for example, nicotine. I am simply asking the question about what it is we are trying to tackle. I am asking this because, when we are talking about adult freedoms and choices, it is not just enough to cite medical evidence. That is why I want the expert panel to really assess the medical evidence and behavioural points. That is where I was going. I am cautioning against seeing everything through the prism of expertise as medical expertise.

As it is the last time I will speak in this stage, I thought I would end on some behavioural insights. Since we last met, the BBC has rewritten its Christmas adaptation of Julia Donaldson’s book over its fears that it would encourage children to smoke. It is The Scarecrows’ Wedding, which as noble Lords will know, features a villain scarecrow called Reginald Rake who, lighting a cigar, accidentally starts a fire. There has been something of a kerfuffle, and the BBC decided that this had to be rewritten. It sounds like some Daily Mail story—how ridiculous, PC gone mad and all the rest of it.

For the purposes of this amendment, a colleague of mine who works in media literacy made the point that the irony is that The Scarecrows’ Wedding is a perfect example of a book for young people that puts people off smoking. Betty O’Barley, who is another scarecrow by the way, is so horrified at the villain, Reginald Rake, smoking that she keeps saying to him “smoking is bad for you”. The whole point about Reginald Rake is that he is the villain of the story. The irony of this is that a media literacy expert makes the point that the BBC’s rewriting of this is completely counterproductive in relation to messaging. I say that because I think it is a bit more complicated than just swapping numbers around. An expert panel, looking at the unintended consequences of well-meaning policy, would not do any harm as we finish Committee on this legislation.

Terminally Ill Adults (End of Life) Bill

Baroness Fox of Buckley Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Lord Farmer (Con)]

My Lords, I rise in support of Amendment 118 tabled by the noble Lord, Lord Hunt of Kings Heath, and I am introducing Amendments 118A and 118B which follow it. I also support Amendments 45, 46, 47, 49 and 58.

This is an atheist Bill that assumes there is nothing after death, which is not a neutral but an ideological position. To those without an active belief that there is something after death, I would say, “How can you be so sure?” What makes the point that it is an atheist Bill? It is that it desacralizes death and by so doing it opens the door to very many evils including coercion and pressure, the subject of this group. The Bill is coercive: it gives oxygen to dark thoughts which can loom especially large when our best days seem to lie behind us, and when we are no longer contributing to family and society in the way we once did. Culturally and societally, it encourages and influences them as much as any person referred to in Amendments 45 and 46. Two of my friends with terminal conditions both followed earlier stages of this Bill in the other place and told me the subject’s very airing made them feel that they were a burden. The message that legislation and policy should amplify is, “You will not walk the valley of the shadow of death on your own”. We should encourage people to make and keep those relationships that will carry them through life and through that dark valley.

Others might also have dug out the words of the Times columnist Matthew Parris, quoted in a debate on assisted suicide in the other place in April 2024. He said that although

“‘Your time is up’ will never be an order”

to the elderly, disabled, severely ill and the others to whom assisted suicide will, inevitably, be extended eventually, it

“may one day be the kind of unspoken hint that everybody understands. And that’s a good thing”.

As the right honourable Stephen Timms said in that debate:

“I cannot see that that would be a good thing. It seems to me that legalising assisted dying would impose a terrible dilemma on frail people, elderly people and others when they are at the most vulnerable point in their lives, especially on conscientious frail people who do not want to die but do not want to be a burden. I do not think that there is any way to avoid imposing that dilemma”.—[Official Report, Commons, 29/4/24; col. 18WH.]


We have heard from the noble Baroness, Lady Finlay, about the data from Oregon, where over half the people who have applied for assisted dying since 2017 did so not because they wanted to die but because they felt that they were a burden. Amendment 47 from the noble Baroness, Lady Coffey, would guard against this “internal coercion”, to use the Royal College of Psychiatrists’ phrase. Further, her Amendment 49 includes,

“body corporate, institution or organisation”,

alongside “person”, which would of course catch the Government themselves. Tragically, and I declare my interests as a Hampshire farmer, there are farmers who have committed suicide ahead of the imposition of the family farm tax, choosing to die early so their land is passed on intact. Law and policy starkly influence personal decisions, hence our responsibility as lawmakers to take these unforeseen consequences into account and not brush them aside.

In her Amendment 58, the noble Baroness, Lady Grey-Thompson, is right to focus on lack of care as a disadvantage that pressurises. If death looks as if it might be painful and protracted then going through it alone, unmissed and uncared for, is too terrible to contemplate, but surely we can do better than help someone act on that dread thought, “No one would miss me; no one cares”.

Amendments 118A and 118B, which are my amendments to Amendment 118 in my name and that of the noble Lord, Lord Hunt, would ensure that wills were scrutinised and the backgrounds of friends, as well as family, were not overlooked if sinister motives suggesting financial abuse were not assumed but at least considered. Legislating for motivation is notoriously difficult, because motives are private, subjective, and easy to disguise. Instead, assisted dying legislation must use clear, objective safeguards to remove the possibility of improper motives influencing the process.

As an aside, I am not sure the Bill prevents any doctors involved profiting from early death, but Dr Harold Shipman did of course inveigle himself into the wills of some of his victims, and that would also be a red flag if found in the commissioner’s checks on wills.

Therefore, I ask the noble and learned Lord, Lord Falconer, why the Bill does not do more to exclude anyone with a financial or personal interest, and by extension anyone who might have been under their influence. We cannot draft either for compassion or for malice, but we can protect applicants by making it clear from the outset that if anyone with suspect motives has any involvement, their application will fall.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I, by contrast, speak as an atheist and humanist, mainly to address my Amendment 45, which would add the word “encouraged” after “coerced”. I support the general theme of the other amendments in this group, which largely tackle the need to strengthen safeguards against patients being indirectly influenced into opting for assisted death—often coerced, in all but name. All these loopholes undermine any certainty that the “choice”, in inverted commas, is made autonomously.

My amendment, supported by the noble Lord, Lord Goodman of Wycombe, may appear to be a small change, as it would add just one word. But before anyone concludes that I am tabling trivial amendments to waste time, I note that, when dealing with a fundamental change in the state’s relationship with its citizens and the NHS’s relationship with patients, and life and death decisions, the specificity and appropriateness of the words in the changed law matter.

At present, the Bill requires doctors to ascertain only coercion or pressure. They are the only two words given in Clause 1; there is no duty even to probe or ask broader questions about more subtle, insidious influences that could affect a person’s decisions. I note that the concept of encouragement is not arbitrary; the encouragement of assistance in suicide is illegal under the Suicide Act but would not be in this Bill. Indeed, CPS policy guidance on prosecuting those who have assisted suicide acknowledges “encouraging”—it uses that word—the victim as a factor in favour of prosecution. It is also criminal to encourage a person to commit an offence under the Serious Crime Act. Therefore, the question is less about why I am bothering to table an amendment to add just one word; the question is why the sponsors of the Bill left out that word “encouragement”.

Adding the word “encouragement” would allow a shift in perception about what undue influence could look like. Even though there are real problems in spotting coercion or pressure—we have heard many examples of that—the concepts at least have a hard edge or overt sense, at least in everyday parlance, that you are talking about people doing something that they really did not want to do. You do not say, “I had a really lovely day today; my husband coerced and pressurised me into doing” something. There is a grey area of much more subtle intervention; an individual could motivate, lead on or nudge someone into opting for an assisted death, rather than making that person aware of all the ways that they might live out their limited time as comfortably as possible. This amendment is trying to get at that sort of encouragement.

As I explained at Second Reading, one of my big dreads is that, once assisted dying is normalised as a positive treatment option, that vibe shift will not be confined to medical scenarios. It can and will mean that it is popularised as a go-to option in broader society. Consider this scenario: you have just received the news that you have a terminal diagnosis and have about six months to live. You are frightened, shocked and seeking reassurance. It is a bleak time and you are depressed because you do not want to die.

But then a third party—a family, carer or friend to whom I ascribe no motivation—says, “Have you thought about asking your GP for an assisted death? I’ve been reading about it all over the place and you can do that now. At least that way you’d have dignity in dying. You know how much you hate hospitals and all those doctors fussing about you, and we all know that you are not good with pain. How would the kids cope with running around having to visit you when you’re in and out of hospital? Wouldn’t it be so lovely to choose when you go, then we could all be with you at the end?” All of this is said in soothing, kind tones. Therefore, you think, “Well, I really don’t want to die. My instincts are to

‘Rage, rage against the dying of the light’,


but I don’t want to be a nuisance either, and they know me so well. They know what I’m like and that I won’t cope. They have my best interests at heart, so I suppose so”. It does not sound exploitative or coercive, but it is an iron fist in a velvet glove.

We have some cultural reference points here. In discussions about how the Online Safety Act will tackle suicide sites, there is consensus about the problems of online influencers encouraging vulnerable people into believing that suicide is a positive way out of their suffering. There is widespread revulsion at those cajoling siren voices encouraging death as an attractive option. In that context, none of us concludes that this encouragement is not problematic because it is not explicitly coercive.

--- Later in debate ---

[Lord Falconer of Thoroton (Lab)]

The Bill makes it absolutely clear that it must be your own decision. Let us suppose that your views of the world are affected by the internet and that you are ill and an organisation is urging you to commit suicide, that organisation should be liable if that happens.

In Amendment 49, the noble Baroness, Lady Coffey, wants “person” to include a body corporate or an organisation in relation to pressure. If an organisation or a body corporate is putting pressure on a group of people or on individuals and that makes them do it—this is putting it crudely, but if an organisation says, “Do have an assisted death; it is the right thing for everybody or for you”—that should be covered by the Bill. The noble Baroness adverted to how “person” can generally include both corporate person and human person, but I can talk to her separately about that to make sure that it is covered.

[Baroness Fox of Buckley (Non-Afl)]

Some clarification is needed in relation to a number of points that you have made. How does anybody know, how does the doctor know, whether any of these scenarios have happened? Is there anything in the Bill that makes the doctor ask and explore? The word I proposed was “encouragement”—that you would ask not just “Were you coerced or pressurised?” but “Were you encouraged?”—because it would develop a richer conversation. Is there anywhere in the Bill where all the things that you have just said—apologies; I should not have said “you” but “the noble and learned Lord”—can be fleshed out, discussed and teased out?

Maybe I have got this wrong, but at the moment as I understand it, you fill your form in, somebody might even ask “Were you coerced?” and you say no, and that is that, out the window and then, Bob’s your uncle, you are eligible and off you go. It does not matter how often that process happens. The noble and learned Lord spoke about “first doctor, second doctor”, but if they do not all explore it, how will we know whether it was anything other than a yes/no? The noble and learned Lord has given a very rich explanation of what could have happened, but the Bill does not allow us to find out whether any of that will have occurred before the assisted death is enacted.

[Lord Falconer of Thoroton (Lab)]

I do not feel insulted by being called “you”, but I do not think that the noble Baroness, Lady Fox, properly understands how the Bill operates. The two doctors and the panel have to be satisfied that the person is reaching a voluntary decision of their own, uncoerced and unpressured. Codes of practice will determine how that is done and, what is more, the panel with the three experts on it also has to be satisfied. The noble Baroness, Lady Fox, is saying that that is a tick-box exercise. With respect, no: this is obviously a very serious matter. I expect the doctors and the panel doing it to take it seriously.