Terminally Ill Adults (End of Life) Bill

Debate between Baroness Fox of Buckley and Lord Hamilton of Epsom

Committee stage
Friday 27th February 2026 Lords Chamber

[Baroness Fox of Buckley (Non-Afl)]

My Lords, my remarks follow on, very usefully, from those of the noble Baroness, Lady Finlay of Llandaff. She made some points I was going to make, so I will not make them, but I will make some others.

We should consider the interaction between the rather murky world of politics and the role of the commissioner. I would not raise that issue if this role were not entirely, as I understand it, a political gift of the Prime Minister—effectively a patronage office. We surely all know the problems that can create; it has been rather vividly illustrated in recent months. I want to probe what happens if this goes wrong, or rather how we can stop it going wrong in the first place, because there is genuine concern about a lack of accountability and transparency around the appointment process for the commissioner. For that reason, I added my name to Amendment 126 in the name of the noble Lord, Lord Udny-Lister. He is unable to be here today, but he is spot on to suggest that the appointment should be accompanied by a public statement by the Prime Minister, whoever the Prime Minister is, attesting to the suitability, independence and neutrality of the candidate, so that the Prime Minister is ultimately held to account for this appointment and it is clear why they have made it.

The commissioner has a crucial role, with the power to both run and monitor this service, yet the Bill seems to leave the commissioner’s role open to self-definition. They are appointed by the Prime Minister, and that is it; we are all meant to trust it. I do not want to be cynical, but the question of independence and neutrality is important, because this is a controversial and polarising issue. If we did not think it was, we have only to look at the rather testy atmosphere every Friday in this Chamber, let alone on the airwaves in between. We owe it to the public that they feel that they can trust the process if the Bill is made law.

We have to ask what happens if a partisan figure is chosen—how can that be addressed democratically? What is the process if there is a problem with the conduct of this commissioner? Who is accountable for that? That is one of the reasons I added my name to Amendment 913A in the name of the noble Lord, Lord Wolfson of Tredegar, which seeks ways for anyone with concerns about the conduct of the commissioner to make representations to the Prime Minister. The amendment seeks to probe the process by which the commissioner can be held accountable for their conduct.

That takes me back to neutrality and independence. Let us consider: if we leave this appointment, as the Bill seems to, to the Prime Minister, who is given complete discretion about who to appoint, how will we protect the role from political controversy and being seen as possibly partisan? The noble and learned Lord, Lord Falconer, will not want to compromise the role in that way, I am sure, so some of these amendments might be helpful to insulate it from any accusation of bias.

[Lord Hamilton of Epsom (Con)]

Is the noble Baroness not concerned, as I am, that we are conflating expertise with bias? People think that because somebody is expert, they are independent. It does not necessarily follow. There could be people who are expert but at the same time very biased in their approach to any subject.

[Baroness Fox of Buckley (Non-Afl)]

I think that is self-evidently true in the real world, if I can put it that way.

I note that the present Prime Minister is himself personally not neutral. As we now well know, he promised Esther Rantzen that assisted dying would be made legal, although that was not a promise made to the British electorate or in the manifesto, but it was certainly made in public with much singing and dancing. Would the Prime Minister’s personal views influence whom he chose as a commissioner? Noble Lords might think that is far too cynical and I am being grubby—that is fair enough. However, I want to know if there is anything in the Bill that guards against such grubby behaviour, because if anyone thinks there is no grubby behaviour in politics, they need to get out more. If the commissioner is perceived—

Terminally Ill Adults (End of Life) Bill

Debate between Baroness Fox of Buckley and Lord Hamilton of Epsom

Committee stage
Friday 30th January 2026 Lords Chamber

[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.

House of Lords (Hereditary Peers) Bill

Debate between Baroness Fox of Buckley and Lord Hamilton of Epsom

Report stage
Wednesday 2nd July 2025 Lords Chamber

[Baroness Fox of Buckley (Non-Afl)]

I am just pointing it out.

They are apparently independent, but not that independent. There is a group of us who are sort of maverick; we are called non-affiliated—God knows what it means. It is very important that we defend the right to be political, to be partisan and to say, “I’m not an expert, but I absolutely believe in this”. If we are to exist in here at all, can we at least have some purpose beyond saying how many PhDs we have or how many charities we run?

The great and the good are great and good, but the writing of laws in this country—being legislators and being political—is not just about that. I am as frustrated as anyone about the way that party politics—the whipping process and so on—can damage political independence and courage on all sides of this House. We have witnessed it tonight and we have witnessed it in the other place over the last few days. That annoys me, because I want people to believe in something. On the other hand, the danger of saying that we are a House of experts, and that we will now have an expert HOLAC group that will decide on how many more experts it will bring in, is that we are kicking politics out of what should be an absolutely political place.

[Lord Hamilton of Epsom (Con)]

My Lords, I will not delay the House long. Many years ago, under a Conservative Government, I advocated that Nigel Farage should become a Member of your Lordships’ House. If we had recognised the role that he played in taking Britain out of the EU, people would have said that he does represent the majority in this country.

At the time, he was polling quite significantly—which is more than one could say for most Cross-Benchers in this House—and he was a very significant political player, whether you agreed with him or not. Neither of the political parties was going to nominate him, so it would have taken the Cross-Benchers to make him an offer to join them. At that time he might well have done so, because he thought he had finished his political career by taking us out of the EU, and he would have had a very valuable role to play in your Lordships’ House.

Think how different things would be today. It does not follow that he could not have led Reform from your Lordships’ House, but I suspect that it would have been rather more difficult. We would have been in a very different position today if he were a Member of your Lordships’ House. When we think about how representative our House is of British public opinion, we have to bear in mind that there are serious players out there who are not represented here, and I believe that they should be.

Retained EU Law (Revocation and Reform) Bill

Debate between Baroness Fox of Buckley and Lord Hamilton of Epsom

Report stage
Monday 15th May 2023 Lords Chamber

[Baroness Fox of Buckley (Non-Afl)]

I am simply asking whether that is the solution to resolving the problems that we face in terms of our disentanglement from the European Union’s lawmaking.

[Lord Hamilton of Epsom (Con)]

Before the noble Baroness sits down, could she tell us, then, what Bill is the ideal Bill to bring an end to the constant use of statutory instruments?