Terminally Ill Adults (End of Life) Bill

Baroness Fraser of Craigmaddie Excerpts

Friday 13th March 2026 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

My Lords, I have two amendments in this group. We have heard a lot of comments about the real world and what is actually going on now, today, out there in healthcare. It will be very interesting to hear how the noble and learned Lord, Lord Falconer, responds to all the criticisms and to the way the inherent dangers in Clause 5 have been highlighted.

My Amendment 201 concerns children. A little boy with advanced malignancies said to me, “I'm going to die when my goldfish dies”. He went on to talk through what he wanted when he was dying and how he would play football in heaven with another boy who had died recently. Not long after, his goldfish was found floating. My strenuous attempts to resuscitate his goldfish failed, and he gently died soon after.

That was some years ago. Today, children live off the internet, not just off what they hear from other children. They know about the debate on this Bill—some raise it in “Learn with the Lord” sessions. If a child is asking questions about this, they must be able to express their fears if they are already ill. They often speak with remarkable frankness. Children’s awareness is phenomenal. They deserve gentle, honest planning of their care that also explains why they are ineligible for assisted suicide. Hence my wording, but the wording of the noble Lord, Lord Rook, provides much clearer guidelines for clinicians involved, to allow them to listen but in no way to hint that the child will be eligible.

Assisted suicide is not a medical treatment. It falls outside McCulloch and Montgomery rulings, hence my Amendment 159. As has been said, if a doctor raises assisted death unprompted, the implication is that this is something you should consider—a tacit implication that this might be your best option. Addressing the comments by the noble Baroness, Lady Hayman, it is a doctor’s duty of care to sensitively explore with open questions and careful listening, to discuss whatever the person wishes to discuss at their initiation. That is patient autonomy and control. Mencap, the Association for Palliative Medicine and the Royal College of Psychiatrists have all warned how patients’ trust gives doctors a dangerous ability to steer decisions if the suggestion comes from the doctor.

Listening with undivided attention is crucial in gentle, honest communication in the face of patients’ anguish. Patients hang on to our every word, so suggesting it as an option signposts them in that direction. It abandons suicide prevention duties under the Mental Health Act and the state’s duty under Article 2 of the European Convention on Human Rights. The amendments overall have a common theme of making the autonomy of the patient paramount in these discussions, their being able to raise assisted death in their own time, at their own pace and at their instigation. I hope these amendments will be taken heed of.

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I thank my noble friends Lord Jackson and Lady Monckton—whose speech was quite spectacular—for raising the example of DNRs. It is very good example when we are talking about who can raise assisted dying in preliminary discussions.

I want to give a very brief illustration. When my father was in hospital, five different medical professionals came into his room and took us, his family, aside, to get him signed up to a DNR. He did not really want that. It might have philosophically been the right medical thing to do, but he was not in the right place. He did not want to be asked, and certainly not five times by five different medical professionals. It left a rather bitter taste in our mouths, because when we were able quietly, as a family, to have that discussion with him, he did have a DNR. We were fortunate to have that time, rather than him having something put at the end of his bed with the Sainsbury’s bag.

This group of amendments is really important. They are all similar, saying that we need some guidance on who can raise the discussion and under what circumstances. If we really believe that patient autonomy is important, then something should come from this group of amendments and be in the Bill.

[Baroness Coffey (Con)]

My Lords, briefly, Clause 6 standing part has been opposed by my noble friend Lord Moylan because of other aspects of amendments he has tabled. I very much support Clause 6 staying in the Bill: it was the one amendment on Report in the Commons where there was a significant majority in favour. In particular, I found it astonishing that anyone could even consider raising this with a child: it disappointed me that the sponsor of the Bill in the Commons voted against that amendment, but I am relieved it got through. It is also worth pointing out to the Committee that there is slightly different wording between Clause 6 and Clause 5(1), which my noble friend Lord Moylan’s Amendment 152 addresses by making sure “other health professional” is included, not just “medical practitioner”.

I have also seen multiple times what my noble friend Lady Fraser has just referred to. It is very irritating, especially when somebody is being taken home to die, if, against their wishes, DNR had been put in place by medical practitioners and then had to be rescinded. It is somewhat frustrating in that regard.

My noble friend Lord Goodman was succinct; I think that is partly the training of a journalist, or it might have been two years of quiet contemplation when he considered his vocation in an abbey on the Isle of Wight.

I want to briefly raise one point: the noble Baroness, Lady Blackstone, referred to the BMA. I am conscious that it is a trade union for doctors and does a lot of work on their behalf, but it is not a clinical body. However, the BMA pointed out its concerns that, without it, there would be uncertainty and legal risks for doctors. The BMA went into more detail on that in its evidence. In contrast, the Medical Defence Union’s written evidence to the Commons Select Committee—by the way, the MDU is an organisation that specialises in providing indemnity and other legal issues regarding doctors—came up with a different thing. It said:

“The MDU is concerned that the legislation, as … drafted … leaves doctors who do raise it at greater risk of a complaint”,


and then subsequent legal things.

So, as has also been pointed out, at what point would this ever be raised? I support more generally the approach and understand that, if a doctor is asked about this, of course that should be open to a response, unless they do not wish to do so, and part of Clause 5 covers that. But, overall, that initiation should not be in the hands of the medical practitioner, and we will come on later in further clauses to debate the recording of such discussions.

Terminally Ill Adults (End of Life) Bill

Baroness Fraser of Craigmaddie Excerpts

Committee stage
Friday 27th February 2026 Lords Chamber

[Lord Moylan (Con)]

My Lords, it is a pleasure to be addressing your Lordships’ Committee immediately after the lunch break.

I have a number of amendments in this group which work together to do two things. The majority of them would prevent any public money being spent on the assisted dying service. One of them, Amendment 917, seeks to create an alternative funding structure. I will say immediately that my alternative funding structure is robust and effective, but I am not saying that there are not others that could be put forward that would have a similar effect. The main point is to say that there needs to be a justification given—and so far, none has been given—as to why this service, when it is created, should be a charge on the taxpayer.

The noble and learned Lord has made much in his comments about the Bill so far of the principle of autonomy—the right to dispose of what happens with your own body, I suppose. The principle of autonomy in this respect has been in place in law since 1961, when suicide was decriminalised. In my view, the Bill goes a great deal further than establishing autonomy. What it is, in fact, is coercive on the rest of us, and one of the ways it is coercive is by envisaging we are all going to pay for it.

The Bill does not say explicitly that the service is going to be paid for by the taxpayer, nor does it say explicitly that it is going to be free. But it is certainly the case that the Bill envisages public expenditure, because the Secretary of State is going to have to pay for the maintenance of the voluntary assisted dying commissioner and its staff and activities. It is implicit and assumed—if I am wrong about this, the noble and learned Lord can certainly tell me—that the provision of the service at the individual level is going to be free, so to speak, at the point of use, by the person applying for what is called assistance.

Why should this be a charge on the taxpayer? It is not, after all, a medical treatment—that is absolutely clear. We provide free medical treatments through the NHS, and the principle of free medical treatment at the point of use has been established for many years in this country. But this is not a medical treatment, so why should it be provided free? Giving someone permission legally to do something which has previously been prohibited—in this case, giving them permission to assist a suicide, which at the moment is legally prohibited—does not imply that the Government have to pay for the person to do what they are now permitted for the first time to do. So that argument does not follow in any sense at all.

It might be said that voluntary assisted dying is an act of compassion. However, it is not the case that the state pays for every act of compassion. There are many organisations that do—mainly charities—and individuals provide and express their compassion through donations and other acts of compassion. The Government are not the only source for that. Anyway, the truth is that many of us do not consider the Bill, or assisted suicide, to be an act of compassion—in fact, we consider it to be an act of cruelty.

My amendments would prohibit the expenditure of any public funds on any activity envisaged in the Bill, with the exception of activities related to Clauses 34, 35 and 36, which will create criminal offences. Of course we would expect the Government to pay for the investigation and prosecution of criminal offences, as that is a state function, but it would be prohibited for the other functions envisaged in the Bill.

In my Amendment 917, I have attempted to show at least that an alternative is possible. The alternative would involve the assisted dying commissioner establishing a budget at the beginning of the year. The budget might not be exactly what he ends up spending. Anyone who has been involved in a local council will know that you are legally obliged to set a balanced budget at the end of the year, but it does not guarantee that at the end of the year it turns out to be a balanced outcome. However, he would be obliged to set a budget and, on the basis of that budget and on the basis of the assessment of demand—which in the first year would be difficult but in later years should be fairly predictable, I imagine—to set a fee. That fee would be payable by those applying for assistance. Provision is made for the applicant to pay the fee in stages, so that the applicant might be charged so much at the preliminary discussion stage, so much later on and so much after that.

People already pay for assisted dying. I do not know what it will cost, but I do not see that it would be any more expensive, necessarily, than going to Dignitas—and people pay to go to Dignitas. Why should we assume the expenditure they make at the moment and put it as a charge on the taxpayer? I could be rebutted if people were to say that this is an argument about nothing and that, in fact, the Treasury will save so much money from assisted dying because we will not have all these sick and elderly people whom we have to pay to look after and that we are going to be quids in. If any noble Lord wishes to make that argument, I invite them to do so.

This is not in itself an argument about whether the service should be provided by the NHS; I know it sounds as though it might be, but it is not. I have later amendments about whether the service should be provided by the NHS. This is a question about whether it should be free. The NHS can provide services and charge for them—it already does. Many hospitals, in London at least, have private wings, where the NHS provides services for which it charges. I am making the conceptual point that this is a distinct question: should it be free or should people pay for it? Should there be a charge on the taxpayer? The case that it should be free, with a charge on the taxpayer, has not been made by the proponents of the Bill. If they wish to make it—it is a little ambivalent in the Bill—now is their opportunity to do so. I beg to move.

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I thank my noble friend for opening this after-lunch debate and outlining that an alternative is possible. I will speak to my Amendments 835 and 868, which I added to this group because they seek to ensure that an assisted dying service is clearly separated from NHS provision, and that therefore there is clear transparency around funding for the taxpayer. Such a service could be set up and funded privately or charitably, in the same way that we currently provide and fund care provision or hospice services. Such a service would be clearly separate from the NHS but could operate, potentially, in partnership. The NHS could commission services if it so chose. It would have to share data and patient records and there would need to be a system for the regulation of such services.

Proposed new subsection (3) in Amendment 835 would require regulations on the definition of “privately funded organisations”. If such a service were to work in partnership with the NHS—as many hospices and third-sector service delivery organisations currently do—then further proposed new paragraphs would require the establishment of the means through which NHS providers can commission privately funded organisations to provide services, the data sharing arrangements to ensure the necessary sharing of records, and, most importantly, a system for regulating the provision of services by privately funded organisations.

Some noble Lords have expressed concern about the use of “private organisations” in my amendment. However, I point to the kaleidoscope of entities that currently provide health and social care already—some of which my noble friend Lord Moylan just mentioned. Many people have made a profit from care homes, many charities provide health services instead of the NHS, and private hospital care coexists with NHS provision, often with the same consultant working in both. I am a Conservative, so I do not think that making a profit per se is a bad thing; I accept, however, that making excessive profit out of death and dying is not particularly morally acceptable, hence the need for robust and transparent regulation of any services.

As I have said before in Committee, this is an area where the supporters of the Bill and those who support the principle of legalising assisted dying have missed a trick. I agree with my noble friend Lord Moylan in posing the question of why assisted dying should be taxpayer funded. It is essential to ask the sponsors of the Bill at this stage how the establishment of an assisted dying model would impact our current healthcare systems and healthcare professionals.

We know that the Secretary of State for Health has stated that there is currently no budget for such a service, and Stephen Kinnock, the Minister of State for Health and Social Care, who voted for the Bill, has said that the Government will have to reprioritise spending to fund assisted dying. Therefore, it appears that funds will have to come out of the health department’s existing budget. Stephen Kinnock also stated that, as it stands, the Bill includes the potential for the provision of assisted dying services privately, as well as free on the NHS. Therefore, in this group of amendments, we are asking the sponsors to ascertain what they intend. We are also asking how the Government feel about the requirement to reprioritise NHS budgets. What services would then be deprioritised?

The Bill currently going through the Scottish Parliament makes it explicit that assisted dying would, if that Bill is passed in Scotland, be delivered by the NHS. However, this Bill is silent. The Scottish Bill is accompanied by a financial memorandum which outlines the cost to a range of public bodies of the implementation of providing assisted dying—the majority of which will fall on the NHS and cover things such as the cost of anticipated clinician hours, staff training, the costs of the substance provided to end life, both the storage and monitoring of it, data collection, support and navigation services, and many others. All are extra costs the NHS will be expected to bear.

Do the supporters of the Bill, as my noble friend Lord Moylan referred to, expect the service to be cost neutral, as referred to in the financial memorandum in Scotland? The Scottish Bill identifies “unutilised healthcare” savings due to the obvious but rather unsettling statement that every person who has an assisted death will not require further care.

I accept that saving health and care costs is not the motivation of the sponsors of this Bill. However, there are many concerns expressed by individuals and organisations that implementing the Bill will have real cost implications and necessitate clinicians diverting time and resources from their already stretched patients to support assisted dying. We need to find a balance between what the Bill sets out to provide and what is best for our current health and care services. Creating a service that is separate from the NHS, as many hospices and care homes already are, would ensure such a solution.

The NHS is not a solution to all issues. I come to this from my experience in the third sector, where the medicalised approach to care and service provision, as would be delivered by the NHS, often does not lead to optimal outcomes for the patient—whereas a demedicalised social model can often be preferable. Hospices provide holistic care, not just medical care, and include support for emotional, social, practical, psychological and spiritual needs, as well as support for the person’s family and carers. Hospice teams may include doctors, nurses and healthcare assistants, but also social workers, therapists, counsellors, chaplains and trained volunteers. Is this not what the Bill’s sponsors want for terminally ill adults?

Public Libraries

Baroness Fraser of Craigmaddie Excerpts

Thursday 12th September 2024 Grand Committee

[Baroness Fraser of Craigmaddie (Con)]

I have sat on the board of the British Library. Partnership with the wider ecology of UK librarianship is in its founding legislation and in its future strategy, Knowledge Matters. As my noble friend Lady Sanderson said, the library already plays a convening role with the Business & IP Centre, the living knowledge network of local public libraries and the national libraries of Scotland and Wales, and with LibraryOn, which could act as a digital front door but falls between DCMS and Arts Council remits.

As the British Library continues to recover from a devastating cyberattack, this remains its priority, and any expansion of a strategic sectoral role has to be scoped and resourced in this context. None the less, the British Library stands ready to work alongside the department and public library authorities to support the ongoing strategic development of the sector. I, too, look forward to a longer libraries debate, not least when a strategy is published.

Miscarriages of Justice

Baroness Fraser of Craigmaddie Excerpts

Wednesday 14th June 2023 Lords Chamber

[Lord Bellamy (Con)]

My Lords, all women have access to safe and legal abortions on the NHS up to 24 weeks of pregnancy. It is not appropriate for the Government to comment on any particular case, although your Lordships will no doubt be aware of the case to which the noble Baroness is referring. This is a contentious issue and the Government maintain a neutral position on possible changes to the relevant criminal law.

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I appreciate that the Minister cannot comment on individual cases, and I need to declare my interest as chief executive of Cerebral Palsy Scotland, but I am very concerned by the case of Auriol Grey, a woman from Peterborough with cerebral palsy and potentially other disabilities, who has received a custodial sentence and been refused leave to appeal. Notwithstanding any of that, could the Minister please explain how the judiciary takes advice? Which disability organisations does it take advice from when ruling on cases of people with disabilities?

[Lord Bellamy (Con)]

My Lords, the relevant judges will decide cases depending on the evidence in that case. There is very substantial judicial training—probably more than there has ever been—on all kinds of issues, including the issues to which the noble Baroness refers.

Assisted Dying Bill [HL]

Baroness Fraser of Craigmaddie Excerpts

2nd reading
Friday 22nd October 2021 Lords Chamber

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I feel incredibly honoured to be part of this debate. Apart from personal interests, I need to declare some professional interests: I chair the Scottish Government’s Advisory Committee for Neurological Conditions, I am a trustee of the Neurological Alliance of Scotland and I am chief executive of Cerebral Palsy Scotland.

In both Scotland and in this place, we are being asked to consider the prospect of legalised killing. People with a neurological condition live with what the Bill defines as a terminal illness in that they have

“an inevitably progressive condition which cannot be reversed by treatment”.

Currently we have no cure for Parkinson’s, MS, Huntingdon’s or MND, which are all awful, terrible conditions. Both Stephen Hawking and Doddie Weir are high-profile examples of those who achieved incredible things post a devastating terminal diagnosis—of MND in both cases. The Bill implies that if you cannot speak, eat, dress yourself or move around without assistance and you require intimate personal care, your life is less worthy than others. However, this is the reality of everyday life for many disabled people.

We have all had much correspondence in preparation for today’s debate, but one letter stood out from me. It was from Ian and Sue Farquhar. Ian’s brother Peter died in 2015, from what doctors and family members had all diagnosed and understood as a progressive and incurable condition. But in fact he was murdered by someone who had entwined himself into his life for entirely financial gain. If Peter Farquhar, who everyone believed to have a terminal condition, had expressed a desire for assisted suicide, none of the so-called safeguards in the Bill would have prevented his death, and therefore his murderer would not now be serving time behind bars. Mr Farquhar was a deeply religious, highly intelligent teacher. I know this because he was my English teacher. I am appalled at the manner of his death and I am deeply concerned that, with a state-sanctioned way of bringing about the death of the elderly, the unwell and the disabled, criminals and fraudsters would be able to take advantage of the most vulnerable in our society, without fear of consequences.

For me, the Bill crosses a Rubicon, enshrined in centuries of law and medical ethics: that every human life is of value. I beg your Lordships to please oppose it.