Terminally Ill Adults (End of Life) Bill

Baroness Grey-Thompson Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Lord Mackinlay of Richborough (Con)]

My Lords, I am in favour of the amendments from my noble friend Lady Coffey. This has been a fascinating debate about the issues that we have with the devolution settlements across our United Kingdom. It is not only about the issues across the English-Welsh border, which have been so ably demonstrated and described by my noble friend Lord Harper, who has experience in this matter from the other place, but we have other strange dynamics going on in this country on the English border over into Scotland, where things are very different. There are other differences between England and Northern Ireland. We are not proposing to usurp the settlement with Scotland or to usurp the settlement with Northern Ireland.

I am quite interested to hear, at the appropriate time, whether the noble and learned Lord, Lord Falconer, will declare whether he is no longer quite so keen on the old devolution settlements that I can but assume he was part of during the Government that he served in, in that it is not quite as convenient now in this Bill to do the things required by those devolution settlements.

I was interested to hear the comments from the noble Lord, Lord Weir, because the Northern Ireland arrangement has a further dynamic, between Northern Ireland and the Republic of Ireland, where there is, again, a swapping over and a commonality of health provision, and it is quite commonplace that people come and go.

The matter of abortion was also raised. That has had a different dynamic across our United Kingdom over many years. My voting record in the House of Commons will show that I took no part in the rather heated debate on abortion that happened some years ago. I abstained because I appreciated that the devolution settlement was a matter for the Northern Ireland Assembly to come to its own conclusions on.

We have to ask ourselves what this Bill is. Is it a criminal justice Bill? We have 42 Henry VIII powers, exercisable by Ministers, so the Bill before us is not actually the Bill that will affect people’s lives; that will be written later because this Bill has so many of those Henry VIII powers in it. Many of those powers, as I described at Second Reading, should not really be there. We should not be having Henry VIII powers to create criminal matters under statutory instruments and delegated legislation; that is just not the way we do things.

So is this a criminal justice Bill? I do not think it is, because it has now morphed very much into a health Bill. It seeks to amend the NHS Act. I think it is the intent of many of the Bill’s supporters that it is the NHS that does these things: advise, provide the medical staff and do the deed. I do not know which chemical might be used. It may be barbiturates in England; it might be heaven knows what in Scotland. These are serious matters.

Is this a medical Bill? I believe that it is. Because it has morphed increasingly into a medical Bill, whether or not we agree with the devolution settlements, we have to respect them. As my noble friend Lord Harper highlighted very clearly, this is the danger of a Private Member’s Bill that is so interwoven with and entrenched in the complications of a devolution settlement. Whether you are for or against this Bill, or whatever, these are complex matters. These are matters of a different potential life or death, depending on which border you are close to in this United Kingdom. This is a matter of health in Wales.

Looking back to Covid, I know that it is a period we all rather like to forget, unpleasant as it was. At that time, I and my noble friend Lord Harper—I am sorry to keep mentioning him—were somewhat active in the space. Do noble Lords remember? These were matters of life and death; I mean, Covid was deemed to be. I was not quite so keen on the measures and voted against them all, but they were deemed to be measures of life and death; that is why they were so draconian.

I remember very clearly that I came up with what I called the Wilkinson conundrum. It is not a good conundrum now, because Wilkinson has subsequently gone into liquidation, but I made the point that because Wilkinson sold everything—fresh fruit and vegetables, tins of beans, and pots and pans—it was allowed to open. The lunacy was that the independent trader next door who sold only pots and pans was not allowed to open. We did that for whatever reason—it was deemed to be a matter of life and death—but Wales did something entirely different. In Wales, Wilkinson had to hide the pots and pans; one could buy beans and everything else, but a cover had to be put over the pots and pans. In matters of life and death, we allowed Wales to have its way.

This is most seriously a matter of life and death. We have a devolution settlement, and it has to be respected.

[Baroness Grey-Thompson (CB)]

My Lords, I declare my interests in this debate: I chair Sport Wales, which is an arm’s-length body of the Welsh Government; I am the president of the LGA; and I am a director of Living and Dying Well. I also spoke recently at a fundraiser event for a hospice in Wales.

A fundamental part of why we are here is to debate legislation, including looking at how this Bill might impact various parts of the UK—most specifically, England and Wales. I am concerned that we could end up with vastly different systems in England and Wales. Generally, there is a lack of understanding on devolution. In sport, I seem to spend quite a lot of time in meetings asking, “What about devolution?”, and we have to be careful about what we do in Westminster and what should be a matter for Wales when the health service is devolved.

--- Later in debate ---

[Baroness Coffey (Con)]

I am very interested in that, because the response that I have had from the Minister is that nobody should be working on this beyond the Bill team, so nobody should be working on implementation. What the noble Baroness says is very interesting.

[Baroness Grey-Thompson (CB)]

I thank the noble Baroness. At the Lady Mayor’s parade, a member of the public introduced himself and told me that this is what he was doing. We agreed to disagree on the outcome of the Bill. Slightly patronisingly, he followed this up by saying how wonderful he thought I was and to keep going.

I did not mean to make a point that was amusing to the Chamber, as this is far from amusing, but these are the details that we need to understand. Is there far more going on behind the scenes? Is the presumption that very few amendments will be accepted, as happened in another place, or are the supporters of this Bill really open to making it better? I have tabled the second-highest number of amendments; my competitive edge fails in this example, as my noble friend Lady Finlay is about 30 amendments ahead of me. My amendments are to improve the Bill. Many are slight drafting changes, changes of words, which are to improve this Bill. That is our role. That is what we must remember. We have to improve this Bill. We have to make it workable.

Coming back to the point of this grouping, we have to make it work for England and Wales and we have to remember, as people who work in Westminster, that we have a responsibility to the people of Wales and should not step into areas that are not for us to step into.

[Lord Wolfson of Tredegar (Con)]

My Lords, this is the first debate in Committee on this important Bill so I hope that the Committee will allow me to take a minute or two to set out the approach of the Official Opposition. As my noble friend Lord Kamall and I said at Second Reading, the Official Opposition have no collective view on this Bill. Although each Member of the Opposition Front Bench will have their own view on the Bill, we will support noble Lords across the House in their scrutiny of the Bill. We will also table a small number of additional amendments where we feel that parts of the Bill need probing further. We will not seek to delay the passage of the Bill, nor will we seek to hold up progress in Committee. Instead, we will seriously engage in detailed scrutiny of the Bill so that we can collectively deliver the best possible piece of legislation.

In that regard, I respectfully pay tribute to the noble and learned Lord, Lord Falconer of Thoroton, for demonstrating his openness to improving the Bill already by tabling amendments that we hope to get to today and which reflect concerns that have been raised by noble Lords. I speak for all my colleagues on the Opposition Front Bench when I say that I look forward to working with him to ensure that we send a better Bill back to the other place.

The amendments in this group relate to the territorial extent of the Bill. My noble friend Lady Coffey is seeking to remove references to Wales in the Bill so that it would apply only to England. While I am not entirely persuaded that making this an England-only Bill is necessary per se, these amendments raise important questions about devolution. The core question for the noble and learned Lord, Lord Falconer of Thoroton, is why the Bill does not apply to the whole of the United Kingdom on the one hand or only to England on the other.

At the heart of this is, as the noble and learned Lord, Lord Thomas of Cwmgiedd, said—although various Acts of Parliament may put us to sleep, a speech by the noble and learned Lord never does; I was listening very carefully—that these amendments speak to the devolution settlement that we work with and the inconsistencies and confusions of that settlement. The noble and learned Lord used the word “complexity”. It is extremely complex. In this area, we have the problem that criminal law is not devolved to Wales whereas health is devolved. To pick up the point made by the noble and learned Lord, with which I respectfully agree, declaring the appropriate interest, Wales should not be regarded as inferior to Scotland. That is a point of general application.

The Scottish Parliament, as noble Lords know, is currently considering its own legislation on this topic. I hope that noble Lords have picked up that the Scottish Bill is significantly different in key ways—most markedly in the definition of terminal illness. In Scotland, it lacks the “six months to live” test which, whatever view we take, is at the heart of the Bill before us. The definition of terminal illness in the Scottish Bill is:

“For the purposes of this Act, a person is terminally ill if they have an advanced and progressive disease, illness or condition from which they are unable to recover and that can reasonably be expected to cause their premature death”.


I am not quite sure about “premature” in that context in all cases, but that is what the text says.

Leaving aside the point that those resident in one part of the United Kingdom will therefore have different rights to assistance under the law from those in another region of the United Kingdom should both Bills pass, I see the point that my noble friend Lady Coffey is making. If the people of Scotland may choose whether to have a law for terminally ill adults who wish to end their lives, why—I ask rhetorically, so to speak, looking forward to the response of the noble and learned Lord, Lord Falconer—should people in Wales not have the same choice? This is the key question that the noble and learned Lord has been presented with by this group of amendments.

--- Later in debate ---

[Baroness Merron (Lab)]

I will certainly look into the matter that the noble Baroness raised and would be pleased to write to her. However, the first point I wanted to make here was about engagement with the Welsh Government. Of course, Ministers themselves have not met with the Welsh Government in relation to this Bill, as again would be expected, as it is not a government Bill. I know that the sponsors have met with the Welsh Government to discuss the policy intent and to negotiate which clauses require a legislative consent Motion.

The sponsors are also leading engagement with Scotland and Northern Ireland while—on the point made earlier by the noble Lord, Lord Harper, and others—UK government officials are providing technical support to support the sponsor and are engaging with Welsh government officials to discuss technical matters in relation to clauses that require a legislative consent Motion or those to which Wales has requested that further changes are made. Officials have regular meetings; they can be as frequent as weekly, as was the case at some points over the last few months.

[Baroness Grey-Thompson (CB)]

The noble Baroness mentioned that the role of Ministers is to ensure that the Bill is legally robust, effective and workable, but surely safety has to play some part in that as well.

[Baroness Merron (Lab)]

I am sure it would be expected that safety is absolutely paramount. The point I am making—and I look forward to hearing from my noble and learned friend—is that our position in government here is not to deal with matters of policy. As I have said, we are restricted to areas to which any Government would be restricted.

We will absolutely work with the Welsh Government, NHS England and the NHS in Wales to understand the impact of any changes to the law and the provision of healthcare services in Wales, during the coming stages of the Bill.

--- Later in debate ---

[Baroness Hollins (CB)]

My Lords, I want to add a correction for the noble Lord, Lord Winston. The Royal College of Psychiatrists voted on the principle and it was a 50:50 split. The issue of this Bill is different. The college has taken the view, after a great deal of consultation, that it does not support the Bill.

[Baroness Grey-Thompson (CB)]

My Lords, may I clarify that? I have just checked the information. My noble friend is correct in what she says, in that the support was 50:50, but the majority of respondents—64%—opposed expanding eligibility and 65% of them were not confident that consent could act as an adequate safeguard against unfree choices, such as those resulting from coercion or psychopathology.

[Lord Markham (Con)]

My Lords, it is clear, I think, that we all want the same thing here. Whatever one’s feelings about it generally, if this Bill is passed, we want to make sure that the person is in the right position—I do not use either “capability” or “ability”—to make a decision on whether to take part in assisted dying.

We all want the same thing, so what we have to decide is whether we believe that the existing framework, the Mental Capacity Act, can work here. I have heard a body of evidence that says it can. I respect in particular the evidence from Sir Chris Whitty, who, as Chief Medical Officer, is probably our highest adviser in the land in the medical space. He believes that it can do it. I also respect the opinions of the psychiatrists who have written in and said that, in their professional opinion, they are able to use the Mental Capacity Act to assess whether a person is in the right position to take part in assisted dying. So, as the noble Baroness, Lady Andrews, and others have made out, we have a body of evidence and 20 years of experience showing that the Mental Capacity Act can work and is already acting in very similar situations.

One can argue whether these two things are exactly the same, but they are pretty similar: both involve life-and-death situations, such as “do not resuscitate” orders, people deciding not to eat or drink any more, and people with motor neurone disease asking to come off ventilators. These are all very similar situations that, today, are decided under the Mental Capacity Act. So we have a system that is being used and which our best adviser says works, and we are setting an unknown definition against that. If we set about asking, “What do we mean by ‘ability’?”, we would probably all come up with very different answers. This would be untried and tested; it may take years, if not decades, to find something, against something that exists today. It would be very confusing: when do you use the Mental Capacity Act and when do you use this new definition?

Again, we all want the same thing: for the person to be in the right position. Our highest expert in the land says that the Mental Capacity Act can do it, and a number of psychiatrists are also saying that they can make the assessment under it. To my mind, that is what we should be considering.

--- Later in debate ---

[Lord Goodman of Wycombe (Con)]

My Lords, in debating ability and capacity, I will speak briefly as a member not only of the Delegated Powers Committee that considered the Bill but of the Select Committee that also did so. Noble Lords have heard differing views from members of the Select Committee about the various goings on that took place there, but I am sure we can all agree that we heard some very fine evidence.

All I wish to do in intervening here is to quote what Professor Alex Ruck Keene, whom my noble friend Lady Berridge referred to earlier, said about capacity and the role of psychiatrists, as it is extremely relevant to the debate on this clause. He said:

“The point I am trying to make is that, if you simply say, ‘Apply the MCA. Apply the principle of the presumption of capacity. Support the person to have capacity to decide their own life’, I anticipate, if you asked very many psychiatrists, they would go, ‘How am I supposed to think about that?’ That is for a very specific reason. For psychiatrists, most of the time, their job is to secure life. Their job is suicide prevention”.


He concluded:

“We need to know—and one of my real concerns is—how this Bill sits in the wider landscape of the law. I need to be able to tell, because I am going to be one of the people writing the books here and giving the training. I need to be able to say, with absolute crystal clarity, to a psychiatrist, ‘This is the point where you are not in the suicide prevention zone, and if you do not do all steps necessary to try to secure this person’s life, you could be prosecuted or you could be charged in various different ways or be civilly liable’. I need to be able to say, with crystal clarity, ‘You’re no longer in that zone; you’re now in the zone of the Terminally Ill Adults (End of Life) Bill’”.


I quote the professor simply to draw to the Committee’s attention once again the complexity of the issues before us. Although “ability” may be flawed and legally powerless, as the noble Lord, Lord Pannick, suggested, “capacity” is deeply problematic in the context of the Bill.

[Baroness Grey-Thompson (CB)]

My Lords, there is probably one thing we can all agree on today: everyone’s frustration with the process of evidence giving. I was hugely frustrated when the committee in another place was looking for evidence but deaf and disabled people’s organisations were not able to give evidence, despite making up 25% of the population.

I hope that I speak on behalf of the whole House when I say how sad it is that my noble friend Lady Campbell of Surbiton is not able to be in her place. She has experience in politics and in the House of Lords of extensively debating capacity, on what became the Domestic Abuse Act and in previous debates on assisted dying. I would urge anyone who has time to look at her contributions on capacity.

My noble friend is an individual who, I am afraid to say, in her 66 years, has been deemed terminal more times, probably, than most of us in the Chamber combined. She has had her capacity challenged probably an equal number of times. I remember a few years ago, when I had not long been in your Lordships’ House, when my noble friend was in hospital and several of us had phone calls to say that we needed to get to the hospital right away because they were challenging her capacity. Her husband was told that she was not able to make decisions on her care because she was delusional. Why was she delusional? Because she had told the doctors that she was a Member of the House of Lords. The response was, “She can’t be in the House of Lords—she’s disabled”. I cannot remember whether her husband got away with taking her pass in; there was talk about having to take her seal in to prove that she was in the House of Lords. But this highlights some of the issues with mental capacity assessment.

I have had personal experience of it. When my father was ill and the doctors found out I had lasting power of attorney, I was taken to one side to argue that he should have a different set of treatment. He had the capacity and ability to decide what he wanted. In this case, he had to have his leg amputated, and he was told that, as a wheelchair user, he would have no quality of life—they said that to me. If there was one thing I could do for my father, I could get him a wheelchair.

More recently, I have had an experience with my husband. At the end of 2020, he had a blood clot on the brain stem—he had a stroke, and he was blue-lighted to hospital. It was a dreadful experience. My daughter was in her first year at university and had to be called home. We did not think he was going to make it, and we were not allowed into the hospital. I was frequently told by the medics that he had no capacity to make a decision on his treatment. My husband said, “Look at the notes”; I said, “Look at the notes”. What they were arguing over in terms of his capacity was his ability to walk. Looking at the notes was really important, because his lack of ability to walk was nothing to do with the fact that he had a stroke; it was due to the fact that he had had a spinal cord injury in 1984 when he crashed his pedal bike into the back of a double-decker bus.

I understand what the Chamber is saying. I have personal experience where I think the Mental Capacity Act has been used in the wrong way. We have to find a way of making it work so we are able to take care of capacity. Like others, I am not entirely sure that “ability” is the right word. I understand what I mean by “ability”; I have amendments later on around the ability to understand decisions. I have one on British Sign Language because of the case of a deaf man who was told by a nurse who could only fingerspell that he had HIV when he did not—he thought for two days that he had HIV—and I have another amendment around people with learning disabilities. So maybe “ability” is not the right word.

My noble friend Lord Pannick talks about legal definitions, and I also have a number of very minor amendments which look at a better legal definition of disabled people. Perhaps we can take this away, work on it and do something. As the noble and learned Baroness, Lady Scotland, said, we have to make it work. We have to look at the Mental Capacity Act through the prism of the Bill, not in terms of what it was designed to do.

[Baroness Coffey (Con)]

The importance of the amendment in the name of the noble Baroness, Lady Finlay of Llandaff, is that, as has already been well described, there are genuine concerns about the appropriateness of the Mental Capacity Act 2005 as it stands. I think also that there has been more interest at this point because, so far, it has not been deemed to be in scope to put an amendment down to amend the Mental Capacity Act 2005—although I noticed that my noble friend Lord Goodman managed to get something in, so I congratulate him on that. That is why it is taking more time to consider aspects of this. I hear a noise—I thought it might have been someone shouting “Order!”, but perhaps it was excitement elsewhere.

I am just conscious that it is without doubt that, in the consideration in the Commons, Professor Sir Chris Whitty—who used to be one of my Permanent Secretaries when I was at the Department of Health and Social Care—suggested that the Mental Capacity Act had a higher test for basically a life or death decision, and then of course changed that evidence. However, I accept that he said, in evidence given orally to the Select Committee in this House, that having something that people are used to using is important. So one of the things that we need to judge is recognising the role of the Royal College of Psychiatrists—admittedly, it is not the Chief Medical Officer—and take its words seriously.

I was somewhat shocked by the words of the noble Baroness, Lady Murphy. I do not know if she ever used the Mental Capacity Act in her time as a professional. I know she is experienced in this in terms of psychiatry, but I was pretty horrified by the words she just used in this Chamber about the witness.

Tobacco and Vapes Bill

Baroness Grey-Thompson Excerpts

Committee stage
Monday 3rd November 2025 Grand Committee

[Baroness Fox of Buckley (Non-Afl)]

The point I am making is that it is true that the majority of smokers do not sit around and discuss whether filters have a benefit to their health. I am quite sure that, had you asked me in that survey, I would not have had a clue. You would then say that I was being conned into using a filter. However, I would be indifferent because that is not the basis on which people smoke, either with or without filters. I am particularly bemused by the idea that, as a woman, if I saw a white filter, I would immediately think “purity” and be forced to smoke a white-filtered cigarette. I mean, goodness me—have we all gone mad?

I want to talk also about the idea of health warnings on actual cigarettes, which, again, is completely disruptive to product design and so on. It is completely petty. Sometimes, I feel as though the public health people have done everything and anything they possibly can and have run out of things to do, so they are now down to the narrowest possible thing: the cigarette itself.

It is interesting that this idea is aimed especially at young people who might be given one cigarette at a party; and that people seem to be saying that, if only such people saw that written warning, it would be enough to stop them. Were we ever young? Were we ever at a party? Did we ever read anything on the side of a cigarette that stopped us? The point I am making is that, as it happens, the majority of young people know that smoking is bad for you; many young people even give adults like me lectures on how smoking is bad for you. The idea of a written warning is not, I think, very helpful.

I just wonder what the health warning would say. Would it say, “Tobacco kills you”? What is it going to say? I have had an idea. Public perceptions on the difference between smoking and vaping are at their all-time worst. Only a minority of current adult smokers—29%—are able to recognise accurately that vaping is less harmful than smoking. So I have an idea: if we are going to have a message on the side of individual cigarettes, perhaps we could say, “Vaping is cheaper and less harmful than smoking”. That is a good message. Why do we not say that? We could even say, “Vaping is good for you”. The point I am making is that that is not where we should be putting messages; we have heard confused messages in this Committee so far.

My final thought is on the success of Canada and Australia in dealing with smoking, which has been cited and thrown into the conversation. Let us look at what is actually happening and today’s front-page headlines in Australia. The only success of Canada and Australia has been the huge growth of a black market in cigarettes and vapes. It is a disaster. Many people in public health are now saying, “Maybe we went too far”. So, before we start emulating them, maybe we should take different lessons. The front page of the Australian newspaper The Age today is about the fact that people are panicking about what they have inadvertently done. This group of amendments is the kind of thing that could lead us in completely the wrong direction.

[Baroness Grey-Thompson (CB)]

My Lords, I wish to speak to Amendment 34 in the name of the noble Earl, Lord Russell, to which I and the noble Baroness, Lady Walmsley, have added our names. I declare an interest as the president of the Local Government Association. I thank ASH—Action on Smoking and Health—for its briefing, in which it laid out these amendments clearly. It supports the amendments in the name of the noble Baroness, Lady Bennett of Manor Castle, though not the one in my name; however, it raises some really interesting points around what we are trying to do and how far we need to go.

It is important to raise the issue of greenwashing and to look at better solutions than the one we currently have. Although this amendment does not go as far as some want, it is a step forward. I came to this amendment, which looks at the equivalent number of plastic straws that are in each cigarette—it is two plastic straws—because I worked on the impact of the ban on plastic straws on disabled people. Disabled people were vilified for daring still to want to use plastic straws, whereas people who smoke do not seem to have that same level of pressure against them.

The noble Baroness, Lady Fox, always makes really interesting speeches and asks really interesting questions. Are we doing this from the point of view of public health, the environment or littering? I would say, “All of them”. As somebody who has never smoked—I question how interesting any of the parties I went to as a teenager were—I presumed that filters were safer. It is only when you do the research that you realise that people have been deceived into thinking that they are safer than they actually are. The number of butts that are littered worldwide—4.5 trillion—is absolutely horrendous; it is the equivalent of 1.69 billion pounds of toxic trash. Look at the impact on the UK: a minimum of 3.9 million butts are littered every day. I am also interested in the fact that cleaning up these cigarette butts costs local authorities around £40 million a year; I think that that money could be spent far better in different ways.

[Lord Patel (CB)]

My Lords, I will speak briefly in support of the amendments in the name of the noble Earl, Lord Russell, and the noble Baroness, Lady Bennett of Manor Castle. The point I am making is slightly different. If I had my way, I would ban cigarette sales completely, but I know we are not going to get that far in a hurry.

As the noble Earl, Lord Russell, said, the filters are made of cellulose acetate that is converted into plastic. They are promoted as a health benefit in the sense that people think they filter out harmful tar, nicotine and carcinogens, which they do not. They are of no benefit. Filters also make people more addicted, because they make the cigarette smoke temperature lower and feel smoother, so I am told. People therefore take deeper breaths and become more addicted to the substances they inhale, because there is a higher concentration of them. They are actually more harmful, despite being promoted as less harmful than just cigarettes on their own.

Tobacco and Vapes Bill

Baroness Grey-Thompson Excerpts

Committee stage
Thursday 30th October 2025 Grand Committee

[Lord Kamall (Con)]

My Lords, I speak to the group of amendments in my name and that of my noble friend Lord Howe, supported by the noble Baroness, Lady Grey-Thompson, to whom I am grateful. Together, these amendments seek to prohibit the manufacture, sale and supply of high-strength oral nicotine products—those containing more than 20 milligrams of nicotine per portion—and empower HMRC officers to seize and detain such products before they reach consumers.

The reason for these probing amendments can be summarised by a BBC article in July which told the story of Finn, a 17 year-old who started using nicotine pouches after getting bored of vaping. What began as curiosity quickly became addiction. He described how he and his friends would use pouches so strong—some claiming to contain 150 milligrams of nicotine each—that they would vomit or become physically immobilised. At school, he hid them under his lip, until one day he turned “bright green” in class and had to run out of the room. His mouth, he said, was “shredded to bits”.

This is not an isolated case. Recent data suggests that use among 16 to 24 year-olds has risen sharply in recent years, a deeply worrying trend. These pouches come in bright tins, flavoured with mango ice or bubble gum, and are marketed as clean, safe, and discreet. In reality, some of these products are many times stronger than a cigarette and far more addictive. This is a form of nicotine ingestion which is socially acceptable and often unnoticeable. Children can and do consume these products, sometimes even in class.

The point is not that nicotine pouches have no legitimate role at all. For adult smokers trying to quit, properly regulated products can have a place as part of the harm reduction strategy and a pathway off smoking. Although the Minister knows that my classical, liberal views mean that I am generally against banning things I do not like, what we have at present is the sale of nicotine products that are so strong that dentists have reported that they can burn gums, cause lesions and even expose the roots of teeth.

For these reasons, more reputable manufacturers already limit their products to under 20 milligrams per pouch. They also want a market that encourages and rewards responsible production, and which acts against rogue operators flooding the market with dangerously high-strength pouches. These probing amendments suggest a possible, sensible and enforceable ceiling that would align with good industry practice and give clarity to both regulators and retailers.

However, prohibiting the manufacture and sale of these products is only part of the solution. Unless enforcement agencies have the statutory power to act, those prohibitions risk becoming little more than words on a page. That is why our amendment to Clause 88 proposes that HMRC officers should be explicitly empowered to seize and detain high-strength nicotine pouches, preventing them entering the market in the first place. I know that the Government have indicated that they recognise the need for action in this area; this amendment probes the Government on how they intend to address concerns over these high-nicotine products.

Do the Government think that we should rely on downstream enforcement after these products have already reached young people? That is my first question for the Minister. My second question is: do the Government agree with the sentiment of the amendment on the need to address this issue at the border, where these goods are entering the country in large quantities, especially by giving HMRC the clear legal authority to do so? Thirdly, do the Government see the need for immediate action, or will they require a series of future consultations? Finally—I know that I am asking a lot of questions—do the Government believe that it is more effective to have a firm and immediate statutory assurance in this Bill, in order both to allow these products to be controlled and to give enforcement agencies the clarity that they need to act?

These amendments can be seen an opportunity to protect people, in particular young people, before they become addicted instead of punishing them afterwards. It is about ensuring that, if these products are so dangerous, they should not be able simply to be bought over the counter or ordered online. I recognise that all tobacco products may to some extent be classified as dangerous—or, at the very least, as not good for you— but the products at which these probing amendments are aimed are particularly dangerous. I am, therefore, interested in the Minister’s answers; in the Government’s position on high-nicotine pouches; and in how the Government intend to address the concerns here, as exemplified by Finn’s story. I beg to move.

[Baroness Grey-Thompson (CB)]

My Lords, I shall speak on Amendments 13 to 15. I apologise for not adding my name to Amendments 139 and 140, but I strongly support them.

I added my name to this group of amendments because I did not know an awful lot about oral nicotine. I was talking to a group of university students about my strong dislike of vaping. They introduced me to the subject and told me—they were at several different universities—that many university students use vapes almost continuously for lots of different reasons.

A lot of my concerns are around the impact on young people. Growing up, I remember the TV adverts that showed all the damage that smoking would do to your lungs, with images such as the pouring out of a glass of tar, but I am not sure that young people necessarily understand the impact that vaping will have on them. I am concerned about the high levels of nicotine in these products, but I am also concerned about the potential for vaping to lead to addiction and cardiovascular issues such as increased blood pressure.

I have read the same report as the noble Lord, Lord Kamall. It mentions young people talking about using vapes until they vomit. The report talks about a young man, Finn, using vapes and says that they immobilise the individual—especially when they use two or three in one go—which is not at all the intended consequence of them. Finn goes on to say:

“You feel this burning sensation against your gums, and then you get the hit”.


As the noble Lord, Lord Kamall, said, these products have impacts on oral health, including gum disease and gum recession. Vaping is also linked to an increased risk of certain cancers, such as oral, pancreatic and oesophageal cancers. It can also have, potentially, a negative effect on adolescent brain development.

My problem with these products is that they are so easy to hide. The fact that children in school are able to use these products should be cause for concern, because young people are talking about sweating, salivating and struggling to concentrate. These products that should not be anywhere around young people. There is also a lot of discussion about how they can be used as a gateway to vaping or smoking. There is a lot of debate around how vaping and smoking are meant to be helping each other, but I have concerns about that as well.

Tobacco and Vapes Bill

Baroness Grey-Thompson Excerpts

Committee stage
Monday 27th October 2025 Grand Committee

[Baroness in Waiting/Government Whip (Baroness Blake of Leeds) (Lab)]

My Lords, we are running out of time. If we want to finish the group, we will have to finish by 8 pm—otherwise, we will have to break midway through. It is up to noble Lords whether they want to keep their comments to a minimum so that we can finish this group.

[Baroness Grey-Thompson (CB)]

My Lords, I shall speak very briefly to Amendment 193, to which my name is added. I thank the noble Lord, Lord Young of Cookham, for explaining its aim so well. I also support Amendment 4 from the noble Lord, Lord Bethell, and declare an interest as president of the LGA and chair of Sport Wales.

With my background in sport, I know that there has been a lot of nudge behaviour in stopping smoking. Some really good work has been done in Wales on smoke-free sport, and the Football Association of Wales has done work on banning smoking around youth games. However, this does not go far enough. I must apologise, as I am working on this and the Infrastructure and Planning Bill, and I have just come out of a debate on how to ensure that we have good physical activity and improve the health of the nation. The adverse impact of smoking on the health of the nation is partly why I am speaking on this Bill.

I am slightly surprised by some of the briefings that I have received, which seem to be more content with vaping than I expected. I am constantly told that it is much better than smoking, but it is hardly healthy. I have never smoked or vaped, so I probably do not come at it with the fervour of a reformed smoker, but I believe that a great deal of harm has been done by smoking and vaping. I shall discuss some of that in later groups. While smoking cessation services have gone some way, they do not go far enough. This amendment is part of a concerted effort to move forward. The way to do it is through a new clause that very clearly lays out the road map so that we can move towards a smoke-free United Kingdom.

Tobacco and Vapes Bill

Baroness Grey-Thompson Excerpts

2nd reading
Wednesday 23rd April 2025 Lords Chamber

[Baroness Grey-Thompson (CB)]

My Lords, I support many aspects of the Bill. I strongly dislike both smoking and vaping. I grew up in a house where both my parents smoked. My mother used it for hunger suppression and weight management. My father smoked just because people did. They both stopped later in life as the detriment to health was more widely realised.

I am delighted that my noble friend Lord Stevens of Birmingham raised Cancer Research UK. Smoking is the leading cause of health inequalities in the UK and accounts for half the difference in life expectancy between the richest and poorest in society. Some would argue that vaping is okay and not as harmful as smoking. The UK Vaping Industry Association briefing stated that vapes continue to drive smoking to historic lows. The association states that Public Health England has shown that vaping is

“at least 95% less harmful than smoking”

and that the NHS Better Health guidelines affirm that while vaping is not without risk, it is

“substantially less harmful than smoking”.

It might be better, slightly, but it is hardly good for you, as early smoking ads would suggest.

As an athlete, I never directly smoked. When I was competing, I spent most of my time avoiding anywhere that anybody smoked. One of the reasons I really dislike vaping is that I do not seem to be able to walk around anywhere without being vaped on or over. Vaping allows for nicotine to be more prevalent in the air, allowing for inhalation by third parties. I can try to be as healthy as possible—I can eat well and I can exercise—but ultimately I am inhaling vape smoke. I am pleased that a couple of noble Lords have raised cannabis, because I seem to spend quite a lot of my life swerving along the street trying to avoid that as well. I am no longer an athlete, but it is still on the banned list for athletes. The fact that it is so available should be cause for concern.

I realise that I am sounding old and grumpy. Quite a lot of things irritate me, but one of the things that irritate me quite a lot is people who pretend that they are not vaping while trying to hide it. People vape in places where they would never normally smoke, such as on buses. I am certain that I have smelt vape smoke in this very building. Being British, all I do is tut loudly. I am worried that vaping is seen as an alternative to smoking.

I accept that the initial reason for vapes and e-cigarettes was to provide a safer alternative, but the evidence has shown that the introduction of vapes has led to the gradual increase of vaping among children and minors. There are loads of statistics out there—72% of 11 to 17 year-olds report that they are exposed to some form of vape promotion. The main source has been in shops, at 55%, while online it is 29%. In March and April 2023, the proportion of children experimenting with vaping had grown 50% year on year, from one in 13 to one in nine. Young people who had used an e-cigarette were seven times more likely to become smokers one year later. The reasons that young people give are anxiety, stress and depression, but nicotine addiction just links these symptoms. We end up being in a Catch-22 situation.

Beyond my personal dislike, we have to look at environmental issues around smoking and vaping. Cigarette butts are currently made of cellulose acetate, which is synthetic plastic. We spent a lot of time in this building banning straws. Each cigarette butt contains around two straws’ worth of plastic. Globally, 6 trillion cigarettes are smoked each year, with 4.5 trillion butts being littered. Even in the UK, around 3.9 million cigarette butts are littered.

Wildlife and Countryside Link reported more than a million disposable vapes going into incineration or landfill every week. When I go to lots of sporting events, I see disposable vapes and vapes littered everywhere; the only thing that horrifies me more is the number of nitrous oxide cartridges that I see.

I am supportive of this Bill. Committee will be very interesting. I know we are going to get on to some contentious issues around smoking around hospitals. I would ban it from all entrances, but I realise that is possibly not possible. The noble Baroness, Lady Thornton, talked about the impact of smoking on her family, and it has probably impacted every single person in this building. I support any Bill that supports a smoke and vape-free future.

Puberty-suppressing Hormones

Baroness Grey-Thompson Excerpts

Monday 16th December 2024 Lords Chamber

[Baroness Merron (Lab)]

I certainly agree with the noble Lord about the vulnerability of children and young people in this regard, which is why we are taking this action. His last point gives me the opportunity to say that we are committed to implementing the recommendations of the Cass review in full. That is a very useful guideline and tool for us to use.

I have no expectation that the situation that the noble Lord described in his third point will happen. Recruitment is subject to all the usual provisions, and I know that the gender services will seek to recruit very positively. If the noble Lord finds out anything else, I am sure he will raise it with me.

On whether the ban could become permanent, the review—at the risk of repeating myself—will report in 2027, as the noble Lord said. I believe that we should wait for that.

[Baroness Grey-Thompson (CB)]

My Lords, like other noble Lords, I welcome the tone of the Statement. In today’s society, there is huge pressure on young people, through social media and more widely. I would really not want to be a teenager right now.

There is also huge pressure on the NHS, with multiple calls on its services. Can the Minister elaborate a bit more on how His Majesty’s Government are going to increase the number of staff and make sure they are trained to support young people? How can we support those staff? This is a tough area for them to work in. We also need to protect them from malicious complaints to make sure that they can do their job.

[Baroness Merron (Lab)]

I am glad that the noble Baroness has raised the issue of staff. It is vital that people are allowed to go about their work—as the noble Baroness, Lady Cass, should have been too—without fear of physical, verbal, online or direct abuse. I am sure that we all agree that the abuse has been an absolute disgrace. I agree about protecting those who are doing this. On the point about service, as has been said, this is about a group of vulnerable children and young people. It is our duty to provide the services to support them and to make them evidence based.

Health and Care Bill

Baroness Grey-Thompson Excerpts

Lords Hansard - Part 2 & Report stage
Wednesday 16th March 2022 Lords Chamber

[Baroness Morris of Yardley (Lab)]

My Lords, I support the comments of the noble Lord, Lord Moynihan. I do not want to repeat points that have been made at this late hour, but I wish to emphasise that the arguments about the importance of sport and well-being do not need to be made again. Everybody from all parties, right across the House, understand their importance and the consequences of not getting them right. The good will has been there for years, but the ability to transform it into effective action has not, and lots of well-intentioned efforts in the past have come to naught. That is what is driving the committee that met under the chairmanship of the noble Lord, Lord Willis, and I agree with the questions that have been asked.

For me, it is a case of not relying on a cross-departmental committee to run this project. It has not worked in the past, and there is no reason to think that it would work in the future. Is there seniority? Is there someone with clout who can bang heads together? Is there someone for whom it is a very important part of their job, and who knows they will be held accountable? I agree with the noble Lord, Lord Moynihan, that the Health Promotion Taskforce does seem to offer hope. Clarity on that—letting us know about its leadership, and the presenting to Parliament of an annual report for discussion—would allay many of our concerns. I look forward to hearing the Minister’s response.

[Baroness Grey-Thompson (CB)]

My Lords, I draw your attention to my interests: I am chair of ukactive, and I have a number of interests in this area. I also sat on the Lords Select Committee.

I too am not going to rehearse the arguments we gave in Committee, but all the names added to this amendment have been involved in this space for many years. We have all been through various iterations of this, and we should be talking about physical literacy and physical activity, and slightly less about sport. That might be surprising considering my background, but as the noble Lord, Lord Moynihan, said, we have an obesity crisis and a generation of young people who are more likely to die before their parents, and there are a number of conditions that can be treated. Frankly, we have been tinkering at the edges of this for way too long. There have been programmes and lots of initiatives that have had some success, but if we are serious about the NHS and the health of the nation, we have to do things in a different way. I feel like I have been talking about this for about the last 30 years—the noble Lord has had a slightly longer time in sport than I have—but I will be interested to hear the Minister’s response in order to understand how we can genuinely make a change and stop going round in circles on this important issue.

[Lord Addington (LD)]

My Lords, the last shall probably be quickest on this. We have all, as is agreed, said that we need to do something that is coherent. This has not been coherent. We have had committees that met once every full moon, provided everybody had had tea of the right quality that day; thus was their infrequency. Nobody was prepared to ensure that something that was inconvenient for one department was done to ensure that another department fulfilled it. There just was not anything. The Olympics did not manage to make them work together. We need coherent leadership and a price to be paid—accountability—for not doing it. If the Minister can give us that, we will have taken a major step forward. I would of course prefer the amendment that has been tabled, but I will take half a loaf any day over no bread. Can the Minister assure us that there will be leadership and that a price will be paid, publicly paid, for not doing it? Without that, as we know, this will merely become a report with somebody else saying, “They should have had a meeting about it some time”. Let us bin this. I am fed up with making that speech, even though it does usually get me out of a lot of trouble.

Health and Care Bill

Baroness Grey-Thompson Excerpts

Lords Hansard - Part 2 & Committee stage
Monday 31st January 2022 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, I rise very briefly, since I attached my name to Amendment 289, in the name of the noble Baroness, Lady Greengross. She set out the reason for the need for this service, but I just want to say explicitly—particularly given the next group of amendments—that I do not believe that independent providers, for-profit providers at least, would be the way of doing this, given the many problems that we have seen in social care, which are highlighted in the next group.

We still have, in some places at least, community hospitals and facilities in communities. These are things that ideally would be developed by the community for the community, being run for public good not private profit.

[Baroness Grey-Thompson (CB)]

My Lords, I speak in support of Amendment 289 in the names of my noble friends Lady Greengross, Lady Watkins, Lady Finlay and the noble Baroness, Lady Bennett of Manor Castle.

Reading the words of the amendment reminded me of the speech that my noble friend Lady Campbell of Surbiton gave in your Lordships’ Chamber on 29 November 2012—col. 274 in Hansard. She talked movingly about a young man, a wheelchair user who had to remain in hospital four months longer than he should have because of a lack of accessible accommodation —a travesty. One can only imagine the impact on the mental health and well-being of someone in this situation. Sadly, many more now know what this feels like.

Although the situation we are in now is somewhat different, I hope that the Minister will be able to give due consideration to the needs of disabled people, in relation to accessibility—for example, regarding toilets, showers, and specialist equipment—but also to the support networks that disabled people may require, while ensuring that appropriate and knowledgeable people are able to support their rehab. This is vital so that many disabled people are not marooned.

While I have been in your Lordships’ Chamber tonight, I have been sent some data on the work carried out by Dr Elizabeth Williamson about the mortality rates of those on the learning disability register over the last 18 months; these rates are, quite frankly, shocking. I need some time to go through the data in detail and digest it. I will write to the Minister to explore this further but, at a quick glance, the data gives me cause for significant concern and means that careful implementation of the amendments in this group will be very important to protect and support disabled people.

Going back to the amendment, a disabled person’s ability to return home may or may not be more complicated than for a non-disabled person during this time but a longer stay than necessary could have a significant impact on someone’s mental health and well-being, especially if not properly supported, and could even hamper their long-term physical recovery, which, in turn, would put more pressure on the NHS.

Health and Care Bill

Baroness Grey-Thompson Excerpts

Lords Hansard - Part 3 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[Baroness Grey-Thompson (CB)]

My Lords, I want to react very briefly to one comment that has been made in debate tonight, which is the issue flagged by my noble friend Lady Wheatcroft. It is something that is continually raised in the wider debate on assisted dying and it is the issue of incontinence being seen as so inherently tragic that people should use it as a reason to want to end their lives. It is considered an important subject; we have an all-party group on it.

Personally, I find it really difficult because I am incontinent and I have never once felt undignified by it. I cannot believe that I am the only person in the House, or, indeed, in the Chamber tonight, who is incontinent and I will happily discuss the many solutions for sorting out this problem. What I see is that people are scared to talk about it, because they think it is something that we should never discuss. I have many solutions for this. I intermittently catheterise; I use indwelling catheters; I have lots of options available to me if those do not work—medication and lots of options on surgery. There is nothing undignified about being incontinent if we support it properly.

[Lord Aberdare (CB)]

My Lords, both these amendments reflect a desire to give people a greater say over the final weeks of their lives. As a strong believer in patient choice, which is, after all, a very central part of this Bill, I am greatly attracted by and supportive of my noble friend’s Amendment 203.

As several noble Lords have said, we are not very good at thinking about, planning for and managing death, despite Benjamin Franklin’s observation that it is one of only two certainties in this world, along with taxes. This amendment would give people diagnosed with a terminal illness the possibility of some degree of agency in their final days. That seems to me a wonderful idea, but it does of course raise questions about who such discussions would be with, and what qualifications might be needed by the people offering them. So, while I support the amendment, I would want to know more about the practicalities of delivering it, hopefully without having to create a whole new regulated profession of mortality consultants. I hope therefore that the Minister will respond positively to my noble friend’s suggestion of discussions on how the amendment might work; I will be interested to hear his response.

On Amendment 297, which I also support, I make only two brief points. First, I very much agree with what everybody has said that tonight is not the time to be discussing the merits of assisted dying; that is not what this amendment is about. Many Members on both sides of the argument have made it clear that Parliament needs to decide this issue, and the amendment from the noble Lord, Lord Forsyth, seeks to find a way of making that possible. I feel the same sort of alarm as my noble friend Lady Wheatcroft in finding myself on the opposite side to that of the noble and learned Lord, Lord Mackay, but, with the greatest respect, I think he himself said we were waiting for a decision from Parliament before the Government could act on this. In that case, there has to be some way or process for making such a decision happen. That is exactly what the noble Lord, Lord Forsyth, is trying to produce with this amendment. No doubt there are ways of improving how that is done, maybe by giving more time to my noble friend Lady Meacher’s Bill. This responsibility is Parliament’s to resolve, and I cannot believe that, in this great Parliament, we cannot find a way of doing it.

Covid-19 Regulations: Assisted Deaths Abroad

Baroness Grey-Thompson Excerpts

Tuesday 10th November 2020 Lords Chamber

[Lord Bethell (Con)]

Well, this is an extremely complex issue. As the noble Baroness alluded to, there is a wide variety of issues at stake, including values issues, questions of faith and, as she rightly said, questions of personal choice. There are the components here for an important national debate. I acknowledge the comments of several noble Lords already that we are approaching the moment when that debate seems more relevant than it has ever done. When that debate takes place, certainly personal choice will be an important part of it.

[Baroness Grey-Thompson (CB) [V]]

What advice did the Secretary of State, Matt Hancock, have from the Director of Public Prosecutions in relation to the official guidance? The response on travelling to Dignitas suggests assisting suicide is an urgent act and encourages the suicide of those with disabling conditions. Some 25 years on from the Disability Discrimination Act, and with the rise in post-Covid mental health problems, this is particularly inappropriate, as data from other countries shows that the major driver for seeking assisted suicide is the fear of being a burden, and other social factors.

[Lord Bethell (Con)]

In direct answer to the noble Baroness’s question, I am not sure whether any advice was given by the DPP, because there has been no change in the law. Nothing we have done here changes in any way either the 1961 Act or the advice of the DPP. So, from that point of view, the consultation is not necessary. What we have sought to do is clarify travel guidance in a way that does not change the application of the law in the country.