(1 week, 1 day ago)
Lords ChamberMy Lords, some intricate and sophisticated schemes have been put forward concerning the nature of the panels. In listening to the noble Lord, Lord Sandhurst, I thought how fascinating it was to hear about the ways in which the Law Society has approached this issue. We have heard a lot of fine speeches challenging everything from the size of the panel to whether it should have investigatory, prosecutorial and even quasi-judicial powers. I suddenly felt like I was in an episode of “CSI” or something; I thought, “They’re only panels”.
At this stage, things are getting so demanding and confusing—and, potentially, overlayered and bureaucratic—that I think we should take a step back. I am very sympathetic to why this has happened. It is driven by a desire for safeguarding and for these panels to have teeth. It is created by the loose wording in the Bill—in my opinion, it is poorly drafted—that means people are asking, “What will these panels be able to do? What should they be able to do? Can we join the dots?”
I want to go back and, more simplistically, if you like, take at face value the panels as they are described by the sponsors of the Bill. They will have three members: a social worker, a legal person, and a psychiatrist or somebody from the psychiatric profession. What will we expect of them? I ask this because just announcing that is not sufficient. Let me say why. I have put my name to Amendment 925A in the name of the noble Lord, Lord Murray of Blidworth, who explained very well what he is trying to do with his amendments. What is needed is a process for how you end up on a panel if you are one of those three people the sponsors want.
Amendment 925A would set up an independent appointments process. It talks about appropriate tests, interviewing people, vetting and so on. That is important, because the one thing we know from all the speeches we have heard is that these panels are going to be important and will make important decisions. You cannot put an ad in the paper saying, “Are you a social worker? Call in”. We have to think about what will be required of them. The noble Lord, Lord Murray, has done us a real service by straightforwardly saying that we need to have a system and that this is necessary, albeit by no means sufficient, to counter any risk of these panels being inadequately staffed by the wrong or inappropriate people and to fulfil the aspirations of the Bill’s sponsors. It is absolutely necessary to counter any notion that the panel members will be just yes-men and yes-women who have turned up. In my opinion, we need to know that they are of the right calibre.
The role of panels is not just crucial in terms of safeguarding for those who go down the assisted dying route. We have heard some important speeches about safeguarding, but we must also consider that a proper process is required to protect panel members themselves from what is potentially likely: the blame game.
I have some qualms about the privacy issue that the noble Lord, Lord Jackson of Peterborough, raised. He conceded that there might be some problems with this. It was another testy exchange with the noble Baroness, Lady Hayter, but we have to consider both sides of that exchange as being valid, because the panels are going to have to take on some difficult issues.
I am sure that the noble and learned Lord, Lord Falconer, will remember what I thought was a tricky exchange on “Newsnight” last year, when he was asked about a situation where a 21 year-old could successfully request an assisted death and their parents would find out about it only after they were dead. Reference has made to the fact that that would happen with suicide, but in this instance, the difference is that heartbroken, grieving mums, dads or other family members would find out not only that their 21 year-old child was dead, but that they had been to a panel of social workers and so on, it had been okayed, and they had not known about it. It is only fair to note that they would want to know exactly on what basis that panel made the decision. They would ask what the qualifications of the people on that panel were. It has to be said that that 21 year-old could have a learning disability, Down syndrome or a previous history of mental illness and had tried to commit suicide in the past. Any people with a similar illness could actually be granted the right to an assisted death by that panel.
You can imagine the multiple scenarios. I thought of that, because I remember in Committee in the other place, Naz Shah, the Labour MP, made an excellent thought-provoking contribution when she said that when such cases happen, the public, including family members of the person who has died, will rightly demand answers and so will the media. They will want to know who the panel members were and why they made the judgment that they did.
There is a lot at stake here. I do not necessarily agree with the view of the noble Lord, Lord Jackson, that everything should be in the public domain, but there will be demands to know what is going on. Is it being hidden away?
The way that Amendment 925A sets up a process will, in the end, protect people, because otherwise, panel members are likely to be on the receiving end of some intrusion whether they like it or not. We have to make sure that the right people are on the panel.
I also just wanted to raise the staffing of these panels. This feels very banal after some of the things people have been talking about, but are there enough social workers and psychiatrists around to go on to the panels? This seems to be a rather practical problem before we get anywhere. At the moment, in terms of professional panellists, there is one psychiatrist on each panel, yet the most recent workforce data shows that one in six consultant psychiatric posts is unfilled. So, that shortfall must cause problems. The Royal College of Psychiatrists has said:
“As things currently stand, mental health services simply do not have the resource required to meet a new range of demands”.
I am just worried that, if the commission struggles to find enough psychiatrists, the temptation will be to appoint anyone available and willing who can be ticked-boxed as a mental health professional. That is a bit nerve-wracking, which is why interviews, qualifications and so on are important.
The same resource deficit challenges exist in terms of legal members who, after all, we are told will replace judges in a way, according to the noble and learned Lord, Lord Falconer. But who are these legal members? Where will they be found, given the immense financial and resource constraints on the justice system that are so bad, we are told, that the Government are embarking on judicial vandalism, in my opinion, in sacrificing jury trials? If there is a problem of scarcity, is the recruitment of real legal expertise to the panel guaranteed?
Finally, on the third panel members, the social workers, given what the British Association of Social Workers have said about the sector being at capacity—and it has noted that the panel proposals are not resource-light—noble Lords can see that there might be a problem. The shortages of all three panel member professionals are not evenly distributed throughout the country, so what does the noble and learned Lord, Lord Falconer, think about a postcode lottery? What if you cannot find the legal expertise, social worker and psychiatrist in one part of the country where there is a great need? Has he consulted, as the sponsor of the Bill, with the likes of the Royal College of Psychiatrists and the British Association of Social Workers about workforce pressures?
My final question is for the Minister, with regard to the panels. What assessment have the Government made of their workability, given the problems raised by the professional bodies of social workers and psychiatrists? If there are not enough people available, surely the panels will not be workable and therefore this part of the Bill needs to be sorted out; otherwise, there is no point passing it as it stands, because it will never happen.
My Lords, I am pleased to follow the noble Baroness, Lady Fox of Buckley, not least because I often do not agree with her but I did agree with several of the things she has just said. She started off by talking about the dangers of intricacy in what we lay down in the Bill—about how the panels should conduct themselves. The more I listened to the speeches and the more I read the amendments, the more worried I was about not only the overly bureaucratic nature of this, and the over-engineering of the processes the noble Baroness referred to, but the invasion of privacy on many levels.
We all recognise the role of the panels in safeguarding against abuse, but there will be a range of people. I was thinking of how I would feel on one of the panels, being interrogated along the lines of some of these amendments. The amendment in the name of the noble Baroness, Lady Gray of Tottenham, says that I must be asked whether I have discussed the request with my next of kin and any other persons I am close to. Where someone has not done so, they will be asked to discuss their reasons for not doing so. That is way too intrusive and well beyond a way of finding out whether I have been coerced in this situation. It goes much too far, is over-engineered and, in the words we started off with today, is not kind to the majority of those who will be seeking help in circumstances they find intolerable. They find the way in which they are dying intolerable; it is not that they want to end their life, but it is because they are dying. I find that the whole tenor of this conversation does not think about the people who are going to be involved in, and subject to, this process. We have to think about them as well, and balance it with the sort of protections that are needed to make sure that bad things do not happen within these processes.
I was also surprised at the level of involvement in the amendment about children and information in the name of the noble Baroness, Lady Finlay—and she and I agree on many things. This is desperately personal stuff within families. The idea that not only should you be consulted on why you have not spoken to a child about this, but that you should have to nominate someone else to report your death, and then you should make sure that there are bereavement services, opens up a whole area. Just like palliative care, bereavement services are very patchy—all over the place—and vary tremendously. Why should this category of parental loss be subject to the obligation of the state to provide bereavement services, as against every other sort of parental loss?
(1 month ago)
Lords ChamberMy Lords, the noble Lord says that we should understand the ordinary meaning of words, and I agree with him. I must say to him, however, that my own mother—who turned her face to the door and stopped eating and drinking—did not commit suicide. We did not feel that. She was at the end of her life, she was terminally ill and she decided that she had had enough. She did not want the next blood transfusion, and she did not want any more time. I find it really offensive to be told that she committed suicide.
I also want to respond to the noble Baroness, Lady Gerada. Words do matter, which is why plain speaking matters. Being told that you cannot say certain words because they might offend someone is unhelpful. Can the noble Baronesses respond to the fact that, in opinion polling, if people are asked whether they support assisted dying, many will say yes? If they are asked whether they support assisted suicide, they say no. In other words, calling something what it is—namely, suicide—is not necessarily something that the noble Baronesses should be frightened of. They cannot instruct us as legislators to do the job of spin doctors in trying to make something more palatable by using kind words. We have to be honest with the public and then they will decide; it is up to them.
(3 years, 11 months ago)
Lords ChamberMy Lords, the noble Lord, Lord Forsyth, made the accusation that lots of the amendments to the Bill of the noble Baroness, Lady Meacher, were a sort of Machiavellian plot to subvert the democratic process. I want to point out that I had tabled one of those amendments, about mental health, partly because I thought that that was our job here, that when a Bill was before Parliament, we followed it through—to every Bill that I have followed through here, there have been myriad, endless amendments. I thought that our role was to scrutinise proposed laws, to debate the merits and demerits and so on. I was therefore disappointed that there was no Committee stage of that Private Member’s Bill. So I do not accept the suggestion that those who put down amendments did so somehow to avoid debate; in fact, it was the opposite.
My general view on the problems of parliamentary and democratic process was best summed up by the noble and learned Baroness, Lady Butler-Sloss. I also feel queasy that there is a kind of subverting of the parliamentary process by an amendment on assisted dying or assisted suicide being put down on the Health and Care Bill. It is totally inappropriate. It is hijacking a Bill. Whatever else assisted dying and assisted suicide is, it does not contribute to improving anyone’s health. It requires ending a life; it is not a healthcare matter, and it will require a major change in the criminal law, so this is the wrong Bill.
However, I have every sympathy with the noble Lord, Lord Forsyth, and feel his frustration. I feel all the time that there are lots of laws I want to change; there are lots of things I want to change about the country; there are lots of times when I feel as though the public think one thing and the Government ignore them. What one therefore needs to do is to lobby the Government—the noble Lord probably has closer access to them than a lot of us—or, as maybe I would do, to organise a demonstration or a protest, unless the Government had got away with banning that by the time we got there. In other words, in a democracy, there are lots of frustrations that need to be expressed if you want to change the law. Using our position as unelected legislators to add an amendment to an inappropriate Bill seems to be completely wrong on a matter of such huge importance.
My Lords, I am glad to have the opportunity to follow the noble Baroness, Lady Fox, because it is important to recognise that she is quite right. We should be able to debate all the amendments that Members wish to debate, in both Houses, on a Bill of this sort—a Bill which, as the noble Baroness, Lady Campbell of Surbiton, said, addresses one of the most fundamental social issues facing society.
However, I disagree that this amendment is nothing to do with health. The last days, weeks and months of your life, the healthcare that you receive, and the options open to you are part of the healthcare provided throughout the NHS and elsewhere. So I believe that it is appropriate to discuss this here.
It is a novel procedure. It is not a procedure that mandates the Government to support the draft Bill that would be brought in. The amendment is precisely designed not to do that but to ensure that a proper and full debate is held. I normally follow the noble Lord, Lord Cormack, closely and often agree with him, but I do not accept that we are imposing something on the other House by passing an amendment to a Bill which is going to have lots of amendments made to it and will go to the other place, where those amendments will be debated and accepted or not accepted.
Most of all, I support this amendment because it is now nearly 20 years since I served on the Select Committee on the Joffe Bill. There have been numerous attempts since then to resolve this most important issue. They have all run into the sand one way or another. Our legislature has not found itself able to produce a result that satisfies everyone that there has been full debate and resolution found to how we should go ahead as a society. In that time, 20 other jurisdictions have managed that task, because they have found a way of providing adequate time so to do. For those reasons, I support this amendment.