Crime and Policing Bill

Baroness Hollins Excerpts

Report stage
Wednesday 18th March 2026 Lords Chamber

Although I have been assured that abortion providers will remain subject to the criminal law if Clause 208 is passed, it is hard to see how this will make a meaningful difference in the case of early medical abortion, since providers who carry out telephone assessments will have met the standard of due diligence required of them. My amendment offers a reminder that the needs of children and young people should be paramount in our thinking and in that of all who work with them, including abortion providers. My amendment asks for one proportionate safeguard: that when a child is the patient, a medical professional meets her before prescribing. I invite noble Lords to consider whether that is really too much to ask.

[Baroness Hollins (CB)]

My Lords, I had prepared a longer speech but I will speak very briefly as most of the points that I wanted to make have been made. Of course, I do not want to see women unduly prosecuted, but I was reassured by the wise remarks in Committee of my noble friend Lord Hogan-Howe, suggesting that the adaptation of police protocols was more suitable than the change in the law proposed by Clause 208. I support Amendments 424 and 425, as indeed do many doctors, including some among the numbers mentioned by the noble Baroness, Lady Monckton, of obstetricians.

One point, perhaps, has not been raised, which concerns the mental health of women who may be isolated. I am concerned about the possibility that home use, in relative isolation, of a self-induced later abortion may increase the emotional intensity and mental health consequences for some women, particularly if she has limited support or medical complications, which are of course much more common in later abortion. Safeguard support and informed consent become much more critical as gestation advances and care shifts away from in-person supervision. I am not convinced by this clause; it just has not had the depth of thought and preparation required to really understand the complexity of what is being proposed. I ask Members to err on the side of caution and to support the amendments that I have spoken about.

Terminally Ill Adults (End of Life) Bill

Baroness Hollins Excerpts

Committee stage
Friday 13th March 2026 Lords Chamber

[Baroness Butler-Sloss (CB)]

My Lords, I remind the House of the extraordinary common sense of the noble Baroness, Lady Cass, who pointed out that there may well be a lack of suitable doctors of one sort or another, and they may have to put up with what actually is the reality.

[Baroness Hollins (CB)]

My Lords, I fully endorse the amendments from my noble friend Lady Finlay, and I think they deserve rereading. There has been a huge misunderstanding of what she actually described. This was not something drafted on the back of an envelope: it is based on years of work spent thinking about how it could work. Her amendments simplify and strengthen the Bill, making the whole process more transparent and more likely to be subject to evidence-based improvement in future, if an assisted death service is approved. My noble friend’s amendments may go some way to addressing the continuing concerns of the medical royal colleges.

However, my main amendments in this group concern the regulation of substances proposed for use in assisted dying. I recently co-authored an editorial in BMJ Supportive and Palliative Care called Untested, Unlicensed, Unregulated: Prescribing and Oversight Issues in Physician-assisted Dying/Suicide. I thank the noble and learned Lord, Lord Falconer, for tabling amendments that attempt to address these matters. My amendments would amend his Amendments 624A and 708A.

In this country, drugs intended for clinical use are subject to evaluation and oversight by the Medicines and Healthcare Products Regulatory Agency, the MHRA, which assesses their efficacy, quality and safety before they can be licensed for human use. These frameworks were specifically designed to ensure that drugs used in healthcare meet appropriate evidence and safety standards before they reach patients. I ask the noble and learned Lord why he is reluctant to rely on the established regulatory framework, and instead proposes the development of a separate framework specifically for substances used in assisted dying. My amendments to his amendments, as well as my Amendments 699 and 709, propose that the Secretary of State, when specifying a substance in regulations, must have regard to recommendations of the MHRA and that the established committee is required to report to the MHRA.

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[Baroness O'Loan (CB)]

It has not changed on the Government’s contemporaneous website. If I go to New Zealand, it says that the doctor cannot advise or discuss assisted dying with you unless you ask for it first. Those are both government websites today. I accept that there may be changes due and that they may come, but they are not there, as far as I can see.

[Baroness Hollins (CB)]

My Lords, when a doctor, the very person entrusted to preserve life and relieve suffering, raises the possibility of assisted dying, it is no longer a neutral act. For some people, particularly those who are depressed, isolated or overwhelmed, the mere introduction of the possibility of an assisted death risks planting the idea that this course is rational or even expected. In an inherently unequal doctor-patient relationship, suggestion is easily perceived as a recommendation.

There is no requirement for an independent advocate—somebody to sit beside the patient and help them process and grasp what is being said. We are leaving some of the most consequential conversations a person can ever have to take place in isolation, within an asymmetrical, authoritarian relationship. There is no requirement for the discussion to take place with someone with specialist expertise. A “registered medical practitioner” could be a locum doctor who the patient has never met before, a foundation-year doctor in their early years of practice, or someone with no training in palliative care or experience of autism or learning disabilities, and yet they are the people who may introduce a conversation that could seriously alter the trajectory of a life.

No clinician should be allowed to initiate such a conversation; it should arise only if a patient independently raises it themselves, and even then the doctor’s role should be limited to acknowledging the request and directing the patient to an independent body while remaining firmly focused on diagnosis, treatment and the provision of appropriate and timely palliative care, as needed. Assisted dying must not be presented as an equivalent option alongside treatment, support and comfort. To do so risks the medical service being seen as one that no longer values preserving and improving life but rather one that enables the end of life.

The Royal College of GPs has stated that the role of a GP should be limited to signposting patients to a designated specialist service if, and only if, the patient raises the subject. This week, the Royal College of Psychiatrists wrote to me expressing its continuing concern. Its view is that

“all applicants should receive a holistic, multidisciplinary assessment at the preliminary discussion stage, including for mental health needs”;

in other words, something much more like the multidisciplinary panel proposed by my noble friend Lady Finlay in the previous group. I therefore suggest that Clause 5, and, in consequence, Clause 6, should not stand part of the Bill.

[Baroness Monckton of Dallington Forest (Con)]

My Lords, Amendment 205 is in my name, as well as those of the noble Lord, Lord Carlile, and the noble Baroness, Lady O’Loan. I declare an interest as founder of Team Domenica, and as the mother of a young woman with Down syndrome. As several of my points have already been covered by other noble Lords, I will be brief.

My amendment is simple and proportionate. It reflects the concern I raised at Second Reading: it is incomprehensible that people with learning disabilities will not be allowed a family member or, in the absence of a family member, a learning disability nurse or qualified practitioner to be with them when a doctor initiates the conversation about assisted suicide. People with learning disabilities may chronologically be adults, but many are still children who lack understanding of abstract principles. It is true that Clause 5(2) specifies that a doctor must exercise

“their professional judgement to decide if, and when, it is appropriate to discuss”

assisted suicide, but I am not satisfied that that provision is sufficiently strong. My amendment would provide an additional layer of protection for this vulnerable group, many of whom have a limited understanding of the concept of death and dying and would therefore be panicked and frightened. This combination of fear and lack of understanding would be, emotionally, absolutely devastating.

As we have heard, there is also—I see this in my own daughter—a desire to please, which is a way of seeking to belong. My daughter is also terrified of doctors, hospitals, dentists and anything medical. I dare not imagine what it would be like for anyone with a learning disability to be in a situation of having a conversation about killing themselves, probably in front of a doctor who they may never have even met, without a family member present. Yes, the Bill requires that there is mental capacity and a clear, settled and informed wish to die, but assessing capacity for people with learning difficulties is complicated on so many levels. I cannot begin to imagine how it would be done. Would it be through an easy-read leaflet with diagrams? It does not even bear thinking about.

I acknowledge—I know that this will come up—that not all families are perfect and that malign family dynamics are a reality, but I suggest that the greater threat would come from a process that fails to accommodate the specific vulnerabilities of people with learning disabilities. I find this lack of understanding extraordinary, but then, people with learning disabilities are so often ignored and forgotten. As my noble friend Lord Harper has already pointed out, during Covid, people with learning disabilities had “do not resuscitate” notices put at the end of their beds. Then came the clinical frailty scale, with nine categories going from category 1, meaning “fit”, to category 9, meaning “terminally ill”. The guidance was to deny those in categories 7 to 9 life-saving treatment. My daughter fell into category 7; thank God we did not have to send her to hospital when she got Covid.

In the Bill, this discrimination may be about saving money. The Government’s own impact assessment has revealed a saving of £2,323 if an independent advocate is not used. It is easy to work out cost, but it is much harder to measure the value of a human life.

Before I end, I thank all the parents who have written to me about the Bill. Some of them have said that they are too scared to die themselves because they do not know what on earth would happen to their adult children. These are parents who have spent a lifetime fighting. One mother wrote to me, as she digested the implications of the Bill for her own child, saying, “Sometimes, it’s easier to cry about the small things”.

My daughter has taught me a different way of looking at the world. She has taught me to live more fully and to be courageous. She has given me the strength to fight for people with learning disabilities so that they are not defined by being different. Their story is our story. We have a shared humanity and an absolute duty of care for this most vulnerable group, from the beginning of their lives to the end. It is on their behalf that I stand in your Lordships’ House and ask noble Lords to support my amendment.

Terminally Ill Adults (End of Life) Bill

Baroness Hollins Excerpts

Committee stage
Friday 9th January 2026 Lords Chamber

I look forward to hearing from the noble Lord, Lord Carlile, and, as I said earlier, from the family Justice Minister, if she is in her place.

[Baroness Hollins (CB)]

My Lords, I have added my name to several of my noble friend’s amendments and I would like to congratulate him on finding a solution that could allow the Bill to meet one of the sponsors’ original aspirations. The impact of Amendments 25 and 120 are many. One that may be attractive to the Committee would be that it would considerably shorten the Bill, as several clauses would be removed and hours of debate would probably become unnecessary.

The Bill states that it will

“allow adults who are terminally ill … to request and be provided with assistance to end their own life”

and refers to eligibility for

“lawful assistance to voluntarily end their own life”.

The Oxford Concise Medical Dictionary defines suicide as

“deliberately causing one’s own death”

and assisting suicide as

“the act of helping a patient to commit suicide by giving them the means … to do so”.

The Office for National Statistics similarly defines suicides as

“deaths resulting from intentional self-harm for persons aged 10 and over”.

Clause 32 on the criminal liability for providing assistance explicitly references the Suicide Act 1961, providing that assistance carried out in accordance with this Bill will be exempt from that Act’s offence of assisting suicide. This reinforces that the subject of the legislation under consideration is assisted suicide.

I am aware that many people would prefer the term “assisted dying” because of the stigma associated with the term “suicide”. The Bill rather contradicts itself by adopting the term “assisted dying” while attempting to modify these other statutory provisions that concern assisted suicide. That creates both conceptual and legal ambiguity. If Parliament is being asked to authorise assisted suicide, then it follows that such decisions fall within the proper domain of the courts. For that reason, among others, I support my noble Lord, Lord Carlile’s amendment that would replace the assisted dying review panel with a court-supervised process.

Amendment 120 appropriately moves decision-making from the medical to the legal sphere. Assisted dying is not a medical treatment; it is an act with profound societal implications, and it therefore requires, I suggest, judicial rather than clinical oversight. For that reason, I believe that it does not belong in the National Health Service. Under the proposed model, doctors would continue to provide expert medical evidence confirming diagnosis and prognosis, but the final authorisation would rest with a judge. That judicial scrutiny provides a stronger safeguard against errors, and enhances transparency and public confidence in the system by placing responsibility for these irreversible decisions in the courts, where I believe they properly belong.

Concerns about capacity in the courts, or potential delay and cost, do not outweigh the need for robust safeguards when decisions of life and death are involved. The appropriate response is to streamline court processes, not to lower the level of scrutiny. The same issues of capacity in taking on a new stream of work would, of course, apply in the NHS. A judge would provide a more independent assessment of an individual application than a panel, which is likely to comprise people who have chosen to do that work and have no track record of dealing with issues such as undue influence. It is regrettable that the other place abandoned judicial oversight in favour of an assisted dying review panel and commissioner, thus seriously weakening the safeguards that were originally envisaged. The assisted dying review panel is not, in its current form, fit for purpose. Its composition does not provide sufficient safeguards for vulnerable individuals, and there is insufficient clarity on how it includes expertise in palliative care, safeguarding and decision-making capacity. A court model would be preferable; without it, the panel would need to be substantially strengthened.

I also strongly believe that, without guaranteed access to a comprehensive multi-disciplinary specialist assessment of palliative, psychological and social care needs, neither judicial scrutiny nor an expert panel would be able reliably to identify inappropriate requests for an assisted death. Those preliminary assessments are the most essential safeguards to ensure that treatable sources of distress, or modifiable psychosocial factors, are considered before an informed decision can be made, both by the individual concerned and by the decision-makers. We will debate specialist multi-disciplinary assessments in the next group of amendments, and I look forward to returning to that.

I also support the amendments tabled by my noble friend Lord Carlile that seek to broaden the scope of safeguards referred to in Clause 1. At present, the Bill limits those safeguards to Clauses 8 to 30, which cover only the procedural steps. My noble friend’s amendments would extend the safeguard requirements to the whole of the Bill, ensuring that every substantive provision—not just the procedural elements—must be complied with before assistance to die can be lawfully provided.

I also support my noble friend’s Amendment 69 to strengthen the definition of “a terminal illness”. The amendment clarifies that a terminal illness must be

“an inevitably progressive disease which cannot be halted”.

The inclusion of “halted” is important; it ensures that eligibility is limited to conditions for which the disease trajectory cannot be stabilised or slowed through available interventions.

[Baroness Berridge (Con)]

My Lords, I will speak briefly to two of the amendments in this group. I am grateful to the noble Lord, Lord Carlile, for meeting me in relation to his proposals under Amendment 120.

This group also contains related Amendment 116, which would introduce the capacity test that the noble Lord expects the court to use. Within that amendment, in the clear and settled intention part of that capacity test, is the introduction of the phrase “undue influence or coercion”. That test is different from the rest of the Bill, which uses “dishonesty, coercion or pressure”. I am sure that the noble Lord is aware, as he has outlined, that undue influence has a particular meaning in civil law and is presumed within certain relationships.

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[Baroness Brown of Silvertown (Lab)]

My Lords, my Amendment 51 and others would require the providers of assisted dying services to ensure that all persons seeking such services have discussed the range of end-of-life options available to them with a palliative care specialist.

The Government and proponents of the Bill have promised that end-of-life care will not suffer in order to accommodate assisted dying. I have significant reservations about whether this would be possible, and I fear a push factor, particularly for those who are vulnerable, those who are without family and, to be absolutely frank, those who are poor and cannot fund their own care. When done right, as we know, palliative care can provide a dignified end of life and alleviate the desire to hasten one’s death. Equitable access to options for end-of-life care must be a cornerstone for this Bill, which is why I have laid these amendments. I want to ensure, as far as humanly possible, that all people have and know that they have equal access to palliative care, to treatments that may extend life and to specialist teams to manage the symptoms and pain and to provide dignity.

This Committee must accept that equal access to these services, as for many public services, is not guaranteed and is rarely delivered. I give just one example, due to time. A Liverpool resident with the terrible asbestos-related mesothelioma cancer can undergo a specialist injection that has a high chance of abolishing the pain, whereas a resident of the Midlands, who may be unfit to travel to Liverpool, simply cannot because there are so few specialists trained to take this work on. Therefore, access is obviously limited.

Clauses 5 and 12 require doctors to have discussions about disease prognosis, treatments and symptomatic alleviation with patients. Clause 5 includes an offer to refer them to a specialist. Although these are important discussions, which must be had, they have to be conducted by somebody properly trained and experienced in such matters. For conditions that are specialist care cases, such as motor neurone disease, most doctors will have minimal involvement in the management of that condition and will likely not have the skills and training to adequately fulfil the duties that the Bill places on them. A specialist referral is absolutely necessary to that ensure patients are able to reach an informed decision about their care with somebody who properly understands the disease, how that disease will progress and what can be put in place to alleviate their distress and pain.

A person seeking assisted dying will be worried about their future, losing their independence and dignity and placing a huge burden on their families. A dedicated palliative care specialist would have the expertise, skill and training to provide the highest level of information and support, tailored to the individual needs of each patient, and have specialist knowledge of the condition that the patient is experiencing. Clause 1 requires that a person

“has a clear, settled and informed wish to end their own life”.

I believe that you can ensure a settled and informed wish and reach an informed decision only after properly exploring all available care and treatment options with dedicated palliative care specialists and having those options available to you. My amendment would therefore create a duty on all people involved in the provision of assisted dying services to ensure that those discussions have occurred, covering care options including symptom management and home care provision.

I welcome the amendments tabled by other colleagues that would ensure a dedicated palliative care assessment is part of the assisted dying process and I believe that my amendment can work alongside theirs. My amendment would also cover consultations with palliative care specialists that occur prior to a person seeking assisted dying, providing they cover the criteria outlined in the amendment. You can reach a clear, informed decision to end your own life only after having the advice and support to truly be able to weigh your options. That guarantee should absolutely be in the Bill.

[Baroness Hollins (CB)]

My Lords, when I first read this Bill, I realised that there was something important missing—a first stage, if you like. This group of amendments is probably one of the most important to address before the Bill can really make progress. Ther Bill, in its drafting, has perhaps failed to recognise the provisions of the Health and Care Act 2022, which my noble friend Lady Finlay referred to, with regard to the new obligations on integrated care boards to commission for the palliative care needs of their local populations.

There are several amendments in my name in this group. I have also added mine to my noble friend Lady Finlay’s amendment. The most important amendment is Amendment 221, and I will try to explain some of the rationale. The amendments are intended to ensure that specialist multidisciplinary palliative care is a mandatory, properly resourced and integral part of any assisted dying pathway. The central purpose is quite simple: it is that no person should progress towards assisted dying until their palliative, psychological and wider social care needs have been fully assessed and understood and, where appropriate, addressed. The medical royal colleges have endorsed this request.

Not all doctors are trained or equipped to provide comprehensive information about prognosis, symptom control or the full range of palliative care options at the end of life. This is not the remit of general practitioners or general physicians, nor should such complex and sensitive discussions be taking place in routine medical settings. For that reason, I disagree with the preliminary discussion clauses and the clauses about first and second declarations in the Bill as currently drafted. Instead, I propose that once a terminally ill person requests an assisted death under this Act, they must be referred for

“a multidisciplinary specialist palliative care assessment”

alongside a psychological assessment within established palliative care services. Given the urgency that often accompanies such requests, this assessment should be completed within seven days of referral. To ensure that any subsequent decision is genuinely informed, the individual must then be offered access to appropriate palliative care and psychological support

“within 48 hours of the assessment being completed”.

A person should not be eligible to proceed until their needs have been assessed, and the treatment and support options have been made available. That is why I propose that, before an application can proceed, there must be written confirmation from a consultant in palliative care medicine that all relevant specialist palliative and end-of-life care options have been discussed, offered and, where appropriate, tried.

Medicine routinely works in this careful, stepwise manner. It is entirely consistent with good clinical care that evidence-based palliative care should be fully explored before considering the irreversible act of ending a life. I have heard discussion in the media suggesting that these amendments would mean that people would be forced to have palliative care against their will. No, that is not their intention; the intention is twofold. First, it is to make sure that patients can make an informed decision. Secondly, it is to ensure that specialist palliative care services are available for people who want them, and that people are not choosing an assisted death because the NHS is not commissioning for the palliative care needs of the population.

Obviously, specialist palliative care itself needs to be properly defined, funded and made universally available and accessible. It is far more than the prescription of high-dose medications at the end of life. It is an active, multidisciplinary approach that supports patients and families at home, in hospital, in care homes and in hospices. That is why defining specialist palliative care, as set out in one of the amendments before us, is so important.

At present, access to such care is inconsistent and heavily dependent on charitable funding. Before introducing assisted dying on a national scale, we must ensure equitable access to high-quality specialist palliative care across the country. As part of the multidisciplinary palliative care assessment, I propose that every individual applying for assisted dying should be considered for NHS Continuing Healthcare through the fast-track funding process. This is an existing, well-established process, although perhaps not well understood within primary care or perhaps even within your Lordships’ House.

Continuing healthcare provides fully funded health and social care support, including assistance with medication, mobility and activities of daily living, but it can be slow to arrange. However, the fast-track pathway exists precisely to ensure that people with rapidly deteriorating or terminal conditions can access this support within 48 hours of their request. It works in practice. It is already there; the architecture already exists.

This can make an enormous difference, enabling people to choose their place of care, arrange nursing support, secure equipment or home oxygen, and relieving families of both emotional and financial burdens at a critical time. Encouraging fast-track access to continuing healthcare within the Bill would ensure that individuals receive timely, holistic support and are not driven towards assisted dying by unmet care needs. Furthermore, patients approved for fast-tracked continuing healthcare funding are more likely to have an accurate prognosis of six months or less. Taken together, these amendments would place specialist palliative care where it belongs: at the centre of end-of-life decision-making, ensuring dignity, compassion and genuine informed choice.

Sentencing Guidelines (Pre-sentence Reports) Bill

Baroness Hollins Excerpts

Committee stage
Monday 19th May 2025 Grand Committee

[Lord Dholakia (LD)]

My Lords, I first offer my apologies for missing the Second Reading of the Bill. I was chairing another meeting at the time and was therefore absent.

I have been involved in race-relations issues since the early 1960s, which, if I may say so, was well before the Lammy review on sentencing. The Lammy review highlights the stark ethnic disparity in all stages of the criminal justice system, and ably describes what happens. It explains that, from the point of arrest, through to prosecution, custodial remand, sentencing and imprisonment, ethnic-minority groups are disproportionately represented and experience disproportionately worse outcomes. The review specifically highlights the importance of pre-sentence reports in tackling such anomalies. It sheds light on individuals from backgrounds unfamiliar to the judges in this country.

My interest in the criminal justice system started in the early 1960s, when I was appointed a member of the board of visitors of HMP Lewes, a predominantly white town in Sussex. The problem was that coachloads of young black people on remand were brought from Brixton to Lewes prison, and the perception of white prison officers was that they were all criminals. It took me quite an effort to convince staff that bringing black people such as doctors, dentists, teachers and technologists into prisons as visitors would demonstrate that they provided a valuable service to the community. I was not surprised by the limited knowledge about different communities within our country and the complete lack of understanding about them. I was well aware that the race relations adviser in the Home Office at the time was stopped and searched at least 35 times when he was driving his car to work or other engagements. That was the situation in those days.

Years later, a parole system review was set up by Douglas Hurd, the Home Secretary, under Lord Carlisle of Bucklow, and I was appointed a member. In the course of our visits to the United States, I was astonished to see the number of black faces in prison. One of the members of the review team was Roger Hood, director of criminological research at Oxford University, and we both came to a conclusion about the need for systematic research so that we did not end up with predominantly black prisons in the United Kingdom. On our return, we approached the Commission for Racial Equality for funding, and it was granted.

We had serious problems with ethnic statistics, which were not kept, except by police forces. We looked at nearly 4,000 cases that had gone through the West Midlands courts, so there was no instance of influencing an ongoing process. In addition, the research looked at 1,000 predominantly white cases as its controlled element. Never before was such a vast research project undertaken. With ethnic data available from police files, and using over 80 sentencing variables, later reduced to about 20, the results were startling. The study revealed a complex pattern of racial disparities influencing variations in the use of custody, sentence length and alternative punishments. It challenged the need to eliminate racial bias from sentencing practices. This was the first major study to examine whether race is a factor in influencing the crown courts in England.

One thing I failed to report was that, when we looked at the statistics of the 4,000 cases before us, we not only identified the discrepancies in the sentencing process itself but were able to identify the judges predominantly involved in this exercise. All these factors appeared well before the Sentencing Council was established in 2010. Despite this, there are still a large number of black faces in our prisons compared with their representation in our community. The same applies to women in prison.

The Government have been wrong in the past and will be so in future. The number of ethnic minority faces will rise in our prisons. A good PSR will allow a judge and probation officer to do sentence planning, with a higher number of community sentences rather than custodial sentences. We need to understand that good sentence planning allows us proper rehabilitation and resettlement instead of planning for gloom and doom. We need a system that is effective and less costly in future.

I am also delighted to support the amendment from the right reverend Prelate the Bishop of Gloucester.

I have racked my brain to find any logic as to why the Bill is necessary. It is a fact that the public and political world is conditioned by gut feeling rather than by examining the outcomes of social research. We are often reliant on prisons as a means of dealing with offenders instead of assisting reforms. There is a crying need to give priority to crime prevention and diverting offenders from the criminal justice system.

I often ask myself: are women’s prisons necessary? I look to our judiciary to ensure that courts should send to prison only those whose offending makes any other course of action unacceptable but, more importantly, to ensure that those sent to prison should not stay there for any longer than is absolutely necessary.

The pattern of crime changes from place to place and from generation to generation. There is ample research into the causes of crime and a good deal of information about how society could respond. I am grateful to one of my colleagues, Bela Mongia, a human rights lawyer, and Janey Starling, who has been supporting Level Up’s No Births Behind Bars campaign for a while now.

Unless we take measures of this kind now, it will be very difficult for overstretched prisons to provide regimes which vulnerable inmates need. We still continue with short sentences which serve little purpose. They are too short for sustained rehabilitation programmes but long enough for people to lose jobs and accommodation and to weaken their family ties. Most of these offenders would be better dealt with by community orders which can provide a longer period of supervision to address their offending behaviour—a point well made by the noble Lord, Lord Marks.

I have repeatedly urged Governments to legislate to make sentencing guidelines take account of the capacity of the prison system. At a time when all other parts of the system have to work within the reality of limited resources, there is no reason why sentences should be exempt from this provision.

The campaign has achieved extensive media coverage and continues to work towards an end to the imprisonment of pregnant women and mothers. It has the support of the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists, and the Association of Child Psychotherapists.

The Sentencing Council has credited this organisation in its decision to introduce two key guidelines: a new mitigation factor for pregnancy guideline, and a new imposition of community and custodial sentences guideline. These avoid custodial sentences for pregnant women and new mothers on account of the risks.

I do not believe there are important sources within the Home Office or Justice Department who possess the expertise required in such matters. I believe the Minister is misguided in reaching a decision on these matters. It is not right to have any birth certificate which identifies a place of birth as “HM Prison”. Public opinion polling shows that the majority of people want to see pregnant women and mothers given community sentences.

[Baroness Hollins (CB)]

My Lords, I will speak briefly about definition, and in particular the lack of definition of “personal characteristics”. There is a possibility that the Bill could have unintended consequences for two groups that I have a particular interest in: first, people with learning disabilities and autistic people, and, secondly, mothers and their children.

On the first point, offending behaviour by people with learning disabilities and autistic people is often a consequence of environmental failures, and custodial sentences do not reduce offending for these groups. PSRs are essential because they may not be easily recognisable without a pre-sentencing report. It is quite worrying, especially at a time when it seems as if new mental health legislation may not adequately develop the community resources that are needed to keep them safe. That is one issue.

I specifically want to speak about Amendment 16, introduced by the right reverend Prelate, and agree with the points she made. I am a retired psychiatrist with a specialism in child psychiatry and psychotherapy, as well as learning disability and autism. I am concerned about the impact this may have on maternal and children’s well-being, in both the short and the long term. The noble Lord, Lord Marks, commented about innocent children, but it is much worse than that. We know unequivocally that perinatal and postnatal periods are critical to the lifelong health and well-being of the child. When mothers are sent to prison, 19 in 20 children are forced to leave their homes at that time. This is not okay.

We have plenty of evidence from developmental psychology, psychiatry and neuroscience that shows that maternal stress and separation during the perinatal period can alter a child’s developmental trajectory. The effects ripple across the child’s whole lifespan, impacting their ability to form secure relationships, regulate emotions, perform in school and thrive in adulthood. That kind of developmental trauma significantly increases a child’s own long-term risk of mental illness, future offending and substance misuse.

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[Baroness Hollins (CB)]

I was talking about unintended consequences and the risks of a lack of clarity. I was going to end simply by urging the Minister to reflect deeply on the evidence. We just cannot afford to legislate in ways that risk compounding harm and perpetuating disadvantage.

[Lord Thomas of Gresford (LD)]

My Lords, I realise that it is now 50 years since I was appointed as an assistant recorder; I was involved in sentencing for a very long time until I finally gave up. I later became a recorder, then a deputy High Court judge, and I dealt with many cases. The principle you have to apply, I think, is that the more you know, the better the sentence. For that reason, I fully support everything that has already been said by my noble friends, in particular that this Bill is completely misconceived.

In sitting here, I was trying to think of an illustration. It comes from a case that I did many years ago in the Midlands. It involved a family from south Asia. The wife of the son of the family was in an arranged marriage. She had come over from India or Pakistan—I cannot remember which—and married the son, who was a taxi driver. She could not speak a word of English. She had come over on a tourist visa, I think; in any case, there was something wrong with the visa. She became extremely fat because she ate with the family, then ate again with her husband when he had finished with his taxi business at night. So she stopped eating, and she slowly dwindled away until she was in a desperate condition. However, she was unwilling to go to the doctor. So the son took her to the doctor, but he went in himself and described her symptoms as if he was suffering from them. He got a prescription for the symptoms by pretending that he was the person who was suffering. The poor girl eventually could not walk, was incontinent and so on. She died. The son and both his parents were then charged with manslaughter. The trial took place, with the three of them charged with manslaughter, and they were all convicted. They then came up before the judge for sentencing.