Terminally Ill Adults (End of Life) Bill

Baroness Thornton Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Lord Pannick (CB)]

My Lords, I agree with the noble Lord, Lord Shamash. The noble Baroness, Lady Finlay, speaks with enormous authority based on enormous experience, but we are considering an amendment which seeks to replace “capacity” with “ability”. As Clause 3 of the Bill makes very clear, “capacity” is the term used because there is a well-established, tried and tested scheme under the Mental Capacity Act 2005.

By contrast, the word “ability”, which the noble Baroness seeks to insert, is inherently uncertain; it has no defined legal meaning. There are later amendments to this Bill, to Clause 3, which do seek to address the concept of capacity in the context of this Bill. They are very important amendments and I look forward to our debates on them—but to insert “ability” as the governing concept would simply cause confusion.

[Baroness Thornton (Lab)]

My Lords, I absolutely agree with the noble Lord, Lord Pannick. The noble Baroness, Lady Finlay, and I have worked together for many years, on many health issues, but I do not think she addressed the issue of why she wants to change the wording.

Given that we worked in 2005 on the Bill that actually put capacity into the legislation, I would be interested to know what her reasoning is. I think that is particularly important because the noble Baroness did not address the issue of choice. Of course, ability, capacity and choice are central to this Bill. I wonder why the committee whose report we have before us did not take any evidence at all from terminally ill people who need to make the choice in this matter. I think that was a grave mistake on its part and that if it had, that possibly would have led the noble Baroness to take a different view.

[Baroness Smith of Newnham (LD)]

My Lords, I was a member of the committee. The committee noted that we did not take evidence from terminally ill people. That was not a decision that we took as a committee. Suggestions were made and the clerks did not, in the end, manage to provide us with witnesses who were terminally ill, but it was not a decision that was formally taken. I agree that, had we taken evidence from—

--- Later in debate ---

[Baroness Scotland of Asthal (Lab)]

We were very grateful to receive evidence from New Zealand, and we heard from a practitioner about the challenges and the opportunities that there are. But we also heard that New Zealand had moved from being the third most successful in delivering palliative care to the 12th, and there was a direct correlation, we were told, between the reduction in the investment in palliative care and the existence of the new service. These are the realities, and there are many who have said that if there is to be a real choice—if I can just finish this sentence, I would be grateful—then the choice has to include a fully funded palliative care service to enable people to choose whether that is the course they want to go down, or another. Without that, the choice is not a real one.

[Baroness Thornton (Lab)]

Would my noble and learned friend care to tell the House which other countries the committee took evidence from?

[Baroness Scotland of Asthal (Lab)]

The difficulty we had was of course with time. We did not take a lot of evidence. The Committee will know that there was a request that we should take written evidence. It would have been possible for us to take written evidence from a number of jurisdictions, which could then have formed a body of evidence that could have been looked at. The decision was made by the committee that we should not take written evidence—so I think the committee was constrained in terms of what it could do and the timing. The committee tried to do its best. I hope that this House will not deny itself the opportunity of looking at evidence from other jurisdictions; we will all be able to talk about that in due course.

Terminally Ill Adults (End of Life) Bill

Baroness Thornton Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, it is indeed an honour to open the second day of our debate on the Terminally Ill Adults (End of Life) Bill. I pay tribute to my honourable friend Kim Leadbeater, who represents the seat in which I was born, for bringing the Bill to us from the Commons. I thank my noble and learned friend Lord Falconer for the clarity and excellence of his introduction to, and leadership on, this Bill.

As my noble friend the Chief Whip said, last Friday’s debate was outstanding and the House of Lords at its best. There are many questions to be addressed as we do our job in scrutinising the Bill, and the questions posed come from those of us who support the Bill and those who do not.

I am greatly relieved that my noble friend Lady Berger and my noble and learned friend Lord Falconer, in their joint email to all Peers, say that their agreement will allow the Bill to go through all its stages in your Lordships’ House. With respect to those who disagree in principle with assisted dying, it is important that we remember that the Bill came to us from the Commons, and has undergone significant scrutiny and change. Our job is to scrutinise it further and improve it if we need do so. It is not our job to kill this Bill.

I was saddened last week when the noble Baroness, Lady May, spoke about this being a suicide Bill. People have written to me in the last week, very distressed. They add things such as, “We are not suicidal—we want to live—but we are dying, and we do not have the choice or ability to change that. Assisted dying is not suicide”.

I hope that today the House will continue to conduct this debate with compassion. I shall read an extract from one of the many letters that I have received, which explains the importance of compassion; I cannot better it. This concerns a woman, Pamela Fisher, a lay preacher in the Church of England and who has terminal cancer. I am reading these words with Pamela’s permission. She says:

“I live in terror at the prospect of how my final weeks of life may be. I have seen other family members (brother and father-in-law) at the end of their cancer journey, and I know what may lie ahead. Even the best palliative care has its limits. This is the dead weight of fear that I carry around with me, all the time.


I am not asking anybody to help me to shorten my life. In supporting the Bill, I seek to have the choice to shorten my death in my final weeks should my pain and suffering prove unbearable. As a Christian, I believe in loving my neighbour as myself and, on this basis, I seek the same choice for eligible others.


As a lay preacher, I cannot reconcile Christian compassion with the status quo that obliges people to suffer a drawn-out process of dying in pain when this is against their will and they have the capacity to choose. Church leaders often apply the concept of the ‘sanctity of life’ to resist assisted dying. The sanctity of life is rightly central to Christian faith. For me, the sanctity of life is about honouring the life of every individual, and this necessarily includes providing the care and treatment they need including, of course, excellent palliative care. I reject the assumption that the sanctity of life requires terminally ill people to undergo a distressing and painful death against their will.


I am asking for you to support this Bill. It would be tragic if the Bill were to fail now, having passed through the Commons with a clear majority. It would be personally devastating for me and for countless others. The majority of the UK population supports the Bill, and there is also a majority among Church of England congregations, despite the Church leadership’s energetic lobbying against the Bill.


Please remember, this is not about shortening life; it is about shortening painful and distressing ways of dying. Despite the best palliative care, around 20 people die in agony and/or awful distress every day”.


This is Pamela’s plea for compassion, and mine too.

Genome Screening: Newborn Infants

Baroness Thornton Excerpts

Thursday 18th September 2025 Lords Chamber

[Lord Winston]

To ask His Majesty’s Government what plans they have to screen the genomes of newborn infants for different genetic conditions.

[Baroness Thornton (Lab)]

My Lords, I beg leave on behalf of my noble friend Lord Winston to ask the Question standing in his name on the Order Paper.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, as set out in the 10-year health plan, this Government have an ambition to offer newborn genomic testing as part of routine NHS care, subject to evidence gathered through the Generation Study, which is using whole-genome sequencing to test 100,000 newborns for over 200 rare conditions. With advice from the UK National Screening Committee and appropriate funding, genomic testing could be available for all newborns in the UK by 2035.

--- Later in debate ---

[Baroness Thornton (Lab)]

I thank my noble friend the Minister for that Answer, because this is of course a very serious issue, particularly in the case of babies and minors. There are grave difficulties in obtaining informed consent. Every person may be born with hundreds of genetic mutations potentially associated with fatal diseases, but nearly all are unlikely to cause serious health issues in the vast majority of those carrying such markers. Can my noble friend say what plans the Government have for funding and ensuring properly informed consent in screening programmes? I thank my noble friend Lord Winston for informing my question.

[Baroness Merron (Lab)]

My Lords, the Generation Study is particularly designed to inform policy of the type that my noble friend is rightly concerned with. These are extremely important issues, and I am glad to have spoken to our noble friend Lord Winston about these matters. Perhaps I could give the assurance that the study will test only for treatable conditions, where there is robust evidence that the condition is highly likely to develop within the first five years of life, and suspected positive results are then reviewed and confirmed through further tests. If genomic testing is used within future screening programmes, informed consent will still be required.

Complications from Abortions (Annual Report) Bill [HL]

Baroness Thornton Excerpts

Committee stage
Friday 6th June 2025 Lords Chamber

Debate on whether Clause 1 should stand part of the Bill.

[Baroness Thornton (Lab)]

My Lords, it was a great honour to listen to the last debate. I commend my noble friend Lord Patel for leading a wonderful debate. However, we move on, and I shall explain to the Committee why I am opposing this clause standing part.

First, I have always understood that a Private Member’s Bill in either House should seek to remedy one problem or issue which needs primary legislation to do so. I say respectfully that I do not think that the Bill of the noble Lord, Lord Moylan, fulfils this criterion. It is not a necessary solution to a problem or lack of something, because there is not a problem to be solved that requires primary legislation. That is why I have not sought to amend the Bill.

The reason why there is not a problem to be answered is that the information about complications from all medical procedures, including abortions, are already collected. We might question the efficacy of data collection, the fact that systems do not talk to each other across our NHS, and all of those things; they definitely need to be improved, but we do not need primary legislation to do so. In the case of abortions, it is the only kind of healthcare in the UK that is governed by specific criminal law. Regulations issued under the Abortion Act 1967 require that for every abortion, a woman’s name, date of birth or personal identifier is submitted and provided to the Chief Medical Officer via the abortion notification system. NHS numbers are not required. This data includes complications which are identified before patients are discharged from clinics and the information is managed by the Department of Health and Social Care.

My second reason is, why should abortion be singled out as a medical procedure? This particular and singular primary legislation would require the UK Government to publish

“an annual report on complications from the termination of pregnancy in England”.

Why not knee replacements, appendicitis operations, operations to remove tumours, heart bypasses, cataracts, hernias and the many other everyday or complex procedures, all of which carry both cures and risks which are explained to patients and whose outcomes are recorded?

The Secretary of State will be required in this case to include the complication rate for abortions by the age of the woman, by the method of abortion, by gestation and by complication type as a minimum. The Royal College of Obstetricians and Gynaecologists is very clear that the proposal in this Bill is neither practical nor deliverable and, if passed, this Bill would therefore require the Secretary of State to produce an annual report using data collections that are inadequate to fulfil its aims.

NHS and Care Volunteer Responders Service

Baroness Thornton Excerpts

Tuesday 20th May 2025 Lords Chamber

[Baroness Merron (Lab)]

This announcement does not affect transparency or services directly provided by the NHS. We are seeking to improve the volunteering offer to make it more cost-effective, and to retain, recruit and better utilise volunteers. I will look at the point the noble Baroness raises, but I emphasise my point to your Lordships’ House.

[Baroness Thornton (Lab)]

My Lords, I declare an interest as a non-executive director of the Whittington Hospital, which is my local hospital. It has a very strong volunteer scheme and is recruiting volunteers all the time. Can my noble friend the Minister assure me that this is about enhancing the work that is done locally, because most volunteers are recruited and most volunteering is done locally?

[Baroness Merron (Lab)]

My noble friend makes a very important point and I can certainly give her the assurance she seeks. Over 50,000 additional volunteers are recruited by NHS trusts, which they then support directly in the way my noble friend describes. Their roles are totally unaffected by the change to this programme. There are many thousands of volunteers who support the NHS directly or indirectly via other local and national voluntary sector organisations, and I pay tribute to them all.

Tobacco and Vapes Bill

Baroness Thornton Excerpts

2nd reading
Wednesday 23rd April 2025 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I would like to thank my noble friend the Minister for her very clear introduction to this Bill. I also thank many people for the briefings we have been sent, particularly ASH, of whom I am very fond, because it supported me at various times as we have dealt with this issue over many years.

I have to confess to a feeling of déjà vu; indeed, my noble friend the Minister and others, including the noble Earl, may also have feelings of déjà vu, because today we start the next stage to allow our children, and certainly our grandchildren, to live in a tobacco and smoke-free world. I thought it might take longer to get to this point, so I am delighted. I also register the importance of taking powers to deal with vaping, because I agree with many noble Lords that we need to recognise that nicotine is an addictive poison too and one about which we do not know as much as we need to.

I was a Back-Bencher supporting the ground-breaking legislation in 2006 to make all workplaces and enclosed public places smoke-free. I confess I was proud when England went smoke-free in 2007. Early results showed that, within the first two weeks of the smoke-free law, compliance rates were 97%. I was the Health Minister when the Health Act 2009 received Royal Assent: from April 2012, large shops in England, Wales and Northern Ireland were prevented from displaying tobacco products, and cigarette sales from vending machines were also prohibited; and, in 2015, small shops had to do likewise. I supported the noble Earl, Lord Howe, as the new Health Minister, in carrying through the necessary regulations.

I have had the great privilege of working with many noble Lords across the House to deliver these crucial public health reforms. I am sorry that the noble Lord, Lord Patel, is not with us today because I know his wise words would have helped us take this Bill through the House over the next few months. There has developed a cross-party support, which saw this legislation start its life during the last Government. That signals to me that there is broad recognition that smoking is addictive and not a choice. It is not a result of freedom of choice, except perhaps for the first cigarette. There is no freedom in addiction. Most smokers want to quit but cannot, and it takes an average of 30 attempts to stay smoke-free. Often the choice to start is made at a young age, therefore locking smokers in for a lifetime, leading to early disability and death.

For many of us, this is not just a huge public health prevention initiative with savings for our NHS, but it is also a rather personal matter too. My mother, Jean Thornton, spent the last 10 years or so of her life with COPD. It was only after severe illness, and when she was initially diagnosed, that she actually ceased smoking, which she had started at the age of 14. She was the eldest of 11 children; all those working-class men and women were smokers; all of them ended their lives with smoking-related disease. That is why this is personal to me indeed.

The smoke-free generation is a long-term investment in the good health of our nation. This Government have an explicit aim at the heart of the health mission to halve the gap in healthy life expectancy between the richest and the poorest. Smoking is responsible for half of that gap. According to government modelling, gradually raising the age of sale year by year could prevent nearly 500,000 cases of stroke, heart disease, lung cancer and other serious illnesses by the end of the century. This is not only a public health victory; it is also a major economic victory, with total societal benefits projected at £77.3 billion.

There are those who will undoubtedly seek to amend this Bill, as happened in the other place, to remove the rising age of sale and replace it with a static age of sale. We must resist that. By increasing the age of sale every year, we prevent the tobacco industry targeting new audiences and recruiting the next generation of smokers. Two out of three people who try cigarettes become daily smokers, regardless of when they start. I look forward to working across the House to make sure this Bill gets on to the statute book.

NHS England Update

Baroness Thornton Excerpts

Wednesday 19th March 2025 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I apologise again for my wonky voice. My noble friend the Minister and I are veterans of running the NHS, when we were both Ministers in the last Labour Government. I am a veteran of leading the Opposition against the Lansley reforms when they came to the House; I spent two years of my life on them.

It is worth reminding the Liberal Democrats that they were party to putting that legislation on the statute book, so we hope they will help to remove it in a positive fashion. This was a huge piece of legislation—as somebody said, it was so big it could be seen from space —and over the years wasted billions that could have been spent on front-line services.

As a veteran of my local CCG and a non-executive director of my local NHS hospital, I value this announcement. I hope that the people who help to run the hospital of which I am non-executive director—the Whittington—who are brilliant managers in difficult circumstances, will be freed up to do their jobs better and more freely.

I ask my noble friend the Minister: what is the timescale—

[Noble Lords]

Question.

[Baroness Thornton (Lab)]

I am just asking the question. What is the likely timescale for when investment might be released? I am thinking particularly about technology and investment in infrastructure, as a non-executive director of a hospital, a large part of which is still a Victorian build.

[Baroness Merron (Lab)]

I thank my noble friend for her reflections on what has gone before and her welcome that the opposition parties can work with us to put this into a better place now. With respect to change and productivity, and a further extension to the point raised by the noble Lord, Lord Kamall, about culture, I can say straightaway that the Government have a 2% productivity growth target in 2025-26. That is immediate. We are not waiting to make this change, because if we do not improve NHS productivity and efficiency, we will not be able to deliver the three shifts needed to future-proof the NHS and support the Government’s growth mission.

We have already invested more than £2 billion in NHS technology and digital in 2025-26, which will help with essential services and drive productivity in hospitals, such as the one that I know my noble friend serves very well. That will free up staff time, ensure that all trusts have electronic patient records, improve cybersecurity and enhance patient access through the NHS app. That is before we even make this change.

We have already achieved a lot in the past eight months, but that is why we have to continue with this reform. We have delivered the 2 million extra appointments that we promised, months ahead of schedule, we have cut waiting lists by 193,000, and, as I said earlier, we have committed to 700,000 extra urgent dental appointments, just to name some. We know about the importance of change, which the noble Lord, Lord Scriven, asked me about, and that my noble friend calls for. That is why we will always continue to take bold steps where we have to, and not shy away.

NHS: Single-sex Provision for Staff and Patients

Baroness Thornton Excerpts

Wednesday 8th January 2025 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, would the Minister agree—

[Baroness Hayter of Kentish Town (Lab)]

My Lords, NHS England wrote to me on the—

[Captain of the Honourable Corps of Gentlemen-at-Arms and Chief Whip (Lord Kennedy of Southwark) (Lab Co-op)]

I think we will hear from the noble Baroness, Lady Thornton, first.

[Baroness Thornton (Lab)]

My Lords, would the Minister agree that once again we must reinforce the need to treat everyone with compassion, dignity and respect, especially in media reports that discuss protected characteristics and cases of alleged discrimination?

[Baroness Merron (Lab)]

I would indeed agree with the comments of my noble friend.

NHS: Independent Investigation

Baroness Thornton Excerpts

Tuesday 8th October 2024 Lords Chamber

[Baroness Merron (Lab)]

I begin by agreeing with the noble Lord, Lord Patel, in his assessment of the noble Earl, Lord Howe, as I am sure your Lordships’ House does. On the issue of capital, the total maintenance backlog stands at £11.6 billion, an increase of nearly 14% on the previous year. As I mentioned in my opening comments, this is holding back the productivity, ability and capacity of the National Health Service. Our financial situation is well documented, but we have asked the department and NHS England to review the health service’s capital requirements, and that includes NHS England’s assessment of long-term estate needs across a range of areas. We will have to establish the position and where we are to go from there, but I assure the noble Lord of the importance of this matter.

[Baroness Thornton (Lab)]

My Lords, I should declare an interest as a non-executive member of Whittington Hospital, and indeed as its maternity safeguarding champion. I have huge admiration and regard for the noble Lord, Lord Darzi, with whom I worked when he graced these Benches as a very successful and effective Minister. I agree with his analysis of the Health and Social Care Act 2012; I was opposite the noble Earl, Lord Howe, when we were debating that legislation—for what felt like many years—before it reached the statute book, and I agree that despite the challenges to the NHS, the vital signs remain strong.

Page 38 of the report addresses the question of inequality in maternity and neo-natal mortality, which is described. Does the Minister agree that after East Kent, Morecambe Bay and Shrewsbury, we do not need further research into understanding the challenges in our maternity services? What we need is leadership, attention and focus, so that our maternity services can benefit from the proposals in this report and the 10-year plan.

[Baroness Merron (Lab)]

I agree with my noble friend. I am pleased to inform the House that just this week I announced a number of pilot programmes, through which maternity staff will be taught and supported to better identify the signs of a baby in distress in labour, so that action can be taken more quickly, and which will help staff deal with obstetric emergencies during caesarean sections. Such actions help to avoid preventable brain injuries and are right for the baby and the mother. We also need to tackle the issue of the more than £4 billion cost of the lawsuits that have been brought over a number of years.

I have seen good examples of teamwork in Bristol and Surrey, to name just two, and there are many things that can be learned. We know what strategies work—one of which is listening to women—but the challenge is, how do we roll out what is successful, including from the pilot programmes? Following the recent report, which showed a devastating situation in maternity and neo-natal care, that is a high priority for this Government.

HIV Care: Access

Baroness Thornton Excerpts

Wednesday 11th September 2024 Lords Chamber

[Baroness Merron (Lab)]

The noble Lord’s campaign in this area is very well regarded, and for good reason; I certainly agree with him. The fact is that engagement in care is strongly affected by a number of factors, including a person’s well-being and quality of life, discrimination and, as the noble Lord says, stigma. That, alongside accessibility of service, will define how successful we are. I am keen that our new plan will absolutely take account of stigma.

[Baroness Thornton (Lab)]

My Lords, the crisis of people lost to HIV care is of course underpinned by serious health inequalities. Are the Government taking account of the pilot work by the Elton John AIDS Foundation in south London, which has successfully returned people to care through case-finding, focus follow-up and wraparound support for people when they return to clinics, thus saving the local NHS millions in the care that would be necessary if they were not receiving it?

[Baroness Merron (Lab)]

I can confirm to my noble friend that we are, and say how grateful we are to a number of charities, including the Terrence Higgins Trust and the Elton John AIDS Foundation. As she says, there have been pilots for emergency department HIV opt-out testing since 2018. A pilot that began in April has expanded that to 47 additional sites, and we will be looking closely at the impact of that.