Terminally Ill Adults (End of Life) Bill

Debate between Lord Ashcombe and Baroness Lawlor

Friday 5th December 2025 Lords Chamber

[Lord Ashcombe (Con)]

My Lords, I wish to express my particular concern regarding Amendment 416. The question I must put to the noble and learned Lord is, why should an independent doctor tasked with providing a second opinion not have access to the notes of the first? Is the intention to prevent any influence on the second medical professional, even when the first has identified grounds for dissatisfaction and declined to proceed with the possibility of assisted death?

We have already engaged in lengthy debates on the crucial matters of decision-making capacity and the risks of coercion. What if the first independent doctor had uncovered evidence of precisely such concerns? This situation inevitably calls to mind the troubling prospect that a patient, or indeed another party exerting influence upon that patient, might seek out a doctor willing to endorse the view of the co-ordinating physician. Surely the medical notes generated throughout the process are of fundamental importance to all involved in the medical profession, and it cannot be right that they should be withheld from any participant in the decision-making claim. I therefore earnestly ask the noble and learned Lord to give me his thoughts on this, as I do not really consider this to be a straight drafting issue.

[Baroness Lawlor (Con)]

My Lords, I would like to refer to Amendment 6 from the noble and learned Lord the sponsor of the Bill, because I have concerns with it. In inserting the words

“has a preliminary discussion with a registered medical practitioner”,

Amendment 6, which is described as a drafting change, adds to the uncertainty about what discussion takes place with the patient and when. It is a dangerous uncertainty as, if the Bill was so amended, it would be left open for one or more such discussions to take place before the person is 18, so long as the discussion that is required as a preliminary discussion takes place after the person has reached 18.

In particular, the amendment would do nothing to restrict the scope of Clause 5(3), which permits a medical practitioner to engage in preliminary discussion about assisted dying with a patient who raises the subject. Since there is nothing to tie the discussion referred to as “a preliminary discussion” to be inserted in Clause 1 with “a preliminary discussion” in Clause 5(3), the amendment will not stop these discussions taking place with under-18s.

Grammatically, a “such and such” refers to any “such and such”, and the word “preliminary” does not imply a restriction on number; there could be one or 100 preliminary discussions. Although Clause 5(3) does not oblige the registered medical practitioner to discuss assisted dying under the Bill’s provisions with any patient who raises it, Clause 5(6) obliges the practitioner concerned to direct the patient to

“where they can … have the preliminary discussion”—

and that is the preliminary discussion. Therefore, even as amended, the Bill requires that any patient, whatever their age, who raises the possibility of assisted dying under the Bill is enabled to have a discussion about it. It cannot be objected that in Clause 5(6), the reference is to “the”, not “a”, preliminary discussion, since here “the” refers back to the preliminary discussion in Clause 5(3) to Clause 5(5), where the phrase used is “a preliminary discussion” or “such a preliminary discussion”—that is to say, any preliminary discussion of the matter.

These points may seem technical and pernickety, but consider how the Bill, even as amended, might lead a young person to end their life prematurely without proper adult consideration of the matter. Take a 16 or 17-year old who is suffering from a disease that makes their life expectancy uncertain, or who has been warned that they might die rapidly or deteriorate and die at any time. We may all try to imagine, but we can hardly know how such a young person might feel: isolated, lonely, afraid, and perhaps hypersensitive to remarks or innuendo, real or imagined, or indeed to some of what we have heard today about social media and pressures from peer groups in the Netherlands. They might share not only the worries about the illness, but the normal doubts of people of that age that even those in the best health who are depressed and unsure of themselves have. How easy for the unfortunate young person to say, “I wish I were dead”.

Employment Rights Bill

Debate between Lord Ashcombe and Baroness Lawlor

Committee stage
Tuesday 29th April 2025 Lords Chamber

[Lord Ashcombe (Con)]

My Lords, it a pleasure to support my noble friend Lady Noakes and the noble Lords, Lord Londesborough and Lord Vaux of Harrowden, on Amendment 5 and their other amendment.

Small businesses and microbusinesses form a vital component of our national economy. These enterprises, while often agile and innovative, are particularly vulnerable to regulatory and financial pressures. Like all businesses—I should declare that I work for a very large American insurance broker—these enterprises have had to absorb the recent increases in the national minimum wage and adapt to the changes in national insurance contributions legislation. However, unlike larger businesses, they often lack the structural resilience and financial buffer to absorb such changes with ease. The impact on them is therefore disproportionate. This amendment proposes a sensible and measured opt-out for SMEs from additional obligations stemming from the proposed changes to zero-hours contracts—specifically, the move towards tightly prescribed guaranteed hours. As the Government’s own impact assessment acknowledges, these reforms are likely to have a disproportionate cost on small businesses and microbusinesses. I stress that this is not speculation but is drawn directly from the Government’s impact analysis.

Small businesses and microbusinesses span a wide range of sectors, but many are embedded within the UK as world-renowned creative industries that bring global acclaim and substantial economic benefit to this country. Many are driven by the energy, passion and commitment of individual entrepreneurs and small teams. I have had the privilege of speaking with several such business owners during the course of this Bill, and a recurring concern has emerged: the smaller the business, the harder it is to digest and manage such legislative change. Some have gone so far as to tell me that they are considering closing their operations altogether. That is a deeply troubling prospect. It is no exaggeration to say that measures such as these, if applied without nuance, risk undermining the very entrepreneurial spirit that we so often celebrate in this House.

There seems to be a regrettable habit forming on the Government Benches of legislating in ways that hinder rather than help the economic engines of this country. This approach is not conducive to national growth. It is not conducive to competitiveness. It is not conducive to job creation. It is certainly not conducive to easing the burden on the Exchequer—quite the opposite. Driving small businesses to closure will reduce tax receipts and increase demand for state support. We need to encourage investment, not chase it away.

Can the Minister explain clearly why this legislation must apply so rigidly to a critical sector of our economy? Why must we impose further burdens on the very businesses that we rely on so much for our innovation, employment and growth? Is there no room for proportionality and no scope for recognising the distinct challenges that are faced by the smallest enterprises? What I have said applies, to a great extent, to the middle-sized companies mentioned in Amendment 282, tabled by my noble friends Lord Sharpe and Lord Hunt of Wirral.

I leave your Lordships with a quote from the Spirit of Law by Montesquieu:

“Commerce … wanders across the earth, flees from where it is oppressed, and remains where it is left to breathe”.

[Baroness Lawlor (Con)]

My Lords, I support the amendments tabled by my noble friend Lady Noakes and the other amendments in this group. I do so as an employer, and my interests are declared in the register.

I am a very small employer, in a not-for-profit company. I am therefore one of the microbusinesses to which my noble friend Lady Noakes has referred—those which have zero to nine employees. I echo what the noble Lord, Lord Londesborough, said: smaller businesses will find it very difficult to afford the costs which this Bill will impose upon them.

Small businesses and the employers in them are not the adversaries of those we take on. Many small businesses, including a number in the digital sector, are start-ups—some started in that garage, about which Hermann Hauser once spoke. They build up their teams and develop by commitment. Each member of the team taken on is an asset—not just an expensive potential asset but a cost to begin with, in time and in the compliance of dealing with every member of the workforce. Such businesses do not have large HR teams or sometimes any HR teams. There is a cost in the salary and in trying to keep the employee by continuing to raise the salary as often as one can. There is also a cost in the investment of time.