Terminally Ill Adults (End of Life) Bill

Lord Birt Excerpts

Friday 30th January 2026 Lords Chamber

[Baroness Blackstone (Lab)]

My Lords, I declare an interest as the chair of one of the medical royal college’s trusts. I want to speak to this group of amendments, taking into account the medical profession. I entirely agree, and I am sure that the vast majority of doctors will also entirely agree, that it is better to have face-to-face consultations in these circumstances. However, nearly all those who have spoken in favour of face-to-face consultations have admitted or agreed that there will be exceptions, and there will be quite a lot of exceptions. We have to remember that many people who are terminally ill are bed-bound; they are not able to get up and go to a face-to-face consultation, even if it is quite near to where they live. The vast majority of doctors would want to discuss with their patients whether a face-to-face appointment is acceptable, possible and desirable and, if not, to have an online consultation with them. That seems to me the right approach.

Moreover, I really wonder whether we should be putting in the Bill a clause that would constrain doctors in a way that I think is unacceptable. We must accept that the vast majority of doctors will go into this work with utter commitment to doing the best possible job they can. I find it a bit disconcerting that there is constant reference to a tick-box approach; you can have a tick-box approach face-to-face, or you can have a tick box approach in a consultation online. It does not seem to me a relevant and important point to make. I suggest that, rather than putting this in the Bill, given that I am sure that there is a very strong case for face-to-face consultations normally, it should instead be part of a code of practice for the medical profession that will certainly have to be developed if and when this Bill is enacted.

[Lord Birt (CB)]

My Lords, we are discussing one of the most important decisions that any individual might make in their lives. It is important for the individual and for the state. I think that it is appropriate to ask that the critical meetings with the medical practitioners should be face-to-face, because that allows a degree of intimacy and nuance which, frankly, the world of Teams, however valuable it is, does not. There are three doctors involved in the process set out in the Bill and, at the very least, for the second doctor who is going to co-ordinate the process, it is reasonable to require that that meeting be face to face.

[Baroness Berger (Lab)]

My Lords, very briefly, I support the amendment that is calling for face-to-face consultations to take place, rather than only in exceptional cases. I want to reflect on why this matters. We know from other jurisdictions that many of these assessments are being done online. It is a really important question for us to consider whether we would want that in our country—and if not, it should be in the Bill. In addition, my comments are informed by the evidence that we were presented with in the Select Committee and drawn from my experience of meeting a number of elderly constituents over the course of nearly a decade as a Member of Parliament.

I reflect particularly on the women I met in their 70s, 80s and 90s who shared their experiences of domestic abuse. This conversation and these amendments matter because this legislation does not happen in a vacuum. The Labour Government today are rightly concerned with addressing the public health emergency of violence against women and girls in our country and has an important landmark mission and goal of halving violence against women and girls over the next decades. The NHS is playing its part and enhancing its efforts in tackling and violence against women and girls, focusing particularly on early identification. There is a lot of other very important work going on via training and investment, and I commend the work of many colleagues who are dealing with this on a daily basis. It was the experts that told us that to identify coercion, undue influence and pressure, doctors and other professionals need to look at someone’s body language. It is not just the words we say, how we say them, the volume or the tone—it is our non-verbal cues and what our body says. It is what we do not say that often shares an important message.

I listened very carefully to the counterchallenge of noble Lords so far. I do not think there is anything to stop the Bill from stipulating that, in exceptional circumstances, the doctors, or the independent advocates or panel members can visit an individual. But I would much rather that we had legislation that supports the Government’s important aim to reduce violence against women and girls, rather than something that will exacerbate the very serious problem that we know that too many women in our country face, particularly at their most vulnerable moments, which includes the end of life.