Terminally Ill Adults (End of Life) Bill
Debate between Lord Bishop of Newcastle and Lord Sandhurst
The Lord Bishop of Newcastle
My Lords, in his opening remarks, the noble Lord, Lord Birt, cited Australia. I am sure that he is aware that no Australian jurisdiction is recognised as one of the 10 comparable jurisdictions in the Bill’s eligibility criteria and the Government’s impact assessment. The most comparable are New Zealand and the United States. This discussion was resolved in our Select Committee by receiving evidence from New Zealand. We need to be consistent and mindful of the Government’s impact assessment and ensure that our comments align with it.
Lord Sandhurst (Con)
My Lords, I agree entirely with the noble Lord, Lord Stevens, with his vast experience, and the noble Baroness, Lady Hollins, with hers.
My point is a simple one, which, as a lawyer, has been troubling me for a long time: conflict of interest. There is an internal conflict of interest here within the health service. Are you going to spend the money on this or on palliative care? Will it affect decision-making by medical practitioners? I have talked to a number of them—one of them is a member of my family; I will not embarrass them by saying more—and know that it is a matter of real concern, because this is not treatment, but something quite different.
We do not have to have non-medical things such as, as we have heard, Department for Work and Pensions assessments done under the NHS label. That is contrary to everything the NHS stands for. There would be a conflict of interest within any trust that funds and administers this as to where the money goes. Will it be given more money, specifically? Will it be limited?
The obvious overseeing Secretary of State for this is the Secretary of State for Justice, because you are going to be dealing with the administration of life and death, not simply trying to cure people and save them from death. It is quite different. You are saying, “You can die, and we are satisfied that there are no bad people around you who are encouraging you to opt for this course”. Then there will be the selection and management of the panels, which will be performing a quasi-judicial function, like other assessment panels.
The obvious place for this, which would remove, or at least limit and reduce, the risks within the health service, would be a separate, specific budget given to the Ministry of Justice. We would then know what is being spent. Otherwise, the XYZ trust will say, “Gosh, what do we take this from?” I will not give emotive examples, but that is what will happen in practice, so we need to know that this is a specific service and that the country has said it will have hundreds of millions of pounds a year to run it, but that it will be on top of and ancillary to anything the ordinary health service provides to people who actually want to live, or at least live in comfort.