Terminally Ill Adults (End of Life) Bill
Debate between Lord Blencathra and Lord Goodman of Wycombe
Lord Goodman of Wycombe (Con)
The noble Baroness, Lady Berger, is quite correct. That is exactly what happened in the Select Committee. For my sins, I sit on a surfeit of committees, including the Delegated Powers Committee, which drew attention to this very deficit in the Bill. So the question for the noble and learned Lord, Lord Falconer, is: since the Minister was questioned in the Select Committee by the noble Baroness, Lady Berger, in the weeks that have followed, has he had any guarantee from the Government that they will ensure that the Secretary of State by regulation ensures that the NHS delivers voluntary assisted dying services? When the Minister replies to the debate, can she cast some light on this matter so that we know whether or not the proposal that the noble Lord, Lord Birt, has put forward and my noble friend has opposed really has any basis in reality?
Lord Blencathra (Con)
My Lords, I was delighted to hear the noble Baroness, Lady Fox of Buckley, hit every nail on the head of everything that is wrong with the amendment moved by the noble Lord, Lord Birt. I shall speak to the amendments in the names of my noble friends Lord Mackinlay of Richborough and Lord Harper, and I have signed some of them. I have done so because the Bill as drafted, and as now proposed to be amended by the noble Lords, Lord Birt and Lord Pannick, promises choice while quietly engineering speed, centralisation and a single-minded pathway to assisted death. That is not a neutral design choice. It reshapes incentives, shifts resources and narrows real options for people at the end of life.
I will give three short examples of why the amendments proposed by the noble Lord, Lord Birt, are wrong, and end with a direct challenge to the noble and learned Lord, Lord Falconer of Thoroton.
First, the amendments would turn life and death decisions into a fast-track process. From first declaration to possible assistance, the clock can run down to 30 days, or as few as 18 days if death is deemed imminent. Panels must decide within 48 hours of referral. Reports are forced within 24 hours. Reflection periods can be cut to 24 hours. That is extraordinary. Courts take months to resolve urgent life issues. Prognoses measured in months are notoriously unreliable. Rushing assessments in this way risks premature deaths, misdiagnoses and inadequate exploration of reversible causes of despair. My noble friends’ amendments, including the ones that I have signed, push back against that compression.
Secondly, as others have pointed out, the assisted dying help service and the personal navigator create an asymmetric system. The navigator is designed to shepherd people quickly through the assisted dying pathway. There is no equivalent statutory guarantee that a person will get timely access to palliative care, hospice support, social services or mental health interventions. In practice, a patient could reach assisted death faster than they could gain access to pain control, a care package, meaningful social intervention or, as the noble Baroness said, a GP appointment these days. That is a perverse allocation of scarce resources and a distortion of choice. When one option is actively facilitated and the others are not, choice becomes a funnel.