Terminally Ill Adults (End of Life) Bill

Debate between Lord Blencathra and Lord Kamall

Friday 23rd January 2026 Lords Chamber

[Lord Blencathra (Con)]

My Lords, I will speak relatively briefly to the amendments in this group. I degrouped them for a technical reason. They are quite narrowly drawn. I know there is a group coming up, led by the noble Baroness, Lady Berger, that is wider ranging and more important than mine. If any noble Lord wishes to speak on the principle of these amendments, they might be better off waiting for the noble Baroness’s group.

The purpose of my Amendment 39B is to ensure that a person who wishes to die is driven by their illness, not by poverty, loneliness, lack of care or other remedial pressures. This would restore the link between the justification for the Bill and its operation. The political case for assisted dying has always been framed around unbearable physical suffering caused by terminal illness, yet the Bill contains no requirement that the person’s motivation must arise from that illness. Without this amendment, the Bill becomes a general choice in adversity scheme, where any reason—financial distress, lack of care, fear of being a burden—can drive the decision.

The noble and learned Lord has now explicitly said:

“I am strongly against saying poor people should not have that choice”.—[Official Report, 16/1/26; col. 2020.]


That is an admission that the Bill permits assisted death for reasons of poverty. My amendment would correct that. It would ensure that the motivation must be principally attributable to the illness itself, not to the state’s failure to provide care, housing or support. This is not about denying autonomy; it is about ensuring that autonomy is real. A decision driven by poverty or abandonment is not a free choice. The amendment would ensure that the Bill remains what the public believe it to be: a response to suffering caused by terminal illness, not a response to social failure.

My Amendment 39C would draw a clear line: financial distress, lack of housing or lack of social support cannot be the primary motivations for an assisted death. Without this safeguard, the Bill risks becoming a mechanism by which poor and unsupported people are offered death instead of help. The Bill is presented to the public as a response to the unbearable physical suffering caused by terminal illness, yet it contains no requirement that the person’s motivation must arise from that illness. Without these amendments, the Bill permits assisted death for a whole host of reasons that Parliament never intended, such as loneliness, poverty, lack of housing, lack of care or feeling like a burden on the state or your dependants.

The noble and learned Lord has now accepted that these motivations are valid choices. That is a dramatic shift from his own 2012 commission, which said that motivations were never legitimate and that safeguards must prevent them. Peers are entitled to ask what has changed other than the political need to keep the Bill workable. International evidence shows that non-medical motivations dominate assisted dying requests. Pain is not the primary driver. We hear that being a burden is a driver, as is the loss of autonomy. Parliament must decide whether it is comfortable legislating for that.

Finally, these amendments ensure that asking “why” has consequences. If the answer is poverty, loneliness or lack of care, the response should be support, not a lethal prescription. These amendments restore coherence, safeguard autonomy and prevent the Bill from becoming a general choice in adversity scheme. I beg to move.

[Lord Kamall (Con)]

In the interests of being brief, rather than repeating everything that my noble friend said, I look forward to the answers from the sponsor of the Bill and from the Minister.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Blencathra and Lord Kamall

Committee stage
Friday 9th January 2026 Lords Chamber

[Lord Blencathra (Con)]

I respect what the noble Baroness has said, but it is also the case that it is disrespectful to Members who have prepared speeches, wishing to say something on palliative care, and who deliberately stayed quiet in previous debates so that they could make a point on a subject in which they are interested. They are now being deprived of the opportunity to do so.

[Lord Kamall (Con)]

My Lords, one reason I was reluctant to get up is that I believe very strongly that all who want to speak in these debates should be allowed to do so, but I ask noble Lords to please bear in mind that there are many others who may want to speak to the group, and we should not make Second Reading speeches. We should repeat what the Chief Whip reminded us of a number of times: please can we speak to the amendments and keep to the point? I will try to do so in summing up very quickly.

It is quite clear that these amendments relate to palliative care and whether people who seek assisted dying services are offered a meaningful choice—not just a choice in theory or on paper because it says it somewhere in the current version of the Bill but a very real choice. I pay tribute to the noble Baroness, Lady Finlay. When I was the Minister taking the Health and Care Act 2022 through the House, she came to speak to our officials in the Department of Health and Social Care who did not know as much as her. She held a teach-in. She did not have to do that, but many officials in the department said that they welcomed the opportunity to learn from such expertise. That is why I think it is important that we learn from all noble Lords, whatever their expertise. We should also thank everyone, especially specialists, currently working in the palliative care sector, which is under pressure.

This refers to a point made early on at Second Reading, when the noble Lords, Lord Hunt and Lord Stevens, said that we know how government works and how money is shifted around government. I do not want to argue about the merits of the Bill—personally, I am torn on it at the moment and am listening to the debates to make up my mind—but the noble Lords said that, if it goes through, the money has to come from somewhere. They feel, having been in government—one having run NHS and one having been a Health Minister—that that money will come at the expense of palliative care. I think that that concern is behind many of the amendments in this group.

It seems that the principle is that anyone who is making that decision, or who seeks that help, should make a meaningful choice, so I welcome the intent of all those who laid amendments in this group—I will not waste time by naming them all; they know who they are, and I thank them. But I point out to them that, as some noble Lords have said, palliative care is mentioned in the current version of the Bill. We see it in Clause 5, on preliminary discussions with registered medical practitioners; in Clause 12, on doctors’ assessments; in Clause 39, on codes of practice; in Clause 40, on guidance about the operation of the Act; in Clause 47, on reporting on the implementation of the Act; and in Clause 50, on review of the Act.

Surely, the crucial question at this stage to both the sponsor of the Bill—the noble and learned Lord, Lord Falconer—and the Minister, are whether they believe that these clauses in the current version of the Bill, as entered this House, address the concerns raised by the many probing amendments discussed in this group. That is the crucial question to the sponsor of the Bill and the Minister.

I have a further question for the Minister, and I know that it is a little unfair because it is probably more a question for the Department of Health and Social Care and perhaps the Treasury, so if the Minister does not have the answer to hand, we understand that she will write to us and place a copy in the Library. Are the Government confident that palliative care will be sufficiently funded so that those who seek assisted dying services are offered a real as opposed to theoretical choice on palliative care, so they can make a more informed decision, understanding what is available to them? I recognise that that may be a difficult question and may put the Minister on the spot, but I hope that she can go back to the Government and ask for an answer that can be shared with your Lordships.

I look forward to the answers from the Bill’s sponsor and the Minister.