Terminally Ill Adults (End of Life) Bill

Lord Carlile of Berriew Excerpts

Committee stage
Friday 5th December 2025 Lords Chamber

[Baroness Lawlor (Con)]

I thank the noble Baroness for her question, and I certainly will consider it, but I think it is important that we have a discussion about what I regard as a compromise Motion, which may be useful in the discussions noble Lords have with the sponsor or those who wish to proceed in that way.

[Lord Carlile of Berriew (CB)]

Would the noble Baroness, for whom I have a great deal of respect, consider whether she is really adding anything at all to the debate by continuing? We can read her amendments; we know the difference between 18, 21 and 25. I and the noble and learned Lord, with whom I do not disagree on the fundamental principle behind the Bill, are both of the view that we should have proper discussion on it and get through Committee in the way that is expected of us as the House of Lords, so when the noble and learned Lord intervenes and says he is willing to hold meaningful discussions, we should do that and move on to the next business.

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The noble Baroness, Lady Coffey, commended a test of domicile. Domicile is one of the most complex legal concepts that we have. There is domicile of origin, domicile of choice and domicile of operation of the law. In my opinion it would be disastrous for us to incorporate such a concept into this legislation, not least because I can have domicile in this country simply because it was the domicile of my parents when I was born. I could have lived my entire life in the United States, France or wherever, but would be able to come back to this country to benefit as a health tourist and take advantage of this Bill if enacted. That is exactly what we all want to avoid. Domicile should be ruled out. I hope that the noble and learned Lord, when he responds, will confirm that.

[Lord Carlile of Berriew (CB)]

My Lords, I agree with my noble friend Lord Pannick. The concept of residence is clearly understood. I recommend to the noble Lord, Lord Moylan, that he might need a criminal lawyer just in case he was prosecuted for doing something wrong. I would be very happy to act for him, of course.

I recommend that all of us who are considering this matter should have a good look, as I have, at the National Health Service ordinary residence tool, which was revised in March this year. It gives a very clear outline of all the possibilities and where they fall in the ordinary residence judgment. What concerns me about the example that the noble Lord, Lord Moylan, gave, which we will come to on another group, possibly even today, is that if somebody has been living in Spain and wants to come back to their former country of ordinary residence for an assisted dying, if this Bill becomes law, it will prove extremely difficult to detect where there has been undue influence, particularly within a family. It would be extraordinarily difficult to investigate that evidence, whether it was done by a court or by a panel. I would be opposed to it on those grounds.

[Baroness Butler-Sloss (CB)]

I also entirely support, including the word “disastrous”, the points that the noble Lord, Lord Pannick, made. As he said, domicile is complex. You would end up in court dealing with the issue of domicile. It really is not a good idea.

Under Clause 1(1)(c), there are two requirements. One is “ordinarily resident”. I say to the noble Lord, Lord Moylan, that if I was trying the case I would have no problem at all. If it says “ordinarily resident”, that is what I would accept, so long as there was the evidence to support it. I do not think we need to be caught up in the Human Rights Act in dealing with such an issue. What worry me are the two requirements,

“ordinarily resident … and has been so resident for at least 12 months ending with the date of the first declaration”.

That seems to be a complete bar for someone who is in an embassy. It is very difficult if they are not ordinarily resident. It looks as though the noble Lord, Lord Carlile, does not agree.

[Lord Carlile of Berriew (CB)]

I hesitate to interrupt my noble and learned friend, whom I regard as being of almost biblical correctness in almost everything. If she were to take a look at the NHS tool that I referred to, which sets out all the requirements to prove ordinary residence, she would find that people who work in embassies, for example, are excluded because they are given fixed-term contracts for a certain time, even though that contract may be extended at some time. It also specifically refers to people who work for charities and who go to work abroad for a temporary period fixed by a contract. I do not think the issue that she has raised is very worrying.

[Baroness Butler-Sloss (CB)]

I am delighted to hear it in relation to embassies and charities, but the other example given was the person living in Spain who wants to come back to die here. It seems to me that needing to be resident in this country for the last 12 months would not allow that person to do so. The noble and learned Lord might just look again at that particular element of residence.

Terminally Ill Adults (End of Life) Bill

Lord Carlile of Berriew Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Baroness Berridge (Con)]

I will just reply to the noble Baroness, then, that within the Bill that is not necessary. I have outlined Clause 10. This applies to the people who are verifying in the process, not to the individual. It was not in the Motion your Lordships’ House approved that that evidence should be taken.

To continue, Dr Annabel Price said:

“Pressure has a broader definition of perhaps strong encouragement, expectation or the worry of letting somebody down”.


The noble Lord, Lord Patel, joined in this mini focus group and asked:

“If I were to use the word ‘pressure’ and if I were to use the word ‘coercion’, how would you interpret the two?”


Professor Mumtaz Patel from the Royal College of Physicians—again opposed to the Bill—said, “It is grey”.

Amendment 846 also reflects the view of the Law Society, which is neutral on assisted dying but opposed to the Bill. Kirsty Stuart said:

“I think it is really difficult because there is not a definition at the moment … in the Bill”.


That is why Amendment 846 is based on the statutory guidance principle from the offence of coercion under the Serious Crime Act. I note that the Home Office has recently had to issue 91 pages of statutory guidance on that offence. It seems the courts are struggling with it.

Even if Thomas Teague is right that you look at the dictionary, are we talking about economic pressure, emotional pressure, financial pressure, spiritual pressure, reputational pressure, internalised or externalised pressure, or pressure of circumstances—for instance, no one provides you with a hospice bed? As Dr Suzanne Kite, from the Association for Palliative Medicine, said:

“We know that there are pressures of, ‘Can we afford the electricity for the oxygen supply?’ … Yes, these are issues”


that people face “on a daily basis”. The Bill is silent as to what kind of pressure is meant.

To move from individual sources of pressure, there can also be group sources of pressure. Alasdair Henderson, from the Equality and Human Rights Commission, spoke to the Select Committee about

“this wider issue of coercion or pressure at a societal level or an attitudinal level”

and

“the broader trends or cultural issues”.

He said that

“pressure is not always applied directly by another individual, but can result from attitudinal barriers, particularly around disability, and lack of services and support in society as a whole”.

Could pressure come from NICE refusing you, on value-for-money grounds, the drug that you think will wipe out your metastasised cancer? Indeed, the pressure could emanate from the Chancellor of the Exchequer in her Budget, or from the Secretary of State for Health and Social Care, to encourage vulnerable people to take assisted dying, a matter I put to the Government Minister, Stephen Kinnock.

Caroline Abrahams of Age UK said:

“The context again for this is a system in which adult safeguarding is under acute pressure because local government is under such acute pressure”.


The British Association of Social Workers also said that unless these statutory services

“are adequately resourced, that may bend people’s decision a certain way … much of social care is self-funded now. If you are poor and you cannot have access to those personal resources, even more pressure is applied to you”.

I look to the noble Lord, Lord Pannick: how does a medical practitioner sign to say that this kind of pressure—from culture, society or attitudes, or lack of statutory services—is not being put on the individual?

There was unanimity in the Select Committee when we started asking the professionals about training. I said that pressure

“is not defined in the Bill, so I am afraid I cannot help you. We have no definition in the Bill. You are going to need training, though, in pressure. Has any of you received any training like that?”

Professor Nicola Ranger from the Royal College of Nursing, Professor Mumtaz Patel of the Royal College of Physicians and Dr Michael Mulholland from the Royal College of GPs all said no. So we now have additional costs added to the Bill, because we have to devise training in pressure and deliver it to a whole raft of professionals, care staff, et cetera, so that they understand it, in particular bearing in mind the vulnerability to criminal prosecution that exists in Clause 34.

I am going to give the noble and learned Lord, Lord Falconer, this opportunity to shorten Committee proceedings. Deleting “pressure” from the Bill, when it has not been consulted on and has not been subject to pre-legislative scrutiny, would aid the Committee in evaluating the Bill.

[Lord Carlile of Berriew (CB)]

My Lords, in a group such as this, which has so many conceptual, linguistic and semantic alternatives on offer, it is very difficult to see how a Committee stage such as this is going to help very much in determining a final solution to the matters under consideration. Therefore, it could become very tempting to enter into the nice and easy solution suggested by my noble friend Lord Pannick, to the effect that the Bill is quite enough and provides sufficient protection. It is right to say that the Bill certainly seeks to provide sufficient protection, and I do not in any way attribute anything other than good motives to those who sponsor the Bill, in particular the noble and learned Lord, Lord Falconer.

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[Baroness Hayter of Kentish Town (Lab)]

If I could just finish. It has been a long time in this debate without hearing from my side—I want to come on to something that the noble Lord, Lord Deben, said anyway.

The amendments to this Bill are about coercion or pressure. As stated by the noble Lord, Lord Pannick, the situation at the moment is that people can go to Dignitas without even proving to a doctor that they are dying, and without any check as to whether there is coercion or pressure, or whether someone is going to inherit their house. They can go, and that is the way they end their life, and they feel it is not worth living any longer. On the definition of coercion, are we really content with continuing the status quo where there is absolutely no check—from a psychiatrist, a social worker, a lawyer, or anyone else—on whether they have been coerced? That is the alternative: allowing the status quo to continue with no checks whatever.

We have to ask, therefore, whether these discussions about definition are really about that, or whether they are about trying to stop the Bill. Perhaps we could discuss whether those who want the wording changed would then support the Bill. If they would, let us get down to discussing that, but if they are never going to, they are wasting the time of those who want it to go through.

[Lord Carlile of Berriew (CB)]

My Lords—

[Noble Lords]

Order!

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[Baroness Hayter of Kentish Town (Lab)]

I was not suggesting wasting time. I was asking whether, if these changes were agreed, people would then allow the Bill to proceed.

[Lord Carlile of Berriew (CB)]

Before the noble Baroness sits down, I have great admiration for her, but I and many others resent her waving her hands at us. The reason we wish to have the sorts of discussions that I was mentioning was so that, believe it or not, we can make a judgment as to whether we are prepared to support the Bill, or to be silent on whether we support the Bill, or to oppose it at Third Reading. It is unworthy of the noble Baroness to allege that all of us here who are expressing concerns are wasting time. It is not true, and it is what she said.

[Baroness Hayter of Kentish Town (Lab)]

I never said that about wasting time. The words did not come; I did not say them. I was asking whether the people who want a better definition will then be able to support the Bill.

Terminally Ill Adults (End of Life) Bill

Lord Carlile of Berriew Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Lord Forsyth of Drumlean (Con)]

My Lords, I do not know if I am alone in being frequently asked by people, from time to time, “What is the point of an unelected House of Lords?” I now have the absolutely mind-blowing answer, which is to refer them to these two days of debate on this really difficult subject and the range of expertise which we have heard.

I am speaking because I tabled an amendment. That was last Friday, so some noble Lords may have actually forgotten what it said. It called

“upon His Majesty’s Government, in the light of the 32nd Report from the Delegated Powers and Regulatory Reform Committee, to ensure sufficient time is available for consideration of amending stages of this bill, and to provide full support at ministerial and official level to the peer in charge of the bill for its remaining stages in the House of Lords”.

Despite the differences that we have heard in these two days of debate, there is a clear and absolute consensus across the House that the Bill is in need of amendment and further scrutiny.

I listened very carefully to the speech of the noble Baroness, Lady Berger, and I see her amendment. I am a little doubtful about how a Select Committee—which is not really a Select Committee because it is not going to produce a report; it is simply going to hear evidence—is going to change or alter the noble Baroness’s opinion on this matter, or indeed anyone else’s. However, it means we cannot actually start that task until 7 November, so we have lost some time.

As many speeches pointed out, none of us knows when and how we are going to die; none of us even knows when the end of the Session is going to be. So, between 7 November and the end of the Session, having listened to all the speeches and thinking of the number of issues that are going to have to be addressed, I venture to suggest that four Fridays for private Members’ legislation, unless we are going to completely destroy the prospects of other people with Private Member’s Bills, are not going to be sufficient time. It therefore seems essential that the Government provide time.

I understand why they do not want to do that: if I were in government and in the Prime Minister’s Office, I would be saying, “But that means we won’t have time for this, that or the other”. But this is an absolutely life-and-death issue and it is important that it is considered properly and put on the statute book, if it is to be put on the statute book, in a way that will satisfy my noble friend Lord Wolfson of Tredegar in his brilliant speech. He showed that what we are doing here is making legislation and we should put legislation on the statute book that has been properly thought through, which means that there has to be government time.

I happen to know that the Cabinet Secretary advised the Government that this should be treated in the way that all Private Members’ Bills dealing with matters of conscience are. Abortion, the death penalty and the decriminalisation of homosexuality were Private Members’ Bills that the Government took on board in order to ensure that they had proper time and were properly supported, and I do not—I was going to say “for the life of me”—understand why that should not apply to this Bill, having listened to these two days of debate. I suspect it might be because the Health Secretary and the Justice Secretary were opposed to the Bill—but we are told that the Government are neutral, and therefore I do not see why they should not provide that time in order to satisfy those people who have written to us on both sides of the debate.

I say to the right reverend Prelate the Archbishop of York, who threatened to vote down the Bill at Third Reading, that I hope he will think again about that. The expectations are sky high and to vote down a Bill that had not been properly considered or given enough time would put this House in a very awkward position, for no good reason. Our duty is to scrutinise the Bill, send it back to the House of Commons and ensure that we have the time to do a proper job.

[Lord Carlile of Berriew (CB)]

My Lords, noble Lords may recall—but I will remind them in case they have forgotten—that I tabled an amendment to amend the amendment from the noble Lord, Lord Forsyth, because it seemed to me that the noble Lord wanted to turn this Bill into a government Bill and give it all the authority of a government Bill, with a Minister in charge, or by putting the noble and learned Lord in the position of being a Minister. However, I have listened to the noble and learned Lord and he has said—absolutely rightly, and I totally agree with him and the noble Lord, Lord Wolfson—that this absolutely should be, and should remain, a Private Member’s Bill.

I have also looked at the potential effect of the amendment to the commitment Motion from the noble Baroness, Lady Berger, who I think has approached the Bill with great energy, superb intelligence and good judgment, and has done great credit to the House. Having considered that and the state of play as it is now, I think it is right that I should withdraw my amendment so that we can move quickly on to other, more substantive matters. I beg leave to withdraw the amendment.

Amendment (to the amendment) withdrawn.

Mental Health Treatment: Waiting Times

Lord Carlile of Berriew Excerpts

Monday 3rd February 2025 Lords Chamber

[Baroness Merron (Lab)]

I agree with my noble friend’s assessment of the impact of what is a totally unacceptable situation, particularly for children and young people. On the point about ensuring delivery locally, I refer your Lordships’ House to the NHS planning guidance, published last week, which not only confirms our commitment to the mental health investment standard but sets out an objective to increase the numbers of children and young people under 25 accessing services in the forthcoming year compared to 2019.

[Lord Carlile of Berriew (CB)]

Does the Minister agree that the long delays experienced by released prisoners in accessing necessary mental health care simply oil the revolving door of their return to prison? Will the Government give high priority to dealing with that problem?

[Baroness Merron (Lab)]

We are extremely aware of the point the noble Lord helpfully makes. The matter of severe mental illness in prisoners has come up repeatedly in Committee on the Mental Health Bill, and we will continue to work to address the points he raised.