(4 days, 22 hours ago)
Lords ChamberI accept what my noble friend says. I hope she has read my note to the committee, which it published, in which I accept that further work is required, in particular on Clause 37. I accept in principle that I have to come back with further amendments in relation to Clauses 27 and 37.
The noble Baroness, Lady Hollins, has made a series of creative suggestions. She is addressing this in a way that is separate from the proposal from the noble Baroness, Lady Finlay of Llandaff. She says that her proposals on substances should apply irrespective of which scheme it is. I need to consider some of them in detail. My noble friend Lady Blake has indicated why some are difficult to integrate into substances for assisted dying. I am particularly interested in the relationship between the Medicines and Healthcare products Regulatory Agency and the approval of these drugs; that needs further thought on the sponsor’s part. In addition to the amendments that I am proposing to Clauses 27 and 37, I should consider them as I think they are valuable.
For the reasons given by my noble friend Lady Blake, I do not support the amendments proposed by the noble Baroness, Lady Grey-Thompson, in relation to clinical trials. Although the MHRA has a part to play, I also accept the limitations on that put forward by my noble friend Lady Blake.
I have seven amendments in this group: Amendments 624A, 708A, 708B, 710B, 862B, 877B and 878A, all of which relate to limiting the power in Clauses 27 and 37, and include a requirement for consultation in respect of the Minister. I do not think that they are contentious, although I accept that people think that I should go further. In the respect that I have mentioned, I am more than willing to think about going further. If and when we reach those amendments, I expect the Committee to agree to them.
I deal finally with the question from the noble Lord, Lord Empey, in relation to Northern Ireland. He asks why the Bill extends the power of the drug regulator in this respect to Northern Ireland. The noble Lord will know that drug regulation is a matter for the whole of the United Kingdom so must be dealt with by a statute in this House. We are not suggesting that Northern Ireland should change its current law, but if there was a law change then there would be no reason why the drugs authorised in whatever process the Secretary of State agrees to should not apply to Northern Ireland. That is why it refers to Northern Ireland.
Does the noble and learned Lord agree with the noble Baroness, Lady Murphy, that assisted dying is part of palliative care?
Assisted dying is about giving somebody a good death. Palliative care is about exactly the same thing.
(2 weeks, 4 days ago)
Lords ChamberWith respect to the Select Committees in the other place, they should be consulted and decide whether they want it.
In the amendment from the noble Baroness, Lady Cass, she draws attention to the fact that the assisted dying commissioner has a function under the Bill. That function is to receive documents, make appointments to the assisted dying panels, make arrangements in relation to such panels—this means that he or she is responsible for making sure the process runs properly—and determining the applications for reconsideration of panel decisions. That means that, if a panel says no to an applicant who wants an assisted death, the voluntary assisted dying commissioner has the power under Clause 18 to say that another panel should look at it. He or she has that power in a semi-judicial function if there is an error of law in relation to it, so that is a function.
The commissioner also has a function to monitor the operation of this Act. If noble Lords go to Clause 49, they will see that he or she is given the power to make reports, give an annual report and identify things that may be of significance in relation to it. One should not confuse this role with monitoring, for example, the performance of doctors in relation to their role. I do not see the very specific functions and the obligation to monitor and give reports, as in any way in real conflict. I think they could be done by the same person, particularly if there is a deputy to be appointed as well. I note what the noble Baroness said, but I do not think it is necessary to make provision in the Bill for a separate role for somebody to do both. I have thought very carefully about it.
The noble and learned Lord, Lord Garnier, has been kind enough to indicate that he has had to leave, but I will deal with his point. He wants not the Prime Minister but the Lord Chancellor to make the appointment. The Prime Minister and the Lord Chancellor are both political appointments. We have chosen the Prime Minister because—even though I think there is practically nobody more important than the Lord Chancellor—the political world, for reasons I am completely unable to understand, regards the Prime Minister as more important. We have chosen the most important person in the Government to make the decision and, with the greatest respect to the noble and learned Lord, I do not think we should change that.
The noble Lord, Lord Weir, asked why we should have a judge. I am a great admirer of judges, and I declare an interest in that I am married to a judge. The reason why we have a judge is twofold. First, ex-members of the Supreme Court, the Court of Appeal or the High Court of England and Wales—it is England and Wales that we have in mind—have high standing. They are regarded as people of calibre, which is why they are put in. Secondly, one of the specific functions in the Bill is to consider whether the rejection by a panel is an error of law. That seems to us to be appropriate to be dealt with by somebody with high legal experience. Separately, the commissioner is somebody who has to issue rules and a process for dealing with it. That is the reason for doing that.
If that is the argument the noble and learned Lord puts forward, with which I entirely agree, does it not lead him to understand that the proposal of the noble Lord who spoke unwillingly earlier, to put this back where it was in the first place—basically, under the control of judges—would be a very good thing to do? Why has he not accepted that most of us would be able to support that, and therefore we would cut down the time we are spending on dealing with the situation when it is not there? If it is necessary, as he says, why not do the whole hog?
We have changed from a judge to a panel because, after considerable debate in the Commons, it was thought that having a legal person in the middle, a psychiatrist and a social worker gave greater reach and understanding of those issues. We debated that issue in full over a particularly long period of time on an earlier Friday. I am more than delighted to redebate it—however, I think that issue has been laid to rest. That does not mean one does not have to have a process whereby the doctors pass their findings to a panel, and that is the role, in part, of the assisted dying commissioner.
My Lords, I did not intend to speak on this particular amendment until something happened at lunchtime. I have to apologise to the noble and learned Lord, because I am not sure that I can make a joke about it, as he has requested me to in any speech I make. The fact of the matter is that at lunchtime I discovered that my local health trust has withdrawn its payment to Marie Curie, which means that there will no longer be Marie Curie nurses helping people in the final months of their lives; that support has been withdrawn because of the tight budgets in the National Health Service. I am appalled that we are in that situation, but it reminds me very clearly of the fundamental problem of a single-issue Private Member’s Bill, because it asks us to consider something not as one of a series of priorities among which government has to make choices, but as something on its own. That inevitably is a real problem.
The second problem is that anyone who has been a Minister knows how the Treasury works. If you ask it to give you some money to spend and then say, “But we’re going to make these savings”, it always counts the spending and refuses to acknowledge the savings. That is a Treasury mechanism that we have all learned—and I see that a former Health Minister knows precisely what I mean.
The problem with this issue is precisely that: money will have to be spent, but the savings—let us leave aside whether this is a suitable balance—will certainly not be considered, which is why the Deputy Health Minister said there would have to be “reprioritisation”.
So I come to this Committee having been shocked at lunchtime. Perhaps the Chief Whip should not have allowed us off for lunch: then I would not have been able to see this. However, the truth is that I am shocked by the fact that one of the most important palliative care services is now going to be ceased for the part of the country in which I live. That therefore brings me back to the amendment. I think we have to say to ourselves, very clearly, that, if we are proposing to spend money on this, it is quite clear from the Government that that will mean “reprioritisation”, which actually means cutting other money in order to save enough to pay for this.
I hope the noble Baroness will not be upset by this, but I do not understand how the Government fail to do this: in all the advice they give us, they refuse to tell us how much they think this will cost. That is a duty of the Government. They should tell Parliament, if it is a Private Member’s Bill of this sort—I will give way.
We produced an impact assessment of the Bill with detailed costings, provided by the health service, so to suggest to the Committee that the Government have not provided the costing is inaccurate.
We have already told the noble and learned Lord what we think about the impact assessment. We have been asking for an updated impact assessment which takes into account the debates we have had and the assessments we have made. The Government have said they will not do that—that is what I am referring to. I want to see an absolutely up-to-date impact assessment based on the debates in which we have expressed and explained real issues which have not been raised before, so that we can, first, know how much it costs and, secondly, begin to ask ourselves, “Is this the priority?”
I will end on this. Is it a priority to provide people with the free chance to kill themselves and not provide people with Marie Curie nurses so they may live the end of their lives in a happier and better place? Anyone who suggests that we get that priority right by funding assisted suicide rather than Marie Curie nurses seems to me to be saying something that the public would not accept. One of the problems with this whole debate is that we have never been prepared to tell the public what the real effect of this is. Therefore, I very much support this amendment—not that I would normally support the kind of position my noble friend raises in his particular way, but he did it most elegantly. I support it entirely because, at long last, we are talking about the facts and what this really means for the people of Britain.
(1 month, 2 weeks ago)
Lords ChamberOn the first point, as I said, the review has to report in the first reporting period required under Clause 50. That means that it reports probably three years before the Bill comes into force, so there will be no cases. It is not doing what the noble Lord, Lord Sandhurst, was saying. On the second point about wriggling out, what the noble Baroness was describing would also be a Fatal Accidents Act case, so it would be covered, one hopes, by what the review deals with.
My Lords, I come back to the idea of having an inquiry and a report. I do not quite understand why the noble and learned Lord does not feel that it is much more sensible for us to have it in the Bill. After all, otherwise you are in a sense dictating what the inquiry shall come up with. The only inquiry that you would want to have is one that found an answer to the problem, but you do not know that if you set up an inquiry. I would rather like to have the answer to start with in the Act so that we know that those people are protected.
The reason, from discussing and thinking about this issue, is that the Government see the most convenient way of doing it is to have a review that can make sure every single aspect is covered. That is the argument for the review.
(1 month, 3 weeks ago)
Lords ChamberThey are fundamentally different, but the idea that removing the respiratory equipment does not involve some acts is not realistic. But I completely accept the proposition that they are different. On the legal point, there is some ambiguity about what the section means and whether it needs to be changed, but I am making it absolutely clear that, from my point of view and that of the promoters of the Bill, it is most certainly not outside the broader founding principles of the NHS.
I accept that very much from the noble and learned Lord. The question I asked, because I think it important, is for the Government to say what the legal situation is, which they have a duty to tell us before we can make the decision. I entirely accept what the noble and learned Lord said about his own position, but this is a question for the Government, if they are independent of this. They have a duty to provide information to the House before we can make these decisions.
The broader question of whether this contributes to healthcare is for each of us to make our own judgment about. If noble Lords take the view—I am talking not about the legal issue but the broader issue—that this is wrong and contrary to the basic founding principles of the NHS, they can vote against the Bill. But if Parliament passes the Bill and says, “We are happy that that is the position”, it is saying that it is an acceptable part of healthcare.
The noble and learned Lord really must accept that there is a problem with this being a Private Member’s Bill. He can say what he likes about the Bill, and I acknowledge and accept his absolute honesty about it, but the Government have the role of informing the House. Indeed, they do it: every time we have a debate, the Minister gets up and says that this or that would be difficult or awkward, or would be contrary to the European Court of Human Rights. I am only asking that they do that job on this. Is what is being proposed contrary to the founding position? Would the law have to be changed? It is up to the Government to tell us. We can then decide whether that matters.
It is for Parliament to decide whether it is willing to pass the Bill. If Parliament is willing to pass the Bill, there may be the need for the legal change that the noble Lord, Lord Stevens, referred to. Whether or not you are willing to make the change is, for the reason I have said, a matter of what you think is the principle. Those are the only remarks that I need to make in relation to that, and I invite the noble Lord to withdraw his amendment.
I apologise; I should have answered that request. I do not want to write; I want to tell the noble Baroness the answer now. The Bill, in the places that I have indicated, says that the panel, the two doctors and the assisting doctor must be satisfied that the consent is informed. If the position is that the person who wants the assistance, or is about to get the assistance, is misinformed in the way that the noble Baroness described, that would not be informed consent. For example, having been subject to digital information that is completely wrong or misleading in what it says would not be informed consent. As time goes on, no doubt doctors and others who have to satisfy themselves that the consent is informed will have to take steps to ensure that the patient’s understanding is right.
This goes to what the noble Baroness, Lady Finlay, said. Sometimes, people do not take in what you are saying. Some people take in the wrong thing. Other people are, in the back of their mind—you cannot know this—thinking of something that is completely wrong. It is for the doctor or the panel in every case to satisfy themselves. It is explicit in the Bill that consent must be informed.
To clarify one issue, the noble Lord, Lord Wolfson, suggested that the Government should answer the question about whether they believe that these circumstances are covered. The government spokesman kindly passed it back to the noble and learned Lord, the proposer of the Bill. Could he please explain why it would not be sensible to put in the Bill precisely what would normally be expected of the doctor? This is merely because we would be much happier if that were there, and it would take it away from the problem the Minister does not want to touch himself, in case in some way he gets infected by not being independent. Why can he not just accept that, if what he says is true, putting it in the Bill does not alter it but makes people much more secure?
I listened very carefully to that. I indicated previously, in relation to powers of attorney, for example, that it would be worth putting it in. First, I am not sure what “it” is. Secondly, “it” is there: the key is the words “informed consent”, which nobody has any difficulty in understanding. It may have a particular implication in a particular case, and you have to give people flexibility in relation to what they say, because it will depend on the circumstances. If I knew what “it” was, I would put it in, but it is just not that simple.
(2 months ago)
Lords ChamberIt is. The reason the two are different is that Clause 1(2) describes what is coming later in Clauses 8 to 30; Clause 1(3) is a mandatory requirement that the steps that come later have to take place when the person is in England or Wales. So they do different things. Subsection (2) is descriptive, and subsection (3) is a legal requirement. I am very happy to say that the shadow Attorney-General is nodding, which is very strengthening on this.
The one point that I have not dealt with properly, or at all, is that which the noble Baroness, Lady Berridge, made about the interaction between the Mental Health Act and the Bill. I was not sure which specific amendment she was referring to; it may have been Amendment 38, but I do not know. However, as far as I can see, there is no legal difficulty in this Bill sitting with the Mental Health Act because, as long as these conditions are satisfied, the patient is entitled to have an assisted death. There is nothing in the Mental Health Act that would prevent that. I am more than happy to have a more detailed conversation with the noble Baroness and Professor Ruck Keene, if she wishes to bring him along and he is willing to come.
I hope that I have dealt with every amendment put forward.
Just one point, as a matter of personal explanation, I did not call the noble and learned Lord Stonewall; it was the noble Lord, Lord Empey, who did so and I do not want to take his excellent comment away from him.
I apologise. I do not know whether the noble Lord feels that he is withdrawing a compliment or withdrawing an insult, but I get what he is doing.
To the noble Baroness, Lady Cash, before she gets to her feet, I say that she is right. In relation to the ECHR points that were raised by, I think, Mr Stevenson, who was the commissioner—I have the name wrong.
Can I encourage the noble and learned Lord in what he has just said? I was going to intervene earlier, but decided I would wait for this moment. I am afraid the noble Baroness, Lady Whitaker, almost drove me to get up; she can say that she does not want to be a burden because she will not be one and I am quite sure her family would not let her be one. The truth of the matter is that we are concerned about making sure that people are given every opportunity to put themselves in the best position in the last six months of their lives. If the noble and learned Lord can find a way of having these questions asked without the disadvantage—I understand the point he makes—it would give us a great deal of support. I would like him to do that.
I hope I have been clear about not liking the amendments as they are and that I am keen to see whether what the noble Baronesses, Lady Smith of Newnham and Lady Fox, said can be incorporated somewhere in the Bill. It may well connect with things we have said already. I hope I have made my position clear.
(3 months ago)
Lords ChamberThe noble Baroness is intervening on somebody who made an intervention on somebody else. We got a very severe talking to about that before, so I do not think that is allowed.
I did not realise that the noble Lord was intervening on me, but I will just say that, for me, it is very difficult to have that argument. Kindness is absolutely the central point of everything that I believe in, so I am very vulnerable to that question. But the truth is, the Bill does not talk about pain at all. There is nothing in the Bill about pain. This is about a totally different circumstance. One of the problems in the country as a whole is that many people who support the Bill do so because they think it is about pain.
We could have a Bill about pain, but then we would come back to the point made by the noble Baroness, Lady Berridge, that that is not what the Bill should have been. The Government should have said that they would give a free vote on a government Bill on this subject, rather than slipping it in in a wholly different way.
However, we are faced with what we have, and in that case it does not seem kind to say to people who are under all sorts of pressures and who are particularly vulnerable that this is a choice they should make. If we want kindness, we should be saying to the Government, “Get the Bill withdrawn and introduce a government Bill that is properly thought through where we can have the real debate that the public as a whole want us to have. You can still have a free vote”, but it should never have been put through in this way.
(3 months, 1 week ago)
Lords ChamberFirst, on there being no need to question someone about why they are withdrawing, if there is material relevant to it, I need to check the Bill to see that it should be recorded. But the Bill contains regular provisions that state that everything must be recorded. If it is not adequately covered—if somebody says, “I’m withdrawing because I think you’re being coerced”, obviously that should be recorded—I will make sure that it is covered.
On Amendment 405—
I genuinely want to understand this. The worry we had about this being a drafting difference is simply because when you could withdraw only on grounds of illness or death, the situation about why you withdrew did not arise. When you remove that, people can withdraw without giving notice of why. Therefore, there ought to be something—the noble and learned Lord has rightly said that he will look at it—to make sure that if somebody withdraws because there is some serious issue in connection with the decision, they have to say what it is. If we do not have that, this very much becomes a weakening point. I know that the noble and learned Lord does not want it to become that, but without something that insists on the information being given, it does become much weaker. This is not a drafting point until that is put right; when it is, it is a drafting point.
I do not accept that it is not a drafting point, but that may be dancing on the head of a pin. The point that both the noble Baroness, Lady Fox, and the noble Lord, Lord Deben, are making concerns making sure that if you are leaving for a reason that will give rise to problems, it is properly recorded. I completely accept that and we will make sure that that is the position, because it is a valid point.
In relation to Amendment 405, the noble Lord, Lord Shinkwin, said that it is a watering down. It is not a watering down at all, with respect. The current draft says:
“When carrying out an assessment in accordance with subsection (2), the assessing doctor must first ensure the provision of adjustments for language and literacy barriers, including the use of interpreters”.
The new draft says that the relevant doctor must
“take all reasonable steps to ensure that there is effective communication between the assessing doctor and the person being assessed (including, where appropriate, using an interpreter)”.
The noble Lord, Lord Shinkwin, is shaking his head; I am more than happy to talk to him about how that could be a change, and if there is some change that he would like in relation to it, let us put it in. But it is, in legal terms, to my eye, wider. It covers a much wider ambit without providing any inadequate protection. Maybe the right course is for me and the noble Lord, Lord Shinkwin, to sit down and for him to identify the changes that he would like. At the moment, I cannot see them.
(2 years, 1 month ago)
Lords ChamberMy Lords, every time in this Committee you think that the Government cannot be more flattened than they were in the previous debate, they are even more flattened. I refer to the speech of the noble Lord, Lord Clarke of Nottingham, who in my respectful submission completely flattened the Government’s case for not allowing the courts in.
I support what the noble Lord, Lord Anderson, is proposing. As the Committee understands, it means that if somebody challenges whether Rwanda is a safe country in general, the courts must decide on it. The Government are obviously under no illusions about what such a clause would mean. It would not mean that an asylum seeker, every time they were in trouble and might be about to be expelled, could raise the question generally of whether Rwanda is a safe country; it would mean in practice that, eventually, one case in a high Court of Appeal would definitively decide whether at that time Rwanda was a safe country in general or not.
The practical consequence of the amendment from the noble Lord, Lord Anderson, is that the courts will determine once—and maybe again in a few years’ time if the position has changed—whether it is a safe country in general, and everyone else will be bound by that. The Government accept that, if the issue is whether an individual’s circumstances put him or her at risk, they have the right to challenge in court anyway. By refusing to allow this to happen, they are cutting out a one-off shot by the courts to determine whether Rwanda is a safe country in general.
Why on earth would they not want that to happen, as their case is not that Rwanda might or might not be a safe country but that it is a safe country? Might I venture to suggest a reason why they are behaving in this extraordinary way? It is because it will take a bit of time for the courts to reach that conclusion—maybe two or three months from the Bill becoming law—and in that time there might be a general election and nobody will have flown to Rwanda. Could a responsible Government be willing to put asylum seekers’ lives at risk on the chance that Rwanda might not be a safe country? Obviously not, without a proper examination by the courts.
What I am saying does not challenge the basic policy of deporting to a third safe country or offshore processing—that debate is for another day—but, if the Government are going to do this, to give people confidence in them and to give the world confidence in the UK, surely they should do it lawfully, not unlawfully. They should not be advancing bogus reasons for cutting out the courts, when the courts are there in every other consideration of whether a country is safe. It is very discreditable.
My Lords, I hope the Committee accepts that I rarely intervene when the lawyers are at it, because I am not of great assistance, particularly to my noble friend of a great many years Lord Clarke. But he asked the Government to tell him of an occasion when this has happened before. I will remind him of one: the court of King Canute told him that, because he was sovereign, he could tell the waters to stop and the tide to go out. Of course, we were never taught it this way round in school, but the truth is that King Canute went to prove to his courtiers that he could not reverse the truth.
The problem with this part of the Bill is that it proposes that the sovereignty of Parliament is able to make a situation true, whether it is or not. In other words, this would be wrong even if the Supreme Court had not ruled that this is not a safe country. It is not part of the sovereignty of Parliament to declare truth; it is part of the sovereignty of Parliament to declare the law—and, in so far as we are sensible, we try to make the law as close to the truth as possible.
Now this Government have done a remarkable thing. There are many bishops on the Bench at the moment, so I will speak with a certain amount of care, but I seem to remember:
“‘What is truth?’ said jesting Pilate, and would not stay for an answer”.
This Government have not even asked the first question. They assert that this is true and, as my noble friend suggested, not only is it true but it will always be true until, I suppose, the Government—because the courts will have no place in this—say that it is not true.
The reason I feel so strongly about this is that I have spent nearly 11 years of my life as chairman of the Climate Change Committee. One of the problems I have faced all that time is people asserting “my truth” —not “the” truth but “my” truth—and that their truth is the equal of anyone else’s truth. That is not the nature of truth. Truth has constantly to be questioned. Doubt is an essential part of faith; you have constantly to question. The Government are proposing a unique situation, which is that we shall never question their decision, at this moment, that Rwanda is a safe place. I am not going to try to say whether I think it is safe or not. I think merely that it should be under constant consideration if we are going to take other human beings out of our jurisdiction and place them somewhere else.
That, if I may say so to my noble friend, is a moral matter. We remove responsibility by doing this, and the one way in which we can protect ourselves is if the place to which we send them is constantly available for questioning. The only place where that questioning can take place is in a court because courts listen to all the arguments, hear all the evidence and make a decision. If you do not like the decision, you can appeal it, but finally you have to accept it. Once you undermine that, I do not see how you can uphold the rule of law anywhere else. Once the Government have said that their truth is true and there is no other truth, we have moved into a position which is entirely unacceptable in a democracy. This Government have to understand that—on this issue perhaps alone—this House will have to stop this Government’s proposal by whatever way. This is our duty. We are not a House which just puts the details of law into some sense. We also have a constitutional position. The Prime Minister made his rather curious statement about the will of the people, but the will of the people can be protected only if this House stands up for the constitution of our nation, and our constitutional position must be that the Government cannot determine truth. Only the courts can do that.
(4 years ago)
Lords ChamberMy Lords, I have very considerable concerns, which have also been expressed by the Delegated Powers Committee, about the Secretary of State being able in effect to double the length of time that a prison sentence can last in relation to both summary offences and either-way offences. How long a person goes to prison for as a result of a magistrates’ court sentence is a considerably important factor in determining which cases are tried by a jury and which are tried by the magistrates’ court. If there is to be a change in the powers of the magistrates’ court of this dimension, it should always be done by primary legislation and not by regulatory powers. I oppose the proposal that the Secretary of State could in effect double the sentencing power of the magistrates’ court and think that should be left to primary legislation. For that reason, I support the amendment tabled by the noble Baroness, Lady Chakrabarti.
My Lords, as a non-lawyer, I have listened to much of this debate before and today and I think this Government are going too far in taking into ministerial powers decisions which should come before Parliament. This is another example of that. I do not want the Secretary of State to be able to do this without Parliament discussing seriously what it means. Parliament ought to be much tougher about its powers being taken into the Executive.
I was first elected to the other place in 1970. Since then, Parliament has become increasingly less powerful and increasingly the Executive have increased their power. I do not believe that the Secretary of State should have this power. I believe it should be Parliament. What is more, I believe that the public think it should be Parliament. Only with the consent of the public does the legal system work.
I usually come here to ensure that lawyers do not do things a bit on their own in legal matters, and I think I am the only non-lawyer here, but I wish to say—I apologise to the noble Lord, Lord Ponsonby, a fellow recalcitrant individual. It seems to me that we have to be much tougher about things that look small because, in aggregate, they become very dangerous, because the public will lose their belief in the fact that the legal system is independent except that it is dependent on the good sense of the elected Parliament and the House of Lords in ensuring that the Executive do not overstep the mark. I do not want this Government to overstep the mark in this or any of the other things they seem to wish to take unto themselves.