Terminally Ill Adults (End of Life) Bill

Debate between Lord Deben and Lord Kamall

Committee stage
Friday 23rd January 2026 Lords Chamber

[Lord Kamall (Con)]

My Lords, it has been a long day at the end of a long week for many noble Lords, so I do not seek to make a long speech. But before I respond to the debate on this group of amendments, I want to thank all staff from across the House who have worked extra hours to ensure that we could be here today and at this late hour. We really do appreciate it.

I thank the noble Baroness, Lady Berger, for introducing the amendments in such a clear and, more importantly, concise manner. As my noble friend Lord Blencathra said, the principle behind this group is very similar to that behind the last group: what is being sought is that doctors should seek to establish whether those who are terminally ill, and who have been given a prognosis of six months or less to live, are seeking an assisted death for those reasons only—their terminal condition—and not material factors.

My noble friend Lord Markham explained why other motivations are relevant, could be relevant or could be reasons for people wishing to die or seeking an assisted death. Contrary to that, the noble Lords, Lord Mawson and Lord Carlile, referred to misunderstandings and pressures, particularly on people from black, Asian and other minority ethnic communities. It reminds me of a comment that the noble Lord, Lord Rees of Easton, made at Second Reading—a man who spent all his life working with black communities in Bristol—who said he was concerned about the impact of this Bill on black communities.

The noble Baroness, Lady Grey-Thompson, has also spoken of her own very real experience and concern for people in the system, if the motivation is not purely because they are terminally ill but might be because of other factors. I know that my noble friend Lord Deben shares these concerns. I just gently remind him that he is not as unique a Conservative as he believes he is; all Conservatives want a better society. In fact, most politicians from all parties go into politics because they want a better society. We are on different Benches simply because we disagree on how to achieve that. Conservatives would probably say that the state is not the same thing as society.

[Lord Deben (Con)]

I am sorry if I misled my noble friend. I merely meant that you can believe in the individual but you have to believe in the individual in a society, and you cannot take the extreme view that suggests that the individual is on their own. No man is an island.

[Lord Kamall (Con)]

Indeed, and in fact many classical liberals and libertarians understand the individual’s role in a wider society. But that is not the basis of this debate, and I digress too much. I will return to the group of amendments.

I know that the noble and learned Lord, Lord Falconer, understands the concerns of those who have raised issues about minority communities and people being stuck in the system. But I also know that he has already made his view clear about the principle of seeking to exclude some of those other principles—if I am incorrect, I am sure he will correct me. So I suspect that, given the strength of feeling, we will return to these amendments on Report.

Given that—I understand that the Minister may not be able to answer all the questions now and we accept that he or one of his colleagues will write to us—we have to understand how the Government envisage how a person’s motivation beyond their terminal condition could be established. That is the crux of the matter. How do you establish that if you can justify it only on the grounds of terminal illness, not other motivating factors?

For example, what work, if any, have the Government or NHS England done to try to understand that? One assumes they may have to draw up guidance for this one day. Have the Government, or anyone in government, looked at how other countries have handled this issue, whether they do handle this issue, and what would have to change? We spoke earlier about the foundations of the National Health Service and what might have to change in guidance for many of the practitioners. Indeed, what training would be required?

As my noble friend Lord Deben has often said, this goes way beyond just the Bill. It will affect the Department of Health, the practitioners and the legal system. These are questions we need the Government to answer. They can still take a neutral position, but they have to understand that noble Lords seek to understand the implications here for government, the costs to government, and how that will change.

I understand these questions are in depth and recognise that the Minister may feel it is slightly unfair. I do not expect all the answers now. But it has been a constant theme throughout the debate and the many days in Committee that we need better answers from the Government. That is not a party-political point; it is purely that we want to see the implications of this on government: what extra costs there will be, what guidance will have to change and, however the Bill finally turns out, and in whatever form it reaches the statute book, how the Government will deal with that. I suspect that, for many noble Lords who are torn the Bill, that might be the deciding factor on how they vote at the end of the day.