Terminally Ill Adults (End of Life) Bill

Debate between Lord Deben and Lord Markham

Committee stage
Friday 23rd January 2026 Lords Chamber

[Lord Markham (Con)]

In terms of, hopefully, being helpful, it is in the impact assessment. It is £28 million or, as I said, 0.000175% of the NHS budget.

[Lord Deben (Con)]

I am perfectly happy to accept the intervention, but I understand why the noble Lord, Lord Birt, did not accept any intervention, as he might have found it difficult to answer the questions that we are asking.

The point that I am making is very simple and it remains: we have to make a decision always among priorities. The problem with this decision—and it is why this should have been a government Bill and not a Private Member’s Bill—is that, as a Private Member’s Bill, it is a single-issue Bill. It is promoted by people who want this to be decided irrespective of its effect on everything else that happens. That it is not acceptable, it seems to me, for the Government. The purpose of my comment is that it is not about how much the proponents think it will cost; it is about the effect of this over the rest of the National Health Service. If the Bill is passed, where is it going to fit? The Government really cannot get up and say that we are entirely independent. They have to tell us, if this Bill is passed, where they see it sitting, because the proponents of the Bill have not expressed this. What is the real cost; that is, not the sum of money, but the effect of it on the rest of the service provided? They also have to tell us how it will impact the essential demands that the public have for so many other things.

We can argue about what the public think about this Bill—I am pretty sure that they think about this Bill rather differently from what it actually is—but we have to recognise that the public also have very strong views about what money should be spent in other areas. The Government have to tell us, from their point of view, how much it will cost, what the effect will be on the other services provided, where it will sit if it is passed, and how they will overcome the problem that many of those who may be asked to support it have said that they will not. Those are things for the Government to tell us and, so far, they have been unable to put answers to any of those questions, which is the second reason—the other is the point that the noble Lord has just made about amendments—why we have constantly to go on arguing, in detail, about this Bill.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Deben and Lord Markham

Committee stage
Friday 16th January 2026 Lords Chamber

[Lord Markham (Con)]

Every point that has been raised is valid, and I am sure that, when the noble and learned Lord, Lord Falconer, gets up to respond, he will acknowledge those points as well. However, I think the question in each case is whether we want it to be a black or white assessment of whether that should apply.

Financial support is a very good example of where in some cases that may be very relevant and in others it may not. I remember that my mother, unfortunately, was given a matter of weeks to live and was helped on her way when there was a matter of days left. The financial circumstances just did not even come into it at that point, so having a black and white assessment saying, “Oh, she didn’t seek financial support or didn’t have it”, was not even a relevant criterion. On the question about mental health and whether someone has had any disorders, that is very relevant if it was a recent episode but I think we would probably say it was not very relevant at all if it was 50 or 60 years ago.

Therefore, in all these circumstances, are we not seeing cases where it depends on the circumstances? To me, it is a question of whether we trust the panel, and whether we trust the doctors assessing the case, who are looking into all the criteria and will have the opportunity to call for any evidence they need on it, to be able to do that.

[Lord Deben (Con)]

Does my noble friend accept that one of the problems is that the organisations of these very people whom we are trusting have said that they want clarification on these things. The issue, therefore, is that we should be giving them that clarification that they want, and then we can trust them. They say they do not want to be trusted unless they have that clarification. That is the only point we are trying to make.

[Lord Markham (Con)]

Again, it is about whether you put that financial support clarification in black and white and say, “This must be something that someone’s done”, where it might not even be relevant to the circumstances, or where the—

Terminally Ill Adults (End of Life) Bill

Debate between Lord Deben and Lord Markham

Committee stage
Friday 12th December 2025 Lords Chamber

[Lord Deben (Con)]

My Lords, the moments in the Bill that most concern me are when it gets nearest to saving money. There are several occasions on which that appears to be the case, particularly when talking about people for whom many have no sympathy at all, and when you are talking about a service in which we all know we are failing. It cannot be true that any Member of this House believes that our prisons are as they should be. Yet we imprison more and more people. We imprison twice as many people as the French or the Germans. I still do not understand why we cannot take this seriously, but we still go on doing it.

First, can one really think that someone in prison circumstances finds it possible to make the same kind of decision as people who are not? Just simply, those circumstances are the pressures, the crowding and the fact that you are not in any company that you would have chosen. I do not believe that those are the circumstances in which the Bill’s proponents meant for decisions of the sort we are talking about to be made.

The second issue is: what about the pressures there? We have been talking about the concerns of those who find themselves under pressure. Do we really believe that there will not be many prisoners for whom the whole issue will be presented as, “You will be better off and we will be better off if you make this decision”?

The third issue is surely this: we know that prisoners have much worse healthcare than people outside prison. Therefore, the fact that they are told that they have but six months to live is much more difficult than it would be if they were in normal circumstances. I put it no more sharply than that, but it does seem to be true.

Fourthly, earlier on, we were talking very strongly about the difficulty that the Government are willing to fund this when they are not funding palliative care for very large numbers of people in the country. I therefore come back to my deep concern that it will become so much easier for people to die than to continue.

The right reverend Prelate, whose experience is remarkable and whom I admire enormously for her work in the prisons, has reminded us of how old the prison population is and how much older it is becoming. I just do not think that those of us in this House who really believe that our major job in this Bill is to protect the vulnerable can possibly agree that people in prison should be included under the Bill. We should take them out.

[Lord Markham (Con)]

May I just offer a different perspective on this? It has been an interesting debate. One of the main reasons I am supportive of assisted dying is kindness—kindness to the people who are scared about the inevitable end of their life and kindness in that they face a lot of pain. They see assisted dying as a way of relieving themselves from that pain.

In this debate, are we saying that people in prison are not deserving of that kindness? People in prison have been deprived of their liberty because of the crimes they committed, and that is the punishment that they have been given in the face of the law. That is the debt being paid to society. But are we saying at the same time that they do not deserve the same kindness that we would give to others and that they should face pain because they are in prison, whereas others should not? That is my perspective on this.

--- Later in debate ---

[Lord Deben (Con)]

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.

[Lord Markham (Con)]

If I may respond on the pain point, I have spoken to lots of people who are terminally ill and heard their evidence. Again, I recommend that as many people as possible hear them because they have heartwarming stories. For them—not all the time, but a lot of the time—it is because they want to have that choice at the end so they do not have to face that pain. That is a key reason for them. The Bill says that you have to be within six months of the end of your life, but then you have the choice within that. For some people, the thought of that pain, and the experience of that pain, is the real reason why they want an assisted death. My point is that I believe prisoners should have exactly that same right so that they have the possibility to avoid that pain.

Ultra-processed Food

Debate between Lord Deben and Lord Markham

Thursday 26th October 2023 Lords Chamber

[Lord Markham (Con)]

Obviously, I am always happy to look at all the research because this is a vital area. This is the fifth time we have discussed it in the last three and a half months, so I apologise for any repetition. We are ever vigilant on this area but, as the contributors to yesterday’s debate showed, the research is mixed. The key things to get behind are the bad features of ultra-processed foods that are high in sugar, salt and saturated fat.

[Lord Deben (Con)]

My Lords, I will ask a very simple question. Was it not true that, before we had the link between smoking and lung cancer, we did have evidence of an epidemiological connection? The problem here is that we have no direct link, but it does seem that there is a connection that we do not yet know is causal. Will the department be very careful not to ignore that evidence simply because it is very inconvenient for scientists if their whole history of understanding nutrition is undermined by it?

[Lord Markham (Con)]

Absolutely—we have to be understanding of the latest research in cause and effect. The evidence I have been shown so far is that it is about the features within those ultra-processed foods—are they high in fat, sugar or salt? Those are the things that are causing the harm. If we find links to the processing itself, we will act on that.

NHS Industrial Action: Government Preparations

Debate between Lord Deben and Lord Markham

Tuesday 13th December 2022 Lords Chamber

[Lord Markham (Con)]

My understanding, based on the long time that this has been in place, is that this is an annual review. April is now quite close; for that April review, it can take into account all the factors, including what happened to inflation during the year. I expect it will take all that into account, quite rightly, in what it comes up with for that next pay review. It is a long-established principle that it is there to do this. I trust it to get the right answer in time for April.

[Lord Deben (Con)]

Will my noble friend be very careful to stick by the case being put forward? We know that those arguing it want to hide behind some discussion of the mechanisms in order not to say what they really think about the pay rises. The Government have a responsibility to stick by the system. If we lose that, it will be the Minister who makes decisions always, which is what we have tried to avoid since the 1980s.

[Lord Markham (Con)]

I agree. Clearly, there are difficult choices; if we changed the position, we would have to take money away from other parts of the system, such as the elective care fund and other front-line services, which we clearly do not want to do. It is absolutely right that we let the experts guide us in this, as all Governments have done for more than 30 years.