Terminally Ill Adults (End of Life) Bill

Debate between Lord Empey and Lord Harper

Committee stage
Friday 27th February 2026 Lords Chamber

[Lord Empey (UUP)]

I accept that that may well be the case. I am simply referring to what was in Hansard in 2021. The noble Lord may have changed his mind, as we all do over our lifetime, and rightly so—if you have a completely solid view of everything throughout your life, it is not a good thing. I am not in any sense trying to demean his position in any way; he is a very highly respected member of your Lordships’ House. My point is that his reference to the euphemism is still valid in my view.

Coming to the nuts and bolts of how things would work in practice, at Second Reading of this Bill, and indeed in previous iterations in which I have had any role, I drew attention to one of the key issues: changing the nature of the service that we are funding. If we decide as a Parliament to make assisted dying, or whatever phrase one wishes to use, a legal activity, that does not necessarily mean that the National Health Service has to pay for it. Can you imagine the finance committee of a trust discussing its budget and getting into an argument? The sums may be modest, but to even put something such as that in this context, when we are talking about life and death, is fundamentally flawed, morally and in every other way. The noble and learned Lord needs to reflect on some of these matters.

[Lord Harper (Con)]

I am grateful to my noble friends Lord Moylan and Lady Fraser for tabling these amendments. They have put forward some important questions which are worth raising explicitly with the sponsors of the Bill, so that we can hear what their intentions are and how they have reached those conclusions.

I have a number of concerns in this area, which I will set out. On a previous day, the Minister currently on the Front Bench confirmed, when we were debating resources, that if Parliament were to pass this Bill then the Government would ensure that all the requirements in the Bill were funded. That is perfectly right and proper. It was clear from that debate that there was no guarantee of any extra resources and that therefore money would be reprioritised—not just in the National Health Service but in the courts’ budget, given the impact that this Bill would have on the courts. That has clearly been reflected by what Stephen Kinnock said in evidence and by the Health Secretary, who commented on the need for prioritisation.

I do not make as much of the cost of this as some people, because I accept what the noble and learned Lord, Lord Falconer, said on a previous occasion. Compared with the NHS’s overall budget, the cost of providing this service is relatively modest. I have a different concern, which is twofold. First, as has been raised already in the debate, it would be perverse if Parliament were to pass this Bill and the taxpayer were to fully fund an assisted suicide service when it only partially funds palliative care. That would set out a very weird set of priorities and choices to the country—that the taxpayer should fully fund helping to kill people and not fully fund helping them to live well.

My question to the Minister—which does not trespass on the Government expressing a view on the Bill—is, in the event that Parliament passes the Bill, and the Government rightly ensure that it is funded, will the Government ensure that palliative care is fully funded by the taxpayer? This is not a question about taking a view on the Bill; rather, it is about making sure that when the Government publish in the autumn—this is why doing it in this order is not helpful, because we are not going to hear about palliative care services until the autumn—they will fully fund those services so that the taxpayer will ensure that any individual facing a choice has a proper choice and, if they choose palliative care, they will have care fully funded by the taxpayer in the same way that they would have a fully funded assisted suicide. If you do not fund it on that basis, you are not providing people with a proper choice. That is a question for the Government to answer.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Empey and Lord Harper

Committee stage
Friday 30th January 2026 Lords Chamber

[Lord Harper (Con)]

The noble Baroness makes a very good point which illustrates the importance of being able to ask people questions directly rather than hearing reports of what they have said or seeing it on a video call. That is the importance of in-person conversation and the ability to ask questions and hear answers so that you know what people actually think. I think the noble Baroness has illustrated and evidenced my point extraordinarily well, and I am grateful for her intervention.

At the beginning of this, the noble Baroness, Lady Gerada, referred to medical assessments. She is right in saying that many of them can be done very well remotely. I think that is excellent. I am a great supporter of technology. We do not all believe in quills and pens, and I do not think the noble Baroness, Lady Pidgeon, was entirely suggesting that we were. She might want to reflect on that remark and whether it was entirely well-intentioned, given what the Chief Whip said to us about treating everyone with courtesy and respect. I support the use of technology where it is appropriate.

The problem here is that the noble Baroness, Lady Gerada, said that we can all rest assured that doctors would never view this as a routine exercise. The problem is that in other jurisdictions there is quite a lot of evidence that they do. While it is true, as the noble Baroness, Lady Blackstone, said, that the vast majority of doctors will approach this in absolutely the right way, I am afraid not all doctors are perfect. There was an example yesterday of a paediatrician at Great Ormond Street who had an appalling record. We have to make sure that the law makes sure that patients are properly protected in all cases, not just in the vast majority of them. Where I disagree with her slightly is that this is a policy decision, not a medical decision. Whether assessments should be face to face, either in every case or that the presumption should be that they are, is a policy decision, rightly for Parliament, not for clinicians. It should be informed by listening to clinicians, but it should also be informed by listening to evidence from the patient experience, so ably set out by the noble Baronesses, Lady Smith and Lady Berger.

The noble and learned Baroness, Lady Butler-Sloss, gave her own testimony that she has had to make decisions in these cases, and I was very struck by her view that we should certainly have a presumption that these decisions should be taken face to face. I was very struck by listening to her on previous occasions. Her experience on these matters carries a lot of weight. I also listened very carefully to the noble Lord, Lord Carlile, when he set out the GMC’s advice. Decisions for patients with a terminal illness about a course of action that will lead to the end of their life seem to me to fall squarely within the set of cases where you would want a face-to-face appointment, but equally I felt there was good counsel for us and challenge from the noble Baronesses, Lady Jay, Lady Pidgeon and Lady Blackstone, to think of the patient, the person who has the terminal illness who wants a decision. They were right to challenge us on that.

That is why I think, if we look at the balance of amendments in this group, they are very helpful because they set out a span of choices for your Lordships, from saying that every decision has to be taken in person, which I think would be wrong for the reasons that the three noble Baronesses set out, that you have to look at the patient’s views, but equally, I think the present wording is too loose and does not set out a presumption that they should be face to face. I would be very grateful to hear the view of the noble and learned Lord, Lord Falconer, on where he thinks he is likely to settle because that will be helpful for all of us when thinking about whether we have to table further amendments. It seems to be a presumption that it is face to face, but with a very limited set of circumstances where it can be not face to face. But we should not accept the presumption in a patient-centred model that the patient always has to go and see the panel or the doctors. It should absolutely be, particularly because so many people in these circumstances are going to be in poor health, that we think of a system that makes sure that when it comes to the panel at least one member of the panel, the independent person, is physically present.

That is important. These amendments touch on two parts of Clause 17. The first is subsection (6), which states:

“The duty under subsection (4)(b) to hear from the person to whom the referral relates does not apply if the panel is of the opinion that there are exceptional circumstances which justify not hearing from that person”.


That means there are circumstances where the panel does not have to hear from the person at all: not by videolink, not in person, not by pre-recorded video, not at all. That was confirmed to me when the noble and learned Lord, Lord Falconer, and I were doing a media programme—I think it was “The Week in Westminster”—where I challenged him on this. He confirmed that there were circumstances in which a decision could be taken for someone to seek assisted suicide and the panel would never have to see them at all. I do not think that is right.

The other subsection these amendments touch on is subsection (5), which states:

“Where the panel considers it appropriate for medical reasons, it may make provision for the use of pre-recorded audio or video material”.


That was inserted in the House of Commons by a Back-Bench amendment. It was not very well debated. The fact that it is pre-recorded means that it gets rid of any opportunity for questioning or challenge. The problem I have with the language there is that it says “medical reasons”, it does not say “medical reasons pertaining to the patient”. This is my last point—

[Lord Empey (UUP)]

We are forgetting that we can use the telephone in this circumstance. It is not even that you would have sight of the person, but you could have a pre-recorded telephone call.

[Lord Harper (Con)]

I am grateful for that. The final point I want to make is that we had experience during the pandemic of too many vulnerable people, people with learning disabilities, having “do not resuscitate” notices put on them by doctors. I do not want to see a system where, if we had a similar circumstance again, these sorts of decisions would be taken remotely at speed. We know from our deliberations in this House, and it is my experience in the other place, that there is no substitute for doing these things face to face where you can challenge people, ask questions, put people under that challenge and get good answers to make good decisions.

I commend this group of amendments to your Lordships, and I look forward to hearing the response of the noble and learned Lord, Lord Falconer.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Empey and Lord Harper

Committee stage
Friday 23rd January 2026 Lords Chamber

[Lord Empey (UUP)]

I have to say that that was not my intention—the noble and learned Lord knows that perfectly well. I raised the point merely to indicate the length of time that this is taking and that a lot of the proposals and amendments on the Marshalled List could be addressed if we had amendments put forward by the noble and learned Lord, which he indicated in an email last week would be forthcoming. They are not here.

[Lord Harper (Con)]

I think that the reason why the noble Lord, Lord Birt, has put down these amendments is that it is not clear, from what the Government have said or what the Bill says, where this service is supposed to be—I see that the noble Lord, Lord Birt, is nodding at that. If the sponsor of the Bill had set out in the Bill more detail about how it would work and where it would sit, if there had been a proper process, many of the amendments from people with concerns would need to have been tabled and we would be moving faster. It is because of that gap and that failure, which is the sponsor’s responsibility, that this is taking a long time. It is necessary scrutiny to get the Bill right. That is what the public would expect of us.