Terminally Ill Adults (End of Life) Bill

Lord Jackson of Peterborough Excerpts

Friday 20th March 2026 Lords Chamber

[Lord Jackson of Peterborough (Con)]

My Lords, I shall touch briefly on two points prompted by both the noble Baroness, Lady Finlay of Llandaff, and my noble friend Lord Blencathra. In a sense they are a challenge to the sponsor, the noble and learned Lord. I think I am right in saying that he was a lot more definitive in his language in the Committee proceedings last week on 13 March about the need for the independent advocate to be present during discussions with the individual seeking to access the service. His Amendment 549A is more opaque in its language and does not specify that. Given the discussions that we had, particularly last week, about the power imbalance between someone who is less confident, less well-educated—a power imbalance between the decision-maker and the person accessing the service—it is an imperative that the independent advocate attends and is present to challenge some of the assumptions or decisions that are being made.

I want also to consolidate a point raised by my noble friend about training. The noble and learned Lord will know, as he and others have lauded the system in Victoria, Australia, that the training provided around the specific issue of coercion is very limited at tier 1. He has potentially missed an opportunity to focus in on training. If you had an in-person independent advocate and poor training, that would not be great, but you would at least have someone attending. Instead, you have a situation of inadequate training and someone not attending in person. It may be that they can send an email, or do a report, or a telephone call, but that is not the same as being there advocating for that individual.

I invite the noble and learned Lord, the sponsor, to address those specific issues of the opacity of his new amendment. I accept that it has been offered to the Committee in good faith to address some of the concerns and issues raised previously, but there is a specific issue about the wording of his new Amendment 549A and a specific issue of training around coercion, which is very important in this respect.

[Lord Wolfson of Tredegar (Con)]

My Lords, we have focused in this debate on the role of the independent advocate, but of course many of the underlying concerns arise with regard to protections for various vulnerable groups and people in situations that expose them to coercion or abuse. It is clear that the text of the Bill as drafted does not specifically address protections for groups such as those with Down syndrome or those subject to coercion.

In fairness to the noble and learned Lord, Lord Falconer of Thoroton, he could reasonably argue that the drafting of the Bill should be wide enough to encompass all of these groups on a generic basis without specifically referencing them. If the Bill is drafted with too much specificity, almost certainly somebody will be left out and we would have to come back at a later stage. That is presumably why the noble and learned Lord has introduced his regulation-making power in Amendment 549A, which I will come back to in a moment.

That said, I would suggest that it is not enough just to say that the drafting of the Bill is broad and that, therefore, we cannot debate its impact on specific vulnerable groups. I would be interested if the Minister could take time in her response to set out how the Government have taken into account the specific needs of the groups mentioned in the various amendments. That seems to me to be part of the work to deal with the practicalities of implementing the Bill.

How, for example, in practice does a person with Down syndrome who might have both speech and hearing difficulties communicate that they wish to die? How will medical practitioners and independent advocates assess that that person has come to an informed choice that they wish to die? Assessing the true wishes of people in that situation can be exceptionally challenging, and many such people rely on loved ones or carers to interact between themselves and medical professionals. How, therefore, do these family members or carers fit into the architecture of the Bill? How do they fit in, for example, with the independent advocate? What is the relationship between family members, carers and the independent advocate within the system of the Bill? Those are general questions which I hope the Minister will be able to respond to.

There is one specific point I ask the noble and learned Lord to consider which arises from his Amendment 549A, which would introduce a new clause after Clause 22. This point was prompted by a comment made by the noble Baroness, Lady O’Loan. If one looks at subsection (2)(b), the regulations must

“require a specified person to instruct an independent advocate to represent and support a person”

if the section applies. In subsection (2)(b)(ii), it says that it applies if

“the person has not indicated that they do not want an independent advocate”.

I was just comparing that to Clause 20 of the substantive Bill, which deals with the situation of when a person who has made either a first or second declaration wants to cancel the declaration as they have decided they do not want to die. In those situations, the person

“may cancel it by giving oral or written notice of the cancellation (or otherwise indicating their decision to cancel in a manner of communication known to be used by the person)”.

On the face of it, therefore, we are requiring much more from a person—oral or written notice—to cancel if they do not want to die than what is needed if they do not want an independent advocate. If we are going to go down the route of Amendment 549A, instead of saying the person has not indicated they do not want an independent advocate, it really should be that the person has confirmed—by written notice or by some sort of firm confirmation—that they do not want an independent advocate. What does “indicated” mean? It is a very loose word and, I would suggest, a very light test. What is happening here is that a person who would otherwise have an independent advocate to protect them is now not getting one; if that person is not going to get one, then we need more than a mere indication from them that they do not want the protection because, ultimately, this is all about protecting people. The contrast with Clause 20 seems to be somewhat stark, so I look forward to the noble and learned Lord’s response.