Assisted Dying Bill [HL]

Lord Jopling Excerpts

Friday 7th November 2014 Lords Chamber

[Lord Newby]

My Lords, consideration was given to that, which is why we are not suggesting that the House sit beyond 5 pm, although it is conceivable, given the number of amendments, that one could go on beyond even then. The other thing that was in my mind, although I cannot speak for anyone else, is that for the country, looking in at our deliberations, the idea that it would be impossible to sit beyond 3 pm on a matter of this importance does not necessarily put your Lordships’ House in a good light.

[Lord Jopling (Con)]

My Lords, to avoid confusion, and because the Minister tends to mumble, may I make it clear that the noble Lord, Lord Joffe, who presented the previous Bill was not me?

Motion agreed.

--- Later in debate ---

[Baroness Finlay of Llandaff]

My Lords, I stated earlier that I saw merit in the amendments tabled by the noble Lord, Lord Carlile, because they took doctors out of the gatekeeping role. I would like to expand on that briefly now.

The advantage of an independent medical expert is that you will know that you have somebody who has been properly trained, whose assessments are audited and, where there is monitoring in the process, that they have to be updated in that area and discipline—and that they carry credentials, as well as being able to negotiate the court process. As part of that assessment, it seems essential that others affected by the death are also considered in the process—in particular, children. I have spoken before in this House about the problems for children who are bereaved. I do not think that the House should underestimate the emotional problems for a child whose parent has committed suicide or had an assisted suicide, or the difficulties that they may go on to feel: that their love was inadequate to support the person whom they loved—their parent—through the last days, weeks or months of their life, and how damaging that can be for the rest of their lives.

I also strongly support the concept of having a court-appointed person who could take the drugs out to the person who has gone through the process and for whom assisted suicide is being agreed. The way that the Bill of the noble and learned Lord, Lord Falconer, is written at the moment is completely impractical because in reality not all patients die rapidly on ingesting their drugs. Some die within minutes but the median time is actually 25 minutes, if we base it on the Oregon experience. However, some take 41 hours to die. That is going to tie people up for a very long time.

We are talking not about therapeutic drugs but about a massive overdose of a drug at a fixed point. Later we will come on to debate lethal drugs and the difference between those and medication. There can also be monitoring of whom the drugs go to when they go out, and the return of drugs to a central point if they have not been used—as well as having someone who is trained to deal with the complications that occur, which has not been addressed and which, I respectfully point out to the House, almost no doctors are equipped to cope with at the moment. Yes, they may learn, but that would be at the expense of patients.

The other reason why I see the merit of having a completely independent process of assessment is, as I said before, that it does not contaminate the care that is being given to the person by the clinicians. It allows conversations to go on without the patient feeling that they have locked themselves in—that in a way they can pursue a parallel track. They can be assessed by the court but they can still have their own practitioner working to improve their quality of life, not believing that, now they are applying to fix a date for their death, some of the interventions feel pointless and futile.

[Lord Jopling]

My Lords, the noble Baroness has just said something that has totally appalled me: that in these circumstances—in Oregon, particularly, I believe—it can take 41 hours for the injections to take effect. I am horrified to hear that. Would she be kind enough to try to give us rather more of an explanation from her background and experience about how this happens? It has come as a shock to me.

[Baroness Finlay of Llandaff]

I will certainly try to explain. The data come from the Oregon Health Authority’s own reports, which are written annually, based on the returns by the doctors. We know only the information that is given by the doctors; we do not know what goes on otherwise. If a doctor does not report it, it is not known. We also know from the Oregon health reports that three patients actually woke up again and did not go on to die.

The point is that you are giving a massive dose of barbiturates that is at least 20 times what you might use therapeutically to render someone unconscious but leave them alive; it is a huge dose. When someone is frail and very near death, they may well die rapidly from ingesting a small amount of an additional drug, but I would also point out that in its data the Oregon Health Authority says that the shortest time was one minute, and that is before any drug would be absorbed. I found that interesting because, in my own clinical experience, there are patients who, when the family says to them: “It’s okay, you can let go”, die within minutes of that statement being made. In other words, when they are given permission to die, they let go of the drive to stay alive. I wonder whether the figures in Oregon showing a very short time demonstrate that the person has signalled that now they are letting go, and that is it. I am worried by the prolonged figures, however, and I would point out that the median means that half the cases take longer than 25 minutes. That still seems to me to be quite a long time, but we will discuss complications later in the debate, not in relation to these amendments.

There is merit in not using the clinical team that is looking after the patient, whoever they are, but using an independent assessment by people who are properly trained in assessing capacity and who have the ability to ask questions about the family that the doctor who was looking after the patient may, for whatever reason, feel uncomfortable or inadequate about asking. They may not be adequately trained, because very few doctors are properly trained in assessing capacity. I also emphasise to the House the merit of having an independent person give the drugs.

My final point is that it is important to look at those jurisdictions that have changed the law regarding what happens if you do not have the kind of control that the amendments of the noble Lord, Lord Carlile, have been trying to put in. We know from Belgium that 32% of its physician-assisted euthanasia—that is how its law is framed—now happens without the explicit request of the patient, and we know from Belgium’s own data that it estimates that 47% is not reported. So without having these kinds of controls, you develop a very leaky system. The thought of people’s lives being ended without their explicit request is something that I find horrifying.

Pensions Advice

Lord Jopling Excerpts

Wednesday 23rd July 2014 Lords Chamber

[Lord Newby]

My Lords, the key innovation in the way we are planning to introduce this change is that of giving every individual coming up to retirement an entitlement to free guidance. To ensure that the guidance is impartial, we have decided that it will be provided by independent organisations which have no actual or potential conflicts of interest; it is not going to be the pension companies providing that guidance. A team has been established within the Treasury to lead on service design and implementation, bringing together expertise from across government, the Pensions Advisory Service and the Money Advice Service. The FCA will be the ultimate backstop in terms of the quality of the advice given and the monitoring of it. We will legislate to give the authority that explicit power in the Pension Schemes Bill later in this Session.

[Lord Jopling (Con)]

My Lords, will the Minister endorse the wisdom of my father who, in giving me an instruction shortly before he died, said that after his death I was to ensure that my mother took no advice whatever from either the vicar or the bank manager?

[Lord Newby]

My Lords, being married to a vicar, I could not possibly say that vicars are not always good sources of advice. The key challenge raised by the Question is that for many people pensions are a subject of complete bemusement. This reform, which I believe is very welcome, will give people much more choice over how they spend their money in retirement. However, they will be able to spend it wisely only if they are given proper guidance, and that is what the Government are committed to ensuring.

Queen’s Speech

Lord Jopling Excerpts

Wednesday 11th June 2014 Lords Chamber

[Lord Jopling (Con)]

My Lords, I am reminded of how quickly things in life change. One of the most vivid political memories of my life was being at Chequers on that Sunday when Margaret Thatcher first met Mikhail Gorbachev. It was that afternoon when she said those memorable words:

“This is a man with whom I can do business”.

That meeting was the start of what brought an end to the communist-inspired Soviet Union. Now, however, having seen it collapse, we see Mr Putin making continuing efforts to put it all together again. One might say that Humpty Dumpty lives again. I wish to talk about three of his efforts to put it together, and what might be our reaction.

First, Mr Putin has been trying to create an economic Eurasian union. He has already signed up Belarus and Kazakhstan; he did that in Astana a week or two ago. Some of the previously Soviet “stans” and Armenia are already expressing interest in joining. I think it was Hillary Clinton who said, some time ago, that we ought to try to stop it, but I should like to know how we could do so. My view is that there is not much we can do if those countries are willing partners of Mr Putin.

Secondly, and much more alarming, is the way in which he is going about it by military excursions to restore parts of the old empire. He has already done so in Georgia by taking over South Ossetia and Abkhazia, which are already occupied with Russian military. I suppose that one of Mr Putin’s great ambitions would be to take over the rest of Georgia, and therefore to control the Caspian Sea pipelines that are not under Russian control as regards the movement of hydrocarbons to western Europe. It is crucial that he fails in whatever ambitions he has to take over the rest of Georgia. I want the Minister in the wind-up to tell us about an important situation. That country is very much hoping that, at the Welsh summit in September, NATO will grant Georgia a membership action plan—a MAP, as it is called. What is the Government’s attitude to that? It will be a difficult decision to take.

We are now faced with Mr Putin’s new incursions into Ukraine and his occupation of Crimea. I suppose Moldova and Azerbaijan could be parts of a future Russian occupation. As far as Moldova is concerned, troops are already well established in Transnistria.

In all Mr Putin’s expeditions and ambitions, the West and NATO have shown great reluctance to get involved militarily. Perhaps our decision not to get involved militarily has given Mr Putin fresh encouragement. However, what we must do regarding these military incursions is react with maximum sanctions. Russia has a weak economy and the sanctions will undoubtedly bite. I realise, of course, that some member states of the alliance are unhappy about the provision of Russian gas. It is necessary that we move, as soon as possible, towards making alternative sources of gas available in those countries where it is important.

I give one small example of sanctions. A few weeks ago in the NATO Parliamentary Assembly in Riga, where I represented the United Kingdom with others in the standing committee, we agreed to throw out the Russians. We were led by an outstanding speech from Sir Menzies Campbell. A decision was taken to take away Russia’s associate status.

I come to my final point, which is the position of NATO. All our allies are protected by Article 5, which provides that an attack on one is an attack on all. There is concern about this in the Baltic states, but we must make it very clear to Mr Putin that any incursion into any NATO state would result in hard force. In the next few months, I hope that Sub-Committee C, under my noble friend Lord Tugendhat, will look into EU relations with Russia. It is one of the most important challenges that face us today.