Terminally Ill Adults (End of Life) Bill

Lord McColl of Dulwich Excerpts

Friday 13th March 2026 Lords Chamber

[Lord Harper (Con)]

My Lords, I will come on to the exposition by the noble Baroness, Lady Finlay, on this group of amendments shortly. I will also pick up on the important and perfectly fair point raised by the noble Baroness, Lady Jay of Paddington, following on from the speech of my noble friend Lord Deben, about what end of the telescope you are looking at this from. She was right to challenge those of us who are focusing on the safeguards. It is also important that a Bill passed by Parliament is workable.

However, there is a reason, if I may just gently say to the noble Baroness, why we are focused in the way we are. It was put extremely well by Johann Lamont, who Members opposite will know was the leader of the Scottish Labour Party between 2011 and 2014. This is in the context of the debate on a different but similar piece of legislation currently going through the Scottish Parliament. She said:

“In my time as MSP I came to appreciate the challenge of understanding that something can be of benefit to some but the unintended consequences for others matter just as much. We should not just ask how it might help some but ask what if it means undesirable results for others”.


In effect, that is the nub of what we are trying to do here.

The Bill’s proposals, perfectly understandably, are focused on those who wish to seek assisted suicide. Those of us focusing on the safeguards in the Bill are worried about all the people who may be adversely affected: the vulnerable, disabled people and—before we fixed the gap in the Bill, which took a very long time to do—those with anorexia. Those are the two perspectives, both of which are valid, and that is what the debates in your Lordships’ House are trying to reconcile in this legislation.

The other very important issue—I am pleased to see my noble friend Lord Markham in his place, because he rightly often references this—is public opinion. On an issue such as this, it is more important that Members of Parliament, including Members of this House, do what they think is right. This is a very important moral question. We should do what we think is right, explain why we are doing what we are doing and then allow ourselves to be judged. People will draw conclusions about your Lordships’ House based on how we conduct ourselves and how we debate this legislation.

Since the proponents of the Bill are often happy to quote polling, it is worth just putting on the record some recent polling by Whitestone Insight for Care Not Killing. Whitestone Insight is a member of the British Polling Council. The key findings are very relevant to this group of amendments. When the public were asked whether they would support a law that enabled patient choice if it risked harm to vulnerable people, 42% said they would oppose such a law, and only 35% said they would support it. More than twice as many respondents strongly prioritised safety over choice, rather than choice over safety, which is not the position of the noble and learned Lord, Lord Falconer, who frequently says to us that the important thing here is autonomy. That polling is important, because that is indeed the job this House is trying to do. It is about making sure that the legislation contains appropriate safeguards, so that it ends up being used only by those who have exercised a genuine wish to do so and not anybody else. That is incredibly important.

Having said that, I turn to the group of amendments put forward the noble Baroness, Lady Finlay of Llandaff. I listened very carefully to what she said. She set out a very good, workable proposition on how to ensure that such decisions are made by a genuine multidisciplinary panel that is clearly separate from the people providing care. She set that out in a detailed way and explained it very well. Noble Lords are free to disagree with her, but I do not think that anybody could reasonably argue that this has not been done in a careful and thoughtful way, informed by her years of clinical experience in palliative care. So, it behoves all of us, whether we agree with her or not, to give her proposal due weight. When the noble and learned Lord, Lord Falconer, responds, I hope he will take time to reflect on her proposal and, even if he does not agree with all of it, see if there are some things that are worthy of taking forward, from his own perspective, even if he cannot support all of them.

One of the important things the noble Baroness referred to—we have already discussed this and is not universally agreed with, but I strongly support it—is keeping the provision of assisted suicide separate from the provision of NHS care. That is very important for several reasons. Assisted suicide is not a healthcare treatment, so it is very important that it be kept separate from healthcare provision, partly for the reason set out very ably by my noble friend Lord Deben: if vulnerable people and other patients facing a terminal illness and needing palliative care think that, at some point, the people providing that care are going to try to end their life, encourage them to do so or put pressure on them to do so, the practical effect will be to put them off seeking palliative care at all.

My noble friend is right that many people fear, if they think there is going to be bad news, approaching doctors and healthcare professionals. Those involved in healthcare delivery know that many people seek medical treatment too late. Speaking as a man, men are particularly bad at going to see the doctor—far worse than women—leaving it until it is too late. That is something we should not be encouraging. We should be trying to make sure that people are comfortable in seeking support. It is important that, when they seek palliative care, they are clear about what they are getting and are not confused.

The points made by the noble Lord, Lord Stevens of Birmingham, are informed by his enormous experience in running the National Health Service. Clearly, in this country, there is an enormous amount of support for the principles of the NHS, whatever the level of performance is at any given time. It is also clear that the founding principles of the NHS would need to be altered to be able to deliver assisted suicide. I personally think that it would be best not to alter the founding principles of the NHS in order to do that. If you are going to do it, that should be an explicit decision of Parliament; it should not be a decision taken by Ministers.

If it is the wish, as I believe it is, of the sponsor of the Bill, the noble and learned Lord, Lord Falconer, to have this as an NHS service, it should be explicitly written into primary legislation, with the necessary consequential changes to what the NHS does. That should be a clear-eyed decision that Parliament takes, with all the consequences that flow from it—we have debated those, and I will not repeat them here—such as challenges about whether decisions will be taken because of funding and resource reasons, and about pushing people down one path rather than another. We have heard examples in previous debates where that has already happened, such as the Liverpool care pathway. For those reasons, I support the amendments set out so ably by the noble Baroness, Lady Finlay. The points put forward by the noble Lord, Lord Stevens, are also very worthy of consideration.

Finally, I return to a point I made earlier in supporting the noble Baroness, Lady Berger. I accept that the noble and learned Lord, Lord Falconer, does not agree with everything we say, but I hope he accepts that all the royal colleges he referenced, having looked at the Bill, do not take a view on the principle, but do not support the legislation in its current form. So, even if the noble and learned Lord is not minded to support these measures, I hope he will at least listen to the concerns other people have expressed and take these as practical mechanisms to try to improve both the Bill and its workability. I hope he accepts them in that spirit.

[Lord McColl of Dulwich (Con)]

Is the noble Lord aware of a rather alarming story from Holland that is relevant to the separation of the two services that he mentioned? A gentleman witnessed the euthanasia of his mother. It was done by an anaesthetist, who came in and said to the lady, “Now, I’m just going to put a needle into your vein and inject this medicine, and you’ll go off into a wonderful sleep and have no further worries”. A month later, the gentleman was involved in a road traffic accident, and he had to have an emergency operation in that very hospital. He was waiting for the anaesthetist to come in, and he was horrified, because it was the same anaesthetist that had dispatched his mother. The anaesthetist used the same words: “I’m just going to put a needle into your vein and give you an injection and you’ll go off into a deep sleep with no worries”.

[Lord Harper (Con)]

I am grateful to the noble Lord for that information, but I am conscious that, because of his intervention, I am well over time. I am going to conclude my remarks there and allow the Committee to hear from the next speaker in the debate.