Terminally Ill Adults (End of Life) Bill

Debate between Lord Rooker and Baroness Fox of Buckley

Friday 9th January 2026 Lords Chamber

[Baroness Fox of Buckley (Non-Afl)]

I have my name on a number of amendments. I did not know that those rules applied—anyway, they do not.

I have added my name to a number of amendments from the noble Lord, Lord Carter of Haslemere, in this group.

In general, I am glad to support many of the amendments on palliative care in this group. The Bill asks us to accept that assisted dying is a medical intervention, albeit an irreversible life-ending one, which is something I am not entirely happy with. It seems obvious to me that there must be guaranteed input from the best-placed medical experts in end-of-life care: that is, palliative care specialists. That is essential for the informed consent of the patient.

I imagine and hope that the noble and learned Lord, Lord Falconer, is very sensitive to the importance of palliative care. I know that he is in the much-cited Demos Commission, which I will not bother quoting again, and I am hoping that he has not changed his mind. I think the noble Lord, Lord Carter, made a very important point earlier to the sponsor of the Bill about the number of amendments, for which we have all been chastised and finger-pointed at and tut-tutted at. I kept my patience last night, although my blood pressure did go up.

None the less, I genuinely think that the number of amendments could be really slimmed down if the sponsor of the Bill were to go through, for example, all the amendments on palliative care and say to us, “I accept the principle of this and I will come back with my own amendment” or what have you. We would then not have this issue. We are not an organised political grouping; people table amendments and add their names to them in good faith, which is what I have done, and they then speak in good faith. We are not trying to repeat things for the purpose of delaying the Bill but because we think that it matters and is important. That is what we are doing here.

On this group, and the concept of 10 important themes, we need an assurance that real choices will be offered to a patient with a terminal illness and they will be given the option of a palliative care assessment and, hopefully, then, possibly palliative care. That safeguard would really reassure us, and it is a key theme, and so on. One of the reasons why I say that is, under the Bill, GPs can mention palliative care to a patient. I am a great fan of GPs; they are fantastic generalists who do a good job. But very often they do not have all the expertise of a palliative care specialist in knowing how precisely medical intervention can improve a patient’s condition, or indeed change their will to live.

It is important for the Committee to note that research has shown that those who wish to hasten their own death often change their mind when they receive more information. Palliative care can mean that people who want to die then want to live, and that is important if we are going to talk about choice. It is possible that you might want to die, that you are determined you want to die in assisted death terms, having had your terminal diagnosis. But why is it that you want to die? That is the motivation behind the discussion in this group.

One of the things that happens is that many people are frightened and fearful, and one of the things they are fearful of is pain and terrible symptoms, which by the way are often graphically described by supporters of the Bill, and I think that they can scare people. It is the idea that your pain and symptoms cannot be controlled. When I talk to supporters of the Bill—some of my friends, colleagues and members of the public—they are completely compassionate in talking about how the Bill will help people who are suffering intolerably and in excruciating pain. None of us wishes that on anyone—or, indeed, on ourselves. It is a frightening prospect.

That is actually often a fear and a dread that the right kind of care can mean will not be realised. Patients are understandably frightened of being in that kind of pain, so they need to know that. Toby Porter, the CEO of Hospice UK, summed up the way I feel about this. He said:

“An outcome in which someone chose an assisted death because of a real or imagined fear that they could not get pain relief or other symptom alleviation, or because their family would not get support through their illness, would clearly be a moral and practical disgrace to any country”.


That is absolutely right.

We all know family and friends and so on who have died and who have had terminal illnesses. People will say that morphine is simply not enough to control the pain. That is the kind of thing that I would say, because I know nothing about medicine. So, it is a great relief to discover that palliative medicine resident doctors say that morphine is the tip of the iceberg for pain management. There are countless other options available, but to know this requires training and experience, which I have not got. When you are having a chat in the pub with mates—or indeed, when I was in hospital pumping in the morphine—it is good to know that somebody, somewhere, has got the experience. That is the palliative care specialist and every terminally ill patient should at least be offered the option to go to see one. This is a modest but meaningful addition to the Bill and I hope that the noble and learned Lord, in the spirit of listening, accommodating and compromise that we heard about last night, will make changes to the Bill accordingly.

There is also a question for the Government and the Minister here. The noble Baroness, Lady Smith of Newnham, explained this very well. In relation to the point made by the noble Lord, Lord Stevens, yesterday, it was a shocking revelation that the Minister responsible for palliative care said that the Government would not publish their modern framework until after the Bill had passed through Parliament. The noble Lord, Lord Stevens—

[Lord Rooker (Lab)]

With respect, he did not say that. The noble Lord, Lord Stevens, said it would not be done “in effect”, the implication being—I do not disagree with what the noble Baroness is saying—that the Government have given a date which is beyond when this is expected to be law. The Minister did not say, “We’re waiting until after the Bill”. The crucial words of the noble Lord, Lord Stevens, were “in effect”. He was very careful in what he said.

[Baroness Fox of Buckley (Non-Afl)]

I had thought I was implying that. I was not trying to imply some conspiratorial holding back; it is just that the noble Lord, Lord Stevens, said this was

“a dangerous reversal of the timetable we require”.—[Official Report, 8/1/26; col. 1416.]

That is the point I was really getting to. That is shocking: not because anyone is malignly behaving in this way but because the Government therefore need to commit to bringing forward that report, so it is available before we reach Report. I urge the Minister to reassure us that that is the case.

I will finish off by saying that the noble Baroness, Lady Brown of Silvertown, explained excellently that, for all of the importance of palliative care, hospices and so on, not everyone has equal access to them, which is well documented. I want to see that framework, because this is one of the chilling aspects of the Bill. For those of us who campaign to raise money for hospices, and who are desperately keen that palliative care is well resourced, to hear, as we heard earlier today, from the noble Lord, Lord Carlile, who stated baldly and perfectly reasonably that whichever choice we had in the previous group would cost a lot of money, makes me think, “Oh, spend the money somewhere else”.