Terminally Ill Adults (End of Life) Bill

Debate between Baroness Berger and Lord Harper

Committee stage
Friday 23rd January 2026 Lords Chamber

[Lord Harper (Con)]

My Lords, I thought we were taking the remote contributors first. If we are not, since there are amendments from my noble friend Lord Mackinlay of Richborough to which I have attached my name—he is unable to be here today; he sends his apologies and has asked me to speak to his amendments—I will speak to Amendments 223A, 223B, 223C, 495A, 771ZZA and 771ZA. For the avoidance of doubt, I am perfectly happy to take any interventions, if anybody wants to ask me any questions, if anything I am saying is not clear or if anyone wants to challenge my arguments.

The primary reason for these amendments, as was ably explained by the noble Lord, Lord Birt, is that the Bill does not really give the patient choice. It is designed to preference one option—that of seeking assisted suicide—rather than to help the patient navigate all the options that may be available to them.

There were limits on the way my noble friend could table his amendments. The advice that we received was that any amendments requiring a personal navigator to help secure or facilitate access to palliative, hospice or other end-of-life care, as an end in itself, were out of scope because the Bill’s collective purpose is provision for assisted suicide, not the wider delivery or co-ordination of end-of-life care. So amendments were admissible only where consideration of alternatives were explicitly tied to eligibility for or progression within the assisted suicide process. If anyone has any criticisms at this stage of the way that my noble friend’s amendments are drafted, I say that they are drafted in such a way as to fit with the advice that we received, so I will be perfectly happy to take criticisms of the drafting on the chin.

I start with a point that the noble Lord, Lord Birt, acknowledged in his opening remarks. He said that it was of great importance that there is universally available palliative care. He went on to say that, in his experience of talking to people, even where that palliative care was available, it did not always do the job that the person required it to. However, he skated over the fact that high-quality palliative care is not universally available. In the debates that we have had so far, to which the noble Lord, Lord Birt, referred, many of us have thought that, if high-quality palliative care is not available as part of the choice that you face, seeking assisted suicide is not the result of a proper, freely reached choice, because you do not have all the range of things in front of you. I think I am right in saying that, when the noble and learned Lord, Lord Falconer, was tested on that, he accepted that you have to make your decision based on the choices that are actually available to you. Many of us think we should actually be trying to make sure that everyone has access to that high-quality palliative care and understanding that should be part of this process.

The point of the amendments that we have tabled is to try to ensure that this navigator does not just have a conversation at the beginning; if you seek palliative care and it is not available to you in the normal course of events, this person could help you seek that, rather than being able only to help you seek assisted suicide. They can help you get the full range of choices that you might wish were available to you because, if they were, you might make a different choice. So that is the purpose of the amendments.

[Baroness Berger (Lab)]

This is a point of clarification about access to high-quality palliative care. It should also be about timely access, because we know that, even in the parts of the country where high-quality palliative care exists, around 100,000 people do not get it at a time that would amplify it and ensure that they get the maximum benefits.

[Lord Harper (Con)]

I am grateful for that intervention; it is a very good point. The importance of it is emphasised by one of the points that the noble Lord, Lord Birt, made in his opening remarks: that many people do not seek to make decisions on these matters until quite late in the process. If you were facing considerable pain as a result of your medical situation, not only might you not think about assisted suicide early on but, if it not available in your area, you may not have sought high-quality palliative care early enough. Again, that needs to be available at pace, as well as the choice of assisted suicide.

The second reason why I think these amendments are important is this. I do not know whether I am the only noble Lord to have thought this, but it does seem odd that what we are, or the noble Lord is, proposing here is a personalised service, I presume funded by the taxpayer—the noble Lord nods his assent—which would support somebody in a very personal, individual way to seek one particular outcome. But as far as I am aware, unless something happens in the National Health Service that I am not aware of, we do not offer a personal navigator to help somebody with their journey through seeking medical treatment that will actually help them live and live well, and it just seems to me a slightly odd sense of priorities that we are proposing to put in place a service that is only available to help somebody die.

Parliamentary Voting System and Constituencies Bill

Debate between Baroness Berger and Lord Harper

Monday 18th October 2010 Commons Chamber

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

I should like to speak to amendments 333 to 340, which aim to correct a serious deficit in our democracy. People will have seen in the media some of the scenes from the recent general election, in which voters queued for hours to vote. That happened in my constituency, where there was a paucity of ballot papers, and some electors are known to have been denied access to their polling station. What is less well known, however, is that a staggering 67% of disabled people surveyed by the Polls Apart campaign reported experiencing barriers to their participation in the ballot. Sadly, this is an acute reflection of the voting experience of thousands of disabled voters at every election for every tier of government since emancipation. It also highlights a worrying lack of accountability, as there is at present no way for people to appeal when they are wrongly denied their vote, other than by mounting an expensive, onerous and bureaucratic legal challenge.

Many disabled people find it difficult physically to access a polling station, and that can be for a variety of reasons, including steps leading to the entrance, narrow doorways and corridors or a lack of a low-level polling booth. As my right hon. Friend the Member for Cardiff South and Penarth (Alun Michael) said, nearly half of all polling stations failed to display a large-print ballot paper, making it virtually impossible for visually impaired people to mark their papers independently and with privacy. Election officials regularly offer postal voting as a panacea for disabled people to participate in the ballot, but disabled people often want to vote in person, like everybody else, or at least to have the choice. The fact that people are disabled is no reason to deny them that opportunity.

It is also important to remember that for a significant minority, postal voting is completely inaccessible. Voters with visual and co-ordination impairments, people with learning difficulties and those with low literacy or English as a second language all find it difficult or impossible to vote independently and in secret using a postal vote. In May, 47% of disabled people surveyed reported difficulty in completing their postal vote. For voters with co-ordination impairments such as cerebral palsy and arthritis, voting by post can present significant barriers. Even if someone can mark their ballot paper without assistance, the need to tear down perforated lines, fold the ballot papers and put them into a series of envelopes can make voting by post difficult and frustrating. I wonder whether any hon. Members here today could imagine going through the postal ballot process if they were blind.

The Electoral Commission said in its briefing for this Committee stage that it intends to work its hardest to ensure that the AV referendum is as accessible as possible. Although I welcome that news, I and organisations such as Scope, the RNIB and Mencap will quite rightly point to the evidence that I just presented to the Committee and say that more must be done. The Representation of the People Act 2000 and the Electoral Administration Act 2006 make some provision to improve accessibility in general, local and European elections. The Electoral Commission has also produced some good guidance, yet the evidence presented by the Polls Apart campaign shows that this last general election excluded thousands of disabled voters. What right have we to exclude them from this referendum or from any ballot box now or in the future?

There are some simple steps that need to be taken. Existing statutory obligations and guidance must be met and an accountability mechanism for returning officers must be introduced if they fail to meet them. Returning officers need to work with disabled people and their organisations when designating and setting up polling stations. Local authorities should annually review the accessibility of polling stations and publish that information for the electorate to comment on. Following the example of the Northern Ireland review, returning officers should write to voters informing them of the inaccessibility of their polling station and give disabled people the right to choose which polling station to attend based on their access needs.

It is essential that this Bill makes provision to minimise the risk that changes to our voting system will impact negatively on disabled people’s right to participate in the electoral process. Without proper scrutiny to ensure that there are no barriers to participation, the proposed changes could make it more difficult for disabled people to exercise their fundamental right to vote.

I want this referendum to be the most inclusive ballot we have ever held in the UK. It should be the ballot that sets the benchmark and this referendum should ensure that every person who wants to is able to exercise their right to vote.

[Mr Harper]

I welcome the principles behind the amendments tabled by the right hon. Member for Cardiff South and Penarth (Alun Michael) and the hon. Member for Liverpool, Wavertree (Luciana Berger). It is very important that everyone has an equal opportunity to cast their vote in the referendum, and I am glad that the amendments raise that important issue.

I want to reassure the Committee that there are significant provisions made throughout the Bill—indeed, later this afternoon we will consider some Government amendments that will give the Electoral Commission further powers to ensure that the forms used are accessible—to ensure that voting is fair for all, including disabled people. Ensuring that ballot papers and polling stations are accessible to all is already a duty that counting officers and returning officers have. For the purposes of the referendum the chief counting officer will also be able to give directions to counting officers on how they discharge those functions.