Lord Harper
Main Page: Lord Harper (Conservative - Life peer)
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.
Lord Deben (Con)
I wonder whether my noble friend could think a little bit about the money involved in this. I am sorry—it sounds a bit odd, but I do feel very strongly that we ought to talk about how much all this is going to cost and where that money is coming from. In the very unsatisfactory answers from the Minister, who gave the opinions earlier on in previous arrangements, I asked directly whether she would assure the House that this money was additional money, rather than money that would otherwise come from the National Health Service. I wonder whether my noble friend would think to himself about the extra cost that this would mean. Where would it come from, and why are we not spending it on a lively attitude, which is to help people when they are ill with better palliative care, instead of going in for this death concept?
Lord Harper (Con)
I am grateful for my noble friend’s comments, and he is right: we had an extensive exchange on this subject on a previous Friday, and I am sure the Minister will correct me if my interpretation of what one of her ministerial colleagues said was incorrect, but it was very clear when I asked whether the Government were going to fund anything in the Bill. The Minister confirmed that, if Parliament were to choose to pass the Bill, the Government would indeed fund it and make sure it could be delivered. But when I asked the Minister whether that funding would be extra funding from the Treasury or would be taken from other parts of the public services—I think this was in the context of the extensive debate we had on the proposals on the court system by the noble Lord, Lord Carlile—it was made very clear that that assurance was not given. I am afraid that the only conclusion I could come to, which was not challenged by the Minister—if she thinks I have got it wrong, she is welcome to intervene—was that the money would come from other parts of the public services.
I have to say for myself that, if this assisted dying navigator proposal were to be funded by taking money away from NHS services to pay for it, I think people would find that quite extraordinary. I personally would find it indefensible that we were, again, taking money away from services to help people live to pay for a service to help them die. That would show a very odd sense of priorities. When the Minister responds, because she is the only one who can answer this question, not the sponsor of the Bill, because he is not, as far as I am aware, responsible for His Majesty’s Treasury, I hope she can tell us—
Lord Markham (Con)
My Lords, I think I heard my noble friend say that NHS resources should be used just to help people live. Of course, we would all agree that is a very important thing, but surely palliative care is all about helping people to die comfortably, which I think we all believe in as well. Given that, maybe my noble friend would agree that helping people to die comfortably, such as through palliative care, is a very good way to spend NHS resources as well.
Lord Harper (Con)
I agree that palliative care is a very good way to spend NHS resources, to help people live the rest of their lives in as comfortable a way as possible; it is not about accelerating their demise. That is a fundamentally different thing. In the exchange towards the end of our debate last week between my noble friend Lord Markham and my noble friend Lady Finlay about what palliative care is and is not, we had that, and I think it came out very clearly.
I do not wish to overstep the time available to me. The purpose of the amendments is to challenge some of the premises of the proposal set out by the noble Lord, Lord Birt. I hope I have set out some of the concerns that we have, and I hope that the House will support the amendments I have supported on the Order Paper.
Baroness Coffey (Con)
My Lords, I shall speak to Amendments 287A, 287B and 771ZB. I call the noble Lord, Lord Birt, my noble friend. We went to the same school, although admittedly not at the same time. I am conscious that he has come at this with an approach of a lot of research, as he set out. The noble Lord knows that I disagree with him, but I understand why he is trying to speed up. However, I wonder whether he has taken account of evidence presented already. The noble Baroness, Lady Fox of Buckley, talked about the CEO of Mind, but also Marie Curie spoke about this and indeed the Royal College of Psychiatrists.
I am particularly thinking of the speeding up and that moment of reflection, which is really important. I think the noble Lord is already suggesting in his Amendment 771 that patients should be aware of their right to withdraw from the assistance process at any stage. There is quite a lot in here that sets out a framework that could be done through the NHS. I completely agree with what the noble Lords, Lord Stevens of Birmingham and Lord Mawson, have said: it worries me that, if this ends up in the NHS, it will accelerate in becoming a routine end of life. In my meetings with the Royal College of GPs, it has been clear that it does not want this to be part of the NHS and it would absolutely resist it being part of the NHS contract.
Lord Harper (Con)
On that point, and the point raised earlier about a conflict of interest, one of the problems if this is in the NHS is the money. The cost of the drugs to end someone’s life, according to the impact assessment, is £14.78, but the saving you would make from four months of healthcare not used would be £13,075, and anyone with any experience of NHS budgets knows that that contrast would inevitably drive people to being pointed towards assisted suicide.
Lord Empey (UUP)
I have to say that that was not my intention—the noble and learned Lord knows that perfectly well. I raised the point merely to indicate the length of time that this is taking and that a lot of the proposals and amendments on the Marshalled List could be addressed if we had amendments put forward by the noble and learned Lord, which he indicated in an email last week would be forthcoming. They are not here.
Lord Harper (Con)
I think that the reason why the noble Lord, Lord Birt, has put down these amendments is that it is not clear, from what the Government have said or what the Bill says, where this service is supposed to be—I see that the noble Lord, Lord Birt, is nodding at that. If the sponsor of the Bill had set out in the Bill more detail about how it would work and where it would sit, if there had been a proper process, many of the amendments from people with concerns would need to have been tabled and we would be moving faster. It is because of that gap and that failure, which is the sponsor’s responsibility, that this is taking a long time. It is necessary scrutiny to get the Bill right. That is what the public would expect of us.
Lord Deben (Con)
My Lords, I think that we can clear quite a number of these things away by taking one central issue. The big problem about being in government is that it is not a single issue that faces you; it is a whole range of issues, and you have to get a balance between them. When we talk about cost, it is perfectly possible to say that there is a majority of people who want this thing, and there is a majority of people who want that thing. The Minister and the Government have to decide how to share out the money that is available between those things. That is crucial to any decision made by this House. My concern is that we are not facing up to that. This is a single issue being presented to the House as if it can make decisions about single issues, irrespective of the effect of the decision on all the rest of the single issues that people also have strong views about.
If you asked the public whether they wanted more money for palliative care, they would almost universally say yes. If you asked the public whether they wanted a National Health Service where they could get an appointment with their GP within a week, they would say yes. If you asked the public whether they wanted a National Health Service where there was someone who could help them through complicated arrangements, they would say yes. The problem for this House is that we have to decide, first of all, what burden these proposals place on the National Health Service, the judicial service and the Government as a whole.
Lord Kamall (Con)
Sorry, I will try to hasten it, actually, in many ways. Maybe we should slow down.
I start by thanking the noble Lord, Lord Birt, for the amendments in the group and the whole idea of establishing the assisted dying help service. As the noble Lord said, it is based on well-established experience. It seeks to address a number of important questions that the current draft of the Bill does not address. How will important services, such as care for the families of those who are seeking assistance under the Bill, be provided? Who will publish the appropriate information about the provisions of the Bill in the public domain? How will those seeking assistance be supported throughout the process? These are thoughtful amendments, but a number of noble Lords have quite rightly raised concerns about the potential downside to speed and efficiency in this case.
The amendments in the name of my noble friend Lord Mackinlay seek to ensure that when a personal navigator is allocated to the person seeking assistance—that sounds like a good suggestion—there must not be a presumption that, when they appoint that navigator, the person will necessarily continue with the process to its end. That gives the person who seeks it the option of changing their mind.
A number of the issues that we have discussed today have been discussed throughout the passage of the Bill. I have a number of questions; they are more for the Minister than the Bill’s sponsor, but I think that many noble Lords have questions for the Minister.
On the specific matter of the assisted dying help service, as well as the duty to publish information on the Act’s provisions, what consideration have the Government given to the interaction between the legitimate dissemination of information about assistance with ending one’s life and the encouragement of suicide, as prohibited by law under the Suicide Act 1961? I know that this issue came up very early on but, in this specific context, it is worth repeating.
A number of noble Lords have rightly asked about the workability of the help service, including what the cost of managing the service and the other running costs might be. Do Ministers feel that resourcing the service adequately might undermine the effective delivery of other parts of government? As a number of noble Lords have said, the Government have not really answered those questions about the available resources and where the money will come from. Once again, I am taken back to Second Reading, when the noble Lords, Lord Stevens and Lord Hunt of Kings Heath—the latter being a former Health Minister—both said, “We know how the system works. This money will come from somewhere, and it will be at the expense of palliative care”. We are assured by those who support the Bill that that will not be the case; indeed, Ministers have themselves said that sufficient money will be made available. However, a couple of weeks ago, I asked almost the same question as my noble friend Lord Deben asked—albeit in a less eloquent way—of the Minister from the Ministry of Justice, and, last week, of the Minister from the Department of Health. To be fair to the Government, I received an answer from the Minister; if noble Lords allow me, I will touch on a few extracts from that letter and paraphrase where possible. The Minister’s letter to me said
“you sought confirmation that the Government is confident that palliative care will be sufficiently funded, so that those who may seek assisted dying services are offered a real, as opposed to theoretical, choice on palliative care to support them making a more informed decision”.
So far, so good. As my noble friend Lord Gove said, the letter talks about support for the hospice sector, including £100 million for adults and £80 million for children—I almost sound like a Minister responding here, I know, but we have to be fair when we challenge the Government on this. The Minister also mentioned the all-age palliative care and end-of-life care modern service framework for England to improve the services. The noble Baroness, Lady Berger, said that it would be published in spring 2026, but the letter says that it will be published in autumn 2026—I think the Minister answered that; let us be fair: that is better than the answers that many Ministers from all parties have given over the years, where they often say “at pace” or—what is the other phrase?—“in due course”, but at least this gives us a real timeframe. The Minister also talked about the framework being aligned with the ambitions of the 10-year plan.
Lord Harper (Con)
On that point, I also got a copy of that letter. It is worth saying that, in the 10-year plan, there is no ambition for high-quality, universal palliative care. It is not there. So, if the plan the Government are going to publish in the autumn is aligned with it, I think we can see that they do not plan on making universal, high-quality palliative care available in the next 10 years. That is a real problem for decisions taken under this Bill.
Lord Kamall (Con)
I thank my noble friend for that intervention. Before commenting on the content of the Bill, I was seeking, just to be fair to the Government, to lay out what they have told me.
Baroness Blake of Leeds (Lab)
My Lords, I was just about to go on to the whole issue of funding, which many noble Lords have raised throughout this morning’s debate. The Government’s position is absolutely clear on this. Should Parliament pass the Bill, the Government would work to undertake development of the delivery model. Until the parliamentary process is complete, we are making no assumptions as to what the delivery model for an assisted dying service would be or what the role of specific departments in delivering the service would be.
Lord Harper (Con)
My Lords, may I ask the Minister something that I do not think is an operational decision but a decision in principle, as mentioned by the noble Lord, Lord Stevens, and does not require the Government to take a view on whether they support assisted suicide or not? Is it the Government’s view—do they agree with the noble Lord, Lord Stevens—that we would have to change the founding principle underpinning the National Health Service to put this service in the NHS? If they agree with him, is that something the Government support? The Government can remain neutral on the principle of assisted suicide, but I want to know whether they think it should be inside the NHS or not.
Baroness Blake of Leeds (Lab)
My Lords, I am very aware of the repeated requests and comments. I come back again to the point that we have been making throughout the debates on these amendments, and throughout the process: until the parliamentary process is complete, we are making no assumptions as to what the delivery model will be. That is absolutely clear and straightforward, and has been emphasised by other Ministers before me.
Lord Harper (Con)
My Lords, I do not want to unfairly ascribe views to the Minister on behalf of the Government, but, just so I understand this, is she saying that the Labour Government do not have a view at all on whether we should change the founding principles of the National Health Service away from it being one that delivers medical treatment to save lives to one that also helps people to die? Is she really saying that they do not have a view?
Baroness Blake of Leeds (Lab)
I am saying that, at this point, the Government are neutral on the whole area.
Baroness Blake of Leeds (Lab)
I do not think it is extraordinary, but I am sure the noble Lord will keep expressing his point of view.
Lord Birt (CB)
I am sorry; perhaps the noble Baroness can talk to me later, as I could not take in what she said.
I am, frankly, open-minded about the NHS question and accept the strength of what the noble Lord, Lord Stevens, says. It may well be that this is an organisation that should be apart from the NHS but uses some of its services. However, I am happy to talk to others about how best to do that.
I reassure the noble Lord, Lord Harper, that the process can, and should, be designed not only to support assisted dying but to painstakingly explore the alternatives to assisted dying, and I did say this. We suggest that palliative care should be one of those services and, whatever the reasons that people have for assisted dying—there may be others beside their chronic near-death state of mind—we also propose that the organisational body should be able to help the person in other sorts of ways. We want it to be a balanced process.
Lord Harper (Con)
I am grateful to the noble Lord for taking my question at this stage of the debate. I listened very carefully to him when he was setting out his proposals and I welcome the fact that he said that the navigator can discuss palliative care and such issues with the person concerned. Unless I misunderstand his amendments, they do not propose to help secure those services for the person. They might set out what they are, but they do not get them, so there is an imbalance there. They will help them get the assisted suicide but not proper palliative care.
Lord Birt (CB)
I do not think it for us, in framing in principle amendments, to deal with that level of issue, but the noble Lord is right—that is exactly what the body should do. We are talking about highly distressed people, and it should facilitate different kinds of response and reaction to their difficulty.
Baroness Finlay of Llandaff (CB)
That is a very helpful intervention because the evidence from the places that have gone down this road and changed their legislation is that the unassisted suicide rate does not fall. This does not seem to prevent suicides from happening and these amendments are about people having information. With these amendments, we are not debating whether the Bill passes; we are debating the contents of the Bill and whether it is safe for patients.
Given the problems, I ask the noble and learned Lord, Lord Falconer: is there a plan to relicense drugs that in this country are available only for veterinary use, for the purpose of ending the life of patients here?
Lord Harper (Con)
My Lords, I will make two brief points. First, I support the important point made by my noble friend Lady Berridge about how we deal with misinformation. In an enlightening exchange I had with Health Ministers on the subject of flu vaccination, I discovered that a significant number of people working in the health service are vaccine hesitant and at least some of them are because of the scare stories that we read about vaccination. I suspect that those people will be more informed than the general public, because they work in the health service, so how we deal with misinformation is very important.
My main question, for which I am pleased to be in this House surrounded by expert lawyers, is a legal question on Amendment 188A, tabled by my noble friend Lady Coffey, about putting current case law in statute. My question is aimed at the Minister, I suspect, but if he is not able to answer it today, I would be grateful if he could write to us. Would it be helpful to put the current case law position in statute? Would that be helpful in the sense of giving Parliament’s imprimatur, saying that we are comfortable and that we think the current position is helpful? Would it in any way inhibit or prevent the development of further case law?
Again, because of what my noble friend Lady Berridge said, I am conscious that a lot of the information that people get is from online sources. Because of the fast-changing nature of the world, artificial intelligence and so forth, I would want to make sure that, in this area, evolving ways of people getting accurate information that they can rely on were able to be taken into account by case law; equally, I would want to ensure that case law could take into account information sources that are not reliable and reputable and give guidance to clinicians about how they deal with informed consent. The danger of putting some of that detail into statute is that it does take some time to update. I am looking for factual guidance about whether that is helpful for us to put into statute or whether it is better to leave it for evolving case law. It is a factual question, and I hope that the Minister can either deal with it today or write to us.
Baroness O'Loan (CB)
My Lords, very briefly, I support these amendments. The process is designed only to kill but, inevitably, as noble Lords have explained, there will be complications. People react differently to different drugs. Only with full information will the patient be able to consent. Without it, that consent cannot exist.
I have questions for the noble and learned Lord, Lord Falconer. Why is the doctor required to discuss the nature of the substance—how it will bring about death, how it will be administered—but not to tell the patient that it may not be successful? Why must the doctor discuss with the person their wishes in the event of complications? Why is there no requirement to explain and discuss the risks of complication? How can a patient give informed consent? If the noble and learned Lord does not intend to accept these amendments, can he tell the House what his intentions are?
Lord Falconer of Thoroton (Lab)
I think that this is absolutely clear in the Bill. Self-administration is what is required. We are discussing how to deal with complications, including whether or not the patient wants some sort of non-intervention, which is perfectly possible. If it is not specifically agreed, and the patient is suffering in some way, the role of the doctor is to save their life, because the doctor cannot kill. I do not think that there is any doubt about that position in the Bill. I do not think that this is properly covered by the terms of this amendment—I will look at it again—and so I do not think that any further change is required.
Lord Harper (Con)
I again apologise for not being a lawyer. I listened to this very carefully. I think there is a big gap here. The noble and learned Lord talked about the doctor, in effect, giving treatment to save the patient’s life. If the patient has expressed a clear and informed wish to die—I think this is the question that the noble Lord, Lord Stevens, asked—does the doctor owe a duty of care then to save the patient’s life? I do not think that that is clear at all. Doctors, I think, are asking what it is they are supposed to do. If they do not do anything and the patient dies and then it is found that they should have done something, that is incredibly serious. Doctors are asking for it to be put beyond doubt what they should do in those circumstances.
Lord Falconer of Thoroton (Lab)
First of all, there is absolutely no need to apologise for not being a lawyer; some of my best friends are non-lawyers. Secondly, this very thing was very closely considered, hence the provision in the Bill to say that, if there are complications, let us try to agree in advance what we should do. We will not, I am sure, be able to cover every complication, hence the questions from the noble Baroness, Lady Finlay, and the noble Lord, Lord Stevens. The answer is clear and beyond doubt—hence the reference to the need to address the question of complications—that the doctor should do what the doctor is always obliged to do, which is to save life.
Lord Harper (Con)
Just for the avoidance of doubt for anyone watching these proceedings, the noble Lord, Lord Polak, is no longer present in the Chamber, but he is very much still with us.
Lord Hamilton of Epsom (Con)
My noble friend Lord Harper is absolutely right: he is still with us, but he is absent for the moment. It might have been that, when he was given his diagnosis that he had six months to live, he was told that his final months would be very grim indeed and he would suffer terribly. He might, if this Bill had been in place, have made the decision to end his life. That was 32 years ago and my noble friend Lord Polak is actually pretty fit and doing a good job in your Lordships’ House. So we have to question medical diagnosis in this case.
I am very concerned and would like to hear from the noble and learned Lord, Lord Falconer, what he thinks about the problems of wrong diagnosis. I am old enough to remember that there was a time when we had capital punishment in this country. One of the reasons why it was abolished was because of the miscarriages of justice and the number of people who were hanged when they were innocent. That was a very serious lever used to get rid of capital punishment. What percentage of misdiagnosis of terminal illness would the noble and learned Lord, Lord Falconer, think would be right before he thought about whether the whole basis of this Bill was to be questioned? I do not think we have any statistics on misdiagnosis—maybe he has some—but it really undermines the whole basis of this Bill if we have doctors who quite innocently say that they think a person has only six months to live but then find that they have not and they live on much longer. This is a matter of tremendous concern to people in this country.
Lord Moore of Etchingham (Non-Afl)
My Lords, I 100% support the motive behind the amendment from the noble Baroness, Lady Berger, and what the noble Baroness, Lady Cass, and others have just said, but my question is this: will it make any difference? If you want an assisted death, would you not be able to get it simply by saying that it is related to your terminal illness? You have your terminal illness and you have the prognosis, and you will therefore be advised by anybody who wants to assist you in your death that that is what you must say. How is this therefore a protection for the problem that we are discussing?
Lord Harper (Con)
My Lords, in this group of amendments—the two parts of it, if you like—I support the amendment that the noble Baroness, Lady Berger, has brought forward, which sets out that the primary motivation for seeking assisted death is terminal illness. That is important because, otherwise, the terminal illness is simply a trigger.
One reason why I think this is important is something that I am very nervous about. I am not saying, by the way, that this is the motivation of the sponsor of the Bill, but he will be aware that many people think that this Bill is just a first step—there are campaigners outside this House who absolutely think that. One problem with the way that it is drafted at the moment is that, because the terminal illness is simply a trigger, it would be very simple, if this Bill were on the statute book, to simply remove that qualification, so that the rest of the structure and processes in the Bill would then allow anybody for any reason, without having a terminal illness, to seek an assisted suicide. With the amendment that the noble Baroness, Lady Berger, suggests—that the reason why you are seeking an assisted suicide is your terminal illness—then you could not do that. If you were to remove the terminal illness piece, there would be no motivation, so you would have to do a lot more work. Those of us who are nervous about this Bill as a Trojan horse would be more reassured if that motivation were in place.
The second part to this goes to what my noble friend Lord Deben said about what the public think that this is about. If we look at the opinion polling on what the public think should be reasons why someone should be able to seek assisted suicide, the powerful reasons that many members of the public—not all, but significant numbers—support is to relieve suffering and pain. People are broadly compassionate and think that that is a good idea. What they do not support is people being able to seek assistance to kill themselves because they are poor or for other reasons. They think that that is a terrible reason. The amendment from the noble Baroness, Lady Berger, and other amendments in this group would more closely align the way the Bill is structured and what it would do with what many members of the public think that it should do.
I also support Amendment 320ZA from my noble friend Lord Blencathra, which explicitly says that the purpose of seeking assisted suicide cannot be various societal factors, such as housing or financial circumstances. That is important. The noble and learned Lord, Lord Falconer, and I had an exchange last week where he made it very clear that he thinks that, if those things are the drivers for you wanting to end your life, he is okay with that. I am not, and the polling evidence is that the public are not okay with that either.
Choices should be proper choices. My noble friend Lord Deben set out very well the sort of society that I think people want to see. If people want to end their life because of something not to do with their terminal illness or their pain or their suffering—because they do not have enough money or they have poor housing, or they have other things that they are not happy about—then those things are remediable. They may be expensive, but they are fixable and we can do something about them. I want to live in a society where we do something about them and we make people’s lives better—even if it is only for the last few months of their life, that is still worth doing.
My noble friend Lord Deben is right. He is not saying that the sponsor or those who support this Bill are thinking like this, but he is absolutely right that people make decisions all the time based on weighing up financial consequences. Noble Lords have talked about NICE today. When it assesses approving drugs, NICE looks at quality adjusted life years against the price of the drugs to the health service. It literally weighs up how much valuable quality life you are buying versus how much money we are spending. My worry is that, if you do not exclude people wishing to end their lives for these other reasons, we will get ourselves in a terrible place where we are not prepared to spend the money on improving people’s lives but rushing them towards ending their life in a way that is not necessary.
That is a big choice for Parliament to make and there are different views. The noble and learned Lord, Lord Falconer, set out his view last week. I have set out mine and my noble friend Lord Deben has set out his—we are in agreement. That is a decision for the House. I hope that noble Lords will support the amendment tabled by my noble friend Lord Blencathra and make the decision that you can only seek assisted suicide if it is because of your terminal illness, not because of your other circumstances. I think that that is the right sort of society we would be creating. The package of amendments in this group would improve the Bill. They would also reassure many people who are concerned about the Bill to not be concerned about it, which would be helpful for everybody. I commend them to noble Lords.
Baroness Royall of Blaisdon (Lab)
My Lords, I completely agree with the noble Lord, Lord Deben, on the society that we are seeking to have. We agree on so many things. We are on different Benches, but we agree on many things. However, the pre-eminent reason for this Bill is a terminal illness for six months. I understand what the noble Lord opposite is saying—that one cannot be sure—but we are talking about six months. As other noble Lords have said, one might aspire to have access to the drugs so that one could take one’s life if one had a terminal illness and it was thought that it was going to last for six months, but it does not mean to say that people are going to use them. It is important to remember that all the time. Six months and a terminal illness is the important thing to keep in the forefront of our minds at all times.
Lord Falconer of Thoroton (Lab)
That was not really an intervention; it was just a statement. I should have said to the noble Baroness, Lady Fox, that, as I said last week, I will make an amendment so that the question of why will be asked, but I do not depart from the proposition that autonomy should be the leading reason for it. We disagree about that, and the House can reject that view on Report, but I am explaining what my position is.
Lord Harper (Con)
I want to pick the noble and learned Lord up on the progress that I thought we had made last week, which he has just confirmed a bit, when he accepted that asking the question was valid. The problem is, if the result of asking that question is that nothing changes, it is just cosmetic window dressing. He may not have intended to, but he illustrated beautifully the point of asking the question. If we talk to somebody and it is clear that the reason they do not wish to go on is that they are lonely and they have no one there, we can do something about that. There are organisations and people who would provide that companionship. I see the noble Baroness, Lady Hayter, shaking her head. There are organisations and people who would do something about that.
It comes down to the point I made last week. We are saying that, if your life is terrible and you get a terminal illness diagnosis, under the Bill, you are more likely to want to end your life with assistance than someone whose life is great. That is a terrible thing for us to do. The noble and learned Lord does not agree with me; that is fine. The House will have to make a decision, and I think that the position that we have set out with these amendments would lead to a better Bill and a better society than the one he is setting out. We will keep making that point and attempting to move him to that position.
Captain of the Honourable Corps of Gentlemen-at-Arms and Chief Whip (Lord Kennedy of Southwark) (Lab Co-op)
My Lords, we are meant to be having brief questions here; these are not brief questions.