Terminally Ill Adults (End of Life) Bill

Lord Harper Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Baroness Hayter of Kentish Town (Lab)]

I just remind the noble Lord, Lord Empey, that of course I did vote for the Brexit legislation and in fact led the Labour Party into the Lobby to support the final agreement on Brexit.

[Lord Harper (Con)]

My Lords, I support the thrust of the amendments in this group, but first, I want to say a word or two on one of the issues that has come up in this morning’s debate. I hope the Committee will indulge me if I just quote a few lines from yesterday’s maiden speech by the right reverend Prelate the Bishop of Chester. The House was a little less well-attended for the debate on the Sustainable Aviation Fuel Bill in which he spoke, but I thought his words yesterday, the ones I am going to read, are very relevant to the debate and the tone of it, so I hope the Committee will forgive me. He said that

“communication is a vital gift for those of us who nurture and curate community. In communication, we need to learn to speak and to listen. This is almost always done in person and directly. Indeed, I argue that one of our primary vocations in this noble House is to be with and to listen, for few disciplines are more vital in the search for wisdom—the search I so often witness in your Lordships’ House. The question for me is not so much how we can be great again, but how we can be kindly present. Greatness is great, but grace is greater”.—[Official Report, 20/11/25; col. 965.]

I think those were wise words. They moved me and I think they are relevant to how we conduct ourselves in this debate on these vital issues.

The noble Lord, Lord Carlile, referred to how useful this debate was, and I believe that it is vital. That is why I quoted those words from the right reverend Prelate. We have raised a range of issues, all connected to people’s capacity to make an informed choice. The point of the debate is for us all—but especially the Bill’s sponsor, the noble and learned Lord, Lord Falconer of Thoroton—to listen to the concerns that have been expressed. I agree with the noble Lord, Lord Carlile, that the noble and learned Lord will then have the opportunity to talk to noble Lords and to bring forward on Report amendments that deal with these issues.

Part of the problem here, and the reason there are many amendments on the Marshalled List and the debate will be lengthy—the noble Lord, Lord Watts, referred to that—is that the House of Commons spent, I think, 17 hours in Committee, focusing on just the first three clauses of this legislation because they are very important. That involved just 23 Members of Parliament. Almost all the proposals that we are discussing were brought up in the House of Commons, but almost all were rejected or disposed of. If some had been accepted and dealt with in the House of Commons, all we may have been doing here is tidying up some of the wording or improving the amendments. However, we have to address them from scratch because they were not dealt with in the House of Commons.

It is our job in the House of Lords to scrutinise legislation and to deal with the things that have not been dealt with. We do that on behalf of people— a number of today’s amendments deal with vulnerable people who do not have the same opportunities that we have. The one thing that we all have in common in this House is that we are all privileged. I am referring not to our material circumstances but to the fact that we have a voice. Many people in this country do not have a voice. Many of the people who have been touched on in these amendments—people of poor material circumstances; people undergoing coercive control, as my noble friend Lord Gove suggested; and people who have severe disabilities—have no one to speak for them. It is our responsibility and duty to make sure that we test these issues and make sure the Bill is as good as it can be.

The noble Baroness, Lady Hayter of Kentish Town, asked whether the noble Lord, Lord Carlile, would support the Bill if some of these things were dealt with. That is not really the question. I have been very clear that I do not support the change, and I will set out why in a moment in relation to one of the amendments. However, I have to confront the possibility that the Bill may become law; I will not find that welcome, but the noble Baroness will. If it becomes law, it is absolutely my responsibility—and the responsibility of everyone in this House—to make sure that the Bill has in it all the protections for vulnerable people. If we were to fail to do that, we would have failed the people of this country, whom we are supposed to support—that is our duty. There will be some people in this House who will, if the Bill is improved, support it; there are some who will not, but that is not the point. The point is to get the Bill in as good a shape as possible.

Let me now turn to the amendments. I will deal first with Amendment 45 on encouragement, so powerfully spoken to by the noble Baroness, Lady Fox of Buckley. The reason that word is important was demonstrated in the short debate between the noble Lords, Lord Pannick and Lord Carlile, on the present position. I hesitate, as a humble accountant, to trespass in the debate between those learned noble Lords, but I will make two points. First, there is a fundamental difference between someone refusing treatment or not having treatment and someone taking deliberate steps to kill themselves. Those are fundamentally different things, and trying to elide them is not helpful to the debate.

The noble Lord, Lord Pannick, talked about the status quo. As I understand it, the current position if you assist somebody to take their own life and the DPP investigates is that the guidance contains the concept of encouragement. There is a specific point, when the DPP is considering whether to prosecute you, about whether you have encouraged somebody to take their own life or tried to talk them out of it. If you have encouraged them not to take their own life but you have, none the less, assisted them, the current position is that that is treated much more favourably than if you had not tried to discourage them. That subtle position in the status quo is something we should maintain, because something very important will happen if this legislation passes, which is why I do not support it: it will, effectively, change society’s view of suicide. In some circumstances it will, effectively, support suicide where currently we do not. In those circumstances, the use of “encouraged” is vital. That is why I support the amendment.

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[Lord Falconer of Thoroton (Lab)]

That will very much depend upon the number of people who apply from particular groups, and I think one can be pretty sure, on the basis of the impact assessment, that there will be sufficient numbers.

[Lord Harper (Con)]

My Lords—

[Lord Falconer of Thoroton (Lab)]

I think it would probably be sensible, unless the noble Lord has something to raise that we have not already dealt with, for me to make a bit of progress.

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[Lord Harper (Con)]

It is directly relevant to the amendment that we are discussing, if the noble and learned Lord will forgive me. I am coming back to what the noble Lord, Lord Carlile, said about the point of the debate. I absolutely get that the noble and learned Lord is very certain about the quality of the Bill. He has set that out in his usual eloquent way. However, if he followed my injunction from the words of the right reverend Prelate the Bishop of Chester yesterday and if he has listened to this debate, he must recognise that that certainty is not shared by many Members of this Committee.

I hope the noble and learned Lord will forgive me if he was coming to this on later amendments, but he has in effect said that he is not persuaded by most of the amendments. If he does not accept that many noble Lords have concerns about the Bill and thinks it is basically fine as it is, I fear that—picking up the point made by the noble Baroness, Lady Hayter—many noble Lords who might have been persuaded to support it had it been improved will not now be persuaded. Is he prepared to listen and amend the Bill in any way at all?

[Lord Falconer of Thoroton (Lab)]

My Lords, first, I am sure that I will not be able to reach the high standard of the right reverend Prelate the Bishop of Chester, but I will try.

Secondly, I do not think I am rejecting the principle of many of the amendments. I am saying that—for example, in relation to an independent decision and to encouragement—the protection is there in practice. I also say to the noble Baroness, Lady Coffey, that her reference to organisations is something we could discuss. I think it may already be covered but let us discuss it.

The noble Lord, Lord Harper, is right: I am saying no to quite a lot of the amendments because, in my opinion, I do not think they are necessary and there is adequate protection. It does not mean I am not listening; but painful as it is, because I respect so many people who disagree with me, I do disagree with some people.

I am very conscious as well of what the Chief Medical Officer, Sir Chris Whitty, said, which is not to over-engineer this and make it a thicket people cannot get through. If you are serious about assisted dying, make sure it is genuinely accessible to people. I am trying to strike that balance.

Terminally Ill Adults (End of Life) Bill

Lord Harper Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

As the Delegated Powers Committee has pointed out, there are already extensive Henry VIII powers in the Bill, and it should be an easy matter to draft a new clause that removes all references to Wales in the Bill but grants a power to the Senedd to do its own Bill. Wales wants control of its own death regime and cannot do it since the Bill is nonsensically regarded as a criminal law Bill in Wales. We have the power to give the Senedd the power it needs to determine its own laws on this matter.

[Lord Harper (Con)]

My Lords, I support my noble friend Lady Coffey’s amendments. I will raise two issues, one on the principle of how we are dealing with devolution. I also want to bring to the Committee what I hope is some valuable experience from my time in the House of Commons about the detail of how these services are delivered on the ground, particularly for people who live close to the border. Given that these are life and death issues, the detail of how these services are delivered is very important.

One lesson from the way in which the 1999 devolution settlement was delivered was that there was literally no thinking done about some of the complexity of the cross-border issues. It took the best part of a decade of hard campaigning work to get this right. In the interim, many of my former constituents sadly did not get the life-saving medical treatment that they deserved as residents in England. This is incredibly important. It is an issue that I suspect will be known only by those of us who have had some responsibility for this. I am sure the Minister will be well aware of it and, if she is not, she will be able to ask her officials to dig out all the background and history for the cross-border delivery of healthcare and the protocols that are now in place, because they will be very relevant to how these services are delivered.

In the first part of my remarks, I will touch particularly on the aspect that my noble friend Lord Blencathra raised. This is partly about my fundamental view that I do not think that delivering this legislative outcome through a Private Member’s Bill is very satisfactory. This issue is one of the reasons why. We have a very uncomfortable situation in which we accept that this is devolved in Scotland—and the Scottish Parliament is busy legislating to deliver assisted suicide in Scotland according to how it wants to deliver it.

I personally do not believe that assisted suicide is a healthcare intervention, actually, but it is clear from what Health Ministers have said that they think this will be delivered by the National Health Service. If it is to be delivered by the National Health Service, you would logically expect it to be done, as my noble friend said, in accordance with the devolution framework. But because what is actually happening here is the amendment of the Suicide Act to put in place the ability for people to help someone take their own life and not be caught by the Suicide Act, that effectively makes it a criminal justice matter. That is not devolved, which is why we are having to legislate for England and Wales. I do not think that makes any sense.

It would have been much better if the UK Government had had some sensible conversations at the beginning of this process with the Welsh Government and come to an agreement about how this was going to be dealt with, either—as my noble friend said—by devolving the power to the criminal law in Wales and allowing a fully devolved solution, or by the Welsh Government and Senedd agreeing that we could legislate at Westminster for both the principle and the operational delivery mechanisms on an agreed basis. We have ended up with a very uncomfortable halfway house, which I do not think will be at all satisfactory, where we will be making decisions here for a service being delivered in Wales, not doing it in line with the wishes of those elected by the people of Wales. We are not really having that proper, sensible conversation.

I turn now to the operational issues. I have looked at the Bill, and because it says almost nothing about how this will be delivered in practice, I will flag up a couple of issues. The Bill applies to people ordinarily resident in England and Wales and registered with a GP practice. For those who do not know, my former constituency is the Forest of Dean. One of the complexities if you live in the Forest of Dean is that there are parts of it where you live in England, so will be covered by the law and the NHS in England, but you will be registered with a GP practice either physically located in Wales and governed by Welsh laws or physically in England but part of a wider practice in Wales. That matters because you will get your primary care delivered according to the rules of that practice. Some of my former constituents have primary care delivered according to Welsh rules, even though they are resident in England. People will be familiar with the fact that there are differences there—about whether you pay for prescriptions, for example.

The really important issue, on which the Bill is silent, is that when you receive secondary care—when you are referred to hospital for treatment—it was the case before we put in place the protocols that now exist that my former constituents in England, entitled according to the law to get services in England, were being referred to secondary care in Wales. There, waiting lists were longer and there were not the same provisions about choice. Therefore, those residents of England were not getting the services to which they are entitled. The Bill does not distinguish between whether you are resident in England or Wales.

The concern is that if the health service in England delivers the service in a particular way but Welsh Ministers decide to deliver the service in a different way, with different checks and balances and different professionals delivering that service, it is not clear in the Bill whether someone who lives in England but is registered with a GP practice in Wales would be entitled to the English or the Welsh provisions. Given that this is about life and death situations, that matters. I, for one, am not content to leave it to secondary legislation. The Bill should spell out the rights you have as a resident of England to the services you get, and if you live in Wales the rights should be according to the provisions of the Senedd.

I see Ministers chatting to each other. This matters. If this is not got right, there will be people in England facing life or death situations who do not get the health professionals involved in this. There will be people potentially coming under the ambit of the Bill who get social care. Social care is devolved, so the level you get, the rules about it and the entitlements to it are different in England and Wales. There has been a lot of talk about the necessary provision of psychiatric services. The provision of secondary care—psychiatrists, for example—is devolved, so it will not be the same in England and Wales. Getting this right matters.

The legislation says nothing about delivering services accurately to people based on their residence. At the moment, we have lumped together whether someone is ordinarily resident in England and in Wales; I do not think that that is satisfactory. You should get the services in England that this House and the other place decide are appropriate, and English Ministers—namely, Ministers in the UK Government responsible for the health services in England—decide that. If you live in Wales, you should get the services that Health Ministers in Wales decide you get. We need to make that very clear in the legislation.

My noble friend’s amendments raise some important issues that go to the heart of the legislation. They have not been thought through by the promoter and sponsor of the Bill. Having raised them today, I hope that Ministers will start thinking about them and will come back to the House with amendments themselves. Otherwise, I will put down amendments—and I suspect other noble Lords will, too—to correct this on Report. It is a massive gap, and it will be an issue for residents in England and Wales, particularly those close to the border, who make up one-quarter of the Welsh population. It will be raised by Members of Parliament up and down the border. My experience as a former Member of Parliament is that it is better to get these things right—

[A noble Baroness]

You have made your point.

[Lord Harper (Con)]

I am going to finish very quickly if you do not interrupt me. The time limit is very clear, and I am going to stick to it, but I am finishing my point. I was coming to the end of my point, and that was not necessary. The Government Chief Whip made it clear that these are incredibly important issues, and we will debate them with courtesy and respect. I will treat people whom I do not agree with on this issue with courtesy and respect. As I have not exceeded the time limit, I do not expect to be yelled at. Let me just finish my point and then I will sit down.

My experience—I am going to go over the time limit only because I was interrupted—as a former constituency MP is that it is better to get these things right in advance, when you draft the legislation, and not spend years trying to fix them afterwards.

[Lord Markham (Con)]

My Lords, I am not an expert on delegated powers, so I must admit to a bit of confusion. I hope that either the Minister or the Bill’s sponsor, the noble and learned Lord, Lord Falconer—or maybe both—can help clear this up.

My understanding of what the Bill is trying to do is to enable the Welsh Senedd to make a choice. If the amendments were to go through as drafted, they would deny that choice, because they would rule out people living in Wales from being able to choose whether they have assisted dying, whereas what I think the Bill is trying to do—I hope that can be clarified in the response—is state that the legislation will enable the Welsh Senedd to decide whether and how it wants to implement the Bill. When the Senedd does that, it can take into account the points that the noble Lord, Lord Harper, made about how the two services could sit alongside each other.

If we were to pass this amendment, we would deny the people of Wales that choice. That cuts right across the principles that the noble Lord, Lord Weir, set out when he said that the decision should be taken in Wales. The amendment would mean that the decision was taken here, which would deny the people of Wales that choice.

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[Lord Harper (Con)]

The Minister has said very carefully today and in answer to some Written Questions that there are officials, rightly, working on the legislative drafting of this Bill to make sure that it is workable. It is completely proper for Ministers and officials to be doing that. I want to probe the Minister on a point raised by the noble Baroness, Lady Grey-Thompson. Does she have officials, in her department or elsewhere, who have gone further than that and who are working on implementing the legislation if it were to pass both Houses of Parliament?

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[Lord Falconer of Thoroton (Lab)]

My Lords, I make a declaration of interest: I have an assistant who is funded by Mr Bernard Lewis and who helps me on this Bill. I make a declaration that Dignity in Dying paid for the printing of the material that was circulated to Peers in my name before this process commenced.

I compliment the noble Baroness, Lady Coffey, on the short way that she introduced the important issue. I very much hope that I can put to rest most of the misconceptions that were expressed during this debate.

As everybody agrees, criminal law is not devolved to the Welsh Senedd. Therefore, any change in criminal law has to come from the UK Parliament. You cannot proceed with assisted dying without changing the criminal law. Therefore, the UK Parliament has to provide a legislative change for that.

Healthcare is rightly devolved to the Welsh Ministers and the Senedd. The Bill makes provision in England for Ministers to produce regulations on how assisted dying will be implemented and regulated in England. Clause 42 requires Ministers to produce such regulations. It is wrong, as part of the devolution settlement, to require Welsh Ministers who are responsible for health in Wales to do that. It is for the Welsh Government to decide what provision to make. Unlike Clause 41, which relates to England, Welsh Ministers are given the option to introduce such regulations as they see fit. Those regulations will permit the assisted dying process to be introduced in Wales, in the National Health Service, and for Welsh Ministers and the Welsh Government to provide whatever provision for it in regulations that they see fit.

The noble Lord, Lord Wolfson, asked why we are legislating for England and Wales but not Scotland at the same time. It is because we are doing exactly what the noble Lord, Lord Gove, asked me to do—and I am so glad he did—which is to respect the devolution settlement. Will the noble Lord let me finish? Then I will come back to him.

The way this structure works is that, first, we in this Parliament determine whether the criminal law should be changed. Secondly, the Welsh Government are given the power to introduce regulations. That power should normally be given to Welsh Ministers by an Act of the Senedd. Therefore, a legislative consent Motion has been proffered by the Welsh Government for the Senedd to decide whether it would be willing to give us consent to legislate in an area that would normally be legislated for in the Senedd.

The LCM—legislative consent Motion—in the Welsh Senedd covers the following. I give these details for noble Lords to consider them at their leisure: Clause 40, which gives Welsh Ministers power to issue guidance; Clause 42, which gives Welsh Ministers power to regulate how this is to be introduced in the health service in Wales and with what regulations; Clause 51, which gives the Welsh Government power to talk about and make regulations about the Welsh language; Clause 54, which gives them a general power to make regulations; and Clause 58, which gives the Welsh Ministers and the Welsh Government power to introduce certain of the provisions.

The sponsor in the other place and I have discussed this arrangement with the Welsh Government, and by that I mean Welsh Ministers and Welsh officials. We have done what the Welsh Government would wish us to do to respect devolution. We have taken these powers in the Bill, subject to Parliament, so that there is not a position where, after this Bill is passed, Welsh Ministers lack the power to introduce regulations if they choose to do so.

I have listened to this torrent of points about Wales saying it has not been thought out. I say with suitable humility that we have thought it out and sought to reflect what good devolution practice would require. I do not invite people to come back, but please think about what I have said and consider—

[Lord Harper (Con)]

My Lords—

[Lord Falconer of Thoroton (Lab)]

Hold on. Consider whether it represents the right position.

Can I just deal with two other points? First, the noble Baroness, Lady Smith, in a very clear speech, said maybe one should amend the Bill to give the Welsh Senedd the power to make a decision about the criminal law in relation to assisted dying. It was a point I thought the noble and learned Lord, Lord Thomas of Cwmgiedd, was sort of flirting with. We have not taken that view. We have taken the view that the right way to deal with this is in accordance with the existing devolution settlement.

If the noble Lord, Lord Gove, has not been satisfied with my answer so far, he may continue with his question.

[Lord Falconer of Thoroton (Lab)]

In relation to the noble Lord’s first point, the Legislation, Justice and Constitution Committee’s point about the width of the legislative consent Motion is that it wants the LCM to extend not just to the health provisions but also to those that relate to the change in the criminal law and the safeguards. It argues that those changes in the criminal law should also be subject to it. My view—and it is a view I think shared by the Welsh Government—is that, no, you do not need a legislative consent Motion for the UK Parliament to do that which it is entitled to do, which is to change the criminal law. I give way to the noble Lord, Lord Harper.

[Lord Harper (Con)]

I am very grateful—

[Lord Falconer of Thoroton (Lab)]

Sorry, the noble Lord, Lord Gove, asked a second question which I did not answer.

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[Lord Harper (Con)]

I am grateful to the noble and learned Lord. I have listened very carefully to what he said, and I absolutely accept that he has conducted extensive engagement with Welsh Ministers based, perfectly understandably, on the framework of the Bill as he and the sponsor in the Commons have drafted it.

The noble and learned Lord will know that one of the concerns of many in your Lordships’ House is the extent of Ministers’ powers and the extent to which some of the regulations should be put in the legislation. I am sure, as Committee progresses, we will have those debates. If it ends up being the wish of this Parliament that more of the detail about how the legislation will be implemented is put in primary legislation, how will we do that in a way that satisfies the desires perhaps of this Parliament but does not trespass, given the way he has chosen to set out the framework, over the devolution framework? Therefore, did he consider just devolving the power to the Welsh Senedd to change the criminal law in this narrow case? Then the Senedd, as the noble Baroness said, would have the full power to change the law and implement it. I accept that what he has done makes sense in the way he has drafted the Bill, but if we significantly change the Bill, I think that will cause a real problem with how it is implemented.

[Lord Falconer of Thoroton (Lab)]

I am not sure I understood the question. As far as devolution is concerned, I do not think the question of regulations on the face of the Bill is the right issue. The right issue is who has power to produce those regulations and does that offend against the devolution settlement. If he has a question about there being not enough detail in relation to other areas, I am happy to answer that, but this is not for this group. Those are my submissions.

[Lord Harper (Con)]

Let me ask him the question.

[Noble Lords]

No!

[Noble Lords]

Yes!

[Lord Harper (Con)]

He said he did not really understand my question. If we set out in the Bill some of the details he currently envisages are in regulations and therefore the House decides on them as opposed to them being for Ministers in either the UK Government or the Welsh Government, that will cause a problem for the approach to devolution that he has conducted. I just wondered whether he had thought about that. That was my question, and I am sorry for not expressing it clearly.

[Lord Falconer of Thoroton (Lab)]

I am not sure the noble Lord has quite understood what I have said. It is for the regulations in so far as they deal with the Welsh health service to be delivered by Welsh Ministers, so it is quite inappropriate for us to put them in this Bill.

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[Lord Rook (Lab)]

My Lords, I will keep this brief. I was not going to share this at this point because it is quite personal and because it takes a lot for me to counter the noble Baroness, Lady Andrews, for whom I have huge respect. She was the first person to invite me to the House of Lords for tea, many years ago. I do not doubt that the Mental Capacity Act has been a huge advance in how we deal with these issues.

I accept that the noble and learned Baroness, Lady Butler-Sloss, is probably one of the few people in this place to make judgments in the courts and the Court of Appeal on mental capacity. I suspect that more of us have had to go through the process of helping a loved one through a mental capacity assessment, although I suspect that number is also still low. My father has dementia. I have had to support him through a mental capacity assessment. No matter how clear the Act or various legislations or definitions may be on paper, it is extremely difficult at times to take someone through that process. All he had to do was prove that he had capacity to instruct a solicitor, a decision far less serious and far less terminal than the one we are discussing today.

If you assessed my father’s capacity, you would find—on the comments made by the noble Baroness, Lady Hollins, about literacy and numeracy—that my father has near-perfect literacy and numeracy. We have had comments about executive function. You would find that he has near-perfect capacity for executive function to make important decisions. You would also find that he has virtually no short-term memory. He is more than capable of making a decision, but that decision is gone in 30 seconds—sometimes sooner. If you apply that to this situation, he would be able to make a decision but would not know about it at the point that decision was acted upon.

Returning to the comment from the noble and learned Baroness, Lady Butler-Sloss, about whether it is capacity or ability, I pick up on the comments from the other side of the Committee recently. There is not enough, in the way we judge capacity at the moment, to make this practicable and desirable. We certainly need more. I am not sure whether it is “ability”, but what we have at the moment is not enough to deal with this in practice.

[Lord Harper (Con)]

My Lords, I have listened carefully to the debate. The noble Baroness, Lady Finlay, has done the Committee a service in tabling this amendment. It has enabled us to think in advance of the debate that we will have when we get to Clause 3 on the existing wording in the Bill about the Mental Capacity Act. Some of those issues came out in the debate that we have just had. It has been helpful to cue that up.

I want to comment on a couple of issues following on from the comments made by the noble Lord, Lord Deben. Two different things are being talked about with capacity and ability. I listened carefully to the comments of the noble Lords, Lord Pannick and Lord Scriven. There is a clear mental capacity test. But as others have said—I will not repeat the quote—experts in assessing capacity from the Royal College of Psychiatrists think that this decision was not thought about when the test was designed and that it is not an adequate test. I will not labour the point now, but we should think about whether we need a new test or, as the noble Lord, Lord Deben, said, an additive process where we take the Mental Capacity Act test and add something to it. There are amendments on both of those—a new test or adding things to it.

That comes to the point that the noble Lord, Lord Scriven, made. Of course, it is true that people make life and death decisions about medical treatment and about whether to refuse medical treatment. But there is a qualitative difference between refusing medical treatment, even if the consequence of refusing that medical treatment will be to hasten the end of your life, and to make a decision for active steps to be taken to administer substances to you which will end your life. They are very different things, and they are treated differently in the law. Perhaps that is the reason why we have had that slight cross-purpose. We need to be very precise about our language when we come to have that debate on capacity. I think that that would be helpful. That is all I will say about that at this point. I suspect that we will have a very extensive debate on Clause 3.

I think that the noble Baroness, Lady Finlay, was getting at something a little wider, which was not just about the capability of the individual to make a decision—that is the capacity piece. It was also about both the information they are furnished with and whether they have all the information at their disposal to be able to exercise their capacity to make a decision. It is not just about whether the information is available but whether the services are available that make that a truly proper, informed decision. Clearly, she has enormous expertise in palliative care.

Whether that palliative care is available in practice is incredibly important. Somebody could have capacity, and we could judge that they do. I listened very carefully to what the noble Baroness, Lady Andrews, said, with her expertise on the Mental Capacity Act, and I listened carefully to my noble friend Lady Browning about the importance of recognising how it works in practice, but it is also about whether those services are available. You could have the capacity and a lot of information provided to you, but if the palliative care services are not available to you, you do not have the ability to make a meaningful choice about whether you wish to end your life. I think that is what the noble Baroness, Lady Finlay, was getting at in that wider use of the word “ability” on top of capacity.

When we get to Clause 3 and the amendments to it, one of the things we should think about is whether we accept that the Mental Capacity Act is a good basis. As people on both sides of the argument have said, it is a tried and tested situation. As we heard earlier, it has been tested in court, up to and including the Supreme Court. We should think about whether we want to replace that with a completely new test or whether we actually stick with the Mental Capacity Act and perhaps have some additions to it, which recognise that it is a qualitatively different decision from whether you are having medical treatment or not. That is the essence of it.

In the place it is in the Bill, just accepting the word “ability” probably is not the right thing to do. We want that wider debate. But the noble Baroness, Lady Finlay, has done us a service in flagging up some of the issues that we can now think about in advance of the debate on Clause 3.

[Lord Winston (Lab)]

Before the noble Lord sits down, perhaps he could just clarify a point. Medical royal colleges are often quoted as having a view, but they are very seldom unanimous. I wonder whether he could tell us not just the percentage of psychiatrists but how many psychiatrists who are members of the royal college specifically had this view and how may did not. That is really important. There were a number of people who just did not respond to a question.

[Lord Harper (Con)]

I am happy to answer. I do not know how many did. My understanding is that the royal college, whatever its decision-making processes are, has publicly said that it does not think this is adequate. As I said, I did not quote it, because it had been quoted at length. I put some weight on that.

As a relatively new Member of your Lordships’ House, I am also very struck that this House is blessed with those who have enormous experience in the law, who have to make some of these decisions in practice, and experienced legislators, such as myself, who have looked carefully at the operation of the legislation, both in taking it and post-legislative scrutiny. Many Members have personal experience, either themselves or through family members, of the exercise of these laws in practice. I will listen very carefully to them.

Therefore, the view of the Royal College of Psychiatrists is clearly an important one that I will put some weight on, but I will also listen very carefully to others in the House, who I think will add enormously to this debate as we weigh up this important piece of legislation. I thank the noble Lord for his question.

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I thank the noble Baroness, Lady Finlay, for bringing this debate to the Floor. I declare my interests as chief executive of Cerebral Palsy Scotland, and I have been involved with the Scottish Government on neurological conditions and policies for many years.

What has struck me in the debate so far is something that the noble Baroness, Lady Hayter, said about concentrating on the interests of the person. This is what I see every day when I deal with vulnerable people and they are dealing with service providers, whether in health, education, housing or whatever. I take the point your Lordships have made that this debate is about the difference between “capacity” and “ability”; capacity, as we define it in the Mental Capacity Act, is something that professionals will assess. They have lots of experience of doing that, and that is great. However, if we come back to concentrating on the interests of the person, the person is quite often in this difficult, complex situation for the very first time. Therefore, as my noble friend Lord Deben said, their ability to take on complex information, potentially when there might be multiple comorbidities and issues going on, is very different.

We see it in children in education and in people with communication difficulties—I have an amendment later on about how we support people with communication difficulties to navigate this. But we see it every day with the ability of people to take on something really profound that professionals are used to talking about—and we are professionals in here; we can talk about definitions and how we define things in legislation. I wanted to question whether people in the street that will be dealing with this have the ability to understand all the options, the prognoses and everything in front of them.

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[Baroness Hayman (CB)]

I cannot accept that. I am talking about the Bill that we have before us. The noble Lord, Lord Harper, asked: should we have a novel approach to this? My answer is no; it is safer to continue with the approach that we have.

I want to say one other thing to the Committee. I hope the Committee will accept that, given the experience that I have had here and the honour I had of being Lord Speaker, no one respects more the contribution that this House can make to improving legislation and the commitment that it should do its work properly. The noble Lord, Lord Harper, said that we were blessed in this House with many experts, and that their opinions should be listened to. The noble Lord, Lord Shinkwin, said that we should listen to the voices of those with lived experience. I am sad that the Select Committee did not do that, but I think that that is absolutely correct.

The one thing that we are not is what was said to me in 1974: “You have now been anointed by the popular vote”. I was then a Member of Parliament. It was a long time ago—in ancient times—but it was true. What has worried me slightly about the tone of this debate is that there has been a sense that this was a Private Member’s Bill introduced in the House of Lords, and that we were having the first go at any scrutiny of it. That is not true; it is not true at all. We do often get legislation from the other place that has not been scrutinised, but that is not true of this Bill. It has had much more scrutiny and I think we should have some respect for the fact that that has happened.

People say that we should not have an arbitrary timetable. Of course we do not want an arbitrary timetable. We have to do our job properly, but we should not be forced into a position where we are incapable of completing that job due to having an enormous number of amendments. We should concentrate on the important issues that we want the other place to take our views on seriously. I really think we are in danger of demeaning that process if we allow so much debate that we do not allow the other place to hear considered views on the important issues.

[Lord Harper (Con)]

I have an enormous degree of respect for the noble Baroness, particularly given her position as a former Lord Speaker. I am a relatively new Member of your Lordships’ House, but I have interacted with it. I look around and there are a number of noble Lords here—such as the noble Lord, Lord Pannick—with whom I had a number of interactions on previous matters. So I am familiar with the different role of the two Houses, and I believe it is absolutely our job to get legislation right.

In the end, this is a Private Member’s Bill. It was not in the Government’s manifesto, so it has not been, to use the noble Baroness’s words, anointed by the popular will. This is our job. If in the end this House decides that this Bill is not fit for purpose and cannot be adequately put into law, it is our role to say to the House of Commons, “It isn’t good enough; we need to do this again”. It is our job to say to the Government that this is of such import that, as the noble Lord, Lord Tyrie, said, the Government should do their job and bring forward a better-drafted piece of legislation. That is our right, and we should reserve that right for later stages.

[Baroness Hayman (CB)]

I follow the noble Lord’s argument, but he said that we should say, “We should do this again”. I think that if we reach that situation, the proper formulation is, “You should do this again”, and the other place could consider that. But the way we undertake that scrutiny should be responsible and reasonable and it should not deny the process of doing our job and putting those views and doing that—frankly, we have to be grown up about this and we have to behave responsibly about it.

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[Baroness Coffey (Con)]

I will respond to that. I do not know the answer about the noble Baroness, Lady Murphy. However, I say to the Committee and to the noble Lord, Lord Bassam, that amendments have been made to the Mental Capacity Act 2005 that have not been enacted by this Government. Therefore, we are not even sure exactly which version of the Mental Capacity Act we will be dealing with in the future. The noble Lord, Lord Bassam, is babbling away, but this happened. Amendments were made in 2023. That was on slightly different matter, but it is something I will come to in Clause 3.

I come back to the attack on Dr Price. Perhaps the noble Baroness could be brave. She has used parliamentary privilege to do that. If she really believed it, she might say those words outside the Chamber and see if she gets a legal letter. I thought it was really poor to attack somebody who had been invited and to try to suggest that, somehow, for such a distinguished royal college, she was manipulating a particular report. That was unfair.

I will make one minor observation about the Select Committee. In my view, it was noticeable how distressed Dr Price started to become during that oral evidence session. I am not a clinician or a psychiatrist; frankly, I am just another woman who could see how distressed she started to become. I also spoke to her outside afterwards. We have to bear in mind that we are used to this bear pit—which is much gentler at this end than at the other end—but that is not true of the others.

I will come back to the discussion and one of the questions I wanted to understand when going through ability versus capacity. We have already heard that things such as depression and mental illness are not a disabler. We already know that having dementia is not a reason to be denied, certainly in the Mental Capacity Act 2005. We know that capacity can fluctuate, and I certainly will not repeat what others have said.

What I have not yet understood is how things such as the power of attorney might work, which can be given over for health reasons. I want to get an understanding of the view of the sponsor and the Government Minister about the application of this, before potentially laying further amendments to discuss this.

We know that the Government do not believe that the Bill is in a fit state. They would not have 16 people working on it and the amount of work that has been going on if they did. By the way, that does not include the Government Legal Department in any way.

I thank the noble Baroness for having introduced this, but there is still quite a lot of debate to be had once we get to Clause 3, if we are allowed to see that it is in scope.

[Lord Harper (Con)]

In case I am not understanding it and it would be helpful for the Minister, is the question my noble friend wants the Minister to answer on lasting of powers of attorney whether it the Government’s understanding that somebody in possession of a lasting power of attorney for health and social care would be able to use that lasting power of attorney to seek an assisted suicide for the person on behalf of whom they hold the lasting power? Is that the question she is asking? I was not entirely certain.

[Baroness Coffey (Con)]

My noble friend has put it more accurately—that is precisely the question I am trying to understand. I am trying to be a legislator rather than somebody who argues in court, but the very fact that somebody can make health decisions on behalf of somebody else is important to consider in this matter, and I am not clear that it is explicit in the Bill—yet—that that power of attorney could not apply. We know that the Mental Capacity Act 2005 does not apply to Section 2 of the Suicide Act 1961. I will not go into a history lesson about the Suicide Act at Clause 1, but at the moment everything seems silent on the use of that lasting power of attorney.

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[Baroness Williams of Trafford (Con)]

It might be convenient to concur with what the Government Chief Whip has just said. We could finish in the normal run of things if there were fewer interventions and perhaps if the Front Benches could be allowed to sum up.

[Lord Harper (Con)]

Since I was standing, I will be very brief. I support what the Chief Whip said. I agree with what the noble Baroness, Lady Hayman, said earlier. I agree with the Government Chief Whip about not giving government time, but we need more time to deal with this as a Private Member’s Bill. I do not think that any reasonable person listening to the debate and the expertise contributed from these Benches could have concluded anything other than that this was a debate that reflected well on the House and that we are doing our job seriously and conscientiously. We need to continue to do that. That is all I would say to the Chief Whip.

[Lord Kennedy of Southwark (Lab Co-op)]

As a final point, I agree with the noble Lord. As Government Chief Whip, I take my job very seriously. I love the House, and I want to do this properly. I assure the Committee that I hear noble Lords’ sentiments. I know how long it has taken on the Bill. I know that views are sincerely held on both sides. I will work in the usual channels to deal with these matters.

Healthcare Provision: Inequalities

Lord Harper Excerpts

Monday 20th October 2025 Lords Chamber

[Baroness Merron (Lab)]

It is an unacceptable situation, as the noble Lord says. However, I refer him to the national approach, which will inform action in communities, including for people with a learning disability and those who are autistic. The Core20PLUS5 informs the reduction of healthcare inequalities among a range of groups; and, extremely importantly, it supports NHS organisations in identifying who might be at risk of poorer experiences, and in addressing this. I agree with the noble Lord that this must include those with a learning disability and those who are autistic.

[Lord Harper (Con)]

My Lords, I support what the noble Lord just said on raising concerns about those with learning disabilities. They have a long-standing issue with access to the health service, and we saw some particularly poor treatment during the Covid pandemic. The last Government took steps to improve training for those working in the NHS in order to improve the situation. Picking up on the Minister’s answer to the noble Lord, what is her ambition in terms of timescale? When might we see some significant improvement in how those with learning disabilities can access National Health Service treatment?

[Baroness Merron (Lab)]

In a number of ways—I refer, for example, to the Mental Health Act, which is very significant in respect of the group we are discussing. We have already taken action in that regard in a legislative form.

However, the noble Lord is right. We started in a difficult place, but I am more than hopeful about the whole approach through the 10-year plan. So while I cannot give a month-by-month answer to the noble Lord—much as I would like to—I can say that in the course of the next 10 years, the matters to which he refers will be addressed. I believe that a neighbourhood health service designed around the specific needs of local populations will be a great contributor to this.

Terminally Ill Adults (End of Life) Bill

Lord Harper Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Lord Harper (Con)]

My Lords, it is a great pleasure to follow the noble Baroness. At the end of her speech, it was very clear that she should have had no concerns about the contribution she would make to the debate—it was a very powerful speech.

We are all the product of our experiences. One of the most profound and shaping that I had in public life was being shadow Minister and then Minister for disabled people. The reason for that was the opportunity I had over the four years or so in those two roles to meet people of all ages who had thrown in front of them, sometimes over the whole of their life and sometimes as a result of circumstances, challenges and difficulties that they faced doing the things that we all take for granted: living an independent life, working, bringing up a family, contributing to society and making the best of what they had in front of them. Many of those people are profoundly concerned by what the Bill will do to society’s view of people who have challenges thrown in front of them.

I know that is not the intention of the promoters of the Bill, but it does say something fundamental about society’s view of life, particularly life lived by people who have profound challenges. That is why the Bill is not supported by a single organisation in this country that represents disabled people—not a single one—and we should listen to their views and take them very seriously.

The second very powerful argument we have heard in this debate, referred to by the noble Baroness, Lady Fox of Buckley, is the one about choice and autonomy. The reason why that argument fails in this case is that you are taking a decision that impacts only upon yourself and has no consequences for others. The problem is that in delivering rights and choices for those who will be the beneficiaries—if that is the right word—of the Bill, you are effectively taking away choices and opportunities from others. There are competing rights, and when we have competing rights, we always have the most difficult decisions to make, and they are always the most charged political conversations we have.

The second reason why that argument fails is that, for choice to mean anything, it has to be a meaningful choice, and we do not have that in this country. We have some excellent palliative care, but it is not universally available to everybody; and in the Government’s 10-year plan for the NHS, there is no plan and no ambition to make it so, not even at the end of that 10-year period. I am afraid that a choice for assisted suicide without access to good quality palliative care is no choice at all.

My final point is about being clear about what we are doing here. As the noble Baroness, Lady Fox, said, and my noble friend Lady May of Maidenhead said last week, this is about assisted suicide. We are amending the Suicide Act to provide a defence for people taking their life. If the promoters of the Bill and those who support it find plain and clear language uncomfortable, rather than attacking those that use that plain and clear language, as they have done with my noble friend Lady May, they should perhaps reflect upon what it is they wish to do.

Oral Answers to Questions

Lord Harper Excerpts

Tuesday 1st March 2022 Commons Chamber

[Sajid Javid]

The hon. Lady is right to raise this matter. As she will know, owing to the pressures of the pandemic we have seen significant challenges for ambulance services throughout the country. Just a few days ago I met the head of the West Midlands ambulance service to discuss some of the issues, and also how the extra funding that we provided over the winter—some £55 million of support for ambulance services—is helping.

[Mr Mark Harper (Forest of Dean) (Con)]

May I press the Secretary of State on how the increases in NHS capacity will be maintained over the medium term? His own Department has forecast that waiting lists may hit 9 million or 10 million in the next couple of years. The Government also have a plan to take the extra funding coming from the increase in national insurance and the health and social care levy out of the NHS to fund our long-term social care plans. How are the two to be reconciled?

[Sajid Javid]

As my right hon. Friend will know, when I presented the NHS’s elective recovery plan for the covid-19 backlog in the House a couple of weeks ago, I made it clear that we expect waiting lists to rise before they fall. That is because some 10 million people stayed away during the pandemic, and we want as many as possible of those who want and are able to come forward to do so. At the same time, the NHS will be massively increasing its activity, in new ways and with new funding. It is essential for there to be much greater integration between the NHS and social care, and we set our plans in detail in the White Paper published last week.

Elective Treatment

Lord Harper Excerpts

Tuesday 8th February 2022 Commons Chamber

[Sajid Javid]

The hon. Gentleman raises a series of very important points, especially in what he said about cancer and radiotherapy. I believe he already has a meeting in the diary with Health Ministers, and I will look out for the output of that meeting. I agree with what he said about radiotherapy and the importance of investment in that, and there is a lot more investment. I referred earlier to the £6 billion extra capital budget, and a large part of that will be used for new diagnostics. I hope he also agrees with me that, as well as radiotherapy, we need to invest in the very latest cutting-edge technology for cancer care, such as proton beam therapy, which I saw for myself last week in London.

[Mr Mark Harper (Forest of Dean) (Con)]

The Secretary of State will know that many on this side of the House were very reluctant, but did support the increase in resources for the NHS through the increase to national insurance and then the health and social care levy. When we are making that argument to our constituents, they will expect that money to deliver results, so may I make one observation and ask one question? The observation is that, while the plan is welcome, only getting to 99% of patients waiting less than a year by March 2024 is not ambitious enough, so will he perhaps be more ambitious? Will he also say a word about how the resources raised through national insurance will be removed from the NHS and flow into social care? From October 2023, we will have to fund social care with the same money. He did not talk about that, and social care is as important as the NHS, so will he say a word about that?

[Sajid Javid]

My right hon. Friend is absolutely right about the importance of making sure that every penny spent in the NHS, or social care for that matter, is spent wisely and in the very best interests of taxpayers. I absolutely agree with him on that, and that also has to translate into the ambition. My right hon. Friend, like other hon. Members, will not have had time yet to look at the plan. I am happy to discuss it with him afterwards if he wishes. I hope he agrees that it is full of ambition. Indeed, if the NHS can go much further than the targets I set out earlier, that is what we all want. As I said in my statement, it does depend on how many people come back to the NHS, and that is very hard to estimate, but I want as many people as possible to come back.

My right hon. Friend is right to raise the importance of social care and the need for much better integration between healthcare and social care. We will set out more detailed plans on just that very shortly.

Covid-19 Update

Lord Harper Excerpts

Thursday 13th January 2022 Commons Chamber

[Sajid Javid]

As I have mentioned, JVT’s move is the country’s loss, but Nottingham’s gain, and I am glad that the hon. Lady is delighted. On investment in the NHS, she will know that, even before covid-19, the Government had already set out, in the long-term plan for investment in the NHS, the extra £30 billion going into the NHS by the end of that period, with huge investment in areas such as cancer care, mental health care and electives. Then during the crisis, which has of course been very challenging for our health and care services, as it has been across the world, we have set out over £40 billion of extra investment, including this year, to help us get through this crisis.

[Mr Mark Harper (Forest of Dean) (Con)]

I welcome the change in the self-isolation rules that the Secretary of State set out. It is a good indication that the Government can be flexible on policy, so let me have another go on the subject I raised yesterday. My right hon. Friend heard the exchange I had with the Vaccines Minister. She agreed with me from the Dispatch Box that persuasion was the best and right way to get health and social care workers to be vaccinated. However, telling a health and social care worker that they will be sacked if they do not get vaccinated is not persuasion, but coercion. Will my right hon. Friend reflect on whether it is sensible on 1 April to continue to try to implement a policy that, according to the Government’s estimates, will mean 73,000 NHS staff and 38,000 domiciliary care workers losing their jobs? When a policy is not working, it is right to ditch it, isn’t it?

[Sajid Javid]

First, I commend my right hon. Friend for the scrutiny that he has constantly provided of the Government’s covid policy. He did that long before I was Secretary of State and I am pleased that he has continued to provide that scrutiny, which is very valuable. It is most valuable to me when he supports the policy, as he did on self-isolation today, but it is still valuable when he challenges the Government to think again about policy. That is very important. I addressed the policy he raised of the vaccine as a condition of deployment in the health and social care sector a bit in my statement. He will have heard that we are committed to it, but that is because it is right that, in those settings where there are people who are more vulnerable than others, they are put first. We know that vaccines limit transmission and that as a result it is safer for patients if the individuals who provide that care—the health and care workers—are vaccinated. The policy is about putting patients first, was voted for by the House with an overwhelming majority, and the Government intend to implement it.

Vaccination Strategy

Lord Harper Excerpts

Wednesday 12th January 2022 Commons Chamber

[Maggie Throup]

I do not recognise the data given by the right hon. Gentleman. We have already invested £465 million in a recruitment and retention programme for care home staff. It is important to recognise that caring is a worthwhile career. The carers I have met are really dedicated and get a lot from it. I come back to the fact that it is important to keep the most vulnerable in our society safe, whether they are care home residents or patients who are acutely ill in hospital.

[Mr Mark Harper (Forest of Dean) (Con)]

My sources in the NHS tell me that last week they received either from the Department or from NHS England instructions effectively on how to go about firing people from the NHS in April if they have not been vaccinated. That caused them considerable concern. The Government’s own analysis, prepared by the Minister’s own Department, is not of the position now; it is of the expectation of where we will be in April. Analysis from her own Department, signed off by her, thinks that 73,000 NHS staff and 38,000 domiciliary care workers will leave.

I want people to be vaccinated, but we know that the protection against infection wanes quite quickly from 10 weeks onwards, which means that we are not protecting others. I want people to be vaccinated, but I—and public health professionals—think that the best way is to persuade them, not threaten them with the sack. If people have not had their first jab by 3 February they will be unable to be fully vaccinated by April, so may I urge her, even at this stage, to come back to the House and reflect on whether threatening people with the sack if they do not get vaccinated is the right policy?

[Maggie Throup]

I completely agree with my right hon. Friend that persuasion is the right way to go. That is why the uptake went up tremendously among care home staff and since we implemented the policy for the NHS the uptake among NHS staff has increased tremendously as well, which is really encouraging. We want it to be a positive choice, and we want people to understand that they are protecting not just themselves and their families but the patients they care for, ensuring that they are safe. Those one-on-one conversations are ongoing to ensure that people understand that, from the perspective of patient safety, this is the right choice to make.

Public Health

Lord Harper Excerpts

Tuesday 14th December 2021 Commons Chamber

[Sajid Javid]

The covid-19 pandemic has caused upheaval across the world, forcing Governments everywhere to wrestle with how to keep their citizens safe while protecting the liberties that we all hold dear. We have learned a lot from our experience and the experience of others, and of course we are still learning. But we can take huge pride that thanks to the defences that we have built, so much of this year has been a year of recovery. We have enjoyed greater freedom than at any time during the pandemic so far. Thanks to the rapid progress of our vaccination programme, our investment in treatments and our decision to open up during the warmer summer months, we are in a far stronger position than we were last winter.

But even as I stood at this Dispatch Box back in July to announce the major milestone of taking step 4 in our road map, I said that

“we know that the greatest risk to the progress we have made is the possibility of another new variant, especially one that can escape immunity and puncture the protective wall of our vaccination programme”.—[Official Report, 12 July 2021; Vol. 699, c. 22.]

We have always known that variants have the potential to knock us off our course, and we have built the capacity to identify and respond to those that pose a threat.

The vast majority of new variants present no risk whatsoever. Since the summer, there have been hundreds of new variants, but only one of them—omicron—has been designated a variant of concern. For example, just last month, I updated the House from this Dispatch Box on AY.4.2, a new form of the delta variant, which preliminary analysis showed at that time might be more infectious. I said then that we would keep it under review, and that is what we did—and we took no action.

But omicron is a grave threat. We acted early to slow its spread, strengthening our testing regime and placing 11 countries on the travel red list, but despite those swift steps, the data over the past few days has shown more cause for concern. I would like to reinforce to the House today—to all hon. Members—why omicron represents such a risk to the progress that we have all made so far together.

[Mr Mark Harper (Forest of Dean) (Con)]

I am listening carefully to the Secretary of State’s comments and am grateful that he has brought these measures before the House. I asked him yesterday whether he would give a commitment at the Dispatch Box to recall the House if the Government had to bring further measures in other than those being proposed today, so that we could be involved on behalf of our constituents in making that decision. He kindly agreed to take that matter away and discuss it with the Prime Minister. Is he able now, at the Dispatch Box, to commit that if the Government were to take further measures to deal with omicron during the recess, they would recall the House of Commons so that we are able to have all the evidence and participate in taking those decisions on behalf of the constituents we represent?

[Sajid Javid]

I of course understand the importance of my right hon. Friend’s question; as he said, he asked it yesterday and, understandably, has asked it again today. I hope he will understand that I am not able to give that commitment alone; it would not be a decision for me and my Department alone, but I know the Government would consider it together seriously.

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[Mr Mark Harper (Forest of Dean) (Con)]

Let me start with a few words about the big picture. My hon. Friend the Member for Winchester (Steve Brine) put this very well. We know that covid is going to be with us forever, and we know that we are going to have variants forever. The chief scientific adviser has told us that, and I agree with him. There are many people who think that we will just have to wait a bit and it will all be over, but that is not happening. We have to be realistic about what we are facing, and according to Jeremy Farrar, we are facing this challenge as probably the best protected country in the world through vaccination.

This was effectively the first big test for the Government: how do we deal with a variant of concern in a very well vaccinated population? I am disappointed that we have quickly gone into panic and emergency mode, with late Sunday night broadcasts—not in the House of Commons where questions can be asked—scaring people witless. For example, they have been told that two doses give them no protection, which is not true. Two doses provide weakened protection from omicron against infection, but they still provide good protection against serious disease. I am concerned that many people out there who have had two doses and who are perhaps vulnerable now feel that they have no protection. That is simply not correct. If this is the first test, I do not think we are doing very well.

[Aaron Bell]

The data from South Africa that we heard this morning in the Science and Technology Committee showed that we still have good protection against severe disease from two doses of Pfizer, but it has gone down from 93% to 70% for hospitalisation. That is four times the risk of hospitalisation.

[Mr Harper]

I have seen that, and I look forward to the information from the UK. The point I have been making in my constant repetition about the House sitting next week or the week after or being recalled—my right hon. Friend the Member for South West Wiltshire (Dr Murrison) also mentioned this—is that we are learning new information every day, and when we get that information, we might need to make different decisions. The House needs to be involved in those decisions; they should not simply be made by Ministers by decree. I repeat that point, and I do not understand why Ministers will not give us that assurance. It would build a lot of trust and good will among colleagues, and I do not understand why they will not give that commitment.

These decisions have significant economic and social impacts, as well as impacts on the NHS’s ability to deliver non-covid treatments. My hon. Friend the Member for Winchester has already pointed out that the NHS is going to scrap a whole load of elective surgeries and consultations with GPs in order to get boosters delivered. That might be the right decision, but I do not think that a proper balancing is taking place. Goodness knows how long it is going to take us to recover from the creation of this new backlog over the coming months. If the Government’s fears, as set out by the Secretary of State, are confirmed in any way, what is the exit strategy? What approach are they going to take to ensure that we do not face on-and-off seasonal restrictions forever? That is a serious question, and it has been raised by other colleagues. We need an economy that functions, people need to build lives that can function and the NHS needs to be able to function and deliver all the other healthcare we require.

Let me turn briefly to plan B. I am happy to support the measures on self-isolation. I simply note that, two weeks ago when we were asked to vote to restrict them, I voted against that. Two weeks later, the Government have agreed that I was right to do so, because they are effectively revoking those earlier measures. I will leave that thought with colleagues for when they decide whether they wish to listen to the advice of Ministers or others.

On vaccine passports, the Government’s plan B makes it very clear that Ministers’ preference is for vaccine-only passports. The only reason why tests have been incorporated is to buy or secure the support of the Opposition. That is the only reason. Ministers’ preference in writing is for vaccine-only certificates, so we know what they would like to do if they could get away with it.

The Secretary of State also made some commitments about not supporting mandatory vaccination for the entire population. The only reason that needed to be said is that, two weeks ago, the Prime Minister put on the table the whole concept of mandatory vaccination and talked about having a “national conversation” about it. All I say is that, if Ministers wish to build trust and good will, they need to be careful about what they say. They should not fling these very troubling concepts around without thinking about them. Words have consequences, both in terms of what happens in the real world and of the trust that needs to be built with Members of Parliament and the public.

What is proposed for vaccine passports is very limited, but that was the case everywhere they were introduced around the world. Everywhere they have been introduced, they have been extended. In Wales, for example, where Labour is in power, they have been extended in terms of the venues to which they apply, so anyone who thinks that Ministers will stick to what is currently on the Order Paper are, I am afraid, kidding themselves.

The final thing I say to colleagues is this: the vote on vaccine passports is not just about the regulations on the Order Paper; it signals how we wish to treat this House, how we wish to be treated on behalf of our constituents, and the direction of travel and the approach. If my colleagues wish to send the Government a clear signal that they need to rethink their approach, then, certainly on vaccine passports, they should vote against them. Send the Government a clear message that we can do better. There is a better way, and we should send that message today.

Covid-19 Update

Lord Harper Excerpts

Monday 13th December 2021 Commons Chamber

[Sajid Javid]

That is not a matter for my Department.

[Mr Mark Harper (Forest of Dean) (Con)]

Mr Deputy Speaker, you will be aware that a couple of days ago the Department of Health and Social Care published something on social media that jumped the gun on the decision the House is being asked to take tomorrow. It is welcome that the Secretary of State intervened, saying:

“No law is decided until Parliament votes on it. I’ve asked for this graphic to be deleted”.

Of course that is not entirely true, because most covid laws, including the mask mandate, have come into force before Parliament voted on them.

This morning the Prime Minister refused three times to rule out further restrictions being imposed before Christmas. I will not ask the Secretary of State to contradict the Prime Minister, but if the Government do decide to announce further restrictions before Christmas, or indeed after Christmas, will he assure me from the Dispatch Box that this House will be recalled to debate and vote on the measures? It is not acceptable to keep governing this country by decree; the Government have to involve Members. I agree with what the Secretary of State said about using Members of Parliament; that means involving us in decisions and getting this House to make the laws. He will then find there is much more of a team approach, rather than decrees and late-night television addresses without taking the House seriously.

[Sajid Javid]

I am not aware of any plans for any further restrictions. As I told the House from this Dispatch Box last week, we are focused on the regulations that are coming before the House and will be subject to the will of the House. We will see if they are approved.

My right hon. Friend asked for an assurance, and I will take that back to my right hon. Friend the Prime Minister.