Terminally Ill Adults (End of Life) Bill

Debate between Lord Harper and Baroness Blake of Leeds

Committee stage
Friday 27th March 2026 Lords Chamber

[Baroness in Waiting/Government Whip (Baroness Blake of Leeds) (Lab)]

Apologies, I was taken by surprise by the lack of an Opposition Front Bench. I thank noble Lords for another important debate on opting into and out of providing assistance and various functions under the Bill. As I have already made clear, I will keep my comments limited to amendments on which the Government have major legal, technical or operational workability concerns.

I first turn to Amendment 189, tabled by the noble Baroness, Lady Fraser. This amendment may give rise to Article 8 ECHR issues, as publishing a register of professionals willing to participate in voluntary assisted dying could expose those individuals to intrusion or a risk to personal safety.

Amendment 657, tabled by the noble Baroness, Lady Fox, seeks to specify:

“The provision of assistance under this Act is not to be regarded as a medical treatment”.


The Government have made no decisions on what a service delivery model would look like. The Committee may wish to note that this amendment may impact the possible service models for voluntary assisted dying by limiting what the Government can achieve through Clause 41 regulations. Clause 41 currently enables the Government to make amendments to legislation, including the NHS Act 2006, to ensure that assisted dying could be delivered as part of the health service, which may require amending or modifying definitions of “treatment” to include assisted dying.

Amendment 664, tabled by the noble Baroness, Lady Lawlor, would allow health and social care professionals to opt out of all training in relation to the Bill.

[Lord Harper (Con)]

I am sorry to interrupt the Minister, but I am grateful that she has allowed me to do so. I want to make sure that I understand correctly what she has just said. I think she just said that, at the moment, the NHS would not be able to deliver this service unless there were some amendments made to make it clear that this was indeed a medical treatment, and it would therefore be necessary to make those amendments to explicitly define it as a medical treatment. I wanted to check I have understood her because, if that is what she is saying, it then opens up the very complex and difficult issues that the noble Lord, Lord Stevens, so ably set out a short while ago.

[Baroness Blake of Leeds (Lab)]

I confirm that it is “may require”: that is the response I wish to give him on that. Again, it is pushing the limits of what I am able to say at this point, in terms of future policy.

[Lord Harper (Con)]

I absolutely accept, as my noble friend Lady Coffey said, that the Minister does not have the policy responsibility, so I am absolutely not going to press her for an answer now. However, it would be helpful if we were to get a written response from the policy Minister that clarifies this point about whether it would be necessary to amend the law so that it was explicitly a medical treatment for the NHS to be able to provide this service. That would be helpful, but I am not going to press her on this. That would be most unfair.

[Baroness Blake of Leeds (Lab)]

I am certainly happy to take the noble Lord’s comments to my noble friend Lady Merron and see whether it is appropriate for her to respond in the way that the noble Lord suggests.

Perhaps I could start again on my response to the noble Baroness, Lady Lawlor. Her amendment would allow health and social care professionals to opt out of all training in relation to the Bill. It would require that, where a health and social care professional agrees to training, written consent must be given. The amendment also creates an obligation to provide official guidance on training in relation to the Bill on the day it receives Royal Assent. The requirement to publish official guidance on the day of Royal Assent may be unachievable, given the work on implementation that must be undertaken before such guidance can be published. It is also unclear how this interacts with other requirements in the Bill, such as the duty to consult various persons before any guidance is issued.

I turn to Amendments 667A and 848C, tabled by the noble Baroness, Lady Hollins. Amendment 667A would require the Secretary of State to make regulations to provide for a specialist register of assisted death practitioners and the criteria for entry in that register. As the Government would begin work on regulations only after the Bill receives Royal Assent, the requirement to make regulations within one month of the day on which the future Act is passed may be unworkable. In addition, significant policy work would be required to understand what a specialty for assisted dying would look like.

Amendment 848C would additionally prevent registered medical practitioners performing functions under the Bill if they are not included on the GMC’s existing specialist register with a primary specialty in geriatric medicine, palliative medicine, medical oncology or clinical oncology. My noble friend Lady Blackstone referred to that. The effect of this amendment would be to exclude clinicians who may have relevant experience and qualifications. This may limit the Government’s ability to design an optimal service.

Amendments 681 and 864, tabled by the noble Lord, Lord Goodman, give rise to two key workability issues. First, they duplicate matters largely covered in Clause 31 and Schedule 3. Secondly, Amendment 681 would introduce a complete right to conscientiously object to taking part in the provision of assistance. This conflicts with Clause 31(7), which contains a small number of duties that cannot be opted out of—for example, recording the cancellation of a first declaration, or passing on or recording information about a person in their medical records, which may be relevant to their eligibility for assisted dying. If a person is able to opt out from participating in any aspect of the Bill, without any exceptions, this may render the Bill unworkable.

I turn to Amendments 668 and 670, tabled by the noble Lady, Baroness O’Loan. Amendment 668 seeks to replace “registered medical practitioner” with “person” in Clause 31(3). This would widen the provision, so that individuals with express statutory duties in the Bill would not be obliged to perform any function under the Bill. This would include, for example, the Secretary of State, Welsh Ministers, the assisted dying commissioner and members of an assisted dying panel. Allowing opt-outs for these roles could make the Bill unworkable. Amendment 670 also seeks to provide an opt-out for ancillary functions, such as administrative tasks or the supervision of staff. This could broaden the range of activities that a person can refuse to carry out and give rise to significant operational issues.

Amendment 679, tabled by the noble Baroness, Lady Grey-Thompson, could limit the places where assistance could be provided. It could, for example, preclude access to an assisted death for those residing in some private hospices or care homes. The Committee may wish to note that this amendment may result in inconsistent treatment for patients when seeking to access an assisted death and could give rise to Article 8 ECHR issues, unless a reasonable and objective justification were provided.

As noble Lords will be aware, the other amendments in this group have not had technical drafting support from officials. The issues raised by these other amendments are rightly matters for noble Lords to consider.

To respond to the direct question from the noble Baroness, Lady Berridge, no civil servant working on the Bill was put under any pressure to work on it.

In response to the noble Baroness, Lady Smith of Newnham, policy decisions regarding opt-outs within the Bill are for the sponsor. However, once legislation is passed, the Government as a whole are expected to implement it. If an individual had an objection to working on assisted dying policy due to a personal conscience objection, issues would be handled case by case, through discussion.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Harper and Baroness Blake of Leeds

Committee stage
Friday 13th March 2026 Lords Chamber

[Baroness Blake of Leeds (Lab)]

As always, my noble friend raises an important point. I will go on to talk about the whole issue of substances, so if I do not address the points he raised, I will be happy to speak or write to him afterwards to make sure that he has had the clarification he requires.

[Lord Harper (Con)]

I want to press the Minister a little for an answer, not necessarily this minute, on the point that my noble friend Lord Deben makes. It is perfectly proper for matters of genuine detail to be dealt with after Parliament has passed primary legislation; there are many pieces of legislation where we do that. However, there are quite a lot of issues which are not set out in the legislation—this is part of the concern that the Delegated Powers Committee set out—and they are not, by any stretch of the imagination, details. They are fundamentally important issues around, in this case, the substances. Can the Minister therefore take away the idea that if the Government cannot answer on some of these really big issues that are left not set out in the legislation, it will make it incredibly difficult, even for people who support the principle of the legislation, to support it in practice? It would be more helpful if, on these bigger issues, the Government could set out what their position is.

[Baroness Blake of Leeds (Lab)]

I just reinforce to the noble Lord that it would be completely wrong to pre-empt the decisions of Parliament—I am sure he is fully aware of that. I just want to give reassurance that, across all these issues, evidence would be considered in the usual way in considering the substances to be used should the Bill pass. I think I have been exceptionally clear on this, and we need to move forward.

Given the size of the group, I reaffirm that it would be impossible to address each amendment specifically, but the broad thematic workability concern is that the use of unclear and ambiguous language could result in unworkable duties and increased risk of legal challenge.

I turn to amendments tabled in relation to the regulation of approved substances and clinical trials. Many of these amendments are policy choices and are therefore a matter for the sponsor and for Parliament. However, noble Lords may wish to note that many of these amendments also introduce new concepts that would require significant work to ensure the policy intent is clearly understood and that they are coherent for the rest of the Bill. I draw noble Lords’ attention to a number of amendments where the Government have major workability concerns.

Amendments 701 and 713, tabled by the noble Baronesses, Lady Grey-Thompson and Lady Hollins, relate to clinical trials for approved substances. First, these amendments could delay implementation of the Bill until a clinical trial or evidence-gathering study is completed, which could make implementation within the four-year timeframe difficult. Noble Lords may wish to be aware that these amendments could create workability concerns relating to the ethical and regulatory challenges for clinical trial processes for approved substances.

Hospitals: Delayed Discharges

Debate between Lord Harper and Baroness Blake of Leeds

Monday 9th February 2026 Lords Chamber

[Baroness Blake of Leeds (Lab)]

I am grateful to my noble friend. I am particularly grateful as I was very active in Leeds, which has a practice going far back that is recognised as one of the foremost in the country in terms of the Home First model. I am delighted to say that it has been picked up by others. Bringing together all the agencies that we have discussed before helps in that process. The early indications are good: a 28% reduction in length of stay and a 7.1-day reduction in rehab. All those elements are critical. It is possible to do this, and we need to replicate good practice wherever we find it.

[Lord Harper (Con)]

I am grateful to the Minister for allowing me in at the end. She has mentioned the independent commission of the noble Baroness, Lady Casey of Blackstock. I may be the only Member of your Lordships’ House who is somewhat surprised to know that the noble Baroness is the only commissioner on this independent commission; there are no others. Given that her name is once again being linked with some vacancies arising at the centre of government, could the Government perhaps appoint some more commissioners to make sure that the independent commission is a bit more resilient?

[Baroness Blake of Leeds (Lab)]

I always look forward to the noble Lord’s questions. I do not think I have an answer to his question at this moment in time, other than to say that the noble Baroness, Lady Casey, is absolutely determined and committed to this work, and we will do everything we can to support her in it.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Harper and Baroness Blake of Leeds

Committee stage
Friday 23rd January 2026 Lords Chamber

[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.

--- Later in debate ---

[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.

[Lord Harper (Con)]

That is extraordinary.

[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.

Northern Powerhouse Rail

Debate between Lord Harper and Baroness Blake of Leeds

Monday 19th January 2026 Lords Chamber

[Baroness in Waiting/Government Whip (Baroness Blake of Leeds) (Lab)]

May I remind noble Lords that this is an opportunity to ask questions of the Minister? Can we keep comments succinct? There is plenty of time for everyone to get in if we all keep our questions sharp, so that he can answer them.

[Lord Harper (Con)]

My Lords, I am grateful to the Minister for recognising the success of the trans-Pennine route upgrade—which was, of course, started by the last Conservative Government, when a lot of significant work was done. The Minister also had responsibility for that in a previous role.

I have two specific questions. Is the £45 billion pound cost envelope that the Minister mentioned calculated in 2026 pounds, or is it going to be uprated for inflation? That is a very important question, given the length of time HS2 has taken and the significance of that. Secondly, is the delivery authority for the Northern Powerhouse Rail project going to be GBR?

NHS Industrial Action

Debate between Lord Harper and Baroness Blake of Leeds

Tuesday 2nd December 2025 Lords Chamber

[Baroness Blake of Leeds (Lab)]

I am very sorry to hear of the noble Baroness’s unfortunate experience and pleased to see her back on the Benches, fighting her corner. This is absolutely the backbone of what this Government intend to do. We knew when we came into government that standards had slipped. The pressures on medical staff have been enormous and it is our job to transform the service. That is what we have put in place.

[Lord Harper (Con)]

My Lords, I listened very carefully to the excellent question from the noble Lord, Lord Spellar, but I was astounded by the Minister’s answer. I think I heard correctly that she talked about modernising the trade union regime. In the Employment Rights Bill, the Government are going to make it easier—less difficult—for trade unions to call strikes on a lower turnout. That is going to make the situation worse, not better.

[Baroness Blake of Leeds (Lab)]

We beg to differ completely with the noble Lord. We believe our Employment Rights Bill is the way forward. It will improve industrial relations and make sure that we have workplaces that are fit for purpose as we move forward through this century.

Independent Commission on Adult Social Care

Debate between Lord Harper and Baroness Blake of Leeds

Wednesday 17th September 2025 Lords Chamber

[Lord Harper]

To ask His Majesty’s Government what steps they are taking to ensure that the Independent Commission on Adult Social Care gives due consideration to the needs of working-age adults to live as independently as possible.

[Baroness in Waiting/Government Whip (Baroness Blake of Leeds) (Lab)]

My Lords, we have made it clear in the independent commission’s terms of reference that its chair, the noble Baroness, Lady Casey, must consider older people’s care and support for working-age disabled adults separately, recognising that services meet different needs. It is, of course, for her and her team to independently consider how to build a social care system fit for the future. The commission will first report in 2026, with phase 2 to follow by 2028.

[Lord Harper (Con)]

I am grateful to the Minister for her Answer. The reason I ask the Question is because, understandably, when this debate on social care takes place it almost inevitably focuses entirely on the needs of older people, whereas almost half of public expenditure on long-term care is on those of working age. I want a system where social care works well with the employment support system and personal independence payments to make sure that people who can work are able to do so. When the Government engage with the commission, whether through Ministers or officials, can they reiterate the importance of focusing on the needs of working-age adults so that they can live independently and work where they are able to, and that we end up with a system that is fit for purpose?

[Baroness Blake of Leeds (Lab)]

The noble Lord raises an incredibly important point; I would expect as much from his background in this area. It is fair to say that local authorities spend more than 50% on the working-age demographic, but he is absolutely right that the main focus—the news interest—tends to be on older adults. I reassure him that our Government will look at all the issues, and enabling people to get back into the workplace and stay there is absolutely critical. The most important thing about the review of the noble Baroness, Lady Casey, is that it will be inclusive. She has already held a cross-party meeting, and there will be ample opportunity for all Members to ensure that their voice is heard.