Lord Wilson of Sedgefield debates involving the Department of Health and Social Care during the 2024 Parliament

Terminally Ill Adults (End of Life) Bill

Lord Wilson of Sedgefield Excerpts
Friday 24th April 2026

(3 days, 5 hours ago)

Lords Chamber
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Baroness O'Loan Portrait Baroness O'Loan (CB)
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This Bill seeks to provide for individuals to be provided by doctors with fatal drugs to kill themselves. Where those patients cannot self-administer, Clause 25(8) says that

“the coordinating doctor may … assist that person to ingest or otherwise self-administer”

the drug. We have not yet debated this clause at length, but it does raise the spectre of Dr Shipman. What protection is there against a Dr Shipman in these circumstances? What protection exists for those who may be subject to coercion, which will not be identified because of virtual assessments—for example, where the assessing doctor is not in the room with the patient or has no way of knowing who else is there or what is going on? These things had to be identified and discussed and amendments tabled to address them.

In the course of our debates and through the submission of evidence to the Committee, we have identified multiple other serious problems. On many of them there was no engagement by the sponsor, as the noble Baroness, Lady Hollins, said. Following clearly argued criticisms, the noble and learned Lord has accepted a long number of problems with the Bill. However, there are virtually no amendments to address those issues. The legal definition of persons exerting pressure must expressly include bodies corporate, to uncover institutional or organisational abuse. Think of the pressures of bed-blocking and budgets in the NHS.

Regrettably, many of the amendments that the noble and learned Lord tabled weaken safeguards for which the MPs voted—such as explicit domestic abuse training or the mandatory independent advocate presence—under the guise of tidying up the Bill. Often these would save the Government money. The Government’s impact assessment reveals that it almost halves the cost of the assisted dying process if independent advocates or translators do not have to be present. There was provision for independent advocates to assist those who have substantial difficulty in understanding the process. Under the noble and learned Lord’s amendments, the advocate does not have to be physically present during medical assessments—and a person is allowed to entirely waive their right to an advocate.

It is perhaps paradoxical and dangerous to expect someone who qualifies for an advocate, precisely because they struggle to understand information, to independently decide to waive that very protection at the outset. The advocate is introduced only after key clinical and eligibility assessments have been completed, rendering them a box-ticking process. Think of the more than 100 languages spoken in England and Wales and of the problems of people with hearing difficulties, articulated by the noble Baroness, Lady Nicholson, and other communication difficulties.

Doctor-shopping possibilities have expanded as a consequence of the noble and learned Lord’s amendments. Let us be very clear. As is appropriate, our debates have ranged over a large number of issues. We have considered the effect on the NHS, the necessity to revise the NHS constitution, and the effect on practitioners who did not join their professions to kill people and who need protection against involvement. We have yet to debate the existing conscience protection provisions, but we know that they are inadequate. The BMA and the royal colleges asked for an explicit opt-in model, which was rebuffed multiple times in the Commons. The noble and learned Lord finally acknowledged the concern, but his Amendment 669A introduces an opt-in requirement only for training, not for assisted dying as a whole.

The Bill provides some protection for professionals but not for all the other people who enable our NHS to work—the administrators, the porters, the cleaners. The current option of going to an employment tribunal if facing disciplinary action in the context of an unwillingness to engage in any way in assisted dying is just not satisfactory. People need their jobs to pay their rent or mortgage, to feed their children. A system-wide opt-in model is the only way to protect staff from institutional pressure, yet the noble and learned Lord drew the line at protecting administrative staff, to ensure that the NHS runs properly.

Too many issues that should be debated fully in this House are to be left to secondary legislation, which Parliament can only accept or reject but not amend—for example, the approval of lethal drugs and the provision of assisted suicide services in England and Wales, which the DPRRC has said should be removed.

We talk of democracy, yet there is nothing democratic about handing sweeping powers to Ministers rather than to Parliament. There are those who, like me, believe that all life is sacred and to be protected, from conception to natural death. That has not been the subject of our debates over these months. As legislators, some with a religious faith and some with humanist beliefs or maybe no beliefs, we have been through this Bill word by word and clause by clause to see whether it can be improved. We have identified the massive inadequacy in the provision of specialist palliative care and the consequences of that inadequacy; the disparity of access to hospice care; the unique identity of hospices in providing a safe place to live and die without pain and at peace; the huge trust that is fundamental to the doctor-patient relationship in places in which people live and die; and the potential consequences if the Bill is passed for private and public funding arrangements for hospitals and the NHS.

Lord Wilson of Sedgefield Portrait Lord in Waiting/Government Whip (Lord Wilson of Sedgefield) (Lab)
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The noble Baroness has spoken for over 11 minutes and it is supposed to be 10 minutes. Can she bring her comments to an end?

Baroness O'Loan Portrait Baroness O'Loan (CB)
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I am bringing my comments to an end.

We have tabled amendments to provide some protection for the vulnerable, the weak, the poor, the disabled, the sick, those with suicidal ideation, those with mental health problems and all those whom we have identified. Many of us have concluded that this Bill is not safe and have worked to try to make it safer. As I conclude, I pay tribute to those living with serious illness and disabilities; people such as Pete and George, who have attended every day of our debates and who sit behind me; and all those—

Lord Wilson of Sedgefield Portrait Lord Wilson of Sedgefield (Lab)
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Can the noble Baroness please bring her remarks to an end now? It is nearly 12 minutes and other noble Lords want to speak.

Baroness O'Loan Portrait Baroness O'Loan (CB)
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The 12 minutes include the interruptions I have suffered.

I pay tribute to all those who have written to encourage us as we fulfil our duties as legislators in your Lordships’ House in scrutinising this flawed and very dangerous Bill.

Lord Young of Norwood Green Portrait Lord Young of Norwood Green (Lab)
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My Lords, I have not spoken in this debate before, but the contribution of the noble Lord, Lord Pannick, last week made me want to do so. He reminded us that:

“Nobody could say that a doctor can tell you that you will die within six months. But the Bill does not so provide. Its conditions require only that the doctor, and the panel in due course, are satisfied that … the person has an inevitably progressive illness or disease which cannot be reversed”—

Lord Wilson of Sedgefield Portrait Lord in Waiting/Government Whip (Lord Wilson of Sedgefield) (Lab)
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The noble Lord is not down as having been present at the beginning of the debate last week.

Lord Young of Norwood Green Portrait Lord Young of Norwood Green (Lab)
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My name was on the list. I checked last week and my name was on there.

None Portrait Noble Lords
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Let him speak.

Lord Wilson of Sedgefield Portrait Lord Wilson of Sedgefield (Lab)
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If it is the will of the Committee to hear the noble Lord speak, then fine.

Lord Young of Norwood Green Portrait Lord Young of Norwood Green (Lab)
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Thank you. I checked before I left, so I am puzzled.

The noble Lord, Lord Pannick, referred to situations where, as set out in the Bill,

“‘the person has an inevitably progressive illness or disease which cannot be reversed … and … the person’s death in consequence … can reasonably be expected within six months’”.—[Official Report, 30/1/26; col. 1261.]

We know from all the evidence we have heard that trying to predict when someone will die is not a precise science, but that is not really the point of this Bill. It is about ensuring that people have a right to choose and are doing so in circumstances where we can feel reasonably confident that safeguards are there.

I look at the safeguards in the Bill, and this is a very cautious step forward:

“Initial request for assistance: first declaration … Witnessing first declaration … First doctor’s assessment … Second doctor’s assessment … Doctors’ assessments: further provision”.


Some noble Lords are speaking as though we have just one doctor, who may not be very mature or experienced. That is not the case in this Bill. It is much more careful and cautious. The noble Baroness, Lady Jay of Paddington, reminded us last time that

“one of the international facts that supports entirely the position he is taking is that, in the … 33 jurisdictions where assisted dying is allowed, it is usually the case—I cite one or two—that, following that suggestion by a doctor, or prognosis or however you want to describe it, over a third of those who make the choice he has described then do not use the provision … There is no question that they want to die; they are simply using it almost as an insurance policy”.—[Official Report, 30/1/26; col. 1262.]

I understand that there is a real difference of opinion in this House. Some feel that, if we make this step forward—I listened carefully to the noble Baroness, Lady O’Loan—without putting more things in the Bill, it will be unsafe. I do not take that point of view. We are giving people, as the noble Lord, Lord Pannick, said, the right to choose. That may not accord with the views of all noble Lords. Others want us to take into account degree of suffering and all sorts of circumstances, but I do not accord with that. I take the view that we in this House are trying, with some difficulty, to ensure that we have a Bill that gives people the right to choose and has significant safeguards. Can it guarantee that we can tell people exactly when they will die? Of course not. Minister Wes Streeting announced recently that we will make significant improvements in cancer treatment, which will change people’s lives fundamentally. On those grounds, I hope the House will continue to support this Bill.

Lord Shamash Portrait Lord Shamash (Lab)
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My Lords, can I address the Committee on a personal note? My late brother-in-law suffered from muscular dystrophy, a horrendous progressive disease that many noble Lords may have come across. In the last years of his life, he was pushed around in a wheelchair. It was very difficult for the family, particularly for my wife, his sister.

Lord Wilson of Sedgefield Portrait Lord Wilson of Sedgefield (Lab)
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Order. The noble Lord is not on the list. He was not there last week and should therefore not be taking part.

Lord Shamash Portrait Lord Shamash (Lab)
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Is the Committee prepared to hear me?