Terminally Ill Adults (End of Life) Bill (Fourth sitting)

Sarah Olney Excerpts

Wednesday 29th January 2025 Public Bill Committees

[The Chair]

Dr Griffiths, do you want to add to that?

Dr Griffiths: This issue highlights a fundamental flaw with the Bill, which is the nonsensical division between a terminal illness and what constitutes being a disabled person. Section 6 of the Equality Act 2010 states that a disabled person is somebody who has a “physical or mental impairment” and the impairment

“has a substantial and long-term adverse effect”

on their

“ability to carry out…day-to-day activities.”

If you have a terminal illness, it is likely that you will be defined within the terms of what is outlined in section 6, so it is a fundamental flaw, because disabled people will be incorporated within this.

The issue also highlights this arbitrary nonsense about a six-month perspective. What constitutes six months left to live, particularly if you are engaging with technological devices, medical assistance and so on? For example, I have a progressive condition that continuously makes me weaker and has respiratory complications and so on. If I remove the ventilator that I use at night, if I remove my other medical devices and if I stop my engagement with therapeutic services, does that constitute me having a terminal illness, because my rapid acceleration towards death becomes more evident?

These concerns highlight fundamental flaws, but they also play into what a key issue: the campaigning that will continue after the Bill, if it is to succeed. You will get people who will say, “Why not five months, or seven? Why not other conditions that are not being highlighted in our current discourses?”

[Sarah Olney (Richmond Park) (LD)]

Q Dr Griffiths, do you think it is possible that disabled people are likely to be or potentially more at risk of being coerced or otherwise persuaded to seek assisted dying as a result of the Bill?

Dr Griffiths: I think so—I think the coercion principles outlined in the Bill are incredibly weak in terms of the scrutinising and the process of how you judge whether coercion has taken place. We know that coercion is a complex issue, but put that against the context of disabled people’s lives; we are talking about disabled people who are struggling day to day to access sufficient support and to live in participatory, accessible societies. The feeling, then, of societal coercion—the feeling that this is a tolerable idea—highlights my concerns about coercion.

It also plays into the issue of support and assistance to understand what your rights are, not just in terms of what we are talking about here but broader disabled people’s rights. There is a lack of advocacy services available to disabled people, and there is a lack of support for disabled people to have accessible information about their rights. If you feel that assisted dying is your only choice—as opposed to accessing support or calling out discriminatory practices in, say, access to social care and healthcare—that highlights, again, situations where coercion will manifest. The infrastructure to support people either to respond to coercion, or to understand that they do not have to be in that position in the first place, is non-existent.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

Q One of the things that we have heard from other countries that have assisted dying is that this is one of the strongest and most robust laws. I wonder whether Professor Shakespeare has any more views on how we could make the Bill even tighter, and provide support and further peace of mind to people who might be worried about it?

Professor Shakespeare: When I read the Bill, I thought that it did have many safeguards. It has, for example, five opportunities for a conversation with doctors or other supporters. That is a good safeguard. I think it makes a criminal offence of dishonesty, coercion or pressure, so that would scare off people. Miro is quite right—there are people who might put influence on somebody, but I hope that they would be covered under clause 26 as having committed an offence. That would scare people who may have a particular view against assisted dying.

How can we make it stronger? We could have more of an advocate for the person who is requesting assisted dying—somebody who will support them, within the law, to make that decision or to think about their decision. We are trying to make sure that everybody who is thinking that this is for them has the opportunity to talk about it and to think about it. The time and the conversations are all about that, but maybe an advocate also would be the person who is requesting this step, who is not a beneficiary in any way of that death, and they could be a neutral party to give advice. I am not sure. However, there is a lot here. There are five conversations. I am not surprised that people thought it was strong. I think it is a strong Bill.

There is scope for doctors and other medical practitioners to act on their conscience and to withdraw from this. Miro made a useful point, which is that we do not want any disabled person frightened of their doctor or worried that their doctor, who has been supporting somebody else to die, might do that with them. In conversation, Marie, we have talked about an assisted dying service as being a part of the NHS, but I wonder whether it might be specifically around this. I think that it is worth considering whether the average doctor is the person to whom a person should take a concern or a wish to die.

So this is about advocacy and maybe having a specific service for people who want to go down that route. However, I think it is a strong Bill as it stands.

Health and Social Care: Winter Update

Sarah Olney Excerpts

Wednesday 15th January 2025 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right. May I, through her, thank health and care staff in her city for the work they are doing to get the people of Birmingham through this particularly challenging winter? What we really need to do to make our health and care system more effective and more sustainable is shift the centre of gravity out of hospital and into the community. We need better and faster access to diagnostics and treatment, as well as a bigger focus on prevention—primary prevention to keep us all healthy and active, and secondary prevention so that fewer people need to call on health services, and particularly emergency departments, which are stretched at this time of year.

[Sarah Olney (Richmond Park) (LD)]

I was pleased to hear what the Secretary of State said about vaccine roll-out, particularly of the RSV vaccine. I am even more pleased that my constituents in Richmond Park are diligent in taking up all vaccines, but they have been puzzled to find that the RSV vaccine is limited to those between 75 and 79 years of age. What plans are there are to extend the roll-out to those aged 80 and above?

[Wes Streeting]

I am grateful to the hon. Member for her question and for showing off her constituents’ uptake—that is exactly what we want. Perhaps ahead of next winter, we should launch a parliamentary competition: who can boost uptake most in their constituencies? We will think about the prize.

More seriously, I am always glad when the pressure is to expand access to vaccines—that is exactly the sort of pressure that we want. We follow advice from the Joint Committee on Vaccination and Immunisation. We will review the experience this winter, and the JCVI will review evidence and data this winter and make recommendations, which we will take into account.

Oral Answers to Questions

Sarah Olney Excerpts

Tuesday 19th November 2024 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

The UK rare diseases framework aims to improve the lives of people living with all rare diseases. I am more than prepared to meet my hon. Friend to look at the adequacy of support available to people with Usher syndrome.

[Sarah Olney (Richmond Park) (LD)]

T8. Last Friday, I met GPs at the Fairhill medical practice in north Kingston in my constituency. They have told me that the increase in national insurance contributions will add £50,000 a year to their costs. Can the Secretary of State tell me whether GPs can expect to see an across-the-board cut in the NICs payable by GPs to help them manage to continue delivering services for families in the area?

[Wes Streeting]

We have not yet announced allocations for general practice for the year ahead, and we are taking into account all the pressures that general practice is under.

Government Policy on Health

Sarah Olney Excerpts

Monday 9th September 2024 Commons Chamber

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat Front-Bench spokesperson, Sarah Olney.

[Sarah Olney (Richmond Park) (LD)]

The Liberal Democrats find it deeply ironic that the shadow Health Secretary has raised this question on the involvement of people with no formal appointment in the development of Government policy. Are they forgetting their record in government? Perhaps we should remind everyone that, under the Conservatives, it was their friends that benefited from large contracts to supply the Government during the covid pandemic. The result is that, just today, as the hon. Member for Eltham and Chislehurst (Clive Efford) has already highlighted, Transparency International UK has revealed multiple red flags in more than 130 covid contracts totalling over £15.3 billion. With the Conservatives out of power, we have the opportunity to clean up our politics, so will the Secretary of State update the House on whether the Prime Minister plans to appoint his own ethics adviser or whether Sir Laurie Magnus will remain in the post? Will the ethics adviser be empowered to initiate their own investigations and publish their own reports?

[Wes Streeting]

I am grateful to the hon. Member for her serious contribution. She is right to say that transparency matters. That is why meetings in my Department, and their attendees, will be published in the right and proper way on a quarterly basis.

It is also right to draw a distinction between those areas of business and meetings in the Department that are about generating ideas and policy discussion, and those that are about taking Government decisions. It is right that people from outside government come into the Department for Health and Social Care, or any Department, to lend their expertise and share their views, and it is right that Ministers make decisions absent of those outsiders. That is the distinction I would draw. The hon. Member raises a specific point about the Prime Minister’s ethics adviser. This is a Prime Minister who does take ethics seriously and will not behave in the way that his Conservative predecessors did. As for individuals, that is a decision for the Prime Minister, but I will ensure that the hon. Member gets a more fulsome reply.