Assisted Dying Bill [HL]

Debate between Baroness Brinton and Baroness Finlay of Llandaff

Friday 16th January 2015 Lords Chamber

[Baroness Finlay of Llandaff]

Before the noble Baroness finishes, will she acknowledge that, quite often, when patients do not undergo further intervention and further treatments they dramatically improve? Indeed, a very good study from America showed that where people had early palliative care, not only was their quality of life better but they lived longer. They were having fewer interventions, not more. The difficulty with all this is that conditions fluctuate. Patients at one point in time cannot believe that they could improve. It is often stated by patients, when their symptoms and their distress are under control, “I never believed I could feel this well again”. When they are in that trough, they are of course inclined to believe that it will go on for ever and that they will go on going downhill and therefore want to curtail their lives.

[Baroness Brinton]

I accept the noble Baroness’s premise that it is vital for medical practitioners to set things out. As I have said, the counterargument to that is that data from Oregon and some other states in America show that people do not make the decision and implement it immediately. There is always a timescale, because I believe that, intrinsically, most people really hope that things will improve.

When the measure has been used in America, it has usually been because there has been such a downturn, when medical practitioners have said to the patient that they cannot help them further. I understand that there will be some people for whom they are seriously concerned and may want to turn to it, but I would also think that a medical practitioner would ask them whether they are depressed at that particular moment and whether it is the right time to make that decision. This Bill allows the practitioner to say, “I don’t think you’re ready for that decision at this particular time”.

I want to say why I believe that the amendment in the name of the noble Baroness, Lady Finlay, is a tripwire. I have been on a series of drugs for my particular condition. My local clinical commissioning group insisted that I went on a drug knowing that it would not work particularly well for me, but would not allow me to have treatment afterwards if I did not have that drug. For six months, I had the drug and it is one of the reasons why I am in a wheelchair, because my condition deteriorated. My worry about the amendment is that it is such a tripwire and could be used to cause real distress to people who are quite clear that they do not want further treatment. To use that to prevent them getting any other treatment or making their own decision seems intrinsically wrong.

[Baroness Finlay of Llandaff]

My Lords—

Serious Crime Bill [HL]

Debate between Baroness Brinton and Baroness Finlay of Llandaff

Tuesday 28th October 2014 Lords Chamber

[Baroness Brinton (LD)]

My Lords, when I was chair of education in Cambridgeshire some 20 years ago, it was brought home to me very starkly how the lack of mandatory reporting had allowed a caretaker to abuse children in a school over a 16-year period. It was not taken seriously at any point over that time when parents, or even some of the children, reported concerns. Had that system been in place—even the first report—the head would have been under a requirement to force a proper inquiry. As a result, this man’s actions would have been curtailed and a large number of children would not have been subsequently abused.

Even though that happened some time ago, the problem still continues. We have heard from the right reverend Prelate the Bishop of Durham about some of the larger cases at the moment. I should have declared an interest: I am a trustee of UNICEF. I echo the point of the right reverend Prelate that if we are talking about mandatory reporting for female genital mutilation, which is a form of child abuse, we should also be considering it for wider child abuse as well.

Another point that has been raised outside the Chamber refers to concerns felt mainly by professional psychotherapists about an exemption in their treatment of perpetrators of child abuse, or would-be perpetrators, under the normal terms of confidentiality if there is a requirement to report. The exemption is in proposed paragraph (8) of the amendment. It quite specifically says that it is possible for a person to have that exemption. We need to reassure professionals that important work such as that should be one of the few exemptions allowed to continue without further report to the law.

I want to raise a more topical concern. Much has been said about the Jay report and what has been happening in Rotherham and subsequently in Sheffield and other places. I am very concerned that yesterday UKIP published a photograph showing a young girl who might be deemed to be a victim of abuse while the headline said something like, “1400 reasons why you should not vote Labour in the PCC election” .

Frankly, UKIP’s hypocrisy is breathtaking. Its record on tackling serious child abuse is disgraceful. The only record of the noble Lord, Lord Pearson of Rannoch, asking Questions about child abuse is on 13 October this year, after the by-election was called, and he has been in this House since 1990. Even that Question was focused entirely on the UKIP obsession with Muslims, ignoring the fact that child abuse happens in all areas of the country and is not exclusive to any culture, community, race or religion.

However, it is not just UKIP in the Lords. In the European Parliament, its Members abstained in a vote to strengthen legislation about sexual abuse and the sexual exploitation of children and child pornography. Further, UKIP’s candidate in the Croydon North election in 2012, Winston McKenzie, said that gay adoption was child abuse. Gordon Gillick, a UKIP Cambridgeshire councillor, told a meeting of some children in care that they were takers from the system and wanted to know what they would give back to society. As we have heard, many children in care are the most vulnerable to grooming and abuse.

We need to have an honest and open debate about child abuse but it is completely inappropriate for a party that has not taken it seriously, even within its own actions when it threw out a paedophile and allowed that person to come back to receptions, particularly those with young UKIP members. We need to make sure that UKIP—it offers a policy of making sure that children are safe—can deliver that by having safe policies itself. I do not believe that the evidence is there.

Finally, I am also grateful for our discussions with the Minister on this. I hope that he will be able to offer reassurance to those of us who want a public debate and public consultation about the mandatory reporting of child abuse. I look forward to his response.

[Baroness Finlay of Llandaff (CB)]

My Lords, I have put my name to the amendment and support it strongly. Current child protection systems, which rely upon voluntary reporting, simply are not seen to be working effectively. There is ongoing underreporting of suspicions of abuse or neglect by professionals working with children. Why might this be? It is worth looking at previous studies, which have suggested that barriers to reporting include the professionals’ own values and attitudes—for example, over the acceptability of physical punishment—and confusion over the thresholds for reporting. Professionals may be worried about issues of confidentiality and the potential impact on their relationship with the child and the family.

The current position for someone reporting is that they may, in effect, feel that they are being a whistleblower on a situation that they feel uncomfortable about. Professionals may fear the consequences and the potential impact on their reputation, leading to further hesitation. Reporting a suspicion that turns out to be unsubstantiated should not be a disciplinary matter for professionals, however distressing for those involved. There is a balance of harms here, and the need to protect vulnerable children should be paramount.

I should like noble Lords to think for a moment of the situation of a GP who is seeing people on 10-minute appointments, and who may know a family, see a child, have some concerns but be unable to put a finger on it. At the moment, the hesitation to report remains there. Other pressures of work come in. I must declare an interest here. When I was a GP, I looked after children in a children’s home and became convinced that something was not right. I went to the authority in whose area I was working but we did not get anything specific to happen. I would go out to the children’s home whenever there was a request for an appointment so that I would see the children on their own territory. I tried to see the children on their own when they were referred for a sore throat, sore ear or whatever. I had this nagging suspicion that something was wrong but I could not pin it down anywhere. All that I can say is that the Christmas after my suspicions began to become aroused the children themselves burnt the home down, which confirmed to me that my index of suspicion was right. However, I had no clear evidence on which to report that abuse was going on, although I was suspicious. I would have welcomed having to report that suspicion because it would have allowed me the freedom to state, “I have a really uncomfortable feeling here”, without feeling that I had to accrue the evidence.

That is my personal experience and where I have come from with it. That is why I stand separately from my professional body, the BMA, which has reservations about this amendment. It is concerned that a degree of professional discretion is required to ensure that doctors can take account of an individual’s circumstances and always act to ensure the protection of a patient. My experience suggests that that is incredibly difficult.