Terminally Ill Adults (End of Life) Bill

Baroness Burt of Solihull Excerpts

Committee stage
Friday 24th April 2026 Lords Chamber

[Baroness Berger (Lab)]

I can reiterate only what I said in previous meetings about having specifics. I do not know which, if any, of the 1,000 amendments—some of which were tabled just the night before and we had to understand them in detail—my noble and learned friend was prepared to accept. I have looked very closely at the communications that I have received, and there have been some indications on two of the measures, but on everything else we have not received that.

I have taken a number of interventions. In conclusion, I will just address one issue that has been raised. The accusation has been repeatedly made, last weekend and this morning, that religion has been driving opposition to this legislation. There are Peers of all faiths and none who have participated in your Lordships’ House and raised concerns. The objections that I and many others have to the Bill are not doctrinal; they are rooted in the real-world consequences the Bill may have for those whom we have spent years striving to represent—in my case, drawn from my direct experience as a Member of Parliament for almost 10 years—including people who do not have the same amount of agency or resources that all in this place are fortunate to enjoy.

I conclude by saying that to insist that we should have glossed over this legislation that will hand the state the ability to end the lives of some of its most vulnerable citizens, ignoring the evidence that we have heard, and a Bill that no professional medical royal college in this country today says is safe, has been a misguided approach.

[Baroness Burt of Solihull (LD)]

My Lords, I cannot tell you how disappointed I am to see this important Bill come down to this. I feel very strongly for the sponsors, as well, over some of the accusations that have been made here. I am not a medical or a legal specialist, but I am going to take just two minutes to make one point.

Despite being given the extra time that we have had, we are faced with a Bill that has not now been properly considered. A great opportunity has been wasted for a very small number of noble Lords to go to the extreme point. I am no stranger to this: I have had several Private Member’s Bills on schools lost for the only reason that they ran out of time.

It is clear to me that the Private Members’ Bill is not suitable for purpose, and this is better highlighted nowhere than here today. The difference is that this started in and passed the House of Commons, so it already has the approval of the House, and not just this House but the proportion of the British public who support it. They can see that the tactic of delay and manipulation is wrong, so I suggest that the Member system should be revised; it is not allowed to play with a Bill that has the clear will of the House—and I believe the collective House, although we never had the opportunity to test that.

However, looking past the non-passage of this Bill, those who took part in its fall have taken away the opportunity, and surely the right, of a painless death if that is a patient’s wish. I hope that the elected House will involve the Parliament Act and stop making the perfect the enemy of the good.

[Baroness Cass (CB)]

My Lords, this debate seems to have characterised everyone in the House as being either supporters or opponents of the Bill. I declare myself somewhere in the middle, and I suspect that there are many others who fall into that category who may have been quieter.

Following the views of the noble Baroness, Lady Harding, I have tried to keep my contributions to two or three minutes every time I have spoken—except once, when I spoke at a greater length to describe what I felt would be a more efficient, effective and safe medical model for delivering what this Bill promises. I have tried to engage in good faith with the sponsors of the Bill, both here and in the other place, to work with them and look at how a shorter and less onerous but safer process might work. This is difficult to do by amendment, however, when one starts from the point of having to make changes to a process which does not seem to fit with the natural patient journey.

When a Bill comes back to the House, I hope it may be possible that it starts from something we talk quite a lot about in the NHS: co-production. That is where we build the blocks upwards, with medical professionals and service users getting together to think about how a viable process might work in the NHS, and lawyers getting together to look at how this could proceed in an effective legal model, and so on for other experts. Rather than starting with pre-legislative scrutiny, as suggested by my noble and learned friend Lady Butler-Sloss and the most reverend Primate the Archbishop of Canterbury, we could start before it with building blocks to create legislation to which people with experience have contributed. That would gain the confidence of all the relevant professional bodies and, most importantly, the people who will benefit from it as patients.

Midwives: Graduate Guarantee

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Tuesday 21st April 2026 Lords Chamber

[Baroness Merron (Lab)]

Again, I refer to the forthcoming 10-year health and care workforce plan, which will take a multidisciplinary approach. I certainly share the noble Baroness’s views about the value of health visitors. As we move services into the community and develop the neighbourhood health service, that will require the greater use of roles such as health visitors. Ultimately, this is a local matter about local employment of staff to meet local need.

[Baroness Burt of Solihull (LD)]

My Lords, given the concerns about unsafe workloads in maternity services, how do the Government justify a situation where qualified midwives are available but not being brought into permanent roles?

[Baroness Merron (Lab)]

That is the very reason why we have brought in this guarantee, because it provides an immediate route into employment for those who are newly qualified. A number of things about that are important, including reducing the risk of graduates leaving the profession because they cannot find jobs. The reason why there are an additional 850 time-limited or temporary roles is to get people in under existing budgets but also to get staff to enter the workforce where there are not immediately permanent vacancies. It is a strong way to address the point that the noble Baroness raises.

NHS Adult Gender Identity Clinics

Baroness Burt of Solihull Excerpts

Wednesday 15th April 2026 Lords Chamber

[Baroness Merron (Lab)]

Yes, I can assure my noble friend that patients are treated as individuals and their care is personalised. It is important, as my noble friend says, to recognise that the law presumes that patients aged 16 and over have capacity to consent to medical treatment. I can also give the reassurance, acknowledging as I have already that patients may have co-existing conditions that warrant additional safeguarding measures, that this will be determined on a case-by-case basis.

[Baroness Burt of Solihull (LD)]

My Lords, if the Government are concerned with safeguarding those aged 18 to 25, can the Minister set out what assessment has been made of the documented harms caused by multi-year waiting lists, including serious impacts on mental health, physical well-being and life outcomes? Given the evidence that regret or detransition among those accessing gender-affirming care is rare, can the Minister clarify what specific risk this proposed safeguarding framework is intended to address?

[Baroness Merron (Lab)]

It might be helpful if I speak in general terms. The Levy review highlighted multi-year waits for adult gender clinics. We recognise that waiting times are too long, and that is why we have increased the number of adult gender services from seven to 12 and we will be establishing a national waiting list. Dr Levy’s report did not make specific reference to concerns about safeguarding, and it is important to see it in that context. I emphasise once again that, where there are additional safeguarding matters, they will be dealt with on an individual basis as is right and proper.

NHS: Violence Against NHS Staff

Baroness Burt of Solihull Excerpts

Monday 2nd March 2026 Lords Chamber

[Baroness Merron (Lab)]

I agree with my noble friend that racism, violence and abuse in the NHS, and indeed anywhere, are quite unacceptable and there is clearly so much more that we have to do. The Government’s progress is about the establishment of the workforce race equality standard, which measures NHS organisations against nine indicators, including bullying and harassment. The report about the standard was published in June of last year. We also have the equality, diversity and inclusion improvement plan, which again identifies six high-impact areas for employers, and this is expected to be strengthened by the introduction of a new staff standard on tackling racism, which is due in April.

[Baroness Burt of Solihull (LD)]

My Lords, the level of violence towards staff in healthcare settings which the Minister has just mentioned is unacceptable. The 2024 NHS staff survey found that violence had increased since 2023, with a quarter of the workplace reporting harassment. Given that staff safety is essential to the functioning of the NHS, what specific funding is being made available to trusts for preventive measures, such as de-escalation training, alongside direct protections such as increased security personnel?

[Baroness Merron (Lab)]

The noble Baroness is right about the increase as reported in the staff survey, and it is indeed shocking and totally unacceptable. The reporting of incidents of physical violence has also increased and, while I do not want to see more violence, if it is there, we need to know about it. On funding and NHS organisations, it comes within their general budgets. We are guiding and supporting those organisations to ensure they use the money in the most appropriate and effective way.

Battery Shortage for NHS Hearing Aids

Baroness Burt of Solihull Excerpts

Thursday 29th January 2026 Lords Chamber

[Baroness Merron (Lab)]

I think my noble friend has heard opinions already expressed on that matter. Certainly, Brexit does give us challenges, without a doubt, that this Government continue to work to resolve. I cannot answer the first question that my noble friend asked about, but I will gladly write to him and can assure him that we are working to overcome some of the challenges that we inherited and have been presented with, and that does include Brexit.

[Baroness Burt of Solihull (LD)]

It should go without saying that rationing hearing aid batteries is totally unacceptable for some of the most vulnerable people in our society. The RNID say that the uncertainty of not knowing how long a battery will last can be very stressful, and no one should be forced to ration their hearing aid use because of supply problems. Whatever the cause, for sure this should never be allowed to happen again. What steps are the Government taking to make sure that it does not?

[Baroness Merron (Lab)]

I certainly agree with the concerns about the impact on individuals. Further to the point raised by the noble Lord, in addition to the noble Baroness, I would recommend that people who are using hearing aids do not ration their hearing. That is not where we want to be, but in fact it is about not giving more supplies than are immediately needed. The real issue is that people are being asked to get their batteries more often. If that is a problem for people, they should raise it with a supplier, who will ensure that, for example, the postal service is used or some other way of getting batteries to individuals.

Women’s Health Strategy

Baroness Burt of Solihull Excerpts

Tuesday 16th December 2025 Lords Chamber

[Baroness Merron (Lab)]

I very much share the noble Baroness’s assessment of the value of women’s health hubs. She will know that I have taken a considerable personal interest in this. The target to establish a women’s health hub in every ICB was the purpose of a time-limited pilot established by the last Government, and that target was met. Women’s health hubs are absolutely effective when it comes to improving access to and experiences of care for women. I have promoted them as the best example of community-based and joined-up healthcare. That is why, as the noble Baroness will have seen in the 10-year health plan, the women’s health hub in Tower Hamlets was specifically highlighted as a best-practice example of neighbourhood health, and we continue to support ICBs to improve their delivery of women’s health hubs.

[Baroness Burt of Solihull (LD)]

My Lords, the latest data from October this year shows that there are over 576,000 women on gynaecology waiting lists and there were 130,000 new referrals in October. How will the Government address this unacceptable wait in the refreshed strategy?

[Baroness Merron (Lab)]

My examination of the gynaecology waiting lists shows a gradual decline since August 2023. However, I absolutely agree with the noble Baroness that the waiting lists are far too long: it is unacceptable. We are now seeing 57% of gynaecology referrals being seen within 18 weeks, compared with 62% across all specialities. I do not want to hide behind improvement, welcome though it is, but we also know that almost nine out of 10 women on the gynaecology waiting lists are waiting for an outpatient appointment. That is why the big change through the 10-year plan is absolutely crucial, as we move from hospital to community. In the women’s health strategy renewal we will be focusing very much on improvement of gynaecology care. I share the noble Baroness’s view on that.

Breast Cancer

Baroness Burt of Solihull Excerpts

Monday 15th December 2025 Lords Chamber

[Baroness Merron (Lab)]

I should be able to answer, I admit, but I would rather be honest with the noble Lord: I would prefer to write to him because of the specific nature of his question. I am content with the role of the research trial and that we are now harnessing AI tools through the EDITH trial backed by some £11 million of government support. Using cross-cutting AI tools in respect of the breast cancer screening pathway will be of great assistance.

[Baroness Burt of Solihull (LD)]

My Lords, I feel quite shocked after the question from the noble Baroness, Lady Hodge. I recently went for my final invited mammogram, so I did a little research. I did not come up with that figure, and I wish I had because it changes everything I was going to say; it is very important. People who do not necessarily enjoy the wonders of the world of AI and all these other things do not know all this. They are told, “Right, you’re over 70, you’re pretty much all right now”. Some people do not get any advice and, given what the noble Baroness, Lady Hodge, said, we should review this as a matter of urgency.

[Baroness Merron (Lab)]

I hope I have outlined to your Lordships’ House how the AgeX trial will greatly assist. Clinical evidence, as and when it is available—it is sought actively—is acted on by the National Screening Committee. I emphasise to the noble Baroness and the noble Earl who raised it previously that, as I said to my noble friend, NHS England is producing public-facing information to communicate to women aged 71 and over that they can have screening every three years if they so wish, and I hope that women will take that up if they so wish.

HIV: Testing and Medical Care

Baroness Burt of Solihull Excerpts

Monday 20th October 2025 Lords Chamber

[Baroness Merron (Lab)]

As I am sure the noble Lord is aware and welcomes, alongside South Africa, the UK is leading the campaign to raise investment for the Global Fund’s next three-year funding cycle. I assure him that we will, as he does, continue to champion global health and certainly remain committed to UK support for the Global Fund. UN aid also plays a very important role in the response and our funding has contributed towards preventing new cases in key populations. Long may that continue.

[Baroness Burt of Solihull (LD)]

My Lords, today, contracting HIV is no longer a death sentence as it once was, unless it is not spotted and treated in time. Testing is freely available, but we need greater awareness among all the communities affected. The currently growing groups tend to be heterosexual communities, and particularly women and ethnic-minority groups. We will not eradicate HIV if we do not spend the money on telling people about it. Are the Government planning to step up to this challenge and finance the eradication of this terrible blight?

[Baroness Merron (Lab)]

We are currently in the process of reviewing existing mechanisms as well as options for improving retention and re-engagement in care for people who live with HIV. This is a crucial part of the new HIV action plan, for which we will not be waiting very long. The noble Baroness makes an important point: there are all sorts of reasons for disengagement from care. It can be due to complex mental and physical needs but also the fear of stigma, as she referred to, particularly in the most vulnerable population groups, which means that they are disproportionately challenged. However, I assure her and your Lordships’ House that the plan will take account of that. Indeed, the 10-year health plan already makes that commitment.

Alzheimer’s Disease

Baroness Burt of Solihull Excerpts

Monday 13th October 2025 Lords Chamber

[Baroness Burt of Solihull (LD)]

My Lords, as we know, Alzheimer’s is the main form of a number of types of dementia. Early diagnosis allows for help to identify the specific type of dementia, leading to targeted treatment and access to support services, which have been discussed already this afternoon. However, the expected time from someone presenting at a GP surgery to diagnosis has increased from 13 to nearly 18 weeks. This is going in the wrong direction. What will the Government do to speed up this diagnosis, so that more people can benefit from some of the treatments that the Minister has referred to?

[Baroness Merron (Lab)]

As the noble Baroness says, diagnosis is absolutely crucial. I feel our health system has struggled somewhat to support those with complex needs, including those with dementia. That is why I emphasise the role of the modern service framework in this area; it is the first time we have had one and it takes a whole view, which I think has been sorely lacking. It will be informed by the independent commission on social care next year—so we are looking at next year, not waiting for years. The final point I make is about the dementia diagnosis rate for patients aged 65-plus. The Government are committed to recovering that to the national ambition of 66.7%; at the end of August, it was 66.1%.

NHS and Social Care: Joint Working

Baroness Burt of Solihull Excerpts

Thursday 26th June 2025 Lords Chamber

[Baroness Merron (Lab)]

I certainly agree with the noble Lord about the importance of the individual needs of the person at the centre. For too long—and part of this is a lack of integration—the needs of the person who receives, wants and needs that care and support have not been at the front. On his suggestion, I would just counsel waiting for the 10-year plan. It may not do exactly what the noble Lord says, but it will set out a way forward on how we will resolve such matters. I am sure that he will participate in further discussions about how we can get to the place that we all want.

[Baroness Burt of Solihull (LD)]

My Lords, I was very pleased to hear the Minister’s words on the progress and planning for this NHS 10-year plan. I was looking through, well, everything that I could find, really, and I could not find that any progress had been made, so I wonder whether the Minister could update the House on what is happening now and when she thinks we might start implementing this programme.

[Baroness Merron (Lab)]

I am not entirely sure, but I think that the noble Baroness is referring to my first Answer.

[Baroness Burt of Solihull (LD)]

Yes, I am.

[Baroness Merron (Lab)]

Good—thank you. This derives from the review by Sir Gordon Messenger. The first review was in 2022 and Sir Gordon came up with seven recommendations to strengthen leadership and management. To build on that, in November, Secretary of State Wes Streeting asked Sir Gordon to deliver further recommendations. That is why we now have a new national entry-level induction for new staff. As of 25 April this year, for example, it is being used by nearly 70% of trusts and ICBs to support staff enrolment. That shows how much it was needed and how much change it will make.