Health Bill

Baroness Campbell of Surbiton Excerpts

Committee stage
Wednesday 28th October 2026 Lords Chamber

[Lord Crisp (CB)]

My Lords, I have been resisting the temptation to get involved in this debate, partly because I was not able to join the Second Reading debate, and I apologise for speaking now, having not done that. I start by making just one point, which is that at the beginning of this century, I was running both the NHS and the Department of Health. I had the two jobs, so I have seen some of what we are talking about from inside. I think some of it was extremely successful. On the point about regional offices, there are some models that I am quite sure can be followed.

The reason I stood up is that the noble Lord, Lord Mawson, spoke about prevention. What I realised when I was running the Department of Health is that, with a hospital management background, I had turned it into the department of the NHS, and we had lost some of our health focus. The future is about health, not just about healthcare. We have to focus not just on prevention but on creating health and the conditions to be healthy. I am not going to get into a Second Reading speech, but I want to ask how the Government are going to preserve the proper role of the Department of Health when it gets all this responsibility for the NHS.

The NHS, on which I speak as a former chief executive, runs 24 hours. You get contacted all the time. How will the important responsibility of leadership for health across government be managed? As the noble Lord, Lord Mawson, said, 80% is about housing, employment and the environment. The health system provides the other 20%, and I have to say it is a vital 20%—if you have a nasty cancer or your leg has just fallen off or something, you need that. My question to the Minister is, how are the Government going to preserve the proper responsibility of the Department of Health for all the health functions, as opposed to the NHS functions?

[Baroness Campbell of Surbiton (CB)]

My Lords, I had not intended to speak in this debate, but I have been listening very closely, and I think what is missing is what happens to people at the grass roots—patients who rely on their ICBs to behave and do the right thing in terms of their care and support. When I heard that NHS England was going to shut down, I have to say that my heart went in my boots. That is because I have been working with certain departments to look at ways that we can deliver NHS personal health budgets, from when they were first conceived to now. There was an awful lot of organisational expertise, memory, support and guidance from what was then NHS England to local ICBs across the country. In doing so, personal health budgets became a good way of delivering personalised care at home for people with complex impairments. I should probably declare an interest because I have been negotiating with my ICB for about 15 years. It is not easy. What I worry about in the transition is that we do not have a plan for what is going to happen to the people in NHS England who have all that expertise, history and know-how in supporting ICBs to deliver their support to complex patients in the community in the future.

I am afraid I am not that positive, because in the last two years, since we heard that ICBs were going to make 50% savings, ICBs have been behaving quite oddly towards people with complex and sometimes expensive care in the community. They are institutionalising them even though they were supported in their own homes quite happily; for example, doing their degrees. They are restricting where you can go with your personal health budget and PA and even whether you can be outside the home, because they have told me that it is unsafe. Something odd has been in the air since we knew that NHS England was going. I believe that there were only four people left in the department supporting those ICBs with their delivery and, quite frankly, they are going backwards. I would be keen to have a plan about what is going to happen when NHS England goes. Who is going to do this work? ICBs need ongoing guidance in this area. They do not have the expertise locally, but someone has to do it.

[Baroness Morgan of Drefelin (Lab)]

My Lords, I want to pick up some of the key points in the amendment regarding what the transition plan should look like and focus on.

I am thinking about the experience of cancer patients post the 2012 changes and what came along with them, which was the abolition of the comprehensive cancer networks that were set up around England to deliver the then cancer plan. There was a vacuum following that change, and it took years to establish the architecture that we now have in place for delivery of the current cancer plan. Given the news that NHS England is being abolished, I am really concerned that the momentum around the delivery of the current cancer plan is being impaired, so the points in Amendment 4 about setting out how the continuity of services during the transition will be maintained are important. My worries are about the cancer plan, how we will drive forward the service improvements set out in it and how all 100 recommendations will be progressed, because that is not the responsibility of any one ICB; it is currently driven forward by NHS England. How are the staff associated with that going to be transferred into the NHS? How do we make sure that there will not be a vacuum? We already had a disappointing delay in the appointment of the chair of the National Cancer Board that has been established.

We really need to make sure that this momentum continues. There is massive consensus around the cancer plan, which we should celebrate. There are 200 different types of cancer, more than 200 different types of cancer charity and many different specialities. One in two of us will get cancer at some stage in our lives. It is a massively important area for the health service, and we need to be confident that the transition will not fall between all the gaps, as it did in 2012, and then take years to re-establish the architecture that we need to deliver the ecosystem of success that we have in UK cancer services.

Terminally Ill Adults (End of Life) Bill

Baroness Campbell of Surbiton Excerpts

Committee stage
Friday 24th April 2026 Lords Chamber

[The Senior Deputy Speaker (Lord Gardiner of Kimble)]

My Lords, the noble Baroness, Lady Campbell of Surbiton, is taking part remotely. I invite the noble Baroness to speak.

[Baroness Campbell of Surbiton (CB) [V]]

My Lords, as requested by the noble and learned Lord, Lord Falconer, I have reflected on the progress we have made on the Terminally Ill Adults (End of Life) Bill to date. I know that we have engaged in vital scrutiny work and made progress, although for the supporters of the Bill it seems agonisingly slow.

I am acutely conscious that the role of this House is not to rubber-stamp legislation. It demands that we draw on our knowledge, our experience and research evidence to demonstrate why revision is necessary and, most importantly, to insist firmly that a Bill is made safe before it leaves us. That is our constitutional duty and it is what we have been doing over the past 14 days in Committee. Yet our work has been dismissed as filibustering or worse. That is simply not true. The breadth of participation in this House reflects deep and genuine concerns shared by NHS doctors, human rights bodies and disability organisations about the risks this legislation may pose to the most vulnerable.

I have spent over two decades studying similar laws internationally. I have long supported autonomy for disabled people, but autonomy without protection is not freedom—it is risk. When the outcome is irreversible, that risk must be treated with the utmost seriousness. Public opinion is given to reflect that caution, despite the high-profile celebrities fronting the campaign for assisted dying. Of course, they get the headlines. Actor Miriam Margolyes’s recent outburst against “a cohort of rabid Catholic privileged Lords out to sabotage the Bill” was heard loud and clear. But please do not be mistaken; this is not a reflection of public opinion.

The latest polling by Whitestone Insight shows that there is no clear or informed public mandate for this Bill. Around four in 10 people do not understand that assisted dying involves administering lethal drugs—when voters are better informed, support falls away; nor is this a public priority, with far greater concern focused on NHS pressures and social care. Importantly, the same polling shows strong support for the role of this House. A clear majority of the public believe that the House of Lords has a duty to amend or block legislation if it risks harm. That is not a call for us to step aside. It is a call for us to do our job.

Without significant amendment, this Bill cannot guarantee protection for those in vulnerable situations or outside its intended scope; nor can it ensure that decisions are made entirely free from pressure. These concerns are shared by, for example, the Royal College of Psychiatrists, the Royal College of General Practitioners, the Equality and Human Rights Commission and disability organisations. Even Liberty, an organisation long associated with defending individual freedoms, cannot support this Bill. It warned Parliament at Second Reading that the risk to those whose rights are fragile must also be protected. As it put it, the autonomy of one group cannot override the rights of another. Rights must be carefully and proportionately balanced. This Bill fails that test.

I also struggle to understand why the Bill’s sponsor appears unwilling to recognise the weight of expert evidence. I welcomed the noble and learned Lord’s open-door policy to engage with our concerns and I sought to assist him to understand the nature of a terminal prognosis. I arranged for two eminent intensive care consultants from St Thomas’ Hospital to meet him and provide a clear tutorial on prognostication. They demonstrated that a six-month prognosis cannot provide a reliable foundation for legislation of this kind. But has he returned with amendments of his own to address this deficit in the Bill? No.

Much of the chatter around the debate inside and outside this Chamber focuses on motives; it should not. Our role is to examine all available evidence, test safeguards and make revisions. Disabled people who have contacted me are very clear: this Bill frightens them, and they want me to explain to your Lordships why it is dangerous for them. They fear unequal access to care shaping their choices, subtle coercion that cannot be easily detected, error in prognosis, persistent assumptions about the value of their lives and a system already under strain being asked to deliver decisions of the utmost gravity. These are real and repeated concerns. I have contributed to amendments that have sought to strengthen safeguards to that end. That is not obstruction; it is our duty.

Terminally Ill Adults (End of Life) Bill

Baroness Campbell of Surbiton Excerpts

Committee stage
Friday 30th January 2026 Lords Chamber

[The Deputy Chairman of Committees (Baroness Garden of Frognal) (LD)]

My Lords, the noble Baroness, Lady Campbell of Surbiton, is taking part remotely. I invite the noble Baroness to speak.

[Baroness Campbell of Surbiton (CB) [V]]

My Lords, before I speak to the amendments in this group, I say that I too have not received the letter sent by the noble and learned Lord, Lord Falconer, regarding amendments he proposes to return with, so I am somewhat in the dark today, should the content relate to remarks I am about to make now. Please would he check the distribution list, as such information is crucial to our deliberations, especially when one relies so heavily on remote participation for inclusion, as I do?

Terminally Ill Adults (End of Life) Bill

Baroness Campbell of Surbiton Excerpts

Committee stage
Friday 16th January 2026 Lords Chamber

This is a really important group of amendments. We need a lot of honesty about what we are trying to do here. I appear to be quoting the noble Lord, Lord Harper, quite a lot today—that is not a scenario I thought would possibly ever happen—but I join him in very much welcoming my noble friend Lady Campbell back to the Chamber today. Her expertise in the Bill is paramount. I would not dream to count how many disabled people are in this Chamber, but there are two wheelchair users. I am very much looking forward to the contribution she will make on the Bill.

[Baroness Campbell of Surbiton (CB)]

My Lords, I hope the noble and learned Lord, Lord Falconer, will forgive me for intervening at this stage. I know we are all in a hurry, and I have not got my name on any of the amendments—yet. Noble Lords will know that I have been away for over six months because of an accident on the high seas, when I found myself hurled across the room by a wave. I broke my leg, I dislocated my shoulder, and I had all sorts of internal injuries. I spent the next six weeks in St Thomas’ Hospital, instead of here talking about the Bill. I do not know quite where I would have rather been, but I am here now. I hope noble Lords will forgive my late interventions having not been at Second Reading, but I am jolly pleased to be back, and thank noble Lords for their welcome, which has been very nice.

I want to say something very briefly about burden and motivation. We all know that burden is one of the primary reasons for people to seek an assisted death. That is not only in the conversations I have had here, but we know it is the primary reason throughout the world. Burden is real. It is why, in another life, I set up the organisation the National Centre for Independent Living, because I realised there were hundreds of disabled people living in institutions or in their mum and dad’s back room, basically just surviving, not living.

I also campaigned for a law called the direct payments Act, with which the noble Lord, Lord Harper, will be very familiar. That allowed severely disabled people to employ their own personal assistants, so that they would no longer be a burden on their families. No one wants to rely on their families or their spouses. I certainly do not want to have to rely on my husband to get me up in the morning or to put me to bed at night. I am his wife: he is not my carer; he is my husband. And that is a good relationship.

There is an answer to burden, and it is good social care support. Good infrastructure or technology allows you to be independent and not to be a burden on others, but to begin to plot your life as you want it to be. I know this because I have helped hundreds of disabled people to do it. Some of them had progressive conditions and would not live for long, but the lives they had for those years were good lives—good months and good weeks.

I am not saying that it is always the answer, but we surely must find out from anybody who is asking for their life to be ended, “What are your reasons? Is it because you do not have adequate social care? Is it because you cannot get out of your house, because nobody from the local authority has come to build you a ramp?” For disabled people, people with terminal illnesses and people with progressive conditions, these small things can make the difference between them wanting to die and them not wanting to die.

I know this, because they have told me. Many disabled people come up to me and say, “Jane, you know, I love my independent living and I love my direct payments. If that was taken away and I was forced to go into an institution against my will, I do not know what I would do. I would probably ask for an assisted death”. They were not joking. It is the truth. We should all think about motivation and that is why I support this suite of amendments. We have not really grasped that nettle.

[Baroness Royall of Blaisdon (Lab)]

My Lords, I too warmly welcome the return of my noble friend Lady Campbell—the most extraordinary person and advocate for disabled people and so many more in our societies. I just remind the Committee that, in all these discussions about burdens and people who have had a stroke— I am terribly sorry that the husband of the noble Baroness, Lady Grey-Thompson, had a stroke—we are talking about six months for somebody who has been diagnosed with a terminal illness. We should reflect on and remember that in all our deliberations on the Bill.