Terminally Ill Adults (End of Life) Bill Debate

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Department: Department of Health and Social Care

Terminally Ill Adults (End of Life) Bill

Baroness Fox of Buckley Excerpts
Friday 20th March 2026

(1 day, 7 hours ago)

Lords Chamber
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Baroness Smith of Llanfaes Portrait Baroness Smith of Llanfaes (PC)
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I thank the noble Baroness for her intervention. However, that is not the case in terms of the practical reason why the Senedd Members raised those points; it is also in relation to the fact that they passed an amendment to this LCM, which I was lately going to touch on, which states that the Senedd “regrets” that this Parliament has not properly considered the

“constitutional implications of this Bill for Wales”.

It is important to note that, yes, they passed the LCM, but they amended it with a point about this Parliament not having done its duty and gone through the implications for Wales in detail. A lot of those in Wales who support the Bill just do not feel that they have had an opportunity to shape this Bill. I thank the noble Baroness for her intervention, and I hope that that clarifies my point a little further.

The point was concisely put by Adam Price during that debate:

“Supporters of assisted dying do not argue for access determined by wealth. Opponents do not argue for a system outside NHS governance in a matter as grave as this … No country’s Parliament should have to stand aside while another decides the terms on which its own citizens live and die”.


He went on to say that he sincerely hoped that the vote was the last time that the Senedd—and other devolved Parliaments—was put in that situation.

The Senedd passed the LCM with an amendment stating, as I just mentioned, that the Senedd:

“Regrets the lack of thorough consideration of the constitutional implications of this Bill for Wales during the legislative process”.


As I just said, the passing of that amendment also showcases that we have failed in our own duty here in relation to those implications.

Amendments 903 and 905 in my name aim to restore an amendment that was agreed in Committee in the other place. The amendment was later taken out on Report without resolving the purpose behind it having been put forward and agreed in Committee. Simply, my amendments would give the Senedd a vote on the final Bill passed here before regulations could be created by Welsh Ministers for the delivery of an assisted dying service in Wales. The reason for this amendment is simple: as I highlighted at Second Reading, although the criminal law is a reserved matter, the legality of assisted dying in this case, and the delivery of such a service, is a devolved matter. Not allowing the Senedd to have a vote nor the opportunity to fully scrutinise and amend this Bill infringes on devolution and disrespects the roles and duties of Members of the Senedd.

Health and social care makes up over half of all spending from the Welsh Government’s budget. Do noble Lords not agree that it is therefore essential that Members of the Senedd are able to scrutinise all health spending? Not allowing Members of the Senedd to shape this Bill limits their ability to do that. The Covid pandemic is the most recent prominent example of how Wales does things differently when it comes to health. This Parliament needs to wake up to this reality and let devolved Parliaments do their job. This matter is an anomaly from a devolution perspective. As in Scotland, this is a fully devolved area. The Scottish Parliament recently had the opportunity to debate and shape its own Bill that could be suitable for Scotland. If the Scottish Parliament has the right, why can this not be the case for Wales?

I turn to Amendment 844, which would create a new clause to address this exact issue. The amendment would deliver parity between Scotland and Wales on this matter by amending the Government of Wales Act to remove offences related to suicide from reserved matters. This would allow the Senedd, if it chose to do so, to introduce its own Bill on assisted dying. It would allow the Senedd’s health committee to take its own evidence, including from NHS Wales and the Welsh Government’s Health Secretary. Your Lordships will be aware of the list of witnesses who were called to recent Select Committees ahead of this Bill. The chief executive of NHS England was called to give evidence, but there were no representations from Wales. I respect the work that members on that committee carried out; however, would they agree that the Senedd should also be able to take evidence from within Wales and be able to make decisions on the establishment of a new service in Wales for the people of Wales, based on Wales-specific information? Amendment 844 would be the best course of action in order to recognise that this Bill has not been designed with Wales or for Wales and to align Wales with Scotland in making a decision on this matter.

I turn finally to the amendments in this group from the noble Baroness, Lady Coffey. In the hypothetical scenario that we passed her amendments alone, we would be leaving Wales in a grey area. Wales would be taken out of this Bill, but with no way for the Senedd to legislate on this matter. In this Committee, we must consider the full consequences and where those decisions will then lie. My Amendment 844 would avoid that scenario and ensure that the Senedd had a way of legislating on this matter if it chose to do so.

To conclude, and as I already highlighted at Second Reading, I support people’s right to choose how they die. However, in the case of services being made available in Wales, they must be shaped and designed by the people of Wales. That must be an ability for the Senedd and not for us here in Westminster.

Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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My Lords, I thank the noble Baroness, Lady Smith of Llanfaes; that was a tour de force. Goodness knows, we rarely agree, and I am hardly a Plaid supporter, but I am from Wales. I want to reflect on couple of tiny things that she said in why I wanted to speak.

Family and friends in Wales were completely confused about what the vote meant when it happened. They asked, “Have we just voted for assisted dying?” It was not clear, the way it came across. They were not sure what was being voted on. In a way, they were not alone, because when I talk to people, I also feel very uncomfortable that the Senedd was basically asked to vote on a blank cheque, as was said, because Members of the Senedd did not, do not and could not yet know what the Bill will look like. You can blame us here for that—we have not got very far—but the truth is that it seems presumptive for the Senedd to be asked to give consent in advance when we do not yet know whether amendments will get through this place and how they will change the Bill. By the way, that includes amendments by the noble and learned Lord, Lord Falconer, the Bill’s sponsor.

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Lord Harper Portrait Lord Harper (Con)
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I will be very brief in my response to that because of the time. That has nothing to do with this issue; this is a completely separate issue. Deciding on assisted suicide is not the same as allowing abortion to term without any legal consequences, which is an extreme provision supported by only 1% of the British public—but I accept that Parliament made a different decision. Those two issues are not connected in any way, so that issue is not relevant to this debate. We raise these issues—real concerns about how this would operate in practice—but we are still waiting to hear specific answers from the sponsor of the Bill. If we had answers earlier, we might make faster progress.

Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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My Lords, I cannot let the noble Lord, Lord Pannick, get away with that. What happened on Wednesday night was a separate issue. As it happens, I argued for a change in the law in relation to decriminalising abortion—but now I am on this side. This sort of easy “swatting away”, “culture war”-style argument is unhelpful. People, in good faith, are concerned about the lack of safeguards in this Bill.

I do not agree with the idea that no one wants to get to Report. I would much prefer to be voting on aspects of the Bill, because a wide range of the concerns that have been raised could be addressed through amendments tabled by the sponsor of the Bill so that we can get on with it. That is what I would want.

The only reason we are discussing Wales, as far as I am concerned, is what has happened since we discussed it on the first day in relation to the Senedd’s decision. It is a perfectly appropriate thing to raise. The idea that we are wasting time talking about Wales—said by people who apparently respect devolution—seems a bit rich. We want to get to Report, and we should keep the insults out in order to do so.

Lord Goodman of Wycombe Portrait Lord Goodman of Wycombe (Con)
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My Lords, my Amendment 765, supported by the noble Lord, Lord Rooker, would delete Clause 42(4). I will briefly read the subsection, as it is not very long:

“Regulations under subsection (3) may make any provision that … could be made by an Act of Parliament, and … would not be within the legislative competence of the Senedd if it were contained in an Act of the Senedd”.


I will not repeat the case put by the noble Baroness, Lady Finlay, who quoted the report of the Delegated Powers Committee, on which I sit, which argued that the clause is highly inappropriate. Rather than do that, I will put to the sponsor of the Bill a simple question, and I would be grateful if he addressed it when he winds up. I quote from the report of the committee:

“Delegated powers that can be used to do anything that an Act of Parliament can do are very rare, with the wording currently appearing in just two Acts: the European Union (Withdrawal) Act 2018 and the European Union (Future Relationship) Act 2020”.


I was not on the committee when that report was produced, but my understanding is that the argument at the time was that the exigencies of Brexit required business to be done by regulation, rather than by an Act of Parliament. My question for the sponsor of the Bill is: what is the exigency in this case that requires the provision, which he believes needs to be made, to be made by regulation, which necessarily has to be dealt with on a “take it or leave it” basis, rather than by an Act of Parliament that Peers and Members of the other place can amend? I would be grateful if he could answer that question when he replies to the debate. If he cannot, I look forward to returning to this on Report, if we ever get there.

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Baroness Hayter of Kentish Town Portrait Baroness Hayter of Kentish Town (Lab)
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My Lords, I am pleased that the noble Lord who moved the amendment is in remission from his cancer. On other Bills we wish he was in remission from his political views, but on this one we celebrate with him.

I used to run a cancer charity, and the truth is that on this issue not everyone is using statistics. Doctors are often using their eyes; when we are talking about the last weeks it is their eyes, rather than going to any statistical table, that will tell them. There is an assumption that all this is going to be based statistically on the six-month period, but it is not like that. My own guess is that most people who are dying will probably start thinking about this only at three months. Tonight I am going to be dining with a recent widower. His wife—a very well-known author but it does not matter who she was—had cancer. She fought it, but fighting it is not enough. It was only really in the last weeks that she realised that what she wanted was help in those weeks. It was at that point that she tried to get to Switzerland, but by then it was too late.

My judgment is that much of this, for many of the patients who will be asking for this, will be very much towards the end. I will be surprised if at that point the doctor is going to their statistical tables, because at that stage the patient’s age and underlying health and other factors will contribute as much to assessing whether it is going to be days, weeks or maybe a month as the particular type of cancer that they have. This attempt to make that process overscientific is probably not right, and we should have faith, which some people in this House do not seem to have, in doctors.

Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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My Lords, it is hard to follow the noble Lords, Lord Moylan and Lord Carlile, whose contributions were made with such panache, wit and insight. What really intimidated me was the noble Lord, Lord Moylan, saying, “This amendment is all about understanding the mathematics”. I thought, “Oh God, I’ve put my name to it. There’s been a terrible error”. I bring absolutely no mathematical understanding to the question.

I put my name to the amendment on the requirement that medical practitioners should discuss underlying data on survival—in terms of the median prognosis of six months and how it is calculated and so on—because I am interested in ensuring that there is maximum transparency for patients under the Bill, so that any choice that they make is well informed. The Bill rightly requires that an applicant for assisted dying is informed, so it seems obvious that being informed should include an understanding of the context of the data and the reliability of a prognosis, which would help them to inform themselves.

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Baroness Watkins of Tavistock Portrait Baroness Watkins of Tavistock (CB)
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My Lords, we have already had extensive discussion about the multidisciplinary team involvement. In 50 years of nursing—not all in clinical—I have never heard a doctor come out with, “You’ve definitely got six months to live”. There are much more subtle conversations.

I accept that people with MAID sometimes want to discuss it and say, “If I come off the support that you’re giving me, how long would I live?” Some of the answers can be very straightforward and we still enable patients to stop treatment when they want to.

I am also delighted that the noble Lord is alive and that he clearly understands statistical formulae.

Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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I just want to ask the noble Baroness for one clarification. I agree that most doctors are not brutal and do not say, “You’ve got six months and that’s it”. I asked whether the Bill, which requires you to have a six-month prognosis to access the service, will encourage doctors to feel that they have to be more definitive to allow people to access this service.

Baroness Watkins of Tavistock Portrait Baroness Watkins of Tavistock (CB)
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I do not think so. I have greater faith in the medical profession and the multidisciplinary team.