Terminally Ill Adults (End of Life) Bill

Baroness Fox of Buckley Excerpts

Friday 24th April 2026 Lords Chamber

[Lord Farmer (Con)]

My Lords—

[Baroness Fox of Buckley (Non-Afl)]

My Lords—

[Lord McCrea of Magherafelt and Cookstown (DUP)]

My Lords—

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[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.

[Baroness Fox of Buckley (Non-Afl)]

My Lords—

[Baroness Blackstone (Lab)]

My Lords—

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I will give way. I am sure that the noble Baroness will do the same for me in a moment.

[Baroness Blackstone (Lab)]

My Lords, I am very grateful to the noble Baroness for letting me get in. I have sat through 13 days of Committee on this Bill and I have hardly spoken at all. I will cut what I intended to say, as I know we are beginning to run out of time, to allow others who still want to come in to have a chance of doing so. Moreover, much of what I wanted to say has already been said by others and I want to avoid what has happened during Committee—endless repetition. However, I will endorse two or three important things that have been said.

I endorse what has been said about the effect of the failure to scrutinise the Bill in a fair, considered and disciplined way, so that voting on possible improvements could have taken place, on the thousands of people who have experienced agony, loss of dignity and a desperate wish to die peacefully and as soon as possible. These people and their close friends and relatives, who feel their pain too, have been let down, I am afraid to say, by a relatively small number of Members of this House who have been determined to block the Bill. I know it has been said already, but I endorse that.

I also strongly endorse the criticism that the opponents of the Bill in this House have refused to take into account the overwhelming support for it from the general public, including from the minority of people in this country of religious faith and from individual disabled people. In both cases, most of them want to see a change in the law and something along the lines of what the Bill is trying to do. Its opponents have damaged the reputation of the Lords, not just by the number of amendments tabled—some of them absurd—and the repetition entailed, but by the lack of accuracy and rigour in making their arguments. That we have not talked about today, and I want to do so in a particular area.

There are many examples I could cite, but I will concentrate on the presentation of the medical profession as being opposed to the Bill. I am not a doctor, but I declare an interest as chair of the trust board of the Royal College of Obstetricians and Gynaecologists, which, like virtually all the royal colleges, has taken a neutral position on the Bill. The noble Baroness, Lady Berger, has just given, in my view, a really misleading impression about this. I regret that she felt the need to do that.

It is absolutely true that, when assisted dying was debated in the House in 2014 and 2015, the medical professional organisations were opposed and there was justification in referring to it at that time. But those who are still implying this have simply not caught up with the changes in medical opinion over that decade. This is reflected in the view of 50 senior clinicians, including 13 former presidents of the royal colleges and the BMA. They said:

“The status quo in this country is not working; the blanket prohibition of assisted dying has made the way we deliver end-of-life care in this country more cruel and more dangerous. You now have an opportunity to vote for legislation that will give people in England and Wales choice and control at the end of life. In our view this choice will come to be seen as a compassionate and integral part of our National Health Service, of immense comfort to dying people and their loved ones. Changing the law will send a clear message to all in society that we will respect their wishes. We believe it is time for Westminster to show compassion by giving … people choice”.


That is very important.

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[Baroness Berger (Lab)]

Before my noble friend sits down, I say that I have been accused of dishonesty in my representations. I will just repeat what I said. I was very clear that, while the overwhelming majority—bar one, I think—of the royal medical colleges take a neutral position on the principle of assisted dying, there is not a single medical royal college in this country that will attest to the safety of the Bill. I reiterate that that should concern us all.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I acknowledge that those who have been campaigning for the Bill, inside and outside here, are well motivated. Many have watched a loved one die in great discomfort, even agony, and are informed by grief. Understandably, they do not want that for their loved ones or themselves. I also acknowledge that they are often driven by choice and autonomy, which are honourable virtues. Facing death, when illness threatens to remove bodily or cognitive control, can be daunting. As the noble and learned Baroness, Lady Prentis, so vividly and movingly described earlier, you can feel how people would therefore want to assert control at the end of their life.

I acknowledge that absolutely, but I want to refute something that keeps being thrown out regularly: the accusation that those of us who raise concerns about the Bill do not care about those campaigners and that we have never listened, or are not listening, to the terminally ill. To note, the terminally ill are not an undifferentiated identity group with a fixed view. Sadly, we will all know people who are terminally ill now. I can tell the House that those I know find that politicians’ enthusiasm for assisted dying—in preference to energy going into palliative care or hospices—makes them feel like a burden, and they are demoralised and dispirited.

It seems that some people are determined to undermine the motivations of those of us who tabled amendments, as though we are all part of some malign Machiavellian plot. Media reports this week—by the way, I must give credit to Dignity in Dying for its good comms and PR; its media work is second to none—have said that we in the Lords should hang our heads in shame. Actually, we should hold our heads up high. At the moment, it is fashionable in politics to look the other way—to see no evil, hear no evil, and so on—but we were charged with a huge task and a heavy responsibility. If there was to be a law that would mean that the state and doctors could help end the lives of the terminally ill, how could we pass that law without creating recklessly unsafe legislation?

This has not been some tactical coup, as the noble Baroness, Lady Hunter, implied. The task was to scrutinise the longest Private Member’s Bill on record—all without any guidance from Government Ministers beyond narrow, technical comments on legal and operational workability, not safety. Also, we were charged with the task of scrutiny not just because of our intrinsic role here but because MPs in the elected House told us that they were relying on our House to fix a flawed Bill.

Contrary to the point made earlier by the noble Baroness, Lady Gerada, what has become obvious is that the people who are not grounded in reality are those who support the abstract ideals of the sponsors. Once amendments try to pin down the practical, specific mechanisms of the Bill about how an assisted dying service would operate on the ground, worrying implications and unintended consequences are exposed. When the Health Minister, Stephen Kinnock, admits that the Government would need to reprioritise spending from NHS budgets to fund assisted dying, it is our duty not to stay shtum. We should not talk it out but we should be talking about it, because we should ask: which health services will be cut? Could palliative care get even less money? When the Royal College of Psychiatrists warns that the requirement for members to sit on AD panels would mean taking them away from overstretched, front-line mental health services, our job is not to ignore that but to ask: would that mean even longer waiting lists for those who are mentally distressed, or a reduction in people at the coalface of suicide prevention because they have been diverted into okaying the state assisting individuals in taking their own lives—that is, not suicide prevention? Such moral dilemmas hint at the fundamental shift in the—

[Lord Pannick (CB)]

No one in this House is suggesting that, as the noble Baroness puts it, we should keep shtum. We have had 14 days of debate on the Bill.

[Baroness Fox of Buckley (Non-Afl)]

Such moral dilemmas hint at the fundamental shift in the raison d’être of medicine that is required. A systemic shift will be needed to change the NHS constitution and redefine “medical treatment”. So I am grateful to this House, whether or not it has taken 14 days, that we heard the noble Lord, Lord Stevens, warn that the Bill’s open-ended Clause 41 would be a Trojan horse clause for fundamental change to the NHS by the back door, yet amendments to it have been sneeringly described as trivial, overly cruel and absurd.

Having sat through hours—days, even—on the Employment Rights Bill in this place, I thought that it was my responsibility to look at this Bill’s impact on workers’ rights. When I asked about two-tier conscience clauses that could leave out junior staff and ancillary workers such as porters and care workers if there were no system-wide opt-in model, the noble and learned Lord, Lord Falconer, batted my worries away. However, since my speech on that topic, I have talked to people, including prison officers, care staff and even a real-life porter—they were all trade union members, by the way—who thanked me for raising it and said that they had changed their minds after the debate because it had made them understand and reconsider the Bill’s broader impact. It seems a credit to the Committee that it has allowed people outside this Chamber to think about lawmaking beyond soundbites and emotive headlines.

My final words are to comment on who we, the alleged filibusterers, are. No disrespect, but we are a bit of a ragbag and not an organised ideological collective. I am in awe of my temporary comrades in arms, who have treated this process with diligence and moral seriousness. It is lazy and insulting to hear people being discussed in the media so disparagingly, or the suggestion that all the amendments were some conspiratorial plot. That is cynical misinformation and an undignified smear. So when—probably—or if any version of assisted dying legislation returns here, I hope that all sides will continue to read the small print, line by line, and that we will stop smearing each other and maybe work together on bringing through safe and workable legislation, if we must have the legislation at all.

[Baroness Hayter of Kentish Town (Lab)]

My Lords—