Assisted Dying (No. 2) Bill

Debate between Barry Gardiner and Norman Lamb

Friday 11th September 2015 Commons Chamber

[Norman Lamb (North Norfolk) (LD)]

I thank the hon. Member for Wolverhampton South West (Rob Marris) for giving us the opportunity to debate this most profound of issues, one that concerns so many people across our country, whichever side of the debate they may be on. I also thank the right hon. Members for Meriden (Mrs Spelman) and for North Somerset (Dr Fox) for expressing the importance of us demonstrating mutual respect in this debate, and for acknowledging the profound importance of this for people on both sides. We should be able to debate it in a decent way that fully respects that.

I have changed my mind on this issue. I used to oppose change, but I am now very clear in my mind that reform is necessary. We are all shaped by the conversations we have and by our own personal experiences, sometimes within our own families. Talking to people who are terminally ill has forced me to think about the principles at stake and led me to change my mind. I came to this view through one man in particular, Douglas Harding, who, for six years, has lived with terminal cancer, and is now very close to the end. When I hear him argue the case to me about his right to decide when to end his life as he faces the closing stages of a terminal illness, I find it impossible to reject that right. When I ask myself what I would want in those circumstances—whether I would want that right—I am very clear in my mind that I would. I do not know whether I would exercise it, but I would absolutely want it for myself. How can I then deny it to others?

I speak as a former Care Minister and I was driven in that job by an absolute determination to improve end-of-life care and to ensure people are treated with absolute dignity in the final stages of their life. One of the issues I had to deal with was the Liverpool Care Pathway and the abuses that sometimes took place under that name. I had many conversations with the hon. Member for Congleton (Fiona Bruce) and we found ourselves on the same side of the argument. We both had deep concerns about some of the things that had happened under the Liverpool Care Pathway and, as a result of the review that I called, the Liverpool Care Pathway is no longer used. The approach taken is that it is the individual’s own priorities that are paramount. Are we really saying that that principle, which applies to issues such as resuscitation where one wants to die, suddenly does not apply when we get to the most profound of questions? At that point, the individual has no right and is left at the mercy of the state’s decision. As the hon. Member for Reigate (Crispin Blunt) said, this is a matter of personal freedom. For me, that is very clear.

[Barry Gardiner (Brent North) (Lab)]

Will the right hon. Gentleman give way?

[Norman Lamb]

I would prefer to make my case, because I want to ensure that others can make their case, too.

Questions have been raised about whether implementing this proposed legislation would have a negative impact on palliative care. For goodness’ sake, it is up to this House and the Governments we elect to ensure that there is decent palliative care in our country. It is up to us to make that decision. It is a dishonest argument to suggest that it would undermine palliative care. In the United States, Oregon is one of the best States for access to specialist palliative care. It is totally consistent with the principle I expressed earlier that in those last stages of life it is the individual’s priorities and wishes that should be paramount.

I just want to say a word about the current law, which puts families in the most invidious position. I applaud the former Director of Public Prosecutions for the guidelines that advanced the position very considerably. However, if someone acts out of absolute compassion, they are still left with their home being declared a crime scene and with a police investigation. As the guidelines point out, the person is referred to as a “suspect”. Someone who has acted out of compassion for a loved one is treated as a suspect, waiting perhaps months to know their fate—whether they will be prosecuted—while they are experiencing bereavement. That is surely an intolerable position. We then have the grotesque situation where those people who have money are able to go to Dignitas, an alien clinic in another country. Someone who is dying is expected to travel to another country to exercise their right. Those who do not have money are left with the invidious choice of struggling on regardless, perhaps in the face of impossible pain, or committing suicide in very difficult circumstances. I find that absolutely intolerable.

J.S. Mill said:

“The only part of the conduct of anyone, for which he is amenable to society, is that which concerns others. In the part which merely concerns himself, his independence is, of right, absolute. Over himself, over his own body and mind, the individual is sovereign.”

We should respect that sovereignty and pass the Bill.

Care Homes

Debate between Barry Gardiner and Norman Lamb

Thursday 1st May 2014 Commons Chamber

[Norman Lamb]

I agree with my hon. Friend. I have spoken to the chair of the CQC, David Prior, specifically about this matter. It is looking at both the use of hidden cameras in appropriate circumstances and at mystery shopping—going into care homes, finding out what is going on and getting a real picture, rather than things perhaps being hidden away from view when a named inspector turns up. All these mechanisms have to be used. We have to be prepared to do these things to ensure that people in very vulnerable situations, particularly people with dementia, are cared for with dignity.

[Barry Gardiner (Brent North) (Lab)]

The care homes sector is growing in size and in profitability. In his remarks, the Minister focused on the low wages that are paid to care workers in the sector. Often, the pay reflects the value that is put on the work that is being done. Will he look at pay and profitability in the sector, and consider the impact that it may have on bad practice?

[Norman Lamb]

The hon. Gentleman makes a fair point. The difference in the providers that pay people properly is clear. Incidentally, domiciliary care is another area where there are concerns. My right hon. Friend the Member for Sutton and Cheam (Paul Burstow) visited Wiltshire recently, which has moved away from the old style of paying people a pittance and now gives care workers a salary. When that happens, the whole culture starts to change completely.

We must ensure that there is compliance with the minimum wage, as well as advocating wages that are better than the minimum. Her Majesty’s Revenue and Customs has done a lot of work in the sector to address the abuse of the minimum wage regulations, which is far too widespread. It is completely intolerable for any care provider not to meet its statutory obligations. As the shadow Minister said, we have to ensure that when they commission care, councils cannot be complicit in an arrangement that they know will end up with people not receiving proper pay.