Terminally Ill Adults (End of Life) Bill

Ben Spencer Excerpts

2nd reading
Friday 29th November 2024 Commons Chamber

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

Prior to my election to Parliament, as a consultant psychiatrist with a PhD in decision-making capacity, I would have met both criteria to be a medical expert assessor under clause 9(3)(b), so I have a particular perspective as someone who, in different circumstances, might have been called upon to make these assessments.

I strongly believe that we should respect and support the right to bodily autonomy for people with full decision-making capacity, subject to the caveat that it does not cause serious harm to others. I argued for this when I was on the working group of the independent review of the Mental Health Act 1983 and on the pre-legislative scrutiny Committee on the Mental Health Bill, which, among other things, aims to prevent people from coming to harm when suffering from severe mental illness. These reforms were debated in the House of Lords this week, and they demonstrate how Parliament should legislate in complex areas that balance individual autonomy and risk.

In contrast, as a private Member’s Bill, there is limited ability for scrutinising this Bill’s provisions. It has had no independent review, no pre-legislative scrutiny and no impact assessments. Many MPs support the principle of assisted dying yet have concerns about implementation, resource implications and safeguarding. That is why I, along with colleagues on both sides of the House, tabled a reasoned amendment calling for an independent review and consultation before a vote in Parliament, to provide a third way through. I thank the Members who supported the amendment, particularly the hon. Members for Shipley (Anna Dixon) and for Twickenham (Munira Wilson), for their work and their extensive and careful consideration.

Although the general debate on assisted dying may focus largely on the principles, legislation must address the limits to and the safeguards on consent. Should people be able to agree to a medically assisted death? If so, what restrictions, if any, should there be on people who can make this decision—age, capacity, terminal illness, intolerable suffering? And then, what safeguards are there to uphold these limits and to prevent abuse—assessments by two doctors, judicial scrutiny?

Given that the main argument I see in favour of assisted dying is the exercise of personal autonomy, I believe the most substantive issues we need to wrestle with are the limits that we set. Why is this Bill limited to the terminally ill and not those who are suffering without that being terminal? What even comes within the scope of terminal illness? With the refusal of treatment and medication, conditions such as type 1 diabetes and HIV can be designated as terminal, despite being fully treatable.

There are many questions, but in this Bill the most prominent problem is that, in a legal context, if the availability of assisted dying is limited only to those who are terminally ill, it is discriminatory either to those with or without terminal illness. Either their right to autonomy is greater than others’, or the value of their life is worth less.

We must also ask whether autonomy can be exercised where there is no choice. If good palliative care is simply not available, can we really rely on this as a true and free decision? I would argue that we cannot, and that this Bill does not safeguard against coercion through state neglect.

[Lola McEvoy (Darlington) (Lab)]

Will the hon. Gentleman give way?

[Dr Spencer]

I usually would, but unfortunately that would impact on other Members who wish to speak. I apologise.

What is fundamental to me, given my interest in capacity, is that we have not considered how much human decision making is driven by altruistic intentions. “I did it for my children” is rightly a primary motivation in many settings, but as a society are we comfortable with a decision to seek a medically assisted death so as not to be a burden on one’s family or to save them money?

This will not impact on capacity. We cannot pretend that capacity assessments will be a shield for these moral concerns. Where is the line, if there is one, between indirect coercion and the natural human responses in a stressed family unit looking after a sick loved one?

I believe that we could introduce legislation on assisted dying that has fully reviewed and addressed these issues, but parliamentarians must deal with what we have in front of us today. Proponents on both sides of the debate frame this vote on Second Reading as a vote on the principle of assisted dying, but in reality it is a vote on implementation as put forward in this Bill.

As a former mental health doctor, I am proud that I was there for the most vulnerable. Today, I think about those without a voice in this debate or in the TV studios. I think about the elderly woman in the care home with mild cognitive impairment, who retains capacity but is nevertheless vulnerable to coercion and undue influence, or the sick mother whose child may lose their job or their relationship due to the burden of caring responsibilities. The Bill would not protect them. It risks placing implicit pressure on people already vulnerable at a time of life when they should receive our unwavering care and support. We should and must vote it down.

Anonymity of Suspects Bill

Ben Spencer Excerpts

Friday 28th October 2022 Commons Chamber

[Sir Christopher Chope (Christchurch) (Con)]

I beg to move, That the Bill be now read a Second time.

I will begin by briefly explaining why I did not move the Mobile Homes Act 1983 (Amendment) Bill. The Government have agreed that the Mobile Homes (Pitch Fees) Bill, which will have its Second Reading on Friday 18 November, will have their support. That Bill specifies a change from using the retail prices index to the consumer prices index as a basis for the maximum annual increase in pitch fees, which would change the maximum from 12.5% to 10.1%. On the basis of that good news, I thought it would be better to raise a separate subject.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

I thank my hon. Friend for his assiduous work to campaign for that change. I put on the record my great pleasure that the Government will support the Bill in November, because it will make such a difference to all our park home residents.

[Sir Christopher Chope]

I am grateful to my hon. Friend. The proof of the pudding will be in the eating. We cannot count our chickens yet, but let us hope that everything goes smoothly in November.

I am most grateful to the hon. Member for Brighton, Pavilion (Caroline Lucas) for allowing me time to speak today. She could have spoken for the whole half hour; I am sure that she would have had more than enough material. I did not intervene on her, but if I had, I would have referred to the fact that Tony Juniper, a former candidate for the Green party and a director of Friends of the Earth, is apparently on record as saying that he could not support the “right to roam everywhere” because

“remote, quiet areas are fewer and fewer”.

I am glad that we have time to reflect on not just what the hon. Lady said but what Tony Juniper said.

Laboratory Animals: Animal Welfare Act

Ben Spencer Excerpts

Monday 7th February 2022 Westminster Hall

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. I thank the hon. Member for Linlithgow and East Falkirk (Martyn Day) for his very powerful opening speech.

This is a very important debate on the welfare of animals subject to research. In preparing my comments for today’s debate, I looked into the Animal Welfare Act 2006 and its definition of unnecessary suffering and what the guidance is in relation to people who are taken to court for that, and into the Animals (Scientific Procedures) Act 1986—ASPA—and the way it regulates research on laboratory animals around the three R’s of replacement, reduction and refinement, and the cost-benefit analysis. I was going to prepare a speech looking at those two different frameworks, the pros and cons, and utilitarian-based ethics around necessary suffering and so on, but it strikes me that the core title of this petition is very much not about the specific frameworks by which research on animals takes place, but rather about whether there should, can or could be animal research full stop and the justification for animal research in its entirety, through whatever regulatory framework is put in place to minimise animal suffering. It is on those points and the more existential question, “Should we have animal research or not?”, that I will focus.

I wish—I think we all wish—that we did not need animal research. And of course, when it takes place, we want to avoid all animal suffering if at all possible. I do not think anyone in this room wants animals to suffer. But the sad truth is that we need animal research. There are situations in which it is essential and in which its likely benefit is clear. In terms of justifying it, I will focus on two areas, the first of which is research for human benefit. I do think there is evidence to show that animal research is very important, particularly in transgenic animals, in looking at disease models for diseases such as Alzheimer’s and in the development of new drugs.

I can give a topical example from a few weeks ago: I think we will all have seen the story about the person who got a transgenic heart from a pig. It would not be possible to develop transgenic animals for organs for human transplantation without research into animals. I cannot see the future of medicine, particularly the exciting stuff such as xenotransplantation to treat diseases, without the use of experiments on animals.

[Dr Cameron]

Will the hon. Gentleman give way?

[Dr Spencer]

I am very happy to take interventions if I am wrong about that and someone wants to correct me.

[Dr Cameron]

I thank the hon. Gentleman for the way that he has approached the debate. He clearly wants to look at the evidence base, which is incredibly powerful and important. Does he agree, however, that to get to the bottom of whether the alternatives are sufficient in today’s world, a scientific hearing of expert opinion is called for? That is something that we in this House should all support to move forward.

--- Later in debate ---

[Dr Spencer]

I thank the hon. Lady for her remarks. The issue is not the general principle but the specifics. As with the example of xenotransplantation that I just gave, one can produce lots of specific examples in which the cost-benefit analysis under the ASPA is probably justified. I am sure that there are lots of specific examples—including the harrowing examples I heard from the hon. Member for Linlithgow and East Falkirk—where, at face value, I might wonder, “How on earth can that be justified?” The argument is more about how the ASPA operates as opposed to whether it should or should not exist. That system should be properly enforced and enable proper scrutiny of decisions based on the cost-benefit analysis for specific research programmes.

The need for animal research is not limited just to human disease. I will give an example that is close to my heart: the Animal and Plant Health Agency. Its headquarters are in my constituency and are known as the Weybridge research site even though, ironically, they are actually situated in New Haw. It is worth looking at what the APHA is doing. It published data on the animal research that it does. It has 32 badgers, which are used to look into the control of tuberculosis; 724 cattle, which are used for research into foot and mouth disease, among other things, to benefit global animal health; 439 domestic foul, the majority of which are used for avian influenza programmes; 69 ferrets to look into avian influenza and covid-19; 221 pigs, again to look at foot and mouth; and 65 sheep and goats to work on parasitology, to protect animal health.

Some of that research is directly beneficial to tackling disease in animals. It is worth remembering the impact that those diseases have on animals. I am sure that many people in this room remember when, in 2001—I was in my early 20s—6 million cows and sheep were culled to give protection from disease during the foot and mouth outbreak. More recently, 15 million mink were culled in Denmark in response to the covid pandemic. When that news came out a couple of years ago, I found it very upsetting. Anyone who knows animals from the Mustelidae family—weasels, otters and ferrets—knows that they are not stupid creatures. They are amazing, highly intelligent animals. Fifteen million are gone, just like that, because of the covid pandemic.

If we are going to take a utilitarian ethics argument, the research done into animal health, and the numbers of animals that research involves, are a drop in the ocean compared with the number of animals who are suffering, who have suffered, or who I worry will suffer, because of animal diseases. Without the ability to do animal research that is correctly regulated with strong welfare protections, we are doing animals a disservice in terms of their future health and the prevention of disease.

Although we all want to live in a world in which animal research is not needed, and we all want to improve animal welfare, the sad truth is that we need that research. I believe that the ASPA provides strong and robust animal protections, and I disagree that we should scrap it and move into a non-animal research world.

I said that there is one caveat. I was persuaded by some of the opening remarks, particularly when it comes to certain types of animals. I think stronger arguments can be made in the case of primates and great apes—chimpanzees, gorillas and orangutans. For a long time I have believed they should have protections above other animals, and I would support calls for a sliding-scale approach to animals. I would have stronger protections for primates and great apes in animal research, and also in general welfare.

Approved Premises (Substance Testing) Bill

Ben Spencer Excerpts

2nd reading
Friday 29th October 2021 Commons Chamber

[Rob Butler]

I thank my hon. Friend for raising that point, although I only half-thank her because I have to say that it is not a measure that I have thus far considered. I will take her up on it and find out more. If the Bill passes its Second Reading, I hope that she will serve on the Committee, so perhaps we could explore her suggestion at that stage. In the meantime I will endeavour to find out more, but I regret that that will probably not happen before I finish speaking today.

Prevalence testing on an anonymised basis would be key to helping HMPPS understand the ever changing drug landscape, and it would allow staff to take appropriate action to tackle the threat of drugs in those premises.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

What is your feeling about what the current prevalence is? You mentioned four different drug groups and the extent of the testing required. When the testing happens, what do you expect the most prevalent drugs will be?

[Mr Deputy Speaker (Mr Nigel Evans)]

Just a reminder not to use the word “you”, please.

--- Later in debate ---

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

It is great to rise to speak on this very important Bill, which has been introduced by my hon. Friend the Member for Aylesbury (Rob Butler).

I just want to make a few brief points in the limited time that I have. I appreciate that my hon. Friend cannot answer the question on the prevalence of different types of drugs, but, clearly, drug use in prisons and approved premises is rife. It is responsible for a lot of misery, delaying people and causing them problems in their rehabilitation process. The more that we can do on drug testing and offering drug testing, the better, particularly in terms of being able to offer proper treatment, packages and pathways for people going through the criminal justice system.

It is worth reflecting on the harms that drug use causes to people. We talk a lot about the harms to society, but there are also harms to people themselves. The most dangerous time to be a heroin user when a person is going through the judicial system is when they leave prison. When they leave prison, they get access to heroin again, take far more than they are used to and have heroin overdoses. It is important we make sure that people are detected and we get them on proper treatment plans so they can be rehabilitated back into society.

I thank my hon. Friend the Member for Aylesbury again for tabling the Bill, which will hopefully make a huge difference in protecting our society and, importantly, helping people on the path to rehabilitation.

Oral Answers to Questions

Ben Spencer Excerpts

Tuesday 14th September 2021 Commons Chamber

[Mr Speaker]

We just need to tone it down a little bit on all sides. I am concerned about some of the language that gets used and some of the accusations that are being made. I am sure we will be able to move on in a much more reasonable way.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

10. What steps he is taking to help ensure effective collaboration between his Department and the Home Office on reducing reoffending.

[The Minister for Crime and Policing (Kit Malthouse)]

The Ministry of Justice and the Home Office are working in close collaboration to beat crime and reduce fear of reoffending. I am the personification of that collaboration. The refreshed integrated offender management strategy is an example of that collaboration, improving working between probation and local police, meaning we can more easily identify persistent offenders in any particular area and take action to stop them from committing neighbourhood crime.

[Dr Spencer]

I thank my hon. Friend for being the personification of collaboration between the police and the Department. Will he join me in thanking and congratulating my local police forces in Runnymede and Weybridge on the incredible preventive work they have done around offending? Does he agree with me that prevention is better than cure, and could he lay out some of the work they are doing in terms of pre-offending, not just reoffending?

[Kit Malthouse]

My hon. Friend is quite right to point out that prevention is better than cure. One emphasis I have tried to bring to my mission as a joint Minister between the Home Office and the Ministry of Justice is that we should shift away from enforcement towards prevention as much as we possibly can. For example, he will know that we funded a series of violence reduction units across the country, working with young people well ahead of them moving towards offending or being involved in crime to make sure that they do not. We are also looking at innovative ways to deal with offenders leaving the secure estate to prevent them from offending, such as GPS tags. We are now currently tagging 100% of acquisitive criminals who leave prison in six police forces, soon to be expanded to a further 13, which is proving to be an enormous deterrent to their continuing offending, and is getting them back on to the straight and narrow.

Oral Answers to Questions

Ben Spencer Excerpts

Tuesday 18th May 2021 Commons Chamber

[Robert Buckland]

In a word, yes.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

As the ban on evictions starts to lift, what preparations has my right hon. and learned Friend made to ensure that the courts can cope with the surge of applications?

[Robert Buckland]

Volumes of possession actions remain significantly low as a result of measures that we took in response to the pandemic. Indeed, although the ban in England on bailiff-enforced evictions will end on 31 May, the requirement for landlords to give extended notice periods to seek possession orders in all but the most egregious cases has really struck the right balance. We intend to taper down these notice periods to pre-covid levels by October, which will help to manage demand in the courts. I pay tribute to senior judiciary for working at pace to develop a case management approach to possession cases.

Oral Answers to Questions

Ben Spencer Excerpts

Tuesday 22nd September 2020 Commons Chamber

[Gareth Bacon (Orpington) (Con)]

What steps his Department has taken to improve criminal legal aid provision.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

What steps his Department has taken to improve criminal legal aid provision.

[James Daly (Bury North) (Con)]

What steps his Department has taken to improve criminal legal aid provision.

--- Later in debate ---

[Alex Chalk]

My hon. Friend raises an important point. We want criminal law and criminal defence to be an attractive, sustainable profession, which is why we put £23 million into the advocates’ graduated fee scheme last year, which can benefit solicitor advocates, and why we put, as the first wave of criminal legal aid, up to £51 million into the profession. It is a great and important job, and we want people to go into it.

[Dr Ben Spencer]

I thank the Minister for his answers. Equity of access to justice is a central tenet of the rule of law. Does he agree that is it essential not only that everyone who needs it has access to legal aid, but that it is set at a level that does not disincentivise lawyers from taking on legal aid cases?

[Alex Chalk]

My hon. Friend makes a crucial point. Anyone in this Chamber could be accused of a crime they have not committed, and we need to ensure that there are lawyers who can take on the cases, challenge the prosecution and evidence, and ensure that justice is done. That is why we have the criminal legal aid review, and we want to ensure that that independently led review secures a sustainable profession into the future, so that justice can be done in the future.