Progression of Bills through Parliament

Debate between Daniel Francis and Lewis Atkinson

Monday 8th June 2026 Westminster Hall

[Lewis Atkinson]

I agree entirely. I absolutely respect the fact that others, including opponents of the Bill, reach different judgments on this difficult issue. Ultimately, as I said, in our parliamentary democracy that is for Parliament to resolve, on the balance of judgment of its constituent-elected MPs. That is explainable to our constituents. If something that constituents wish for is decided on by Parliament, that can be explained; what struggles to be explained is when tactics and filibustering are used to not reach a decision at all. I will come on to talk a little about that.

At this stage, it is important to say that I spoke to groups opposed to assisted dying as part of my preparation for the debate—again, not to discuss the substance of assisted dying itself, but, as part of balance, to get their view about the process. It is fair to say that their position includes the assertion that the Lords were justified in not reaching a decision on the Bill because Commons consideration in Committee was flawed. I personally disagree; having sat in Committee for more than 100 hours—way in excess of nearly any other Bill—I might be expected to say that. Those exact same arguments, however, were available to Members before Third Reading.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

As my hon. Friend knows, we both sat long and hard on that Bill Committee. But if we sent the Bill to the other place in good shape, why did the sponsor there table 77 amendments to it? Is my hon. Friend able to outline why that happened?

[Lewis Atkinson]

I am not here to speak for the sponsor of anything; I am here to speak for parliamentary democracy. Fundamentally, on Third Reading, MPs clearly backed the Bill. That was the final chance for MPs to have their say. In all those debates, my hon. Friend made his points well and ably, as I made mine, in Committee and beyond. I entirely respect his perspective, but I am bringing us back to the issue of parliamentary democracy.

It is entirely appropriate, and no one is disputing—the petitioners are not disputing—that the Lords should scrutinise and indeed amend legislation passed to them from the Commons; what the petitioners find outrageous, frankly, is the failure to consider it. I will come on to that.

Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting)

Debate between Daniel Francis and Lewis Atkinson

Committee stage
Tuesday 25th March 2025 Public Bill Committees

[Daniel Francis]

The annual reporting does give us some reassurance, but when we accepted some of Mencap’s recommendations last week, I said that I would welcome it if the entirety of its recommendations were accepted—and it wanted an overall review at an early stage in the process.

Amendment 493 to 495, in my name, address those concerns. A consistent concern of mine is how we address issues that come to light from specific communities, particularly those with learning difficulties, and amend the legislation at a reasonable stage in the process.

[Lewis Atkinson (Sunderland Central) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Roger. I will be brief.

I am in favour of retaining the Bill as it stands. The key thing is the interplay between this clause and clause 42, on commencement. I would have been minded to support changes to the reporting period had the Bill been commencing within two years, as clause 42 as drafted sets out, but my hon. Friend the Member for Spen Valley has tabled an amendment that will change the backstop of the commencement period to four years. The timescales set out in this clause are from the day on which the Bill is passed. It makes no sense to carry out a formal review of the operation of the legislation before the services have come into being. We will have a four-year timetable, potentially, for the backstop of the commencement. Throughout that time, the annual reporting requirement of the commissioner, who will undoubtedly have been appointed in advance, will kick in.

I also draw the Committee’s attention to new clause 35, tabled by my hon. Friend the Member for Penistone and Stocksbridge, which speaks to some of the concerns raised by my hon. Friend the Member for Bexleyheath and Crayford. I strongly support the new clause, and the establishment of a disability advisory board to report annually on the effect on disabled people of not just the Act but the implementation. Picking up any concerns or views about its effect on people with disabilities would happen in a timely manner under new clause 35.

Terminally Ill Adults (End of Life) Bill (Twenty-second sitting)

Debate between Daniel Francis and Lewis Atkinson

Committee stage
Wednesday 12th March 2025 Public Bill Committees

[Daniel Francis]

Yes, I am aware of some of those submissions from those individuals. I will come to this, but clearly even some people who were in support of making changes did not recommend the ones that we have now incorporated.

First, I would argue that people giving evidence to the panels should be doing so under oath. In my 20 long years as a local councillor, I gave evidence under oath to an investigation by a health and safety executive into the demolition of a building. I would say that the demolition of a building and this matter are very different, and therefore I query why this evidence is not being given under oath.

[Lewis Atkinson]

My hon. Friend is making a thoughtful speech. Has he had the chance to consider the situation with mental health tribunals that I mentioned yesterday, which usually do not take evidence under oath? Clearly, they make very serious decisions regarding sectionings and deprivations of liberty without invoking oath-taking powers.

[Daniel Francis]

I accept what my hon. Friend says, but there are differences of opinion. I accept that that is a very serious matter, but I would argue that a matter of life and death is more serious, and there are processes that we know. As I said, I gave evidence under oath about the demolition of a building and whether someone had followed the correct health and safety regulations, yet we would not be doing so in this case.

Terminally Ill Adults (End of Life) Bill (Twenty First sitting)

Debate between Daniel Francis and Lewis Atkinson

Committee stage
Tuesday 11th March 2025 Public Bill Committees

[Daniel Francis]

I am not entirely persuaded. I think there is currently a mixture of cases, and there will potentially be a mixture of cases in future. I hear what the right hon. Member says, but my primary concern is about the way things are. As I say, I am minded not to support the amendments on balance, but I am concerned that we could end up hearing stories about someone’s loved one of 50 years, or their child with a learning disability, having had an assisted death—and the first they knew about it was when it was too late.

[Lewis Atkinson (Sunderland Central) (Lab)]

It is a pleasure to serve under your chairship this afternoon, Ms McVey.

I feel that we are dancing on the head of a pin, but I oppose the amendment. Members across the debate have recognised that, as Dr Sarah Cox from the Association for Palliative Medicine said, it is always for the patient to decide. As my hon. Friend the Member for Rother Valley pointed out, both the original clause and the amendment rightly retain that decision with the patient. They also retain the discretion of the doctor, whether that is on an appropriate test or a best interests test.

I note that in its submission the Royal College of Physicians advocated the removal of the clause, saying that it goes beyond current practice. I support the clause on balance, because of the importance of these conversations and so on, but the physicians who are likely to carry out the conversations think that it is inappropriate to specify these conversations in primary legislation.

There are two phrases in the amendment that I think are entirely inappropriate. First, there is “concluded in good faith”. I am sure it is not the intent of the author and mover of the amendment, but it suggests that in other instances people might be acting other than in good faith. I commend the words from my hon. Friend the Member for Ipswich. We have to start from the point that doctors are operating in good faith. It is dangerous to set up a good faith test, as opposed to an “other faith” test, in primary legislation.

Secondly, I am certainly not trying to reopen the long debates we had about the Mental Capacity Act, but Members will recall that in those debates we were very clear that the “best interests” test should not and does not apply. Introducing language about best interests the first time in the Bill is very dangerous, and totally against the spirit and principle of what we have debated so far. For those reasons, I am against both amendments.

Terminally Ill Adults (End of Life) Bill (Seventeenth sitting)

Debate between Daniel Francis and Lewis Atkinson

Committee stage
Tuesday 4th March 2025 Public Bill Committees

[Lewis Atkinson]

I do not disagree with my hon. Friend. I gently say that the GMC guidance specifically references that Act, so that is what I was referring to.

I am pleased to see amendment 341, which I believe would bring the legislation into line with that GMC guidance, ensuring that removing the duty to refer would absolutely not be a licence for people to be left without access to care. The GMC is very clear, as the hon. Member for Reigate said, that people must be given sufficient information and be empowered to seek the options and information that they need. Therefore, I am pleased to support the amendment.

[Daniel Francis]

It is a pleasure to serve under your chairmanship, Mr Dowd. I note that my hon. Friend the Member for Spen Valley has said that she is minded to accept amendment 341. I will, however, still briefly speak to amendment 338 and new clause 13, which stand in my name.

The British Medical Association has said that it strongly urges MPs to support the amendments, which would remove the referral requirement in relation to preliminary discussions and establish an official body to provide factual information to patients about the range of options available to them. As the hon. Member for East Wiltshire mentioned, Dr Green, in his oral evidence, said:

“The provision of information would be very useful, because in a situation where a doctor was unwilling to have an initial discussion with the patient, it would provide a way for the patient to get that information that was in no way obstructive.”––[Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 28 January 2025; c. 46, Q37.]

He went on to say:

“I do not believe that it is ever appropriate for a doctor to recommend that a patient goes through an assisted dying process.”––[Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 28 January 2025; c. 48, Q40.]

He also said:

“The word “referral”, to a doctor, means writing a letter or communicating with another doctor to see, but some doctors would find themselves not able to do that. For that reason, we believe that there should be an information service for the doctor to direct to.”––[Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 28 January 2025; c. 48, Q41.]

The BMA’s position is that the proposal is analogous to doctors’ professional legal obligations regarding abortion, and consistent with the Bill’s inclusion in clause 23 of a right to refuse, for any reason, to carry out activities directly related to assisted dying. It has said:

“In tandem, we believe creating an official body to provide individual information and advice to patients, to which doctors could direct (rather than refer) patients, would ensure that the doctor’s views are respected, whilst also—crucially—ensuring that patients can easily access the information and support they need. Currently, whilst the Bill acknowledges the need for accurate, impartial information and advice for patients, it gives no indication of how this might be delivered—generic published information would not be sufficient. Patients would need individual advice, guidance, and support so that they can make informed decisions, and an independent information service could meet this need.”

As the hon. Member for Reigate mentioned, a member of the Royal College of General Practitioners also said:

“The BMA referred to the word “refer”—referring to a colleague, for those who did not want to do it. We agree that signposting is a better process.”––[Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 30 January 2025; c. 279, Q365.]

He went on to say:

“Similar to other services, such as termination of pregnancy, we think that the best option would probably be that the GP could signpost to an information service, such as something like what the BMA suggested the other day. They would not have to do anything more than that, and they would not withhold any option from the patient.”––[Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 30 January 2025; c. 273, Q354.]

Therefore, I commend amendment 338 and new clause 13 to the Committee.

Terminally Ill Adults (End of Life) Bill (Thirteenth sitting)

Debate between Daniel Francis and Lewis Atkinson

Committee stage
Tuesday 25th February 2025 Public Bill Committees

[Daniel Francis]

I hear that point but, looking at my postbag, the people who berate me for not supporting the Bill often talk about their loved ones with motor neurone disease or Parkinson’s, which I understand from oral evidence will be exempt. We need to make it clear which disabilities and conditions will be eligible, and I am not sure that the amendments before the Committee nail it down. I am concerned that the wording would lead to potential loopholes and legal challenges.

We should still be concerned about legal review of the Bill, based on indirect disability discrimination. The Equality Act says that indirect discrimination happens when a rule, a policy or even a practice that applies to everyone disadvantages people with a particular disability, compared with people who do not have that disability, where that cannot be shown to be justified as being intended to meet a legitimate objective in a fair, balanced and reasonable way.

If we accepted this amendment to allow the inclusion of cancer and some other disabilities set out in the Equality Act, I believe it would be argued in due course that other disabilities meet the criteria for assisted dying and, despite the promises made to this Committee and to the House in good faith, the loopholes would allow the criteria to be widened.

Other amendments in this group retain the reference to the Equality Act 2010, which could equally result in legal challenges down the line, for the reasons my hon. Friend the Member for Spen Valley outlined this morning. I am not deliberately being difficult, but I am not sure that any of the amendments would completely achieve what they seek to achieve.

I await the Minister’s view on the matter but, as things stand, I am concerned that we will take the clause back to the House without completely satisfying Members’ aims. By allowing those with cancer to seek assisted dying, there could be a loosening of the rules for other disabilities. I fear there could be manuscript amendments on this matter, but I await the Government’s view on the robustness of these amendments if they were to be accepted.

[Lewis Atkinson]

I want to come back to the Bill as drafted. The key factor in clause 2, for me, is the focus on terminality. That is what determines eligibility: that death is reasonably expected within six months. The clauses that we are discussing, subject to amendment, merely clarify—rightly, because this is important, and I too will wait to hear the Government’s guidance—that solely having a disability or a mental disorder does not in itself provoke eligibility. I fear that we are overcomplicating matters; the focus on terminality is in the name of the Bill. It is the Terminally Ill Adults (End of Life) Bill, and that is what we are focusing on today. I urge Members to think about that point when they consider the amendments, including amendment 181 from my hon. Friend the Member for Spen Valley.