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

Jack Abbott Excerpts

Committee stage
Wednesday 19th March 2025 Public Bill Committees

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

It is a pleasure to serve under your chairship, Mrs Harris. I was also not intending to speak, but I think there are two slightly different issues here. Prior to Second Reading, the Equality and Human Rights Commission produced a briefing paper on some of the issues that have been covered in amendment 500. It also gave oral evidence where it was not happy about some aspects of the Bill and about not having the equality impact assessment.

I hear what my hon. Friend the Member for Sunderland Central says, but the briefing that the EHRC produced—although I appreciate what the Equality Act says—did not talk about sexuality, for instance, but it did talk about many of the aspects that are in the amendment of the hon. Member for Richmond Park. In the oral evidence, Dan Scorer from Mencap particularly talked about the experience in covid—for example, someone was five times more likely to have a do not resuscitate order placed on them if they have a learning disability. There is wide evidence of that, as Members, and me in particular, were well aware before we heard that oral evidence.

As a councillor, I remember the experience of ethnic minority communities during that period. I used to represent a council ward with a high west African population. There were clear cultural issues around people’s experiences with the health service during that period, and whether they wanted to take up the vaccine. As the then leader of the opposition on my council, I had regular meetings about the different levels of uptake of health services among different communities.

Beyond new clause 8, tabled by my hon. Friend the Member for Spen Valley, which would require the Secretary of State to engage with the Equality and Human Rights Commission, there is a valuable reason for seeking to have that data and for ensuring that the assisted dying commissioner has that data. As I will talk about in debates on subsequent groupings, Dan Scorer from Mencap clearly asked about what happens if things go wrong for people with certain protected characteristics, and at what stage we will review that.

Some of us have legitimate concerns about the characteristics in the amendment tabled by hon. Member for Richmond Park, and about coercion, particularly of women. People have listened long and hard about where I am coming from on this issue, and unlike some other Committee members, I am not opposed to assisted dying per se. I have come to the position, however, that it is vital to try to capture the data on people with learning disabilities or for whom there is a judgment about their level of mental capacity, and that should be in the Bill. I therefore support the amendment.

[Jack Abbott (Ipswich) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mrs Harris. I was not planning to speak on this group either, but the debate speaks to a number of the things that we have talked about in the past few weeks. I add the caveat that all hon. Members present acknowledge that the promoter of the Bill, my hon. Friend the Member for Spen Valley, has repeatedly made it clear that data collection is essential to what we are proposing. I am also sympathetic to what my hon. Friend the Member for Sunderland Central said about not necessarily needing to put everything in the Bill.

Without trying to sound like a broken record, however—I have made this point several times over the past few weeks—it is critical that in certain situations, although there may be some regulations or inferences that exist that may lead to certain outcomes that we on this Committee would all like to see, there is nothing necessarily wrong with putting them explicitly in writing.

Hon. Members have used different stats from different jurisdictions in their own way to lend weight to their arguments, and although many of those stats are relatively consistent in a number of areas, they are not necessarily decisive. I cited a stat yesterday when speaking to an amendment that around 10% of people using the assisted dying route have complications during the final stages, but as I said then, that came from an incredibly small sample size of just over 100 people.

It is therefore critical that, if the Bill is passed and we go down this path, we pursue robust and expansive data gathering in a number of different areas, and I am sure that any Government would look to do so. As long as it does not create any loopholes or unintended consequences, that sort of evidence gathering should be in the Bill because, at the very least, that would provide reassurance that it will happen if the Bill is passed.

[Sarah Sackman]

I do not have a lot to add, but I point out that, as the Bill stands, clause 34 requires the chief medical officer to, among other things, submit an annual report to the relevant national authority on the operation of the Act. Amendment 382 tabled by my hon. Friend the Member for Spen Valley would make the voluntary assisted dying commissioner responsible for that function instead. Amendment 274 would require that the report under clause 34 contains an analysis of the additional information to be collected under new clause 10 and amendment 273. I remind the Committee of that because we are discussing what information should be gathered, and at what point in the process. There is then the monitoring, reporting and co-ordinating function performed by the voluntary assisted dying commissioner, should those later amendments be passed.

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[Daniel Francis]

I will speak to amendment 394 in my name, which provides that codes of practice may be issued on

“the provision of information and support to persons with learning disabilities who are eligible to request assistance to end their own life under this Act, including the role of advocates for such persons”.

I am aware that my hon. Friend the Member for Spen Valley may speak to amendment 517 and new clause 25, which we will discuss shortly.

I tabled a number of amendments, one of which was accepted, following conversations with Mencap. Dan Scorer from Mencap gave us oral evidence on advocacy support, the discussions and the role of families and said:

“Individuals should be able to choose who supports them with those discussions, whether it is friends or family members or an independent advocate—that would probably be our preference—who is specifically trained to support people with a learning disability who are considering their end-of-life options.”––[Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 30 January 2025; c. 273, Q355.]

I will not go on at great length—hon. Members have heard my views on support for people with learning disabilities, and I am conscious that we will come to other amendments on this issue—but I will move my amendment when we get to the relevant stage, in a manner consistent with the approach that I have taken in Committee so far.

[Jack Abbott]

I realise that we could be called away to vote at any moment, but I rise to speak to amendment 534. It is relatively small, and I appreciate that what it seeks may already be covered by regulations, but it would ensure that it is also put in a code of practice.

Anybody seeking an assisted death under the Bill who meets the eligibility criteria should be able to access it. However, there is a risk that the requirement that patients provide two forms of proof of identification could present challenges for certain groups, causing inequalities of access—[Interruption.]

[The Chair]

Order. The sitting is suspended for 15 minutes for a Division in the Chamber. The Committee will reconvene at 7.15 pm.

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On resuming—

[Jack Abbott]

We all know that inequitable access to good quality health and palliative care is a massive issue across the country. People in certain communities—for example, those living in areas of high deprivation, those from black, Asian and minority ethnic communities and those from inclusion health groups, such as the homeless—already experience significant challenges in accessing quality care.

We have a duty to ensure that anyone meeting the eligibility criteria who wishes to seek an assisted death under the Bill can do so. We must therefore ensure that the requirements for which forms of proof of identity are acceptable do not exacerbate existing inequalities of access and prevent those who would otherwise meet the eligibility criteria from seeking an assisted death should they choose to.

The question of which forms of proof of identity are acceptable is therefore essential, as we know that photo ID requirements can present additional barriers to certain demographics and communities. Data from the Electoral Commission following the 2023 local elections found that while only 3% of all non-voters said that they did not vote because they did not have the required ID, that figure was 8% for unemployed non-voters and 9% for disabled non-voters who reported being “limited a lot” by their disability or health condition.

The data also found that awareness of ID requirements was lower among those without an accepted form of ID—only 74%, in contrast with 92% of the population overall. Awareness of the requirement was also lower among young people and those from black and ethnic minority communities. Clearly, a photo ID requirement could present barriers to equitable access to assisted dying. We must ensure that requirements about which forms of proof of identity are acceptable do not create new inequalities of access.

The requirement for proof of identity has been included in the Bill for a good reason, because it is a necessity and a critical safeguard. Ensuring that the Bill has the requisite safeguards for assisted dying to be safely implemented is essential to what the Committee is doing. It is therefore important to get right the question of what forms of proof of identity are acceptable for someone to access assisted dying under the Bill. We must also ensure equity of access to the service without diluting critical safeguards.

Clause 6 says that the regulations regarding the forms of proof of identity that are acceptable are subject to the negative procedure, but the issue is too important to be left to that negative procedure without sufficient parliamentary scrutiny. By including the requirements for which forms of proof of identity are acceptable in clause 30, the amendment would rectify that. It would entail that the regulations pertaining to which forms of proof of identity are acceptable under clause 6 are subject to the affirmative procedure and that, prior to the Secretary of State issuing a code of practice in relation to the question, they would have to consult such persons as they considered appropriate.

By agreeing the amendment, we would guarantee that the question of which forms of proof of identity are acceptable is given the requisite consideration. That would ensure that the requirements do not act as a barrier to equitable access to assisted dying, without diluting the safeguards that the requirement inserts into the Bill.

[Danny Kruger]

I want to quickly explain that my amendment 523 is consequential on amendment 447, but there is drafting issue. I will not go into the details but, if amendment 447 is made, as I understand it will be, my amendment 523 is not necessary. I would be grateful for the Minister’s guidance: if he has been advised by parliamentary counsel that the clause as amended by amendment 447 is okay and there is no need for amendment 523, I do not propose to press it to a vote.