Assisted Dying

James Cartlidge Excerpts

Monday 4th July 2022 Westminster Hall

[The Parliamentary Under-Secretary of State for Justice (James Cartlidge)]

It is a pleasure to serve under your chairmanship, Mr McCabe. I congratulate the Petitions Committee and the hon. Member for Gower (Tonia Antoniazzi) on securing the debate. Introducing a debate on a matter like this means speaking at a very pressured moment. I thought she spoke with bravery and set the tone for what has been a very moving, powerful debate with high-quality contributions on both sides. It has shown Parliament at its best, as is often the case when we are freed from pre-set whipping, Government positions and so on.

I am grateful to the more than 155,000 people who signed the petition. Obviously, we must not forget the role of our constituents and the public in this matter. This debate is a welcome opportunity for the House to debate, for the first time in this new Session, an issue of such profound sensitivity and importance. We all experience the death of people we care about and, wherever one stands on the underlying issue, we must surely all want dignity and compassion for those in their final phase of life.

Before turning to the Government position and contributions from colleagues, I want to start with a note on the language, as referred to by my hon. Friend the Member for Aberconwy (Robin Millar). Some people draw a distinction between assisted dying, which they see as allowing dying people to have a choice over the manner and timing of their imminent death, and assisted suicide, which they see as helping people who are not dying to choose death over life. To be clear, the criminal law currently makes no such distinction; under section 2 of the Suicide Act 1961, the offence is “encouraging or assisting” suicide, and my use of the term “suicide” reflects that. It does not indicate prejudice either way, and it is not an indication of the Government taking one side over the other.

The Government’s view remains that any relaxation of the law in this area is an issue of individual conscience and a matter for Parliament to decide. To be clear, that does not mean that the Government do not care about the issue at hand—far from it. It means that the ultimate decision on whether to change the law is for Parliament to decide, in the tradition of previous matters of conscience that have come before the House.

While I note the petition’s call for the Government to bring forward legislation to allow assisted dying for adults who are terminally ill and have mental capacity, our neutral stance means that such a change would have to be made via private Members’ legislation. If, at a future date, it became the clearly expressed will of Parliament to amend or change the criminal law so as to enable some form of assisted dying, the Government would of course undertake the role of ensuring that the relevant legislation was delivered as effectively as possible.

Turning to the many contributions made by colleagues today—I apologise if I do not cover all of them—I think it is fair to say that there is a strong consensus on the need to ensure that we have high-quality palliative care. Those on both sides of the debate agree strongly on that. As my hon. Friends the Members for South West Bedfordshire (Andrew Selous) and for Devizes (Danny Kruger) mentioned, the Government have shown in recent legislation the importance that they attach to the matter.

I can confirm that NHS England is developing an ambitious programme focused on transformational approaches for the next five years. The programme will build on the work of the palliative and end-of-life care strategic clinical networks, which sit across the seven regional footprints. The Government recognise that high-quality palliative and end-of-life care should include the opportunity for individuals to discuss their wishes and preferences so that they can be taken fully into account in the provision of their future care—also known as advance care planning.

Of course, resources matter. Many Members made that point, including the hon. Member for North Antrim (Ian Paisley) and the hon. Member for Bristol South (Karin Smyth), who has NHS management experience. Obviously, the Government strongly agree. We are providing £4.5 billion of new investment to fund expanded community multidisciplinary teams providing rapid, targeted support to those identified as having the greatest risks and needs, including those at the end of their life.

On hospices, my constituency neighbour and right hon. Friend the Member for West Suffolk (Matt Hancock) —the former Health Secretary—made a point about the joint funding model. Most hospices are independent charitable organisations, and they receive around £350 million of Government funding annually to provide NHS services. As part of the covid response, which my right hon. Friend of course oversaw, more than £400 million has been made available to hospices since the start of the pandemic to secure additional NHS capacity and enable hospital discharge.

Turning to some of the core issues raised today, a number of colleagues referred to what is happening in other jurisdictions. My right hon. Friend the Member for Sutton Coldfield (Mr Mitchell) and others made the point that change is happening in many other jurisdictions and argued that we should be reflecting that. Equally, however, my hon. Friend the Member for Hastings and Rye (Sally-Ann Hart) made the point that some evidence from those jurisdictions may be negative. I think she referred to the experience of the medical profession in Canada. Clearly, whatever we do and however we move forward, we should always be cognisant of what is happening in countries and jurisdictions where the law has changed.

Perhaps the key point of principle here, which is where this becomes a matter of conscience, is choice—choice versus the risk, shall we say, of abuse, and the need for safeguards and so on. Many colleagues spoke about choice, including my hon. Friends the Members for Thirsk and Malton (Kevin Hollinrake) and for Boston and Skegness (Matt Warman), the hon. Member for Brentford and Isleworth (Ruth Cadbury), and my right hon. Friend the Member for West Suffolk. The hon. Member for Glasgow Central (Alison Thewliss) said it is about the right to choose “a good death”.

I was particularly moved by the hon. Member for Sheffield Central (Paul Blomfield), who said that we should consider the choice not just of the individual but of their family, who, because of fear of the criminal situation, may feel that they cannot discuss the matter. His was one of the most moving speeches I have heard in my time as an MP, and I hope that people on all sides respect the fact that he spoke under great duress, shall we say, but added much to the debate.

Equally, there is a concern that choice is restricted by income, particularly when we are talking about Dignitas. That point was made by my hon. Friend the Member for Sevenoaks (Laura Trott) and others. However, against that—we must remember this—the right hon. Member for East Ham (Sir Stephen Timms), whom I support, spoke eloquently about the risk of pressure on those who may feel that they have to take an action that they would not have felt they should take before any change in the law. That is an incredibly important point. My hon. Friend the Member for Darlington (Peter Gibson) made a similar point, as did my hon. Friend the Member for Devizes, who said that it could be argued that that actually restricts choice because of the pressure it implies. My right hon. Friend the Member for Gainsborough (Sir Edward Leigh) spoke about the proposed change implying death on demand.

On the position of the public, polling does seem to have shifted. My right hon. Friend the Member for West Suffolk and the hon. Member for Gower both referred to what is happening with the opinion polls. However, my right hon. Friend the Member for New Forest West (Sir Desmond Swayne) made the point that a poll is not an argument and we are, after all, a representative democracy. Ultimately, it will be for this House, through a private Member’s Bill or another mechanism, to make the change.

As there are only three minutes left, I will rattle through my remaining points. There was much talk of the slippery slope from the hon. Member for Swansea West (Geraint Davies) and others. I just say to my right hon. Friend the Member for Gainsborough that if a doctor were injecting drugs with the aim of ending life, that would not be assisted suicide or assisted dying; that would be murder under common law. [Interruption.] I am afraid that, because of the time, I will finish with this point.

I think that colleagues on both sides are calling for a national conversation and, if not an inquiry, then certainly an investigation by the Health and Social Care Committee, for example. Obviously, if any of those steps go forward, the Government will do their best to assist, within the constraints of their neutral position, which I take very seriously. The matter was recently debated at length in the House of Lords. It is for hon. and right hon. Members, if they wish, to bring forward private Members’ Bills or debates in the usual way, such as through the Backbench Business Committee.

Wherever we stand, I think we can all say that this has been a very passionate debate that has moved forward the public’s understanding of the key positions on both sides. We should all be proud of the way in which the Petitions Committee has allowed the public to see all the arguments, and I am grateful to all hon. Members who contributed to the debate.

[Steve McCabe (in the Chair)]

I call Tonia Antoniazzi—you must conclude before 7.30 pm or the motion will lapse.