Terminally Ill Adults (End of Life) Bill

Jeevun Sandher Excerpts

Friday 13th June 2025 Commons Chamber

Amendment 13, in the name of the hon. Member for Glasgow West (Patricia Ferguson), would require the appointment of the new voluntary assisted dying commissioner to be approved by the Health and Social Care Committee. The commissioner, a role created from scratch, will be a high-profile, influential and important position. Adding a second layer of approval would add more rigour to the appointment process, and provide transparency in the event of any problems that arise. It is vital that Members of this House have the opportunity to scrutinise and debate that new role, which was not included in the Bill on Second Reading.

[Dr Jeevun Sandher (Loughborough) (Lab)]

Thank you, Mr Speaker, for allowing me to rise to speak to new clause 6, which proposes a special representative for ethnic minorities. I am not white, as some Members may have noticed. The fact that my presence in this House is unremarkable is in and of itself remarkable. That did not happen by chance; it happened because of those who came before me.

The Mother of the House, my right hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott), has spoked powerfully in this debate, and I know that my unremarkable presence here is due to her remarkable achievements. We may not always hold the same opinions, but we have always shared the same Labour values. She will never know how grateful we all are to her. I may be part of the last generation of MPs who can say this to her while she is in the House: thank you.

My hon. Friend the Member for Vauxhall and Camberwell Green (Florence Eshalomi) has spoken powerfully in this debate, and my right hon. Friend the Member for Walsall and Bloxwich (Valerie Vaz) has tabled new clause 6. I know I stand on their shoulders too, and I do not doubt their good intentions, but this Bill has nothing to do with the colour of my skin. New clause 6 proposes a special representative for ethnic minorities. I disagree with the new clause, because the colour of my skin has no bearing here and no special place in this debate. Equalities data will be reported through the Equality and Human Rights Commission, as set out in clause 51, and the Secretary of State can already consult community representatives. For every person of every skin colour, this Bill gives those already dying a choice to end their suffering—

[Mr Speaker]

Order. We need to make sure that contributions are tied to the amendments. We are not debating the general points of the Bill—we have gone past that. The hon. Gentleman is making more of a Third Reading speech, which he might want to save.

[Dr Sandher]

It is to the point of where we are—

[Mr Speaker]

Order. I will make that decision. Please do not challenge the Chair.

[Dr Sandher]

I do apologise, Mr Speaker.

What I meant to say is that new clause 6 would introduce a special representative for ethnic minorities, and I am trying to explore why we do not need one. A duty to consult is already included in clause 51.

[Anna Dixon (Shipley) (Lab)]

This is a very sensitive issue. There is data to support the fact that people from minoritised ethnic groups are less likely to trust their health professionals—the figure is 18% among the general public, but as high as 30% among those groups. Does my hon. Friend not think it is necessary to make sure there are additional protections for those who face additional barriers, such as people from minoritised ethnic groups?

[Dr Sandher]

My hon. Friend makes a powerful point, and other hon. Members have also spoken powerfully about the impact that the Bill could have on ethnic minorities. Does any hon. Member know how many ethnic minorities access assisted dying in other nations? I will give way on this point; the hon. Member for Richmond Park (Sarah Olney) raised it earlier.

[Sarah Olney]

The hon. Member calls me to speak. If we do not know, it is probably because those other nations are not collecting the data. My position is that we should be collecting the data, which is why hon. Members should vote for my new clause 19.

[Dr Sandher]

We do know. Ethnic minorities are less likely to access assisted dying in jurisdictions where it is in place. In Oregon, 10% of those accessing assisted dying are ethnic minorities, but they make up 40% of the population. In California, ethnic minorities make up 15% of people accessing the option, but 30% of the population. However, that is not the point. The point of the Bill is to give people the choice to end their life regardless of the colour of their skin. There is no special quality about the colour of my skin that affects my access or the need for a special representative in this case, which is covered by the ECHR and by the Secretary of State.

[Naz Shah (Bradford West) (Lab)]

I am quite perplexed by my hon. Friend’s speech, but I would like to understand whether he has data related to the demographics of those jurisdictions compared with the UK. If he does, could he present it to the House to support his argument?

[Dr Sandher]

I have spent a lot of time around data, but I am not sure that I understand the question.

[Simon Hoare]

Will the hon. Member give way?

[Dr Sandher]

I will make a bit more progress.

This has been a heated debate, and hon. Members on both sides of the House feel strongly about it. I am grateful to Members who came before me, who made my place here possible and who have spoken so powerfully and movingly in this debate, but I believe—and the evidence shows—that the colour of my skin does not belong in discussion of the Bill.

[Rebecca Smith (South West Devon) (Con)]

I rise to speak to amendment (a) to new clause 15, tabled in my name, which I hope hon. Members will support. Although it may seem technical, it is in fact a simple amendment with a significant impact. It will ensure that there is genuine protection against abuse, proper detection of coercion, and effective scrutiny of how the law works in practice. Simply put, it will ensure that deaths from assisted dying under the Bill will still fall within the coroner’s duty to investigate deaths under section 1 of the Coroners and Justice Act 2009. I will explain why that is important.

Like many hon. Members, I have been deeply concerned from the outset about how the Bill is drafted, its workability, and its impact on the NHS and on the lives of vulnerable people up and down the country. To be clear, my view is that one unintended death as a result of the Bill becoming law is one too many. I humbly ask hon. Members who are still considering their position, or who are minded to support the Bill, to consider this point about my amendment carefully: what is an acceptable error rate?

Based on the figures in the Government’s impact assessment, which I think underestimates the impact, even a 1% error rate would see a minimum of 13 wrongful deaths in year 1, with 45 per year by year 10. A 5% error rate would see 65 deaths in year 1 and 227 in year 10. A 10% error rate would see 131 deaths in year 1 and 455 in year 10. As I say, I think those are low-ball estimates, but they are nevertheless chilling. If this law is passed, it will be exceptionally difficult to say whether there have been errors or instances of abuse; or, at the very least, any errors picked up will be but a fraction of the true picture, as tragically those who would testify to the fact will already be dead. My amendment (a) to new clause 15 directly addresses that issue.

In England and Wales, a coroner will investigate a death when certain legal conditions are met. This duty is primarily governed by section 1 of the Coroners and Justice Act 2009. Judge Thomas Teague KC, who served until 2024 as the chief coroner of England and Wales, notes:

“any death arising as a consequence of the ingestion or administration of a lethal substance constitutes an unnatural death which the local coroner is under a statutory duty to investigate”.

Clearly, assisted dying meets that definition, and it is right that such deaths be afforded the best possible posthumous judicial scrutiny.

--- Later in debate ---

[Munira Wilson (Twickenham) (LD)]

Even though I am not opposed to the principle of assisted dying, I have a number of deep concerns about the content of the Bill, the process by which we are legislating for such a monumental change and, importantly, the context in which it would be enacted, given the numerous challenges facing our health and care services. That is why I have tabled amendment 21 relating to palliative care and end-of-life needs, which has attracted cross-party support.

I am grateful to the hon. Member for Spen Valley (Kim Leadbeater) for supporting the amendment. I want to pay tribute to her today for kick-starting a debate about dying well and, in particular, about palliative care—a topic that has been neglected by many of us, myself included, for far too long.

Amendment 21 would require the Secretary of State to lay a report before Parliament a year after the Act has passed detailing the availability, quality and distribution of health services to those with palliative and end-of-life needs. Marie Curie estimates that one in four people who could benefit from specialist palliative end-of-life care do not receive it. People who are poorer, less educated and, yes, non-white are even less likely to receive it.

I was horrified, if I am honest, by the earlier speech from the hon. Member for Loughborough (Dr Sandher). All the data shows us that people from minority ethnic communities are less likely to access the healthcare services they deserve, in particular palliative care. There is a deep distrust of health services, and those of us who were in this place during the covid pandemic saw that played out in real time in hospitals and care settings up and down the country, with far more people from minority ethnic communities losing their lives and far more healthcare professionals from ethnic minorities not protected in the way that they should have been. If those people from minority ethnic and disadvantaged communities are less likely to access palliative care as a result of the Bill being passed, contrary to what its supporters say, my fear is that more people—rather than fewer—will die a terrible, horrendous, traumatic and painful death and they will be disproportionately from those communities.

[Dr Sandher]

The hon. Member raises a powerful and excellent point about the people from ethnic minorities who died during covid and their access to healthcare. As she will understand, that is of deep importance to me too. She is right about the need for greater palliative care and I am glad, as she says, that we are having that discussion.

If we look at assisted dying around the world and concern around ethnic minorities being more likely to access it, the stats show that it is the other way around and they are less likely to access it. However, that point is neither here nor there; rather, given that the safeguards are in place, the question is: is the process working well? Those are where the stats are going forward. I believe that the hon. Member raises the matter in good faith, and I thank her for doing so.

[Munira Wilson]

I actually think the stats the hon. Member cited undermine his own argument, because all the data shows us that the members of the communities I am talking about are less likely to access the healthcare services they need and therefore, less likely to end up accessing assisted dying. The hon. Member for Stroud (Dr Opher) gave the game away—he is acknowledging it—that wealthier people tend to access assisted dying more because they have the choice, as well as the services to have that meaningful choice. Those inequalities deeply concern me.

My grave concerns about the Bill becoming law are that the people I am talking about do not have the loudest voices or well-funded campaigns to support them. This whole debate about inequalities in access to palliative care should be the topic of a debate on a separate day and I hope there is the chance to have that debate.

Marie Curie also warns that there is

“no realistic national or local plan to address the scale of this challenge”,

and that the whole system is in “a perilous state” due to a

“lack of sustainable funding…and limited prioritisation of…end of life care”.

A 2023 survey of integrated care boards found that half had no plans to invest capital in palliative care services and 40% admitted that their services were inadequate for the needs of their population.