Terminally Ill Adults (End of Life) Bill

Jess Asato Excerpts

2nd reading
Friday 11th September 2026 Commons Chamber

[Kit Malthouse (North West Hampshire) (Con)]

As co-sponsor of the Bill once again, I am acutely conscious that there is more at stake today than merely the fate of those who are facing their end, because the conduct of the other place means that our democracy is also on trial today. I sat in the Chamber at the other end of this building on a number of occasions when it was debating the Bill, and I saw more of the debate on television, and I watched with unfolding horror the game that was being played there—a game that was marked in homes across the country with dismay, misery and agony. I contemplated the Lords effectively putting up the pretence of scrutiny, but at the same time tabling 1,000 amendments—

[Jess Asato (Lowestoft) (Lab)]

On that point, will the right hon. Gentleman give way?

[Kit Malthouse]

I will not. The Lords tabled 1,000 amendments, many of which were cruel or absurd; they were effectively designed to be sand in the engine, and to slow up what should have been proper parliamentary process—a process that the dying deserve to see operate correctly.

We have to be aware in this House that expectations are high, and the people who send us here should be able to rely on decisions made in this House proceeding into law. I am afraid that what is at stake today is our democracy. If this Bill falls today, one of the biggest losers will be the standing of this House and this institution as a whole.

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[Jess Phillips (Birmingham Yardley) (Lab)]

I pay tribute to my hon. Friend the Member for Filton and Bradley Stoke (Claire Hazelgrove). Mainly because I am a bit lazy, I rarely prepare to speak in debates, and never have copious notes. Her remarks have led where my remarks will go. I will cover the issue of coercion, which hon. Members have mentioned, and, like her, will talk about my mother, who also died when she was 61 years old, unfortunately when I was much younger than my hon. Friend. My mother died when I was 28 years old—many years ago now.

My mother had a leiomyosarcoma, and suffered with it for around three years. The prognosis did change—I hear the arguments that some hon. Members are making—but towards the end of her life, at one point she felt she was going to die. It was coming to the end. She was in a wheelchair. She was completely paralysed. She was doubly incontinent by this point. To give hon. Members an idea of the kind of woman my mother was, she was an absolute titan. She was like Erin Brockovich, but with a bad perm, in the 1980s. She could lay claim to being able to spot talent, because she gave a job to the current Prime Minister, who worked for her for some time. He is often teary-eyed when I talk to him about her.

My brothers live in different parts of the world and country, but I live 20 minutes from where I was born and where my mother lived. When she got to this stage, we all went back to be with her, because we believed that this was it—that she was going to be taken, that she was going to die. She did not die on that occasion, so my brother, who lives in France, went back home. Then, when it came to the point that a doctor made the call and said, “Your mom is about to die,” my brother could not come back—this was about four weeks later. So it was me who was with my mom when she died—not all of her children, and not all of her grandchildren. I am eternally grateful that I was there. This was a woman who had written every part of her funeral. She knew exactly what she wanted us to feel. She had planned, to the nth degree, what would happen after she was gone. The other day, I found a recipe for Christmas puddings and the PIN for her credit card—she was like, “Your dad might not be able to get money.”

My mom had thought about everything, but she was not gifted with the ability to think about this. She would have taken the choice on that day, when my brothers were surrounding her. She did not die in terrible pain—I recognise what my hon. Friend the Member for West Lancashire (Ashley Dalton) is saying. She was not writhing. It was not awful. However, she should have been able to choose to have her family with her. I will vote for this Bill. I went to women’s liberation playgroup, which she set up with a load of women. She raised me to believe in a right to choose—my gosh, more than anything else in life. She would tell me what to do today.

Many people have mentioned coercion. I am a scholar of coercion, and I say this to everybody today: do not rest on your laurels thinking that, if we do nothing, people today will not be coerced to death. That will literally happen today. The idea that if we just do nothing—

[Jess Asato]

Will my hon. Friend give way?

[Jess Phillips]

I am not going to, because Madam Deputy Speaker has been clear.

The idea that if we do not pass the Bill today, we are going to walk out of here and women in our country will be any safer is an absolute myth. Doing nothing is not the same as acting.

[Layla Moran (Oxford West and Abingdon) (LD)]

I pay tribute to all the Members who have shared their story; I feel we have learned a bit more today about how the hon. Member for Birmingham Yardley (Jess Phillips) became how she is. I am sure we have all heard so many heartbreaking stories from our constituents, and I want to thank all those who have contacted me, whether or not we agree, because sharing these stories is profoundly difficult.

One constituent with incurable cancer contacted me, asking for the freedom to choose when to give up their battle. Her own brother had an incurable melanoma spreading down his neck, which left him barely able to speak to his loved ones. He went out at 2 am in his dressing gown, climbed on to a bridge and jumped on to a motorway below. This was witnessed by two girls who were walking home from a party. My constituent asks:

“how many more need to take their own lives in horrific ways because they simply cannot bear the pain, discomfort and hopelessness any more?”

She wants the right to decide for herself when enough is enough.

Then there is the constituent whose sister went abroad to access assisted dying. The 84-year-old sang to her sister, who ended her life peacefully with her family around her. My constituent said:

“It was a painless, peaceful and dignified death at the time of her own choosing. Together with giving birth to my children, it was one of the most beautiful experiences of my long life.”

I do not believe that only families with means should be able to have that experience; it should be open to everyone.

Let me turn to the issue of palliative care. I pay tribute to the hon. Member for Calder Valley (Josh Fenton-Glynn), who is a fellow member of the Health and Social Care Committee. Although we wrote the reports together, I have come to a different conclusion, with great respect. It is, frankly, a stain on successive Governments that palliative care is in this state. Our Committee’s findings were stark: commissioning variation creates a postcode lottery, bereavement support is frequently inaccessible, services are fragmented, workforce and skill shortages are widespread, and systemic inequalities persist.

[Jess Asato]

Will the hon. Member give way?

[Layla Moran]

No, I shall not.

It is worth noting that the NHS has not been meeting its own standards on palliative care for decades. The then Minister for Care, the right hon. Member for Aberafan Maesteg (Stephen Kinnock), appeared before our Committee in the spring, and he mentioned the importance of workforce. I ask again, where is that workforce plan? We need it, but that will not be the whole answer; we also need better data and early identification, clearer guidance and joined-up working with adult social care and local authorities.

The Government have said that they will publish a modern service framework for palliative and end-of-life care, and it is very positive that the interim MSF has been published, but let me tell the House how I see it as Chair of the Health and Social Care Committee. I genuinely do not believe that palliative care would have been included in the early batch of MSFs if it were not for this Bill forcing the Government to do so. Furthermore, given all the issues and competing priorities of the NHS, let alone the competing political priorities of this Government or any other that comes after it in the next four years, I do not believe that palliative care will improve as fast as we want it to without the pressure of a Bill like this. I do not believe that this is an either/or proposition. I want palliative care to improve, therefore I will be voting for this Bill.

I have to end with one more constituent’s story, and it is the story of Robert. His two parents had different views on this issue: his father did not agree with assisted dying, but his mother did. We are lucky in Oxfordshire that we have some of the best palliative care in the country. He described how her care was exemplary—she died without pain and was well looked after—but he felt that her wishes were not respected while his father’s were, and there were consequences to her not being able to access assisted dying, as her brother could not be there at her bedside when she passed. For those constituents who want a real choice at the end of life, I will tirelessly continue to want to improve palliative care, but I will also be supporting the Bill.

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[Jess Asato]

If the primacy of this place is the most important point, why has the Bill’s promoter said that she will not allow amendments in this House at this stage?

[Andrew Lewin]

The right hon. Member for North West Hampshire (Kit Malthouse) made it clear that it is because of the actions of a very small number of peers, and he has no faith—and neither do I—that that would not be repeated this time around.

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[Sarah Champion]

I am not going to give way, because we are really pushed for time. I want to say to those people that the Bill is tightly drafted. It specifies that it is for people of sound mind who have a terminal diagnosis of six months or less, and that has to be verified by two clinicians and then a panel to ensure—

[Jess Asato]

On that point, will my hon. Friend give way?

[Sarah Champion]

I am still not giving way. The two clinicians, followed by the panel, will ensure that the person is of sound mind, and will make sure that this is something that they want to do.

A lot of time has been taken up debating the issue of coercive control. I defer to my amazing hon. Friend the Member for Birmingham Yardley (Jess Phillips) on that subject; her entire career has been spent fighting against coercive control. As she said in her powerful speech, there are not robust measures in place for people—generally women—who are suffering domestic violence or coercive control, but in this Bill, there are some measures to try to ensure that there is no coercion of people who take this action.

What is this debate about? It is about choice. It is about giving adults of sound mind choice in the last six months of their life. Currently, the only choices available are these: if people have a lot of money and are physically able, they can go to Dignitas; otherwise, as was so powerfully and emotionally outlined by my hon. Friend the Member for Filton and Bradley Stoke (Claire Hazelgrove), they can take their own life. It is not acceptable for us to continue with that position.

The issue is not just about pain. However, I know from experience that there is some pain that is unmanageable, and not everybody gets the dignified death that they want. I would like adults who are able to make an informed choice to be able to choose the time. Let us look at what has happened internationally. Many people who go through the process and get to certification do not actually use it. It is a comfort blanket to them, an insurance policy. Let us not be under the illusion that as soon as people get their certificate, they are marched off, and that is it. That is absolute nonsense. The choice is there, all the way through. When hon. Members walk through the Lobby later today, I ask them to think about their constituents and their ability to have an informed choice. I genuinely believe that this legislation provides that.

[Shivani Raja (Leicester East) (Con)]

As Members of this House, our fundamental obligation, above all political considerations, is to protect those who are most exposed, most vulnerable and least able to advocate for themselves. I acknowledge that colleagues from all parties view this Bill as a measure of compassion, but if compassion is to truly serve the public interest, then it must be paired with rigorous scrutiny and an examination of all consequences of the intended legislation.

I voted against this Bill on Second Reading in 2024 and on Third Reading in 2025, and I intend to do so again today. I believe that Government should assist people to live, not to die. Our focus should be on providing hope and support to all those who feel that death is the only way out of a dark situation. That is the purpose of humanity—to preserve life.

We should prioritise the improvement of palliative care and end-of-life care, as opposed to directing taxpayer money away from those services and into assisted suicide. Around 60% of the public agree that we should first fix our NHS before even considering whether to introduce assisted suicide into law. I note that during his tenure as Health Secretary, the right hon. Member for Ilford North (Wes Streeting) concurred with that majority in June 2025, describing how such a measure would take time and money that is already in short supply.

In addition, our new Prime Minister has outlined his commitment to a new national care service and to implementing reforms to strengthen our existing services. I welcome the fact that this Prime Minister is acting to protect the function of our health and care networks to support our constituents in life, because ultimately the NHS should be saving lives, not taking lives. Our palliative and end-of-life care services are an essential part of our NHS and wider healthcare system.

I pay tribute to LOROS hospice, which provides free and high-quality care to terminally ill and adult patients across Leicester, Leicestershire and Rutland. It cares for around 2,500 people and plays an important role in our community in Leicester East, not only in its direct support for patients, but through its provisions to wider families and friends affected by such situations. In its evidence to the Public Bill Committee, it highlighted that there should be one specialist palliative care bed for every 12,000 people, but, with just 22 beds, it has one bed for every 55,000 people. How can I turn around to my constituents and say that they will have a choice other than assisted death against that backdrop?

[Jess Asato]

Will the hon. Lady give way?

[Shivani Raja]

Respectfully, I will not take interventions. Many colleagues wish to speak, and I am mindful of time—please forgive me.

I am disappointed and concerned that the hon. Member for Rochester and Strood (Lauren Edwards) has reintroduced an identical Bill to the House and ignored all the issues revealed, even the ones admitted to by the noble and learned Lord Falconer in the other place. This Bill’s failure is not just a sign of how inadequate the private Member’s Bill process is for a Bill of this magnitude; it is an alarm over the lack of safeguards for vulnerable people—the very demographic that we in this House are supposed to protect and support.

The purpose of this House is to legislate well. We are here to advocate for our constituents, share our differing opinions and use our privileged positions of influence to impact the outcome of legislation, but the methods and attitude of the hon. Member for Rochester and Strood completely discount the hours of debate that took place on the assisted suicide legislation in the last Session. The amendments tabled in the other place were not unreasonable; they were legitimate safeguards to protect those in our society who are vulnerable.

Many of those amendments were from external organisations, and 26 amendments were from the Law Society. Those amendments would have ensured the safety of those with eating disorders and Down’s syndrome and increased the chance of catching abusive situations in which an individual is being pressured to end their life. There were amendments from trade unions to protect the compensation rights of families of workers suffering from occupational or industrial diseases who seek an assisted death.

The Leader of the House told MPs before summer that lessons needed to be learned about how we take the public with us and build consensus, rather than just keep ploughing on. He said that Members should consider if the PMB route is really appropriate, but it seems that his words fell on deaf ears. We stand here in the mother of Parliaments as representatives of the millions of British citizens throughout our constituencies, and we have the right to debate issues, because generations before us fought tirelessly to secure that right. The threat of the use of the Parliament Acts to drive through this legislation completely disregards safeguards for vulnerable people. It requires us not to care if no further changes are made to the Bill. I am well aware that this subject of debate is not easy or straightforward, and that it is painful for a lot of our constituents and distressing for Members across the House.

Let me come to my last point. One of my many concerns with the concept of assisted suicide relates to coercion. As we have heard in the House, coercion can come in many forms. Members across this House will know that my constituency of Leicester East has one of the highest concentrations of non-white British and multi-ethnic populations in the country, and I will say again that I am enormously proud of that, but I will not support any Bill that leaves them vulnerable to coercion.

Legal experts gave evidence to the Bill Committee during the previous Session stating that in some cultures,

“decision-making is a collective process involving family and community members.”

We cannot allow the fear and distress of people experiencing palliative care, end of life care or simply struggling with the prospect of living another day to be taken advantage of. It is dangerous that this House would consider creating legislation that would allow space for people to be encouraged and, in some instances, forced to take a decision to end their life when at their most vulnerable.

Let me conclude by reminding the hon. Member for Rochester and Strood that 59% of voters in her own constituency agree that this Bill should not be the priority of this Government. Does she sit here today to truly represent her constituents? If she does, and if she takes into account the situations of those in her constituency who are vulnerable, she will acknowledge that it would be morally void to support this Bill any further.

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[Noah Law]

My hon. Friend makes a very important point.

Each year, independent hospices help around 20,000 people spend their final days outside hospital settings, and this saves the NHS an estimated 1.5 million bed days and more than £800 million annually. Our Prime Minister is right to say that we must fix palliative care, and I greatly welcome his commitment to work cross-party to end the decades of political drift on social care, too. Ballooning budgets have hit not just the NHS but local authorities, particularly those in Cornwall—they have hit us really hard. We need to fix the system so that it gives people dignity.

[Jess Asato]

Will my hon. Friend give way on that point?

[Noah Law]

I will keep going, so that everyone has a chance to speak.

We must give people dignity, security and support when they need it the most. At present, palliative care remains lovingly—but to an embarrassing degree—funded through donations and by supporters who run marathons, charity shops and fundraising events for hospice charities across the UK. The National Audit Office concluded that, in 2023-24, around two thirds of the independent adult hospice sector’s total income was generated from those charitable sources, while around 29% of total income was Government funded, primarily through integrated care boards. I am all for social enterprises and charities using their assets to generate income, but the reliance on this model has to stop. Why not have a system in which the Government provide consistent, centralised support frameworks for hospices, reflecting the consistent and vital services that they provide to our NHS and people at the end of life?

It is in our Government’s gift to fix this. If we believe that high-quality palliative care is a fundamental service at the end of life, but recognise that it currently depends on commissioning decisions from integrated care boards, ad hoc grants and the fundraising of local hospices, is the system really fit for purpose? We must ensure that a consistent national minimum standard of provision is delivered by every integrated care board, to end the end-of-life postcode lottery.

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[Christine Jardine (Edinburgh West) (LD)]

I thank the hon. Member for Rochester and Strood (Lauren Edwards) for reintroducing this Bill and giving us another chance to debate the issue—although part of me regrets, as I will explain, that we have that chance. I respect everyone who has taken the responsibility of coming here today to debate this again, and I particularly respect those who have shared their very moving personal stories with us all.

Most of all, though, I respect and I would like to apologise to those who are again going through the trauma of waiting to find out whether they will have the choice. I have huge sympathy for them, because they believed when we originally passed this Bill and sent it to the other place that, if they needed it, in four years’ time they would have the choice. It would be in their hands. That hope has been snatched away from them—and not by us.

We fulfilled our responsibility to the electorate. We spent hundreds of hours in Committee, in private discussions, in debates and on Report, going over this Bill in minute detail until we could, with confidence, send to the other place the best Bill we thought possible. Of course, we thought that it would amend it and bring things back, but we had fulfilled our role and respected the will of the British public. Unfortunately, when the Bill went to the other place, that was not what happened. A handful of peers blocked it.

[Jess Asato]

Will the hon. Member give way?

[Christine Jardine]

Sorry, I will not take interventions.

Those peers did not show the same respect for the repeatedly expressed will of those who face the end of their lives.