Terminally Ill Adults (End of Life) Bill

John Hayes Excerpts

2nd reading
Friday 11th September 2026 Commons Chamber

[Lauren Edwards]

No, I will make some progress.

If, at that point, Members of this House decide to vote the Bill down, I and many others, in this Chamber and outside, would be upset and disappointed, but I would accept that as a result of the proper democratic processes being followed. What I cannot accept, and what many people both inside and outside the Chamber cannot accept, is the current situation, where a small number of unelected peers filibustered legislation that was supported by this Chamber. That is not how our democracy is supposed to function.

[Sir John Hayes (South Holland and The Deepings) (Con)]

I am very grateful to the hon. Lady, whose speech is a series of oxymorons: she does not like polling that is against the Bill, but likes it when it is in favour; she feels the Bill should be amended in the House of Lords, but not with amendments that would improve safeguards. On that subject of safeguards, will she explain to the House why the previous legal safeguards to assuage doubts about efficacy were entirely dropped from the Bill?

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[Mims Davies]

Absolutely; we are here to make good laws. Today’s vote, as we have heard, is not simply on the principle of the Bill, but on the detail—or, frankly, the lack of detail. Good intentions are not enough. We are voting not on what we want to happen because of the Bill, but on what will happen. We cannot continue to divorce it from reality. It will have an impact right across Government and our communities, and intertwine us swiftly in new challenges. Too often in this place, we have good intentions but no delivery plan. We cannot continue in that way. The Bill’s sponsor in the other place felt the need to bring forward 70 amendments of his own.

[Sir John Hayes]

Will my hon. Friend give way?

[Mims Davies]

Let me make some progress.

I have four main concerns: funding, the assessment process, the lack of institutional opt-outs and, crucially, the auto-commencement clause. Can we all look our local NHS teams in the eye, knowing that we are ultimately taking more resources from them?

The equality impact assessment explicitly acknowledges the impact on disabled people and those from ethnic minorities—people we often speak about in this place, because we are the ones who can speak up for them. This Bill is at odds with that. There is much more I would like to say, but I need to conclude.

This Bill, although well intentioned, is simply a mixture of naivety, idealism and wishful thinking. There is no delivery plan, and it greatly raises the hopes of our constituents in their hour of need for care, good support and understanding. We are being asked to send this Bill back to the other place and perhaps to use the Parliament Act to force it through, regardless of its fitness for purpose and with full knowledge of its flaws and lack of workability, just to get it done. However, that means we are not listening even to the doctors who have spoken in this place today. I cannot subscribe to this type of lawmaking, no matter how well intentioned.

I am grateful that we are talking about life and death, end-of-life care and the value we put on people and loved ones. We are fighting for better palliative care, and we are doing what we can to give people all they need as death approaches. However, I cannot in good faith support an unsafe private Member’s Bill or the process we are undertaking today.

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[Sarah Smith (Hyndburn) (Lab)]

I am sure that I am not the only Member who came to this place because I felt that the voices of the people I wanted to represent are seldom heard, and I felt a duty to ensure that they were heard in decision making at the highest level. While I am the Member of Parliament for everyone in Hyndburn and Haslingden, and I recognise that many people in my constituency might support the principle of an assisted death, when I vote today, I must consider the perspective of the many hundreds of people who have written to me for whom this Bill is a terrifying prospect.

Many of those who have written to me are disabled; caring for severely disabled children or family members; people who are getting older, and who worry that they will become a burden; or people who know that because of the colour of their skin, they will face different treatment in our NHS, and who worry about what that would mean for them or their elderly parents. We must all consider the privilege that we in this place hold. We have the confidence to challenge a doctor’s assessment, and to turn down the suggestion of assisted death, and the belief that we might be able to afford the care that we need when we are older, and so can make a true choice about how we might die. However, we must remember that this is not the experience of most people, and certainly not the experience of those with lower levels of education, those from ethnic minority backgrounds, those with disabilities, or those who are struggling to make ends meet. For them, the suggestion made by a doctor may easily sound like a decision based on what is best for them. The likelihood of their mental capacity being accurately assessed is far lower than it would be for many of us. For them, and indeed for most of us, the assessment of how long they have left to live is often hugely inaccurate.

[Sir John Hayes]

The hon. Lady is absolutely right. This debate illustrates a difference across this House. It is a difference between those who feel that individual agency is always supreme, and those who, like her and me and many others, believe in social solidarity and our responsibility, indeed our mission, to protect the very people she describes, who will be at risk. There is no doubt that they will be at risk from this Bill.

[Sarah Smith]

I could not agree more. Those people cannot escape the often unintentional prejudice that they face every single day in their engagement with our health services. They know that the Bill would treat them unequally, and they are begging us not to pass it into law. Disability rights groups have shared with us that introducing assisted dying devalues the lives of disabled individuals by framing dependence as an intolerable condition, and one not intrinsic to all our lives. Relying on each other is what makes our society strong, and we must not tolerate a situation in which individuals make decisions from which they cannot return on the basis that they perceive themselves to be a burden.

This law, if passed, will almost certainly further increase the gap in life expectancy between the richest and poorest, given that people living in more deprived areas are likely to acquire complex multi-morbidity seven years younger than those in the richest areas, and are far more likely to feel that they are a financial burden on their family. It is reasonable to anticipate that this will lead to people with less money dying younger. Is that the legacy that those voting for this Bill today want?

In Hyndburn and Haslingden, I have seen how systemic failures in social and palliative care have added to the suffering and challenges that many in my community have faced. Like many of us, I have sat with loved ones as they were dying without the palliative care that they needed. According to Marie Curie, one in three people die without good palliative care. During these debates, we have heard so many horrific stories of death, and of course we must do all we can to avoid those situations.

I spoke with one of the most highly regarded palliative care nurses in the world, who has spent most of her career in South Africa with children who have AIDS and who die far too young. She told me that, in her decades of practice, in which she has cared for thousands of patients, she could bring to mind only two patients whom she was unable to offer a good death, with the right treatment and care.

Assisted dying is not a choice if palliative care is not provided as an alternative. As it stands, the cost of assisted dying is supposed to come from the existing health budget. Research by Sue Ryder found that if we offered consistent palliative care to every patient who needed it, we would need to double NHS funding for that care; it would cost around an extra £300 million a year.

We have to be clear about the priorities and honest about what is possible. This Bill intends to force the NHS to implement assisted dying within four years. Given the budget constraints and capacity limitations, it is just not realistic to say that we can simultaneously improve palliative care and introduce assisted dying. We are taking 10 years to implement the proposed SEND reforms, yet we expect to do this within four. This Bill should provide that assisted dying will not be introduced until palliative care is fixed, and it fails to do that. Furthermore, the evidence from other countries is overwhelmingly that introducing assisted dying leads to decreased investment in palliative care.

In closing, it was a Labour Government who introduced the national health service, with the aim of securing

“improvement in the physical and mental health of the people of England and Wales and the prevention, diagnosis and treatment of illness”.

It is that mission that NHS staff have signed up to deliver. Let this Labour Government not be the one to bring in a Bill that effectively entirely undermines and changes that founding purpose of the NHS, and let us instead vote today to kill this Bill.

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[Ms Oppong-Asare]

I will not.

I believe the concerns raised by organisations such as the Royal College of Physicians and the British Geriatrics Society about the uncertainty of the end of life, safeguarding and the definition of terminal illness deserve careful consideration.

I cannot separate this debate from my own experiences. Members of my family have experienced discrimination in the healthcare system. Those experiences leave a lasting impression; they remind us that trust, access and outcomes in healthcare are not always experienced equally by everyone. Those inequalities do not disappear when people become seriously ill.

[Sir John Hayes]

Under the Bill, what we would be saying to those clinicians is, “We want you to do much, much more. We want you to gauge whether people are being coerced. We want you to make a definitive judgment about how long someone has to live.” That is an unbearable pressure on those who have a mission to save lives, not to take them.