Terminally Ill Adults (End of Life) Bill

Debate between John Hayes and Sarah Smith

2nd reading
Friday 11th September 2026 Commons Chamber

[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.

Sentencing Bill

Debate between John Hayes and Sarah Smith

Report stage & 3rd reading
Wednesday 29th October 2025 Commons Chamber

[Sarah Smith (Hyndburn) (Lab)]

I want to speak in support of new clause 36, which would require offenders to comply with an earned progression scheme before being subject to release. I think that is an important opportunity to enhance the Government’s ambitions for this Bill, because shoplifting, antisocial behaviour and car break-ins continue to plague my constituents in Accrington town centre.

Increases in levels of town centre crime and break-ins are often caused by offenders released early who have failed to receive the rehabilitation they require. They often have drug or alcohol addictions, and they are back on the streets trying to feed those addictions, and stuck in a cycle of lose, lose, lose—for my residents, for the police and for the taxpayer. Although we must be tough on crime, we must also tackle the root causes of crime and ensure that the system delivers for victims and stops the revolving door of our prisons that serves none of us.

The reforms to the community order requirements will lead to less crime and safer streets for my constituents in a number of areas. The Bill will provide a more tailored and effective approach to punishment and rehabilitation, because courts will have expanded tools to tailor community and suspended sentence orders to better fit the individual offender, the offence and the risk posed. The Bill adds new community requirements to the list of options attached to a community or suspended sentence order, such as prohibitions on driving or attending pubs, bars, clubs or public events, and being restricted to geographic zones. That enhanced flexibility means that sentences in the community can be more meaningful and effective—not just a series of generic tasks, but specifically calibrated to the offender’s behaviour, the harm caused and the need to protect the public and victims. It ensures that community-based sentences are not perceived as light or ineffective, but carry real conditions and consequences.

The Bill also strengthens public protection and victim confidence; in fact, bolstering protection for victims and communities is one of the key aims of the reforms. By allowing restriction zones, bans on attending premises that sell alcohol or public events, and driving prohibitions, the Bill enables courts to impose orders that explicitly guard against certain behaviours or contexts associated with risk. Those measures reassure victims that offenders remain under meaningful restrictions and that community sentences carry real weight and oversight, rather than being a passive “watch and wait” approach. In turn, that helps to maintain public confidence in our justice system and supports the principle that people who offend should face real consequences.

Furthermore, the Bill supports rehabilitation while reducing the unnecessary use of custody, which must be for the most violent and serious offenders. It complements the broader move to ensure that custody is used appropriately—not as a default for lower-level offenders, but reserved for cases where it is necessary for public protection. By strengthening community orders and equipping the courts with more tailored requirements, the Bill supports the case that many offenders can be managed in the community through conditions that deter, restrict and rehabilitate. For far too long, the evidence has shown that it is those changes that will tackle the ongoing problems that the courts and prisons are facing, as well as the ongoing issues with that low-level but incredibly damaging crime happening time and again in our communities.

Such approaches help to reduce prison overcrowding, better align our resources, and focus custodial capacity on those who most require it. At the same time, the reforms encourage compliance—for example, by introducing a community sentence progression scheme, under which offenders who fully comply with the requirements and complete their sentence may have their community order terminated early.

There are practical benefits for communities, offenders and the Probation Service. For communities, community orders become more visible and meaningful. The added conditions reflect the reality that punishment and supervision in the community should be not lesser than custody, but different. For offenders, the structured environment of a community sentence with tailored requirements offers the possibility of real change through supervision, conditional freedom and accountability, rather than automatic imprisonment, which can increase harm and reoffending. For the Probation Service, the Bill’s provisions also include strengthened investment in community supervision, better tools for monitoring and enforcement, and clearer mechanisms for rewarding compliance.

In conclusion, the Bill represents a significant advance in our justice framework, offering modernised, flexible and robust community sentencing options that strengthen public protection, shore up victim confidence, support rehabilitation and make more effective and efficient use of our resources. The new community order requirements and community requirements are central to that: by giving courts more precise, meaningful powers, they ensure that justice is done in the community as well as through custody. I am confident that they will make a real difference to my constituents in Hyndburn, who are rightfully frustrated that they see the same people causing the same problems, and no real solutions to the crimes that those people are committing.

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

As we return to consideration of this dreadful Bill, we debate amendments and new clauses that are designed to mitigate its worst effects, in particular new clauses 43, 21, 18, 19 and 20, which I have signed, and new clause 1.