Terminally Ill Adults (End of Life) Bill

Judith Cummins Excerpts

Friday 16th May 2025 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

I remind Members that we currently have a 15-minute guide limit for speeches, so please help each other so that as many Members as possible can speak.

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[Gregory Stafford]

On a point of order, Madam Deputy Speaker. I would like your advice. Mr Speaker said that more than 90 people wish to speak in the debate. We have been debating the amendments for an hour and a half and four speeches have been made. If we go to 2 o’clock, that will mean fewer than 20 speakers. I understand that whether a closure motion can be moved is at the discretion of the Chair. If we have not got past, let us say, 20 or 30 Members speaking in the debate, can you give us any indication of whether, if you are still in the Chair, you would accept a closure motion at that point?

[Madam Deputy Speaker (Judith Cummins)]

I thank the hon. Gentleman for his point of order. We will cross that bridge when we come to it. We are currently asking Members to keep their contributions to 15 minutes and that, of course, will be reassessed very shortly—I can give him assurances about that.

[Anneliese Dodds (Oxford East) (Lab/Co-op)]

Madam Deputy Speaker, since I have been in the Chamber, I have received the truly awful news that three people died last night in a fire in Bicester, including two members of the Oxfordshire Fire and Rescue Service. The hon. Member for Bicester and Woodstock (Calum Miller) has had to leave the Chamber to liaise with those on the ground and we both want to take this opportunity, if we may, to convey our deep sorrow for and solidarity with the families of those who have died, and our fervent and heartfelt best wishes to the two firefighters who remain in a serious condition. We are grateful for their heroism and that of their colleagues when, as ever, they ran towards danger to serve us all. [Hon. Members: “Hear, hear.”]

I rise to speak in favour of new clause 16 and amendment 14, and I am very grateful for the opportunity to speak. When the Bill first came before the House, I was a Minister attending Cabinet and therefore unable to speak on the subject. I genuinely thank my hon. Friend the Member for Spen Valley (Kim Leadbeater) and every single Member who served for so many hours on the Bill Committee for this incredibly important Bill. I also thank the hundreds of my constituents who have contacted me with their views. I genuinely believe that every single one of them was motivated by compassion and a determination to reduce suffering, and in many cases their views were shaped by their experience of death and of suffering in life. I know that that is the case for many of us in the Chamber as well, so I hope that the same spirit of respect that we saw previously will continue throughout the passage of the Bill, whatever our views may be.

New clause 16(1)(a) would exclude from the scope of the Bill those who do not want to be a burden on others or on public services, and paragraph (b) would exclude those experiencing a mental disorder, including depression. On the former, we have discussed this morning whether it is appropriate to mention international analogies. They will, of course, be instrumentalised by those who have different views about this important subject. I have personally found survey evidence from the Oregon example of people expressing that they felt they were a burden to be highly compelling. I do not believe that it indicates that that was the primary reason why they sought assisted dying, but I believe that it is an important piece of evidence that we need to take into account.

I also believe that we need to look at situations where people who are potentially subject to coercion have been evaluated by professionals in our society, and where we might be concerned about the outcomes. I ask for Members’ understanding here.

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[Daisy Cooper]

I supported the Bill on Second Reading on condition that it would be strengthened to tackle the issue of capacity. Does the right hon. Lady accept that the Bill that we see today is very different from the one that we saw on Second Reading? There is a requirement for capacity. If there is any doubt at all, a doctor is compelled to report that person for additional assessment, and independent advocates have been introduced for people with learning disabilities, autism or mental disorders. Social workers are now included in the panel of experts, specific training on mental capacity is required, and there is a disability advisory board too. Does the right hon. Lady—

[Madam Deputy Speaker (Judith Cummins)]

Order.

[Anneliese Dodds]

I agree that the Bill has been improved, but there is a difference between mental capacity, at least as assessed by medical professionals, and the presence of mental disorder. I know the Committee examined that subject at length. It was very clear from the discussion in Committee that it anticipated that elements such as being able to assess information and make judgments between alternatives would be covered by the mental capacity provisions—but the evaluation of those alternatives, which can be impacted by mental disorder, is not part of that process. The reality is that those subject to a number of mental disorders—including, sadly, eating disorders—may be highly intelligent and may well be able to carry out many logical procedures to assess information, but their evaluation of the value of their future life and their assessment of the value of bodily control, in relation to other factors, are different from those of someone who is not ill. I believe that issue has not been fully understood.

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[Anneliese Dodds]

I am aware of what my hon. Friend quite rightly refers to. Of course, any such condition would have to be coterminous with a terminal illness, but we know—the Committee thrashed this out for a long period—that depression is often present at the same time as a diagnosis of terminal illness. We also know that concepts such as “terminal anorexia” have started to be used in certain contexts. That unfortunately suggests that, despite the many protestations of those who understandably support the Bill, there is the possibility that those subject to eating disorders will be pulled within its scope. I am very pleased that amendment 14 would rule that out—it is important that it does so. It is critical that this Chamber sends that message too, given the potential confusion about scope.

I am very grateful for the opportunity to speak to new clause 16 and amendment 14. Above all, I hope we can continue this important discussion, which is critical for so many of our constituents.

[Madam Deputy Speaker (Judith Cummins)]

I call the Father of the House.

[Sir Edward Leigh (Gainsborough) (Con)]

I wish to speak to new clauses 16 and 17. Rather than giving my own views, I think that powerful testimony on behalf of someone who actually runs a care home should be heard by the House. I want to quote, as briefly as possible, Dan Hayes, who runs the Orders of St John Care Trust, which runs care homes in Lincoln generally and in my constituency:

“we believe that the Bill as drafted is flawed, and the risks to older, vulnerable people, residing within social care environments are substantial.

We believe that any assumption by those drafting the final legislation that it is not intended for use by those living with conditions regarded as part of the ageing process, would be mistaken. Any legislation would be immediately tested and assumed to be accessible to such a cohort of people.

To that end we believe that in order to provide the necessary protections to such a vulnerable part of our society, the Bill must be explicit in its reference to older people living in residential services.”

That is why these new clauses are so important. He continues:

“The Bill must take account of the current unfairness and instability at the heart of our social care system, and question whether such legislation can be introduced whilst such problems exist.

The Bill must recognise that an individual health/social care professional’s ability to remove themselves from the process of Assisted Dying is so difficult, that specific exclusion of the care home sector should be a feature of the Bill. In any case, organisations, and sites, should be given the ability to exclude themselves from the act of an assisted death without prejudice to their approval as providers of services to the state.”

We have experience of that, with regard to Catholic adoption agencies. There is a real risk that some care homes may feel they have to withdraw from this sector. I will carry on quoting:

“Those that fund their own care pay substantial sums, often saved for over a lifetime—including property wealth. These savings will have been set aside for retirement and to pass on to loved ones. Instead, they are used to fund the costs of their own residential care, and to substantially subsidise the state.

We see the real prospect that those that might fit the criteria for assisted dying under the Bill, but have no wish to accelerate their death, would feel an immediate dilemma between prolonging their own lives, and the future quality of life of their loved ones. For illustrative purposes, the six-month period stated within the current Bill would equate to between £25,000 and £40,000 of expense borne by an individual paying for their own residential care in the current system.

Failings in the system mean that older people who should not be in hospital are held there, causing a burden to the NHS, and Local Authorities face an ever-growing proportion of funding needed to support social care, without a proportionate increase in funding from central government.”

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[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Before I call the next speaker, I will be asking Members after him to limit their comments to eight minutes.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I start by thanking the hon. Member for Spen Valley (Kim Leadbeater) for introducing the Bill and for giving me the opportunity to serve on the Bill Committee.

I rise to speak in favour of my amendment 4, which goes to the very heart of what the Bill is all about: dignity, compassion and choice at the end of life.