NHS Breast Screening

Juliet Campbell Excerpts

Monday 29th June 2026 Westminster Hall

[Juliet Campbell (Broxtowe) (Lab)]

It is a pleasure to serve under your chairship, Mr Vickers. I thank my hon. Friend the Member for North Ayrshire and Arran (Irene Campbell) for her thoughtful opening remarks. I pay tribute to all those affected by breast cancer, those facing diagnosis, and their families, friends and carers who stand beside them. It is their experiences that make this debate so important. I also pay tribute to my constituents for signing this petition, and I thank the petitioner for starting it in the first place.

I welcome the Government’s ambition for the national cancer plan, which commits the NHS to ensuring that, by 2035, 75% of people diagnosed with cancer will be cancer-free and living well five years after diagnosis. The plan will also develop further AI-assisted interpretation of images for suspected breast cancer diagnosis, and it will help us to detect breast cancer in women under 50 with denser breast tissue.

Under the last Government, cancer performance targets had not been met since 2014, leaving too many women facing delays and poor health outcomes. However, I know that my constituents want this Government to go further and to include women aged 40 in routine invitations for breast cancer screening. According to CoppaFeel!, cases of breast cancer in under-50s are on the rise. A recent report states that we have seen a 5% increase in the last year. Patients under 50 are more likely to have their symptoms missed and to be diagnosed at a later stage in their cancer journey compared with those over 50.

That issue is even more pronounced for women from minority and ethnic backgrounds and for those from deprived and rural areas, who have less access to screening opportunities in their communities. Additional public health attention needs to be paid to that. According to Breast Cancer Research, those groups are 10% more likely to begin treatment after the cancer has already become invasive and 20% more likely to require a mastectomy.

To achieve our cancer outcome aspirations, I ask the Minister to extend routine mammogram invitations to women from the age of 40. I hope she will also consider the roll-out of alternative diagnostic measures that will affect the diagnosis of younger women.

Nottingham Maternity and Neonatal Services

Juliet Campbell Excerpts

Wednesday 24th June 2026 Commons Chamber

[Juliet Campbell (Broxtowe) (Lab)]

I pay tribute and give my admiration to the families who have fought so hard and who have been so strong at this time in their lives, when they have had to repeat what they have been through over and over again. Their fight for justice and accountability is truly fought. I also pay tribute to my hon. Friend the Member for Sherwood Forest (Michelle Welsh), who has not stopped this fight and has continued the story, and I commend her for everything that she has done.

The findings of the Donna Ockenden review are harrowing. It is indefensible that babies, mothers, fathers and families in my constituency have suffered injury, death and lasting trauma under the care of the NHS. The Ockenden review has made it clear that mothers’ voices were not listened to and that families were not treated with the dignity, respect and compassion that they not only deserve but is expected from our NHS. The indifference that people have shown to families is indefensible. The public listening to the debate at home will understandably be wondering how we are here again and asking when things will change. I say to the Secretary of State: let us not treat these recommendations as just another set of recommendations to put on the shelf, but let us look at them as a catalyst for change and improvement, making sure that inequalities are addressed. Will the Secretary of State outline what immediate steps the Government will be taking on the most urgent recommendations in the review, and set out how they will be monitored and reviewed?

[James Murray]

I thank my hon. Friend for her comments about the role of the families in fighting for justice. She is absolutely right that the recommendations of the Ockenden report, Baroness Amos’s report, which is due shortly, and other reviews and inquiries into maternity services must not simply end up on the shelf gathering dust. That is why the process that I have spoken about today, whereby the national taskforce that I chair will produce a comprehensive action plan by the end of the year, is so important. That will give us the right forum to develop a plan across all aspects and from all angles on this horrific scandal, including the inequalities faced by different families from different backgrounds that my hon. Friend alluded to. I agree with her wholeheartedly that this moment and this process that we are now going into must be a catalyst for change.

Oral Answers to Questions

Juliet Campbell Excerpts

Tuesday 21st October 2025 Commons Chamber

[Wes Streeting]

We are putting £26 billion more into the NHS this year, which is investment that was opposed by the Conservative party.

[Juliet Campbell (Broxtowe) (Lab)]

As the chair of the all-party parliamentary group on dyslexia—an issue on which I have campaigned for many years—I remain alarmed at the high number of dyslexic people who still need to use mental health services. Will the Minister meet me to discuss how we can better serve dyslexic people in Broxtowe and across the UK, and will he consider measures to prevent more dyslexic people from needing mental health services?

[Dr Ahmed]

I am very grateful to my hon. Friend for sharing her personal experiences, and I would be delighted to meet her.

Baby Loss

Juliet Campbell Excerpts

Monday 13th October 2025 Commons Chamber

[Juliet Campbell (Broxtowe) (Lab)]

I thank my hon. Friends the Members for Sherwood Forest (Michelle Welsh) and for Rossendale and Darwen (Andy MacNae) for securing the debate. It coincides with Baby Loss Awareness Week, a time when we pause to remember every baby who has been lost far too soon. The week provides us with a chance to take stock of this sensitive issue and to commit to supporting family members, including fathers and siblings, by improving services for all families affected by baby loss.

In 2023, there were more than 4,000 baby deaths in the UK, behind each of which is a family whose lives will never be the same again. The pain that those families experience is the same as the pain of losing any child, and they deserve to be treated with the same sensitivity as with any other bereavement. Although we have made significant progress over the past few decades, the rate of baby deaths remains too high, and disproportionately so in African, Caribbean and Asian families and those from deprived backgrounds. That inequality is a challenge that our society, our NHS and our Government must address urgently. Our NHS maternity and neonatal services must have proper funding and training to provide care and support through a service provision that recognises the medical, social and emotional needs of those families. It also means ensuring that staff have the support to offer a service with empathy and compassion, and to understand that baby loss has a profound impact on all members of the family. Every parent experiencing miscarriage, stillbirth or neonatal loss deserves a safe space where they can grieve with dignity.

Finally, I take this opportunity to pay tribute to Forever Stars, a charity based in my Broxtowe constituency founded by Michelle and Richard Daniels, who have lived experience of baby loss. Their strength and dedication to families who have experienced baby loss has flourished into an organisation that provides understanding and comfort to hundreds of families across Nottingham and Nottinghamshire, but that should not have been left to a grieving family. The creation of baby loss services, memorial gardens and specialist bereavement spaces should be a standard part of our health and social care service. I therefore call upon the Government to see this as an opportunity to design and develop improved services for families who experience baby loss.

Rare Cancers Bill

Juliet Campbell Excerpts

2nd reading
Friday 14th March 2025 Commons Chamber

[Juliet Campbell (Broxtowe) (Lab)]

I thank my hon. Friend the Member for Edinburgh South West (Dr Arthur) for introducing the Bill. Many of my constituents have shared with me their experiences of rare cancer, and the experiences of their families and friends. Rare cancers make up almost half of cancer diagnoses, so the Bill is very much welcome.

A constituent wrote to me recently about their seven-year-old son, who was diagnosed with medulloblastoma, a rare form of brain cancer. Sadly, their son did not survive, despite that cancer having a 75% survival rate. Medulloblastoma is on a spectrum of high to low risk, which further complicates ability to predict the outcome of treatment. I am here to represent that child, their family and other families affected by rare cancers. I welcome the increase in research, funding and support for early detection and diagnosis. I welcome the introduction of the Bill and wholeheartedly support it.

Terminally Ill Adults (End of Life) Bill (Twentieth sitting)

Juliet Campbell Excerpts

Committee stage
Tuesday 11th March 2025 Public Bill Committees

[Dr Opher]

Actually no, I will not. I will go on, if that is okay.

Amendment 459 states that the second-opinion doctor “must produce a report” outlining their reasons for reaching a different opinion, but the whole nature of this is that the doctor is independent. As we have heard, if it is suggested that someone either is or is not allowed to get an assisted death, that might affect the assessment of the independent doctor. It would not be good medical practice to have that assessment in front of the independent doctor—that would lead to poor assessments. We need a right to a second opinion and we should have a truly independent doctor.

Amendment 460, which is the last in the group, would allow a patient only one declaration in any part of their lives, even if circumstances change. Although there will be vanishingly few instances where that would be relevant, I do not feel that such a provision would make the Bill any fairer or safer.

Amendment 143, tabled by my hon. Friend the Member for Broxtowe, would allow a second and a third opinion. It is my opinion, and the opinion of many of us, that we do not want doctor shopping. We want to allow one second opinion from an independent doctor, but not more than that.

[Juliet Campbell (Broxtowe) (Lab)]

Amendment 143 has been withdrawn.

[Dr Opher]

Has it? Okay. I thank my hon. Friend.

The amendments in this group all come from a good place, and I understand where hon. Members are coming from, but I do not feel that anything in them would make the Bill any safer or fairer for patients.

Terminally Ill Adults (End of Life) Bill (Twenty First sitting)

Juliet Campbell Excerpts

Committee stage
Tuesday 11th March 2025 Public Bill Committees

[Dr Shastri-Hurst]

The hon. Member makes an important point. In practice, one would of course discuss the side-effect profile of any medication or substance to be administered. I do not feel that specifying that in the Bill, as amendment 305 is drafted, would achieve its purpose. The amendment refers to “any other effects”, but it does not specifically mention side effects. In any event, it must flow from the interaction between clause 9(2)(b)(iv) and clause 9(2)(c) that the conversation about complications as a result of the administration of a substance will encompass a conversation about side effects.

It is worth noting that all substances have a side-effect profile; what the side effects are will be specific to the substance in question. I do not think it a helpful improvement to the Bill to presuppose what the side effects may be. Amendment 305, although imperfect, is therefore preferable in my view to amendment 362, which would require that specific side effects be set out and which presupposes a scenario involving a particular set of medication.

Nevertheless, I remain concerned about the wording of amendment 305. I would be grateful if the hon. Member for Spen Valley provided some reassurances as to the steps she has taken to honour the intention of the amendment tabled by the hon. Member for York Central and achieve a tighter piece of legislative drafting.

I turn to amendment 142, tabled by the hon. Member for Broxtowe. It seeks to ensure that the discussion with the assessing doctor includes a discussion of how the substance will be administered. Although it may not be strictly necessary, because that should be a conversation that takes place when someone is going through an informed consent process, I do not consider that its inclusion would undermine the operability of the Bill. I am therefore minded to support the amendment. I do not consider that it will be restrictive should the circumstances change, because there may be a broad conversation about the variety of substances that can be administered, depending on the circumstances. As the drafting of the Bill does not preclude or prohibit such a wider discussion, it would be eminently sensible to include the route of administration.

Amendment 306, in the name of the hon. Member for York Central, would require the assessing doctor to include the escalation of medical intervention in their discussion should complications arise. In many ways, that issue is covered by clause 9(2)(c), so the amendment would not aid the operability or interpretation of the Bill. It would be much better dealt with under the code of conduct, to avoid the Bill becoming overly prescriptive and to allow flexibility as scientific and medical knowledge adjusts and adapts over time.

[Juliet Campbell (Broxtowe) (Lab)]

I will speak to amendment 142, which would insert

“and how it will be administered”

into the Bill. It would require the assessing doctor to explain and discuss with the person how the substance that might be provided to assist them to end their life will be administered.

The amendment would be a key step towards giving peace of mind to a terminally ill individual who is seeking an assisted death. It would also preserve their autonomy right up to the final stage. Ensuring that the method of administration is thoroughly explained would provide the doctors and the individual seeking an assisted death with the opportunity to consider the options—if there are options available to them—and decide which method would best preserve the autonomy of that individual.

Assisted dying presents many opportunities for individuals to be coerced, especially at the final stage—death itself. Therefore, the method of administration is key information for the individual to know, and it is not sufficient for it to be withheld from them. We must make it a prerequisite of the Bill that it is supplied. Making an informed choice about the assisted death pathway involves careful consideration, and knowing and understanding every step of the process. It is appropriate for the person to maintain their agency. Minimising the role played by the doctor at the administration stage is also key to ensure that the final act belongs to that individual.

We must acknowledge that many individuals seeking assisted death may experience significant mobility and physical limitations, particularly because of their terminal illness. Those limitations can affect their ability to engage with the process in ways other people may take for granted. For example, a patient suffering from severe weakness, paralysis or chronic pain might have difficulty physically positioning themselves or administering some types of substance, depending on the options available. A person may have difficulty swallowing and would not be able to ingest a substance in the form of a pill, but they may be able to autonomously operate a system that would allow them intravenous administration.

In these cases, the method of administration must be carefully considered and explained in a way that accommodates the patient’s unique physical needs. By discussing the challenges openly at this stage, doctors can help to ensure that the patient understands the options open to them, while making the process as comfortable and accessible as possible. Addressing their mobility and physical limitations in this context is not only a matter of practicality, but a reflection of our compassion and respect for that individual’s circumstances.

By limiting the doctor’s physical role, we also ensure that the patient retains control over the process. Making the act of self-administration as independent as possible ensures that the final part of the process gives the patient agency in choosing how and when to end their life. The individual must maintain a primary role in their death, but the actual administration is the final assurance and assertion of the individual’s choice to end their life. The amendment emphasises the importance of ensuring that, within the Bill, the doctor’s involvement is limited to preparation and support. That is key to making sure that the patient’s final moments are self-directed and as free from any unnecessary external interventions as possible.

Subsection 6 of clause 18, on the provision of assistance, discusses the role of the doctor in administration. It says that a doctor might

“assist that person to ingest or otherwise self-administer the substance.”

By ensuring that the method of administration of the substance aligns with the physical capabilities that a person has to self-ingest, which may be limited, we limit the role played by the doctor at this crucial stage, and limit the chance of the coercion of the individual or of the individual having a death that lacks real autonomy.

In conclusion, amendment 142 plays a crucial role in safeguarding the rights and autonomy of a terminally ill individual seeking an assisted death. By ensuring that the method of administration is clearly explained, we empower patients to make an informed, autonomous decision about the way in which they wish to end their life.

[Danny Kruger]

It is a pleasure to serve under your chairmanship, Dame Esther. [Interruption.] You are Dame Esther, aren’t you?

--- Later in debate ---

[Daniel Francis]

I will withdraw amendment 105 later, but will speak to it briefly, as my name is on it. The amendment aims to require court rules to be made that would ensure an adversarial court process, by appointing an advocate to the court. It would also require them to hear from the person seeking assistance to end their life and both assessing doctors, and to consider also hearing from family members and others involved in the person’s care.

In our oral evidence sessions, we heard from Nicholas Mostyn and Alex Ruck Keene about some of the merits of doing so, with reference to the Bill that was before us at that stage. Since then, a significant number of amendments and new clauses have been tabled, so I will not press this amendment to a vote, given the other amendments now before the Committee.

[Juliet Campbell]

I rise to speak to amendments 407 and 410. Amendment 407 would leave out the word “may” and insert the word “must”, and would require the High Court to hear from and question all persons who made the application for a declaration. It is a probing amendment, which aims to question the guidelines for the judge to question and hear from some people and not all people. I will not press the amendment to a vote, but I seek clarity on what the criteria would be for the judge to question some people and not others.

[Kim Leadbeater]

I hope I can provide some reassurance. This issue is covered by my new clause 21. The amendment, I think, asks why the High Court would not have heard from the patient. My new clause would ensure that the panel—as it potentially would be—will hear from the patient.

[Juliet Campbell]

I thank my hon. Friend for that explanation.

I move on to amendment 410, which would remove the ability of the court to hear from and question any person other than the person who made the application or the declaration for an assisted death and the assessing doctors. I have strong reservations about using a proxy or giving another person the right to speak on behalf of an individual who wishes to have an assisted death, and I question the scope of those people who could be the proxy to speak on behalf of a person requesting an assisted death. Who exactly would those people be?

One of the arguments we have consistently debated in this Committee is around coercion and patient autonomy. When multiple third parties such as family members or caregivers are allowed to testify, there is an increased risk that an individual might influence the court’s decision in a way that is not aligned to the true wishes of the applicant. In some cases we have talked about pressure from family members or loved ones, for whatever reason—whether their vested interest is financial or something else—to have the applicant hasten their death or have an assisted death. I would not want that kind of pressure to be put on the person and I do not believe any third party should be allowed to speak on their behalf or to be a proxy.

By limiting the scope of the testimony to the applicant and assessing doctors only, the amendment helps to safeguard against such manipulative tactics and ensures that the court focuses solely on the applicant’s own will and the medical assessment of their eligibility, removing the potential for family dynamics or any other outside influence to interfere with the judicial review. It offers a necessary refinement to the Bill for assisted deaths, a request that is both efficient and respectful of the autonomy of all people involved. By limiting the court testimony to the applicant and assessing doctor, the amendment addresses several of the concerns I have spoken about.

[Jake Richards]

I will speak briefly, because many of these issues and themes will be debated in clause stand part and amendments 371 and the others from my hon. Friend the Member for Spen Valley. Amendment 267 was not moved, but I would have opposed it in any event, on the basis that the discretion given there was way too wide and I did not understand the basis of the amendment in any way. Amendments 105 to 107, tabled my hon. Friend the Member for Derby North (Catherine Atkinson), attempt to add an adversarial element to proceedings. Again, I will not comment too much because that issue comes back in the fourth grouping under this clause.

I turn briefly to amendment 410, to which my hon. Friend the Member for Broxtowe just spoke. My understanding is that, although this relates to the High Court—which may be deemed redundant as we move on through this clause—the amendment aims to limit the people that the judge or panel can hear from. In my view that would be wrong and dangerous. The purpose of a judge or a panel is to explore the circumstances in this matter. That must mean that they have discretion to hear from others as well. In my view, this amendment, if passed, would significantly limit the safeguards and be quite dangerous.

As my hon. Friend has already said, amendment 407 has been superseded, and I think we all agree on that.

[The Minister of State, Ministry of Justice (Sarah Sackman)]

It is a pleasure to serve under your chairship, Mrs Harris. As I and my colleague and hon. Friend the Member for Aberafan Maesteg have made clear throughout the debate, the Government continue to remain neutral on this Bill and do not take a position on assisted dying. My remarks will therefore focus on the legal and practical impact of the amendments, to assist the members of this Committee in undertaking line-by-line scrutiny.

Amendments 267 and 105 to107, which have now been withdrawn, deal with the Bill as currently drafted in relation to the High Court. Clause 12 as currently drafted would require the High Court to make a declaration that the requirements of the Bill have been met, following a person’s first declaration to receive assistance to end their own life, with statements from a co-ordinating doctor and an independent doctor. The amendments relate to how the High Court will declare itself satisfied that a person has a clear, settled and informed wish to end their own life and that they have not been coerced or pressured.

Briefly, amendments 407 and 410 seek to change who the High Court—as others have said, we might come on to debate some of these themes relation to the panel—would engage with when considering applications for assistance under the Bill. In determining whether the person has a clear, settled, and informed wish to end their life and that they have not been coerced or pressured, the High Court would be required to hear from and question the person seeking assistance, as opposed to having the option to do so. As my hon. Friend the Member for Spen Valley pointed out, in the later provision in relation to the panel, that has now become a requirement.

As my hon. Friend the Member for Broxtowe made clear, under her amendment 410 the High Court would lose the ability to hear from or indeed question any other party other than the person seeking assistance and the assessing doctors. Removing the ability—whether of the High Court or, as we may come on to debate, of the panel—to hear from and question any other party may limit that body or court’s ability to interrogate wider evidence or points of view.

[Juliet Campbell]

The probe that I have on that point is that the individual who is seeking the assisted death, and the doctors who have been working with that person, really have all the information. I am trying to ascertain, if we are not going to agree on this amendment, who else they would be seeking information from. Is there a risk if they are getting evidence from family members or other people, or having them give evidence or speak on behalf of that declaration?

[Sarah Sackman]

As I understand it, both in the context of the High Court—which has the ability to speak to whomever it likes—and of the panel, when we come to debate its role, that is a discretion. It is a requirement to hear from the person seeking an assisted death; it is a requirement to hear from the co-ordinating doctor. However, hearing from others is discretionary, which means that, if it is necessary in order to be satisfied that the eligibility criteria are met—which is what the scheme requires—in that context, under the panel’s or the High Court’s discretion, it may seek evidence from elsewhere. That is what the provision, as the Government reads it, is designed to do.

The amendment that my hon. Friend the Member for Broxtowe puts forward clearly limits that discretion; whether that is desirable is a policy choice, but that is how it is intended to function. As I have said, the Government will continue to remain neutral on these substantive policy questions, but I hope that is useful to members of the Committee.

Terminally Ill Adults (End of Life) Bill (Nineteeth sitting)

Juliet Campbell Excerpts

Wednesday 5th March 2025 Public Bill Committees

[Juliet Campbell (Broxtowe) (Lab)]

I will speak to amendment 127, which is a probing amendment. I will not press it to a vote, but the reason I tabled it is that I felt that the phrase “as soon as reasonably practicable” was a little vague. I was taking into consideration the fact that we often talk about people who have six months to live, who are eligible for the assisted death, but sometimes people learn later on and do not have six months. If people are thinking about having an assisted death, there might be some pace at which the doctors need to work together—the co-ordinating doctor and whoever else they speak to.

I put 10 days, because I needed to put something down, and that is why I am saying amendment 127 is probing, but I do think that we need to be a little tighter with the timeframe in which we enable doctors to speak to each other, so that the patient is aware of what is happening. Also, if the patient wants to change their mind and is speaking to another doctor, they would know what timeframe they have got. The amendment is probing, and I will not press it to a vote.

[Rebecca Paul]

I think most points have been covered, so I will be brief. The point of the amendment 296 is to recognise the challenges faced by medical practitioners in the NHS. It is really well intended. I suspect that there are different ways to do this, which we could discuss, but the amendment would recognise that medical practitioners will come under a lot of pressure.

The very nature of the assisted dying process means there is pressure to move quickly—for obvious reasons. If someone is in pain and an assisted death is what they have chosen to do, they are going to want to move forward at pace. It cannot be as usual, with however long it can take in the NHS—often for a normal procedure. The point of the amendment is simply to be cognisant of the fact that other patients, too, require healthcare. This comes back to the debate we have had many times about what is healthcare and what is not. It is one of the issues that comes up when we have assisted dying amalgamated with general healthcare in the NHS.

We are hearing concerns from doctors on the frontline. In written evidence, eight doctors, six of them GPs, say that the NHS lacks both the time and the capacity to create the new role of co-ordinating doctor with its grave responsibilities. The statistics bear out their concerns. In a 2024 survey by the Royal College of General Practitioners, over 40% of UK GPs who responded said that they were “unlikely” to be practising still in five years’ time; 40% feel stressed to the point of “not coping” at least once a week; and 79% are concerned about having fewer GPs at their practice and its impact on the quality of care that their practice can deliver. The reality of the matter is that we have to recognise that the introduction of assisted dying places another pressure on our health system, and to try to address that head on.

Terminally Ill Adults (End of Life) Bill (Nineteeth sitting)

Juliet Campbell Excerpts

Committee stage
Wednesday 5th March 2025 Public Bill Committees

[Juliet Campbell (Broxtowe) (Lab)]

I will speak to amendment 127, which is a probing amendment. I will not press it to a vote, but the reason I tabled it is that I felt that the phrase “as soon as reasonably practicable” was a little vague. I was taking into consideration the fact that we often talk about people who have six months to live, who are eligible for the assisted death, but sometimes people learn later on and do not have six months. If people are thinking about having an assisted death, there might be some pace at which the doctors need to work together—the co-ordinating doctor and whoever else they speak to.

I put 10 days, because I needed to put something down, and that is why I am saying amendment 127 is probing, but I do think that we need to be a little tighter with the timeframe in which we enable doctors to speak to each other, so that the patient is aware of what is happening. Also, if the patient wants to change their mind and is speaking to another doctor, they would know what timeframe they have got. The amendment is probing, and I will not press it to a vote.

[Rebecca Paul]

I think most points have been covered, so I will be brief. The point of the amendment 296 is to recognise the challenges faced by medical practitioners in the NHS. It is really well intended. I suspect that there are different ways to do this, which we could discuss, but the amendment would recognise that medical practitioners will come under a lot of pressure.

The very nature of the assisted dying process means there is pressure to move quickly—for obvious reasons. If someone is in pain and an assisted death is what they have chosen to do, they are going to want to move forward at pace. It cannot be as usual, with however long it can take in the NHS—often for a normal procedure. The point of the amendment is simply to be cognisant of the fact that other patients, too, require healthcare. This comes back to the debate we have had many times about what is healthcare and what is not. It is one of the issues that comes up when we have assisted dying amalgamated with general healthcare in the NHS.

We are hearing concerns from doctors on the frontline. In written evidence, eight doctors, six of them GPs, say that the NHS lacks both the time and the capacity to create the new role of co-ordinating doctor with its grave responsibilities. The statistics bear out their concerns. In a 2024 survey by the Royal College of General Practitioners, over 40% of UK GPs who responded said that they were “unlikely” to be practising still in five years’ time; 40% feel stressed to the point of “not coping” at least once a week; and 79% are concerned about having fewer GPs at their practice and its impact on the quality of care that their practice can deliver. The reality of the matter is that we have to recognise that the introduction of assisted dying places another pressure on our health system, and to try to address that head on.

Terminally Ill Adults (End of Life) Bill (Seventeenth sitting)

Juliet Campbell Excerpts

Committee stage
Tuesday 4th March 2025 Public Bill Committees

[Stephen Kinnock]

I agree with my hon. Friend on that point. As I stated at the start of my comments, officials have worked with her on new clause 19, which I think goes a long way to clearing up many of the points that have been raised, including hers.

[Juliet Campbell (Broxtowe) (Lab)]

rose—

[The Chair]

Order. The Minister is in the middle of responding to a particular question. Will Members wait until he has done so before standing up to ask a question on a question, please?

[Stephen Kinnock]

Thank you, Mr Dowd. I have answered the question from my hon. Friend the Member for Spen Valley and am happy to take another intervention.

[Juliet Campbell]

Throughout the debate, we have spoken consistently about things that happen normally within medical practice, but the amendment we are discussing would move us away from ordinary practice. Could the Minister explain why we would do that?

[Stephen Kinnock]

As I have set out, officials have looked at amendment 297 and raised a couple of flags or questions about it. One is what we have discussed about the transcript. The other is that it is not clear whether other people should be included in the consultation. I do not think it is so much about departing from common practice as about the questions that the amendment raises. As always, the Government are neutral. The Government trust that if the Committee, in its wisdom, sees fit to pass the amendment, it will be workable, but as things stand it raises a number of questions. That is all I am flagging.

--- Later in debate ---

[Danny Kruger]

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendment made: 341, in clause 4, page 2, line 33, leave out from “subsection (3)” to the end of line 36 and insert

“is not required to refer the person to another medical practitioner but must ensure that the person is directed to where they can obtain information and have the preliminary discussion.”—(Rebecca Paul.)

This amendment would provide that a registered medical practitioner who is unable or unwilling to have the preliminary discussion with a person must provide information to the person about where they can have that discussion, but that this need not take the form of a referral.

[Juliet Campbell]

I beg to move amendment 125, in clause 4, page 2, line 35, leave out from start of line to end of line 36 and insert

“who is on the Register of Assisted Dying Medical Practitioners.”

This amendment provides that only a medical practitioner who is on the Register of Assisted Dying Medical Practitioners as provided for in NC7 would have a person referred to them.

[The Chair]

With this it will be convenient to discuss the following:

Amendment 126, in clause 23, page 15, line 5, at end insert—

“(1A) Medical practitioners who wish to provide assistance under this Act must “opt-in” to the Register of Assisted Dying Medical Practitioners under clause (Register of Assisted Dying Medical Practitioners).”

This amendment provides that any medical practitioner who wishes to provide assistance under the Act must have opted in to the Register of Medical practitioners.

New clause 7—Register of Assisted Dying Medical Practitioners—

“(1) The Secretary of State must, by regulation, establish a Register of Assisted Dying Medical Practitioners.

(2) A medical professional may only carry out the role of co-ordinating doctor or independent doctor under this Act may if they are listed on the Register of Assisted Dying Medical Practitioners.

(3) Initial discussions under section 4 may only take place with a registered medical practitioner if they are listed on the Register of Assisted Dying Medical Practitioners.

(4) Regulations made under subsection (1) must provide that the Register of Assisted Dying Medical Practitioners includes all registered practitioners other than those to whom the conditions in subsections (5) and (6) apply.

(5) The condition in this subsection is that only medical practitioners who have completed such training as required by the Secretary of State by regulation must be listed on the Register.

(6) The condition in this subsection is that only medical practitioners who wish to provide assistance under the Act must “opt in” to be listed on the Register.

(7) Regulations under subsection (1) and subsection (5) are subject to the affirmative procedure.

(8) Before making regulations under subsection (1) and subsection (5), the Secretary of State must consult such persons as they consider appropriate.

(9) Regulations under subsection (5) must be laid within six months of the passing of this Act.

(10) Regulations under subsection (1) must be laid within twelve months of the passing of this Act.”

This new clause requires the Secretary of State, by regulation, to create a Register of Assisted Dying Medical Practitioners. Only those who are on the register would be able to hold initial discussions or act as a co-ordinating or independent doctor, or hold initial discussions under section 4 of the Act. Only those who have had training as specified by the Secretary of State in regulations can be on the Register. Registered medical practitioners would only appear on the register if they had “opted in”.

--- Later in debate ---

[Juliet Campbell]

I will speak to amendments 125 and 126, which are linked to new clause 7. Given the discussion we have just had, and given that amendment 341 has been made, I will not push amendment 125 to a vote. Amendment 126, however, provides that any medical practitioner who wishes to provide assistance under the Bill must have opted in to a register or a service for practitioners who are comfortable with providing care related to assisted dying. In other conversations, my hon. Friend the Member for Spen Valley has said that the opt-in model is provided within the Bill. The challenge is that it is not explicit in the Bill, and I would like to see it so.

The BMA wrote in its evidence to the Committee:

“The Bill should be based on an ‘opt-in’ model, so that only those doctors who positively choose to participate are able to do so. Doctors who opt in to provide the service should also be able to choose which parts of the service they are willing to provide (e.g. assessing eligibility and/or prescribing for eligible patients)…An opt-in model is not explicit in the Bill…We urge the Committee to make it explicit in the Bill that this is an opt-in arrangement for doctors.”

The BMA says that it wants it explicit in the Bill, and at the moment it is not. The Royal College of General Practitioners aligned with this viewpoint, stating that an explicit opt-in system is completely necessary in the Bill. It is my hope that members of the Committee will support amendment 126, which I intend to push to a vote.

[Kit Malthouse]

I am afraid that I will disappoint the hon. Lady by rising to oppose her amendments, although I understand why she has tabled them.

It was clear from the BMA’s evidence that it opposes the creation of a list of registered providers, which the hon. Lady proposes to create with these amendments. The BMA’s opposition and my opposition are based on two or three—

[Juliet Campbell]

Based on the fact that we agreed on amendment 341, I am prepared not to press amendment 125 to a vote. It is amendment 126 that I am proposing.

[Kit Malthouse]

I understand that, but amendment 126 also refers to a register of appropriate medical practitioners being maintained. Of course, new clause 7 would similarly create such a list. We are debating all three proposals, so I wanted to explain why I oppose them, as indeed the BMA does.

As has been outlined in previous speeches, the Bill creates an opt-in model effectively, whereby people who want to be the co-ordinating doctor or indeed the second doctor have to opt in and be trained, and therefore become accredited, so by definition they would be approved for that service.

However, the Bill does not envisage that the initial conversation is necessarily with the co-ordinating doctor. There might well be other medical personnel or practitioners—we have talked a lot about semantics in this debate—who are presented with the situation where a desperate person, somebody who has been given some extremely bad news, wants to talk about their situation and what their options might be. We hope and believe that training will spread throughout the NHS to those who want it. Nevertheless, we have to leave open the option that someone may not be accredited and that they may need to pass on someone, by whatever means the Bill determines, to a doctor who is accredited, who can act as the co-ordinating doctor, who has had the appropriate training and opted in, and I am afraid the register would not allow for that.

The second thing that concerns me slightly, and which we need to avoid for the benefit of both the patient and the system, is any kind of “doctor shopping”—the notion that there is a list of doctors that I can shop around and choose from. I worry slightly about that.

My hope is that these types of conversations, which are necessarily private and sensitive, will take place in an environment of embrace and familiarity between doctor and patient. We have talked a bit about whether doctors have to refer or provide information—obviously, we have just accepted an amendment that seeks to set out how that will work. What I would oppose, for two reasons, is the creation of a list that people can move up and down on, and pick somebody they like the look of, or who they think might be handy for them. First, I am not sure that it would be entirely reputable; secondly, we have to remember who we are dealing with here. These are dying people who may not have long left to live—we are talking about six months as a minimum, but actually they might have only two or three months to go. We need to create a sense that this is something that will be provided to them in an environment that is familiar. They will not have to spend their time finding a doctor on a list, and their phone number, then ringing up their office and saying, “This is what I want to do. Can I make an appointment?” There is a privacy aspect to it.

My third objection is, to be honest, about privacy—not just that of the patient, but that of the doctor. The hon. Lady will know that unfortunately—I do not know whether she thinks it is unfortunate, but I do—there are some people who object so strongly, for example, to abortion that they are willing to go and protest outside clinics that provide that service. This House has legislated to balance the rights of those who want to avail themselves of that service and those who want to protest. That has been a source of conflict.

I am afraid that a public list of doctors who provide this service would raise questions about the privacy of doctors, about patient privacy and about access to that service. I am concerned about it from that point of view.

--- Later in debate ---

[The Chair]

For clarity, amendment 125 is not being pressed to a Division, as I understand it. If the hon. Member for Broxtowe withdraws amendment 125, there will be an opportunity to vote on amendment 126 and new clause 7 later.

[Juliet Campbell]

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendment proposed: 288, in clause 4, page 2, line 36, at end insert—

“(6) All efforts to dissuade the person from ending their own life must be recorded in the clinical records and subsequently made available to the medical examiner.”—(Sean Woodcock.)

This amendment would require the coordinating doctor to record efforts to dissuade the person from taking their own life and subsequently make this available to the medical examiner.

Question put, That the amendment be made.