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 (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 (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.

Women’s Health

Juliet Campbell Excerpts

Thursday 27th February 2025 Westminster Hall

[Juliet Campbell (Broxtowe) (Lab)]

It is a pleasure to serve under your chairmanship, Dr Huq. I congratulate my hon. Friend the Member for Hastings and Rye (Helena Dollimore) on securing this debate.

Menopause is a biological process that marks the end of a woman’s menstrual cycle and fertility, and it typically occurs between the ages of 45 and 55. It is a universal experience for women around the world. The journey to that point is known as perimenopause, which can last for several years, and that is what I will focus on today. The perimenopausal stage in a woman’s health remains in the shadows, under-prioritised and under-resourced by policymakers, employers and healthcare providers alike. Perimenopause is overlooked despite its relevance to health, education, employment and demography.

During the transition into the menopause, a woman’s body undergoes various changes as it prepares to end its reproductive years. Typically, the transition begins in the mid-40s, but it can start as early as the mid-30s and last as long as into the mid-50s. It usually lasts for about four years, but it can extend to up to eight years. During the perimenopausal stage, oestrogen levels fluctuate, leading to irregular menstrual cycles, and as the ovaries gradually produce less oestrogen, it can cause various other symptoms.

Perimenopause is diagnosed based on symptoms and menstrual history, and the treatment focuses on managing the symptoms, including through lifestyle changes, hormone therapy—although less so—and other medications. The symptoms of perimenopause can affect daily activities. They affect work and relationships. Women in my Broxtowe constituency have told me that they have needed to take time off work due to the symptoms, which they did not understand and neither did their healthcare professionals.

We know that absences from work have a significant impact on our economy. As has been said, it can cost billions of pounds per year. Some women need to reduce their working hours, to take extended leave, or to leave the workforce entirely. This can affect their career progression, depending on how young they are. At a time when the Government are focusing on growing our economy, we cannot ignore the economic costs of not helping and supporting women in their perimenopause.

Few women seek help or attention, and due to a lack of understanding they receive very little support if they do. Their symptoms might be subtle and they will come on gradually. They might not even know that they are connected to the hormone fluctuations of the menopause transition. Many women do not even understand the signs and symptoms of the perimenopausal stage, as the menstrual cycle continues. This lack of awareness and education about the perimenopause, among both women and healthcare providers, leads to underdiagnosis and undertreatment.

I raise this issue because I would like to go back to my constituency and assure people that perimenopause will be included in any future Government policy.

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

Juliet Campbell Excerpts

Committee stage
Tuesday 25th February 2025 Public Bill Committees

[Danny Kruger]

I am grateful, Mr Dowd. I recognise the force of what the hon. Member for Penistone and Stocksbridge is saying. To be clear, the amendments that I am supporting would not deny disabled people any of the other rights that are being awarded in the Bill. She is absolutely right that a disabled person with a terminal illness would qualify just as much as someone who was not disabled. That is absolutely right.

The purpose of the amendment is to ensure that people whose illness is a direct consequence of a mental disorder in particular would not be eligible. The reference to disability is because of the confusion, which I expect the hon. Member for Spen Valley recognises in current law and guidance, about where the distinction between disability and terminal illness lies. That is our concern. The purpose of the amendment is to ensure that people would not be deemed as eligible for an assisted death in consequence of disability or mental illness. I know that is what the hon. Lady is trying to do with the amendment, and with the clause that it amends, so we are on the same page. Our concern is that, by including the words “For the avoidance of doubt” and the word “only”, we will be leaving quite a large loophole, through which, I am afraid to say, some vulnerable people might fall.

I look forward to the Division on the amendments. We have not been able to discuss them all in close detail, but I am grateful to Members for the debate that we have had.

Amendment 399 agreed to.

[Juliet Campbell (Broxtowe) (Lab)]

I beg to move amendment 123, in clause 2, page 1, line 23, leave out “an inevitably” and insert “a typically”.

This amendment changes the definition of what it is to be terminally ill from having an “inevitably” to a “typically” progressive illness, disease or medical condition that cannot be reversed by treatment.

[The Chair]

With this it will be convenient to discuss the following:

Amendment 9, in clause 2, page 1, line 24, after “reversed” insert

“or the progress controlled or substantially slowed”.

This amendment would mean that illness, disease or medical condition etc, the progress of which can be managed or controlled by treatment are not characterised as terminal illness.

Amendment 48, in clause 2, page 2, line 2, leave out

“can reasonably be expected within 6 months”

and insert

“is expected with reasonable certainty within 6 months, even if the person were to undergo all recommended treatment”.

Amendment 282, in clause 2, page 2, line 2, leave out

“reasonably be expected within 6 months”

and insert

“be expected with reasonable certainty within one month, even if the person were to undergo all recommended treatment.”

This amendment would restrict the scope of assisted dying to people who, with reasonable certainty, would die within one month, even if they were to undergo all recommended treatment.

Amendment 51, in clause 2, page 2, line 2, leave out from “expected” to end.

This amendment would remove the six-month time requirement for a person to be eligible to request assistance under the Act.

Amendment 234, in clause 2, page 2, line 2, leave out “within 6 months” and insert—

“(i) in the case of a neurodegenerative illness, disease, or medical condition, within 12 months; or

(ii) in the case of any other illness, disease, or medical condition, within 6 months.”

This amendment changes the definition of a terminal illness for the purposes of the Act to include neurodegenerative illnesses, diseases or medical conditions where a person’s death in consequence of such an illness can reasonably be expected within 12 months.

Amendment 10, in clause 2, page 2, line 6, at end insert

“, providing the treatment does not alter the overall prognosis of the condition.”

This amendment, which is linked to Amendment 9, would mean that illness, disease or medical condition etc, the progress of which can be managed or controlled by treatment are not characterised as terminal illness.

Amendment 402, in clause 2, page 2, line 6, at end insert—

“(2) A person who would not otherwise meet the requirements of subsection (1), shall not be considered to meet those requirements as a result of stopping eating or drinking.”

This amendment means that someone who is not terminally ill within the meaning of subsection (1) cannot bring themselves within that definition by stopping eating or drinking or both.

[Juliet Campbell]

The amendment would change the definition of what it is to be terminally ill, from having an “inevitably” to a “typically” progressive illness, disease or medical condition that cannot be reversed by treatment.

The limits of medicine, and where they manifest in our healthcare system, have been repeatedly discussed and have come up in oral and written evidence. The Bill’s supporters have frequently used the argument that our current medical care is limited to highlight the benefits of assisted dying, by stating that even with the best care available, not everyone can be prevented from experiencing significant suffering as their life comes to an end. However, such an understanding of the limits of medicine is not consistently applied in the Bill. The truth, as is repeatedly corroborated in the written evidence, is that in many cases we simply cannot reasonably know how long a person could survive.

Witnesses have explained that predicting whether someone is inevitably terminal is often not a certainty. Even when a disease is considered advanced or at the end stage, there are variables—such as an individual’s response to a treatment, access to care, new clinical trials, medical intervention, or a person’s overall resistance —that can influence the outcome. When practising medicine, doctors often use terms like prognosis, life expectancy, or expectation, rather than definitive statements on the degree of someone’s terminal prognosis. The variables in prognosis make the amendment necessary.

The term “typically” better acknowledges the limitations of the knowledge of medical practitioners. In written evidence, Dr Chris Paxton, a retired GP of 38 years, says:

“No doctor can accurately predict if a terminally ill patient has six months or more to live. I have seen many patients being told they have only months to live, continuing living many years after their ‘terminal’ diagnosis.”

The concept of a condition being “typically” terminal acknowledges that although a disease usually leads to death, there may be exceptions where individuals survive longer than expected, or even achieve remission.

The process of assisted dying must maintain honesty and transparency with patients who are seeking assisted death. A declaration of certainty is implied by using the word “inevitably”. In her written evidence, Dr Ariel Dempsey, who is currently studying end of life care, says:

“Physician prognostic estimates are variable, optimistic/pessimistic, uncertain, and more often than not, inaccurate. For example, a prognosis of 6 months is required for hospice eligibility in the U.S., yet it is not uncommon for hospice patients to live beyond six months, even without life-prolonging treatment.”

For individuals seeking assisted death, the use of the word “inevitably” can lead to an over-reliance and overconfidence in the judgment of their doctors. If someone believes without question that they will inevitably die within six months, an assisted death may seem like an obvious and minimally life-limiting choice. The problem is that a claim that someone’s death is imminent and inevitable within six months simply may not be true.

Not only does the use of the word “inevitable” risk embedding dishonesty in our law, but it risks doctors who agree to engage in assisted dying and end of life care becoming overburdened with the responsibility of proclaiming an individual’s prognosis. Having considered the circumstances that surround a person’s illness, a doctor can only give a prognosis that is typical and give a typical indication of their life expectancy.

--- Later in debate ---

[Dr Neil Shastri-Hurst (Solihull West and Shirley) (Con)]

Will the hon. Lady give way?

[Juliet Campbell]

I have almost finished, so I will carry on.

If we give doctors the essentially impossible task of proving that death will inevitability occur in six months, there is a risk of an individual being advised to stop treatment, to accelerate them artificially into a serious or terminal state or speed it up to ensure their eligibility. As medical intervention is so key in the prognosis of a seriously ill patient, it makes no sense to me to use language that is not consistent with real-life medical experiences or reasonably within the scope of medical diagnosis.

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

It is an honour to serve under your chairmanship, Mr Dowd. I speak in support of amendment 234, which is tabled in my name and seeks to ensure that people suffering from neurodegenerative conditions are not excluded from the dignity and autonomy that the Bill seeks to provide. The amendment would extend the eligibility period for those with neurodegenerative conditions from six months to 12 months—a simple yet crucial change that could alleviate needless suffering and ensure fairness in our approach to end of life care.

The intention of the amendment is to change the law to match that in five of the six Australian states. The wording mirrors that found in those jurisdictions. Conditions that would be affected by the change include motor neurone disease, Huntington’s disease, multiple system atrophy, progressive supranuclear palsy, Parkinson’s and many others. Although Alzheimer’s is a neuro-degenerative condition, those with Alzheimer’s would not be eligible for an assisted death should the amendment pass because they would not have the mental capacity.

--- Later in debate ---

[Kim Leadbeater]

Colleagues will be pleased to know that, despite my copious notes, I do not intend to speak for very long, because I believe we have had a very thorough and robust debate on these issues. The Minister makes a valuable point on amendment 402, which I do not think anyone else raised. Coincidentally, it relates to the person in the Public Gallery this morning, whose mum had a horrible form of cancer and had to have her tongue removed. She would have stopped eating or drinking, but it was not a choice; it was an inevitable result of her condition. She would have been excluded from having an assisted death, which I am sure is not the intention of my hon. Friend the Member for Bradford West.

We have had an excellent debate and covered a lot of ground. I do not intend to add anything more on this group of amendments. I will only say that if we get a move on, we might be able to get through clause 2 before we close at 5 o’clock.

[Juliet Campbell]

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendment proposed: 9, in clause 2, page 1, line 24, after “reversed” insert

“or the progress controlled or substantially slowed”.—(Rebecca Paul.)

This amendment would mean that illness, disease or medical condition etc, the progress of which can be managed or controlled by treatment are not characterised as terminal illness.

Question put, That the amendment be made.