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

Kim Leadbeater Excerpts
Daniel Francis Portrait Daniel Francis
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I will return to that. I understand what amendment 11 seeks to do, but I think we should have a hybrid, because I do not think either amendment would completely achieve what we want. I will seek the Minister’s advice in due course. I understand the legal advice to my hon. Friend the Member for Spen Valley on this matter, and I understand that all the amendments have been tabled in good faith, but I am concerned about the loopholes that could remain.

We heard on Second Reading that assisted dying will not be available to disabled people, but let us imagine an individual who does not consider themselves to be disabled. If they were diagnosed with cancer tomorrow, our current legislation states that they would be disabled from the point of diagnosis. They could live with that cancer and receive treatment for a considerable time, while continuing to have no other disability. When they receive a six-month prognosis, they would be eligible for assisted dying due to the same disability they have had for a very considerable time, and it would remain the only disability they have had in their entire life. I remain concerned that my hon. Friend’s amendment still talks about disability, potentially leaving that loophole.

Kim Leadbeater Portrait Kim Leadbeater (Spen Valley) (Lab)
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My hon. Friend makes an interesting point, but the purpose of the Bill is that a person with a terminal cancer diagnosis and six months left to live would have the choice of assisted death. As we have heard, they might have seen the suffering of relatives with a similar cancer, and they might have seen what their death looked like. I understand that people might disagree, but that is the purpose of the Bill.

Daniel Francis Portrait Daniel Francis
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I hear that point but, looking at my postbag, the people who berate me for not supporting the Bill often talk about their loved ones with motor neurone disease or Parkinson’s, which I understand from oral evidence will be exempt. We need to make it clear which disabilities and conditions will be eligible, and I am not sure that the amendments before the Committee nail it down. I am concerned that the wording would lead to potential loopholes and legal challenges.

We should still be concerned about legal review of the Bill, based on indirect disability discrimination. The Equality Act says that indirect discrimination happens when a rule, a policy or even a practice that applies to everyone disadvantages people with a particular disability, compared with people who do not have that disability, where that cannot be shown to be justified as being intended to meet a legitimate objective in a fair, balanced and reasonable way.

If we accepted this amendment to allow the inclusion of cancer and some other disabilities set out in the Equality Act, I believe it would be argued in due course that other disabilities meet the criteria for assisted dying and, despite the promises made to this Committee and to the House in good faith, the loopholes would allow the criteria to be widened.

Other amendments in this group retain the reference to the Equality Act 2010, which could equally result in legal challenges down the line, for the reasons my hon. Friend the Member for Spen Valley outlined this morning. I am not deliberately being difficult, but I am not sure that any of the amendments would completely achieve what they seek to achieve.

I await the Minister’s view on the matter but, as things stand, I am concerned that we will take the clause back to the House without completely satisfying Members’ aims. By allowing those with cancer to seek assisted dying, there could be a loosening of the rules for other disabilities. I fear there could be manuscript amendments on this matter, but I await the Government’s view on the robustness of these amendments if they were to be accepted.

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Stephen Kinnock Portrait Stephen Kinnock
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My hon. Friend makes an excellent point. She brings us back to the fundamental point made in the Bill, which is that it has to be “an inevitably progressive illness”. Eating disorders do not fall under that definition: that is very clear. I hope that that explanation and the observation that I have made on the other amendments are helpful to members of the Committee in their consideration.

Kim Leadbeater Portrait Kim Leadbeater
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I will keep my comments brief, because we have had a very thorough discussion today. I will first speak briefly to amendment 123, tabled by my hon. Friend the Member for Broxtowe. Amendment 123 would change “an inevitably” progressive disease to “a typically” progressive disease. [Interruption.] Is that the next grouping? Oh, I am peaking too soon—my apologies, Mr Dowd.

I will come back to my hon. Friend the Member for Broxtowe, but let me turn to amendments 399, 400 and 401, on the exclusion of “medical condition”, which the hon. Member for East Wiltshire submitted a few days ago, before the end of the recess. I looked at them over the weekend and was very interested to hear his reasoning for them today. This is the purpose of the Committee; I have listened carefully to what the hon. Gentleman has said, and he has made some valuable points. All along, I have taken the view that this legislation must not only be the strongest anywhere in the world, but be very clear in its intentions and leave no room for ambiguity regarding who is entitled to request assistance under its provisions.

I am very comfortable with the definition of terminal illness in the Bill, but across the world—I have done lots of research into this, as I know other colleagues have—some jurisdictions use the term “medical condition” or, actually, just the term “condition”, and others do not. Many in Australia do, but in New Zealand, for example, which has a similar law to what is being proposed here, “medical conditions” do not feature, nor do they in a number of states in America.

While I do not necessarily think that it would definitely be problematic to include the term “medical condition”, I appreciate the argument that the hon. Gentleman has made. We have to be as cautious as possible to ensure that the Bill achieves its purpose but does not create a lack of clarity. That point has been very well made.

The advice that I have received from officials is that, as the hon. Gentleman suggested, “medical condition” does not have a clear legal definition and could therefore be seen as imprecise. That does worry me. The purpose of the Bill is clear—it is in the title. It is to give choice to terminally ill adults at the end of life. They must have a clear, settled and informed wish, and be expected to die within six months, in circumstances that are inevitably progressive and cannot be reversed by treatment. The hon. Gentleman has, I believe, helped to make that even clearer, and I am grateful to him for doing so.

Naz Shah Portrait Naz Shah
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My hon. Friend is making her points very clearly. The last words of amendment 181 are:

“Nothing in this subsection results in a person not being regarded as terminally ill for the purposes of this Act if (disregarding this subsection) the person meets the conditions in paragraphs (a) and (b) of subsection (1).”

Does that not demonstrate that the amendment does not change the test for terminal illness?

Kim Leadbeater Portrait Kim Leadbeater
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My apologies; I am speaking to amendments 399, 400 and 401. I will be happy to come back to that point at the appropriate time, but I first want to finish my comments on those amendments.

As I have said, the hon. Member for East Wiltshire has done a good job this morning of improving the clarity of the issue. That shows that the Committee is doing its job and working effectively. I am therefore open to supporting those amendments.

Danny Kruger Portrait Danny Kruger
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I am delighted to hear it. I am grateful to the hon. Lady and to other hon. Members who have indicated their sympathy for the amendment. I look forward to the Division and to the Minister’s decision.

May I follow up on a point made by the hon. Member for Bradford West? I do not know whether the hon. Member for Spen Valley would like to intervene to help me understand the point. Amendment 181 would redraft clause 3(2) to make it clear that a person does not qualify as terminally ill

“only because they are a person with a disability or mental disorder”.

It would add to clause 3(2) the following additional sentence:

“Nothing in this subsection results in a person not being regarded as terminally ill for the purposes of this Act if…the person meets the conditions in paragraphs (a) and (b)”.

Does the hon. Member for Spen Valley agree that that will essentially mean that the clause does nothing? It confirms the terms of eligibility set out earlier in the Bill, and confirms that a person would still be eligible to receive an assisted death if they had conditions that were a consequence of a mental disorder or a disability. If she feels like intervening on me, I would like her to help me understand what that additional sentence adds. To my mind, it negates the purpose of the clause.

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Rebecca Paul Portrait Rebecca Paul
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I thank the hon. Member for that thoughtful intervention, and I completely concede that it is not entirely clear, and there are different sources that describe it differently, which, for a non-medical person like myself, makes it difficult. There are certain websites, including NHS England, that may reference it as “progressive”, but equally I am sure that there are other sources that do not describe it in the same way. The hon. Member for Harrogate and Knaresborough makes a really good point, and he will see that I quite often talk about things arguably being the case; I am not saying that it definitely is—I am just highlighting that there is a risk, because if people disagree on whether it is progressive, that is when we have an issue. I see this as an opportunity to tighten up any of that potential risk.

I would say the ordinary person on the street would not expect diabetes to ever fall within the definition of a terminal illness, yet there is a risk that it could do, for the reasons I have explained. That means that the drafting of clause 2 is not quite tight enough in my view.

Kim Leadbeater Portrait Kim Leadbeater
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Just before the hon. Lady moves on, we may actually have come to a very sensible position based on the other amendments we have been discussing—amendments 399 to 401. I have done a little bit of googling, and diabetes generally is referred to as a “condition”. It might be referred to in other ways as well, but maybe that would be another reason for us all to support amendments 399 to 401.

Rebecca Paul Portrait Rebecca Paul
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I thank the hon. Lady for that extremely good news. That would definitely be helpful and provide some reassurance.

Amendments 9 and 10 are essential to ensure that those people who are never intended to eligible for assisted dying under this Bill are kept outside of it. Amendment 9 seeks to ensure that it is not just illnesses that can be reversed by treatment, but illnesses where the progress can be controlled or substantially slowed by treatment, that are ineligible—diabetes being the classic case, which can be slowed and controlled by treatment. Amendment 10 further bolsters that by ensuring that treatments that improve prognosis are not disregarded under clause 2(1)(a).

The problem that we have with clause 2 in its current form is that it fails to distinguish between those who are truly at the end of their life and those who only become terminal if they do not access treatment. There is no requirement for a person to be receiving medical care when their prognosis is assessed, which means that many manageable but irreversible conditions—like diabetes, potentially, and chronic kidney disease—could qualify as terminal if treatment is stopped. Let us take the example of someone with type 1 diabetes, like my hon. Friend the Member for South Northamptonshire (Sarah Bool), who tabled these amendments. If she were to stop taking her insulin, she might meet the criteria for terminal illness under the Bill and qualify for an assisted death—I mean, I certainly hope she would not. Without treatment, type 1 diabetes could arguably be an inevitably progressive and irreversible condition that would result in death within weeks or months.

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Naz Shah Portrait Naz Shah
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I agree very strongly with the sentiments expressed by my hon. Friends the Members for Spen Valley and for Penistone and Stocksbridge, and I hope that the Committee can later return to the state of palliative care in this country.

I underline that the matter of the six-month prognosis was not some minor detail on Second Reading; rather, it was a central plank of the arguments made by those who said that we should pass the Bill because its safeguards were the toughest of any assisted dying law in the world. It is less than three months since my hon. Friends spoke those words, and yet we are already discussing an amendment that would remove the six-month prognosis.

Kim Leadbeater Portrait Kim Leadbeater
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We need to be fair to the hon. Member for Harrogate and Knaresborough, who has said that he will not press the amendment to a Division. Indeed, it would not be something that I would support if he did do so, for the reasons that my hon. Friend has stated. I also think that we need to give him credit for ensuring that the voices of people with neurodegenerative conditions, such as MND, Parkinson’s and Huntingdon’s, are heard. They are an important part of this debate, whatever our views might be on the tightness that is needed in the Bill.

Naz Shah Portrait Naz Shah
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I thank my hon. Friend, and my hon. Friend the Member for Penistone and Stocksbridge, for making it clear that they would not vote for the amendment. I also thank the hon. Member for Harrogate and Knaresborough for bringing forward an amendment that discusses those issues. However, whether it is withdrawn or not, it is an amendment that we are debating and talking to.

The hon. Member for Harrogate and Knaresborough, who tabled the amendment, no doubt feels very strongly that the conditions of patients with neurodegenerative diseases make a case for relaxing the six-month prognosis to 12. There may well be a good case for doing so, but we can only consider the case for extending the prognosis to 12 months because of the challenges created by neurodegenerative diseases if we have first considered that extremely complex subject.

We cannot say that the Committee has studied the difficult subject of neurodegenerative diseases and how they would affect the administration of the Bill. We have not heard from witnesses on the subject, and we have not been able to ask them questions. We did solicit evidence on whether neurodegenerative diseases would affect the ability to self-administer lethal drugs, but we have not had time to study the written evidence.

I appreciate that the hon. Member for Harrogate and Knaresborough is not going to press the amendment to a Division, which leaves some of what I wrote earlier obsolete. I appreciate the hon. Member’s efforts. We are sent here by our constituents to represent them to the best of our ability. I certainly try to do that, and I know my hon. Friend the Member for Spen Valley always tries to do that—I have no doubt that the hon. Member for Harrogate and Knaresborough and all others are trying to do that. We vow to represent our constituents, and had the amendment gone to a Division I would not have been able to support it, simply because we cannot make those difficult decisions without being properly informed. We cannot make up our minds to change the Bill because of a complex set of diseases.

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Naz Shah Portrait Naz Shah
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I thank my hon. Friend for his intervention. Actually, there is nothing in the Bill that suggests that. We can only imagine and try to empathise as much as we possibly can with any person who has been given a diagnosis of six months to live. In that six-month process, they might not wait; as my hon. Friend, who is a doctor himself, has said, this is about autonomy. They might not wait until they get to a position where there is a lot of suffering; they might not wait to see those six months out. They might decide they do not want to take that risk, when actually they might have lived another 15 years, another year or another two years. That is the point of this amendment.

Kim Leadbeater Portrait Kim Leadbeater
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My hon. Friend is making a powerful speech and it is good to have this debate. May I ask her opinion on two things? One is that, as my hon. Friend the Member for Stroud has alluded to, the research around the world shows that between 30% and 40% of people who sign up for assisted death never actually do it, because they do get better or because the treatment makes their condition manageable—or because they have a death in a different way. What are her thoughts on that? The other thing to point out is the number of people who we know, sadly, are taking their own lives because they are terminally ill at the moment. I go back to the point that I make quite regularly: no one is monitoring that—

None Portrait The Chair
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Order. As I said before, these are interventions seeking clarification. They are not mini-speeches.

Naz Shah Portrait Naz Shah
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I thank my hon. Friend for her intervention. If we take that 30% to 40% figure, and the figure—she might correct me if I am wrong here, and I am happy to be corrected—that there are about 600 people on average going to Dignitas, for example—

Kim Leadbeater Portrait Kim Leadbeater
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It is people taking their own lives.

Naz Shah Portrait Naz Shah
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Sorry—would my hon. Friend like to intervene?

Kim Leadbeater Portrait Kim Leadbeater
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Just to clarify, my understanding is that it is between 600 and 700 people who take their own lives; it is suicide.

Naz Shah Portrait Naz Shah
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If we take that number, then that 30% or 40% who do not take that decision is maybe a few hundred people. However, the truth from Professor Sleeman’s evidence is that we are talking about thousands of people who are misdiagnosed every single year. She was talking about 3,516 who lived longer than expected. Yes, I recognise and value my hon. Friend’s comment that 30% or 40% of people do not take up assisted dying, but—perhaps I will talk about this when I move on to the next amendment—there is also a risk. If we go back to the Bill promoter’s intention to make the wording tighter, then surely this is a safeguard that she would support, just to ensure that we are making it as tight as we possibly can.

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Naz Shah Portrait Naz Shah
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Actually, it was the other way around and I am happy to provide a reference to the right hon. Gentleman. Nine cases found lack of capacity, but still not in the best interest. One of the girls was 19 years old. The judge found that they lacked capacity to make decisions about their treatment. The question of whether they had the capacity to decide to end their life is completely different and not something we have asked judges to rule on before. The judge’s ruling clearly implied the capacity to refuse force-feeding even if it resulted in their death. I am happy to provide the references for that. It was against their best interest to force-feed them. Tragically, in nine of the 10 cases the judges accepted that that would inevitably lead to the deaths of those young girls.

My hon. Friend the Member for Spen Valley has repeatedly stressed that her Bill is modelled on the Death with Dignity law in Oregon.

Kim Leadbeater Portrait Kim Leadbeater
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Actually, I have not said that.

None Portrait The Chair
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Order. With the greatest respect to Members, this is not a dialogue; this is a debate. This is not chit-chat. It is a very serious issue and interventions of that nature are not helpful.

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Kim Leadbeater Portrait Kim Leadbeater
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On a point of order, Mr Dowd. If something is said that we know not to be correct, what should we do?

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Danny Kruger Portrait Danny Kruger
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The hon. Member invites me to suggest that I think it would be possible to draw a safe safeguard. I do not. I think that one month is better than six months, because with one month we can have more accuracy and doctors are more genuinely right when they say that someone is close to death at that point, while six months is much more inaccurate and 12 months is notoriously inaccurate. If we restrict the Bill by using a time limit, that limit should be as close to death as possible in my view.

Kim Leadbeater Portrait Kim Leadbeater
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Does the hon. Member agree that if we were to reduce it to one month, there would be absolutely no way to have the robust process set out in the Bill—or, indeed, I would argue, to have any sort of robust process?

Danny Kruger Portrait Danny Kruger
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I accept that, which is why amendment 282 is probing only. It is trying to demonstrate the point. I recognise that even the expedited process is likely to take up to a month to get through, so that would be difficult. Nevertheless, if our intention is to restrict this to people who are literally in their last days, which is frequently what we hear, I think it would be appropriate to restrict the time.

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Stephen Kinnock Portrait Stephen Kinnock
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I thank my hon. Friend for her intervention. I am just talking about the amendment to reduce the time from six months to one month. I will come on to the issue of eating and drinking in a second.

As amendment 282 would reduce the time within which the person is expected to die from six months to one month, it would also limit the number of people with a terminal illness who would be eligible for assisted dying under this legislation. Furthermore, there may be very challenging workability issues in delivering a service within one month, given the other time-dependent safeguards elsewhere in the Bill.

Amendment 51 would remove the requirement for the patient to have a six-month prognosis to be defined as “terminally ill”. If agreed to, it would expand the pool of people eligible for lawful assistance to voluntarily end their own life beyond those with a life expectancy of six months or less. In other words, it would remove the timeframe requirement of when death can be reasonably be expected.

Amendment 234 would widen eligibility to include cases of neurodegenerative diseases, illnesses or medical conditions where a person is reasonably expected to die within 12 months. Matters such as this are for the Committee, and ultimately for Parliament, to decide, but it is clear that the effect of the amendment would be to broaden the number of people eligible for lawful assistance to voluntarily end their own life under this legislation.

Amendment 10 would provide that, if treatment exists for a person’s progressive illness, disease or medical condition that alters the overall prognosis of that person’s condition, they are not terminally ill and would not be eligible for assisted dying services.

Amendment 402 would exclude a person who would not otherwise meet the definition of “terminally ill”—namely, being diagnosed with an inevitably progressive illness with six months or less to live—if that person meets that definition as a result of stopping eating or drinking. The effect of the amendment would be to prevent a person from being defined as “terminally ill” as a result of their own actions of stopping eating or drinking, or both. The Government’s analysis suggests that this may also exclude people who are terminally ill under the definitions of the Bill and who are, for various reasons, unwilling or unable to eat or drink. For example, it may include those with conditions such as oesophageal cancers, which could result in their being unable to eat or drink.

Furthermore, it is unclear whether someone who is on intravenous fluids or being fed through a feeding tube would be considered to have stopped eating or drinking under the amendment. I think that addresses the concern expressed by my hon. Friend the Member for Bradford West, but she is welcome to intervene again if she would like to. The amendment could therefore lead to uncertainty over the person’s eligibility for assistance under the Bill.

The Government have taken a neutral position on the substantive policy questions relevant to how the law in this area could be changed. Questions around the definition of terminal illness and who should be eligible to access voluntary assisted dying under the legislation are matters for the Committee and for Parliament as a whole. However, I hope that these observations are helpful to the Committee in considering the Bill and the amendments tabled by various Members.

Kim Leadbeater Portrait Kim Leadbeater
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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 Portrait Juliet Campbell
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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.

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

Kim Leadbeater Excerpts
Jack Abbott Portrait Jack Abbott (Ipswich) (Lab/Co-op)
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Q Dr Fellingham, given your experience of both the British and the Australian healthcare systems, do you believe there are any fundamental differences that would affect how assisted dying is implemented in this country? If there are, how might we be able to mitigate them?

Dr Fellingham: In the UK you are missing a number of the challenges that we have, such as the geographical challenges in a state as vast as Western Australia. You also have a golden opportunity to look, as you are, across every jurisdiction that already has laws in operation and cherry-pick the best bits of what is working well in those jurisdictions, and so create the very best, most robust and most patient-centred legislation you can.

The healthcare systems are broadly similar. We are both first-world, developed western countries. We are still operating in a context of resource limitation, but not resource limitation that is so prohibitive that it would make it particularly difficult to enact a law in the UK. The United Kingdom would be broadly able to follow any of the laws that exist in Australia and implement them very successfully.

Kim Leadbeater Portrait Kim Leadbeater (Spen Valley) (Lab)
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Q Thank you for joining us this morning. I am interested in following up on what Dr Mewett said about the relationship with palliative care, which has an important role to play in end of life treatment. What is the relationship between assisted dying and the palliative care world like? Also, I would like to hear a bit more about the multidisciplinary board, which I think you set up, Dr McLaren. What does the multidisciplinary approach look like in your jurisdictions?

Dr Mewett: There is no doubt that traditionally palliative care has eschewed any idea of voluntary assisted dying, for a number of historical reasons that I have spoken about in other fora and will not go into now. But it is changing, and there is a general change in attitude, especially among the younger palliative care training doctors and young clinicians, who see this as part of patient-centred care, honouring the patient’s autonomy and choice, while still addressing deeply their concerns and suffering in pain management and so on.

That will see a change. I do understand where it has come from. When one looks at it almost forensically, it does not stack up and will continue not to stack up to have someone saying, “Well, VAD is not part of palliative care.” VAD is part of patient choice and it will be part of palliative care ongoing. That will evolve over time.

I am sorry but I did not quite catch the meaning of the question about the multidisciplinary aspect, Ms Leadbeater.

Kim Leadbeater Portrait Kim Leadbeater
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Q Was it a multidisciplinary board that Dr McLaren set up to look at the safety and quality of voluntary assisted dying?

Dr McLaren: This was born out of when we started as a Victorian group. We were very individual and we interpreted the law in our own ways. We complied with it as best we could, but we did not have a centralised discussion board or peer group set up at the time. We have propagated advice through the other states to ensure that there are what we call community practices, where clinicians can discuss their cases and learn from each other.

Several months after, from I think June to November, we had no interconnection with other VAD-practising doctors. In November, we had a forum set up where we are able to connect and talk about difficult cases and how we would each interpret them. As the subsequent states came online, we were approached by some of the practitioners from other states saying, “We don’t really want to reinvent that wheel, so can we join your community of practice?” Because it was set up by our state government, they were unable to join, so I saw a gap in terms of creating an organisation where we could propagate that knowledge and not all start from scratch.

It initially started as a group of voluntary assisted dying medical practitioners, and we would discuss cases across the board and ask things like, “What would you do under your legislation?” and we all learned from that. Then we were approached by pharmacists, nurses and others involved in voluntary assisted dying provision, including legislators who wanted to contribute to the custodians of the voluntary assisted dying law, who are the people who actually run the projects. That then led to the creation of Voluntary Assisted Dying Australia and New Zealand, which is a multidisciplinary group of predominantly doctors, but we do have nurses, pharmacists and legislators involved. We have had two annual conferences where we discuss issues faced by many of our practitioners. That has been a great resource for people.

We are developing standards. We feel that in our legislation there was perhaps too much about instilling what the standards are. We feel as though the appropriate-ness of such things as telehealth should be regulated via standards rather than via legislation, which it currently is in Australia. These are the types of topics we have weighed in on and created position statements for in order to protect the laws that we believe in, uphold and like to think of ourselves as responsible practitioners of.

Neil Shastri-Hurst Portrait Dr Neil Shastri-Hurst (Solihull West and Shirley) (Con)
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Q Dr Fellingham, to circle back to the issue of training, could you go into more detail about what the initial training consists of—the nature of it and the number of hours—and how that compares with the refresher training? What is the system for mentorship, supervision, appraisal and continuing professional development requirements?

Dr Fellingham: It is important to reflect that only people who are at quite a significant point through their own specialty careers are eligible to become assisted dying practitioners in this country. For instance, I was a consultant anaesthetist and I had already been practising for more than a year. I had lived experience of caring for patients both living and dying, both anticipated and unexpectedly, over a career spanning more than 10 years, before I came to the point of assisted dying.

To become eligible to offer assisted dying, I then had to undertake training developed in a special package by the Queensland University of Technology. That training package takes about two days to complete and there is an exam at the end before someone can become eligible. The exam has a 95% pass rate.

Once someone has qualified with that training, they are offered the opportunity to give their details to the state-wide care navigator service. The vast majority of people opt to do that. Once they do that, they basically become engaged in this incredibly supportive, collaborative and nurturing multidisciplinary team within a professional organisation that, in our state, covers all the assisted dying practitioners—the doctors—but also the care navigators, the pharmacy service, the individual voluntary assisted dying programme managers and the end of life choices co-ordinators, who exist in all our hospital systems.

Because we are all consultants in our own specialties, there is not the same level of supervisory oversight as we would give to junior doctors—there are not forms that we fill in; we do not accredit one another—but we do acknowledge that we are all learning and growing in this space. These are new laws: even the oldest in Australia has only been going for five years. Every single one of us is motivated from a place of wanting to support, collaborate, grow and learn from one another, and ensure that the care we are offering to people in this challenging space is of the absolute highest quality.

We have a really robust community of practice. We meet monthly. Half those meetings are online to allow our regional practitioners to join, and half of them are face to face. They are extremely well-attended closed sessions where, especially over the time that we have developed relationships with one another, we find an incredibly supportive space to share our experiences and to learn, grow and develop from one another.

In terms of CPD, we all have to maintain our professional registration. I have both general and specialist registration with our supervisory body, which is like the General Medical Council. I complete my mandatory CPD requirements each year, as per my specialist college. On top of that, I have just redone the refresher training, which is once every three years. That is just what was mandated in our state. If someone has not done VAD practice, they have to do the whole thing again. That is only for people who have been active in this space. That training is shorter—it is about half a day—but it is really a reflection of what we are doing on a weekly basis. We are living and breathing this work, and really strongly collaborating with everybody else who does it.

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None Portrait The Chair
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I am afraid that has to bring this session to a conclusion. Dr McLaren, Dr Mewett and Dr Fellingham, thank you for giving up your evening for us. The Committee is indebted to you. Thank you very much indeed and have a good night. While we are changing over, I call the Member in charge of the Bill to move a motion.

Kim Leadbeater Portrait Kim Leadbeater
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I beg to move,

That in the list of witnesses set out in the table in the sittings resolution agreed by the Committee on 21 January 2025 and amended on 28 January 2025, leave out “Professor Jane Monckton-Smith OBE” and insert “Hourglass”.

Unfortunately, we found out in the early hours of this morning that one of our witnesses is unable to join us this afternoon.

Question put and agreed to.

Examination of Witnesses

Professor Tom Shakespeare, Dr Miro Griffiths, Yogi Amin and Chelsea Roff gave evidence.

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None Portrait The Chair
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I am sorry, but we still have more Members and questions than we have time, so I am going to come down to one question per Member.

Kim Leadbeater Portrait Kim Leadbeater
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Q Thank you for coming to give evidence this morning—it is incredibly helpful. I am going to come back to clause 2 of the Bill, which concerns the definition of terminal illness. I am very clear on who the Bill is aimed at helping and who it is not aimed at involving. The definition says that the person has to have

“an inevitably progressive illness, disease or medical condition which cannot be reversed by treatment”.

It also says, for the avoidance of doubt, that this cannot be “a mental disorder” or “a disability”. I hear your concerns, and I want to support you and work with you on this. I am keen to know: what else do you want to see in the Bill that would reassure you that this is not about disabled people or people with mental disorders?

Dr Griffiths: I am conscious of time, so I will be very quick. My first point would be, why would you stick it at six months then? Why not have it at seven days, for example, as a way to take out our concerns? If you are talking about prognosis, let us go back to Chelsea’s point and the point that I made before. My condition is a neuromuscular condition. I have had meetings with clinicians where some have referred to it as a terminal illness, some have referred to it as a life-limiting condition, and others have referred to it as a progressive condition. The articulation of the ideas and the ways in which we think about conditions show the complexity of the issue. We are talking about terminal illness, and people who are terminally ill do constitute disabled people under the Equality Act, so you cannot make the distinction.

If you want to be quite proactive about it, then why not reduce the prognosis timeframe and make it as short as possible to take out the concerns about prognosis, and the concerns around whether individuals are going to live longer or could be facilitated access to alternative treatments to prolong life? I do not understand why we are fixated on a six-month prognosis because, as we have seen in other countries, as soon as you pass the legislation on six months, you will have individuals who say, “Why not seven months? Why not five months?” You will have campaigners who will say, “This does not include me and I have been campaigning for this.” There will be pressure to change and Governments will change. There is no guarantee that you can make that the eligibility criteria will be fixed.

Danny Kruger Portrait Danny Kruger
- Hansard - - - Excerpts

Q I want to give Professor Shakespeare the chance to respond to the point that we have heard. I am interested in whether you recognise that many disabled people—in fact, not just disabled people, but anybody who declines treatment that keeps them alive—would qualify as terminally ill under the terms of the Bill? What protections we could give to prevent that?

Professor Shakespeare: First of all, a terminal illness is defined as a “condition which cannot be reversed by treatment” I know that that does not mean a cure; you are not aiming at a cure—but it says, “cannot be reversed”. Surely that would not include things like HIV and diabetes because they can be reversed. They cannot be cured; they are still there, but they can be reversed with insulin, antiretrovirals or whatever.

I think, yes, terminally ill people are disabled people almost always, but that does not mean that all disabled people are terminally ill. Even if you have a disease or a condition—like Miro does or like other people do—that will probably result in your death eventually, you are not going to die tomorrow or in six months. You may die in 16 years or whatever. It is very difficult to define terminal illness, and that is why six months, I think, is used in this Bill.

Very recently, my aunt died. She was unconscious for the last month or so of having cancer and then she finally died. She would not have been able to express her will and her preference to have assisted dying, even if she wanted it. Therefore, I think six months when you can have capacity, you can anticipate, you know you are going to die but you want to have control in the manner of your death, is more useful than seven days or less, when you might be unconscious and you might not be able to express a will or preference.

Terminally Ill Adults (End of Life) Bill (Money)

Kim Leadbeater Excerpts
Kim Leadbeater Portrait Kim Leadbeater (Spen Valley) (Lab)
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On 29 November last year, in a debate widely described as showing Parliament at its best, this House sent the Terminally Ill Adults (End of Life) Bill into Committee for scrutiny by a majority of 55. It was the clear will of this place that the Bill should be allowed to proceed, in the knowledge that Members will have further opportunities on Report and beyond to decide whether it should be enacted. For that process to continue, the resolution before us today must pass.

Those who oppose the Bill on principle—something they are absolutely entitled to do—are seeking to suggest that there is something extraordinary or improper about this process, and on that they are simply wrong. This is a standard procedure that comes before this House all the time. Without it, there can be no Bill—that, I humbly suggest, is sadly what some people intend. This is not a blank cheque, as some Members have suggested. The right time to discuss the detail of what expenditure may be required is when we know the final shape of the Bill. At that point, if Members are concerned about the expenditure required, or indeed anything else, they can of course vote as they wish.

John Hayes Portrait Sir John Hayes (South Holland and The Deepings) (Con)
- View Speech - Hansard - - - Excerpts

The hon. Lady says that the right time to discuss the capacity of the judiciary and health service to deliver the Bill is presumably once it has completed its Committee stage, but should the Committee that considers the Bill have the impact assessment that allows it to scrutinise it line by line, mindful of the implications that it might have on our health service and our judiciary?

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Kim Leadbeater Portrait Kim Leadbeater
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I respect the right hon. Gentleman’s question, but I would say that point is slightly out of the scope of the money resolution. However, I think it is a fair point, and I acknowledge that a lot of work is being done, as the Government said it would be, to look at the workability and operability of the Bill. I am working closely with Departments on those issues, and those conversations will continue, alongside the work of the Committee. I hope that provides him with some reassurance.

The other point is that I have never sought to stifle debate on the Bill or this really important issue; quite the contrary. I value it and I welcome it, but I do ask that it continues to be conducted in the same respectful and considered manner as on Second Reading. Where we disagree, let us do so with respect and without questioning each other’s motives or integrity.

Ruth Cadbury Portrait Ruth Cadbury (Brentford and Isleworth) (Lab)
- Hansard - - - Excerpts

I congratulate my hon. Friend on how she has conducted this important debate. On stifling debate, does she share my hope that there will be no vote against the money resolution, because such a vote would end debate? While there was a strong vote in support of the Bill, there were many strong arguments for amendment and there was opposition. Does she agree that that debate needs to happen as the Bill proceeds and not be stifled and ended today?

Kim Leadbeater Portrait Kim Leadbeater
- Hansard - -

I absolutely agree with my hon. Friend. Having done such a powerful job of debating this issue on Second Reading, it is crucial that we continue that debate in the right manner, as Parliament voted to do. It would be wrong for anything that happens today to put a stop to that debate and those discussions.

Let us not forget that the public are watching our deliberations carefully and that the issue we are discussing means a huge amount to many people. It is extremely serious and, for many, hugely emotive. We owe it to our constituents to treat it with the seriousness it deserves. I ask Members to consider carefully what it would say about us as a Parliament if such an important debate were to be curtailed as a result of procedural manoeuvring, which, sadly, is what I worry is being attempted by some colleagues today.

The money resolution is not about the pros and cons or the detail of the Bill; it will simply allow for proper scrutiny—including of any cost involved—to continue, and mean that the Bill Committee can begin its important work. I urge Members to support the resolution.

None Portrait Several hon. Members rose—
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Brian Mathew Portrait Brian Mathew
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There would be added expense. Social workers are trained in understanding family dynamics, and need desperately to be involved in these situations.

Kim Leadbeater Portrait Kim Leadbeater
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I take that point on board. I had a very productive meeting with the Association of Palliative Care Social Workers yesterday, and we had a useful conversation on that issue.

Brian Mathew Portrait Brian Mathew
- Hansard - - - Excerpts

I thank the hon. Lady.

Hospice and Palliative Care

Kim Leadbeater Excerpts
Monday 13th January 2025

(1 month, 2 weeks ago)

Commons Chamber
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Paul Kohler Portrait Mr Paul Kohler (Wimbledon) (LD)
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I beg to move,

That this House has considered hospice and palliative care.

First, I thank the Backbench Business Committee for granting time to support this important debate, and I thank colleagues from across the House for supporting my application and joining me today to discuss a subject that, to use an old cliché—but in no more apposite a context—is truly a matter of life and death.

When this House debated the Terminally Ill Adults (End of Life) Bill last November, the crisis in hospice funding and concerns over the provision of palliative care were a constant refrain in the subtext of many of the speeches from supporters and opponents of the Bill. As someone who entered the Chamber that morning undecided as to how I would vote, I became increasingly convinced throughout the five hours of powerful argument and testimony that no matter what the House decided, the time had come to address hospice funding for the provision of palliative care head on, for death is as much a part of life as living.

While as parliamentarians we readily focus on what makes a good life, we rarely consider what makes a good death. It is possible to have a good death, as I saw with my mother, who passed away in comfort at the beautiful Arthur Rank hospice in Cambridge, and with my father, who died in the exceptional palliative care facility at Bellevue hospital in New York. As a family, we remember those times as sad, but cathartic, with moments of laughter as well as tears, as when my father—somewhat confused towards the end of life, but with a glint still in his eye—asked, as I sat next to him stroking his forehead, whether I was a lady friend.

Sadly, however, too many in our society do not experience a good death, and we need to start asking why. The hon. Member for Spen Valley (Kim Leadbeater) bravely took on that challenge with her private Member’s Bill, and I hope that this debate will afford us an opportunity to build on those foundations.

Kim Leadbeater Portrait Kim Leadbeater (Spen Valley) (Lab)
- Hansard - -

Does the hon. Member agree that the renewed focus on the hospice and palliative care sector is extremely welcome and overdue? Does he agree that the extra £100 million of investment shows how seriously this Government are taking the issue, showing that people approaching the end of life are fully supported in whatever choices they make?

Paul Kohler Portrait Mr Kohler
- Hansard - - - Excerpts

I agree with the hon. Lady, and I will be coming to those points.

Today is not about rehashing the arguments made that Friday, but to allow Members time to discuss and reflect on this separate, but inextricably linked subject. It is not the last word on hospice and palliative care, but an important step in forging a consensus that I hope will unite us, no matter where we ultimately stand on assisted dying.

I began by referencing the crisis in hospice funding. Before I proceed further, I echo what the hon. Member for Spen Valley said and thank the Health Secretary for the £100 million in capital and digital moneys he announced last month. It will make a profound difference to the sector’s current financial position. I have been asked by individual hospices and Hospice UK to convey their genuine gratitude. In a similar vein, the Government’s recently announced commitment to extend the children’s hospice grant by a further year is deeply appreciated and equally vital to maintaining levels of service in this heartrending, but profoundly important part of the hospice movement. However, these are only short-term fixes and fail to provide the long-term funding and certainty critical to securing the future of the hospice movement.

Currently, only one third of hospice funding is provided by the Government, with the rest coming from charitable sources. That leaves hospices vulnerable to increased cost pressures, as can be seen in a recent Hospice UK survey, which found that at least 20% of hospices had cut services in the past year or were planning to do so. Becca Trower, the clinical director of the wonderful St Raphael’s hospice, which provides excellent care to residents in my Wimbledon constituency, was unambiguous when she told me:

“We have a funding crisis and we need to protect our hospice.”

Last year, that meant that St Raphael’s was forced to strip £1 million from its £6.5 million budget by ending its hospice at home service that provided vital care, advice and support to patients and carers in their own homes. It was a virtual ward, in fact, but not one that fitted within the NHS definition of such, which would have attracted the separate integrated care board funding available for such initiatives. In just one month, the cuts to the service directly impacted 26 patients, many of whom spent their last days taking up valuable hospital beds, dying in the one place they did not want to die and putting further pressure on the NHS. When the Government are aiming to move medicine into the community, it makes no sense for hospices to be forced into a position that achieves the opposite.

That contradiction is mirrored in the current funding settlement, where the Government have given with one hand and taken with the other by increasing employers’ national insurance contributions. The refusal to exempt charities will exacerbate the challenges confronting hospices. The amazing Shooting Star children’s hospice, for example, provides wonderful support for families in my constituency. It estimates that the change will add another £200,000 to next year’s cost base.

Hospices need certainty. Doubts over funding undermine morale and sap energy, making the recruitment and retention of staff another huge issue for the sector. To address these problems, the Government need to introduce a consistent, reliable funding mechanism that reflects the rising costs of care. Hospices consequently need to be included within the NHS’s much-anticipated 10-year health plan. In parallel, staffing needs must be addressed in the next NHS long-term workforce plan.

It should not be forgotten that hospices provide a variety of services in addition to palliative care, including emotional, psychological and spiritual support, as well as physio and occupational therapy, practical support, complementary therapies, respite care and bereavement services. Much of that is beyond the clinical, and not something that the NHS can be expected, nor can afford, to provide. That is why no one I spoke to in the hospice movement thought that hospices should be subsumed within the NHS. They provide a complementary service that extends well beyond the clinical, and to which a charitable funding model is more effective and appropriate.

Mental Health Treatment and Support

Kim Leadbeater Excerpts
Wednesday 7th June 2023

(1 year, 8 months ago)

Commons Chamber
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Kim Leadbeater Portrait Kim Leadbeater (Batley and Spen) (Lab)
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“We should be frank. We have not done enough to end the stigma of mental health. We have focused a lot on physical health and we haven’t as a country focused enough on mental health.”

Those are not my words, although I agree with them wholeheartedly. They were spoken in 2016 by the then Prime Minister, David Cameron. He went on to say that if we

“intervene much earlier with those suffering from poor mental health…we can stop problems escalating… By breaking the mental health taboo, by working with businesses and charities…I believe we can lead a revolution in mental health treatment in Britain.”

Yes, yes and yes. My question is: why, seven-and-a-half years and four Tory Prime Ministers later, are we still waiting? Mr Cameron has long departed these Benches. This is not the occasion to lament the mess that he left behind, but the experience in my constituency—and, I respectfully suggest, in the constituencies of many, if not all, hon. Members—is that the Government’s approach to mental health remains, all these years later, wholly inadequate.

We have heard a lot of statistics in the debate. The numbers matter, because they show the overwhelming scale of the problem that we are facing. Every one of those numbers is an individual, and around them is a network of family and friends whose lives are impacted day in, day out by the very real challenges of confronting mental illness. I have met many such individuals and families in my constituency. Just last week, I hosted a roundtable at which I heard heartbreaking stories of such daily struggles, many of which involve children and young people.

Amelia is now 16. She was diagnosed with autism at the age of seven. For the past nine years, her mum, Anna, and her family have been trying to get help and support, and they are on their knees with exhaustion. Amelia has attempted to take her own life several times, and has been so let down by the system that she says that she just does not trust it anymore. It feels to her that she only gets any kind of support when there is an absolute crisis. I believe that, if she had got the support that she needed a long time ago, she and her family would be in a much better place today.

Eli is 10. He has been diagnosed with Tourette’s syndrome. He has various tics affecting his eyes, face, neck, back, hands and feet. He is a fantastic young man, but he is regularly in pain, which affects his ability to cope with days at school and has a huge effect on his mental health. Until recently, he was told that he just had conjunctivitis. His mum, Natalie, told me that she has struggled to find the psychiatric support Eli needs, and every time she calls CAMHS she is passed from person to person. She has been told that there are no NICE guidelines on Tourette’s and the best they have been offered to date has been worry management.

Those are just two examples, but they reflect a much bigger problem across society and in all our communities. I have meetings regularly with teachers across Batley and Spen, but we spend far more time discussing the mental health needs of their pupils and their families than we do the many other challenges faced in education—another sector that is underfunded and under-resourced. We cannot keep pushing this issue back on schools. Teachers do an amazing job, but we cannot expect them to take on responsibility for what is a widespread societal health issue because of more than a decade of lack of focus and national leadership on mental health.

It is not just teachers. Because we do not have the mental health experts and provision that we need in the places where we need them, it falls to others in the community to pick up the pieces. In Batley and Spen, I am incredibly proud of the many voluntary organisations, sports clubs and charities that do a magnificent job week in and week out under huge pressure. I pay tribute to groups such as Andy’s Man Club, Game Changerz, Blue Tulips, Team Daniel and Luke’s Lads, but the voluntary sector is propping up the NHS and society as a whole. That is not sustainable and it is simply not right. We would not expect teachers, sports coaches, voluntary groups and others to deal with a burst appendix, a broken leg or an ear infection, so why are we asking them to deal with the mental health crisis? They are, of course, part of a wider, holistic solution, but they should not be the only solution. That is not the parity of esteem between mental health and physical health that David Cameron spoke of. While I am hugely optimistic about the excellent plans Labour has to address the mental health crisis, people such as Natalie, Eli, Anna and Amelia cannot wait any longer, which is why today’s debate is so important.

Oral Answers

Kim Leadbeater Excerpts
Tuesday 25th April 2023

(1 year, 10 months ago)

Commons Chamber
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Neil O'Brien Portrait Neil O’Brien
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We are leaving no stone unturned. Last month, we passed legislation enabling the GDC to increase the capacity of the ORE. We have also made it easier for overseas dentists to start working in the NHS: as of 1 April, no dentist will need to pay an application fee. We also want to radically reduce the time that dentists spend in performers list validation by experience, and we will set out further steps in our dentistry plan.

Kim Leadbeater Portrait Kim Leadbeater (Batley and Spen) (Lab)
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T2. What is the Secretary of State doing to tackle the severe national shortage of desperately needed psychiatric intensive care beds, which means that people, including some of my constituents, have to travel hundreds of miles to see their loved ones?

Maria Caulfield Portrait Maria Caulfield
- View Speech - Hansard - - - Excerpts

We are spending an additional £2.3 billion a year on mental health services, and we have recently announced £150 million for crisis community support, because we are trying to reduce the number of people being admitted in the first place by treating them at an earlier point in their mental health illness. That will free up beds, but it will take time. Community crisis intervention is the way in which we want to make progress.

NHS: Long-term Strategy

Kim Leadbeater Excerpts
Wednesday 11th January 2023

(2 years, 1 month ago)

Commons Chamber
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Kim Leadbeater Portrait Kim Leadbeater (Batley and Spen) (Lab)
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We are in the middle of the greatest NHS crisis for a generation. Hospital beds are full, hospital corridors are full, patients are waiting hours, even days, in ambulances outside A&E, GP and the dentist appointments are almost impossible to get, medicines are running out, waiting lists continue to grow, and doctors, nurses and care staff are exhausted. We all know this, and I think we also know where the blame lies. It lies at the door of the Government, not only for their inaction over the last few weeks and months, but for the years of mismanagement that have left the NHS under-resourced, underfunded and understaffed.

With the greatest of respect to Conservative Members, people in Batley and Spen and elsewhere are not interested in international comparisons; they are interested in solutions. After 13 years in power, the Conservatives have to take responsibility for the current crisis in the national health service. There is quite simply nowhere for them to hide, and I think they know it.

Every hon. Member has stories of constituents who have faced an absolute nightmare in recent weeks and months. I would be extremely surprised if Conservative Members have not received the same kinds of emails that every Labour Member receives every day about the current state of the NHS. I have a list of constituents, friends and family members who have not received the care they deserve due to the huge pressures within the system.

Of course we understand the impact of the pandemic, but the NHS would be in a far better position to cope with the demand it now faces if there had not been a lost decade, and more, of underfunding and staff shortages. The public and our incredible, tireless NHS staff are now paying the devastating price for this Government’s failings.

Last week I visited Cleckheaton group practice, a GP surgery in my constituency. I spoke at length with the practice manager about the pressures it is facing, its struggle to recruit and retain staff, the dramatic increase in case load, the increasing level of abuse and the real pain of not being resourced to provide the service that the practice wants to provide.

When patients ring for an appointment, receptionists desperately want to book them in to see a GP. They understand patients’ desperation, but the capacity is simply not there. The practice received 690 phone calls in just two hours. Staff are doing their very best, but they are struggling on a professional level and a human level. We often talk about the NHS as an organisation, as a thing, but we must never forget that it is full of real people who feel the daily impact of this crisis and longer-term Government mismanagement. The impact on their physical and mental health must not be ignored.

Where is the serious work needed to prevent the next crisis or to introduce longer-term preventative health measures to free up capacity in the years and decades to come? The Government have a role to play, but this type of forward thinking, solving problems before they arise, has been sorely lacking for the last 13 years. I am enormously reassured that, as a Government in waiting, we in the Labour party have begun that work, setting out the long-term plans and fixes our country needs. The next Labour Government will make the decisions needed to ensure that our country is fit for the next generation.

However, in the short term, I plead with the Government to treat the NHS crisis with the seriousness and leadership it needs, and to work collaboratively with healthcare staff and the unions. We all rely on the NHS being there in our time of need, and I know that I speak for many constituents who are deeply concerned that, if they become ill in the next few weeks, an ambulance will not be there for them, the hospital bed they need will not be free and the doctors and nurses will not be there to care for them. The Government are failing in their primary duty to keep us safe, and what we are seeing under their watch is simply not good enough. Our constituents deserve better, our NHS deserves better, and Britain needs and deserves better.

NHS Staffing Levels

Kim Leadbeater Excerpts
Tuesday 22nd November 2022

(2 years, 3 months ago)

Westminster Hall
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Kim Leadbeater Portrait Kim Leadbeater (Batley and Spen) (Lab)
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I congratulate my hon. Friend the Member for Wirral West (Margaret Greenwood) for this important debate on a subject that is close to my heart. I have many friends and family who work in the NHS and I speak to them regularly about the severe pressures they are under. I doubt there is a single Member of Parliament whose inbox is not full of casework, both from patients whose treatment has been delayed because of staff shortages and from overstretched NHS workers who are frustrated that, with the best will in the world, they simply cannot meet the demands they face each and every day.

I want to mention a couple of the emails I have received in recent weeks. Eamon works in the NHS and told me:

“After over 10 years of underfunding, I see my colleagues and staff within the hospitals I visit every day look more and more dejected, run down, insulted and demoralised. Where once was pride, a smile, laughter and camaraderie, there is now worry, depression and a feeling of hopelessness.”

Tracy expressed the feelings of many long-serving health workers when she told me:

“Some of us cannot cope on the wages we earn and are considering leaving the NHS. We cannot afford to lose any more staff—we are struggling to staff wards as it is. I work six days a week to get a decent wage. I’m 60 years old and I have worked all my life. This can’t be right.”

Eamon and Tracy are hard-working professionals, dedicated to helping the patients in their care. That people like them should be so worn down and unhappy at work that they are considering leaving should be a wake-up call to the Government. Yet all we hear from the Prime Minister down is that decent wages for nurses and other healthcare workers are unaffordable. Is it any wonder that people look elsewhere in the economy and see employers doing what the Government should be doing in the NHS? That is, offering higher wages and better working conditions to help recruit and retain the staff they need.

In my constituency of Batley and Spen, Amazon is seeking to build a huge new warehouse development. I am opposing the plan for a number of reasons, not least the damage it would do to the health and wellbeing of local residents and the impact on the already-overloaded transport network. However, I also have serious reservations about the number and type of jobs such a development would create and I worry that our exhausted NHS workforce may be tempted by such developments, whatever the reality. We cannot afford for our nurses, porters, drivers and other workers who keep the NHS going to be lured away by the promise of higher wages in other sectors. We need them.

The impact of staff shortages has already led to vital services in my constituency being significantly reduced, leaving patients having to travel long distances to access care that, until recently, was available in their own communities. Such local care is really important. To take just one example, the Bronte Birth Centre was a lifeline for expectant mums, but it was forced to close—hopefully, temporarily. However, some fear it could become permanent, because the centre simply cannot get the maternity staff it needs. A recent advert for midwives did not lead to a single application.

NHS management is doing its best, looking to support recent graduates, attract back retired staff and recruit internationally. However, it is clear that the fundamental problem remains the same across the health service: low morale, wages that fail to keep up with prices and working conditions that are getting progressively worse, month after month and year after year. We remain incredibly proud of the NHS, especially on this side of the House, but I accept in other parties too. After 12 years of under-investment, it is now stretched to breaking point. Unless we take urgent action to strengthen the workforce, restore the pride that NHS staff have in their ability to do their jobs and properly reward them for their work, we are putting the future of our NHS at serious risk. I hope we can all agree that that is something we must avoid at all costs.

Baby Loss and Safe Staffing in Maternity Care

Kim Leadbeater Excerpts
Tuesday 25th October 2022

(2 years, 4 months ago)

Westminster Hall
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This information is provided by Parallel Parliament and does not comprise part of the offical record

Jill Mortimer Portrait Jill Mortimer
- Hansard - - - Excerpts

You have done. Yes, that loss never goes away. I still feel guilty, because it was so early; I did not go through what people such as my hon. Friend have gone through.

Kim Leadbeater Portrait Kim Leadbeater (Batley and Spen) (Lab)
- Hansard - -

I thank the hon. Lady for sharing her deeply personal and emotional story. I want to place on the record my thanks to Alex Walmsley in my constituency, who recently won a BBC Radio Leeds “Make a Difference” award for founding Sands United West Yorkshire, a football team that provides peer support for men affected by baby loss. We often tend to focus on the women, but it is really important that we talk about the fathers who have suffered that loss as well. Does the hon. Lady agree that keeping open local maternity units, such as the Brontë birth centre in my constituency at Dewsbury and District Hospital, is essential to maintaining safe and quick access to maternity services for our communities?

Oral Answers to Questions

Kim Leadbeater Excerpts
Tuesday 19th July 2022

(2 years, 7 months ago)

Commons Chamber
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Steve Barclay Portrait Steve Barclay
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My hon. Friend will be aware that, through this Government’s funding, we have opened five new medical schools and, from memory, 1,500 additional undergraduate places. That is thanks to the work of the former Secretary of State, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who championed this specific initiative to address workforce pressure.

More widely, I am always happy to meet my hon. Friend the Member for Worcester (Mr Walker) to discuss issues in Worcester.

Kim Leadbeater Portrait Kim Leadbeater (Batley and Spen) (Lab)
- Hansard - -

Does the Secretary of State agree that one way we can take some of the pressure off overstretched GP services is to ensure that pharmacists can continue to play their vital role in looking after the health and wellbeing of patients? Pharmacies across the country are closing because of financial pressures, so will he urgently look into extra support for them to recruit and retain staff?

Steve Barclay Portrait Steve Barclay
- Hansard - - - Excerpts

The hon. Lady raises a valid and important point about getting the right service to patients, which can often best be delivered by a pharmacist. That is why, as I signalled earlier, we need better use of tech to support patients in understanding where they can best access the advice they need.