Terminally Ill Adults (End of Life) Bill

Lord Beith Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Lord Beith (LD)]

My Lords, I do not bring to this debate any medical knowledge or expertise. My relevant experience is in having cared at home for both my first and my second wife as they faced the terminal stages of metastatic cancer. Noble Lords will have memories of my second wife, Baroness Maddock, and her work in this House, which she continued with determination as she coped with her cancer treatment.

Whatever ethical or religious view I might take about assisted dying or assisted suicide, I respect the sincerity and strength of feeling of those who want this change in the law. Whatever view I individually take, as a liberal I cannot simply deny that freedom to others, unless granting the freedom causes or could cause so much harm to others that it justifies the intervention of the law. The debate has demonstrated that there are potentially very significant harms to others which could result from the Bill. Whatever our personal view, we are duty-bound to assess the harm and consider whether it can be successfully mitigated or is so great that the Bill should not proceed.

I will not list all the numerous dangers already identified, but high among my concerns is the fear that many people will have that they and others will be put under or feel pressure to end their lives. They may feel that they should take this course rather than being seen as a burden to their families, the health service or society—and that is envisaged in the impact assessment.

I am concerned that this will severely damage the way medical staff interact with patients, and it would be quite wrong to offer an unequal choice to patients between assisted suicide and palliative care when the suicide help is available but the necessary level of care may not be. I have met wonderful people working in palliative care, but there are not enough of them, and the service varies greatly in availability and quality in different areas.

I am also concerned that existing palliative care practice could be adversely affected by the Bill. If medical practitioners have administered drugs to relieve pain and symptoms for a patient, and that patient dies within six months, will they be accused of failing to go through the procedures this Bill provides for intended death when there was no such intent and the drug use was entirely to bring comfort to the patient?

The hospice movement, which is massively dependent on charitable giving, has many concerns about how the Bill would operate, both in clinical practice and in its impact on giving from people who do not want their gifts to support assisted suicide. As the Bill stands, hospices, whether residential or home-based, are not allowed to opt completely out of the system, and that cannot be right.

I serve on the Constitution Committee of this House and fully endorse the objections it has raised to the use of unamendable secondary legislation and disguised legislation to define many of the most central features of the system being created and its relationship to the NHS. I am also worried by the exclusion of the coroner’s jurisdiction in England and Wales. There will be cases which would, without this provision, justify investigation and, in some cases, an inquest. It is unwise of us to forget that, although doctors and families will almost always be acting in good faith in very distressing circumstances, medical carelessness, malpractice and undue influence can occur.

I was also struck by the reference of the noble Baroness, Lady May, to the Bill’s potential to impact on the very worrying level of suicide among young people. The Bill may offer a wholly unintended signal that taking your own life is the answer to your problems, and we will have to do something about the growing crisis if the Bill proceeds.

If I were a determined supporter of the Bill, I would still want it to have the most careful scrutiny informed by detailed evidence, not just a few Fridays of conventional House of Lords sittings. We may get that, although under a very tight timetable. I say this not in criticism of the Bill’s promoters; they were working within the straitjacket of Private Member’s Bill procedure. But that means that we now have to set about filling the gap to make sure that, if the Bill goes ahead, our concerns are met to a much greater extent than was achieved in the Commons. If that cannot be achieved, some of us would feel that we should give up on the Bill and start again. I have this fear—this instinct—that this is one of those big decisions that society may one day regret. There will be no way back.

Terminally Ill Adults (End of Life) Bill

Lord Beith Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[The Deputy Chairman of Committees (Lord Beith) (LD)]

Does the noble Baroness intend to withdraw the amendment?

[Baroness Coffey (Con)]

I was hoping to get an answer; we can speak more than once in Committee, because we are trying to understand. Otherwise, later days in Committee and Report could become quite painful. I hope to get an answer from the Minister today.

Terminally Ill Adults (End of Life) Bill

Lord Beith Excerpts

Committee stage
Friday 5th December 2025 Lords Chamber

I will be among those who, in a later group, will be looking to strengthen the safeguards being applied to the eligibility test, but I do not recognise this question of residence as a safeguard. I regard pretty much all these amendments, other than my own, as devices to create bureaucratic impediments to people’s eligibility for this service. Whatever we may think in principle, for or against the Bill, we should not be depriving people who are accessing NHS services in this country of access to this service for reasons of bureaucratic differentiation, rather than because they are eligible or otherwise for substantive reasons. I hope that, on Report, my amendments might find favour with the sponsor of the Bill.

[Lord Beith (LD)]

The noble Lord talked about bureaucratic impediments. A later amendment of mine addresses the bureaucratic impediment that if you are a resident in England and Wales who lives a few miles from a general practice in Scotland, and you are registered with that practice, you are disqualified from the scope of the Bill. It seems to me there is quite a bit of work to be done on these border issues, which I hope the noble and learned Lord might indicate he is willing to see done, to try to sort them out. If he is so willing, I will not need to move Amendment 17, which we come to a little later.

[Lord Falconer of Thoroton (Lab)]

I am very willing to address these border issues, which are incredibly important. The noble Baroness, Lady Finlay, specifically raised them in the context of the Isle of Man patient who comes to, say, Liverpool for treatment. What will happen when Scotland and the Isle of Man have different laws on assisted dying? If, as this draft says, you have to be ordinarily resident in England and Wales to get the benefit of the exception to the Suicide Act, those who offer to help someone get back to the Isle of Man for an assisted death there would be committing a criminal offence because the person would not be ordinarily resident in England and Wales.

The British Medical Association has a proposal that we amend the Bill to say that if you help somebody to go to another part of the country to have an assisted death in accordance with the laws there, that would not be a crime. To answer the point by the noble Baroness, Lady Finlay, I have been in discussion with the BMA as to how one might introduce an amendment to that effect. We need to discuss that, and these cross-border issues definitely need to be discussed. I would very much welcome such a discussion taking place with interested parties.

[Lord Beith (LD)]

What I am talking about is a group of people who live in England, are ordinarily resident in England, but who happen to be registered with a general practice in Scotland. That has no impact on what the Scottish situation would be in other respects—that is a matter for the Scottish Parliament—but it does affect the scope of the Bill.

[Lord Falconer of Thoroton (Lab)]

I was addressing the wider issue, the one that the noble Baroness, Lady Finlay, was talking about. But it goes to those ordinarily resident in Scotland, who come to England for their medical advice—and if the medical advice says, “Go back to Scotland if you want an assisted death”, would that be a crime? But I also wish to deal with the GP point. If you live in England but have a GP in Scotland, does it debar you from getting it here? I am more than happy to include that in the discussion.

Terminally Ill Adults (End of Life) Bill

Lord Beith Excerpts

Committee stage
Friday 23rd January 2026 Lords Chamber

[The Deputy Chairman of Committees (Lord Beith) (LD)]

My Lords, the noble Lord, Lord Shinkwin, and the noble Baroness, Lady Campbell of Surbiton, will be taking part remotely. I remind the Committee that unless they are leading a group, remote speakers speak first after the mover of the lead amendment in a group and may therefore speak to other amendments in the group ahead of Members who tabled them.

Clause 1: Assisted dying

Amendment 35

Moved by

Terminally Ill Adults (End of Life) Bill

Lord Beith Excerpts

Committee stage
Friday 27th February 2026 Lords Chamber

[Baroness Cass (CB)]

My Lords, I will be brief, because I believe that my Amendment 122 and the consequential amendments that follow it address a very straightforward and practical issue—saying that could be the kiss of death, but never mind. It is absolutely self-evident that, if this Bill passes into law, the monitoring of its implementation will be absolutely crucial.

There are several aspects of implementation that we will need to follow closely. The first is any evidence of the concerns that have been widely expressed in this House of coercion, particularly to take account of differentials in the socioeconomic circumstances of those seeking assisted deaths. Secondly, we need to be aware of postcode lotteries in implementation and particular challenges in staffing and delivery in certain localities. Thirdly, we need to be aware of creep, as has occurred in other jurisdictions.

In a later amendment, I have proposed that voluntary assisted dying services should be commissioned by the specialised commissioning team currently located in NHS England. This team commissions highly specialist small volume services, and the assisted dying services would fall within this definition. The advantage of this approach is that there would be a national service spec, nationally defined workforce requirements and quality standards, and monitoring of the contract by the national team.

In late January, the noble and learned Lord, Lord Falconer, notified us of his planned amendments to ensure that the service will be regulated by NHSE or the CQC, or both. However, it is not yet clear how that might work in practice. This leaves us with the currently proposed arrangements in Clause 4, in which the voluntary assisted dying commissioner has a dual role. He or she is required to take on much of the operational delivery of the process and, at the same time, monitor the operation of the Act and report on it to national authorities. I submit that it is not appropriate for the commissioner to be both poacher and gamekeeper and to mark their own homework, because they will be mixing their roles as shamelessly as I have just mixed my metaphors.

My amendments therefore seek to separate the role of the commissioner, to make it much more like that of the Children’s Commissioner, who is fully independent from the agencies she has oversight of, with a director to undertake the delivery aspects of the work. These may or may not be the finally agreed terms or mechanisms, but I think the intent is clear, and I leave it open to both the noble and learned Lord the sponsor and other noble Lords to discuss other ways in which this separation of roles might be achieved.

My only other point is to draw attention to my Amendment 131, which makes it clear that, although the commissioner is supposed to be an individual who has held high judicial office, neither the commissioner nor the director is discharging a judicial function in undertaking their responsibilities under this Act. On this point, I am just a warm-up for the noble Lord, Lord Weir of Ballyholme, who will doubtless speak further to his Amendment 129 on this aspect. I beg to move.

[Lord Beith (LD)]

I will speak briefly to my amendment in this group because it is my duty shortly to chair the Committee. To broaden the debate that the noble Baroness, Lady Cass, introduced, I simply say that there is clearly a need to establish that this post can have confidence and a degree of consensus around it. I am not sure that that has been achieved by what has been proposed so far.

My amendment simply brings in the procedure used in the Commons for most regulatory posts: they are the subject of some sort of hearing process by the relevant Select Committee. That system was developed in the years when I was in the Commons, and as chair of the Justice Committee I operated it several times. It works reasonably well. In rare cases, the Treasury Committee, for example, has a veto on the appointment, as this amendment suggests, but it is a means of trying to ensure that the right questions are asked at the right time when appointments are made. Surely, after recent weeks, we have learned the lesson that, if you do not have proper scrutiny of appointments and a system in which the right questions are asked, things can go very badly wrong. We certainly do not want them to go badly wrong in this area. That is sufficient to explain what my amendment is about.

[Lord Garnier (Con)]

My Lords, I am grateful that the noble Lord was able to introduce his remarks before he has to go and perform his functions as chairman of the Committee. I have only a few things to say, and my amendment is discrete, in the sense that it does not really affect much of the rest of the Bill. It can be taken quite briefly, and I hope that the noble and learned Lord, Lord Falconer, will be able to agree to it, not least because it bolsters the job that he once held.

With respect, I disagree with only one point that the noble Baroness, Lady Cass, made. The function of the commissioner is not simply administrative; there is a judicial element to their work, which is found in Clause 4(4)(d). One of the principal functions of the commissioner is

“determining applications for reconsideration of panel decisions under section 18”.

That said, I fully accept that it is a mixed-function job: it is partly administrative and partly judicial—but then so are quite a lot of senior judicial jobs. The Lord Chief Justice and the Master of the Rolls all have heavy administrative burdens as well as having to perform a judicial function, and no one would suggest, I venture to say, that those people should be appointed directly by the Prime Minister.

It is more constitutionally appropriate for the voluntary assisted dying commissioner to be appointed, as so many other judicial and quasi-judicial posts are, by the sovereign on the recommendation of the Lord Chancellor. I appreciate that the office of the Lord Chancellor has changed a lot since the 2005 Act—more’s the pity, in my view, but there we are. That was a long time ago. When I become Prime Minister, of course, I shall have it changed.

There is a nice distinction to be drawn with the appointments made in the way that I suggest. If my amendment is accepted by the Committee or by the House as a whole, it will obviously have a knock-on effect on the appointment of the deputy commissioner under paragraph 3(1) of Schedule 1—but let us not delay ourselves with that. All I am saying is that it is more appropriate for this particular function to be appointed by the sovereign on the advice of the Lord Chancellor, as so many similar posts are.

A Minister responding for the Government in the other place said that the investigatory powers commissioner is appointed by the Prime Minister, and he, like the assisted dying commissioner, has to be a sitting or retired member of the senior judiciary. But that is a false point. The distinction between this job and the investigatory powers commissioner is that the investigatory powers commissioner deals with matters of national security—which are essentially a matter for the Prime Minister—whereas this assisted dying commissioner will deal not with matters of national security, foreign policy or anything of that nature but simply with the workings of this Bill, or this Act as it may yet become.

This a very short and simple point that I am sure the noble and learned Lord can easily agree with, because it does not damage the Bill. It is simply a technical adjustment of the route to appointment, and I urge the Committee to support it.