Terminally Ill Adults (End of Life) Bill

Lord Blencathra Excerpts

2nd reading
Friday 12th September 2025 Lords Chamber

[Lord Blencathra (Con)]

My Lords, I am not opposed to assisted dying in principle but I am opposed to this appallingly drafted Bill, which is a travesty of a Private Member’s Bill. It is a massive 51 pages, with 59 clauses and three schedules, and is one of the largest so-called Private Members’ Bills ever introduced in Parliament. It is larger and more controversial than many government Bills, and should have proper scrutiny. Since we need proper government Bills to make laws on prison sentences, penalties for killing with knives or dangerous driving, serious drugs et cetera, it is wrong to pass a law on how people should die through the Private Member’s Bill procedure.

The Delegated Powers Committee has issued a scathing report on the excessive 38 delegated powers, including all the Henry VIII powers, and that report alone should be enough to condemn this Bill to the scrap heap. Then yesterday, the Constitution Committee criticised it. If this Bill passes, it will not be MPs and we Peers writing the law on how we die but civil servants in the Department of Health writing up all those 38 delegated powers. Quite simply, I do not trust the Department of Health to write one word on the implementation details. The department has so far failed to implement single-sex wards for women and it failed for many years to take action on the discredited Liverpool care pathway, where 3% of patients being expedited to death actually recovered. A department that apparently cannot tell the difference between men and women is not fit to write guidance on legislation on when people should die and the drugs used to kill them.

Every year, 550,000 people die of terminal illness in the UK. From my 42 years in Parliament, I am convinced that it is impossible for Parliament to draft a general law—even with thousands of pages of regulations—which can cover every possible individual circumstance relating to those 550,000 people. We as parliamentarians have to realise and accept our limitations. I can draft a foolproof law for myself but not for any of your Lordships’ situations, nor for half a million others. The variables are simply too great. There are numerous cases of people diagnosed with terminal cancer making a full recovery and living five to 20 years longer than expected, proving correct the famous Sir William Osler, the father of modern medicine, who said:

“Medicine is a science of uncertainty and an art of probability”.


Prognostic uncertainty is one reason why the Royal College of Physicians does not support the Bill.

This Bill will give lawyers the ultimate power to make the final decisions, not the doctors. We have all seen firms of lawyers pursuing fraudulent medical negligence cases in respect of our soldiers who fought bravely in Afghanistan and Northern Ireland, and corrupt immigration lawyers running fake cases. Almost every clause in this Bill can be used by lawyers on all sides of an assisted dying application to take the case to court, and all those regulations will be a judicial review paradise for lawyers. I will trust my doctor to do what is in my best interest on my deathbed on the basis of the medical mantra, “First, do no harm”. I will be damned if I let any lawyers decide how I die.

In 2016, I tried to help pass the Medical Innovation Act, also known as the Lord Saatchi Act, which aimed to promote innovation in medical treatments in England for terminally ill patients. I recall at the time that most doctors were in favour of it, but the lawyers were opposed since it would remove their ability to sue if the treatments did not work. My perception is that most doctors have serious concerns about this Bill, but most lawyers are in favour. I do not want lawyers to come within a million miles of decisions about how people should die.

We need to start again, possibly with a royal commission led by doctors who will set out the principles and all the safeguards required. Then, there needs to be proper public scrutiny on a draft Bill that a joint parliamentary committee can consider. Finally, we need a proper government Bill and to see drafts of all the regulations that will be made. We cannot buy a “pig in a poke”, which this Bill is, and hope that the regulations will be just all right on the night.

Terminally Ill Adults (End of Life) Bill

Lord Blencathra Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Lord Weir of Ballyholme (DUP)]

My Lords, I rise to support the amendment standing in the name of the noble Baroness, Lady Coffey. Some people may detect from my accent that, although I hail from the great city of Bangor, it is not the great city of Bangor in north Wales but the great city of Bangor in Northern Ireland. I have particular empathy with the amendments that have been put forward by the noble Baroness due to my experience as a Minister in a devolved Administration. The clarity the noble Baroness seeks goes to the heart of the relationship between the devolved Administrations and Westminster, and it is of particular relevance to this Bill.

Generally speaking, a Minister in a devolved institution will face three categories of legislation. First, there will be reserved matters, which are entirely within the purview of Westminster—national issues, which I think everyone would accept. Secondly, there will be a range of issues which, although not strictly reserved, are of such obvious applicability across the United Kingdom that a legislative consent Motion should be applied. I do not see the noble Lord, Lord Foulkes, in his place, but on occasions even the SNP Government in Scotland have been prepared to sign up to legislative consent Motions. The third category—the bulk of legislation—is situations that should be decided locally, where a devolved Government and a devolved Parliament can choose whether to follow what is happening at Westminster and in England, to take a different path in seeking either to virtually replicate or to amend, or to go in a tangentially very different direction. That is at the heart of democratic accountability in devolution.

I believe that this is an issue that should be decided in Wales. It is an issue that should clearly fall into category three. We all know that we have a very unusual constitutional set-up in the United Kingdom, where devolution to Wales, Scotland and Northern Ireland is on a slightly different basis in each case. That can produce some unusual aspects. What we have today is a certain level of anomaly, because this legislation falls into what may be described as a fourth, hybrid category. As the noble Baroness, Lady Coffey, highlighted, the distinction is between the aspects that deal with criminal justice and criminal responsibility, and those that deal with health and social policy, with the former being reserved and the latter being devolved.

It is very clear that the heart of the Bill makes major decisions that impact on health and social policy. However, we are left with a situation for Wales that means, if this goes through unaltered, that the criminal responsibility will be lifted but there will be no regulations coming from this House as to how that will actually be brought about. It is the equivalent of this House saying that we are going to bring in new road safety measures, which will not apply to Wales, but if you are caught speeding on the motorway there could be no criminal sanction against you. What we have potentially arrived at for Wales is the worst of all worlds.

We need to take a step back. We need to ensure that the wishes of the Welsh people, as exercised by the Senedd—they may change over time—are respected. Rather than, in effect, imposing something that then has to be more or less corrected in Wales by way of changes to their health and social policy, we should be allowing the issue of assisted dying to be decided by the Welsh Senedd. If they decide to make those changes, this Parliament should then reflect them by way of changes to the criminal justice system, which I think would be relatively easy to do.

In the absence of that, the importance of these amendments, as outlined by the noble Baroness, Lady Coffey, is that if we cannot get things definitively the right way round, we can at least get a level of clarity over what aspects apply to Wales, rather than a potential wall of obfuscation. This is an ideal opportunity for the Government and the sponsors to highlight where exactly the demarcation is, which will be very helpful as we move through the rest of this Bill.

[Lord Blencathra (Con)]

My Lords, I support my noble friend Lady Coffey’s amendments in this group. As I looked at the title of the Bill, “terminally ill”, and then saw clause after clause talking about the patient and the doctor’s involvement, I was clear that this was a medical Bill. We had the Secretary of State for Health saying that he was in charge of it, and the Department of Health and Social Care, which seconded about 30 officials to help rewrite it, in a way taking ownership of it. Then I asked myself: why on earth are we legislating for Wales when health is a devolved matter in Wales and the Senedd is in charge of health matters? This is where it is really Pythonesque, because although this is a medical Bill in England, it is a criminal Bill in Wales, and criminal matters are not devolved to Wales. How on earth can the same Bill be a health Bill in one country of the union and a criminal Bill in another?

On 23 October last year, Senedd Members, including the First Minister, Eluned Morgan—the noble Baroness, Lady Morgan—and the Health Minister, Jeremy Miles, voted against a Motion calling for a new law to allow assisted dying in Wales and England. Miles had earlier warned of “huge ramifications” for Wales if the law changed. In total, 19 Senedd Members voted in favour of the Motion, with 26 against and nine abstentions. However, the Senedd does not have the power to change the law on assisted dying in Wales, so the vote was symbolic. The Senedd does not have the power to legalise assisted dying, but the Health Minister indicated that it is likely that future legislation will require another vote to give Parliament consent.

The Welsh NHS, which is almost totally devolved and overseen by Cardiff politicians, would be responsible for implementing the law. However, I understand that the Senedd can still vote on whether to implement the legislation, as parts of the Bill touch on devolved areas, so the Welsh Government would need to pass specific regulations and gain an affirmative vote from the Senedd before the Welsh NHS could provide the service. I am not a great fan of the devolved Administrations, but they exist and they have a genuine job to do. In Wales, this would mean that their NHS and its doctors would have implemented all the provisions of an English law, which they had no power to change. That does not seem right. If the Senedd in Wales can be trusted to run the NHS in all medical facilities in Wales, it should be trusted to make its own terminally ill end-of-life Bill.

Next year there will be Senedd elections, and on current polling there may be a large majority of Plaid Cymru and Reform Members elected. It cannot be right that they inherit a Bill relating to the deaths of about 35,000 people in Wales each year and that they have no say over how their constituents die.

Of course, the Senedd could refuse to give consent to the legislation, but I suspect it will be threatened and blackmailed into doing so. It will be told that it is the English Bill or nothing and that Wales has no power to do its own law, so the Senedd had better approve it or else. But the Senedd could do its own law; all we have to do is grant it the constitutional power to do so.

--- Later in debate ---

[Baroness Berridge (Con)]

As people around me are saying, I do not think I said that. They are neutral. The royal colleges have said that they have problems with the Bill, but they have been neutral on the principle, save for the Royal College of General Practitioners. I am sorry; I stand corrected on that. They are neutral, as is the Association for Palliative Medicine, which is not a royal college.

When one looks at the evidence that we took, of course individuals from within that group would come along whom we had to call. It was right that we did that, but one looks at a corporate view. I enormously respect Professor Sir Chris Whitty, but I heard his evidence on this and he was not the highest expert in the land. He was humble enough to write to correct himself, as he had misunderstood the Mental Capacity Act when he gave evidence in the Commons.

[Lord Blencathra (Con)]

My Lords, we should all be grateful to the noble Baroness, Lady Finlay of Llandaff, for bringing this matter before the Committee, but also to my noble friend Lord Harper, who has highlighted some of the deficiencies in in the Mental Capacity Act. Yes, it may be tried and tested in its current usage but, as we heard from many sides of the Committee, it may be inadequate for dealing with death issues.

I was going to speak in support of Amendment 2, but I might also be willing to support the potential oral amendment from my noble friend Lord Deben. When considering important decisions, particularly in the context of healthcare, it is crucial to understand the distinction between capacity and ability. This is especially relevant for terminally ill patients, as questions about decision-making may arise on treatment options, advance directives and legal matters.

I believe that we should change references from “capacity” to “ability” when discussing decision-making for terminally ill patients. The reason for this change is to ensure clarity and accuracy in describing a person’s actual situation. We should not be afraid to bring in a new word if it is more relevant than “capacity”. Although “capacity” is a legal and clinical term for specific criteria, “ability” is a broader term that may better reflect the practical realities and nuances of an individual’s situation. Using “ability” can help to avoid misunderstandings and ensure that patients are supported in ways that are appropriate to their unique circumstances.

Terminally Ill Adults (End of Life) Bill

Lord Blencathra Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Lord McCrea of Magherafelt and Cookstown (DUP)]

I do not believe that people are tabling amendments simply to wreck the Bill. That may be the noble Lord’s opinion, but he should remember that other people have different opinions. I respect the noble Lord’s opinion, but I hope that he will in turn respect my right to have an opinion. I believe that we must scrutinise this well. I noticed that the noble Baroness, Lady Hayter, objected to the fact that practically no one who supports the Bill has spoken. I know of no one supporting the Bill who has been stopped from speaking. They did not get up to speak, and therefore they were not stopped. If there are those who want to support this Bill and to get up to speak, they are free to do so. I certainly would like to hear their opinions just as well. I believe that I have an opinion that ought to be heard equally, as they have.

I come from a family that knows what the reality of suicide means and the heartbreak of suicide, where we examine and wonder whether something more could have been done before that person ended their own life in suicide. I know the pain of that and the loneliness that they went through. Therefore, I believe we must get this right.

In the domestic abuse and coercive and controlling behaviour context, a victim may, due to intimidation or trauma, deny that their actions are caused by wrongful coercion. Is the doctor supposed to be weighing the patient’s words against the very limited evidence that they can see in an examination room? Professor Jane Monckton-Smith OBE, professor of public protection at the University of Gloucestershire, emphasised in her testimony to the Select Committee the significant difficulties in relying solely on a person’s verbal denial of abuse when assessing coercion:

“I have worked in this area for a very long time. I have seen victims refuse medical help when they have been hit in the head with a hammer through fear. That is not an isolated example. If you speak to the other people here, I think they will probably agree with me. What I am saying is that coercive control is a serious social problem. It will impact on the people who are going to look to this Bill”.


Also in the Lords Select Committee evidence, Cherryl Henry-Leach of Standing Together Against Domestic Abuse warned

“the difficulty is the lack of insight into the impact of coercive control on somebody’s ability to make decisions, even though that has been enshrined in case law”.

I do not want to detain the Committee, but in over 50 years as a minister I have experienced people coming to the end of their life. I have been with them in their moments of their deepest pain, and, as a noble Lord said, was there with the families after the occasion, trying to minister to them. I also know what it is from my 25 years as a constituency Member of Parliament in the other House, and we should not close our minds to the fact that people can be coerced. Sometimes it is done very subtly and gently within family dynamics, and that is difficult for assessing doctors to detect in limited formal settings.

Therefore, I believe it is vital that the words put into this legislation, if it is passed, are the correct ones that cover all these possibilities. Remember, when the person takes that lethal injection or whatever potion they take, there is no return as far as this life is concerned, but they go to another.

[Lord Blencathra (Con)]

My Lords, I had intended to give my strong support to Amendments 3, 45 to 49, 52 and 58—a mere eight amendments out of the 21 in this massive group—but in the interests of time I will dump my notes on all those and speak merely to Amendment 58 in the name of my friend, the noble Baroness, Lady Grey-Thompson, who has made a crucial point with regard to that amendment.

Coercion and pressure do not always manifest themselves as direct, intentional acts by individuals. Instead, they can arise from broader and societal structures and conditions that constrain genuine choice. When a person facing terminal illness is subject to circumstances such as chronic poverty, social isolation or a systemic lack of quality healthcare, their options are severely limited. In such scenarios, the choice to pursue end-of-life options may not be a true expression of free will but rather the result of enduring disadvantage and unmet needs.

At Second Reading, my noble friend Lord Moylan made the telling point that many people contemplating suicide do not want to die; they just want their life circumstances to change for the better. Therefore, “structural disadvantage” refers to the social, economic and institutional barriers that systematically disadvantage certain groups. When terminally ill individuals lack access to palliative care, social support or financial resources, they may feel compelled to consider end-of-life options not out of genuine preference but because their suffering is exacerbated by these systemic failures.

Poverty is a profound social vulnerability. A terminally ill person living in poverty may fear becoming a burden to family or may lack the means to access pain relief, counselling or hospice care. The psychological and practical impact of poverty can create a sense of hopelessness, making the option of hastening death appear more acceptable or even inevitable. When systems persistently fail to address the needs of the most vulnerable, this neglect can be seen as a form of institutional or collective intent. Thus, the responsibility for coercion or pressure extends beyond individual actors to the structures that shape people’s lives and choices.

Many years ago, my illustrious predecessor in my constituency, the great Willie Whitelaw, said to me, “David, I was never interested in pensions until I turned 65”. The wonderful thing about this House of ours is that the average age in here is 71, I understand, and our average death age is 81. That, as we have heard from many noble Peers, gives us a unique insight into the sorts of infirmities that we and our close relatives suffer and the close experience of those near to us who have died from them.

We have heard from many noble Lords, including my noble friend Lord Polak and the noble Lord, Lord Griffiths, their experience of beating the odds because the prognosis was not right. I quoted in my Second Reading speech that Sir William Osler, the father of modern medicine, said, in about the 1890s:

“Medicine is a science of uncertainty and an art of probability”.


Because my noble friend Lady Berridge mentioned NICE, I am tempted to cite an example. I have experience of NICE. I am grateful to it in some ways and hate it in others. One of the side-effects of MS is that one’s feet feel nailed to the ground: they are as heavy as lead and do not move. Fifteen years ago, NICE approved an experimental drug call Fampridine. I was one of about 500 patients put on it at the National Hospital.

Fampridine is an absolutely miraculous drug. What does it do? You saw it in effect this morning. It helped me stagger from my chair to here. With assistance from my noble friends, I can manage to walk—not very fast—to the Dispatch Box. Every six months, I have to do a walking test. If my walking is not fast enough with the drug, they cut it off and I do not get it any more.