Terminally Ill Adults (End of Life) Bill

Debate between Lord Falconer of Thoroton and Lord Lansley

Friday 27th March 2026 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

Yes, there can be no duty to raise a question of assisted dying if an Act of Parliament says that there is no duty to raise it. That case, the Montgomery case and the normal negligence cases do not in any way lurk in the background waiting to, as it were, stop this. It is absolutely plain that the effect of this provision and the provision in Clause 31 is that if you did not raise it, there can be no legal kickback of any sort. That is why it was phrased like that, and that is why putting in the words “it is not a treatment” would not be sufficient.

[Lord Lansley (Con)]

I entirely agree with what the noble Lord, Lord Stevens of Birmingham, just said. We just heard from the Minister that one of the possible implications of the Bill is that, because of Clause 41(4), the NHS Act 2006 would need to be amended in order to bring this service into the scope of what the NHS Act says is the role of the National Health Service.

Potentially, if I understood the Minister’s wording correctly, bringing assisted dying within the context of treatment under the NHS Act 2006, rather than amending the NHS Act to say that the NHS is going to provide this service, is entirely the wrong thing to do, but it does not form any part of the comprehensive service that the NHS provides for promoting the improvement of people’s physical and mental well-being.

How this Bill would be interpreted in the context of the responsibilities of the NHS, as the noble Lord, Lord Stevens, told us on a previous day, is a very important question to which the sponsor of the Bill is not giving us an answer.

[Lord Falconer of Thoroton (Lab)]

We have discussed this before and the noble Lord, Lord Stevens, is right. He is referring to the 2006 Act—not the noble Lord’s Act but the one before it—which says that the obligation of the National Health Service is to provide treatment and care. There is then a question of whether that includes assisted dying, which is unresolved. If it is to be provided by the NHS then there must be some amendment to that Act, as it refers to the basic constitutional point.

That is of little assistance to a doctor who needs to know whether he could be in breach of any legal duty by not providing assisted dying. That is the key question that is raised—and it is unequivocally answered by Clauses 5 and 31.

--- Later in debate ---

[Lord Lansley (Con)]

In Amendment 189, the lead amendment in this group, my noble friend is looking for who one goes to in order to provide the necessary assistance to a person if the original conversation is not something the doctor wants to pursue. All doctors are supposed to have training, and they opt in to the training, but how do we know who they are if we do not have a register?

[Lord Falconer of Thoroton (Lab)]

The precise knowledge of who does it, where the list is kept, who registers with whom—for example, whether they register with the commissioner—is about detailed implementation, and I am strongly of the view that we should not try to get into the nitty-gritty in relation to that in the Bill. I recognise why the noble Baroness, Lady Fraser, proposes putting this into the Bill, but I hope she will understand why, first, in relation to opt-in, I am not sure it quite gets there, and, secondly, in relation to a register, I am not in favour of it at the moment.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Falconer of Thoroton and Lord Lansley

Committee stage
Friday 5th December 2025 Lords Chamber

[Lord Lansley (Con)]

My Lords—

[Lord Falconer of Thoroton (Lab)]

Can I just finish this sentence?

On the tourism point, it invites the possibility that you can come and genuinely live here until you die in order to get an assisted death, and we do not want that.

[Lord Lansley (Con)]

I think the noble and learned Lord knows that the definition of “ordinarily resident” that is used in the National Health Service is defined in common law. It is about living here as part of your normal pattern of life for a settled and continuing purpose. It is not “at a moment in time”. That is why the 12 months is particularly inappropriate, because it is a matter of judgment at the point at which a test of ordinary residence happens, and one has to demonstrate that one is here for a settled purpose.

[Lord Falconer of Thoroton (Lab)]

I accept that completely. The reason the 12 months is here is to give some degree of assurance that the reason you are living here is not because of an assisted death but because it is your genuine home.

I come to the proposal from the noble Lord, Lord Frost. The way it is drafted, although I cannot believe he meant this in the way that he put it, you have to be ordinarily resident in England or Wales, you have to be a British citizen and you need indefinite leave to remain. I was surprised he was saying it would be an easier test to apply. It would not be an easier test to apply, because you would have to apply both ordinary residence and whether you are a citizen or have indefinite leave to remain. Even assuming the proposal is the more limited one, namely, that you only have to be a British citizen or have indefinite leave to remain and you do not have to be ordinarily resident here, that would not be appropriate, for two reasons.

First, the policy choice that the sponsors of the Bill, myself and Kim Leadbeater, have made is that, if you live here—if you are ordinarily resident here—whatever your citizenship or status, you should be entitled to it. Secondly, and separately, I do not think it is appropriate to make it available for people who, for example, have not lived in this country for 50 or 60 years and have no intention of returning. That would invite death tourism, to use the phrase.

The noble Lord, Lord Harper, said that doctors should not be required to make the assessment. If the position is that there has to be some residence requirement, it is perfectly okay for the two doctors who are concerned with this to make inquiries about where someone lives and how long they have lived here. That is not difficult, and in 99.99% of cases it will not give rise to any problems. Let us assume that most people are honest, and say to the doctor, “I actually live in France but I’m coming here because I want this”. The doctor will say that it is not available. I hear what the noble Lord says, but I do not think it gives rise to particular problems. If there are particular problematic cases, these can ultimately be resolved by the panel.