Terminally Ill Adults (End of Life) Bill

Lord Kamall Excerpts

2nd reading
Friday 12th September 2025 Lords Chamber

[Lord Kamall (Con)]

My Lords, I thank the noble and learned Lord, Lord Falconer of Thoroton, for the comprehensive way in which he presented this Bill. In opening the debate for the Official Opposition, let me be clear that, as a Front Bench, we have no collective view on either the principle of terminally ill people receiving interventions to end their lives early or on the drafting of the Bill. Noble Lords on this side of the House will have a free vote both on the Bill and on the Motions we are debating. The Official Opposition do not have a collective position on those Motions.

Given this fact, I will speak neither in favour of nor against the Bill. But, as the noble and learned Lord said, this is a historic occasion. It is not hyperbole to say that this Bill may be one of the most significant pieces of legislation ever to be considered by this Parliament, with far-reaching implications for our society and the sort of society that we want to live in. Noble Lords will appreciate this significance simply from the sheer volume of correspondence received. Those speaking on both sides of the debate will be informed by their own experiences, whether that be professional or personal experience. We will hear many moving stories in these debates, and perhaps even shed a few tears. But, as a revising Chamber, I know that noble Lords will respect those experiences and reflect on them in good faith as we work to properly scrutinise and improve the Bill where necessary.

As the noble and learned Lord, Lord Falconer, said, we have received a clear signal from the elected House on the principle of the Bill. While that does not prevent noble Lords opposing the Bill per se, it is the duty of your Lordships’ House to do its work as a revising Chamber diligently. This Bill has received much scrutiny in the other place: over 100 hours across all stages, more than other Private Members’ Bills. But we should also not forget that 174 amendments were made to the Bill in Committee, and further amendments were made at Third Reading, not all of which have been properly scrutinised. So the Bill your Lordships received in this House is much changed since its introduction and is in need of thorough scrutiny.

The arguments around this Bill are finely balanced. A noble friend of mine who, let us put it this way, is not exactly known for sitting on the fence, said to me that he attended the last time we debated this and that, after almost every speech, he found himself agreeing with the speaker. To this day, he remains torn. It just shows how finely balanced these arguments are.

Let me attempt to frame the debate and touch on some areas that noble Lords may wish to probe in Committee. In debating this Bill, we must have in mind the well-being and dignity of those for whom it was originally proposed: the terminally ill who want to end their lives early. We will hear powerful arguments based on compassion and bodily autonomy from the Bill’s supporters.

The noble and learned Lord, Lord Falconer of Thoroton, has indicated his openness to amendments to the Bill. We on these Benches welcome that openness. I expect amendments to come from supporters of this legislation who want to make it the best Bill possible. We have seen that in some of the emails noble Lords have shared with each other; we also saw it in Committee in the other place, where the Bill’s sponsor, Kim Leadbeater, tabled 142 such amendments.

On the other side of the debate, there will be noble Lords who oppose the Bill on principled grounds. For some, it will be based on their faith. Others may support the principle behind the Bill but not the current drafting, either because of insufficient safeguards or because of limited access to palliative care, which denies patients a meaningful choice. They too approach this Bill with compassion. This is a matter of conscience, and as the Government Chief Whip said, we should respect the views of noble Lords who disagree profoundly with this Bill just as much as we respect the views of those in favour of it. Those who oppose the Bill will also choose to bring amendments to improve it, despite their overall view. So, whether an amendment is tabled by a supporter of the Bill, an opponent of the Bill or someone who has yet to make up their mind, those watching the debate from outside your Lordships’ House should not mistake amendments to this Bill for outright opposition.

A number of organisations, including the Law Society, the Complex Life and Death Decisions group at King’s College London, the Royal College of Pathologists and the Royal College of Psychiatrists, have proposed amendments to address some serious concerns over the drafting of the Bill as it stands. As the noble and learned Lord, Lord Falconer of Thoroton, has himself acknowledged, both the Delegated Powers and Regulatory Reform Committee and the Constitution Committee have recommended amendments to the Bill, highlighting that there are now 42 regulation-making powers in this version of it—the version that came to this House. Both the Hansard Society and the Constitution Committee have pointed out that, as it is a Private Member’s Bill and the Government remain neutral as to its purpose, it is unclear how these powers will be used. These are all important challenges that we must take the time to consider carefully.

There are noble Lords with strong views on both sides of this debate, but all approach it in good faith. My opening comments are not meant to persuade your Lordships to vote one way or the other or to support certain amendments over others; they are an attempt to frame the overall debate and to touch on some of the issues that may need to be probed in Committee. The decisions we take are not easy and the consequences are not always clear, but I have no doubt that the Bill will receive the scrutiny needed in this House—whether we are in favour or against—with all the emotions and concerns that will be expressed. No matter how challenging that may be, let us work together to examine the Bill in detail and do our work diligently.

Terminally Ill Adults (End of Life) Bill

Lord Kamall Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Baroness Berger (Lab)]

My Lords, I have spoken already about how my experience as a Member in the other place has made me very concerned about this Bill, and more determined that it must not be a cause of further harm to vulnerable people. Many unanswered questions about the Bill before us have been raised during the course of this important debate. This is why I have tabled the amendment and the following Motion to hold a Select Committee before Committee of the whole House begins.

This is a significant and complex piece of legislation by any definition. It demands a process that can withstand the weight, but it is clear that there are serious shortcomings, as both the Constitution Committee and the Delegated Powers and Regulatory Reform Committee noted in their reports last week. Indeed, I am concerned that the legislative process is being asked to compensate for the absence of robust policy-making before the Bill was published: no comprehensive review; no public consultation or prior engagement with professionals and other stakeholders; no Green Paper or White Paper, which we would have seen had it been a government Bill—I understand the case made for why it is not a government Bill, but that has diminished what is before us today; and no published analysis of international experiences. Instead, Parliament has been asked to grapple with questions about implementation, safeguards and NHS implications without this groundwork, which we would usually turn to for a law change of this magnitude.

Back in March, Jill Rutter of the Institute for Government—which is neutral on the principle of assisted dying—said:

“We’re expecting Commons scrutiny to do far too much—things it simply can’t do … Commons scrutiny is being left to solve a whole range of problems it isn’t equipped to deal with”.


We have seen the dropping of key but expensive safeguards, such as the review by a High Court judge, and whole new clauses and schedules introduced to replace them with very little opportunity for thorough scrutiny.

It was a clear pattern in the other place that when significant concerns were raised that had not been anticipated, the response was often to add another delegated power. There are now, as we know, 42 delegated powers contained within the Bill: 42 areas where government will work out the detail later, with Parliament largely excluded from the conversation. The result is a Bill that is today substantially different from when the Bill Committee in the other place took evidence in January this year, but now with less clarity.

I do not wish to detain the House any longer than is necessary, but I have been asked many questions on the process about what is before us, which I will seek to address. My amendment ensures that we can have some evidence, expertise and insight on the Bill before us today. We need this information before we commence line-by-line scrutiny.

Noble Lords will have received a letter setting out a condensed list of witnesses that I and other supporters believe this House must hear from, including my noble and learned friend Lord Falconer of Thoroton and those who will bear the responsibility for delivering the Bill, should it pass, and setting out how they would use their delegated powers. These witnesses are to include the Secretary of State for Health and Social Care, the chief executive of NHS England, the Secretary of State for Justice and the Chief Secretary to the Treasury.

We must also take evidence from the professional bodies whose members will be asked to carry out the functions that the Bill sets out: the Royal College of Psychiatrists, the Royal College of Physicians, the Royal College of General Practitioners, the British Association of Social Workers and the Law Society.

We are, of course, not able to hear from serving members of the judiciary, but may hear from the former Chief Coroner of England, Thomas Teague KC, and Sir James Munby, President of the Family Division of the High Court. We must also ensure that we understand the impact of the Bill on our hospices and care homes, through Hospice UK, the Association for Palliative Medicine and Care England.

A previous suggestion of a Select Committee in parallel, alongside a Committee of the whole House, would not achieve—

[Lord Kamall (Con)]

I apologise, I do not want to detain the House any longer than is necessary. Just to clarify, will all the evidence before the Select Committee be published?

[Baroness Berger (Lab)]

I am very grateful for the intervention, and I was just about to come on to that, but I will answer that now. The answer is yes, absolutely. The intention is that all the evidence accumulated and amassed during that time will be published for everyone in the House to interrogate and consider in advance of us going into Committee of the whole House. To confirm, this Select Committee cannot take place in parallel in order that we can receive evidence on vital parts of the Bill before we go into debate, so that we are not in the unenviable position of knowing what is wrong with the Bill but being unable to amend it.

My Motion provides that a Select Committee would be intended as a focused piece of work, hearing vital expert oral evidence, as I have just set out, rather than it being a more time-intensive open exercise. It may report by simply publishing that evidence before we go into Committee of the whole House, in order to inform our detailed consideration of the Bill. As I understand it from the clerks, the revised timetable allows the committee to hold six meetings over three weeks, with two panels of witnesses on each of the days, to begin the week commencing 20 October and allowing it to conclude by 7 November. The revised timetable ensures that the Bill can progress to its next stage and maintain the opportunity for four sitting Fridays before Christmas.

We have, over the past two Fridays, shown the determination of your Lordships’ House to discuss the Bill in a considered and constructive way, and it is my strongest hope that we can continue to do that. If my amendment is accepted, I do not intend to speak on the Motion that will follow, which contains the detail that I have just set out. I am grateful to my noble and learned friend Lord Falconer of Thoroton—

Terminally Ill Adults (End of Life) Bill

Lord Kamall Excerpts

Committee stage
Friday 5th December 2025 Lords Chamber

[Noble Lords]

Front Bench!

[Lord Kamall (Con)]

My Lords, I hesitate to rise as I want to ensure that everyone feels that their voice has been heard in this debate. We do not want to make law on a basis on which people look back and say that we did not properly debate a particular issue. If all noble Lords who wish to speak in this debate have spoken, I am very happy to make my contribution, but if there are any other noble Lords who wish to make their point, I should give way.

Well, that answers that question; I tried my best. I want to make that point clear. It is really important that everyone who feels they want to speak can do so, but I also say to noble Lords, including my noble friends, that it is also important to respect the rules and conventions, to speak to the amendments and not to repeat Second Reading speeches or make wider debates. I hope we can get that appropriate balance. I have taken time making those points, so I will try to be brief.

I pay tribute to the noble Baroness, Lady Berger, especially for the way in which she delivered the Select Committee process that preceded our deliberations in Committee. The evidence submitted to that committee will be invaluable to noble Lords as we continue our work to scrutinise the Bill.

Without making a long speech, I will reflect on the specific amendments on changing the minimum age. I was talking to a noble and learned friend about this, and he said that, frankly, the law around age is a mess—and that has come out in some discussions. Sometimes we are speaking from our own experience. My two children are in their 20s, and I wonder whether they would really have the capacity to make this decision. But at other times, I sit in awe of them and the decisions they make. They express maturity way beyond 20 years, and, in fact, more maturity than much older people.

It very much depends on the individual in these cases. We have to look at whether there is a way to achieve that right balance; otherwise, we will just be making another age limit. You can join the Army at 16 but you cannot serve in combat until you are 18. The Government are talking about reducing the voting age to 16, but then we are hearing debates on neurological competence and capacity. It is important that we understand and express these points.

The point that came out for me in this whole debate about neurological development is that there is no such thing as “the science”. Science is contestable. We heard this from noble Lords who are experts in their field. We must be very careful about saying that “the science says this”. It also has implications for other decisions.

I turn to a couple of points which may already be treated in the Bill. I want to check the understanding of the noble and learned Lord, Lord Falconer of Thoroton, on what is in the Bill. The noble Baroness, Lady Hollins, asked: what happens if a new treatment is available? Clause 2 says

“which cannot be reversed by treatment”,

which probably takes care of that point, but I would like the noble and learned Lord, Lord Falconer, to share his interpretation and say whether it addresses her concerns. The noble Baroness, Lady Hayter, said that we should think about these young people who will be suffering and in pain, yet nowhere in Clause 2 are the words “pain” or “suffering”. We must be very careful to read what is in the Bill when we are making these points.

I welcome the intervention by the noble and learned Lord, Lord Falconer, that while he is quite clear about 18, he is sympathetic to the idea of cognitive development and maturity between 18 and 25, and there might be some discussion. Who knows—I cannot speak for the noble and learned Lord, who has looked into this issue very deeply—but perhaps in those discussions he may be persuaded. He is saying 18 at the moment, but clearly he is open to enhanced measures for those aged between 18 and 25. That is something that I hope the whole Committee will welcome.

There are many other points that I could make, but it is important to hear from the Government and what the noble and learned Lord believes in response to the points that have been raised.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I am grateful to noble Lords for their contributions to this debate on the age of eligibility for those who are provided with assistance under the Bill. I have made it clear previously, and reiterate, that I will keep my comments limited to the issues on which the Government have major legal, technical or operational workability concerns.

The amendments tabled by the noble Baronesses, Lady Berger, Lady Lawlor and Lady Hollins, seek to raise the age at which an individual would be eligible for the provision of assistance under the Bill. The points that I wish to raise here relate to the European Convention on Human Rights. There are potential risks that I am raising to inform the decision-making of noble Lords, but the underlying policies are rightly a matter for Parliament. Under the convention, the amendments in this group could give rise to legal challenge; for example, that excluding people who are under 21 or 25 from accessing assisting dying may not be justified under Articles 2 or 8 of the EHCR, or that this amounts to unjustified discrimination under Article 14.

Noble Lords will be aware that differential treatments, such as raising the age of eligibility, may be lawful if it is possible to persuade the courts to agree that the age limit is justified, necessary and proportionate. There would need to be a reasonable justification for restricting access to assisted dying to people aged either 21 and over or 25 and over. Noble Lords will want to consider this in relation to these amendments.

Terminally Ill Adults (End of Life) Bill

Lord Kamall Excerpts

Committee stage
Friday 12th December 2025 Lords Chamber

[Lord Kamall (Con)]

As I set out last week and will repeat if noble Lords will forgive me, I completely agree with what the Government Chief Whip said about noble Lords ensuring that they speak to the amendments and do not give Second Reading speeches, but, at the same time, I think it is important that all noble Lords who want to speak to an amendment are given the opportunity to do so.

I thank the noble Baroness, Lady Finlay of Llandaff, for her amendment in this group. It seeks to ensure that someone who currently is or has recently been deprived of their liberty will not be eligible under the Act. This amendment refers to the Mental Capacity Act 2005, which is also the Act underpinning capacity for the purposes of this Bill. I appreciate the underlying logic behind the amendment, which has opened up a valuable discussion of who exactly should have access to assisted dying services. I am sure that all noble Lords would agree, whatever their position, that there should be robust provisions and safeguards in the Bill and that it should be available only to those who are suffering from terminal illnesses who are of sound mind, so that we do not inadvertently open it up to those with issues related to their capacity.

I am also grateful to the noble Baroness, Lady Berger, for her contribution in place of the noble Baroness, Lady Keeley. It is very important that, given the backlog in the system, not just those who have DoLS but those who have made an application for DoLS are deemed not to have capacity when seeking to end their lives. It would be very interesting to hear the Government’s perspective on this and that of the noble and learned Lord.

These questions all fundamentally ask whether the Bill is right to use the Mental Capacity Act 2005 as the basis for defining capacity. I am very grateful to the noble and learned Lord, Lord Falconer of Thoroton, for offering to meet those who have tabled these amendments. That is very constructive and helpful and should be acknowledged. I also look forward to hearing the noble and learned Lord’s responses to some of the issues that have been raised.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I am grateful to noble Lords for their contributions on this group. To echo the comments of my noble friend the Chief Whip, the Government remain neutral on the principle of assisted dying and on the passage of this Bill. Whether the law in this area should change is a matter for Parliament. As before, any comments that I make will focus on amendments where the Government have major legal, technical or operational workability concerns.

This group relates to deprivation of liberty and eligibility for seeking an assisted death. I thank the noble Baroness, Lady Finlay, and my noble friend Baroness Keeley for tabling the amendments in this group. Amendments 16 and 114, tabled by the noble Baroness, Lady Finlay, seek to prevent individuals who have been deprived of their liberty within the last 12 months under the Mental Capacity Act being eligible for an assisted death. In the case of Amendments 16A and 114A, tabled by my noble friend Lady Keeley, someone would be ineligible as a result of an application for deprivation of liberty having been made, irrespective of the outcome of that application.

Noble Lords may wish to consider that the amendments would introduce a departure from the Mental Capacity Act framework by linking a lack of capacity in one area—capacity to consent to care and treatment arrangements that amount to confinement—to lack of capacity in another area, that being capacity to make the decision to end one’s life. Amendments 16A and 114A go further and would make a person ineligible on the basis that only an application for deprivation of liberty had been made. This may result in a situation where the application was unwarranted, but that person would still be ineligible for assisted death.

Regarding the European Convention on Human Rights—

--- Later in debate ---

[Lord Kamall (Con)]

The question that a number of noble Lords are concerned about, when discussing this amendment, is that the Mental Capacity Act was passed in 2005. Of course, the guidance has been updated, but it might be helpful to those in the Committee who are concerned that this Act is 20 years out of date to talk about any guidance that has been updated, so that it is not seen as out of date—if that makes sense. This is just to clarify that we are not dealing with an Act that was set in stone in 2005, as things have changed since then.

[Baroness Merron (Lab)]

I am grateful to the noble Lord and feel that this would probably be a very appropriate point to move on to my noble and learned friend.

--- Later in debate ---

[Noble Lords]

Front Bench!

[Lord Kamall (Con)]

I have never been so popular; it will not last, I know.

I thank the noble Baroness, Lady Grey-Thompson, for her amendments. I pay tribute to her for her sincere and long-standing commitment to protecting the most vulnerable in society. If we cast our minds back to Second Reading, many of the contributions made and concerns raised were regarding those who are the most vulnerable in our society. I remember at Second Reading being particularly touched by the words of the noble Lord, Lord Rees—he is not in his place now—who raised concerns about the vulnerability of some ethnic-minority communities, particularly those from disadvantaged communities as well.

Let us quickly rush through some of the points. On Amendment 22, which would make prisoners ineligible for end-of-life services as envisaged by the Bill, I completely understand the underlying principle. Many have spoken, rightly, about the vulnerability of prisoners. While for some it might seem wrong, as the noble Lord, Lord Farmer, has suggested, that a prisoner who has a terminal illness may have a way of cutting short their sentence by means of this Bill, as my noble friend Lady Coffey alluded to, others may say “Good riddance”. I also recognise the argument that prisoners with a terminal illness should be treated with the same compassion and care at the end of their lives as other terminally ill people subject to the Bill, as my noble friend Lord Markham recognised.

We also have to recognise some of the concerns over moral hazard. I do not know how large the incidence of this would be. Would it really encourage those who are terminally ill to commit crime? No studies have been done, but I am open to that concern. There is also the idea about higher levels of suicidal ideation, as raised by the noble Baroness, Lady Fox. These are really important points that we have to take account of.

The right reverend Prelate and my noble friend Lord Deben spoke about the pressure of reducing the prison population, while the noble Lord, Lord Carter, spoke about the higher rate of suicide among male prisoners. These are all reflections that should give us cause for concern, and things we should take account of as we consider what we will do between Committee and Report.

I thank the noble Baroness, Lady Grey-Thompson, for raising the issue of those who are pregnant. As the noble Baroness said, this was not debated in the other place, so I am grateful that the noble Baroness was able to give us the opportunity to debate it. I am also grateful to the noble Baroness, Lady Berger, for sharing statistics about expectant mothers. It was important that we heard those stats. I cannot begin to imagine the difficulty an individual in those circumstances may face. I understand the concern that it does not seem right that the safety of an unborn child may be endangered under the provisions in the Bill. I also understand that there might be precedence in other legislation. I wonder what the noble and learned Lord’s reflections on that are, given his expertise.

I note the amendment tabled by the noble Lord, Lord Farmer, on access to this for those who are awaiting trial. Once again, I would be very interested in the noble and learned Lord’s legal experience on whether that seems relevant and should be within this Bill. During the debates on the Mental Health Bill, my noble friend Lady Berridge was assiduous in spotting gaps in legislation or inconsistencies between different Acts. My noble friend has done the same thing here by raising concerns over the vulnerability of those with education, health and care plans. I think this needs further consideration.

I also thank the noble Baroness, Lady Grey-Thompson, for her amendments relating to those who are homeless or who live in insecure and temporary accommodation. I welcome the experience of the noble Baroness, Lady Gray. I still remember a conversation I had with one homeless charity that we are all one or two unlucky events or bad decisions away from homelessness. I heard from homeless people who told me that they had a great job and a great family life and that everything was going their way. They lost their job, which then led to them losing their marriage. After incidents of sofa surfing and testing the patience of their friends, they ended up homeless. It could happen to anyone. It is important that we do not dismiss the homeless as people who cannot be bothered or are idle. It could happen to anyone. Any noble Lords who have met those in homeless communities will know that some people had been incredibly successful but, after two or three bad decisions or unlucky things that happened in their life, they suddenly found themselves homeless. They are also judged by the way they look when they are homeless.

I remind all noble Lords that the Bill relates only to those who are suffering from a terminal illness and those who have been given an expectation that they will not live for longer than six months. We have to be very careful that, although we have sympathy for the homeless and prisoners, the Bill relates only to those who have a terminal illness. I know there are concerns that the Bill may be widened beyond that, but that is the debate at this stage. We should be quite clear that we are focusing on those with a terminal illness. So, much like on the question of prisoners and others, I recognise the arguments on all sides, but this is an opportune moment, not only because of time but because of the noble and learned Lord’s legal experience, to hear his reflections—after the Minister, obviously.

[Baroness Merron (Lab)]

I am most grateful.

My Lords, I thank all noble Lords for their contributions to the debate on this group. As is my consistent introduction, my remarks will focus only on issues where the Government have major legal, technical or operational workability concerns. Many of the points that follow relate to the European Convention on Human Rights. These are risks that I am raising to inform noble Lords’ decision-making, as I said on the first group. I wish to be clear that the underlying policies are a matter for Parliament. I say to noble Lords who referred to my ministerial colleagues in the other place that it is the role of Ministers, whether in your Lordships’ House or in the other place, to flag the risks to the Bill, including potential legal challenges. As I said, policy decisions remain a matter for the sponsors. Decisions in this regard rest with Parliament.

I begin with Amendment 22, tabled by the noble Baroness, Lady Grey-Thompson, and Amendment 30C, tabled by the noble Lord, Lord Farmer. These amendments would make prisoners, a defendant on remand, a defendant on bail or those detained by a hospital order ineligible for assisted dying services, even if they have a terminal illness and meet all other criteria. Aside from the right to liberty—Article 5—the ECHR requires that prisoners, a defendant on remand or a defendant on bail should have the same rights as those who are not. The rights engaged by this amendment are Article 8 on the right to respect for private and family life and Article 14 on prohibition of discrimination. Noble Lords may wish to note the risk that making these groups ineligible for assisted dying would, on the face of it, lead to a difference in treatment, which would need to be objectively and reasonably justified in order to comply with ECHR obligations.

Likewise, making ineligible hospital in-patients who are under a hospital order would lead to a difference in treatment. Without sufficient justification for the discriminatory treatment, this may be a breach of the ECHR, which could lead the courts to issue a declaration of incompatibility.

The noble Baroness, Lady Grey-Thompson, has also tabled Amendments 24, 458, 308 and 347. The purpose of Amendments 24 and 458 is to exclude those who are pregnant from accessing assisted dying, while that of Amendments 308 and 347 is to make persons who are homeless, or living in supported or temporary accommodation, ineligible for assisted dying services. As I have previously noted, the reasons for this difference in treatment would need to be adequately justified to avoid the risk of a successful challenge under the ECHR.