Lord Sandhurst
Main Page: Lord Sandhurst (Conservative - Excepted Hereditary)
The Lord Bishop of Newcastle
My Lords, in his opening remarks, the noble Lord, Lord Birt, cited Australia. I am sure that he is aware that no Australian jurisdiction is recognised as one of the 10 comparable jurisdictions in the Bill’s eligibility criteria and the Government’s impact assessment. The most comparable are New Zealand and the United States. This discussion was resolved in our Select Committee by receiving evidence from New Zealand. We need to be consistent and mindful of the Government’s impact assessment and ensure that our comments align with it.
Lord Sandhurst (Con)
My Lords, I agree entirely with the noble Lord, Lord Stevens, with his vast experience, and the noble Baroness, Lady Hollins, with hers.
My point is a simple one, which, as a lawyer, has been troubling me for a long time: conflict of interest. There is an internal conflict of interest here within the health service. Are you going to spend the money on this or on palliative care? Will it affect decision-making by medical practitioners? I have talked to a number of them—one of them is a member of my family; I will not embarrass them by saying more—and know that it is a matter of real concern, because this is not treatment, but something quite different.
We do not have to have non-medical things such as, as we have heard, Department for Work and Pensions assessments done under the NHS label. That is contrary to everything the NHS stands for. There would be a conflict of interest within any trust that funds and administers this as to where the money goes. Will it be given more money, specifically? Will it be limited?
The obvious overseeing Secretary of State for this is the Secretary of State for Justice, because you are going to be dealing with the administration of life and death, not simply trying to cure people and save them from death. It is quite different. You are saying, “You can die, and we are satisfied that there are no bad people around you who are encouraging you to opt for this course”. Then there will be the selection and management of the panels, which will be performing a quasi-judicial function, like other assessment panels.
The obvious place for this, which would remove, or at least limit and reduce, the risks within the health service, would be a separate, specific budget given to the Ministry of Justice. We would then know what is being spent. Otherwise, the XYZ trust will say, “Gosh, what do we take this from?” I will not give emotive examples, but that is what will happen in practice, so we need to know that this is a specific service and that the country has said it will have hundreds of millions of pounds a year to run it, but that it will be on top of and ancillary to anything the ordinary health service provides to people who actually want to live, or at least live in comfort.
Lord Weir of Ballyholme (DUP)
Is it not also the case, if we are looking at assisted dying much more from a justice prism, that one of the broader, important elements to establish, where death has occurred, is whether there has been any criminal action or intent, in terms of the administration but also in a situation where people coerce somebody to die? That is another reason why, if this is to happen, it should sit much more with the justice side of things than with the health side.
Lord Sandhurst (Con)
I agree entirely with the noble Lord. That is why at the start, perhaps briefly and elliptically, I talked about bad agencies and people. That is not the health service’s primary role. It will happen from time to time. I know a medical professional —I mentioned this at Second Reading—who has a relative in charge of safeguarding in a major London trust. One of the concerns they have, and what they have to deal with from day to day, is families who are not all united in their support for an elderly and tiresome relative and would often, in fact, like them helped on their way. I will not say more, but I think the point is clear that this structural point is a major failing in the Bill.
Lord Moore of Etchingham (Non-Afl)
My Lords, the noble Lord, Lord Stevens, who speaks from great experience and professional knowledge, made a very clear case about how the assisted dying navigator is quite outside the normal purposes of the National Health Service. I guess it could be described, in effect, as a form of advocacy. In the ancient world, the dead were carried across the River Styx by Charon. It seems that role would be performed by the navigator, because where is he navigating you to? It is to the River Styx; he is not trying to navigate you to anywhere else.
If that is included in the National Health Service, it would create a quite different purpose from the normal purposes, as the noble Lord, Lord Stevens, described. I wonder, therefore, whether we should consider whether this actually amounts to the National Health Service trying to persuade people to accept assisted dying. If it does, and if you think of the vulnerability of the individual cases that so often will occur, could it be argued that it might become an institutionalised form of coercion?