Terminally Ill Adults (End of Life) Bill

Lord Weir of Ballyholme Excerpts

2nd reading
Friday 12th September 2025 Lords Chamber

[Lord Weir of Ballyholme (DUP)]

My Lords, 60 years ago Parliament passed what I think would be by common consensus one of the most significant pieces of legislation of the 20th century—namely, the abolition of capital punishment. The rationale for that decision was largely based on three principles that are difficult to argue against: first, that in a modern civilised country it was barbaric for the state to decide to kill its own citizens, even after a judicial process; secondly, that whatever protections or procedures were put in place with a judge, jury, tribunal or panel, it is made up of human beings who ultimately from time to time will make mistakes; and, thirdly, that when we are dealing with a situation involving the death of a person, the consequence of a mistake in those circumstances is irreversible. The clock cannot be turned back six months later when new evidence emerges, if that person is dead.

Those principles have held firm throughout the decades, which is perhaps why, in the 60 years since then, there has never been a realistic prospect of that law ever being revoked. But I contend that the legislation before us today reverses and repudiates all three of those principles, with the added expense of offering in return a false prospectus of a painless, easy death.

If this legislation passes, the state will have control over who is eligible for assisted suicide and control over how that is done, and it will ultimately be administering the killing of the individual. Whatever procedures we put in place, the panels will make mistakes. We know that the prognoses that doctors make, no matter how qualified or specialist they are, cannot be got right all the time. But what worries me most is the issue of coercion. This is not simply an academic or hypothetical question. Sadly, we have seen too many cases over the years, particularly those resulting in the tragic deaths of partners or children, in which it has then emerged at a later stage that there were years of abuse and coercion. The reality is that coercion is not easy to spot because it happens behind closed doors. It can be blunt and aggressive, but it can also be sophisticated and subtle—a drip-drip message to a person that they are a burden on their family.

The reality is that even beyond the coercion that comes from others, there is a risk in this legislation of what I would call self-imposed coercion, whereby a person decides or convinces themselves that the burden that they place in terms of caring and financial responsibilities means that they feel compelled to make the supreme sacrifice for their family. As with capital punishment, if we get it wrong on an issue of coercion, we cannot look back six months or a year down the line and reverse that decision.

Finally, to use a classical analogy, today we cross over not only the River Styx but the Rubicon if we accept this legislation. Some of the proponents of this legislation are already saying that it is the first step. We have seen that happen in country after country, perhaps less in a direct change of the law and more in change of practice. While I am sure that we have great faith in this country, we cannot be that uniquely arrogant to believe that we will be the one country where there is not an expansion of the issue of assisted dying.

This Bill, rather than being progressive and permissive, is cruel and regressive. This House should do the mature thing and reject it.

Terminally Ill Adults (End of Life) Bill

Lord Weir of Ballyholme Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Baroness Coffey (Con)]

My Lords, group 1 is perhaps not the ordinary place to start when we are considering the issue of Wales, but I have tabled 40 amendments with specific reference to Wales for a reason. We will get into aspects of this in more detail and I am grateful to the noble Baroness, Lady Smith, and the noble and learned Lord, Lord Thomas, for degrouping some of their amendments, because I think it is important that we have a considered debate about how the Bill could potentially apply in Wales. I am also conscious that the Committee will want to get on to the key principles that we will cover in later groups.

My reason for raising this is that the Bill started as a judge-led process, with quite a focus on, in effect, decriminalising parts of the Suicide Act. I am in no doubt that that is a reserved competence: having the one judicial system. I completely accept that. That is not what I am seeking to get into. However, what has happened in the Commons, and even more now in Committee in your Lordships’ House, with the amendments that have been tabled, has basically flipped the Bill into being a Bill on NHS-provided assisted dying—or “assisted suicide”, or “assisted help”; I have forgotten the varieties that are now being proposed on what it is going to be called—and without doubt, health is devolved to the Welsh Government, and therefore the Welsh Senedd.

There have been a number of debates in the Welsh Senedd, and the Welsh Senedd has consistently said that it does not want assisted suicide to go ahead, particularly in Wales, under its devolved elements. That vote was actually taken fairly recently and, as a consequence, I am concerned that aspects of the Bill will, in effect, potentially be breaking the Sewel convention, although I accept that the Welsh Government are now on to their second legislative consent Motion and will have more.

When I have asked the Government questions, I have tried to do it through freedom of information requests, just trying to understand what concerns the Government have had about the Bill and why it has needed, I think, 11.7 full-time equivalent civil servants working in the Department of Health and more than three in the Ministry of Justice to work through and understand the issues that have made the Government decide, “That’s not workable”, “That’s not practical”, “Let’s think about the legal element”. I have been blocked at pretty much every turn. I have been told, on FoI elements, “It’s going to take too long to answer you”. Indeed, I am still waiting for an answer from the Department of Health, but I got another one just saying, in effect, “Well, the Minister mentioned it basically in Committee in the other place, you can look it up yourself”. I am not sure that that is the attitude that is going to help us get through this detailed understanding of where we are.

Returning to Wales, the Government have been having weekly technical meetings with Welsh Government officials. It has not been possible to get information about what has been discussed. Recognising that both Governments are supposed to be neutral on this, this is not a case of government policy formation, which is protected under the Freedom of Information Act, but nor do I feel it is in the spirit of considering the most important Bill of this entire parliamentary Session, indeed of this entire Parliament.

The other aspect I am concerned about is what is happening in the Welsh Senedd. There is clearly a difference of view between the Welsh Senedd and the Welsh Government, and information is not currently being released. I am not trying to get into a whole debate on Wales, but can the Minister give us an understanding of what is happening? I appreciate that the sponsor of the Bill may have the answers, but let us be candid: it is the civil servants who have been doing all the technical work and the sponsor has been doing the more general policy ideation—at least, that is what Ministers told the Select Committee. I know the Select Committee had limited time and I tried to get a discussion about Wales during it, but it was not possible.

I am not going to delay debate on the first group, but it needs some careful consideration. I could make lots of references to reports, which are online, but there is a huge difference in what the Welsh Senedd believes should be devolved and what needs a legislative consent Motion. I am still awaiting an answer from the Government about whether they have requested the legislative consent Motion.

There are many more clauses the Welsh Senedd believes should be in here, and I am looking for a straightforward response from both Ministers on the clauses that they believe are not devolved and why. Ideally, I would like to hear it on the Floor of the House but if the information is not available today, I would be grateful if it could be responded to in a letter to be laid in the Library so that everyone has a proper understanding of what is the responsibility of this House and what is the responsibility of another Parliament. We need to be transparent about what that means, because we should not assume that we have the opportunity to ride roughshod over what other devolved Administrations and Parliaments believe. I beg to move.

[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.

Terminally Ill Adults (End of Life) Bill

Lord Weir of Ballyholme Excerpts

Committee stage
Friday 5th December 2025 Lords Chamber

[Baroness Berridge (Con)]

My Lords, I will speak to Amendment 4, in the name of the noble Baroness, Lady Berger, to which I added my name.

As well as this Bill, the Private Member’s Bill in the name of the noble and learned Lord has, as a requirement, the safeguard of a six-month prognosis. When one looks at this in relation to those over 18, I am interested in what pre-legislative scrutiny or consultation the noble and learned Lord, or the other Bill’s sponsor in the other place, had on the science. I am not a scientist, but I have a researcher who is a scientist, so I took advice on how to treat the science when one speaks in a debate with those who have great eminence, such as the noble Lord, Lord Winston. Having looked at that, I believe it is relevant to the age limit in the Bill. There will be specific types of vulnerability for certain groups of young people—as the noble Baroness, Lady Fox, outlined—but those will be discussed in later groups.

According to peer-reviewed studies—which, I am told, are the best way to begin to treat the science—the brain reaches its full size physically at the age of 14, but the neural circuitry does not develop to enable enhanced decision-making and cognitive function until the age of 25. I am also informed—I am sorry to disagree with my noble friend Lord Sandhurst—that the study that was quoted by the BBC is viewed as an outlier from the peer-reviewed studies that we have in this regard.

When looking at terminally ill adolescents—I am grateful to the noble Lady, Lady Hayter, for reminding us of that—we also need to consider that there are psychological reports that they may have an unrealised concept of the finality of death, which I think is relevant to what the noble Lord, Lord Moore, said. As the Children’s Commissioner stated in her letter of evidence to the Select Committee:

“Compelling arguments have … been made about the additional difficulties present in diagnosing young people in this age group, and predicting with certainty the chance of living for six months”.


Of course, if that is wrong, it could lead to an earlier, untimely death, if assisted dying is made available to them.

I was really intrigued by that statement and sought to look at the scientific evidence. I have found peer-reviewed papers, in particular one from the University of Manchester reporting historical data that finds that, even with advanced diseases such as thyroid cancer, this group has a better rate of survival than adults over the age of 25. The report outlines that that may be because a more efficacious response to treatment, as a younger body may be better able to receive it; it may be due to an elevated sense of hope, which is often reported in young adults; or it might be because such a devastating diagnosis at that age is hard to fathom, as it is not a disease they think would ever happen to them. That sense of hope possibly contributes to a positive impact on the immune system, thus resulting in a better response to the administered medication.

The second reason I outline is that—as the noble Lady, Lady Hollins, briefly alluded to—there is a significantly increasing life expectancy in terminally ill young adults due to the incredible advances that we are beginning to see in treatments such as advanced immune therapies and personalised genotype-directed treatment. Both have seen increased survival rates of up to five years in up to 80% of patients with terminal cancers. Although we will come to the matter of young people and the EHCP in a later group, I think it is right to reiterate that we have policies that treat those between 18 and 25 differently in certain situations.

The Children’s Commissioner also brought to our attention that young people already often fall into a gap at the ages of 16 and 17. Some community palliative care services end at 16, and then others do not begin at 18. That makes me wonder whether we need to think more about their access to specialist palliative care in this Bill in later groups.

Can the noble and learned Lord outline what process there was, before both Bills were put together, to look into the scientific evidence? It seems to me that the assumption in both Bills is that a six-month prognosis affects or applies to all groups of the population in the same way. Is that indeed the case? We know from evidence from the European Society for Medical Oncology’s Professor Stone that a six-month prognosis is inaccurate in over half of cases. Is six months the right level to use—that might be a connected change—or is 18 too young an age? I would be grateful to know whether the noble and learned Lord has already engaged with this science. Perhaps with the assistance of the noble Lord, Lord Winston, this, I think, would be a valuable way of looking at the evidence behind Amendment 4.

[Lord Weir of Ballyholme (DUP)]

My Lords, this is an important group of amendments, particularly to those of us who have an interest in young people. It is very important that we have heard today a range of opinions on where age eligibility should lie. When dealing with age eligibility in this Bill, it seems that there are three critical questions. First, at the lower end of eligibility, should there be an age limit below which it is impossible to access assisted dying? Secondly, if it is agreed that there should be an age limit, is 18 the appropriate age? Thirdly, as has been posed by the two sets of amendments in this group, if we feel that 18 is too young an age, what is the appropriate age that we should set?

On the first issue, I am glad to say that at least the proponents of this Bill have not gone down the line—as has been argued, I think, by some lobbyists and has been the case, for example, in Belgium and the Netherlands—that there should be no lower age limit. I welcome the fact that this seems to be accepted by the proponents of this Bill. However, I reiterate the question that has been asked—I look forward to the noble and learned Lord, Lord Falconer, summing up in relation to this—about what assurances we could have if we ended up in the position where the eligibility is at 18. What confidence could we have that that will be stuck to?

On the second issue of whether 18 is the appropriate level, I cannot claim any particular knowledge or expertise on neuroscience, but I have a lot of experience having served twice as Education Minister in Northern Ireland. I am sure that, if you speak to anyone who has served in that sort of role in any of the jurisdictions, they will say that the greatest privilege you have in that ministerial capacity is meeting young people on a day-to-day basis and talking to them about their lived experiences. It is a great joy to meet the many very healthy, confident young people who can look forward to a lifetime ahead of them. However, it is also the case that you come across a number of young people who are very vulnerable, who have extremely life-limiting conditions and who have a terminal illness.

In my experience, the families of those young people reorientate themselves through their love, so that the focus of almost all family activity is on that young person. The by-product of that, at times, can be that some of those young people feel themselves to be a burden on their family: that they are disrupting everything that their family does and not allowing their family to lead a normal life. They sometimes feel a sense of guilt.

While I am sure that we will come on to this in later stages, I note the concern about what might be described as “self-imposed coercion”: people coming to the conclusion that they will be doing a service to their loved ones by going down the route of assisted suicide. We know that concerns have been raised in relation to the disabled and the elderly feeling under a particular level of pressure, but it would be naive to believe that young people in that position do not also feel themselves to be pressurised. I do not want us to create a situation where a young person, in the run-up to their 18th birthday, asks, “How can I facilitate my family by taking that ultimate step?” So, on the issue of maturity, I contend that 18 is perhaps not the right boundary point in this case.

Finally, there are competing amendments about whether it should be 21 or 25. While I came to this in a fairly agnostic manner, I have been persuaded much more towards the position of the noble Baroness, Lady Berger. I am also persuaded in many ways by the words of the Children’s Commissioner. I have considerable experience of dealing with both the Children’s Commissioner in England and her opposite number in Northern Ireland, and I believe that the commissioners tend to have a particular worldview: when they look towards young people, they want the world to be permissive towards them. They are progressive in their nature—and sometimes, I have to confess, they may be a little too progressive on certain subjects for my own liking. But they always look, where possible, to extend rights to children that are normally given to adults. So, when we see a situation such as this, where a Children’s Commissioner is, in effect, saying, “Be very careful in relation to the law. Do not extend this to younger people between 18 and 25”, we need to pay cognisance to that.

Terminally Ill Adults (End of Life) Bill

Lord Weir of Ballyholme Excerpts

Committee stage
Friday 16th January 2026 Lords Chamber

Moved by

[Lord Weir of Ballyholme]

30: Clause 1, page 1, line 12, at end insert—
“(e) is not substantially motivated by—(i) not wanting to be a burden on others or on public services,(ii) a mental disorder (including depression),(iii) a disability (other than the terminal illness),(iv) financial considerations, including a lack of adequate housing,(v) lack of access, or delayed access, to treatment or other service which a public authority is required (or can reasonably be expected) to provide, or(vi) suicidal ideation,”

[Lord Weir of Ballyholme (DUP)]

My Lords, I have notified the Lord Speaker’s office and the Whips that I shall be moving Amendment 30, which stands in my name and those of the noble Baronesses, Lady Foster—who is unable to be with us today—and Lady Fox, and the noble Lord, Lord Empey. This group of amendments deals with the issue of motivation, and there is a level of link with the previous group, which dealt with eligibility. In the interests of time, I will allow the proposers of the other amendments to speak to those and will concentrate entirely on Amendment 30.

The purpose of Amendment 30 is largely to ensure that the Bill remains true to what I think is one of its key underlying principles: that when dealing with the substantial motivation of anyone applying for the assisted dying service, there is a critical, causal and direct link between that desire to have an assisted death and the terminal illness, and the application for an assisted death does not arise from a range of other motivations. Also linked to this is an attempt, at least, to ease the gap between two tensions that will lie within public policy should the Bill become law. Should it become law, the state will play a role in assisting the death of members of the public, while at the same time there is a public policy commitment and priority to try to prevent suicide. In many ways, those two objectives are pulling in opposite directions. Amendment 30 at least tries to create a little bit of clear blue water between the two; it cannot square that circle, but it goes some way towards dealing with the issue.

Sticking to the original principles of the Bill is all the more important because one of the most fundamental motivations behind it had to be abandoned from the face of the Bill. We know that the proposer of the Bill in another place, Kim Leadbeater, has said on numerous occasions—both before the Bill was proposed and during the debate on it—that it is principally about pain and suffering. Indeed, on one occasion, she made the comment to the then Archbishop of Canterbury:

“My proposed legislation is less about ending life, but very much about easing suffering and shortening death”.


I am sure that the noble and learned Lord, Lord Falconer, will give us very good reasons as to why this is the case, but nowhere do pain and suffering appear as part of the Bill. That issue will be probed particularly by the amendments in this group tabled by the noble Baroness, Lady Coffey.

To ensure that there is that strong, critical, causal link between the termination of life being the motivator and the assisted death, Amendment 30 seeks to exclude six other areas that could be considered as substantial motivation for an assisted death. The first is a lack of access, or delayed access, to alternative medical treatments. I do not wish to reiterate the earlier debates we have had—for instance, on palliative care, or the question marks that are sometimes there about a certain level of postcode lottery in the NHS. Those issues have been debated already, but if we are to fulfil what I think is one of the key arguments for the Bill—that of bodily autonomy—and if there is to be autonomy, autonomy has to be real choice. If there is no reasonable opportunity for access to any alternative medications, it is not really a choice, and that should not be the motivation for an application.

Secondly—again, this was touched on during the debate on the last group—the substantial motivation should not be lack of resources. I agree on one thing with the noble and learned Lord, Lord Falconer: this should not discriminate against people on the basis of socioeconomic background. Therefore, lack of resources should not become a driver for the poor to go down this route because they do not have any other opportunity. This is not simply a hypothetical concern; we have seen it happen time and again, particularly in the Canadian example, in which people—particularly those with mounting debts, which are quite commonplace among those who are debilitated by illnesses—feel under massive financial pressure, and that the only route through is to have an assisted death. That should not be the principal motivator.

Thirdly, it should not be because someone feels themselves to be a burden. We have mentioned before that we will want to put in all the provisions that we can on the issue of coercion. However, what might be described as “soft coercion” is a feeling among those who are terminally ill that they are a burden on their family and loved ones, and perhaps on society as a whole, which acts as a driver towards assisted dying. Again, there is plenty of evidence that this is a major factor in other jurisdictions. For example, among those persons who applied for assisted dying in Oregon in 1997, around 13% indicated that feeling a burden was a substantial part of their motivation. That figure has now risen to 42% of those applying, and in other jurisdictions it can be even higher. We want to safeguard against that.

Terminally Ill Adults (End of Life) Bill

Lord Weir of Ballyholme Excerpts

Committee stage
Friday 23rd January 2026 Lords Chamber

We really must be told, by the promoter and by the Minister, which Secretary of State will be responsible for choosing the panel, because there are a lot of references to the Secretary of State in the Bill. Will it be the Secretary of State for Health, or whatever the relevant one is at the time, or will it be the Ministry of Justice?

[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.

--- Later in debate ---

[Baroness Berridge (Con)]

Well, I hope that he will write to me personally about this.

In relation to the evidence on which the noble Lord, Lord Birt, is basing his argument, I was surprised that the right reverend Prelate mentioned the Australian non-comparable. Paragraph 8.4 of the impact assessment, on the delivery model, states that

“in most jurisdictions where assisted dying is legal it is provided through the healthcare system”,

so looking for international comparators is an unusual approach. The 30 jurisdictions that we keep hearing about include the Isle of Man, Tuscany in Italy, and only 13 of the 50 United States. This is not a wave that we must get with, as many progressive politicians like to say it is. Denmark considered this in 2024, and 16 out of 17 members of the Danish Council of Ethics voted against introducing assisted dying into their jurisdiction. Only yesterday, the French Senate decided not to go forward with legislation. This is in no way a progressive train that we need to get on.

My second point relates to the speed of these decisions for families. We know that the Bill is philosophically based on individual autonomy, which is anathema to many communities. For families to know that this was done within 18 days will only compound what we believe will be complicated grief. I am particularly concerned about how the speed of service will fit in with the increasing uncertainty of diagnoses for 18 to 25 year-olds because of the various positive effects of treatments for them. The noble and learned Lord, Lord Falconer, has admitted that there are, sadly, deficiencies in Clause 43 in relation to advertising. I do not think I am a cynic, but I am sorry to say that I can see a competition: “Can I get to 18 years and 18 days and be the first young person to meet that milestone?” We do not want a culture of speed in this process, limiting reflection.

Finally, maybe I am the only noble Lord sitting here without the benefits of the pre-legislative scrutiny of a consultation White Paper but, with many amendments, I am wondering how this service will fit together with a panel—or will it be a judge, or a judge with a couple of other members? That is the deficiency: in Committee, we are still trying to put right the lack of pre-legislative scrutiny, and I do not know whether that is possible.

[Lord Weir of Ballyholme (DUP)]

The noble Baroness raised the issue of speed. It comes back to a point raised by the noble Baroness, Lady Fox. Often in public policy issues, there is a trade-off between the speed of a decision and its quality. Sometimes when we short-circuit or fast-track decisions it can inevitably lead to a greater level of mistakes being made. But in a wide range of other public administration or public policy decisions, there is at least the advantage that if a mistake is made, there is the opportunity at a later stage to come back and correct it—to perhaps appeal, review or reverse it. Of course, the major problem with this is that if we fast-track things and it leads to a death that should not have occurred, we cannot bring the person back to life.

I agree with the noble Lord, Lord Markham, who said in response to an intervention from the noble Baroness, Lady Berger, that he perfectly acknowledged that we should have the safest possible system—I see that he is nodding now. I therefore find it very difficult to see how we get the safest possible system if these amendments go through and decisions are fast-tracked, inevitably leading to greater numbers of mistakes and shortcuts.

[Baroness Finlay of Llandaff (CB)]

My Lords, in introducing this group of amendments, the noble Lord, Lord Birt, said that one of the reasons he tabled them was that the proposals in the Bill are potentially chaotic and prolonged. This group is in some ways something and nothing. The proposals make the case for a profound imbalance, with assisted death actively facilitated, accelerated and led through the dedicated service with speed. As my noble friend Lord Stevens said, this is not in scope for the NHS and NHS services, and we have to look at the NHS constitution. I ask the Minister whether, in the light of some of the proposals, there is a plan to rewrite the NHS constitution as well as the fundamental principles of the NHS, as read out by my noble friend.

The amendment’s structural conflict is between efficiency and caution. In responding, can the noble Lord, Lord Birt, explain how the clock will be stopped and by whom, and whether a request to shorten the process will trigger enhanced scrutiny? If so, how that will be done? Will all the assessments be face to face to improve the chances of detecting coercion to death? Will all the contacts with the navigator be recorded and audited so that one can be sure that the auditor is not acting in a profoundly subtle and coercive way?

The navigator seems to bypass a search for many things and, without the amendments in the names of the noble Lord, Lord Mackinlay, and others, I cannot see how that imbalance would be corrected. At least the imbalance is there, but Amendment 771 gets to the heart of the problem: it tries to make all of this a profound NHS responsibility. As we have heard, the NHS cannot cope. We have patients on extra beds in the middle of wards, seriously ill patients being looked after in corridors and patients sitting on plastic chairs waiting for a bed, sometimes dying on those plastic chairs.

The NHS is not the place to have a dignified death in a hospital setting in the lovely planned way that seems to be described and desired by some people. People are working themselves into the ground trying to manage their current workloads. As has been said, the workforce itself is completely on its knees. GPs are already overstretched. Evidence suggests that assisted dying would require around 30 hours for an individual case, yet many palliative care doctors and psychiatrists would opt out, therefore decreasing the pool. That is relevant to the way these amendments are put together.

I will respond to some of the points raised about whether the public want this. When the public are asked in polls what they understand about assisted dying, 52% say that it is a right to stop treatment. They already have that right. Nobody should be treated against their will, and they should be supported in that decision. Some 17% of people think that assisted dying is hospice care.