Terminally Ill Adults (End of Life) Bill

Meg Hillier Excerpts

2nd reading
Friday 29th November 2024 Commons Chamber

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

In my brief remarks today, I want to touch on principle, policy and practice. We have to be very clear that we are having a debate not just on the principle, but on the Bill. The principle at stake is that we would cross a Rubicon whereby someone who is terminally ill, according to the definition in the Bill, is assisted by the state to die. That is a fundamental change in the relationship between the state and the citizen, and the patient and their doctor. If we have a scintilla of doubt about allowing the state that power, we should vote against the Bill today.

Like most of us, I came into politics partly to stand up for the vulnerable, and we have heard heartbreaking stories today about those vulnerable at the point of death. We have also heard—and I concur completely with my right hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott)—about those who are vulnerable for other reasons and who could be coerced or persuaded down this route.

I have had the privilege of being around the hospice movement for nearly 50 years, as my father established one of the first national health service hospices in this country. I saw what he did as a doctor in a world where death was not talked about, where surgeons would say, “We’ll whip this bit out and you’ll be fine.” He would be one of the first to have to tell the patient that they were actually going to die. The work that he did, on the back of giants such as Dame Cicely Saunders, is something we should be proud of. We were the first country in the world to recognise palliative care as a separate profession, and some of the tragedies we have heard about today arose from a failure in that system. A failure in palliative care and support is not a reason to continue.

I have personal experience of this. Many hon. Members will remember when my daughter was very ill a few years ago. I had not intended to speak about this today, but she was admitted to hospital as a teenager with acute pancreatitis. The Bill would not have covered her, but I did not know for five days—in fact, many months—whether she would live or die. For those first five days she did not sleep and she did not eat, and she was crying out in pain. I saw what good medicine can do. It palliated that pain and got her to a place where, although she was unable to eat for two and a half months, she was saved and her pain was managed. Our best friends were the pain nurses and the anaesthetists. I have other examples of another family member, but I do not have time to go into them today.

I hope my daughter forgives me for raising her personal situation in the House today—

[Lola McEvoy]

Will my hon. Friend give way? I pay tribute to her for the strength that she is showing. Indeed, I pay tribute to all Members on both sides of the House who are dealing with this very difficult issue. Does she agree that we already have assisted dying in this country? Legislation already allows for choice, proving that people would be able to die at home with carefully administered, practitioner-led pain management. Does she agree that the inconsistency of this application of good pain management at the end of life, causing compassionate legislators to feel that the only option is to vote for the Bill, is a failure of our existing national health system, and does she—

[Madam Deputy Speaker (Caroline Nokes)]

Order. Interventions will have to be short in this debate because many Members wish to speak, so perhaps that is enough.

[Dame Meg Hillier]

I thank my hon. Friend for that intervention. She is absolutely right. When we see the system working, it is great, but some of what we have heard today has referred to a failure of the system. That cannot be a reason for us to accept the Bill today. For more than 30 years I have been scrutinising the policies and actions of public bodies and seeing the mistakes that they make, both in the care sector when I was in local government and more recently as Chair of the Public Accounts Committee.

[Mr Adnan Hussain (Blackburn) (Ind)]

The time for us to make this decision is wrong, frankly. At a time when 44,000 terminally ill pensioners are set to lose their winter fuel allowance—indeed, many of them have lost it—we are discussing whether we will pass a Bill, a state-sanctioned Bill, dealing with a taboo that many of us are reluctant to talk about.

[Dame Meg Hillier]

Where I do agree with the hon. Gentleman is that the time is not right. We have not had the proper discussions about palliative care. Some of us have been trying to talk about it for many years, and we need to ensure that this debate does not stop today, but the Bill must stop today. It is not developed to deliver the palliative care resource that we need. I do want to touch on the policy, but let me first return to the point that I was making before the hon. Gentleman’s intervention.

We have seen many failures in the system, including contaminated blood, and whistleblowing in the NHS repeatedly shows such failures. There is great trust among those who support the Bill that these safeguards will deliver. I will not go into the details, because others have already done so, and I am sure that many more will, but we made coercive control illegal in 2015, and although the Bill refers to safeguards, I fear that that will not pick up coercive control. When we ruled it to be illegal, we thought that was a moment of progress in the House.

Given the time, I will now move on to some of the practical challenges. My constituents are struggling to see doctors face to face, and seeing the same doctor twice seems like a miracle in today’s Britain. My right hon. Friend the Health Secretary is trying to sort it out, but it will take a long time. We need to sort out our battling health service, we need to support palliative care, and we need to discuss what a good death is. Cicely Saunders campaigned and triumphed to ensure that we had one of the best hospice movements in the world.

If Members have any doubt in their minds about the impact of the Bill on people who do not have the same capacity as those who are talking about this in the television and radio studios, they should think of those in my constituency who have poor English, or the woman who came to see me a month ago with terrible pain in her gall bladder. Removing it would have been a simple daytime operation, but she did not understand what the doctor had told her, and she was not going to have her gall bladder taken out because she did not know what it meant to be without a gall bladder. Let me say this to those Members: if someone who was English, a bright woman in her 60s, was unable to challenge what was said to her and to have that conversation with a doctor, just think what passing the Bill today would mean for many more vulnerable people.

I thank the House for its indulgence.

Terminally Ill Adults (End of Life) Bill

Meg Hillier Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[Adam Jogee (Newcastle-under-Lyme) (Lab)]

I am grateful to you, Madam Deputy Speaker, for giving me my first opportunity to speak in the Chamber on this most important of issues. As I do so, I think of all those who were killed in the horrendous plane crash in India yesterday. I think of their families, their friends and the lives they have left behind. May their collective and individual memories be a blessing.

I rise to speak to amendment 42, tabled in my name and those of more than 60 colleagues from the majority of parties in the House, representing constituencies in all four nations of our United Kingdom. It would remove the automatic commencement of the Bill’s provisions in England. It is a safeguard, good and proper.

As it stands, the entire assisted dying process will commence automatically in England four years after the Bill is passed. Notwithstanding some of the comments we have heard, that will happen regardless of how far along the plans and preparations are—plans for the manufacturing and supply of the drugs that will be used to end the life of anyone who chooses this step; for the identification and training of those on the panel; for the impact on the national health service in England and Wales and its budgets; and all the rest.

Colleagues will know that, as the Bill was originally drafted, the process would have commenced two years after it was passed. I welcome the fact that my hon. Friend the Member for Spen Valley (Kim Leadbeater) amended that period from two years to four. That was a genuinely welcome acknowledgment that such a serious and consequential change to every aspect of our country, from our healthcare system to our legal system, should not, must not and cannot be rushed. Therein lies the basis of my amendment. If this change is going to happen, let us do it properly. Let us not impose a timeframe that puts us in a bind—one that means we are driven by timing over purpose, and the pressure that comes with a ticking clock, rather than by the need to do it properly.

People living in Newcastle-under-Lyme and York Outer, in Buckingham and Bletchley and Pembrokeshire, are counting on us parliamentarians—those of us who are concerned about assisted dying and those who passionately support it. The Bill’s supporters have won every single vote, apart from on this issue in Committee. Our people are counting on us to make sure, if the Bill passes, that it is a success, that it will be consistent and, most importantly, that it will be safe. If the Bill passes, it will introduce assisted dying in the biggest jurisdiction yet by population. These are uncharted waters; this will not be like anything else. The last thing we should do is rush this process.

In Committee, the hon. Member for Richmond Park (Sarah Olney), who spoke excellently earlier today, tabled an amendment to remove the automatic commencement deadline for Wales. It provided that assisted dying could be rolled out only once Welsh Ministers deemed that everything was ready for a safe roll-out. The Committee voted by a majority to give that extra safeguard to the people of Wales. If it was good enough for the people of Wales in Committee, it is good enough for the people of England today. We face a situation in which assisted dying may proceed in England months or even years before it does in Wales. The provisions and systems may look different. The process of organising the English system to meet the arbitrary four-year deadline would almost certainly lead to rushed decision making.

My hon. Friend the Member for Spen Valley has sought to remedy the disparity, but her solution is not to extend to my constituents in England the safeguard that the members of the Bill Committee—members that she appointed—voted for. No, her remedy is to allow for automatic commencement to happen in Wales as well, removing the safeguard that the Committee voted for. The answer is not to fast-track the roll-out of assisted dying in both England and Wales, potentially putting the lives of some of the most vulnerable at even greater risk due to rushed decisions that are not fully thought through.

I have not been on these Benches for very long, but I know that arguing for the automatic commencement of legislation is generally, in the kindest interpretation, unusual. For legislation of this magnitude it is, I am afraid to say, reckless, and reinstating automatic roll-out in Wales when the Committee explicitly voted against it borders on the undemocratic.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

I visited the Isle of Man and met the sponsor of the Bill there. The House of Keys, which has only 24 Members, took three years to get to this point, and the sponsor of the Bill thinks it will take at least five years to implement the Bill in that much smaller jurisdiction.

[Adam Jogee]

My hon. Friend makes a very good point.