Terminally Ill Adults (End of Life) Bill Debate

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Department: Department of Health and Social Care

Terminally Ill Adults (End of Life) Bill

Lord Gove Excerpts
Friday 14th November 2025

(1 day, 10 hours ago)

Lords Chamber
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Lord Rooker Portrait Lord Rooker (Lab)
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My Lords, in my modest experience of six departments in both Houses of Parliament, I have always come to the conclusion and repeated that Whitehall does not do devolution. By the way, I declare an interest: I live in England but within 10 miles of the border of Wales. Therefore, I commend the noble Lord, Lord Harper, on raising this in a practical fashion that probably nobody else in the House is able to do. I doubt that Members of Parliament in the other place had the opportunity to raise it in detail, because there will be MPs running on both sides of the border. I commend him on raising it, and I resent the fact that he was interrupted at the end.

Lord Gove Portrait Lord Gove (Con)
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My Lords, I support the noble Baroness, Lady Coffey, in raising this question. Whether or not the suggestion from the noble Baroness, Lady Coffey, is the right way of addressing this issue is genuinely a moot point. But she is absolutely right to raise the whole question of the fitness for purpose of the Bill, given the nature of our devolution settlement.

I speak with a modicum of experience. For just over four years, I was the Conservative Government’s Minister for Intergovernmental Relations, responsible for seeking to make the devolution settlement work at a time when we obviously had a party of one colour in government in Westminster and parties of very different complexions in Belfast, Cardiff and Edinburgh. Prior to that, as Secretary of State for Justice, Lord Chancellor and Secretary of State for Environment, Food and Rural Affairs, I had to navigate the thickets of our devolution settlement.

It requires care to make it work. In order to do so, we have to take account of conventions, of legislative competences, of precedents and, as my noble friend Lord Harper pointed out, of the interwoven nature of the lives of communities that live on our borders. It is absolutely right that we should do so, both as a revising Chamber and as a revising Chamber considering legislation of such moment.

As everyone has pointed out during the passage of the Bill, strong feelings are engaged on every side. If we are thinking about fundamentally changing the responsibility of the state and our NHS when it comes to the balance between alleviating pain, prolonging life and, in certain circumstances, ending life, then we must proceed with care.

It was the explicit wish of many in the House of Commons, including in Committee, that the Bill takes seriously the operation of the legislation—so it is not finicky, an abdication of responsibility or something to be criticised when raising these specific and precise questions. It is our role.

Of course, many of us recognise, whatever our feelings on the Bill, that the House of Commons clearly gave its express wish that those who are living with a condition that means that their life will soon end in any circumstances should be able to choose the timing and manner of their death. I respect that clearly expressed wish. Some of us may take a different view about that imperative sent to us from the House of Commons as a matter of first principle, but all of us have a responsibility to look at how the legislation operates, because we are not in the business of simply recognising and respecting a sentiment, no matter how sincere; we are in the business of introducing legislation that must work and be made to work. Therefore, it is our responsibility in the days ahead to look in detail.

That is why I make no apology for specifically referring to the operation of the Sewel convention. Introduced by Lord Sewel of Gilcomstoun, a fellow Aberdonian and a former Labour Minister, it is a convention that broadly governs how we and the Government should legislate with respect to devolved matters. The Sewel convention makes clear that the Government should not normally legislate in areas that are strictly devolved without the full consent of the devolved legislative chambers—the Senedd Cymru, the Holyrood Scottish Parliament or the Northern Ireland Assembly.

Because it is a convention, of course it is the right of Westminster—Westminster is ultimately sovereign—to legislate without that consent. But the broad convention, on which the success of our devolution sentiment rests, is that that should be exercised only sparingly. This point was made very well and repeatedly by the promoter of the Bill in this House himself, the noble and learned Lord, Lord Falconer. On a variety of occasions in the past, when the Government of which I was part sought to legislate in a way that may have caused disquiet or opposition in devolved legislatures, he has pointed out the importance of the Sewel convention, and he is not alone in doing so.

The former Prime Minister, Gordon Brown, in a report commissioned by the current Prime Minister in the other place on the operation of the Sewel convention, recommended that the Sewel convention be made justiciable and that it should be the case that it should move from a constitutional convention to be a legislative part of our constitution. The Government have not yet taken that step, but it is the stated intention and policy of the Government to ensure that, if one did choose to legislate without the consent of a devolved legislature, that would be capable of challenge in the courts, which it is not yet.

In stressing the importance of making sure that we proceed with care, I am doing no more than expressing not just my experience of how important it is to respect the devolved sentiment but my acknowledgement of the direction of travel that the Government had set out with their belief in making the devolved settlement work better.

The point has been made that our devolved settlement with regard to Wales is complex, and indeed it is, as a number of noble Lords have pointed out. Crime and justice are not devolved, but health is. But again, even in the area of crime and justice, there is no settled will.

I participated in the convention looking at the future of the constitution with regard to Welsh devolution, led by the former Archbishop of Canterbury, Lord Williams of Oystermouth—Rowan Williams. In it, he made the case—I believe it is a case that exercises the sympathy of the noble and learned Lord, Lord Thomas of Cwmgiedd—

Baroness Watkins of Tavistock Portrait Baroness Watkins of Tavistock (CB)
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My understanding is that the Senedd is undertaking its usual processes around legislative consent, with reports from the health committee and the justice committee to be published soon. A date for agreeing legislative consent has not been set, but it is likely to be either shortly before or immediately after Christmas. It normally would take place before Report, so that amendments can be drafted in line with the feelings of the Senedd at the time. I wonder whether we need to look forward rather than historically.

Lord Gove Portrait Lord Gove (Con)
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I am grateful to the noble Baroness for making that point, because it takes me to two of the points that I was about to make about the two committees in the Senedd that have looked at this: the Legislation, Justice and Constitution Committee and the Health and Social Care Committee. Both have explicitly raised concerns about this legislation.

The point that I was making about criminal justice is that, if there is a broad view among what one might call progressive parties in Wales—and certainly those parties that are likely to form a majority after the next Senedd election—it is that crime and justice should be devolved. That is not the case at the moment. It should not govern how we legislate in this House. But if we have to have regard to sentiment and to making the devolution settlement work, as I believe we should, we should be aware that legislating without the consent of the Senedd in areas such as crime and justice is certainly putting an additional strain on the devolution settlement. Let me put it no more highly than that.

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Lord Falconer of Thoroton Portrait Lord Falconer of Thoroton (Lab)
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Hold on. Consider whether it represents the right position.

Can I just deal with two other points? First, the noble Baroness, Lady Smith, in a very clear speech, said maybe one should amend the Bill to give the Welsh Senedd the power to make a decision about the criminal law in relation to assisted dying. It was a point I thought the noble and learned Lord, Lord Thomas of Cwmgiedd, was sort of flirting with. We have not taken that view. We have taken the view that the right way to deal with this is in accordance with the existing devolution settlement.

If the noble Lord, Lord Gove, has not been satisfied with my answer so far, he may continue with his question.

Lord Gove Portrait Lord Gove (Con)
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I am very grateful to the noble Lord for the clarity there. As a broad point, the devolution settlement encompasses not just inter-governmental relations but respect for devolved legislatures and their committees. With respect to that, the Legislation, Justice and Constitution Committee of the Senedd has expressed concern that the Welsh Government have said that only a narrow number of clauses in the Bill should be subject to commencement by Welsh Ministers in the Senedd alone and has expressed concern about the lack of detail from the Welsh Government on these matters. I would be very interested in the noble and learned Lord’s views about the adequacy of both the Welsh Government and the UK Government’s sharing of information. More broadly, the committee also pointed out that there is dubiety at the very least about whether Clauses 42(1), 42(2), 51(2) and 51(3) of the Bill will be implemented only by regulation of Welsh Ministers or will be subject to automatic commencement through the automatic commencement backstop in due course.

Lord Falconer of Thoroton Portrait Lord Falconer of Thoroton (Lab)
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In relation to the noble Lord’s first point, the Legislation, Justice and Constitution Committee’s point about the width of the legislative consent Motion is that it wants the LCM to extend not just to the health provisions but also to those that relate to the change in the criminal law and the safeguards. It argues that those changes in the criminal law should also be subject to it. My view—and it is a view I think shared by the Welsh Government—is that, no, you do not need a legislative consent Motion for the UK Parliament to do that which it is entitled to do, which is to change the criminal law. I give way to the noble Lord, Lord Harper.

Lord Falconer of Thoroton Portrait Lord Falconer of Thoroton (Lab)
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Sorry, the noble Lord, Lord Gove, asked a second question which I did not answer.

Lord Gove Portrait Lord Gove (Con)
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I am very grateful for that clarity, because it is clear that as a result of that, even though Westminster will be operating within its own legislative competence, it will be doing so in a way that violates the expressed wish of the committee. Again, as I pointed out in the previous section of this debate, it is also the expressed wish of many within Welsh Labour to see criminal justice devolved, but put that to one side.

The other key question was: can Welsh Ministers commence Clauses 42(1), 42(2), 51(2) and 51(3) of the Bill by their regulations only, or might the automatic commencement backstop apply in those cases?

Lord Falconer of Thoroton Portrait Lord Falconer of Thoroton (Lab)
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It will depend on the decision made by the Welsh Ministers. I give way to the noble Lord, Lord Harper.

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Lord Gove Portrait Lord Gove (Con)
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My Lords, I speak briefly in support of the point made by the noble Baroness. I entirely understand why many Members of the Committee regard the suggestion to replace “capacity” with “ability” as wholly inadequate. The challenge that has been made by my noble friend Lord Markham and others is entirely fair enough, but the definition of “capacity” in the Bill itself is inadequate.

It is the case that the Mental Capacity Act was not designed for this purpose and that this legislation has been retrofitted to use the Mental Capacity Act because inadequate effort was put into defining the ability of an individual to make this decision in an appropriate way. It is the case that the Office of the Parliamentary Counsel has made it clear that the effort to put this Bill together was “done on a shoestring”. It is also clear, as the noble Baroness pointed out, that the Royal College of Psychiatrists—the people who are responsible for addressing mental capacity—said that assessing a person’s mental capacity to decide to end their own life is an entirely different and more complex determination requiring a higher level of understanding than assessing capacity for treatment decisions, which is the purpose of the MCA.

We have been told by those responsible for the mental health of vulnerable people that the safeguard that we are about to legislate for is inadequate. More people will be placed at risk by its inadequacy. We may feel that the noble Baroness, Lady Finlay, in putting forward “ability”, is failing to meet the needs of the legislation. However, it is not her responsibility, but our collective responsibility, the promoter of the Bill’s responsibility and the Government’s responsibility to ensure that psychiatrists and this House can be satisfied that the threshold is sufficiently high.

We all recognise that, while this Bill may be about respecting personal autonomy, personal autonomy is not sovereign. We recognise that there may be circumstances in which that right cannot and should not be exercised. The promoters of the Bill have been very clear that they want to draw the lines narrowly to ensure that this is available only to people who are consciously capable at a time when their life will automatically end within a certain period.

Lord Empey Portrait Lord Empey (UUP)
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Does the noble Lord agree with me that one of the issues, which has been sporadically mentioned, is the inconsistency of capacity or ability brought about by the interaction of certain drugs on an individual? They may be lucid at a particular point in time, but not lucid at another. Under our current proposals, the people who would be making that judgment do not even have to know or to have treated that person. Surely that has to be dealt with in any definition.

Lord Gove Portrait Lord Gove (Con)
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The noble Lord is absolutely right. Again, there has been some debate about the evidence from psychiatrists and the reasons why they expressed doubts, but that evidence is plentifully available to Members of this House.

As a number of Members have made clear, the work of Alex Ruck Keene KC and the Complex Life and Death Decisions group of King’s College, which is available to this House and was examined in the Select Committee, makes it clear that the Mental Capacity Act is inadequate. It is inadequate to deal with the concept of suicidal ideation that occurs. It is inadequate to deal with the fact that capacity fluctuates, and that fluctuation can be affected by mental health and well-being in its broadest sense, as well as by other syndromes and conditions.

The psychiatrists would not have intervened as they did if they had felt that this was a matter that could be left to one side, a matter that was entirely, as it were, within the scope of parliamentarians or legislators to shrug their shoulders and to accept. They have sent a message to us that the Bill as framed endangers those who are most vulnerable. Can we really proceed on the basis of the MCA, a piece of legislation conceived at a different time for a different purpose and rendered in the eyes of the professionals as not the correct way to go forward?

Baroness Murphy Portrait Baroness Murphy (CB)
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My Lords, I wish to comment on the previous statement made by the noble Lord, Lord Gove. I am a fellow of the Royal College of Psychiatrists, and I must have used the Mental Capacity Act dozens of times throughout my career. Capacity assessment, and how to do one, is included in very extensive codes of practice and in the training that people have. It includes ability in those things that have been mentioned. You need to know whether somebody has understood those elements that go to make up capacity to make a specific decision. It is a tried and tested piece of legislation. I will come back to it when we get to the amendments to Clause 3, but there is nothing in the capacity assessment that excludes making an appropriate judgment or having a really good understanding of the ability of the individual to grasp what is being proposed and all those things around it. It takes account of fluctuation—remember that this has to be a settled decision, and it takes account of that.

I did not want to say this, but noble Lords should understand that there has been internal politics inside the Royal College of Psychiatrists. There has been a serious shift towards against supporting this Bill, not since it came to the House but because of a change of personnel at the top of the Royal College of Psychiatrists. The individuals who made up the report that now comes to the House, both from the GLAD group and from, for example, Dr Annabel Price. She has a personal view that she does not like the principles of the Bill and would not support it.