Terminally Ill Adults (End of Life) Bill

Munira Wilson Excerpts

Friday 13th June 2025 Commons Chamber

[Melanie Ward (Cowdenbeath and Kirkcaldy) (Lab)]

I am almost in my 13th hour of trying to speak on this topic, so I hope Members will understand that I am not going to take any interventions. I rise to speak in support of new clause 4, tabled by my hon. Friend the Member for Peterborough (Andrew Pakes); amendment (b) to new clause 14, tabled by my hon. Friend the Member for Rochdale (Paul Waugh); and amendment 13, tabled by my hon. Friend the Member for Glasgow West (Patricia Ferguson).

Let me start by saying that ending suffering is a shared goal of all Members across this House. No one has a monopoly on wanting to end suffering; the question is how best we do it. As a former aid worker and someone who has risked my own life in order to alleviate the suffering of total strangers in war zones, I promise the House that I am motivated to end suffering at least as much as the next Member. It is worth the House knowing, too, that my darling dad died of terminal cancer in a hospice that was run and funded by a charity, because the NHS does not have that provision.

New clause 4 matters, because we do not live in an equal society, although many of us—particularly on the Labour Benches—seek to bring one about. This is a deeply flawed Bill, and the truth is that in seeking to give choice to some, it risks causing new harm to a much larger, vulnerable group of our citizens. The safeguards, which were watered down in Committee, will not prevent this. Indeed, this week, we have seen a letter from over 1,000 doctors saying that the Bill will “widen inequalities” and that it is “simply not safe”. Earlier, we heard a powerful speech from my hon. Friend the Member for Rochdale about the impact of advertising on the most vulnerable. New clause 4 would increase the collection of data about the impact on the most vulnerable and bring in proper oversight from the chief medical officer, including in relation to those with protected characteristics.

Last time we debated the Bill, we heard from my hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis). We are in the shared situation of having close and dearly loved family members who have complex disabilities. My hon. Friend and our families know how it is to have to struggle—to fight every week for the access to basic state services that our loved one is entitled to but cannot access. Those services and precious state resources would increase their equality and ability to live well, but were stretched beyond breaking point by successive Tory Governments. It is that experience that brought me into politics and into the Labour party, and to this day—away from my day job as a Member of this House—I still have to fight on behalf of my loved one, who has significant physical impairments as well as learning difficulties, for them to access the healthcare and support that they desperately need.

Vulnerable people do not always make decisions in their own best interests, and I also know from my family experience that they can be highly susceptible to pressure from others who do not have their best interests at heart. That is why the transparency created by new clause 4 matters. I remind the House, too, that the Royal College of Psychiatrists has described the so-called safeguards in the Bill as “inadequate”, and that in Washington state, almost two thirds of those who had an assisted death in the last year for which data is available cited fear of being a burden on their family, friends or caregivers as a reason for doing so. I do not want that to happen in our country. Over 350 disability rights organisations oppose the Bill as it stands, and one of my constituents has told me that the Bill contributes to a sense among disabled people that “We are disposable.”

Amendment 13 and new clause 4 both make important changes to the role of the voluntary assisted dying commissioner. I ask my hon. Friends on the Labour Benches whether they have questioned the wisdom of the Prime Minister himself having to personally appoint the death tsar—as the media have christened that role—shortly before the next general election.

Finally, earlier this week, I heard an hon. Member say that he believes the Bill is flawed, but plans to vote for it anyway so that it becomes law and we would have to sort out the problems later—we have heard more of that today. The hon. Member did not specify how he thought this would happen, or when. He is right that the Bill is flawed, but he is wrong that we can ignore those problems. To do so would be to fail in our job as legislators. Being in favour of these amendments and against the Bill does not mean accepting the status quo, as some have tried to suggest. It means that we choose, instead, to protect the NHS and to work, to fight and to battle for a palliative care system that is worthy of those we represent, rather than diverting time and energy into helping people to kill themselves.

[Munira Wilson (Twickenham) (LD)]

Even though I am not opposed to the principle of assisted dying, I have a number of deep concerns about the content of the Bill, the process by which we are legislating for such a monumental change and, importantly, the context in which it would be enacted, given the numerous challenges facing our health and care services. That is why I have tabled amendment 21 relating to palliative care and end-of-life needs, which has attracted cross-party support.

I am grateful to the hon. Member for Spen Valley (Kim Leadbeater) for supporting the amendment. I want to pay tribute to her today for kick-starting a debate about dying well and, in particular, about palliative care—a topic that has been neglected by many of us, myself included, for far too long.

Amendment 21 would require the Secretary of State to lay a report before Parliament a year after the Act has passed detailing the availability, quality and distribution of health services to those with palliative and end-of-life needs. Marie Curie estimates that one in four people who could benefit from specialist palliative end-of-life care do not receive it. People who are poorer, less educated and, yes, non-white are even less likely to receive it.

I was horrified, if I am honest, by the earlier speech from the hon. Member for Loughborough (Dr Sandher). All the data shows us that people from minority ethnic communities are less likely to access the healthcare services they deserve, in particular palliative care. There is a deep distrust of health services, and those of us who were in this place during the covid pandemic saw that played out in real time in hospitals and care settings up and down the country, with far more people from minority ethnic communities losing their lives and far more healthcare professionals from ethnic minorities not protected in the way that they should have been. If those people from minority ethnic and disadvantaged communities are less likely to access palliative care as a result of the Bill being passed, contrary to what its supporters say, my fear is that more people—rather than fewer—will die a terrible, horrendous, traumatic and painful death and they will be disproportionately from those communities.

[Dr Sandher]

The hon. Member raises a powerful and excellent point about the people from ethnic minorities who died during covid and their access to healthcare. As she will understand, that is of deep importance to me too. She is right about the need for greater palliative care and I am glad, as she says, that we are having that discussion.

If we look at assisted dying around the world and concern around ethnic minorities being more likely to access it, the stats show that it is the other way around and they are less likely to access it. However, that point is neither here nor there; rather, given that the safeguards are in place, the question is: is the process working well? Those are where the stats are going forward. I believe that the hon. Member raises the matter in good faith, and I thank her for doing so.

[Munira Wilson]

I actually think the stats the hon. Member cited undermine his own argument, because all the data shows us that the members of the communities I am talking about are less likely to access the healthcare services they need and therefore, less likely to end up accessing assisted dying. The hon. Member for Stroud (Dr Opher) gave the game away—he is acknowledging it—that wealthier people tend to access assisted dying more because they have the choice, as well as the services to have that meaningful choice. Those inequalities deeply concern me.

My grave concerns about the Bill becoming law are that the people I am talking about do not have the loudest voices or well-funded campaigns to support them. This whole debate about inequalities in access to palliative care should be the topic of a debate on a separate day and I hope there is the chance to have that debate.

Marie Curie also warns that there is

“no realistic national or local plan to address the scale of this challenge”,

and that the whole system is in “a perilous state” due to a

“lack of sustainable funding…and limited prioritisation of…end of life care”.

A 2023 survey of integrated care boards found that half had no plans to invest capital in palliative care services and 40% admitted that their services were inadequate for the needs of their population.

--- Later in debate ---

[Mr Lee Dillon (Newbury) (LD)]

I hear the argument from hon. Members on both sides of the Chamber about palliative care in this country not being at the level that we would expect, and I accept that. What I do not hear from those who oppose the Bill is exactly what level we need so that assisted dying can go hand in hand with it as a genuine option.

[Munira Wilson]

I note that the Health and Social Care Committee and the hon. Member for York Central (Rachael Maskell) have undertaken a report, so they will advise us on that issue. [Interruption.] I am aware that I need to finish, so I urge hon. Members to support the amendments of my hon. Friends the Members for Wimbledon (Mr Kohler) and for Richmond Park (Sarah Olney) to ensure that we do not allow the Bill to implement sweeping Henry VIII powers on such a sensitive and important issue, and to ensure that we collect, through new schedule 2, important monitoring data on how any assisted dying or death service will operate. We need transparency.

[Lloyd Hatton (South Dorset) (Lab)]

I rise to speak in support of new clause 15 and amendment 54, and against new clause 5. As right hon. and hon. Members will be aware, new clause 15 would not classify a death under the Bill as suspicious or unexpected, so a full coroner’s inquest would not be needed.

If the Bill becomes law, assisted dying would be a legal, strictly regulated and well monitored choice made freely by the individual concerned. To be absolutely clear to hon. Members, it is not assisted suicide. The Bill concerns people who want to live but who, faced with an inevitable, irreversible and terminal diagnosis, want choice over the manner of their death. That is an important choice that removes some of the trauma and anxiety for not only the patients but their family and loved ones. New clause 15 and its consequential amendment 54 will ensure that families who are naturally grieving the loss of their loved one are not needlessly subjected to an invasive coroner’s investigation.