Terminally Ill Adults (End of Life) Bill

Rachael Maskell Excerpts

Friday 16th May 2025 Commons Chamber

[Liz Jarvis (Eastleigh) (LD)]

I am grateful for the opportunity to contribute to this vital debate. It is imperative that we get the Bill right and that the protections and procedures are watertight. I thank my constituents on both sides of the debate who have written to me.

I support amendment 4, tabled by my hon. Friend the Member for Harrogate and Knaresborough (Tom Gordon), which would allow those with neurodegenerative diseases to be eligible for an assisted death if they are within 12 months of dying. Nigel Hartley MBE, the chief executive officer of Mountbatten Hampshire hospice in my constituency, told me that palliative care and assisted dying are not and should not be at odds with each other. Palliative care can provide incredible support. I am very glad that this debate has reopened the national conversation about funding for palliative care. However, as I know from my personal experience with my mum, who died last March after a seven-year struggle with Alzheimer’s, sometimes palliative care can only go so far. Amendment 4 recognises that those with neurodegenerative illnesses deserve the same compassion, control and dignity as others at the end of their lives. By extending the timeframe to 12 months, they will be given more control over their ultimate decision.

I support new clause 10, which extends the right for any professional to opt out of providing assistance under the Bill, and extends the protections to a broader range of professionals who may be involved.

I also support amendments 59 and 62, which relate to training on domestic abuse. Those amendments are critical to ensuring that the co-ordinating doctor can identify signs of domestic abuse. The inclusion of training enhances the Bill’s protective framework, as no medical professional without specific and up-to-date training on domestic abuse will be able to serve as a co-ordinating doctor. Importantly, amendment 74 defines “domestic abuse” using the language of the Domestic Abuse Act 2021, which explicitly includes coercive, controlling and economic abuse.

Amendment 63 removes any ambiguity about the scope of eligibility, and makes it clear that only terminal illness qualifies under this legislation. That clarity is essential to maintaining public trust and ensuring that the Bill is not open to misinterpretation or misuse. It can be incredibly difficult for people with disabilities, and their families and carers, to get their concerns across—they can often feel unseen and unheard—so the amendment is vital.

Finally, I pay tribute to the hon. Member for Spen Valley (Kim Leadbeater) for her work on the Bill and her tremendous courage, determination, willingness to engage and resilience. As others have said, the decision before us is fundamentally about whether we believe in an individual’s right to have choice at the end of their life. I know what my mum would have said.

[Rachael Maskell (York Central) (Lab/Co-op)]

I rise to speak to amendments 26, 45 and 46, which stand in my name and the names of other Members. I am grateful for their support.

On amendment 26, hospice care is not a formulation of care, but a clinical setting where palliative care is delivered, so I trust that the House will accept my amendment in the interests of accuracy.

On amendment 45 and consequential amendment 46, the literature points to complex clinical decision making—which the subject of the Bill is—being safer if it happens in the context of multidisciplinary teams, as was advocated for by the professional bodies at the very start of the process. Such a context screens out unconscious bias and provides for clinical accountability with robust interdependency. It demands a deliberative process and it safeguards clinicians and patients with more secure outcomes. I have talked extensively to the professional bodies and clinicians, and I have read the academic evidence. In drawing on best practice, this amendment would provide such safeguards and ensure that the patient is at the heart of the process.

Members will know from the evidence given to the Bill Committee that the initial assessment is the most important part of the process, and clinicians and professional bodies do not understand why psychiatrists and social workers are being placed in a quasi-judicial role, rather than being used for their clinical and social expertise. The process makes the wrong assumptions. Without the amendments, there is a predication towards an assisted death, rather than the Bill recognising the insecure position that someone with a terminal illness finds themselves in and the safeguards that are required. There are many reasons for suicidality, and they should be explored.

In clinical practice, should someone determine that they want to end their life for whatever reason, a clinician would seek to ensure that the right professionals were involved in the care of the person, with exploration, diagnosis and, where necessary, therapeutic and pharmacological interventions.

[Sir John Hayes]

Will the hon. Lady give way?

[Rachael Maskell]

I will not. Dr Lade Smith, the president of the Royal College of Psychiatrists, could not have been clearer, and academic research says the same: when someone is in receipt of a terminal diagnosis, there is frequently an episode of depressive disorder. Dr Price said in evidence:

“Those who had a wish to hasten death were 18 times more likely to also feel suicidal”.––[Official Report, Terminally Ill Adults (End of Life) Bill Public Bill Committee, 30 January 2025; c. 275, Q359.]

They say that mental disorders are treatable. The spike in suicidal ideation and action is highest in the first few months following terminal diagnosis and then dissipates with time or intervention. Again, that is evidenced. People change their mind and no longer want to die.

As with other aspects of the Bill, poor care, poor pain management and poor symptom control—or the fear thereof—are reasons why people seek to end their life. That can be palliated. Colleagues must recognise the paucity of mental health provision given to somebody when they receive a terminal diagnosis. Often there is no psychological aftercare. People are failed, but that should not be a reason to die.

I ask for a panel, which would include a social worker, to assess the psychological needs of a patient. They are experts in detecting coercion, whether intrinsic or extrinsic, and understanding people at their most vulnerable with a fusion of complex emotions, anxiety and fear. Solutions can be found by them. There would also be a psychiatrist. Depression, anxiety and fear are natural responses to trauma, but they can be treated with the right interventions, if detected at the point that somebody expresses a wish to die, and a person can have a wish to live. The travesty of getting it wrong is unconscionable.

There would be a palliative care consultant who is registered on the GMC’s specialist register. They would understand the actions that could alleviate someone’s suffering. Evidence to the Bill Committee from Sue Ryder showed how poor provision led to someone considering an assisted death. Likewise, the president of the Association for Palliative Medicine, Dr Sarah Cox, said:

“We know that effective palliative care can change a terminally ill person’s point of view from wanting to die to wanting to live.”––[Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 28 January 2025; c. 70, Q84.]

That is evidence. It is a point I have heard from all leaders on the Commission on Palliative and End-of-Life Care. These are the specialists who know how to palliate the physical, psychological, social and spiritual problems of a patient, and they have techniques that many people have not had access to, because of poor provision.

The palliative care commission reported on Tuesday and I urge hon. Members to read its evidence-rich report, which draws on best practice. We reported that excellence in end-of-life provision is achievable, but that too many people are not getting access to it. Without that, I fear that the Bill only leads the patient down one route—to die. This is not a choice at all, but a path to an assisted death.

Sanctions Implementation and Enforcement

Rachael Maskell Excerpts

Thursday 15th May 2025 Commons Chamber

[Stephen Doughty]

The right hon. Gentleman will know that we have been ramping up that pressure—indeed, the new measures we took just last night on support to Russia and its military industrial complex do exactly that, let alone the huge package of designations we have introduced against the shadow fleet. Again on the topic of enforcement, during its first six months of operation—from 1 October last year to 6 April this year—the UK’s voluntary insurance reporting mechanism has challenged 271 suspected shadow fleet vessels in the English channel on their insurance. Not only are we putting these measures in place, but we are following up on them. We have been very clear that President Zelensky is serious about peace—he has repeatedly shown that by his actions. Vladimir Putin has not. We are clear that our sanctions will remain in place and we will continue to do all we can to choke off support for the Russian war machine, which is causing such devastation in Ukraine.

[Rachael Maskell (York Central) (Lab/Co-op)]

Given that sanctions provide crucial leverage and deprive individuals and regimes of power and resources, it is vital that they are applied equally. When we see the effect that sanctions have had on Putin’s Russia, we question why the Government have not brought equality against the Israeli regime, whose treatment of the Palestinians is pushing people into starvation and famine and ultimately bringing 2.1 million people to their deaths. In light of Israel’s actions, we need equality, and while I understand that the Minister will not make pronouncements from the Dispatch Box today, could he set out how he formulates the evidence by which the thresholds are reached for sanctions to be applied? Will he look again at those frameworks to ensure that there is equality, so that we can use sanctions effectively and the world understands where this country is coming from?

[Stephen Doughty]

My hon. Friend asks about the broad principles that underlie our sanctions action. Essentially, there are three parts: the first is to deter malign activity, the second is to disrupt malign activity, and the third is to demonstrate values. As I referenced, we have imposed sanctions in relation to extreme settler violence, and we have worked with other partners on a range of measures. She will understand that I am not going to comment on future designations, as I said a moment ago, but we remain deeply seized of the situation in Gaza at present. The Minister for the middle east, my hon. Friend the Member for Lincoln (Mr Falconer), as well as the Foreign Secretary and others, are deeply engaged with this issue, and I have set out a number of the steps we have taken to respond to it.

My hon. Friend can be assured that we act around the world through our sanctions regime, and I have given a number of examples—not just geographic areas, but in relation to themes. I have mentioned the theme of tackling illicit finance and kleptocracy more widely. We have introduced a number of measures in that regard, so she can be assured that this is not simply about Russia and Ukraine sanctions, but about acting globally.

Gaza: UK Assessment

Rachael Maskell Excerpts

Wednesday 14th May 2025 Commons Chamber

[Mr Falconer]

The House has heard me speak of my frustration on a number of occasions—I share that with my hon. Friend. I think I have addressed the three substantive points that he raises already in this session.

[Rachael Maskell (York Central) (Lab/Co-op)]

You’re the Minister!

[Mr Falconer]

I am the Minister; these responsibilities weigh particularly heavily on me. I am not blind to the IPC or to Tom Fletcher’s testimony at a session that we called. Do hon. Members think that I am unaware of the horrors being meted out to people in Gaza? I am not unaware: I am taking every action that I can, as are other Ministers. It is an intolerable situation, as hon. Members heard from the Prime Minister earlier, and we are lifting every effort to try to change it.

--- Later in debate ---

[Rachael Maskell]

UK manufacturers of F-35 components can place GPS markers on every single component, and the UK Government can ensure that every component that is exported has a GPS marker on it, so what is the Government’s excuse for continuing with their programme on F-35s when they can distinguish the destination of every single component?

[Mr Falconer]

I have set out the position on F-35s and the manner in which the global spares pool works. That is information provided by the experts who are responsible; I understand that some hon. Members may disagree with those facts. The discussion is happening in a judicial review this week, and I will not get ahead of that process.

Palestinian Authority Prime Minister Visit

Rachael Maskell Excerpts

Tuesday 29th April 2025 Commons Chamber

[Mr Falconer]

As I said in my previous answer, we are clear that the single most significant contribution that can be taken on that problem is ending the blockade of Gaza. We have been clear with the Israeli Government at the highest levels, including on 15 April, in the meeting between the Foreign Secretary and his Israeli equivalent, that that blockade must be lifted. On the longer-term questions of health and some of the other basic social services, I will say that of course we discussed those issues with the Palestinian Authority and relevant Ministers over the past two days. As the right hon. Gentleman says, this is very urgent, and the World Food Programme has been clear. That is why we made the statement over the weekend.

[Rachael Maskell (York Central) (Lab/Co-op)]

It was sobering yesterday listening to Dr Mustafa, the Prime Minister of the Palestinian Authority, not least as he stressed the UK Government’s leadership role and the importance of the recognition of the state of Palestine. Bearing in mind that leadership role and the fact that 147 jurisdictions already recognise that state, will the Minister explain to the House today the reasons for the impediment to that recognition? It is really important that we hear that, because we are here to hold the Government to account.

[Mr Falconer]

Some 147 states have recognised a Palestinian state, yet no Palestinian state is fully functioning. That underlines the importance of taking the practical measures that will be absolutely vital not only to support Palestinian life, but to ensure that two states can co-exist peacefully, side by side. Many Members have referred to some of the practical impediments, whether it is the removal of Hamas from the Gaza strip or the economic challenges that face the Palestinian territories in both the west bank and Gaza. Let me be clear. An extremely violent conflict continues. Without a ceasefire, it is hard to imagine the creation of a state. I am sure that we will continue to discuss the merits of recognition, but let us not pretend that there are not serious practical considerations to bear in mind before the practical establishment of a Palestinian state is possible. The British Government are focused on changing the actual facts on the ground. That is the approach that we will take.

London Sudan Conference

Rachael Maskell Excerpts

Thursday 24th April 2025 Commons Chamber

[Mr Falconer]

Like the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell), the shadow Foreign Secretary raises important questions about the African Union. We thought it was particularly important that we co-hosted this event with the African Union; clearly, this is an important conflict with wide implications for those in the neighbourhood and in east Africa. We are taking practical steps, and we conducted the conference in closed session in order to enable the kind of frank discussion that is required to advance towards a more peaceful solution in Sudan.

I would not wish to give the House the impression that we have made dramatic progress towards an end to the violence in Sudan. We are all familiar with the terrible reports that continue to come in—even this morning—of events in Darfur and across Sudan.

Through the conference, we were able to bring greater unity among the international community on what the necessary next steps must be and on the importance of maintaining open border crossings, which, as the shadow Foreign Secretary sets out, are vital, in addition to trying to ensure that humanitarian access can be exercised right across Sudan. We have been in discussions with Tom Fletcher, the emergency relief co-ordinator, who has today spoken to some of the key participants. In terms of practical steps, I can confirm that we remain in direct contact, through our special envoy for Sudan, with both the RSF and the Sudanese armed forces. We are absolutely clear that we need a civilian process towards civilian Government.

[Rachael Maskell (York Central) (Lab/Co-op)]

The Government were right to co-ordinate this conference as a first step on the path to peace. It is obviously disappointing that it was not possible to establish a contact group at the end of the conference, but I know the Minister will be working hard to progress bilateral talks, not least with the external actors in this conflict such as the UAE and Egypt.

I want to put the spotlight on women and girls in this conflict, who are experiencing high levels of sexual violence. What discussions were there on the protection of women and girls, and on the further steps that could be taken both to ensure the safety of those experiencing trauma today because of their experiences and to protect women and girls in the future?

[Mr Falconer]

My hon. Friend is absolutely right to put the focus on violence against women and girls in Sudan. It is absolutely appalling—the latest reports are lurid and graphic in their details of what is befalling women and children right across Sudan. The Minister for Africa has been leading international efforts to maintain a spotlight on these questions. He chaired a UN Security Council briefing on conflict-related sexual violence in Sudan just last month, and was also at the UN Security Council in November further highlighting this issue. This conflict is disproportionately affecting women and children, and the UK will remain completely focused on doing everything we can to bring that to a close.

Persecution of Christians

Rachael Maskell Excerpts

Tuesday 8th April 2025 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to see you in the Chair, Ms Butler.

As we prepare ourselves for Easter, it is right that we turn our eyes to those persecuted around the world for following Christ, so I pay tribute to my hon. Friend the Member for Newport West and Islwyn (Ruth Jones).

It has been poignant and humbling to listen to the speeches by Members today, as it is sobering and challenging to read the reports of those who share the same faith as me but whose experiences are so different. Today, around a third of the population, and growing, share the Christian faith in the far reaches of the world, but for many their experiences are so different. As we ruminate over the census of decline here in the UK, we see the persecution of Christians around the world, and the sharp intolerance and violence that their faith often draws.

The Open Doors world watchlist, Aid to the Church in Need, overseas organisations and charities, among many, expose the deep scale of persecution on the basis of faith. Most conflicts and war crimes are also associated with faith, and we know that about 380 million Christians across our planet are killed or experience high levels of persecution because of their faith. We see suppression and imprisonment of people, and the destruction of churches. If there is not such sexual or physical violence against Christians in the west, persecution can often show itself as psychological or spiritual suppression of the all too few who dare to speak the name of Jesus freely—even in a place like the UK, where there are no bounds but people still dare not speak his name.

There are three policy areas that I will touch on briefly. One is covered by the Home Office—ensuring that we have safe and legal routes for people who experience persecution to come to the UK. We talk about such routes, but the reality is so different, and because I represent a human rights city, that is a vital point.

The second area is covered by the Foreign Office. ODA has an incredible impact, ensuring more security and greater resilience, and it is so important that we return to 0.7%. Even in a world where our global economy is so disrupted, we must find space to restore ODA to 0.7%.

Thirdly, on trade, I think about China, as I always do. It is 15th on the Open Doors world watchlist, yet we have just signed a trade agreement with it. How much emphasis was put on the need for freedom of religion and belief in China alongside the ink that marked that agreement? We think, of course, of the suppression of the Church and its leaders in China, and of the public denial of the sacraments to Jimmy Lai. It is so important that we review our policy. We said when we left the EU that we would put human rights at the heart of our trade agreements, but we have work to do to achieve that.

This week, I was listening to a sermon ahead of Easter, which reminded me of persecuted Christians around the world. It talked about coming to the end of the road, where there is no hope, as the Israelites came to the Red sea and the disciples came to the cross. It marked so much as the end. In a nation and world in chaos and crisis, it is hard to find hope. For many persecuted Christians, who are imprisoned and tortured or living in fear, it is hard to find hope. There is such little hope in politics, on our streets or across the world. Yet the sermon went on to say:

“and then there was Jesus”.

That spins logic, and everything else, on its head. The Red sea opened. There was resurrection Sunday. For all of us who put our trust in Christ, we know that there is eternal hope.

It is with that hope that we see the most incredible witness of those who are persecuted. Their hope and their unfathomable joy reminds us all that no regime can suppress the cast-iron security that the Easter message brings. Such hope could not hold Jesus in a grave. It enables persecuted Christians, and all of us, to know that no matter what we face, Jesus is always with us and always will be. As we invest in Him, we invest in ourselves, and have such certainty that the hope in this broken world, including for those who are persecuted, will never be destroyed and can only be found in Him.

Gaza: Israeli Military Operations

Rachael Maskell Excerpts

Wednesday 2nd April 2025 Commons Chamber

[Mr Falconer]

As the hon. Gentleman knows, I was a diplomat before, and ultimately it is diplomacy that will resolve this conflict. That is the lever to which we must most vigorously apply ourselves.

[Rachael Maskell (York Central) (Lab/Co-op)]

Just suppose that we closed our airbase in Cyprus. Just suppose that we applied greater sanctions, and withdrew export licences. Just suppose that we recognised the state of Palestine. Would the Minister be making the same statement? What analysis has he made of that?

[Mr Falconer]

It is hard enough to respond to the facts as they are. I will not be drawn by my hon. Friend into such a complex chain of hypotheticals.

Conflict in Gaza

Rachael Maskell Excerpts

Thursday 20th March 2025 Commons Chamber

[Mr Lammy]

I condemn any attempts to annex Gaza or the west bank. I know that the right hon. Gentleman has raised this issue in the past. It would not be appropriate for me to comment on operational military matters, but I have been absolutely clear about our assessment. Under the legislation that he and I supported when it was put through this House under the last Government, the assessment is about there being “a clear risk” of a breach of international humanitarian law. I remind the House gently, as a lawyer, that that assessment of a clear risk is a low standard, but on the assessments that I have seen and continue to see, that is my assessment. I therefore think the right hon. Gentleman should be comforted that we are not assisting in what we are seeing in Gaza.

[Rachael Maskell (York Central) (Lab/Co-op)]

May I correct my right hon. Friend when he uses the words “both sides”, since neither the Israeli Government nor Hamas represent the interests of the Palestinian people? We need to recognise that they do not have the voice necessary to bring them the protection that they need. However, I want to raise the definition of genocide. Many times, my right hon. Friend has rightly said from the Dispatch Box that it is for the courts to determine whether or not a genocide has been committed. Can he say what efforts he has made to ask the courts to make such a ruling?

[Mr Lammy]

As my hon. Friend probably knows, I meet from time to time with those who lead our international humanitarian law architecture, including the International Criminal Court in particular and the International Court of Justice. These are constitutional matters for them, and we must stand by the separation of powers, and therefore it is right that they get on and do their proper work. We as politicians make our judgments, but we are not courts. We cannot pronounce that from this Dispatch Box—certainly not on behalf of a Government. In a free democracy, Back Benchers are of course free to say whatever they feel in this House, and that is proper, but speaking on behalf of a Government, it must be right that courts make these determinations.

Gaza

Rachael Maskell Excerpts

Tuesday 4th March 2025 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

Order. I am planning to run this urgent question for only about another 10 minutes, so it would be very helpful if questions were short, please.

[Rachael Maskell (York Central) (Lab/Co-op)]

Over recent days, we have seen the power of co-ordinated action when addressing a most challenging diplomatic, military and humanitarian crisis, yet in 17 months we have not seen a parallel in addressing the challenges over Gaza. What action is the Department taking to ensure that there is such a co-ordinated effort, and will the Foreign Secretary call such a summit?

[Catherine West]

I thank my hon. Friend for that suggestion. The UK will certainly continue to work, as it has done, ceaselessly with Israel, the Palestinian Authority, the US and regional partners to build consensus for a post-conflict Gaza governance and security framework that supports conditions for a permanent and sustainable peace. Her request has been heard in the Chamber.

Oral Answers to Questions

Rachael Maskell Excerpts

Tuesday 25th February 2025 Commons Chamber

[Anneliese Dodds]

As I just stated, our policy on reparations is clear: we do not pay them.

[Rachael Maskell (York Central) (Lab/Co-op)]

11. What steps he is taking with his international counterparts to help de-escalate the conflict in Sudan.

[The Secretary of State for Foreign, Commonwealth and Development Affairs (Mr David Lammy)]

Ending the conflict in Sudan is a personal priority for me. I recently visited the Adré border with the Chadian Foreign Minister to increase international attention on Sudan, and to meet Sudanese civilians who are bearing the brunt of this crisis. I am happy to announce that I will convene Foreign Ministers in London in April, around the second anniversary of the outbreak of the civil war in Sudan, to foster international consensus on a path to ending the conflict.

[Rachael Maskell]

I thank the Foreign Secretary for all that he is doing. As in so many conflicts, the discourse about this brutal Sudanese war is being fuelled by external actors with economic and mineral interests in Sudan, and with interests in wider geopolitical agitation, such as Russia; Egypt, with its support for the Sudanese Armed Forces; and the UAE, with its support for the Rapid Support Forces. There is also the wider user of mercenaries. What further steps can the Foreign Secretary take to use our leverage, not least our trading leverage, to ensure that actors are not fuelling this horrendous war and humanitarian crisis?

[Mr Lammy]

My hon. Friend will be pleased to hear that I raised these issues in my contribution at the G20. I had a lengthy discussion with Amina Mohammed of the United Nations, with the Foreign Minister of Angola, and with President Ramaphosa on the situation in Sudan. I am looking forward to convening this conference in London, and working with the French and the African Union. We continue to emphasise, with all international partners, the importance of refraining from actions that prolong the conflict.