Terminally Ill Adults (End of Life) Bill (Fourth sitting)

Rachel Hopkins Excerpts

Committee stage
Wednesday 29th January 2025 Public Bill Committees

[The Chair]

I mean no discourtesy to the Committee, but we have 20 minutes, and 10 Members wishing to ask questions, so we have to move this on I am afraid.

[Rachel Hopkins (Luton South and South Bedfordshire) (Lab)]

Q Can I ask you, Mr Amin, about your views on coercion, particularly in the light of clause 2 in reference to the Mental Health Act 1983 and the Mental Capacity Act, and any thoughts you have about that in relation to the groups you represent?

Yogi Amin: As I said, I have worked in this area for over 20 years. I represent individuals week to week in this area and safeguarding is all across what is needed for these individuals. The professionals who are involved in their lives are regulated. We are talking about doctors who are meeting individuals, and they understand what it means to identify safeguarding triggers and where referrals are required. That makes it quite strong in this particular Bill.

I am comfortable with the wording as you have it in the Bill, and I say that as someone who has worked in the area for many years. Lawyers will go to court and pick over words, but the way it is drafted, it is understood that there is voluntariness, as described in the Bill, and coercion. I do not think that additional words are necessary to describe what is required here—it is a voluntary, free-will decision, and coercion is defined. When we are talking about a doctor trying to understand that and a court then interpreting it, I think it is pretty clear what that is, so I am comfortable with the way it is drafted.

Generally, from a safeguarding perspective, there are, as Tom said, a number of points at which professionals ask individuals for a decision on this over a number of weeks, and it goes into months. There is quite a robust process. I point also to footnote 3 for paragraph 4 of my written evidence, where I have referred to the current existing law outside the Court of Protection, where it might be thought that the person has capacity but there are concerns about coercion and so on. There is, under section 42 of the Care Act 2014, the provision for safeguarding referrals. There is, under section 222 of the Local Government Act 1972, provision for a local authority where referrals are made to bring the matter before the court under the inherent jurisdiction.

The inherent jurisdiction does not go away; it is here and available where there are concerns over the safeguarding of an individual to allow them to make their own individual, free-will decision. It is not there to do anything other than protect that individual and have a safety net around them to ensure they can make individual, autonomous decisions. Nothing needs to be tinkered with in the current Bill, because that is there—Parliament has already provided for that. Have I answered your question?

[Rachel Hopkins]

You have given clarity. Thank you.

[Juliet Campbell (Broxtowe) (Lab)]

Q My question is for Professor Shakespeare and Dr Griffiths. Clause 4 of the Bill offers the opportunity for clinicians to instigate the discussion on assisted dying. Could you both tell me your view on that, please?

Professor Shakespeare: It is natural and right that somebody should discuss their wishes with a doctor who supports and treats them. I do not think there is a problem there. Marie’s suggestion that there should be a wider body to look at this is very relevant. At the moment, doctors refer women for abortions, and that does not stop them also supporting pregnant women. I do not think that women would distrust their doctor because they are sometimes involved, at some point, with an abortion decision. That is quite obvious. As my colleague Yogi Amin said, the Bill covers what the terminal illness is, and why we should support people to voluntarily exercise their choices. Lots of doctors will not be in favour of this, but they will be clinically professional and they will discuss with the person. I do not have a concern about that. You are more likely to be kept alive against your will than you are to end your life under this Act.

Dr Griffiths: My first point is that, for me, the Bill raises concerns because it relies on doctors’ interpretations of prognosis. If a doctor assumes that you have six months left to live, and is therefore going to start having a conversation with you about the possibility of assisted suicide, that draws into question how we allow assumptions to be made about whether an individual has six months left to live. That is particularly the case given that we have evidence that shows that, with certain interventions or mishaps surrounding prognosis, individuals can live for months, years and decades longer. The idea of bringing in the conversation from the point of view of the medical practitioner could, arguably, accelerate one’s death—if you take into account that their idea of prognosis might be flawed.

It also, I think, raises problems, because we know that many individuals with health conditions and impairments—irrespective of whether we want to create this false line between disabled people and people with terminal illness—do not have access to advocacy or representation in these kinds of processes. Having a conversation where there is extreme credibility and validity that rests on the medical practitioner could exacerbate issues around coercion.

We could take a moment of reflection. When we were going through the pandemic, the Parliamentary and Health Service Ombudsman highlighted how medical practitioners could think about “do not attempt resuscitation” orders and how they were utilised in the disabled people’s community. That has parallels with the issue we have here, where medical practitioners will be making assumptions about whether conversations or applications should be made.

Yogi Amin: Can I just raise one point on representation? I point Members to paragraph 10 in my written submission, which tries to make the important point that if we are involving courts, individuals need access to justice. They need access to advice, and that means legal aid. I point in that paragraph to the provision of non-means-tested legal aid, just like in the case of parents of children and the withdrawal of life-sustaining treatment. Those current rules are in place for parents, and a similar arrangement could be put in place for individuals who are brought before the court in this matter.

Hospice Funding

Rachel Hopkins Excerpts

Thursday 19th December 2024 Commons Chamber

[Karin Smyth]

The hon. Gentleman was a Government Minister, so he had plenty of opportunities to change the system, had he wanted to do so at the time.

[Rachel Hopkins (Luton South and South Bedfordshire) (Lab)]

I thank the Minister for her announcement of a huge funding boost for the hospice sector. Will she join me in thanking all the brilliant staff at Keech hospice, which serves Luton South and South Bedfordshire, and especially all the volunteers who are out fundraising with Smiley Sam and Santa’s train across the streets of Luton, including Farley Hill tomorrow and Wardown Crescent on Saturday?

[Karin Smyth]

I thank my hon. Friend for making that point, and wish the volunteers well in their weekend activities. She is right to highlight not only staff but the hundreds of thousands of volunteers across the country who work to support the hospice sector and others with end of life care. That support is so important for people receiving end of life care and their families. It is something that I have experienced; my father died over the Christmas period a number of years ago. It is a hard time of the year to have a death, and I warmly support what those volunteers are doing this weekend.

Income Tax (Charge)

Rachel Hopkins Excerpts

Tuesday 5th November 2024 Commons Chamber

[Rachel Hopkins (Luton South and South Bedfordshire) (Lab)]

As we all know too well, politics is about choices. The choice in this Budget is clear: five more years of the same failed Conservative policies and more austerity, or change with a Labour Government who will invest in Britain’s future so that we can fix the NHS and rebuild our country.

The Chancellor’s tough but fair choices will benefit so many people across the country, including in my constituency, by delivering on tax commitments to help fund our vital public services. This includes ending both the non-dom tax loophole and VAT tax breaks for private schools so that everyone pays their fair share.

I am pleased to see the £11.2 billion investment in our education system to give every child the best start in life by increasing per-pupil funding in real terms, providing £1 billion in additional support for the SEND system and enabling the roll-out of free breakfast clubs in thousands of primary schools.

For far too long, working people have paid the price for the previous Government’s failures. Whereas the previous Conservative Government focused on funnelling pounds into the pockets of their friends through dodgy covid contracts, this Labour Government have chosen to put pounds in the pockets of working people. The increase in the national living wage to £12.21 is therefore very welcome in my constituency, where over 3,000 people in Luton alone will be better off as a result.

As well as the boost to people’s wages, I am delighted that we will deliver the biggest boost to affordable housing over this Parliament, with a £500 million boost to the affordable homes programme to build up to 5,000 additional affordable homes. Reducing the discounts on the right-to-buy scheme and enabling councils in England to keep all the receipts generated by sales will also deliver on our commitment to protect existing council house stock.

Of course, the NHS is the cornerstone of our public services. Investment in education, jobs and homes will be fruitless if we do not have a healthy population. Our healthcare system was pushed to the brink under the previous Government, with waiting lists for vital scans and operations stretching to months or even years, 24 hour-plus waits in A&E, and the worst staffing crisis in history.

The creation of the NHS was the pride and joy of a post-war Labour Government, and it is a Labour Government who will rebuild it once again by investing an extra £25.6 billion over the next two years. The 40,000 extra elective appointments per week will mean reduced waiting times.

Where previous Budgets felt like reading lines from the same tired script, I can say with pride that this Labour Government’s first Budget really is the start of a new chapter in making Britain better off. It supports better wages, ensures that the NHS is there for people when they need it, and invests in building homes, infrastructure, roads and railways to create wealth and opportunity for all. That is the power of a Labour Government.

NHS: Independent Investigation

Rachel Hopkins Excerpts

Thursday 12th September 2024 Commons Chamber

[Wes Streeting]

I thank the right hon. Gentleman for that question. He is not too far away from me geographically, but he is miles away from me politically, and I always get nervous when he stands up to praise me. We have to keep a sharp eye on value for money. The Darzi report presents some politically challenging messages about NHS management. I could be wildly popular with the country if I stood up and said, “I’m going to take the axe to management across the country and sack loads of managers.” What we need is better management and a sharp eye on value for money. The NHS would not work without good leadership. We have to ensure that we have the right people in the right place, delivering against the public’s expectations, so it is a more nuanced position, but I am sure that what he says will have been heard by his local trust. I will certainly keep an eye on value for money across the country.

[Rachel Hopkins (Luton South and South Bedfordshire) (Lab)]

The Darzi report rightly says that prevention is better than cure, and that public health interventions that protect health are far less costly than tackling the consequences of illness and ill health. Does my right hon. Friend agree that the recklessness and incompetence of the 14 years of Conservative government, stripping millions of pounds from local authorities, which deliver the public health work, has contributed to children being sicker than they were 10 years ago, and adults getting iller sooner?

[Wes Streeting]

My hon. Friend is right, and at some point the Conservatives will have to take responsibility for it. We learned through bitter experience that if we did not change as a party, the country would not choose to change the Government. Long may the Conservatives continue, therefore, with their head in the sand, and long may we continue to get on with the job of clearing up their mess and building an NHS that is fit for the future.

The relationship between the NHS and local government, and between my Department and local government, is of particular importance in relation to social care, which is why I was especially delighted that the Prime Minister chose this week to appoint Tom Riordan, the chief executive of Leeds city council, as second permanent secretary. He is an outstanding public servant with a demonstrable record on health and care integration, public health and prevention. I look forward to having that local government perspective, and local community delivery perspective, at the heart of our Department.