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

Rachel Hopkins Excerpts

Committee stage
Thursday 30th January 2025 Public Bill Committees

[The Chair]

Order. I am sorry, but you are only allowed one question.

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

Q My question, directed at Chloe, is about the practical application of access to doctors for patients, as suggested in the proposed legislation, and how doctors have those conversations with patients—particularly, when it comes to geriatricians, older patients. We heard from somebody yesterday who said that there were concerns around how older people were treated, and the potential risk of elder abuse. I would be interested in the practical application of those conversations, in your experience.

Dr Furst: First up, a patient has to specifically ask me about voluntary assisted dying. They have got to use words that really imply that that is what they want. I will often ask any relatives to leave so that I can have a conversation just with them, to try and reduce the risk of coercion, and then invite the family back.

One of the practical things that I often ask the patient is when they started thinking about this. Is it something that they have always considered should be a right, or is it more of a new-found belief given their current suffering? I want to understand what their current suffering is. I ask specifically whether they feel a burden on their family and friends. It is an hour-plus long conversation to really understand them and their suffering.

Again, I make sure they understand all the other treatment options available to them and what good palliative care looks like. I will often be prescribing other medications as part of that good palliative care—opiates and anxiolytics. As a geriatrician, I am also making sure that their mood is also addressed, and that this is not a reactive depression. I am really doing a holistic and comprehensive geriatric assessment as part of that voluntary assisted dying assessment as well.

[Dr Marie Tidball (Penistone and Stocksbridge) (Lab)]

Q This question is for Dr Furst and Professor Blake. Many of us on the Committee are committed to the need to protect disabled people and to ensuring that the Bill has as many safeguards in as possible. We heard evidence yesterday that anorexia may qualify under assisted dying laws in other jurisdictions. Have there been any cases of people with anorexia accessing assisted dying in Australia, and in your view do the respective laws across Australia allow for that? Secondly, are there any lessons that we can learn on building in safeguards in relation to those with learning disabilities?

Dr Furst: All around Australia, mental health as the primary terminal illness is excluded, so anorexia by definition is excluded. I have had a patient come to me with anorexia as their terminal illness requesting voluntary assisted dying. It is a relatively easy assessment because they do not meet the standard criteria, and I was able to explain to them that they were not eligible. But it opens the opportunity to have good, in-depth conversations with them about what they are going through.

I cannot talk to the learning disabilities question, other than to say that every time a patient comes to me the assessment is directed to the patient. I saw a patient today with motor neurone disease who is on continuous bi-level positive airway pressure and is using Eyegaze. The assessment and conversations I have with her are based around what she can do for me. I have had patients who have been able to put a thumb up and down, and I have had trachy patients. I cannot necessarily talk about learning disabilities, but as a holistic practitioner you are trying to make sure that the patient in front of you understands everything and is given the full opportunity to express their wishes.

Professor Blake: I would just say—

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

Rachel Hopkins Excerpts

Committee stage
Thursday 30th January 2025 Public Bill Committees

[Naz Shah]

Q Professor Preston, in your written evidence to the Committee, you said that Parliament should:

“Consider whether there should be a stated exception to the usual presumption of capacity under the Mental Capacity Act 2005 in the Bill.”

What kind of standard do you think Parliament should consider adopting instead of the use of the Mental Capacity Act, and why do you think that?

Professor Preston: Again, this came from my colleague Suzanne Ost, who is a professor of law. As Naomi said, this is something very different from choosing to consent to an operation or even a research study. This is finite—it is a finite decision, so therefore the assessment should be a bit more. What I will say about mental capacity is that we had a PhD student who assessed mental capacity decisions by hospice care staff—particularly doctors, but also a lot of the nursing team who were making the decisions. She was a lawyer, and her conclusion was that it was incredibly well assessed. That was in terms of safeguarding—so, when people were going back to what we might consider unsafe homes—but that is what the person wanted, because their life was that unsafe home. I am talking about social deprivation and things like that. The people in this particular team were very good at assessing that and applying the Mental Capacity Act, according to her research.

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

Q Claire, you mentioned multidisciplinary teams and decision making. We have heard in a couple of other evidence sessions from palliative care social workers, nurse practitioners and the Royal College of Nursing about the multidisciplinary approach in care. What are your thoughts on the ultimate approval as set out in the Bill being a doctor, another doctor and then a legal okay at the end? Would a more multidisciplinary approach to approval have stronger outcomes or better safeguards?

Claire Williams: I absolutely agree that a panel/committee approach would have better safeguarding for patients, because the decision is being made collectively with legal expertise and with other healthcare professionals—that might be palliative—or ethicists like myself. It is having that collective view, ensuring that everybody is happy and that that is exactly what the patient wants. I believe it should be a committee/panel-based approach for the final decision. As I said before, expecting a High Court judge—just one individual—to make that decision alone is hugely burdensome and not an approach that we should be taking.

[Tom Gordon]

Q Professor Preston, we have heard from a wide range of different people from different jurisdictions. What we have heard and the evidence suggest that where we see assisted dying as an option, we tend to see improvements in palliative care. Do you have any comment on that and how we could better integrate into giving people that choice? You talked earlier about different routes and different systems in countries where it might sit outside the healthcare setting. Would that limit the choice and hinder people’s ability? How do you see that having a play in this?

Professor Preston: There is a bigger and bigger conversation in a lot of these countries, including the Netherlands and Switzerland, that this is not about healthcare. I know that sounds a really strange thing, but it is about self-determination and a life choice. I remember someone saying to me, “Well, you wouldn’t check who I’m marrying.” They feel it is such a personal choice. I think patients do bring this up. They bring it up all the time now. Studies in Spain have shown that if a patient has a desire for hastened death, the best thing you should do is explore that desire. Why do they have that desire? How can we help you? Are there other needs we can meet? Most people will not want to then go ahead and have an assisted death. This is a minority of people. Could you remind me of the rest of your question?

--- Later in debate ---

[Lewis Atkinson]

Q Pat, if the Bill, as it is currently drafted, had been in place in your family’s situation, what difference would that have made to your family’s experience?

Pat Malone: In all three cases, it would have improved their lives and their deaths. My father died at the age of 85 from pancreatic cancer. He asked me to help him kill himself while he was in hospital in the last three or four weeks of his life. Obviously, I was not able to do so. He suggested that I put poison in his water, which I had no idea how to action. I spoke to his consultant and asked whether he could do anything to hasten his end, and he said, “No, no, no, I can’t.” After that, he lasted another three weeks and he had a horrendous death. It has scarred our family to this day.

My brother contracted the same disease, pancreatic cancer, and having seen my father die, he—having gone to six doctors and asked them whether they could help him end his life; he was under home hospice palliative care at that time—contrived his own suicide. Unfortunately, he asked his wife to sit and hold his hand while he died, as a result of which there was a police investigation into collusion. She and her daughter, who was also in the house at the time, were not cleared for eight months, during which they were interviewed repeatedly about anomalies and what they did or did not know. It was absolutely unconscionable to pile that on top of their grief, at a time when they had just lost their father and husband.

My sister’s death, having seen those two deaths, was much easier. She got motor neurone disease and was not really suffering in the way that my father and brother had been. She knew that her end was going to be as a live brain in a dead body, and that was the horror that she faced. From the beginning, she was fixed on going to Dignitas, which she did. It was not easy because, after the example of my brother’s family, she would not allow anybody in her family to have anything to do with the arrangements that she had to make, which were quite complicated and became ever more difficult for her. First, she could not drive a car any more and was going around on a mobility scooter, gathering endless documents and having all the tests that you need to have. Ultimately, she said, “This is my golden ticket.” When she was accepted by Dignitas, she said that it was the greatest relief of her life. She said, “I know I am not going to get cancer or dementia. I’m going to die painlessly at a time and place of my choosing.”

That is exactly what she did, but she died 1,000 miles from home. She should have died in her house with her family, and her dogs on the bed. She should not have been denied that. Had this Bill been enacted in her time, it would have been a much easier operation. The problem with this legislation mainly is that it is so long overdue. There are people now who are in that position. You may think our family is star crossed because we have had three deaths like that, but I think we are just a normal family. It is happening all the time. Chris Whitty talked on Monday about how we should not rush into this. We are not rushing into it; we are at the back of the queue, really.

[Rachel Hopkins]

Q Thank you all for sharing your family stories today. It is really moving. Julie, I want to ask about your experience in Spain and how you found that particular process in comparison with what we have in the Bill. How did it work? What was positive or difficult for you?

Julie Thienpont: Guido had decided right from the word go, even before he got sick, that that was the way he would want to end his life, if there was a possibility of it. He was from Belgium originally, so he expressed a wish that if ever he needed it, he would like to go back there.

The law in Spain is very similar to the Bill, which I have read through countless times. There are a lot of similarities. There were very rigorous checks. It involved much paperwork, counselling and family liaison. The difference was that it went before a board, so it was a panel that would allow or not allow the decision—it was not decided in a court. That would be the main difference, but the process was rigorous. It was slightly difficult for me, because although I can speak Spanish, the terminology was frequently more difficult, so they very kindly translated for me. They explained everything: what would happen and how it would happen, if it happened. It was a big celebration for Guy when he was actually granted this. They also told us that he could change his mind after he had made the decision, should he wish to. He did once. It was me who asked him to do that, because I did not feel he was sick enough, which sounds a bit silly, I know.

He was an intensely private person. The palliative care in the part of Spain where we were is excellent, but it was quite irrelevant for him because he had already expressed that he wanted to die at home. We lived up a mountain; we were quite remote. Being such a private person, he never wanted to be in a situation where somebody else had to see him in any vulnerable situations, especially with personal hygiene and so on—even me, although I was able to help him in many ways. I had to do a lot of procedures for him, after being trained to do so, but he was more than happy with the situation of having assisted dying once it was granted. He did not need any other sort of care, although we still had a nurse coming every few days and the family doctor came up at least once a week. That does not sound much, but he did not want her any more often than that.

[Danny Kruger]

Q This is a question for Mr Malone. May I say how greatly I sympathise with what you have been through? I am very sorry to be fighting against you in this matter. I really can imagine how that feels. Thank you for what you said. I just want to ask about your sister’s experience. On the eligibility question, is it your belief that she would have qualified for an assisted death under the Bill, with the six-month terminal illness criterion? To follow up on that, do you think we should expand the scope to include people with motor neurone disease who might not fall within the six months?

Pat Malone: She would not qualify, because there was no telling how long she would live as a live brain in a dead body, as she said. It could have been months or even years, so she would not qualify in any case under this Bill. However, you have moved mountains to get to this point, so the last thing in the world I want to do is pile more requirements on the Bill. I would like to see some stuff stripped out of it, actually, to make it easier, but I am not going to ask for that because we desperately need to get away from the status quo. This Bill gets us away from the status quo.

--- Later in debate ---

[Kit Malthouse]

Q I also want to explore this issue of capacity a little further with Dr Price, because I share my colleague’s slight confusion.

You talked about a percentage who wish to hasten death. The people we are talking about are facing death in any event within a foreseeable period, and they may be contemplating a death that is not pleasant. Some of the characteristics you talked about are presumably to be expected and may not necessarily interfere with their ability to make rational decisions in what they believe is their own best interest. In those circumstances, I do not understand why the Mental Capacity Act would not apply. I understand that you may be coming at it from a practitioner point of view, but if I make a decision to decline treatment to hasten my own death, I am not sure I would necessarily see that as qualitatively different, from the point of view of my own capacity, from saying, “I know I am going to die in three months’ time and I would like you to assist me to die slightly earlier.” Why are the two qualitatively different, from an MCA point of view? At the moment, one would be dealt with through the MCA, but you are saying the second would not necessarily be.

Dr Price: You are equating a refusal of treatment, in capacity terms, to hastening death by assisted dying. If those two things are equated, in terms of the gravity and the quality of the decision, the Mental Capacity Act may well be sufficient, but there are differences. There are differences in the information that the person would need and what they would need to understand. They would need to be able to understand the impact of the substance they are taking and what the likely positives and negatives of that are—all of those things.

The informed consent process is different from a refusal of treatment, and the informed consent process feeds into the capacity assessment. This is an area where we need to think carefully about whether the processes of the Mental Capacity Act, as it stands, map neatly enough on to that decision to make it workable.

[Rachel Hopkins]

Q Dr Mulholland, I want to push a little on where you were saying the royal college sits on the ability of members to say that they would not want to participate in assisted dying, if it came through, and on your written evidence saying that you would like to see a separate body. Given that many GPs are already very much involved in the care of their patients and will often be doing a lot of palliative care themselves, particularly around medications, and given that the Bill is about terminally ill adults with a diagnosis of six months left to live, do you mean that all GPs would stop at that six months and it would go over to an independent body, or are you saying that those GPs who want to continue that care could do so but that those who do not want to be involved in a potential route to assisted dying would step out? I would like a little clarity on that, given the person-centred care that so many GPs do so well.

Dr Mulholland: The shape of the service is not set out in the Bill. We would say that GPs need to have a space where they can step away from it: that is the key point that we want to get across. For those who want to take part, it may be that they decide to do it, but it would have to sit outside the core general medical services that we provide at the moment. This is an additional thing; this is not part of our core job. We think that a separate service—it may not just be GPs; there may be lots of different practitioners and health professionals involved —would sit better with that. You could then assess the capacity and assess those other parts that are so important and are in the Bill at the later stages.

The GP may have a role, but that would be very much up to the individual GP to decide. It would not be set out that they should be taking part. They would then probably be part of this additional service to which the others who are not taking part could signpost. We just want to make sure that there is that clear space.

[The Chair]

As we have time, I call Danny Kruger.

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

Rachel Hopkins Excerpts

Committee stage
Tuesday 28th January 2025 Public Bill Committees

[Lewis Atkinson]

Q I think around 650 people with a terminal illness currently take their own lives a year. If we see a success with the Bill, I wonder whether there would be a reduction of that number going forward. Do you think that could be incorporated in monitoring going forward? Do you think there are opportunities to avoid that suffering? People are clearly experiencing traumatic deaths at the moment.

Dr Cox: It is really difficult to know how many people who die by suicide because of their terminal illness would instead access assisted dying, and it is really difficult to understand the impact of assisted dying legislation on that. If we look at the evidence of suicide, we know that it is increased in people with serious illnesses, but it is actually increased in the first six months after diagnosis, not in the last six months of their lives, so it is about the trauma of the diagnosis. What we need for that is better mental health services, better support around diagnosis and earlier palliative care.

The other piece of evidence that I would offer to you is that the global picture of what happens to suicide rates after assisted dying legislation is introduced is confusing and mixed. But there are jurisdictions, for instance Germany, where after the introduction of assisted dying legislation the incidence of suicide has gone up year on year. I do not think we can say that introducing assisted dying legislation will stop those suicides.

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

Q I want to build on the comments about the multidisciplinary teams that you all work with. The chief medical officer said, in one of the sessions earlier, that discussions about death, dying and end of life are increasing. They are getting better. However, importantly, when we heard from Professor Ranger of the RCN and from the Association of Palliative Care Social Workers, they also talked about the conversations that they have, as part of the wider team. Quite often, it is nurses having those conversations.

I was struck by the way the RCN talked—and you, Dr Clarke, used the word as well—about not being paternalistic, about having the patient at the centre of that conversation, and about ensuring that we listen to the patient and ask them, “What is it that you want?” That, for me, is all about autonomy. Do you agree? The emphasis must be on patient autonomy and their choice at the end of life.

Dr Clarke: One hundred per cent. Sometimes, those of us who work in palliative care almost see the extent to which we try to place the patient at the centre of everything as quite radical, when contrasted with a lot of the other medical specialities. My opinion about what is best for a patient does not matter; their opinion is what counts.

The power of the multidisciplinary team, and the reason for thinking that it may be worth considering amending the Bill so that there is a greater role for a multidisciplinary team, is this: the fact that everybody in that team brings their unique perspective. In my hospital, whenever there is a tricky issue regarding a palliative patient, we will have an MDT. There may be 10 people in the room, all discussing the issues. It might be that someone has decided that they want to withdraw their life-prolonging treatments, or they want to have life-prolonging treatment and, for whatever reason, it is really complicated. We will have the patient, their family, doctors, nurses, social workers and dieticians—a big group of people—in the room because that is the way to make the decision most safely and most effectively, in terms of enabling the patient to have the treatment that they wish to have. It is incredibly important to have that.

[Rachel Hopkins]

Can I ask Mr Sanderson to reflect on that, for the different context, Mr Dowd?

[The Chair]

No. Order. We have two and a half minutes to go. One other hon. Member wants to ask a question. I want them to come in.

Terminally Ill Adults (End of Life) Bill

Rachel Hopkins Excerpts

2nd reading
Friday 29th November 2024 Commons Chamber

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

I am glad to have the opportunity to speak in this hugely significant debate, and as a co-sponsor of the Bill to support my hon. Friend the Member for Spen Valley (Kim Leadbeater) in advocating choice at the end of life. Since I came into this place five years ago I have spoken many times about assisted dying and the desperate need for reform of the law, and I believe this Bill is a landmark opportunity to change the status quo once for all, so that mentally competent terminally ill adults have the right to choose a peaceful, safe and compassionate death.

We hold a responsibility in this place to legislate for all people across the United Kingdom—for society. The overwhelming opinion of the public is clear. A poll conducted earlier this year found that 75% of people would support a change in the law to make it legal for terminally ill adults to access assisted dying in the UK.

The current blanket ban on assisted dying forces terminally ill people to suffer against their will as they near the end of their life, while loved ones watch on helplessly. Some choose to avoid that fate and seek assisted death abroad, but that comes at a substantial cost of around £15,000 to travel to Switzerland for that purpose. That highlights systemic inequality, whereby only those with the necessary financial means have access to a choice over the timing and manner of their death.

[Dr Arthur]

Will the hon. Lady give way?

[Rachel Hopkins]

I will continue, I am afraid.

As a humanist, I believe we have but one life and that we should live it well and make it meaningful. I believe that individuals should have autonomy in life. Similarly, I believe that at the end of life every person should have agency and the right to die with dignity and to a safe and painless death, on their own terms, subject of course to strong safeguards. I believe that the Bill contains stringent safeguards.

Although my humanist beliefs have contributed to my view, personal experience when young sparked my initial questions about the manner in which our lives end. My grandfather, Harold Hopkins, was an optical physicist and is remembered as one of the most innovative scientists of modern times. Many of his inventions are in daily use throughout the world, including zoom lenses, coherent fibre-optics and rod-lens endoscopes, which revolutionised modern keyhole surgery.

Unfortunately, my grandfather was not immune to the grip of a cruel terminal illness, and he sadly suffered greatly in the final weeks of his life, while battling prostate and secondary cancers, rendered blind during his final days, which was a cruel irony for a man who did so much to advance optics. But it was the haunted look on my father’s face when he arrived home having spent the final few days with Harold, who was in terrible pain and suffering before he finally died, that had a lasting impression on me. Surely, in a modern society, if we are able to live a good life, we must be able to have a good death.

My grandfather was just one of many who have faced such a fate. I have heard from many constituents and from other families—many who are here today—who have shared their own stories of watching their loved ones die in unnecessary pain and indignity. While many have raised concerns around the need for better funded and supported palliative care services in our country, I reiterate the point that the Bill does not represent an either/or proposal.

As my hon. Friend the Member for Spen Valley has said over the past few weeks, at its core this legislation is about not ending life, but shortening death. This is fundamentally an issue of dignity, compassion and humanity, and I encourage all Members across the House to use their power as elected representatives to alleviate the needless pain of thousands of individuals and their families by taking the first step towards providing choice at the end of life by legalising assisted dying.

Oral Answers to Questions

Rachel Hopkins Excerpts

Tuesday 14th May 2024 Commons Chamber

[Alex Chalk]

I thank my right hon. Friend for that important point. Fewer than 1% of tenancies required court action in 2019, but for difficult cases that do escalate to the courts, the Government recognise the importance of making sure that the process is smooth and efficient. Nearly 90% of county courts are currently listing possession hearings within four to eight weeks after a claim is received. On bailiff recruitment issues, we are running recruitment campaigns and have reduced administrative burdens to free up resources for bailiffs to focus on enforcement activity.

[Rachel Hopkins (Luton South) (Lab)]

T2. The Government’s latest panic measures to deal with the prison capacity crisis, including expanding the early release scheme to 10 weeks, have simply fuelled the probation crisis instead, with staff warning that many of these releases are unsafe and result in recall in a matter of days. Can the Minister confirm what specific extra resources he has recently put into this struggling service, so that it can cope with the sharp rise in probation workloads?

[The Minister of State, Ministry of Justice (Edward Argar)]

The hon. Lady is right to highlight the work of probation. I put on record—as I know my shadow would and I know she would—our gratitude to all those who work in our probation service. Over the long term, since 2021 we have put an extra £155 million a year into the probation service, and 4,000 more staff in training. She will have also seen the recent announcement made by my right hon. and learned Friend the Lord Chancellor in respect of the probation reset to enable probation officers to focus their time on where it makes the greatest difference and has the greatest impact.

Oral Answers to Questions

Rachel Hopkins Excerpts

Tuesday 22nd November 2022 Commons Chamber

[Kate Hollern (Blackburn) (Lab)]

2. What assessment he has made of the potential impact of the Common Platform on the delivery of justice by HM Courts and Tribunals Service.

[Rachel Hopkins (Luton South) (Lab)]

13. What steps he is taking to improve the performance of the Common Platform.

[The Parliamentary Under-Secretary of State for Justice (Mike Freer)]

We have rolled out the Common Platform at 173 criminal courts in England and Wales and 76% of courts are now live. It has improved the format and timeliness of outcomes of hearings generated and shared with our criminal justice partner agencies and removed the need for staff to re-key information across different IT systems. If we are to reform the criminal justice system, we need to press ahead and reform the IT that underpins it.

[Mike Freer]

The simple answer to that question is no.

[Rachel Hopkins]

Last month, staff at courts across the country, including the magistrates court in Luton, went on strike—not over pay or pensions, but because the Common Platform IT system is so flawed that it is effectively unusable. That should have been enough to make the Government sit up and take notice, but if the Minister will not listen to his own workers and their trade union, the Public and Commercial Services Union, maybe he will listen to the judges who are speaking out? One judge called the Common Platform “completely unsuitable” and “not fit for purpose”. Does the Minister agree?

[Mike Freer]

No, I do not agree. All new IT systems take time to bed down and officials continue to work with user groups, both staff within the criminal justice system and judges. The system replaces eight legacy systems that are at the end of their lives, support for which is being withdrawn. If we do not reform the IT system underpinning the criminal justice system, we will not be able to make the progress we wish.

Assisted Dying

Rachel Hopkins Excerpts

Monday 4th July 2022 Westminster Hall

[Rachel Hopkins (Luton South) (Lab)]

It is a privilege to serve under your chairmanship, Mr McCabe. I thank my hon. Friend the Member for Gower (Tonia Antoniazzi) for leading this debate and for the emotion she put into her speech.

The blanket ban on assisted dying has resulted in unacceptable failings in patient safety. As we have heard, dying people are forced to matters into their own hands without sufficient protection or support for them, their families or the clinicians who care for them. Through the APPG on choice at the end of life, of which I am a member, I have heard from families who have seen family members have a difficult and undignified death not of their choosing. As a humanist, I believe that people are fundamentally good, so I struggle to accept some of the caricatures of people being cynical with their loved ones at the end of life.

Assisted dying reform is a matter of freedom of choice at the end of life. Assisted dying laws can be introduced with robust safeguards. The current system is broken. Research from the Assisted Dying Coalition found that more than one person per week is forced to end their life abroad. This demonstrates an inbuilt inequality in the current system, as only those who can afford the high costs are able to go abroad to do so. If someone is rich, they have a small amount of choice, but if someone is poor and of limited means, they have no choice.

Looking at examples of legislation abroad, we see that all six states in Australia have legalised assisted dying, joining an ever-expanding list of states in the USA, New Zealand, Canada and many countries in Europe that give their dying citizens choice. I want to make one thing very clear: there is no credible evidence from jurisdictions that have legalised assisted dying that vulnerable people will be pressured to end their life.

As has been said, this debate is not about choosing between assisted dying and palliative care. International evidence shows that assisted dying does not harm access to palliative care. A report by Palliative Care Australia concluded that there is no evidence to suggest that the palliative care sectors were adversely impacted by the introduction of the legislation. If anything, in jurisdictions where assisted dying is available, the palliative care sector has further advanced. Evidence shows that the current law is not only cruel but dangerous, as there is little oversight of death by suicide linked to terminal illness or Dignitas deaths, and no formal monitoring. We need transparency and upfront safeguards in legislation, not a continuation of lonely, secretive deaths, with oversight occurring only afterwards.

We have heard how medical opinion supports assisted dying. The British Medical Association decided in 2021 to end its opposition to assisted dying, following a survey of its members. The BMA survey found that half of all doctors personally support legalising a right to die for those who are incurably suffering or are terminally ill.

Thanks to increasing public awareness, the public mood is changing. The petition to legalise assisted dying for terminally ill and mentally competent adults gained more than 100,000 signatures, 120 or so from constituents in Luton South. Public support for assisted dying is unwavering, regardless of age, class, gender or political persuasion.

Whether through an inquiry, a commitment to parliamentary time from Government, or the Government simply recognising that the current law in England and Wales fails dying people and their families, the UK needs to explore whether current laws are fit for purpose. The public need action from the Government and from us, their representatives. It is my opinion that the status quo is failing the public. This is not about either/or. It is about different pathways at the end of life and the right to have a choice.

Ten-Year Drugs Strategy

Rachel Hopkins Excerpts

Monday 6th December 2021 Commons Chamber

[Rachel Hopkins (Luton South) (Lab)]

I welcome the strategy’s holistic approach, but there is an element of irony in it, given that it is the Minister’s party that has cut 60p in every £1 to local authorities over the past decade and has failed to address the structurally flawed police funding model affecting counties such as Bedfordshire, which has contributed to increasing drug-related issues in towns such as Luton. Will the Minister commit to addressing the core funding formula issues affecting forces such as Bedfordshire, to ensure the longer-term resilience of our police to tackle organised crime groups and drug-related crime in Luton?

[Kit Malthouse]

I am hesitant to point out that it was the hon. Lady’s party that crashed the economy, but nevertheless I feel compelled to do so. As she may have heard me say from the Dispatch Box, we have committed to bringing in a new funding formula, and work is under way to devise exactly that.

Prison Officers: Pension Age

Rachel Hopkins Excerpts

Tuesday 16th November 2021 Westminster Hall

[Rachel Hopkins (Luton South) (Lab)]

It is a pleasure to serve under your chairship, Sir Charles. I congratulate the hon. Member for Sittingbourne and Sheppey (Gordon Henderson) on securing this really important debate. Violence in prisons, especially against workers, has increased significantly since the mass cuts to staffing and other budgets from 2013 onwards, with assaults on staff tripling to more than 10,000 a year by 2019. That level of workplace violence should be unacceptable for any employee, but there is increased danger for those over the age of 60. It simply cannot be right to expect officers in their 60s to control and restrain people who are a third their age.

Ministers have not provided any evidence to show that frontline prison officers over 60 can work safely in such a dangerous operational environment. I am aware that the report by Lord Hutton of Furness proposed that some uniformed services—as we have heard, police, firefighters and the armed forces—should be exempt from the rise in the retirement age to 68. The decision excluded prison officers from the “uniformed services” that were spared the retirement age rise. That has never been explained or justified, which has caused anger and despair among prison officers. Expecting officers to manage, care for and control violent, dangerous and difficult people until the age of 68 is quite simply unfair, unsustainable and, as the hon. Member for Sittingbourne and Sheppey said, dangerous.

The Prison Act 1952 gives serving prison officers

“all the powers, authority, protection and privileges”

of police officers. It is quite right that police can retire at 60, given the often violent and volatile nature of their job. Will the Minister explain why prison officers are not afforded the same protection?

Pension age should be negotiated as a stand-alone issue, but it is clear that Ministers see employee contributions as part of the discussion. But those relate directly to pay, and if pay is going to be on the table, the starting point must be the Prison Service Pay Review Body’s recommendation of a £3,000 uplift to entry-level salaries, which the Government deemed unaffordable. According to the Prison Service Pay Review Body, officers

“were said to be leaving the Service for…supermarkets; the Police; Border Force; railway companies; and other security and uniformed services”,

with one prison visited experiencing a turnover rate of almost 25%. Low pay and a high pension age are both reasons why morale is at an all-time low. The current recruitment and retention crisis shows that we need a complete pay overhaul that makes salaries competitive, attractive and fit for purpose.

Lastly, I am concerned about the growing number of female officers who fail their annual fitness test. The Prison Officers Association believes that menopause may be a factor. The situation has caused accusations of unfair and discriminatory treatment of women. Does the Minister agree that the annual prison fitness test is not fit for purpose, and will she commit to replacing it with a system that measures relative fitness, considering factors such as age and sex?

--- Later in debate ---

[Victoria Atkins]

I am conscious that I have only 4 minutes, so I will continue.

My hon. Friend the Member for Sittingbourne and Sheppey has already made the point that we have tried to make change on this before. When the Prison Officers Association membership were balloted eight years ago, they did not accept the package to retire at the lower age of 65 with heavily subsidised additional contributions to the scheme. Although POA members rejected the offer, the Prison Governors Association accepted it and as a result some manager grade staff now have a lower pension age. Another offer was made in 2017, in which prison officers would have incurred no cost to access a pension at the age of 65, but again this was rejected by a union ballot union.

[Rachel Hopkins]

Will the Minister give way?

[Victoria Atkins]

I will finish, if I may, because I want to deal with the points about security and I must finish at 5.48 pm in order to give my hon. Friend the Member for Sittingbourne and Sheppey time to respond.

Any lowering of the pension age for prison officers would invariably mean that their pension contributions would have to increase. Prison officers’ pension contributions are less than half those of schemes for firefighters or police officers.

Oral Answers to Questions

Rachel Hopkins Excerpts

Tuesday 14th September 2021 Commons Chamber

[Rachel Hopkins (Luton South) (Lab)]

8. What discussions he has had with Cabinet colleagues on the effect on the (a) recruitment, (b) retention, (c) safety and (d) morale of prison officers of raising the retirement age for that role to 68.

[The Parliamentary Under-Secretary of State for Justice (Alex Chalk)]

Our prison officers have done a truly remarkable job during the pandemic, and through their decisive actions and rapid contact tracing, literally hundreds if not thousands of prisoners’ lives have been saved. Although there are no plans to revisit the retirement age, we are pursuing a series of initiatives to boost morale, safety and retention, and ensure that prisons are as secure and rehabilitative as possible.

[Rachel Hopkins]

The Government have previously stated that because of the higher potential for serious injury and fatality among firefighters and police, they do not consider prison officers deserving of the same pension age protections and the right to retire at 60. With serious violence against staff still plaguing our prisons, does the Minister accept that the message received by prison officers is that they will have to wait until one of their own is killed in the line of duty before their safety concerns are taken seriously?

[Alex Chalk]

The hon. Lady makes an important point. Mercifully, during the pandemic violence has come down in prisons, which we welcome. It is also important not to make false comparisons. For example, employee contributions for police officers are at 12%, and 14% for fire officers, and 5.45% for prison officers. Of course we keep such matters under review. We made a generous offer in 2017 to bring forward the retirement date when the taxpayer would pay the entirety of employee contributions, but I regret that that was rejected by the POA.