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

Debate between Rachel Hopkins and Kit Malthouse

Committee stage
Thursday 30th January 2025 Public Bill Committees

[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.

Ten-Year Drugs Strategy

Debate between Rachel Hopkins and Kit Malthouse

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.

Oral Answers to Questions

Debate between Rachel Hopkins and Kit Malthouse

Monday 13th July 2020 Commons Chamber

[The Minister for Crime and Policing (Kit Malthouse)]

The Government are now spending over £15 billion on policing—an increase of £1 billion on last year, with £700 million being allocated to police and crime commissioners to recruit 6,000 additional officers by the end of March 2021. While there is no direct connection between police numbers and crime, this will give them the capacity to be much more agile in the face of changing crime.

[Rachel Hopkins]

Her Majesty’s inspectorate of constabulary recently stated in its annual assessment of policing that policing and some other public services are closely linked, and that the level of investment in one public service will have an effect, good or bad, on another, referring to health, particularly mental health, drug and alcohol services, housing and social services as examples. What assessment has the Minister made of the huge detrimental impact that covid-19 has had on local authorities responsible for these services, and the fact that many local councils, including Luton Borough Council in my constituency, are being forced into making significant in-year budget cuts, thus having an impact on local policing?

[Kit Malthouse]

The hon. Lady is quite right to draw the connections between policing and other services in the public sector. I cannot speak for the resilience or otherwise of the finances of her particular local authority. I can say, however, that the Prime Minister has tasked me and the Home Secretary with the job of driving cross-Government working to deal with some of the causal factors in crime, beyond enforcement, and we will be talking to local authorities across this country about the part that they can play.