Terminally Ill Adults (End of Life) Bill

Rachel Taylor Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[Alison Hume]

I will make some progress, thank you.

It is still a crime, even when the person is of sound mind and even when it is their deeply considered wish. Anthony wanted a good death—he wanted to die peacefully and with grace, without pain and without profound suffering. He got that in a foreign country, far from home and far from family, because our laws force people like him to make that desperate journey abroad. That is why I support this Bill and, in particular, new clause 15, as there is no need for coroners to investigate an assisted death.

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

One of my constituents told me of her mother’s pain in her last few months of suffering. It was so painful that she could not bear to be touched by my constituent or her brother. Now, both my constituent and her brother are facing post-traumatic stress disorder because of the difficult situation they witnessed while their mum was dying. Does my hon. Friend agree that if they had helped her to die in the way that this Bill allows, they should not then be subject to a coroner’s investigation? It is not going to help them, and it is not going to help their mother.

[Alison Hume]

My hon. Friend makes a powerful case on behalf of her constituent. New clause 15 is a compassionate and practical clause, ensuring that the Bill works not only for the individual making the choice, but for the families they leave behind. Let us not turn our backs on people like Anthony and Louise; let us not make criminals out of the compassionate. The death of a loved one is always difficult. When someone has gone through the legal and safeguarded process of assisted dying, it is not right that their family should face an unnecessary, potentially lengthy and distressing coroner’s investigation.

--- Later in debate ---

[Mr Kohler]

I thank my hon. Friend for her intervention. Giving people a choice when they look on the internet and see how awful their death might be because of the shocking state of palliative care is not a free choice.

This is an extraordinary Bill. It has 55 clauses and 38 regulation-making powers, of which five are Henry VIII powers—in other words, powers to modify primary legislation. As Ruth Fox of the non-partisan Hansard Society, which is absolutely neutral on assisted dying, made clear, there are lots of powers in the Bill conferred on Ministers. Why is that a problem? Lord Hermer KC, the Attorney General, in his Bingham lecture last year, puts the point as follows:

“Henry VIII clauses…upsets the proper balance between Parliament and the executive. This not only strikes at the rule of law…but also at the cardinal principles of accessibility and legal certainty.”

I am afraid the Bill is an example of such excessive reliance. That is a major problem because in large part the safeguards are left to be decided by regulations. What level of qualification and training will doctors need to have? How will mental capacity be assessed? Who can be a proxy? What happens if the self-administration of drugs goes wrong and a person suffers complications but does not die? When pressed on the key safeguards and key issues, supporters of the Bill say that they are problems that can be approved later.

The same goes for how the Bill will actually be delivered. Will it be delivered by the NHS, and if so, how? Will private providers be commissioned, and if so, how, by who and on what terms? Will for-profit providers be allowed? All those questions go unanswered by the Bill. I had hoped that they would be answered in Committee, but they were not, and instead we got even more reliance on delegated powers.

First, that means that MPs cannot make a judgment about assisted dying and how it will work in practice. On training, for example, MPs might assume that the training provided will be a robust two-week course on assessing coercive control, but there is no such requirement in the Bill. Indeed, the impact assessment suggests that it would be a short course. Secondly, regulations cannot override statute and are ultimately bound by it. While it might be reassuring that a code of practice must be issued to take into account how depression can impair a person’s decision making, as the Royal College of Psychiatrists recently reminded us, that does not change the fact that impaired judgment does not mean that someone lacks capacity. Thirdly, leaving all those matters to be considered by guidance and regulations places them outside the democratic control of MPs. With limited exceptions, we will not get a vote on those regulations, and will have no input, directly or indirectly, in formulating them.

The case for the defence might be that reliance on such guidance and regulations is inevitable with a Bill of this complexity, but the experience of other common law jurisdictions suggests that that is not the case. In Victoria, the first Australian state to legalise assisted dying, there are only 20 pages of regulations and much more has been included in the Act, which is necessarily longer than the Bill before us. That is a good thing, as it means more parliamentary scrutiny.

I wholly understand why it was not possible for the hon. Member for Spen Valley (Kim Leadbeater) to draft a Bill as detailed as the Australian Act before Second Reading, but I had hoped that with the help of Government resources, those gaps would have been filled in Committee and on Report. Sadly, that is not the case. [Interruption.] I had much more to speak about, but heeding your cough, Madam Deputy Speaker, let me say clearly that I will vote against the Bill, but even if Members disagree with me, they should please vote for my amendments.

[Rachel Taylor]

I begin by thanking my hon. Friend the Member for Spen Valley (Kim Leadbeater) who has exemplified the integrity and transparency that we need in public service.

I will speak about amendments 82 to 86, which were introduced by the right hon. Member for Salisbury (John Glen) earlier, because as a former lawyer, they concern me. In Committee, the Minister of State, Ministry of Justice, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman) was clear that the panel’s decisions will be subject to public law principles. That will include procedural propriety and an absence of bias, including the appearance of bias. My concern is that the panel is deliberately designed to be inquisitorial. It is intended to collect information; it is not meant to be adversarial like a court.

[Dr Ben Spencer]

Will the hon. Lady give way on that point?

[Rachel Taylor]

No, I will make some progress. Requiring a judicial oath would be inappropriate because the panel is not performing a judicial function. It is a specialist, administrative panel whose first priority must be focused on safeguarding and the review of evidence.

[Jess Asato]

Will my hon. Friend give way on that point?

[Rachel Taylor]

No, I will make some progress and expand on my point. Disqualifying retired and deputy judges would only shrink the pool of experienced candidates, and I do not believe that those changes would make the process safer, more effective or better. Instead, they would make it more difficult to appoint experts to allow the panel to function as the necessary safeguard that it needs to be.

Finally, I turn to the most important aspect of the Bill, which is those who are affected directly. Opponents present hypotheticals, but I have heard real stories from my constituents who support the Bill. One constituent told me about her husband who died of metastatic prostate cancer. He wanted to die at home, and despite the efforts of a dedicated palliative care team, his final month was marked by excruciating pain. Our constituents deserve better. They deserve the choice to say goodbye in peace, surrounded by loved ones, without unbearable pain. For me, this debate is about whether the status quo is acceptable. After hearing these stories and listening to lawyers and doctors, I know that it is not. If we vote in favour of the Bill, our constituents must be able to expect that it will be brought into law quickly. I therefore oppose amendment 42.

The British public overwhelmingly support the Bill. They are looking to this House for courage and leadership. That is why I will vote for the Bill, with the amendments that strengthen it. Let us bring dignity, peace and choice to those facing the end of their lives in difficulty and pain.

[Dr Ben Spencer]

Before I come to the substantive part of my speech, I would like to pick up on the comments of the hon. Member for North Warwickshire and Bedworth (Rachel Taylor). I have signed the amendments tabled by my right hon. Friend the Member for Salisbury (John Glen). I support them because I think the panel needs strengthening. It is not the case that courts have to be adversarial. Tribunals are set up to be inquisitive. In fact, the mental health tribunal is set up to be inquisitive. That is why, in Committee, I tabled amendments to use a tribunal panel as the mechanism for scrutinising decision making.

It has been a real pleasure to listen to the debate, particularly in relation to the prohibition of advertising, because the debate started to move to focus on the issue of suicide promotion and prevention. I have been quite concerned from the beginning that that has not been part of what we have been talking about. Duties to prevent suicide—whether they be doctors’ duties under article 2 of the European convention on human rights, the NHS’s clinical duties around suicide prevention, or duties relating to the Mental Health Act 1983—are a blind spot in the Bill.

The reason why the issue has not been focused on until now is that the Bill has been framed as the assisted dying Bill, as opposed to the assisted suicide Bill. I blame myself in part for that, because I started by called it physician-assisted suicide, but then I started using the term “assisted dying” because it was in common parlance and it was what everyone was using. The problem is that it frames it as something else. It frames it as reducing the dying process as opposed to what it is, which is an act to end somebody’s life. That is why the Bill amends the Suicide Act, and it is why I have tabled similar amendments on how it is conceptualised.

National Cancer Plan

Rachel Taylor Excerpts

Tuesday 4th February 2025 Commons Chamber

[Andrew Gwynne]

I congratulate the hon. Gentleman on being smoke-free. Hopefully, he is the first of many as we move towards a smoke-free UK by 2030. He makes a real and serious point about not just community care—one of the big shifts in the health mission is from hospital to community—but how we approach the hospice sector. Last weekend I was at my local hospice, Willow Wood in Ashton-under-Lyne, where staff made exactly the same point. That will be fed into the national cancer plan.

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

I thank the Minister for his statement, and particularly for his deep understanding of women’s health issues and the difficulty that many women face in getting their GP to understand what they are going through. The Women and Equalities Committee has spent some time looking at that this year.

The George Eliot hospital in my constituency serves many of my constituents, who often complain about the length of time it takes to get scan results. Between June 2023 and 2024, almost 12% of people waited more than 28 days to receive MRI results, compared with 6.5% nationally. I know that the team there are working very hard to bring the time down, but can the Minister reassure my constituents that the use of AI will speed up the time it takes for them to get their scan results and the treatment they need?

[Andrew Gwynne]

My hon. Friend makes some really important points. The need to get people scanned more quickly, and to get results to consultants, is in part why we now have extra capacity through community diagnostic centres, where there are extra facilities for scans. She is absolutely right to raise the issue of where AI and emerging technologies may take us, which will almost certainly lead to faster identification of cancers.

Women’s Health Strategy

Rachel Taylor Excerpts

Thursday 30th January 2025 Commons Chamber

[Karin Smyth]

The hon. Gentleman is right to highlight those long waits. That is why we particularly highlighted gynaecology for attention in the elective reform plan. It is shocking that the last Government left 600,000 women on these lists, and moving back to making sure people wait no longer than 18 weeks will predominantly be helping those women.

The hon. Gentleman is also right to highlight the appalling maternity situation. The Secretary of State and my noble Friend Baroness Merron, who leads in this area, have met many families to discuss their experiences, and we know those experiences are unacceptable. We know there are big issues around staffing, and it is a priority to work with NHS England to make sure that we grow workforce capacity as quickly as possible so that we can be sure that those situations are safe. There are many debates in this place about the issue and we will continue to update the House.

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

Under the last Government, five times more research went into erectile dysfunction, which affects 19% of men, than went into premenstrual syndrome, which affects 90% of women. Women are waiting more than eight years for endometriosis diagnoses. GPs are not required to undertake a gynaecological rotation within their training. Women’s health must be put at the head of our agenda. Will the Minister assure women in this country that things will change under this Government?

[Karin Smyth]

I absolutely will give my hon. Friend that assurance. The situation will change partly because there are more people like her and more women in this place. We have more women across all parties raising this issue and more women in senior positions in the National Institute for Health and Care Research. Crucially, we have women leading in science and research. Dealing with the misogyny around the system and in medical systems is also important for making sure that women lead this work. We want to make sure that the NIHR, which has a strategy to address this issue, rectifies the situation that she outlines.

Speech and Language Therapy

Rachel Taylor Excerpts

Monday 27th January 2025 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairship, Mr Vickers. I congratulate my hon. Friend the Member for Lichfield (Dave Robertson) on introducing this important debate, and on the passionate, moving and powerful way in which he spoke, particularly about his mother. I would really like to thank him for sharing those personal experiences. I also thank every Member who has spoken today. We have heard really compelling accounts about access to speech and language therapy for both children and adults.

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

I thank my hon. Friend the Minister for giving way, and my apologies, Mr Vickers; I had to leave earlier for a ministerial appointment.

In 2018 my father suffered a stroke, and the staff at my local hospital, the George Eliot, could not do enough for him—they were absolutely fantastic. I know that my father stayed in hospital longer than he needed because that was the only way in which he could access the speech and language therapy that he needed, as well as the help to enable him to swallow. It was fantastic to see him recovering that speech because of their intervention. As he had served for nearly 50 years as a volunteer magistrate, it is wonderful to see him now being able to challenge my ideas and give his comments on my contributions in this House.

Last week, I held a consultation event in my constituency where a dietician told me that she felt there was not enough ability for her and her team, as well as speech and language therapists, to give help in the community. She was quite excited about our ideas for virtual wards and asked me, on her behalf, to plead with the Minister to ensure that we give recognition to putting more speech and language therapy in the community. I know that my dad would have been very pleased to receive that.

[Martin Vickers (in the Chair)]

Order. Interventions should be brief— I was very generous.

Puberty-suppressing Hormones

Rachel Taylor Excerpts

Wednesday 11th December 2024 Commons Chamber

[Wes Streeting]

I am grateful to the hon. Gentleman for what he said. These issues weigh heavily on my conscience. On what he says about the safety and efficacy of puberty blockers, the simple fact is that we just do not know enough. That is why building the evidence base and research is important. I want to ensure that young people with gender incongruence and dysphoria are receiving the best quality healthcare to improve their safety, welfare and wellbeing as children, and that they live long, healthy and happy lives as adults. That is the basis on which we are taking decisions, and we are approaching the issue with care and sensitivity, as I know my counterpart in Northern Ireland also does.

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

Today will be a difficult day for trans young people, not because of the Secretary of State’s statement, but because of how our media might choose to portray what has been announced in the House. I welcome the remarks of the shadow Secretary of State, and I hope that we can take things forward together.

I know that one of my constituents will be upset, but will reflect on this with his mum, who has been supporting him. He was referred by his GP for gender dysphoria when he was in year 8. He has still not been seen by a specialist, and he is now in his first year doing his A-levels. He has had to endure going through periods, and suffering at school with the embarrassment of that. He decided to stop eating and was diagnosed with anorexia because that was the only way that he felt he could stop his periods and stop his breasts growing. Those are the kinds of things that trans young people go through day in, day out. Three and a half years later, it is not good enough that he has still not been seen by a medical professional. He is in the west midlands, which is one of the areas where we are not yet announcing that specialist services will be extended.

I welcome the gravity with which the Secretary of State has dealt with this matter. In particular, he responded to me when I asked him to meet trans young people, which he has done. I hope that we can move forward together and improve the mental health of all our young people. We must take this issue seriously and work together, rather than make this into a culture war.

[Wes Streeting]

My hon. Friend demonstrates powerfully why waits of the length that she describes in that case are simply unacceptable and unjustifiable. She also details the real pain that is being experienced by young people who are not being seen by the NHS, and not receiving the care and support they need. That is why I am determined to improve waiting times and quality of care. It is also why those of us in positions of influence or power, or those who have access to the microphone or the pulpit, need to think very carefully about the way that we talk about this group of children and young people, and trans people more generally. It is why headline writers and editors in our media have a responsibility to think carefully about how they exercise their freedoms in the media responsibly—freedoms I strongly support—and create a culture where we are not adding to the harms of that group of children and young people. That is for the exact reasons that my hon. Friend describes with that utterly heartbreaking case.

NHS: Independent Investigation

Rachel Taylor Excerpts

Thursday 12th September 2024 Commons Chamber

[Wes Streeting]

Every time the right hon. Gentleman praises my zeal for NHS reform, Labour Members get very nervous. Let me reassure him that I have looked at other countries, and I will definitely continue to do that. I genuinely do not think that it is the model of funding that is the issue—the publicly funded, public service element. I hope that he knows me well enough to understand that if I did think so, I would be more than happy making, and would quite enjoy taking on, the argument, but I think that the equitable principle that underpins our NHS is one that we should cherish and protect. The single-payer model has enormous potential for the century of big data, AI, and machine learning. There is huge potential there that we must unlock, but that does not mean that we cannot learn from the way that other countries organise care, particularly in the community and particularly social care. This week, I met virtually with my friend the Health Minister in Singapore. I will continue to work with my international counterparts to learn from other countries whose health outcomes are far better than ours.

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

In my constituency of North Warwickshire and Bedworth, patients wait far too long for GP appointments. The Conservative party has presided over sticking-plaster solutions, papering over the cracks in our health service rather than making it fit for the future. Does the Secretary of State agree that today’s report is a chance to get the right diagnosis of the problems, so that this new Labour Government can come up with the right prescription, and my constituents can once again get the treatment that they so desperately need?

[Wes Streeting]

I am delighted to see my hon. Friend in her place. She is absolutely right. We will take Lord Darzi’s diagnosis to write the prescription and ensure that our reform agenda benefits every part of the country—not just big cities and the wealthiest communities—so that every person, wherever they are from, grow up and live, has access to the very best health and care services.