Marriage Regulations

Sarah Olney Excerpts

Thursday 12th March 2026 Westminster Hall

[Sarah Olney (Richmond Park) (LD)]

It is a pleasure to serve under your chairship, Sir Christopher. I congratulate the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) on securing this debate, which has made me reflect on the hurdles I had to overcome to get married.

I am a Roman Catholic; my husband is Church of England. We got married in the ecumenical chapel of my old university. That meant we had to apply for a special licence, which turned out to be an extraordinary document in calligraphy and with a seal. We had to get a letter from both our dads to confirm that neither of us was already married. We had to get permission from our local parish church and consent from the Catholic Church. It took a very long time to arrange all that paperwork—obviously because of the religious requirement, rather than Government administration.

I am happy to say it was worth the trouble, and my husband and I will be celebrating our silver wedding anniversary next year. [Hon. Members: “Hear, hear!”] I take this opportunity to send my best wishes to anyone in my Richmond Park constituency or, indeed, across the country who is planning a wedding this year, whether in Gretna Green or not.

The Liberal Democrats firmly believe that couples should be able to celebrate their marriage in the way they want. Changes to marriage regulations would be small, but they would change the lives of so many people who want to demonstrate their love for one another in a manner that reflects their own religion or beliefs. That includes humanist celebrations. The Liberal Democrats made this case during our time in the coalition Government, but it was blocked by the Conservatives, despite 90% of the public supporting the legislation. We will continue to back full legal recognition of humanist marriages, in this Parliament and beyond.

In 2020, the High Court found that the failure to recognise humanist marriages was discriminatory, and in the summer of 2022 the Law Commission recommended modernising marriage law and breaking down unnecessary barriers to weddings for engaged couples. The Law Commission concluded that the law in its current state was out of date, complex and uncertain, yet still the Conservatives failed to act.

I welcome this Government’s intention to modernise our marriage law to recognise humanist weddings, as well as to permit legally binding religious ceremonies in the UK to take place, including Sikh, Muslim, Buddhist and Hindu weddings. Many of those weddings involve beautiful ceremonies, joyous moments and ultimately the declaration of love and commitment by couples. Ruling such marriages as unlawful does not represent modern-day Britain, our values or the acceptance and welcoming of other cultures.

The Liberal Democrats firmly support the liberalisation of marriage law through the Government’s proposals, and we have long supported the need for reform. Enabling couples to commit to spending their lives together is a fundamental principle of British culture. Although we term these proposals as modern, the reforms should have been introduced a long time ago. The Government have stated that they will consult on their proposals in early 2026, and I would like clarity on the date the consultation will be opened, considering that we are nearing the end of the first quarter.

The legal recognition of more marriages will provide a boost to our economy, as the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale recognised in his opening speech. Allowing more couples to take part in legally binding ceremonies is expected to add over £100 million to the public purse, while providing a significant boost to the events and weddings business sectors, which are important parts of the hospitality industry in all our constituencies.

The Liberal Democrats are proud to have been instrumental in securing the legalisation of same-sex marriage during the coalition Government, with the then Lib Dem Equalities Minister, Lynne Featherstone, fighting the Conservatives to introduce the legislation. We long campaigned for that change, and the announcement that same-sex marriage would be legally recognised is one of the biggest achievements of the coalition.

Marriage for same-sex couples was a crucial step towards equality, and one that has touched so many lives for the better. The joy of getting to marry the person you love, surrounded by family and friends, is something everyone deserves the chance to experience. Although at the time it was considered a contentious issue, I am delighted that public opinion is now overwhelmingly in favour of same-sex marriage. That is not to underestimate the extent to which homophobia remains an issue in our society. In the year ending March 2025, nearly 116,000 hate crimes were recorded—an increase on the previous year—but recognising same-sex and other marriages has established a footing for social acceptance, and it is a step towards a more tolerant society.

The proposed reform to wedding law will have positive implications for family law. It will ensure that more couples enter marriage with a secure legal foundation, and it will prevent issues from arising where couples assume their religious ceremony is legally binding, only to find that it is not. Issues such as a lack of financial protection causing significant hardship on separation can be a result of non-legally binding ceremonies. The Liberal Democrats believe that modern marriage should be recognised under the law, and therefore that these couples deserve exactly the same rights as any other married couple.

Oral Answers to Questions

Sarah Olney Excerpts

Tuesday 3rd February 2026 Commons Chamber

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

I thank my hon. Friend for raising this very important issue on the Floor of the House. All my thoughts are with the victims and survivors of this horrific situation in Scotland at the Queen Elizabeth university hospital. The Bill’s duty of candour will create a powerful new obligation on all public bodies and officials to help investigations and inquiries find the truth that is needed, placing them under a legal obligation to provide information and evidence with candour. The duty will apply UK-wide, including in Scotland.

[Sarah Olney (Richmond Park) (LD)]

T4. One of my constituents is the director of a small property company that commenced the eviction process nearly a year ago against a tenant who had not been paying their rent, but due to court errors, enforcement has not yet taken place. The delays have cost my constituent over £6,000. During a housing crisis, we should be freeing up housing for reliable tenants. Does the Minister recognise that lengthy court delays are stifling the rental market?

[Sarah Sackman]

I am sorry to hear about the case the hon. Lady raises. County court rules require that possession claims be listed for hearing within eight weeks of receipt and, in the main, we are hitting that target. Readiness for the coming into force of the Renters’ Rights Act 2025 will be important, as will the modernising introduction of the end-to-end digital possession claims service, which will improve the situation for constituents like hers.

Oral Answers to Questions

Sarah Olney Excerpts

Wednesday 28th January 2026 Commons Chamber

[The Deputy Prime Minister]

One of the greatest privileges of my life is visiting our servicemen and women who are stationed abroad. We are renewing the contract with our veterans, providing millions to eradicate veteran homelessness, and investing £50 million into a nationwide network of support centres.

I want to take this opportunity to pay my respects to Private Jonathan Kitulagoda. He was the first British soldier killed by enemy action in Afghanistan, on this day in 2004. He was just 23. The valour and heroism of those who have served our country to keep us safe must never be forgotten.

[Sarah Olney (Richmond Park) (LD)]

Q9.  A month ago today, protests erupted across Iran. In response, the Iranian Government launched a deadly crackdown. They fired indiscriminately on protesters, and they shut off internet access to hide what they were doing from the outside world. In April 2024, the then shadow Home Secretary, who is now the Foreign Secretary, asked the Conservative Government if they would finally proscribe the Islamic Revolutionary Guard Corps as a terrorist organisation. Just two weeks ago, she described the Iranian regime as a “consistent threat” to the UK’s“stability, security and freedom and to the UK national interest.”—[Official Report, 13 January 2026; Vol. 778, c. 789.]The world order that we thought we knew is being shaken up. The US is no longer able to show moral leadership to Governments who kill their own citizens. Can this Government step up and take the lead, and will they now proscribe the IRGC?

[The Deputy Prime Minister]

I utterly condemn the Iranian regime’s brutal repression of peaceful protesters. It is a long-standing position under successive Governments not to comment on whether a specific organisation is being considered for proscription. We have long criticised Iran’s authoritarian regime and taken robust action to protect UK interests from Iranian state threats, and that includes over 220 sanctions on Iran and placing the entirety of the Iranian state on the enhanced tier of the foreign influence registration scheme. We are working at pace, of course, to explore what further measures can be taken to respond to these horrific events.

Sentencing Bill

Sarah Olney Excerpts

Consideration of Lords amendments
Tuesday 20th January 2026 Commons Chamber

[Jess Brown-Fuller (Chichester) (LD)]

I thank Members of both Chambers for their contribution and their continued work, in particular the prisons Minister for engaging collaboratively with Liberal Democrats in the other place and for making concessions both in the legislation and at the Dispatch Box.

We are pleased to see Government amendments (a) and (b) in lieu of Lords amendment 7, which introduce the provision of free transcripts of sentencing remarks to victims. It has been a long-standing campaign of my hon. Friend the Member for Richmond Park (Sarah Olney) to see the provision of all court transcripts, and victims gaining access to an improved level of transparency and accountability is a great first step.

[Sarah Olney (Richmond Park) (LD)]

I just want to take this opportunity to say my personal thanks to the Minister and everybody involved in bringing the legislation to this stage. I pay tribute once again to my constituent Juliana Terlizzi, who came to see me when she was charged £7,000 for the transcript of the trial that saw her rapist sent to prison. The amendment in lieu is a huge step forward for victims of all kinds, and I am really pleased to see it in the legislation. I want to put on record my huge thanks to everyone for that.

Terminally Ill Adults (End of Life) Bill

Sarah Olney Excerpts

Report stage
Friday 20th June 2025 Commons Chamber

[Sarah Olney (Richmond Park) (LD)]

Many Members present will look forward to the day when it is possible for people in this country to die in peace, with dignity and at a time of their choosing. The opportunity to bring that about is closer than ever before, but it can happen only if Members vote against the Bill today. The express will of the House, as reflected in the Second Reading vote; the momentum generated by the Bill; and the support of the Prime Minister, as we understand it, to change the law have created a moment when it is possible to grasp the chance to bring in assisted dying legislation, but I warn Members that if this Bill passes, the case for assisted dying will be fatally undermined, and it will put back their cause for a generation.

I have sat through Committee and Report, listened to the oral evidence and participated in the debates. This Bill, if it passes, will be challenged in the courts. It will be subject to endless attempts to amend it in Parliament. It will be difficult to implement effectively, and ultimately it will lose the confidence of the public.

It was immensely challenging to properly debate the Bill in Committee, because we frequently found ourselves needing an understanding of medical practice or points of law that MPs are not typically expert in. We spent many hours, for example, debating whether or not the provisions of the Mental Capacity Act 2005 were sufficient for someone who was making the decision to die. Of course, we consulted experts, and some said the provisions were sufficient, some said they were not. I do not believe that this particular decision is one that politicians are best placed to make.

[Bradley Thomas (Bromsgrove) (Con)]

Will the hon. Lady give way?

--- Later in debate ---

[Sarah Olney]

I am sorry, but I will make progress. We would all have been better served by asking a team of experts to evaluate the evidence, draw on their professional experience and come to a settled consensus among themselves on this point about mental capacity and, likewise, the questions we had about how best to approach anorexia within the context of assisted dying and whether the Bill provides a suitable framework for the provision and control of drugs designed for the ending of a life.

These are not political decisions. They have, however, been decided by politicians, and we have approached them in our usual adversarial way, where the right answer is not the one arrived at after careful thought, consideration and consultation, but the one that can muster the most votes. We have therefore reached a most unsatisfactory conclusion.

This legislation imposes duties and responsibilities on professionals who do not think them compatible with their expert practice. It was amended in Committee to require that a panel approve an application for assisted dying, and that the panel include a psychiatrist. The Royal College of Psychiatrists has stated that it opposes this legislation.

[Mr Adnan Hussain (Blackburn) (Ind)]

Will the hon. Lady give way?

[Sarah Olney]

I will not give way, sorry. Assisted dying under this legislation cannot be implemented without psychiatrists, but they would be acting outside the advice and guidance of their professional body.

[Daisy Cooper (St Albans) (LD)]

Will my hon. Friend give way?

[Sarah Olney]

I am not giving way. Will there be sufficient psychiatrists prepared to implement the provisions of this legislation, against the advice of their professional body, to ensure that enough panels can be convened for the purpose of facilitating assisted dying? It is hard to see how there could be.

[Daisy Cooper]

Will my hon. Friend give way?

[Sarah Olney]

I am not giving way. By contrast, many decisions are expressly reserved for politicians. Should the limited resources of the NHS be used to deliver an assisted dying service, or should it be possible to offer the service as a profit-making enterprise? What information should be collected and reported about assisted dying? Who should oversee and regulate its practitioners? Members of Parliament are to have no say over any of those matters at all. Those are all powers to be reserved to the Secretary of State, to be decided behind closed doors. Once again, this legislation grants these responsibilities to people who do not want them.

Neither the current Health Secretary nor the current Justice Secretary are supporters of this Bill. After today, the House of Commons will be shut out of further decision making on this Bill, even though many of the decisions still to be made are rightfully ours to make. The lack of professional consensus or acceptance of the requirements of this legislation, coupled with a lack of political scrutiny of many of its more important provisions, creates an unstable foundation upon which to build an assisted dying service. For such a service to succeed, it needs professionals willing to deliver it, who can have confidence that they are acting within the law and will be supported by their professional peers and by society at large. I do not see how this legislation can deliver that.

It is instructive to compare this piece of legislation with the Abortion Act 1967. That, too, was a private Member’s Bill, brought to this House by the Liberal MP David Steel, but it was preceded by a medical advisory committee chaired by the president of the Royal College of Obstetricians and Gynaecologists, which approved the Bill. The professionals who would be needed to enact the legislation had indicated their support for the Bill before it reached the Commons. The Bill only delegated one power to the Secretary of State. The legislation was hotly debated then as now, but once it was passed, it came into force within six months.

Remarkably, with the exception of amendments required to bring it into line with successive Human Fertilisation and Embryology Acts and to extend its provisions to Northern Ireland, the provisions that the Abortion Act brought into law have remained almost entirely unchanged in 58 years—until just this week, in fact. The careful consideration of the issues that took place before the legislation came to the Commons, combined with the fact that all its provisions were included within the primary legislation to be debated and voted on in one go, has enabled a settled consensus to develop around abortion provision in this country, in contrast to other jurisdictions. It has enabled vulnerable women to seek the help they need and given healthcare workers the confidence and support they require to meet those needs. That is what we need, if we want to deliver a successful assisted dying service, and this legislation cannot deliver that.

If Members want assisted dying, vote against this Bill and make the most of the moment to press for a better approach that can deliver a sustainable framework, accepted and supported by the medical profession, and in which the public can have confidence. If people’s lives are going to be ended prematurely as a result of this legislation that we pass, we cannot take risks. We cannot afford to pass this Bill.

Independent Sentencing Review

Sarah Olney Excerpts

Thursday 22nd May 2025 Commons Chamber

[Shabana Mahmood]

Studies show a 60% reduction in offending. My hon. Friend is right to say that, for one subset of offenders, offending relates to power. For another subset of offenders, we believe that a combination of chemical suppressants and psychological interventions can have a big and positive impact. A pilot has been trundling along for many years, and nobody has shown much interest in it, including any of my predecessors—Tory Justice Secretaries just let it carry on. I am not willing to do that, and I am not squeamish about taking further measures. We are going to have a national roll-out of this programme, and I will ensure that is what happens. I am expanding it to two further regions, including for prisoners in 20 further prisons, so that we can build the evidence base and make sure that we are using every tool at our disposal to cut reoffending.

[Sarah Olney (Richmond Park) (LD)]

I welcome the Government’s commitment to extending the pilot scheme to give free sentencing transcripts for rape and serious sexual offences—something for which I have long campaigned. I am sorry that the Victims Minister, the hon. Member for Pontypridd (Alex Davies-Jones), has just left the Chamber, because I wanted to pay tribute to her for all her work on this issue. I also pay tribute to the victims, survivors and campaigners, and particularly my own constituent Juliana Terlizzi, for their bravery and advocacy on this issue. I look forward to continuing to work with the Minister on this issue. Can the Lord Chancellor tell us what measures will be taken to ensure that victims know about the scheme, and that they understand their right to request a transcript of the sentencing remarks? I know that the pilot has shown how much that contributes to their recovery and their welfare after sentencing.

[Shabana Mahmood]

I pay tribute to the hon. Lady for her work in this area, and I will pass on her remarks to the Victims Minister. I also pay tribute to her constituent. It is very difficult to raise these issues and talk about them openly, and her constituent has shown real bravery in coming forward and explaining why the scheme would have made a difference to her own recovery.

I am very pleased to extend the pilot scheme. We will learn the lessons about how the first pilot scheme worked in the first year, and if we need to do more on publicising what the scheme can do and its availability, we will do so. The hon. Lady will know that I want to make further progress on using AI technology to make transcripts more widely available, because I believe in a transparent justice system. I do not believe that we are very far away from having tech that is accurate enough to be a matter of court record, but we are not quite there yet. It is something we continue to work on.

Victims and Courts Bill

Sarah Olney Excerpts

2nd reading
Tuesday 20th May 2025 Commons Chamber

[Sarah Olney (Richmond Park) (LD)]

I pay tribute to the hon. Member for Knowsley (Anneliese Midgley) for her incredible speech, to Olivia’s family, and to the Government for listening to their call and including that provision in the Bill. I want to talk a little more about provision for victims, and in particular my court transcripts campaign; the Minister knows this is coming. I thank my hon. Friend the Member for Eastbourne (Josh Babarinde) for his generous tribute on that point.

I am really disappointed that there is no mention of court transcripts in the Bill. Trials are lengthy and traumatising experiences, which victims do not routinely attend; some are actively advised against doing so. Reviewing the sentencing remarks can help provide victims and survivors with clarity and closure, but too often accessing those sentencing remarks is unaffordable, which only adds more barriers to achieving justice. That is why throughout the last Parliament I campaigned on providing victims and survivors with free access to copies of their transcripts. I am glad that my open letter to the then Justice Secretary received support from the then Mother and Father of the House, as well as the former Chair of the Justice Committee.

I was glad to have cross-party signatories to my amendment to the Victims and Prisoners Bill in the last Parliament, which, if accepted, would have enabled all victims to receive a transcript of both the sentencing remarks and the judge’s summing up free of charge. Despite broad support, the amendment was ultimately unsuccessful both in this House and in the other place, where a similar amendment was tabled by my colleague Baroness Brinton and blocked by 187 Tory peers.

Given the previous Government’s refusal to address this gross inequality and their inexplicable opposition to this policy, letting down victims and survivors, I have been interested in the Conservatives’ change of heart. I notice the shadow Justice Secretary’s recent support for transcripts, and the right hon. Member for Goole and Pocklington (David Davis) raised the issue of the accessibility of court transcripts with the Justice Secretary last month. I am glad to see indications that they may be finally acknowledging the extent to which the last Government failed victims.

Following my campaigning on this issue, and the invaluable work of campaign groups working to support victims, I am glad that a 12-month pilot scheme was introduced in May last year. The scheme gives victims of sexual assault and rape access to court transcripts of their trials at no cost to them. Victims and survivors who have made use of the pilot have reported that its impact has been transformational, yet to my recent question on the issue, the Minister responded:

“We are currently assessing the pilot’s uptake and impact and will be able to say more on our plans for future provision in due course.”

As I am sure the Minister is aware, last week I introduced a Bill to the House that called for the rape and sexual offences free sentencing remarks pilot scheme to be made permanent. My recent early-day motion on this issue, which calls for the scheme to be expanded to cover all victims of crime, has also received cross-party support. If the Government do not make the scheme permanent, not only will they fail victims, but they will be not upholding the commitment in the King’s Speech last year to strengthening support for victims.

I have heard directly from constituents who have accessed their transcripts, having not attended their trial, as well as from members of the public from across the country who have been through similar experiences. They have told me of the hugely positive impact that accessing a court transcript has had on them and their journey. With just eight days until the scheme is due to end, and given that I still await a response to the letter that I and my hon. Friend the Member for Eastbourne sent to the Justice Secretary on the issue, will the Minister outline the future plans for the scheme? I urge her to make support for victims permanent. I also ask the Ministry to make clear its basis for discontinuing the pilot scheme.

I welcome so many measures in the Bill, and I really welcome its additional support for victims. I really hope that as the Bill continues through the House, we can amend it to extend the pilot scheme and make it permanent.

Terminally Ill Adults (End of Life) Bill (Twenty-eighth sitting)

Sarah Olney Excerpts

Committee stage
Tuesday 25th March 2025 Public Bill Committees

[Sean Woodcock]

I accept that it could work, but my view is that it is far less likely to work and that it is more likely to be successful if it is wholly the responsibility of public authorities.

I will vote in favour of amendment (d) to new clause 36. It would remove subsection (6), which says:

“Regulations under this section may make any provision that could be made by an Act of Parliament; but they may not amend this Act.”

It strikes me as dangerous to provide in the Bill for the Secretary of State to amend primary legislation, and we should vote to remove that power. It is surely a weakening of the Bill’s safeguards. Assisted dying must remain firmly in the control of the democratically elected Parliament. I urge Members to join me in voting to remove subsection (6).

If we fail to rule out the possibility of private provision and allow the Secretary of State the power to amend primary legislation, we will fail to implement the necessary safeguards. Amendments (c) and (d) to new clause 36 would go some way to addressing that, by ensuring that the state that sanctions assisted dying is also the body that provides it. Assisted dying services need strong reporting and accountability; otherwise, we risk inequality, or the abuse of assisted dying going unchecked. The provision of assisted dying through public authorities is essential to proper accountability, reporting and best practice, so I urge the Committee to support the amendments.

[Sarah Olney (Richmond Park) (LD)]

It is a pleasure to serve under your chairmanship, Ms McVey.

In Richmond Park, a Henry VIII power has traditionally meant the right of the monarch to hunt the deer in the large open space that gives my constituency its name—something that I am sorry to say he has in common with the dog of the hon. Member for East Wiltshire—

[Danny Kruger]

I didn’t know it was illegal. [Laughter.]

[Sarah Olney]

He paid a hefty fine, I think.

The efforts of Henry VIII’s descendants to try to enclose the park and maintain the powers for the exclusive benefit of the royal family were defeated by a popular and somewhat genteel uprising of the residents of Richmond. I stand here today as the Member for Richmond Park to do a similar job: to assert the rights of the House of Commons and the Houses of Parliament to determine what legislation is, and not to allow it to be delegated under Henry VIII powers.

The normal approach is that legislation made by Ministers is delegated legislation, and such legislation is therefore of subsidiary character to primary legislation. However, there is a type of power, known as a Henry VIII power, that gives Ministers the power to amend even primary legislation. The glossary on Parliament’s website says:

“The expression is a reference to King Henry VIII’s supposed preference for legislating directly by proclamation rather than through Parliament.”

We may in the course of time start to refer to them as President Trump powers—who knows?—but that is the precedent we act on.

The Hansard Society, a non-partisan organisation that is neutral on assisted dying, issued a report that was critical of the power in the Bill. It said this:

“little can be deduced about how it is thought this power will be used in practice, beyond the fact that it may, in particular, be used to enable the provision of assisted deaths through the National Health Service.

But as the DPRRC”—

the Delegated Powers and Regulatory Reform Committee—

“has previously stated, where a power provides that delegated legislation may ‘in particular’ include a specified matter, it implies the legislation may deal with matters beyond that specified matter. The explanatory notes shed little more light, except to clarify that the power could be used to make arrangements for the funding of any provision made by the regulations. Could the regulations thus be used to enable the provision of assistance through the private sector on behalf of the health service in England and in Wales? If the intention is that the regulations will be used only to establish an assisted dying service, either within or separately to the NHS, would they require that the service be free at the point of access to the person requesting assistance?

A key principle that the House of Lords Constitution Committee has applied to delegated powers is that they ‘should not be framed in such a way that gives little indication of how they should be used.’ The DPRRC’s Guidance to Departments states that the Delegated Powers Memorandum should set out how it is proposed that a power should be exercised.

In the current absence of the DPM, MPs may therefore wish to seek clarification from the sponsor of the Bill, Kim Leadbeater, about how she envisages the power being used, and similarly from Ministers how they expect to use this power if it were granted to them.”

The drafter of the Bill, Dame Elizabeth Gardiner, appeared on the Hansard Society podcast and gave some further detail on this power and how it arose:

“In other areas, like, is it going to be delivered through the National Health Service or in some other way, indeed the regulation of any substances that might be involved, in the time available, we didn’t have time to go into all the detail of how those regimes work and to make the provision on the face of the Bill, and so there are regulation making powers there, which enable that provision to be set out in detail, as you say, when the Government has looked at it and decided how it would implement it.”

Given the time available and the constraints of the private Member’s Bill process, the hon. Member for Spen Valley can be forgiven for not including the detail of how assisted dying will be provided on the NHS in the Bill on its introduction, but she and the Government have now had months to think about it. Many people had hoped that clause 32 would be replaced with detailed arrangements for the delivery of the service, to be put on the face of the Bill by way of an amendment, which the Committee could properly scrutinise.

On 5 March, the hon. Member for Spen Valley repeatedly said that it would be made clear by clause 32. When the hon. Member for East Wiltshire called for clarity in the Bill as to how the service would be delivered, the hon. Member for Spen Valley said: “It will be.” The Minister said:

“Officials are working on amendments to later clauses to establish the operating model for her consideration.”––[Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 5 March 2025; c. 802.]

This does not appear to have happened, which means Parliament will be limited to a 90-minute debate on this issue when the regulations are eventually made, and such a motion will be unamendable. Surely the issue of how the service is to be delivered is much more important than that and deserves greater scrutiny.

It is disappointing to see new clauses 36 and 37 as the replacement clauses. Ideally, instead of the new clauses we would have had a detailed set of amendments to specify exactly how assisted dying is to be delivered. We do not have that; instead, we have a Henry VIII power that provides even more power than the one in clause 32, because the new one includes a power to modify Acts of Parliament passed subsequent to this legislation.

New clause 36 provides very little guidance on how the Henry VIII power would be exercised. Will assisted dying be provided by the state? If so, would that be on the NHS or through another body? Subsection (1) one does not specify that it must be on the NHS. Subsection (4) gives the power, but not the duty, to change section 1 of the National Health Service Act 2006—a foundational piece of Labour legislation if there ever was one, as the hon. Member for Banbury said—but subsection (5) requires it to be free at the point of use.

The question of whether assisted dying should be provided as part of normal NHS services, or in a parallel service, as requested by both the BMA and the Royal College of General Practitioners, is not answered by new clause 36, although hopefully it can be fleshed out in the debate on the amendments in the name of the hon. Member for East Wiltshire. Alternatively, it would seem that the power can be used to commission private providers to deliver the service on behalf of the state. Instead of deciding between the various models, new clause 36 simply leaves it open. It therefore gives very little indication about how it should be used.

When giving the Gray’s Inn reading at Gresham College last year, Lord Falconer said:

“The wider the power—because there is less material in primary legislation to define how it should be exercised—the greater the reduction in parliamentary scrutiny, but also the harder”—

it would be—

“to identify any legal basis of challenge.”

He went as far as to suggest that such wide Henry VIII powers were “unconstitutional”. Given his great support for the Bill, it would be interesting to hear the response of the hon. Member for Spen Valley and the Minister to Lord Falconer’s remarks.

--- Later in debate ---

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

My hon. Friend the Member for Luton South and South Bedfordshire referred to IVF. My wife and I have been through IVF, and what exists is exactly what the hon. Member for Richmond Park described. There is an annual show at Olympia where it has been commercialised and it is put to people, “Why not go down this route? Why not go down that route?” Does the hon. Member agree that that is really not a route we want to go down?

[Sarah Olney]

I am grateful to the hon. Gentleman for that point, because it provides a comparison. We are talking about there potentially being a market for end-of-life services. I do not think that is the way we should be going.

[Dr Opher]

I thank the hon. Lady for her impassioned speech, but we are rather getting off the point. The division between private and NHS provision is spurious in a process that will be delivered by doctors who are working under a code of practice. They will be rewarded in their pay which, as we have said, will be stipulated by the BMA in contracted arrangements with the Government and will be proportionate. The doctors will do the work and get the money for that. That is no different from IVF or anything else. If we accept that the NHS will be the commissioning body and will ensure standards in that way—sorry, I am going on a bit, Ms McVey; I shall now finish—the division between an NHS provider and a private one is spurious.

[Sarah Olney]

The issue is who is commissioning the service. The issue is not the doctors or how they are recompensed for the work that they do, but who is doing the recompensing and what their incentives are. If the process is part of an NHS-provided service where it is agreed that it is a compassionate end of life choice, and where it is properly regulated within the wider NHS service and connects with other NHS services, that is one thing.

If the person commissioning that doctor has any kind of incentive around making a profit—and any profit-making organisation will be incentivised to increase the amount of profits that it makes—then, however carefully regulated, there will be subtle influence, pressure, coercion or persuasion that assisted dying is an option that patients should choose, or possibly not-so-subtle influence, to take the example from the hon. Member for Bexleyheath and Crayford. Under other circumstances, in an NHS model, that may not have been a solution they would have been persuaded to choose. It is that issue of persuasion and of incentives that really troubles me.

[Kit Malthouse (North West Hampshire) (Con)]

I am not clear: is the hon. Lady suggesting that doctors who operate in the private sector are less ethical than doctors who operate in the public sector?

[Sarah Olney]

I think I said very clearly to the hon. Member for Stroud that it is not about the doctors. It is about the people who are commissioning them. I absolutely do not believe that about doctors operating in the private sector, who in my experience are often the same doctors as the ones in the NHS. It is about who is commissioning them and who is asking them to carry out this work, and whether those commissioners are motivated by a profit incentive as opposed to the incentive in the NHS to provide the best possible care.

[Danny Kruger]

I entirely agree with the hon. Lady. We are all equally ethical and unethical—the point is that we respond to incentives, and incentives have their effect. Does she agree that there is a further concern? If we had a tariff system, which we probably would, that would by definition create a market, if there was the opportunity for private provision, to earn tariffs—to make more money the more assisted deaths one provides. Furthermore, to the point made by the hon. Member for Stroud that this is all perfectly fine and normal, what about the opportunity to top up the public provision—the tariff one gets from the NHS—with one’s own money, therefore definitely creating the opportunity for some sort of upmarket arrangement through the additional fees and services that might be provided? As the hon. Member for Bexleyheath and Crayford said, we could see expos dedicated to providing the most luxury or glamorous forms of assisted death through private providers with NHS funding.

[Sarah Olney]

That is not a prospect I particularly want to reflect on, but it is worth noting that the particular risk in assisted dying services is that, as we heard in oral evidence from the chief medical officer, it is really hard to define, first, whether an illness is going to be terminal and, secondly, that somebody has only six months to live. There is an element of subjective judgment in assessing who is going to be eligible for assisted dying. Aligning subjective judgment to a profit incentive could create a serious ethical minefield.

I want to state absolutely clearly for the record that I am not questioning the ethics of doctors or the ethical standards of doctors or of any of the bodies that represent them in any way at all. My question is merely about introducing a profit incentive to this issue. As I said, this process could be contrasted with something like the provision of abortion services. Abortion services are clearly available only to pregnant women. The fact that the qualification, as it were, for this service is on a rather more subjective basis creates a risk.

Without this amendment, I am concerned that the Bill commodifies the end-of-life process and pushes what should be a sensitive, careful process towards being a transactional one. It also increases the risk that everything becomes focused on facilitating ending the patient’s life rather than supporting the holistic ethos of the NHS in addressing all the patient’s needs. Without the amendment, I worry that the Bill opens a door to the commodification of death, as the hon. Member for East Wiltshire has so graphically anticipated. What should be a careful, compassionate process could slide into something more transactional: a service that is marketed, packaged and sold.

We need look only to the parallel of care homes to see that danger writ large. In England, social care has been quietly overtaken by for-profit providers. Today, 75% of adult care homes, and over 80% of children’s homes, are run for profit—not by design or explicit policy, but by the slow creep of market forces. The Economics Observatory, drawing on studies such as Patwardhan et al. 2022, Barron and West 2017 and Bach-Mortensen et al. 2022, reveals a stark truth: for-profit care, particularly where private equity is involved, consistently delivers worse outcomes.

Similarly, a 2019 BMJ study found that private providers running NHS-funded services had higher rates of complications in procedures such as hip replacements compared with NHS trusts. The focus on cost efficiency can lead to skimping on follow-up care or using less experienced staff. Why does that happen? Profit-seeking behaviour drives cuts to staff, to resources and to time. Now, if we transpose that to assisted dying, let us imagine the pressures on a private provider to trim costs and the pressures on the quality of assessments. How thoroughly are mental health conditions, or the risk that something else might be going on, explored? How great is the depth of attention to medical records? Is what is relevant to the doctor influenced by the ticking clock? Will they tick a box rather than a safeguard?

[Kim Leadbeater (Spen Valley) (Lab)]

The hon. Lady said that she is not questioning the ethical judgment and practice of doctors, but the comments she is making suggest otherwise.

[Sarah Olney]

Again, I am talking about the companies that are running the service. I am not questioning the ethics of the doctors involved. I am merely suggesting that the people who are commissioning the doctors to carry out the service will have their own priorities that are not directly related to the safety or welfare of patients.

--- Later in debate ---

[Sarah Olney]

It clearly remains to be seen, but that may be an outcome as we do not yet know what model we are proposing for the delivery of assisted dying. Perhaps doctors will feel pressured to deliver an outcome because that is how the model has been set up. If we have a model that incentivises profits, particularly if we do not have a similar service within the NHS itself, it is quite possible that that will happen. It will not necessarily affect the care that doctors give to patients at the end of life, but the point is that we do not know.

We cannot fully explore that matter in Committee, because we do not have the full clarity of exactly how the process will be delivered, so we cannot examine the proposed model and identify its potential risks and pitfalls. That continues to be a real concern. Perhaps doctors will feel that pressure; perhaps the service will be precisely designed to encourage them to, for example, diagnose someone with having fewer than six months to live even when it is a slightly more subjective judgment and a different doctor operating in a different system may come to a different view.

[Kit Malthouse]

That is an extraordinary claim to make against doctors.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I am just trying to wrap my head around the argument. We already know that integrated care boards and other commissioning bodies have incentives given to them when they commission services, so it would be in their interests to diagnose or produce a demand for a service in a particular area. There is already an analogous situation within the NHS; I do not see how that is any different.

[Sarah Olney]

I thank my hon. Friend for his intervention, but those incentives are not about creating profits that make money for individuals. They are about directing the way that resources are allocated to ensure that a broader range of health outcomes are achieved. When I talk about a profit incentive, it is an entirely different kind of incentive from the one he has just raised.

[Danny Kruger]

This is a very important debate, and my concern is that there is a naive assumption that the innate goodness of doctors will render them impervious to all the incentives in the system. As the hon. Lady suggests, if it were possible, as I think it is under the Bill, for a profit-making organisation—a company—to set itself up to provide an assisted suicide conveyer belt as a pathway through this process, and to earn money publicly or privately according to the volume of the provision it enables, we are setting up incentives that would corrupt the doctors who would be required to sign it off.

I regret that my right hon. Friend the Member for North West Hampshire has such an optimistic view of human nature that he thinks that no doctor would respond to the incentives in the way that is clearly enabled through the Bill. There are other medical professionals—ethical doctors—who do respond to incentives, such as those in the cosmetic surgery industry.

[Danny Kruger]

I would, but actually I am making an intervention. It may appear that I am making a speech, so I will soon sit down, but I would be interested in the hon. Gentleman’s response to the suggestion that even he —the paragon of virtue that he is—might not be entirely resistant to the economic incentives in the system. That is why we have an NHS that explicitly tries to exclude profit making from the provision of healthcare.

[Sarah Olney]

I thank the hon. Member for his intervention, but I do not associate myself with his use of the word “corrupt”; I am absolutely not implying that in any way, and I want to be very clear about that. However, there is a grave risk—even for the most ethical person, if they are offered money to carry out an action that they are inclined to carry out anyway as part of their professional practice—that those incentives drive behaviour that leads to worse outcomes for patients, specifically in relation to assisted dying.

[Dr Opher]

There may be an incentive to review a patient for assisted dying, but there is absolutely no incentive in the Bill to approve assisted dying. The idea that doctors would approve assisted dying for financial reasons is completely spurious.

[Sarah Olney]

As I say, we do not have a model before us that we can fully scrutinise or test for risks, and we will not have the opportunity to propose amendments to address those risks—nor will we at any stage. There is a serious risk about all the different parts of the system, not just the doctors, being incentivised by private profit. My amendment would comprehensively remove that, so it would not be a risk. Given that we cannot fully and properly scrutinise the proposed model, my amendment is the best we can do.

[Dr Opher]

I really want to point out that there is no incentive to agree to assisted dying, only to assess for it. There is no reason for people to be corrupted into agreeing, because it would not mean they would get any more money.

[Sarah Olney]

We do not have the model to scrutinise, and we do not know within that whether the first or second co-ordinating doctor will be paid for their services in carrying out those initial assessments. To say that there is no incentive for making the final decision ignores the fact that people might be incentivised for making those initial decisions, where the professional judgment is required and may differ between doctors. That is why there is a risk.

[Kim Leadbeater]

Clause 40(4) is very clear that medical practitioners can receive only “reasonable remuneration” for the provision of services, so it is clear that they cannot make money from the provision of assisted dying. Is the hon. Lady saying that where there is a private provider or one commissioned by the NHS—the model that I have set out in the Bill—there is a financial incentive for doctors to do more hip or knee operations, or other things? That is a question about the model of public and private healthcare as it stands, not about assisted dying.

[Sarah Olney]

On the hon. Member’s comment about clause 40, “reasonable” is a fairly elastic term. We will find in time that the word “reasonable” will come to have its own accepted definition, but it does not preclude a profit margin.

[Kim Leadbeater]

I would argue that it does.

[Sarah Olney]

But the Bill does not say that. It does not say that the payment to the doctor should not include any consideration of profit. Regarding hip operations, someone would have one only if they needed it. My point is that assisted dying is one of a range of options at the end of life being presented here. The concern is that people motivated by profit would be incentivised to push for assisted dying at the expense of other options for the patient that do not attract the same level of reward. That is the issue. It is not a binary decision in the way that most treatments are.

[Danny Kruger]

In response to the hon. Member for Spen Valley, the scenario that she mentions is exactly the problem in many healthcare systems around the world, particularly in America, where doctors are incentivised to deliver volumes of treatments and procedures that are often not strictly necessary. We do have a problem even in our own system with the over-prescription of certain medical treatments, particularly pharmaceuticals, so incentives do apply. Doctors are subject to them, and we do our best to regulate them out of the system. One of the great advantages of the NHS compared with other healthcare systems is that we manage to prevent the over-provision of services in response to economic incentives. That is a founding principle of the NHS that we are overriding with this process.

[Sarah Olney]

I will conclude my remarks by observing that the only reason that we are looking at contracting out assisted dying services to a private provider is that the country is simply not ready for assisted dying. We know how overstretched and under-resourced our NHS is, and we are looking at cutting corners in the Bill, in our policymaking, in our scrutiny of this legislation, and in how this legislation and the service is delivered.

[Naz Shah (Bradford West) (Lab)]

It is interesting to follow the hon. Member for Richmond Park, because I rise to speak to amendment 537, tabled by my hon. Friend the Member for Shipley. The amendment goes further than the hon. Member for Richmond Park would as far as local authorities are concerned.

The amendment also concerns both the national health service and the provision of healthcare by charities. My hon. Friend the Member for Shipley knows both fields extremely well. She was the director of quality and strategy and chief analyst at the Department of Health, and then had a senior role at the Centre for Ageing Better. Her amendment would mean that assisted dying services could be provided only by charitable organisations and not by the national health service.

I strongly support the general principle that if we do have assisted dying, it should be free at the point of use. If this House decides that people do indeed have the right to an assisted death under the conditions that this Bill sets out, then it should not be something limited to those who can afford private healthcare. There are, however, strong objections among general practitioners to providing assisted dying as part of their services, and I do not think we should plan to have private firms work under contract from the NHS to provide assisted dying either.

The Royal College of General Practitioners said in its written evidence that

“any assisted dying service should be seen as a standalone specialised service that healthcare professionals may opt to provide with additional training and should not be deemed core GP work.”

The royal college’s advice, which is founded on the views of its members, means that we should give very strong consideration to putting assisted dying outside the normal workings of the NHS. If we do that, it seems that there are a few options. One is for the Secretary of State to invite private firms to tender for contracts and administer assisted dying services. As I have said, there are very strong reasons why we should not plan to have private firms work under contract to the NHS to provide assisted dying; for me, that it is one of the worst possible options.

Another option is for the NHS to fund a specialised assisted dying service that would be separate from its other functions. That could potentially be feasible, but it could also represent a significant cost for the NHS, because we still have not had the impact assessment from the Government and we have no idea how significant that cost may be.

There is also the worry that if assisted dying becomes available on the NHS, some people will become too frightened to access palliative care, as was outlined to the Committee by Dr Jamilla Hussain. I will read a brief part of her written evidence to the Committee. After talking to the patients in ethnic minority and other disadvantaged groups, she said:

“Overwhelmingly, racialised communities expressed deep concerns that they would be more likely to be pushed towards AD through systemic biases and societal attitudes about whose lives are valued… While safeguards were acknowledged, many remained sceptical that they would be applied fairly and equitably, fearing that vulnerable individuals, particularly those who lack strong advocates or English proficiency, might be at greater risk of being guided towards AD rather than offered appropriate care options.”

I want to share something with the Committee. We often get taxis to and from work and home; I got into a cab yesterday, and the chap who was driving was called Dave. His 84-year-old aunt died on Friday. When we were discussing this option, he told me really clearly that she has opted for a cremation, which would cost less money, just because she internalised that idea of burden and she did not want a cost for those that she left behind. She had not seen a doctor for 40 years. That brought home the idea of internalised coercion, internalised pressure and mistrust, because he also talked about what happened during covid. We had an interesting conversation. I told him that it was interesting that he had said that, and today I am talking about it. That is the reality: it is about how people perceive healthcare provision, the potential inequalities, and what the barriers are to access—all the preconceived ideas that we have about the provision of healthcare.

That brings me to a potential third way, which is what amendment 537 is about: charities. Charities are one way of addressing the concerns I and the hon. Member for Richmond Park have outlined about the risk with private companies and the risk of loss of confidence and access to the NHS, as well as the concerns outlined by the Royal College of General Practitioners. They could well be mitigated by ensuring that the lead responsibility for administering assisted dying is given to charities rather than the NHS.

--- Later in debate ---

[Lewis Atkinson]

I hope to help the hon. Gentleman with the points I am about to make.

What I would say to begin with is that we have talked throughout this Committee about using an opt-in model. There is this idea that everyone will be doing this, but we have rightly set out requirements for specialised training and so on. There will clearly be individual doctors in the NHS, and so on, who decide that they want to provide these services, and specialisms and appropriate regulation will accordingly be developed as part of that.

The other thing I would highlight is that the current drafting explicitly requires a range of provision. The second doctor must be independent. Indeed, clause 8(6)(d) requires that they must not be

“a partner or colleague in the same practice or clinical team as the coordinating doctor”,

so although some are suggesting, perhaps in a positive sense, that there should be one, entirely separate organisation that does all this, that would not meet those requirements. There are those who are trying to instil a fear of one large organisation being set up to take someone from start to finish, but that is not possible under the Bill as drafted.

[Sarah Olney]

I am reflecting on the earlier intervention on me by the hon. Member for Stroud about how the only payment under assisted dying would be made at the very end, so therefore there would no possibility of a doctor making an assessment at an earlier stage in the process being influenced. Now the hon. Member for Sunderland Central is saying—this is obviously implied by the drafting—that the different bits of the approval process would need to be delivered separately. Whether that involved a payment from the NHS or a private provider, the doctor making those assessments will clearly be paid at different stages in the process.

Does the hon. Gentleman agree that this points to the fundamental problem we have in this Committee, which is that we do not have a proposed model that we can properly scrutinise? All of us are just talking about potential suppositions about how things might work. We are effectively talking about a range of straw men.

[Lewis Atkinson]

No, I do not agree with the hon. Member, and I will tell her why. The reality is that the shape of the health provider landscape is different in different parts of the country. For example, in Wolverhampton, there has been a significant amount of vertical integration, such that in many cases GP services are part of the NHS provider trust. Therefore, those amendments that would prohibit any public body from participating would explicitly prohibit GPs in Wolverhampton from that provision. Elsewhere, some hospices—a small number—are provided directly by the NHS. Given the history of the hospice sector in the UK, there is clearly a strong voluntary and charitable element of that provision, which is entirely right, but that varies in different parts of the country.

To return to the point made by the hon. Member for East Wiltshire, there are some hospices and end-of-life providers who have made it known that, if this law passes, they may wish to explore whether they will provide such services. Equally, others will not. This goes back to the conscience debate that we had last week. There will be no obligation, so a hospice in one part of the country may well say, “Yes, we wish to provide this service as an option to our patients,” whereas a hospice in another part of the country might say, “We do not.” We need to get past this metropolitan mindset, whereby ll the providers are within easy travelling distance from each other.

--- Later in debate ---

[Lewis Atkinson]

The hon. Gentleman is providing a masterclass in scaremongering. I know he needs Labour votes to switch before Third Reading, but this service must be explicitly commissioned by the Secretary of State, and it is inconceivable that they would commission that in the way that the hon. Gentleman describes. The co-ordinating doctor is of course one person, and they would be involved in the first assessment and the provision of assistance. Whether that is a doctor employed by the NHS or somebody else, it can only be one individual, but there are the other safeguards we have talked about, such as the panel, which the hon. Gentleman has spoken against. It is absolutely appropriate that the Secretary of State has the powers and the duty to commission the service, and that they will do so from range of providers, reflecting the differences.

On the other point that some hon. Members have made about regulation, I remind the Committee that any provider will be regulated not only under this Act, but by the Care Quality Commission, in entirely uniform manner. I am therefore confused by the points made by opponents of the Bill. Some have said there should be no provision of this by the NHS or any public body, some say there should be no provision by charities—including, presumably, local hospices, should they make that decision—while others say there should be no provision by local GP practices to provide continuity of care.

Perhaps those different points reflect different ideologies within the Committee that are deeper than this issue, but they perhaps also reflect the fact that opponents of the Bill simply do not want this service to be provided at all.

[Sarah Olney]

Will the hon. Member give way?

[Lewis Atkinson]

No, I am going to finish this point.

The hon. Member for East Wiltshire did a good job of reading a Bevan quotation before—although I do not advise him to seek Labour party selection with such gravitas in his voice. However, I think he is the heir not to Bevan, but to Bernard Braine, the Member for South East Essex, who said in the 1967 debate on the David Steel abortion Bill:

“The idea has been spread around that it will be available on the National Health Service.”

In reference to the waiting lists, Braine went on to ask:

“Are our consultant gynaecologists going to make that list longer by making beds available to those who want abortions?”—[Official Report, 13 July 1967; Vol. 750, c. 1382.]

That is the tradition of objection that the hon. Member for East Wiltshire is in. Just because he does not wish to have the option for himself, he does not believe that there should be free-at-the-point-of-use provision on the NHS for anyone else.

I will take Bevan back to this side of the Committee Room. He said:

“The essence of a satisfactory health service is that the rich and the poor are treated alike, that poverty is not a disability and that wealth is not advantaged”.

At the moment, at the end of life, wealth clearly is advantaged. Those who are wealthy and are able to go to Switzerland do have choice at the end of life. Dignity and independence and autonomy should not be based on ability to pay. That is why we need to pass this Bill; that is why the powers to commission in new clause 36 are entirely appropriate and necessary; that is why I support it.

Terminally Ill Adults (End of Life) Bill (Twenty-second sitting)

Sarah Olney Excerpts

Committee stage
Wednesday 12th March 2025 Public Bill Committees

[Sarah Olney (Richmond Park) (LD)]

To pick up on what the hon. Member for Spen Valley said, the multidisciplinary panel comes at the very end of the process. She has talked about the different stages, but they all occur in isolation. There is a doctor, then there is another doctor, and then there might be a psychiatric referral. We heard clearly in oral evidence about the value of the multidisciplinary panel referring to each other and taking evidence collectively. The strength of it would be that it occurred at the beginning of the process. I wonder whether the hon. Member will reflect on that.

[Daniel Francis]

I think that is the case. As the hon. Member said yesterday, people from those professional fields—in their written evidence, particularly—asked to be included in the process, but I do not think they were asking to be included at the end of the process; I think they were asking to be included earlier.

Terminally Ill Adults (End of Life) Bill (Twenty-third sitting)

Sarah Olney Excerpts

Wednesday 12th March 2025 Public Bill Committees

[Danny Kruger]

I regret that my right hon. Friend is making that argument. The fact is that the panel is already going to consider whether it is appropriate. There might not be some professional who is there with the purpose of suggesting that there are other things that the panel should consider, but the patient is already lying there waiting for powerful people in another room to make a decision about whether they are going to get an assisted suicide or not. That process is already going on.

On my right hon. Friend’s point that it is intolerable for somebody to hear the case made against their assisted death, let me put to him an alternative hypothesis. Rather than somebody in the situation that he describes, let us imagine somebody who is the victim of years of coercive control, who has undiagnosed mental health conditions, who is feeling a burden on their family and whose relatives want their money. None of that has yet been fully identified through the initial doctor’s stage of the process, but it has been commented on in some of the evidence that the multidisciplinary team heard. That person might hope that somebody is there making the case for them, as might their family.

It is totally appropriate for a court to hear that this procedure should not go ahead because of those other factors, which are only now being properly understood by the decision maker. That decision maker is doing so openly, not in a private session. The decision is being made not by people who are committed to the procedure and process of assisted suicide, but by an independent judge, sitting in their judicial capacity in open court, with all the safeguards and accountability that the judicial system has. That feels to me like a perfectly appropriate safeguard, and I suggest that it is, in principle, what the House of Commons thought they were getting when they supported this.

[Sarah Olney (Richmond Park) (LD)]

I am just reflecting on the right hon. Member for North West Hampshire’s intervention. Does the hon. Gentleman not agree that the purpose either of the panel or the High Court judge is to establish beyond all doubt that if a person is assisted in their death, no crime is being committed, and that in order to establish that, we need to apply the highest standards of evidence? Whether an adversarial or an inquisitorial process is used to collect that evidence, there must be some sort of process. That may be uncomfortable for the patient but it is necessary for their friends, relatives and the doctors being asked to assist. That is really what we are trying to achieve.

[Danny Kruger]

I am grateful to the hon. Lady for making that absolutely central point. This is a judicial process, and a decision is being made. I recognise that the hon. Member for Spen Valley has correctly abandoned the claim that this is a judge-led process—because it is not—but the function of this panel will be essentially judicial, not least because the decision to proceed with an assisted death entails the people involved in administering it being exempt from criminal law and not being liable to prosecution under the Suicide Act 1961. We have made an exemption for what is otherwise a crime, and if they do not get the go-ahead from this panel, they will be committing a crime if they proceed. So in all essence, a judicial decision is being made, and it is right that we have the protections of a court.

Let me make a couple of brief points about the practicalities, and they have partly been made by others. The central point is that we do not know whether the professionals who will be required to take part in this panel have the capacity to do so. We know that the judges do not have the capacity under the current design of the law, which is an essential flaw—or we think they do not, because that point has been comprehensively argued by the judiciary and I suspect by officials at the Ministry of Justice. What we do not know is whether the psychiatry and social work professions have adequate capacity. There has been no impact assessment, and we have had a lot of comments from representative bodies expressing anxiety about the capacity of these professions to supply the panels.

The point I am trying to make is that we cannot, and should not, legislate in the dark. We should not draft laws in ignorance of these basic facts. We need to know whether the law before us is workable in the real world, and I would be grateful for clarification on that from Ministers when they speak to this clause. In my view, we need robust and clear data on how many professionals might take up the posts, and more importantly, we need the clearest and earliest warning of where there might be deficits that would compromise the entire system, particularly around the capacity of psychiatrists. We have a central problem with ignorance around capacity, but my strong view is that we do have a problem with capacity.

An important point was made by Alex Ruck Keene in evidence around the judge-led process, which we discussed earlier. His point was that it would not be possible for the judge to decline an assisted death on the basis of what he calls service denial—that is, there is not enough social care treatment or medical treatment available for the patient. If the reason why the patient were to receive an assisted death was that the local authority would not provide them with improvements to their home or funding, or that they could not get the medical treatment they wanted early enough, that would be a legitimate reason, or would not be a reason not to proceed with an assisted death. That is a very grave concern to us, and it is what happens in other countries. We heard this morning about evidence that when a patient is denied the medical or social care that they need to carry on living and living well, they are offered an assisted death. In those circumstances, I would really hope that the decision maker would conclude that it is wrong that we offer an assisted death, and that we in fact need to insist that they get the support they need to live well. I reference that because, as I understand it, there is no opportunity in the new clauses for the panel to decline an assisted death on grounds that it is being sought only because of the inadequacy of the wider care system.

It has been suggested that the judicial option remains, through the judicial review system. Other hon. Members have responded to that point, so I will not labour it. However, I want to make the point that new clause 17 makes judicial review less likely because it offers the opportunity for a sort of appeal. It is an appeal only in one direction—against a refusal—but there is a sort of appeal process in the system. As my hon. Friend the Member for Reigate said, if there is a JR, it is likely to take a long time. There is nothing about whether legal aid will be arranged. The state has proposed to pay for people to go through the assisted dying process, but is not prepared to pay anybody to challenge it, so they would have to raise their own money. It would also take a long time. It would be much simpler and better, whether it is a panel or a judge, to set up the system in a way that allows both sides to be told and that does not rely on a cumbersome judicial review system.

I reiterate that I support the multidisciplinary team. It is a very good thing that the hon. Member for Spen Valley has decided to introduce a proper stage at which a psychiatrist and a social worker will have to consider the application properly. I have concerns about how it would actually work, which I will come on to, but having a multidisciplinary team is in principle the right system. I stress that the professionals who made the case for multidisciplinary teams as part of the assessment process have not endorsed the new clauses. They are not saying that we have adequately met their concerns about the process.

--- Later in debate ---

[The Minister of State, Ministry of Justice (Sarah Sackman)]

It is a pleasure to serve under your chairship, Ms McVey.

As my hon. Friend the Minister for Care and I have made clear throughout debate, the Government continue to remain neutral on the Bill and do not have a position on assisted dying. Once again, my remarks will focus on the legal and practical impacts of the amendments, with a view to assisting Committee members. I will first speak to amendments 371 to 373, 377, 378, 381, 388, 390 and 391, new clauses 14, 15, 17 and 21, and new schedules 1 and 2, all tabled by my hon. Friend the Member for Spen Valley.

In executing our duties to ensure that the legislation, if passed, is legally robust and workable, the Government have worked with my hon. Friend the Member for Spen Valley in relation to the amendments, which propose the voluntary assisted dying commission and the panels. They reflect my hon. Friend’s intent to replace the court approval process that is currently set out in the Bill. I confirm that this change was driven not by capacity concerns from within Government, but by the Bill promoter’s policy intent. Let me be clear: the High Court stage could be made to work, but if the Committee and Parliament elect for the commissioner and panel model, the state will work to deliver that.

New clause 14 and consequential amendment 391 would provide for the establishment of a voluntary assisted dying commissioner. In keeping with other appointments of this significance, the commissioner would be appointed by the Prime Minister, and the individual in post must hold or have held office—so it is not sitting judges, but could be a retired judge—as a judge of the Supreme Court, the Court of Appeal or the High Court.

New clause 14 sets out the central functions of the commissioner, which will be detailed further in new clauses 15 and 17 and new schedule 1. The commissioner would receive documents, including the reports from the co-ordinating doctor and declarations under the legislation, make appointments to the list of persons eligible to sit on assisted dying review panels, and refer cases to those panels, which would replace the role of the High Court in the original draft of the Bill. In addition, the commissioner would have the responsibility for monitoring the Bill’s operation and reporting annually to Parliament, which we will no doubt come to in clause 34. It is important to pause there, because that is one aspect in which the commissioner model is distinct from that of a court or tribunal. It will serve multiple functions, not least the monitoring of the Bill’s operation and reporting on that annually to Parliament.

New schedule 1 contains practical arrangements for the office of the voluntary assisted dying commissioner, as established in new clause 14. In practice, we anticipate that the commissioner’s office will be a non-departmental public body. The establishment of such an office to support the Government-appointed chair or commissioner is common practice for roles of this nature. One such model is the Investigatory Powers Commissioner, which is chaired by a person who is holding or who has held high judicial office. The schedule also introduces the role of a deputy commissioner, who, like the commissioner, must have been appointed by the Prime Minister and hold or have held office as a judge of the Supreme Court, the Court of Appeal or the High Court.

Both the commissioner and deputy commissioner would be appointed for terms of five years, with their remuneration set by the Secretary of State. The commissioner would have the ability to appoint their own staff, having obtained approval from the Secretary of State in regard to the number of staff, the remuneration and the terms, as well as providing an annual statement of accounts. In the ordinary way, such a public body would be subject to other statutory provisions, not least the Equality Act 2010.

New clause 15 would establish the mechanism for the referral by the voluntary assisted dying commissioner to an assisted dying review panel. When the commissioner receives a first declaration from the person seeking assistance, and reports from the co-ordinating and independent doctors as to their assessments of the person—including a statement by those doctors as to the person’s eligibility for assistance—they would be required to refer the case to a panel as soon as reasonably practical. In practice, the task of organising the work of each panel would fall to the commissioner’s office. The co-ordinating doctor would be required to inform the commissioner where a first or second declaration is cancelled. Where the commissioner is informed of the cancellation of the first declaration, they must not refer the case to a panel, or must inform the panel to disregard the application if already referred.

Amendments 371, 372, 373, 377, 378, 381, 388 and 390 are all consequential amendments on new clause 21, and together establish the mechanism for the consideration of cases by the assisted dying review panels in place of the High Court. Panels would be required to review each case and issue a certificate of eligibility where they are satisfied that all requirements set out in the Bill have been met.

[Sarah Olney]

I seek clarification. As drafted, in clause 12(1)(c), the High Court would give

“a declaration that the requirements of this Act have been met”,

but in new clause 21(6)(a), the panel is required to issue a certificate of eligibility, to which the Minister just referred. I seek the Minister’s guidance on whether it is the Government’s view that the High Court declaration has equal weight in law to the certificate of eligibility set out in new clause 21. I ask particularly because that certificate will be relied on for the purposes of suspending the Suicide Act 1961, under which a criminal offence would otherwise have been committed. The certificate of eligibility will need to be relied on to demonstrate that no criminal offence has been committed under that law. Is it the view of the Minister and the Government that a High Court direction, as originally required, can now be fully replaced by, and have equal weight with, a certificate of eligibility?

[Sarah Sackman]

As I understand it, everything has to be internally coherent in whatever the final draft of the Bill is. Within this structure, because in this case it is a panel that issues the certificate, it is its own sui generis certificate appropriate to this process. The declaration that was referred to in the earlier draft is one that the High Court would normally do. Given that this is on the face of the Bill, and will be in primary legislation, it would have legal force and would, if it were internally coherent with the rest of the legislation, have the legal effect of operating coherently with the criminal offences and, indeed, with the suspension of the Suicide Act, as the hon. Lady just asked. That is my understanding.

[Sarah Olney]

My original question was more about whether it has the same legal force as a High Court direction.

--- Later in debate ---

[Sarah Sackman]

I drew the comparison for the purpose of showing where judges and legal experts are deployed in a multidisciplinary forum that is not a court or tribunal. I was not suggesting that there is a straight-line analogy. After all, a Parole Board panel is performing a different function to make a global assessment of risk. That is what it is ultimately doing; it is not strictly speaking an adversarial process in that sense.

The situation that the Bill addresses is that of an individual seeking to establish their eligibility for a right that—if the Act is passed—Parliament will have conferred on those who meet the criteria. It is not an adjudication. It is the panel’s function to assess, through the various conversations and provisions and by interrogating the information that has been provided, whether it is properly satisfied that the eligibility of the person’s election to avail themselves of that right is sound.

[Sarah Olney]

I am trying to clarify this for my own benefit, because I am not familiar with some of these procedures. Is there a difference between a High Court judge leading an inquiry or sitting on a panel, using their legal experience to provide advice or recommendations or give an opinion, and having a judge sitting in the High Court, who, under the original wording of clause 12, would be giving a direction? If there is a difference, have we not crossed from one role to the other by introducing a panel rather than a High Court direction? Does that matter for the purposes of the legislation?

[Sarah Sackman]

To be absolutely clear, what we are discussing reflects the intent of my hon. Friend the Member for Spen Valley. It is important to break it down. We have a judge in the role of the commissioner, and the commissioner will set up the framework and guidance for how the panels will operate and will lend their expertise. Our judges often sit on the Civil Procedure Rule Committee, developing the appropriate practice to govern the process in question. In this case, it would be the process of providing the third layer and the assessment whether the eligibility criteria have been met.

The commissioner would also—and this is where the role is distinct from that of a court or tribunal—provide a monitoring and reporting function to Parliament on the operation of the Act. That is a fundamental distinction from the model that we will have if we pursue clause 12, because in that case each application for an assisted death would go to whichever High Court judge happened to be sitting on that day. There would be no requirement for particular expertise on the part of the High Court judge, and that judge would not have to report on the operation of the Act. It is a different model that my hon. Friend has elected.