Terminally Ill Adults (End of Life) Bill

Sarah Smith Excerpts

2nd reading
Friday 11th September 2026 Commons Chamber

[Andrew Lewin (Welwyn Hatfield) (Lab)]

Thank you for calling me, Madam Deputy Speaker. I mean that sincerely on a day when so many colleagues want to speak. I promise you that my remarks will be brief.

Our debate today is about who has choice and agency in our society both in respect of the authority of this elected House of Commons and what limits should exist on the role of the other place, and, more fundamentally, in respect of the right of a terminally ill person to exercise choice at the end of their life and whether the state should be able to override that. We are back here for a Second Reading of the Terminally Ill Adults (End of Life) Bill not because the question before us has changed since November 2024, but due to the actions of a small number of Members of the other place.

[Sarah Smith (Hyndburn) (Lab)]

Will my hon. Friend confirm how many amendments were accepted in the House of Lords, and that it was about 90 peers who were involved in supporting all the amendments tabled?

[Andrew Lewin]

I am grateful for my hon. Friend’s intervention. I do not have that number; what I do have is the number of amendments that were proposed. There were 1,286 wrecking amendments.

There are many thoughtful and compassionate critics of the Bill who I respect deeply. I want to put on record my admiration for my hon. Friend the Member for West Lancashire (Ashley Dalton) and for her astonishingly brave speech. However, what I cannot condone is the actions of Members of the other place whose motivation in the last Session of Parliament appeared to be to block the democratic process.

--- Later in debate ---

[Hilary Benn (Leeds South) (Lab)]

This is a very difficult moral and practical question, but for me it is fundamentally about whether we can act to relieve human suffering. We have heard a number of profoundly moving speeches in the debate, and I highlight in particular the speeches of my hon. Friends the Members for West Lancashire (Ashley Dalton) and for Filton and Bradley Stoke (Claire Hazelgrove). We are talking about people who fear or face unbearable pain, choking or gasping for breath, or loss of control at the end of their lives. Are they not vulnerable, too? For me, that is an important point.

The question is, can we really look these people in the eye at the moment and say, “I’m very sorry, but I am not prepared to vote to support your being given the means to remove that fear”—not everyone will take advantage of the provision, but for them it is an assurance—“or to relieve that suffering, even though that is what you wish”? Are we going to say, “I’m sorry, but I will not give you the means of determining the manner of your passing from this world, surrounded by those whom you love”?

[Sarah Smith]

Will my right hon. Friend give way?

[Hilary Benn]

I will not give way because of the constraints of time.

I do not think we can any longer justify the contradiction that is at the heart of this debate. We know that people with terminal illnesses are already killing themselves. That happens. It is not at all covered by the protections contained in the Bill that my hon. Friend the Member for Rochester and Strood (Lauren Edwards) has proposed. The biggest contradiction of all for me is the fact that there are those who travel abroad. We know that is happening, and I think it is a very uncomfortable fact for those who oppose the Bill for this reason: it is a gaping hole in the argument against the Bill.

The truth is that the Crown Prosecution Service faced a terrible dilemma. It could see the number of people going to Switzerland, and it had to ask itself, “Are we actually going to prosecute mums, dads, spouses, lovers, friends, brothers and sisters for going with those whom they love to be with them at the end?” That is how the CPS came to draw up its guidelines. For me, they are full of common sense, because they say that in these circumstances, it is not in the public interest to prosecute someone. If we look at the figures, the vast majority of family members who have accompanied their loved ones to Switzerland have not—rightly, in my view—been prosecuted for what I would regard as a final act of love. Indeed, it would be an outrage to prosecute them.

Despite those guidelines, some people are fearful, because they get questioned when they come back, and some have not gone to Switzerland with their loved ones, to hold their hands at the last, for fear of what might happen to them. The question I put to the House is this: if we have in effect legalised assisted dying for British citizens who have the money and means to do it abroad, and that is what we have done—I have heard no one in the debate criticise that—then why are we not prepared to provide the same means to people who are terminally ill to bring their lives to an end here in the United Kingdom?

Coming to terms with our own mortality is about the final journey that we will make. We talk about awe and wonder; I never fully understood what awe and wonder meant until I was present at the death of those I loved most dearly. When the previous Bill was given its Second Reading, and the result was declared, there was this extraordinary moment—complete silence in the House. Why was that the case? Because we understood the significance of what we had just done and the consequence of the Bill that we would eventually vote to send to the other place.

Today we are once again called on to make our choice. I have made mine. I will cast my vote to enable those who are terminally ill and who want to take control of the moment of their death, who want to be able to relieve their suffering, and who want to feel that they do not have to fear what is coming, to take that decision, if that is their choice. I urge the House not to deny those people that choice.

--- Later in debate ---

[Sarah Smith (Hyndburn) (Lab)]

I am sure that I am not the only Member who came to this place because I felt that the voices of the people I wanted to represent are seldom heard, and I felt a duty to ensure that they were heard in decision making at the highest level. While I am the Member of Parliament for everyone in Hyndburn and Haslingden, and I recognise that many people in my constituency might support the principle of an assisted death, when I vote today, I must consider the perspective of the many hundreds of people who have written to me for whom this Bill is a terrifying prospect.

Many of those who have written to me are disabled; caring for severely disabled children or family members; people who are getting older, and who worry that they will become a burden; or people who know that because of the colour of their skin, they will face different treatment in our NHS, and who worry about what that would mean for them or their elderly parents. We must all consider the privilege that we in this place hold. We have the confidence to challenge a doctor’s assessment, and to turn down the suggestion of assisted death, and the belief that we might be able to afford the care that we need when we are older, and so can make a true choice about how we might die. However, we must remember that this is not the experience of most people, and certainly not the experience of those with lower levels of education, those from ethnic minority backgrounds, those with disabilities, or those who are struggling to make ends meet. For them, the suggestion made by a doctor may easily sound like a decision based on what is best for them. The likelihood of their mental capacity being accurately assessed is far lower than it would be for many of us. For them, and indeed for most of us, the assessment of how long they have left to live is often hugely inaccurate.

[Sir John Hayes]

The hon. Lady is absolutely right. This debate illustrates a difference across this House. It is a difference between those who feel that individual agency is always supreme, and those who, like her and me and many others, believe in social solidarity and our responsibility, indeed our mission, to protect the very people she describes, who will be at risk. There is no doubt that they will be at risk from this Bill.

[Sarah Smith]

I could not agree more. Those people cannot escape the often unintentional prejudice that they face every single day in their engagement with our health services. They know that the Bill would treat them unequally, and they are begging us not to pass it into law. Disability rights groups have shared with us that introducing assisted dying devalues the lives of disabled individuals by framing dependence as an intolerable condition, and one not intrinsic to all our lives. Relying on each other is what makes our society strong, and we must not tolerate a situation in which individuals make decisions from which they cannot return on the basis that they perceive themselves to be a burden.

This law, if passed, will almost certainly further increase the gap in life expectancy between the richest and poorest, given that people living in more deprived areas are likely to acquire complex multi-morbidity seven years younger than those in the richest areas, and are far more likely to feel that they are a financial burden on their family. It is reasonable to anticipate that this will lead to people with less money dying younger. Is that the legacy that those voting for this Bill today want?

In Hyndburn and Haslingden, I have seen how systemic failures in social and palliative care have added to the suffering and challenges that many in my community have faced. Like many of us, I have sat with loved ones as they were dying without the palliative care that they needed. According to Marie Curie, one in three people die without good palliative care. During these debates, we have heard so many horrific stories of death, and of course we must do all we can to avoid those situations.

I spoke with one of the most highly regarded palliative care nurses in the world, who has spent most of her career in South Africa with children who have AIDS and who die far too young. She told me that, in her decades of practice, in which she has cared for thousands of patients, she could bring to mind only two patients whom she was unable to offer a good death, with the right treatment and care.

Assisted dying is not a choice if palliative care is not provided as an alternative. As it stands, the cost of assisted dying is supposed to come from the existing health budget. Research by Sue Ryder found that if we offered consistent palliative care to every patient who needed it, we would need to double NHS funding for that care; it would cost around an extra £300 million a year.

We have to be clear about the priorities and honest about what is possible. This Bill intends to force the NHS to implement assisted dying within four years. Given the budget constraints and capacity limitations, it is just not realistic to say that we can simultaneously improve palliative care and introduce assisted dying. We are taking 10 years to implement the proposed SEND reforms, yet we expect to do this within four. This Bill should provide that assisted dying will not be introduced until palliative care is fixed, and it fails to do that. Furthermore, the evidence from other countries is overwhelmingly that introducing assisted dying leads to decreased investment in palliative care.

In closing, it was a Labour Government who introduced the national health service, with the aim of securing

“improvement in the physical and mental health of the people of England and Wales and the prevention, diagnosis and treatment of illness”.

It is that mission that NHS staff have signed up to deliver. Let this Labour Government not be the one to bring in a Bill that effectively entirely undermines and changes that founding purpose of the NHS, and let us instead vote today to kill this Bill.