Terminally Ill Adults (End of Life) Bill

Debate between Stephen Kinnock and Gregory Stafford

Friday 16th May 2025 Commons Chamber

[Stephen Kinnock]

I thank the right hon. Gentleman for that intervention. As I say, the Government do not take a position on the policy intent that my hon. Friend the Member for Spen Valley has set out. I would simply observe that if somebody has been in a home for a considerable period of time, that home is then considered to be their home. As such, any action to take them out of that home could engage article 8 of the ECHR, on the right to family life.

I now turn to the procedure for receiving assistance under the Bill, including safeguards and protections. First, I will speak to the amendments that have been tabled by my hon. Friend the Member for Spen Valley with technical workability and drafting advice from the Government.

Amendment 58 clarifies the duty on the Secretary of State to make through regulations provisions for training about reasonable adjustments and safeguards for autistic people and those with a learning disability. That remedies previously unclear wording in the Bill. Amendment 60 is required to make provision for circumstances where the independent doctor dies or, through illness, is unable or unwilling to act as the independent doctor. Amendments 67 and 68, tabled by my hon. Friend the Member for Spen Valley, clarify that an approved substance can be self-administered using a device should the individual be unable to self-administer without one. Amendment 91 gives effect to amendment 273, which was accepted in Committee, by ensuring that data will be recorded in the final statement to ensure coherence within the Bill.

I turn now to the amendments tabled by other Members on the subject of procedure, safeguards and protections that the Government have assessed may create workability issues if voted into the Bill. New clause 7 would limit the number of times two doctors can be jointly involved in the assessment of a person seeking assisted dying to three times within a 12-month period. In situations where there is a limited pool of doctors in any geographical location or area of medicine, that could limit access to assisted dying and create inequalities in access. New clause 9 would require the co-ordinating doctor, independent doctor and assisted dying review panels to apply the criminal standard of proof that requires them to be satisfied beyond reasonable doubt. Cases considered by the panel are civil matters, and as such it would not be usual practice for the criminal standard of proof to be applied to their decision making—and it is a very high bar. The provision would also impose additional standards on the assessing doctor that fall outside the usual framework for medical decision making.

[Gregory Stafford]

Is the Minister saying that, in his view, it is better that someone who should not die does die, than that someone who should die does not?

[Stephen Kinnock]

As a Minister at the Dispatch Box, with the Government being neutral, I am not commenting on the policy intent of the Bill. What I am saying is that the new clause could create significant uncertainty. For example, it is not clear how the standard it introduces would interact with the definition of “terminal illness” set out in clause 2, which requires that a person’s death

“can reasonably be expected within six months”,

as it is not clear whether “reasonably be expected” fits within the balance of probabilities threshold or is beyond reasonable doubt.

Amendment 101 would exclude any person with a learning disability, including people with Down syndrome, from a preliminary discussion about assisted dying unless they raise the subject themselves, irrespective of whether they would otherwise be eligible. That may be subject to challenge under various international agreements, including the United Nations convention on the rights of persons with disabilities and article 14 of the European convention on human rights, which prohibits disability discrimination.

Amendment 102 would introduce a requirement that

“the registered medical practitioner must ensure that the person has no remediable suicide risk factors which pose a significant risk to their life”

before holding a preliminary discussion under clause 5. The terms “remediable suicide risk factors” and

“a significant risk to their life”

have not been defined, so the amendment may be difficult to operationalise.

Hospice and Palliative Care

Debate between Stephen Kinnock and Gregory Stafford

Monday 13th January 2025 Commons Chamber

[Stephen Kinnock]

The hon. Gentleman will not be surprised to know that I have a section in my speech on employer national insurance contributions. I will get to it.

A number of colleagues raised concerns about regional variations. Facts and evidence are very important in that context. To address that issue, NHS England has developed a palliative and end of life care dashboard, which brings together all the relevant local data in one place. The dashboard helps commissioners to understand the palliative and end of life care needs of their local population, enabling ICBs to put plans in place to address, and track the improvement of, health inequalities, and to ensure that funding is distributed fairly, based on prevalence.

[Gregory Stafford]

Will the Minister give way?

[Stephen Kinnock]

I will, but I have to finish at 9.58 pm, so there is only about five minutes left of my contribution.

[Gregory Stafford]

It is generous of the Minister to give way, so I shall be brief. Would funding continue to be produced through ICBs, or will the system be funded centrally?

[Stephen Kinnock]

That is precisely the topic of conversation for officials in my Department and NHS England, who are looking at this issue in the round and deciding how we will work. We need a system that empowers ICBs to deliver at the coalface, but we also need accountability from the centre to ensure that things are delivered. Getting the balance right is never easy, as I am sure the hon. Gentleman will understand; that is what we are trying to navigate.

Alongside NHS England, my officials and I will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, to understand the issues that they face. In fact, I will meet the major hospices and palliative care stakeholders, including Hospice UK, early next month to discuss potential solutions for longer-term sector sustainability. That will inform our 10-year health plan.