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

Debate between Stephen Kinnock and Liz Saville Roberts

Committee stage
Wednesday 5th March 2025 Public Bill Committees

[Stephen Kinnock]

What we are trying to say is that the important thing here is to ensure that, when the Secretary of State brings the regulations forward, the hands of the Secretary of State are not tied too tightly, so that the Secretary of State is able to bring together the right people, to deliver the right training, to achieve the outcomes that are required through the regulations. Our assessment is that this amendment would, in essence, narrow the pool of people available to do the training. That would seem to pre-empt the idea behind doing this through regulations, which is to ensure that there is up-to-date training that is responsive to where we may or may not be two years down the line from the Bill having its commencement. It is about having that flexibility and that ability to build capacity.

Amendment 340 would place the Secretary of State under a duty to make regulations requiring a co-ordinating doctor to have specific and up-to-date training relating to reasonable adjustments and safeguards for autistic people and people with a learning disability. I note that amendments 185 and 186, if passed, would impose a duty on the Secretary of State to specify the training, qualifications and experience that the co-ordinating doctor will need.

The consequence of this amendment would be to require the Secretary of State to introduce a further requirement on the co-ordinating doctor—to have undergone training relating to reasonable adjustments and safeguards for autistic people and people with a learning disability. In considering whether the amendment is required, I note that the Health and Social Care Act 2008 requires that all CQC-registered health and adult social care providers ensure that their staff receive specific training on learning disability and autism.

Amendment 427 would impose an obligation to take all reasonable steps to ensure that the co-ordinating doctor is proficient in the Welsh language if services or functions under this legislation are to be provided to an individual in Welsh in Wales. The amendment does not make it clear who would be obliged to ensure that those steps were taken, or who would assess and enforce whether the “fluent proficiency” standard was met.

[Liz Saville Roberts]

What the Minister is referring to is the appropriate authorities, because areas related to training and regulation of registered practitioners in Wales are devolved to the Welsh Government. I will be touching on that later, but I would beg him to approach the amendment in that spirit.

[Stephen Kinnock]

I know that we are coming on to the question of appropriate authorities and I absolutely see and understand the spirit in which this amendment is suggested. The challenge is just about the potential for it to lead to operational issues, such as a reduced pool of registered medical practitioners who are able to carry out the function of a co-ordinating doctor under this legislation.

[Liz Saville Roberts]

That is exactly why the amendment includes a reference to “all reasonable steps”. It is with that in mind. This is reflected in other legislation where similar concerns have been expressed.

[Stephen Kinnock]

I thank the right hon. Lady for that. We go back to the point about the true significance of the 2011 Welsh Government Measure, which sets a basic foundation for the duty of the Welsh Government to ensure that Welsh language provision is provided through the Welsh NHS. There is absolutely no debate about that point; that is nailed on. The question is simply how we ensure, if we are to amend this Bill along the lines that the right hon. Lady suggests, that that does not create a lacuna or confusion in the system. I think we need to sit down and discuss that, to ensure that whatever we propose is watertight.

It may be helpful to note, as in discussion of amendment 413, that regardless of this amendment, under the Welsh Language Measure of 2011 the NHS in Wales has a statutory duty to deliver its services to the public in both Welsh and English. That legislation gives the Welsh language official status in Wales, and the Measure states that individuals in Wales should be able to conduct their lives through the medium of Welsh if they choose to do so. The Welsh Government’s active offer for health is intended to support all staff across NHS Wales to provide a service in Welsh for patients without their having to ask for it.

Under amendment 20, regulations made by the Secretary of State on the necessary training, qualifications and experience of the co-ordinating doctor would be required to include mandatory training relating to domestic abuse, including coercive control and financial abuse. Amendments 185 and 186, tabled by my hon. Friend the Member for Spen Valley, would require that regulations made by the Secretary of State on the necessary training, qualifications and experience of the co-ordinating doctor covered training related to assessing capacity and whether a person has been coerced or pressured by another person. But I note that, as my hon. Friend the Member for Spen Valley has said, she is minded to support amendment 20, which clearly would ramp up the requirement, as previously discussed.

As I have said, the Government have taken a neutral position on the substantive policy questions relevant to how the law in this area could be changed, but to clarify the intent of the Bill, we have worked with my hon. Friend the Member for Spen Valley in relation to amendments 185 and 186, which would place the Secretary of State under a duty to make regulations regarding the necessary training, qualifications and experience of the co-ordinating doctor. That would include specific training on assessing capacity and assessing whether a person has been subject to coercion or pressure.

I hope that that explanation and those observations have assisted the Committee. I thank hon. Members for their attention.

--- Later in debate ---

[Stephen Kinnock]

Amendments 144 to 171, tabled by the right hon. Member for Dwyfor Meirionnydd, relate to the powers and duties vested in the Secretary of State under the Bill. The purpose of the amendments is to change all references throughout the Bill from “Secretary of State” to “appropriate authority”. Amendment 169 defines “appropriate authority” as the Secretary of State in relation to England and as Welsh Ministers in relation to Wales. I note the intent of the promoter of the Bill, my hon. Friend the Member for Spen Valley, that the Bill’s provisions extend and apply to both England and Wales.

The amendments would mean that all the powers and duties vested in the Secretary of State are instead shared between the Secretary of State where they relate to England and Welsh Ministers where they relate to Wales. I would like to put on the record the Government’s continued commitment to devolution and to working with the devolved Governments. Having taken a neutral position on the Bill and the matter of assisted dying, the Government are still committed to working with the Welsh Government to resolve legal and technical issues and discuss constitutional matters that might arise thoughtfully and amicably.

With regard to the phrase “appropriate authority”, the challenge is that in each case throughout the Bill the appropriate authority would be determined by the devolution position of the clause in question—what is the underlying question that the clause seeks to address, and is that a reserved or devolved matter? I have discussed this with parliamentary counsel and others, and the concern is that a blanket provision of this nature may well be premature at this stage. Until we have finalised and determined the constitutional nature and impact of each clause, putting a blanket provision in place may run counter to that process.

[Liz Saville Roberts]

I have a simple question: in relation to the Sewel convention, if not now, when? We should have clarity on these points. I hope the Minister will forgive me if this is slightly longer than an intervention, but he gives me no option in the here and now but to withdraw the amendments, because I will not push them to a vote if it is likely to be lost. However, these are serious questions. How does this respect the Sewel convention? As a Back-Bench MP, I am not in a position to answer that, and I would have expected the Government to provide clarity on these points earlier than Committee stage. I assure the Minister that I will push this issue on Report if we do not have a satisfactory resolution on the Sewel convention.

[Stephen Kinnock]

It is, of course, the right hon. Lady’s prerogative to press amendments as and when she sees fit. I am simply flagging that terminology such as “appropriate authority” risks tying the hands of the legislative process in a way that could have perverse outcomes. A clause that should be the lead responsibility of Welsh Ministers could instead end up in the hands of Secretary of State due to the lack of clarity or relative vagueness of the term “appropriate authority”.

The Government’s suggestion is to work through each clause and be specific about the lead responsibility in each case—is it the Secretary of State or Welsh Ministers? We are open to discussing whether it is better to do it that way or with the terminology “appropriate authority”; we are simply flagging that there are risks associated with that term.

[Liz Saville Roberts]

Before the Minister sits down, will he commit to engaging with me on this issue to identify the specific needs in the spirit of what I have bought forward?

[Stephen Kinnock]

Yes, absolutely, and before Report. Let us ensure that we do that, and that parliamentary counsel is in the room. I am not a constitutional lawyer, so we definitely need people in the room who can speak to these issues. Of course, it also needs to be done in close dialogue with colleagues in the Welsh Government, particularly given what was said earlier about the need for a legislative consent motion.

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

Debate between Stephen Kinnock and Liz Saville Roberts

Committee stage
Tuesday 4th March 2025 Public Bill Committees

[Stephen Kinnock]

This group of amendments focuses on language and literacy barriers, including discussion of the use of interpreters and translations. If amendment 414 is agreed to, a registered medical practitioner who conducts a preliminary discussion with a person will first have to ensure the provision of adjustments for language and literacy barriers, including the use of interpreters. It may be helpful to note that, in all areas of practice, registered medical practitioners must uphold the standards in the GMC’s “Good medical practice”, which includes the provision of adjustments for language and literacy barriers.

The purpose of amendment 413 is to require medical practitioners in Wales who are conducting the initial discussion outlined in clause 4 to

“discuss with the person their preferred language of Welsh or English.”

It may be helpful to note that under the Welsh Language (Wales) Measure 2011, the NHS in Wales has a statutory duty to deliver its services to the public in both Welsh and English. The Measure, which gives the Welsh language official status in Wales, states that

“persons in Wales should be able to live their lives through the medium of the Welsh language if they choose to do so.”

The Welsh Government’s active offer for health is intended to support all staff across NHS Wales to provide a service in Welsh for patients, without their having to ask for it.

Technically, I would note that the amendment does not require the medical practitioner to conduct the initial discussion in the person’s preferred language, or to refer the person to another medical practitioner who can conduct it in the person’s preferred language, if they are unable to do so themselves. I have discussed that point with the right hon. Member for Dwyfor Meirionnydd and am more than happy to have a further discussion about how her amendment might work. The concern that I simply flagged was that we have the 2011 Measure and, as with so many of these things, there is a law of unintended consequences. An amendment that may be designed with the best possible intentions could end up disrupting the system and causing confusion or uncertainty, which I am sure she would not want. As with all these things, that is the challenge.

[Liz Saville Roberts]

We have raised already in the Committee the need for an impact assessment. I have also raised with the Minister the need for an impact assessment in Wales. The fact that we are having this conversation shows that there is an element of uncertainty about exactly whether it is necessary for this provision to be included in the Bill. I am concerned that it could be in a code of practice; I share the concern expressed by the hon. Member for Bradford West that we do not know how such codes of practice will operate, or whether we will have any say over how they operate. However, as the Minister has come to this in a spirit of co-operation, I hope that we will find some clarity. If it appears that it is better for Welsh language speakers that such a provision be set out in the Bill, I hope that he will agree in that respect.

[Stephen Kinnock]

I am happy to have that discussion, to better understand how it might all work in practice.

If amendment 415 is agreed to, it will mean that an assessing doctor making an assessment under subsection (2) must first ensure the provision of adjustments for language and literacy barriers, including the use of interpreters. As with amendment 414, the Committee may want to note the existing standards that all medical practitioners must uphold, which include requirements for the provision of adjustments for language and literacy barriers.

Amendments 416 and 417 would amend clause 30, which states that the Secretary of State may issue codes of practice on a number of matters, including on arrangements for ensuring effective communication and the use of interpreters. The amendments would impose a duty on the Secretary of State to issue one or more codes of practice in connection with arrangements for ensuring effective communication, including the use of interpreters, and to do so within six months of the passing of the Act. The requirement to issue any such code of practice within six months may prove unworkable. Under clause 30, it would be necessary to consult on the code of practice, make regulations to allow for the code of practice to come into force, have the regulations approved by both Houses of Parliament and then issue the code of practice, all within a six-month period after the passing of the Act.

As I have said, the Government will continue to remain neutral on whether or how the law in this area should change. As I have made clear, that is a matter for the Committee and for Parliament as a whole. However, I hope that these observations are helpful to members of the Committee in considering the Bill and the amendments tabled to it.

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

Debate between Stephen Kinnock and Liz Saville Roberts

Tuesday 11th February 2025 Public Bill Committees

[Stephen Kinnock]

As I set out from the Dispatch Box when we had the money resolution, the Government will publish an impact assessment before Report. Given that this is a highly dynamic Bill, with a whole range of amendments having been tabled, and that it is not really possible to publish an impact assessment on the basis of a Bill that has not cleared a Bill Committee, there is a simple point of sequencing. That is why we are going to publish the impact assessment after the Bill Committee has completed.

[Liz Saville Roberts (Dwyfor Meirionnydd) (PC)]

I was glad to hear what the Minister said about the Government accepting the Mental Capacity Act as a basis. We should remember that in 2005, that Act widened the availability of autonomy for individuals. We are discussing that here: how to enable autonomy for individuals. I also really welcome what the hon. Member for Bradford West said about impact assessments. Can the Minister commit now to an impact assessment specifically for Wales? The context of health and social care there is very different from that in England.

Support for the Welsh Economy and Funding for the Devolved Institutions

Debate between Stephen Kinnock and Liz Saville Roberts

Tuesday 5th July 2022 Commons Chamber

[Stephen Kinnock]

Madam Deputy Speaker, I am sure that you would love to give me another 10 minutes to talk about the achievements of the Welsh NHS, but unfortunately I am not sure that I would get away with it. The fact is that there is a list of achievements. It has invested more in the recruitment of nurses, which is at record levels. The Welsh NHS vaccine roll-out programme was a tremendous success; I recognise that the roll-out has been a success across the United Kingdom, and I am absolutely delighted about that, but the Welsh NHS really stepped up and delivered. There are so many achievements that we do not have time to discuss today, so perhaps the right hon. Member for Preseli Pembrokeshire would like to secure another debate on the topic.

I feel for the people of England and Scotland, who have not had the support that we have had in Wales. The answer is clearly for them and their fellow British citizens across the UK to vote to replace this pitiful, debased and degraded UK Conservative Government with a Labour Government driven by purpose, patriotism and the national interest, rather than the self-interest and saving of their own skin that we are seeing from the current Government.

[Liz Saville Roberts]

Does the hon. Gentleman join me in welcoming the decision taken by Labour in Wales over the weekend to increase the size of the Senedd? Surely the point is that we need better scrutiny of the services carried out in Wales. Does he also join me in welcoming the major initiative, also agreed to in the vote over the weekend, to change the voting system, moving away from first past the post and towards a list system? It shows that in Wales we can bring about a different sort of politics by working together.

[Stephen Kinnock]

The reality is that the Senedd simply did not have enough Members to hold the Government to account. There were not enough Back Benchers on Committees. Scrutiny is a vital part of our democracy—the right hon. Lady is right about that point.

Wales faces a UK Government who have broken their promises to the people of Wales. It has become clear that when providing a replacement for EU farm funding, the UK Government are deducting EU receipts due to Wales for work that was part of the 2014 to 2020 rural development programme, meaning that Wales’s rural communities are £243 million worse off than they should be. That is a devastating blow to those communities.

HM Passport Office Backlog

Debate between Stephen Kinnock and Liz Saville Roberts

Tuesday 14th June 2022 Commons Chamber

[Stephen Kinnock]

On the causes of this, it is absolutely vital to recognise that the lack of investment in our public services is what has fundamentally left us exposed, and these are the problems we are facing today. On the hon. Gentleman’s specific point, the fact of the matter is that there should be an apology to people whose holidays have been wrecked and who have not been able to get to job appointments, funerals and weddings within the timeframe that we are discussing today.

Crime was already at record highs going into the pandemic, but now the court backlog is so long that in 95% of cases victims of violent crime will be waiting more than a year for their day in court—a direct result of Conservative Ministers cutting one pound in every four from the justice budget. Those who need an operation on the NHS can enjoy the luxury of 6 million people on NHS waiting lists, or, if they are in too much pain, they can take their sleeping bag down to their local A&E department for a 12 or 13-hour stay. If you want to go on holiday, you had better hope that you have ridden your luck in the game of pre-flight bingo we are all now forced to play as we cross our fingers and turn up at an airport—that is, of course, assuming that you are lucky enough to receive your new passport. Welcome to backlog Britain.

[Liz Saville Roberts (Dwyfor Meirionnydd) (PC)]

I am sure the hon. Gentleman will share my dismay at learning that a professional seafarer was forced to miss the crew change on his vessel having waited for 11 weeks to receive a replacement for a damaged passport, specifically because of this Government’s inefficiency. This is a professional seafarer who is a key worker forced to miss his crew change. It is not just a matter of holidays—it is affecting people professionally as well.

[Stephen Kinnock]

The right hon. Lady is absolutely right. There are holidays, weddings and funerals, but there are also direct impacts on people who have needed to go on work assignments abroad. There is the seafarer that she mentioned. There are so many examples of why, when public services are failing, that directly undermines productivity in the private sector. That is why this debate is so important in terms of our economy.

This brings me to a very particular catalogue of failure delivered by the Home Office and a Home Secretary who is completely out of her depth. Under the current Home Secretary, the Home Office is simply not fit for purpose. Crime is up by 18% while prosecutions have collapsed. The six-month asylum waiting lists have hit 73,000 because the number of asylum decisions made under the Home Secretary has halved, costing the taxpayer £4 million a day in emergency hotels alone. The Passport Office delays are causing sleepless nights for thousands of families nationwide.

So today Labour Members will be voting to demand an apology from the Minister to the British people for the abject failure of the Passport Office to meet the standards that it has promised and that the taxpaying British public expect and deserve. The Government had two years to prepare for a spike in passport applications once travel restrictions were lifted. Ministers were warned repeatedly about the possible backlog but they failed to plan and so inevitably failed to deliver. Indeed, the Government’s own data shows that the number of full-time HMPO staff has dropped by 681 over the past five years. After a really tough couple of years, British families deserved a well-earned break, but thousands have missed out.

Refugees from Ukraine

Debate between Stephen Kinnock and Liz Saville Roberts

Wednesday 16th March 2022 Commons Chamber

[Stephen Kinnock]

The vast majority of the issues that need to be resolved around bringing Ukrainians into this country are clearly to do with immigration. The fact that this brief has been shifted is a clear indication that the Prime Minister has lost confidence in the Home Secretary.

[Liz Saville Roberts]

Does the hon. Gentleman share my confusion about that comment by the Minister, given that the Home Secretary was responsible for putting refugees in deeply unsuitable circumstances in Penally camp in Pembrokeshire, which has since had to be closed?