Terminally Ill Adults (End of Life) Bill Debate
Full Debate: Read Full DebateTom Gordon
Main Page: Tom Gordon (Liberal Democrat - Harrogate and Knaresborough)Department Debates - View all Tom Gordon's debates with the Department of Health and Social Care
(2 days, 14 hours ago)
Commons ChamberI thank the right hon. Gentleman for his intervention—it teaches me not to take them. I also thank him for helping my street cred this morning. He raises an important point.
Members of this House have been told that this Bill—it is this Bill we are voting on, not the principle—was rigorously tested and refined in Committee. However, we are now seeing efforts to undermine the decisions of that same Committee. Amendments 94 and 95 serve the singular purpose of undoing amendments introduced in Committee to improve the Bill and make it a safer and more conventional piece of legislation, but their implications go beyond just that: they challenge the basic tenets of our democracy.
One of the key roles at the heart of our democratic system is the role of the or a Minister of the Crown. It is our Ministers who prepare the groundwork for legislation to be enacted successfully, and amendments 94 and 95 would completely do away with that core ministerial function. They would see the responsibility for ensuring the roll-out of assisted dying in Wales—the power that we the people entrust to our Ministers and democracy—taken away from them. [Interruption.]
Conscious of your cough, Madam Deputy Speaker, I shall quickly move towards the end of my remarks—I have taken half of them out already. In my view, Ministers should be able to lead the roll-out of assisted dying in Wales, just as they should in England. It is Ministers, not the supporters of the Bill, who will be responsible for delivering these seismic changes to our health and legal systems, so it is only right that they decide when the provisions become law. Amendment 42 would put England back on an even footing with Wales.
Getting this right is literally a matter of life and death. It makes sense to avoid any possible pressure on decision making and decision makers and, at the very least, allow Ministers to enact legislation with the usual constitutional powers. One death because of a rushed decision would be one too many and should give us all food for thought. I do not want it on my conscience that our collective sticking to an arbitrary deadline led to a death or deaths that may otherwise have not taken place. We must recognise that we can prevent any such situation, and we can prevent that with our vote today. To do so, we must remove the deadline for automatic commencement in England and uphold it in Wales. I urge Members to support my amendment 42 and to vote against amendments 94 and 95.
I rise to speak to amendment 3 in my name, which would do the exact opposite of the amendments of the hon. Member for Newcastle-under-Lyme (Adam Jogee)—in fact, it would see the commencement period reduced from four years to three years. As a member of the Bill Committee, when we had the initial conversation about increasing the commencement period from two years to four years, I was the only person to speak against it, and I pushed it to a vote.
What frustrates me about the situation we are in is that, in effect, we are acknowledging that the reason we are here and debating this Bill is that the status quo is not acceptable. People are pushed to taking decisions that they should not be and having to go to foreign countries to have opportunities overseas. Those of us who support the Bill are broadly in agreement on those principles. A number of things frustrate me about the four-year period, principally that the people in office—the Government of the day—will not necessarily be here to implement it. I am really hesitant about supporting a Bill when we do not know who would see through those details.
Amendment 3 would reduce the threshold back down to three years, which would still be more than most jurisdictions around the world. Countries have implemented assisted dying legislation after as short a time as six months, 12 months or 18 months, so three years would still be a substantial increase compared with other countries. We are not innovators or leaders in this field: there is no reason why we cannot take best practice and learn from and speak to colleagues around the world. I believe that this Bill has the strongest safeguards of any, which is why I think an implementation period of three years would more than meet the requirements.
I want to put on record my sincere thanks to my hon. Friend the Member for Spen Valley (Kim Leadbeater) for the way that she has approached this Bill. Her willingness to listen to concerns from across the House has been evident, not least in new clause 14, brought forward in the names of the hon. Members for Reigate (Rebecca Paul) and for West Worcestershire (Dame Harriett Baldwin). That is a testament to how we can work together on these deeply sensitive issues.
I rise to speak in favour of new clause 14 and against amendment (b) to new clause 14. I absolutely understand the intent behind the amendment in the name of my hon. Friend the Member for Rochdale (Paul Waugh). Nobody in this House wants to see voluntary assisted dying services being advertised in a way that is insensitive, inappropriate or exploitative. We all want to protect individuals, particularly those who may be vulnerable or more easily influenced, so I fully share that concern. Although I respect the principle behind the amendment, however, I do not believe it offers the right solution.
New clause 14 rightly prohibits advertising voluntary assisted dying services to the public, while giving Ministers tightly defined powers to create appropriate exceptions through regulations. That is important, because in a healthcare system as complex as ours, we must be able to draw the line between unethical promotion and responsible professional communication. I think the new clause gets that balance right.
I associate the Government with the words of the Opposition spokesman regarding the tragic incident in India.
As Members will know, the Government remain neutral on the passage of the Bill and on the principle of assisted dying. We have always been clear that this is a decision for Parliament. However, the Government are responsible for ensuring that the Bill, if passed, is effective, legally robust and workable.
Let me start with a brief observation about the process and, in particular, the time made available to Parliament to scrutinise the Bill. The Bill has received over 90 hours of parliamentary time, which is more than most Bills receive. More than 500 amendments were tabled and considered in Committee. I thank Members on all sides of the debate for their contributions during the extensive consideration and scrutiny that the Bill has received.
Given the time, I will confine my remarks on the amendments to those about which the Government have significant legal or operational concerns, and those tabled by my hon. Friend the Member for Spen Valley (Kim Leadbeater) to address significant workability concerns. Before I get into the detail, I remind the House that a full list of amendments tabled by my hon. Friend that the Government deem essential or highly likely to contribute to the workability of the Bill can be found in the letter sent to all Members by me and the Minister of State at the Ministry of Justice, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), on 15 May.
Let me start with amendments tabled by my hon. Friend the Member for Spen Valley. New clause 13 and amendments 69, 53 and 72 would allow the Government to create or change legislation to set out the end-to-end process in relation to approved substances to be used for assisted dying. They would allow for monitoring and for a regulatory regime to be designed that will offer robust oversight of approved substances and the devices used to administer them, specifically in the context of assisted dying.
Amendment 54 and new clause 15 would replace clause 35, which is currently unworkable in the wider legal context. They would align the scrutiny and certification of assisted deaths with the existing process for deaths that are not deemed unnatural. That means that assisted deaths would be scrutinised by a medical examiner rather by a coroner unless reported to the coroner by anyone who has concerns about the death.
Amendments 92 to 94 would ensure that the Secretary of State and Welsh Ministers have powers to make necessary regulations to approve assisted dying services in Wales. Amendment 95 would bring the Welsh commencement powers in line with the devolution settlement and remove the requirement in clause 54 for Welsh Ministers to lay commencement regulations before the Senedd for approval, to align with usual procedure.
I now turn to amendments tabled by other Members that the Government assess as creating potentially significant workability challenges. Amendment 97 would require the MHRA to license the approved substances to be used in assisted dying. That may present workability challenges, as licensing is not possible if the approved substances do not meet the definition of “medicinal product” under the current relevant legislation. Furthermore, licensing is reliant on the manufacturer applying to the MHRA for a marketing authorisation for that indication and providing the necessary evidence of safety and efficacy in support. Should the Bill pass, the Government would work to put in place an appropriate regulatory regime for the approval of substances. It may be helpful to note that my hon. Friend the Member for Spen Valley has tabled new clause 13, which recognises the need for a robust regulatory framework and would provide the powers needed to introduce such a framework.
Amendments 105 to 107, amendment (a) to new clause 13 and amendment (a) to new clause 14 would restrict the scope of Henry VIII powers available to the UK and Welsh Governments to make provision about assisted dying services. They would further restrict the use of powers in relation to the regulatory framework for approved substances and the devices used to administer them, and to the prohibition on advertising. I point Members towards the delegated powers memorandum published by the Government, which sets out our consideration of the Henry VIII powers in the Bill. As with legislation more broadly, the Government recognise the need, in appropriate cases, for amendment by Henry VIII powers. Members will be aware that the Delegated Powers and Regulatory Reform Committee will issue its own consideration of the Bill, which will of course be made available to all parliamentarians.
Amendment 3 seeks to shorten the commencement period to three years. Should the Bill pass, an entirely new service with robust safeguards and protections will need to be carefully developed and tested, with input from a range of delivery partners. The Government’s view is that the Bill, as amended in Committee, with a four-year backstop for commencement would be more likely to provide for safe and effective implementation.
One of the key things that the Bill’s sponsor, the hon. Member for Spen Valley (Kim Leadbeater), has said throughout is that four years, in the Bill as it currently is, would be a backstop. Can that be the case if the Minister is talking about a requirement of four years and that it could not have been delivered sooner?
I can confirm that it is absolutely the policy intent of the sponsor for that to be a backstop. The Government are working on that basis to ensure that it is a backstop and not a target.
Amendment 42 seeks to remove the four-year backstop. Although that is a matter for Members to decide, we note that if both that amendment and amendment 94, tabled by my hon. Friend the Member for Spen Valley, were accepted, nobody would have the power to commence reserve provisions in Wales. That would create major workability concerns for the service in Wales.