We have now reached the committee stage of the Terminally Ill Adults (End of Life) Private Members’ Bill. From the very beginning, I have been consistently concerned that this Private Members Bill process, which is widely acknowledged to offer the least effective scrutiny in parliament, is simply not the right vehicle to legislate on such profound societal change and huge matters.
As you will recall, MPs voted in favour of the Terminally Ill Adults (End of Life) Bill at second reading, following which the Bill was scrutinised by a Public Bill Committee. Kim Leadbetter MP, the Bill’s sponsor, chose the 23 members of the Public Bill Committee that have gone through this Bill line by line. As I have explained previously, it remains my view that the Public Bill Committee has illustrated why this legislation is so unworkable and this is why this process should have been more robust.
Through this process, Kim Leadbetter MP, however, has been forced to delay the implementation of assisted dying powers until at least 2029, remove a key safeguard in terms of the High Court judge, and work to grant the Senedd (or Welsh Parliament) the powers to block assisted dying in Wales. Crucially, the Bill still contains no detail on how services will be delivered, regulated or held to account. It is simply not good enough to ask Parliament to pass any law, let alone one with such enormous societal implications, on such a basis and with so much still unknown. We understand the principles; we now need the detail on which good law is based.
I also share the deep concern of so many constituents who have written to me that the central safeguard - the High Court judge - has simply been dropped from the Bill. In addition to two doctors, the original Bill said that a High Court judge would have to check each person’s eligibility for an assisted death before granting that right. This included whether they were of sound mind and had not been coerced into ending their life. It was an absolutely key pillar of the Bill’s ‘thorough and robust’ safeguards which persuaded a lot of MPs to vote for the Bill at its Second Reading. It’s hard not to be worried about our most vulnerable and the pressures they may feel.
However, the Bill has now been amended to replace the oversight of a judge with that of a panel of experts - made up of a psychiatrist, a lawyer and a social worker. The Bill sponsor’s decision to remove the involvement of the High Court judge comes as no surprise to me. Given the backlogs in the courts, this was never a serious proposal. Incredibly, Ms Leadbetter failed to consult the Royal College of Psychiatrists (RCP) before giving them a central role in the panels.
The president of the RCP would have told the Bill Committee that there are many challenges with this proposal, including workforce shortages. Indeed, on the 13th of May, 3 days before the Bill returned to the House of Commons, Dr Lade Smith, president of the RCP, formally withdrew their support saying: "The RCP has reached the conclusion that we are not confident in the Terminally Ill Adults Bill in its current form, and we therefore cannot support the Bill as it stands."
While it is convention that the make-up of these committees reflects the view of the House of Commons at a bill’s second reading, I also worry the Committee was too unbalanced in favour of those who support changing the law – with 14 supporters of the Bill and 9 opponents - and that this has contributed to the removal of safeguards in the Bill and the rejection of many proposed safeguards designed to protect vulnerable people. Therefore, was this the real scrutiny needed?
As is usual, members of the committee had laid various amendments to the Bill in their bid to strengthen the legislation. This includes 327 amendments which sought to provide additional safeguards, such as legally excluding those with eating disorders and Down’s syndrome. It is extremely disappointing that these were given short shrift by the Bill’s sponsor and were voted down with little justification from the Bill’s supporters.
Further amendments were debated when the Bill returned for Report Stage on Friday 16 May which I attended and which was heavily over-subscribed, where MPs debated the first of two groups of amendments. The group included proposed amendments relating to: the obligations, duties and protections for medical practitioners, hospices and care homes; the procedure for receiving assistance under the Act, including safeguards and protections; eligibility for assisted dying; and mental capacity. Two of the amendments, tabled by my colleague Rebecca Paul MP, aimed to ensure care homes and hospices can decide whether or not to be involved in assisted dying and that their funding would not be affected by their decision. She told MPs: “Whether you’re in favour of assisted dying or not, we must preserve the rights of organisations, companies and charities to choose whether to offer it. They must never be bought into it by public funding being conditional on the provision of assisted dying.”
You can read the full debate transcript here:
Terminally Ill Adults (End of Life) Bill - Hansard - UK Parliament
A second day of debate is scheduled for Friday 13 June; I hope MPs continue to carefully scrutinise this re-drafted Bill ahead of that debate and subsequent votes in Parliament. I hope this stage is not rushed through and hastened to Third Reading.
I would like to finish by saying I am grateful the Assisted Dying Bill, despite its myriad problems, has ignited debate across the country and helped to shine a spotlight on the quality of care given to people approaching the end of their lives. I have nothing but praise for our hospices and the wonderful staff and volunteers and the attention, time and support they give to enable people to live as well as possible until they die. I am also appreciative of the support and care offered to families and loved ones before, during and after death. However, one of the first and biggest campaigns into my inbox after the General Election demonstrated the widespread support there is for palliative care provision in this country.
It is incredibly important we work to improve access to, and funding of, high quality palliative services and end of life care across our hospitals, our communities, hospices and care homes. To that end, I welcome the publication of a new report from the Commission on Palliative and End of Life Care: “Palliative Care and End-of-Life Care - Opportunities for England” (Volume 1).” You can access the report here:
Commission on Palliative and End-of-Life Care
It bears repeating that I completely recognise there are deeply held views on this hugely difficult debate and I have received a great many personal, heartfelt emails from constituents detailing their thoughts and experiences from both sides of the argument. I really appreciate these and am grateful to all those who have kindly shared their opinions, views and concerns. I fully accept that assisting or ‘encouraging’ suicide, assisted dying and euthanasia are all subjects on which it is entirely possible for people to hold widely different but defensible opinions and it can be highly emotive due to very individual circumstances related to this. Death is never an easy process and, as we know, can be incredibly harrowing and painful for all involved.
I have attached a document sent to me by Baroness Tanni Grey-Thompson, in which she has summed up all the problems that I, as an experienced Parliamentarian, can see in this Bill as it currently stands - “Whatever your view on the principle, this Bill is not the way forward”.
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