Terminally Ill Adults (End of Life) Bill
(Limited Text - Ministerial Extracts only)
Read Full debate09:36 - The House divided: - Ayes: 208 / Noes: 261 - Question accordingly negatived.
09:50 - The House divided: - Ayes: 213 / Noes: 266 - Question accordingly negatived.
00:00 - The House divided: - Ayes: 223 / Noes: 269 - Question accordingly negatived.
10:15 - The House divided: - Ayes: 275 / Noes: 209 - Question accordingly agreed to.
10:27 - The House divided: - Ayes: 274 / Noes: 224 - Question accordingly agreed to.
14:14 - The House divided: - Ayes: 314 / Noes: 291 - Question accordingly agreed to.
Vicky Foxcroft (Lewisham North) (Lab)
This is my first speech in this Chamber since the general election, and if I am honest, I wish I was not speaking in this debate, as I wish this legislation was not being put forward. I have not always been opposed to assisted dying. Indeed, in 2015, I voted in favour of the Bill put forward by Rob Marris MP, but that was before I served four years as shadow Minister for disabled people. During that time, I spoke to hundreds of disabled people and the organisations that support them. They were, and remain, extremely fearful of assisted dying.
I took on that role at the start of the covid pandemic. Disabled people were disproportionately affected by the pandemic. Nearly six in every 10 people who died were disabled. Many had “do not resuscitate” notices unilaterally pasted on their medical records, without them being informed. It made them fear for their lives. It made them fear that the authorities thought that their lives were worth less. It also made them fearful of what would happen if assisted dying was brought forward. That is why Disability Rights UK and other disabled people’s organisations have moved from the neutral position they had in 2015 to a position of opposition now.
I do not claim that every disabled person opposes assisted dying, but I do claim that the vast majority of disabled people and their organisations oppose it. They need the health and social care system fixing first. They want us as parliamentarians to assist them to live, not to die.
Disabled people’s voices matter in this debate, and yet as I have watched the Bill progress, the absence of disabled people’s voices has been astonishing. They have wanted to engage. Indeed, they have been crying out to be included, yet the engagement has been negligible. I believe that only one disabled people’s organisation was given the opportunity to provide evidence to the Committee. Furthermore, throughout Committee and at the initial publication stage of the Bill, accessible formats were not available. A large-print version of the Bill was published several weeks after the original, but no other formats, such as easy read and British Sign Language, have been made available. These are basic things that we should be doing when consulting on such important pieces of legislation, making it accessible so that everyone’s voices and views can be heard.
Many of those expected to deliver this legislation also do not want it. They believe that it could destroy the doctor-patient relationship. The experts have all been clear. The Royal College of Psychiatrists, the Royal College of Physicians, GPs, disability charities, mental health charities and domestic abuse charities have all warned that the safeguards in the Bill are insufficient and will put vulnerable people in harm’s way.
I will finish by saying that I am not opposed to the principle of assisted dying, but until we have a system that supports the right to life, I cannot support it. Until we ensure that all safeguards are in place, I cannot support it. And until the vast majority of disabled people and their organisations support the legislation that is being brought forward, I cannot support it. We are not voting on principles today. This is real and we have to protect those people who are susceptible to coercion, who already feel like society does not value them, who often feel like a burden to the state, society and their family. I urge anyone in this Chamber who has any doubts that this Bill does not protect them, who has any worries and concerns: please do not vote for it today. Let us fix our NHS, social care and wider society first and then consider this topic again in the future, when the time is right.
Kit Malthouse (North West Hampshire) (Con)
Those of us who have come here today to support the Bill do not speak lightly of life and death, as some have accused us: we come here to recognise that this House has a responsibility to draw lines where there are none. Many of us have campaigned for many years, as the Mother of the House, the right hon. Member for Hackney North and Stoke Newington (Ms Abbott), said, to give voice to dying people—not because they want to be rescued, but because time and again they are begging us for mercy.
It is worth reiterating that this Bill is about not choosing death but how to face death when it is already at the door. It is about that final chapter of life—that short chapter. As many of our constituents have told us time and again, it is a chapter that they write in pain, fear and desperation.
We are here today to ask a simple question: in essence, is the law, in those final, often agonising moments, to be a barrier? Are we to be a barrier, or are we here to be a companion, to assist those people to fulfil their dying wishes? I believe in autonomy—I believe in dignity—but, more than that, I believe in compassion governed by care, not chaos. That is what the system lacks.
Right now, friends, as the hon. Member for Spen Valley (Kim Leadbeater) said, we live with the cruel illusion that doing nothing is neutral. It is not. Those who have objected to the Bill are conspicuous in not saying that they accept the status quo for however long the Bill may take to reappear if it fails. We have heard, again and again, stories of people forced to travel abroad to die in lonely circumstances. We see loving spouses prosecuted for holding the hand of someone they have loved for 50 years. We see lonely suicides in quiet suburban bedrooms: lives ended not because of terminal illness, but because of a lack of legal options.
The Bill brings order where there is confusion; it brings safeguards where there is silence; and it replaces secrecy with structure and fear with honesty. Notwithstanding the claims made today and elsewhere, it has been built in the right way. This House has taken its duties seriously, in all its forms of legislation. The Bill has gone through detailed scrutiny in Committee and concerns about coercion, training, eligibility and oversight have been met head on and addressed through carefully considered amendments. The panel model that we have now is shaped by those concerns. To ensure the right expertise, legal oversight and continuous consent checks are in place from beginning to end. This is how Parliament should legislate: carefully, collaboratively and with humility in the face of complexity.
To those who worry about coercion, I would say that the greatest risk of coercion is under the status quo. Today there are no checks, no panels, no oversight. We do not know who is choosing freely because there is no system to ask and no conduct to examine. We have heard the argument about a slippery slope, and I would say this. This law is very tightly drawn. There is no constitutional pathway here for expansion by stealth. Any change would require this House—us—to decide again. It cannot drift. It cannot slide. It is anchored in law and in the authority of this place.
To those who talk about misdiagnosis, I say that the Bill requires two independent doctors, clear clinical criteria and a final check at the point of delivery. Even then, the person must still be mentally competent and willing at every step. The answer can be no, but at the last—at last—there will be the possibility of a choice. To those who ask, often movingly, what if the patient lives longer than expected, I would say, “Good—they live.” This law does not force a single death. It simply allows a dying person to decide when enough is enough.
Madam Deputy Speaker, I will finish with this.
I have sat with dying friends. I have watched the slow unwinding of bodies that once held vigour, humour and pride. I have seen families trying to honour the unspoken wishes of someone too far gone to speak. Finally, I will say this. We do not honour life by prolonging suffering. We honour life by giving it meaning and power. The one thing that dying people ask for in their agonising final moments is control over the disease that is destroying them. The status quo, my friends, is completely unacceptable. Whatever you think of the Bill, it is indisputable that it is an improvement on what we have now, and I urge you to support it.
The Minister for Care (Stephen Kinnock)
I stand at the Dispatch Box alongside the Minister of State, Ministry of Justice, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), not as the MP for Aberafan Maesteg, representing the views of my constituents—although I thank each and every one of them who took the time to contact me with their considered opinions—but as the Minister responsible for ensuring that the Bill, if passed, is effective, legally robust and workable.
I thank Members across the House, on both sides of the debate, for their consideration of this legislation through its parliamentary stages and for their thoughtful contributions. I particularly thank the members of the Public Bill Committee for their detailed scrutiny over more than 29 sittings and 80 hours. This Bill has received more parliamentary time than most Government and private Members’ Bills, and the debate has been respectful and well considered throughout.
It is worth noting, of course, that the subject has received extensive and detailed consideration over a number of decades, both in this House and the other place, as well as beyond Parliament. Many Members will recall that the Bill before us today follows many years of examination and analysis, including reports such as the inquiry of the Health and Social Care Committee in 2023 and the accumulation of evidence from other jurisdictions. I would like to pay tribute to colleagues and campaigners on both sides of the argument for their contributions to this profoundly important conversation.
I will make some brief comments about the most significant alterations to the Bill since its introduction, from the perspective of their importance to the technical and legal workability of the legislation. The scheme set out in the Bill now includes assisted dying review panels. Multidisciplinary panels would grant a certificate of eligibility if they were satisfied that all the relevant requirements had been met. The panel would have to hear from the person seeking assistance, at least one of the doctors, and any other relevant persons. They would be responsible for monitoring and reporting on the operation of the Act, a role that was previously assigned to the chief medical officer. The commissioner would also appoint a dedicated board to advise on the impact of the Bill on disabled people.
The Bill’s commencement clause has been amended so that any provisions that have not yet come into force will automatically do so four years after the Bill is passed. Specific training requirements for doctors playing a formal assessing role under the Bill have been added. There is now provision for an independent advocate to support qualifying persons to understand their options for end-of-life care and the process under the Bill.
In terms of employment protections, amendments that have been made on Report mean that no one is under any duty to participate in the provision of assistance in accordance with the Bill. There are also now employment protections to protect employees and other workers from being subject to any detriment from opting in or opting out of providing assistance under the Bill, and to protect employees from dismissal.
It just falls to me to thank all hon. Members once again for their extremely valuable contributions to this sensitive debate, and to reiterate that should it be the will of Parliament for this legislation to pass, the Government will ensure the safe and effective implementation of this service.
Kit Malthouse
claimed to move the closure (Standing Order No. 36).
Question put forthwith, That the Question be now put.
Question agreed to.
Question put accordingly, That the Bill be now read the Third time.
Division 245
Ayes: 314
Labour: 225
Liberal Democrat: 56
Conservative: 20
Green Party: 4
Plaid Cymru: 3
Independent: 3
Reform UK: 2
Social Democratic & Labour Party: 1
Noes: 291
Labour: 160
Conservative: 92
Liberal Democrat: 15
Independent: 12
Democratic Unionist Party: 5
Reform UK: 3
Traditional Unionist Voice: 1
Plaid Cymru: 1
Alliance: 1
Ulster Unionist Party: 1