Terminally Ill Adults (End of Life) Bill
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Lord Wolfson of Tredegar (Con)
My Lords, this is the first debate in Committee on this important Bill so I hope that the Committee will allow me to take a minute or two to set out the approach of the Official Opposition. As my noble friend Lord Kamall and I said at Second Reading, the Official Opposition have no collective view on this Bill. Although each Member of the Opposition Front Bench will have their own view on the Bill, we will support noble Lords across the House in their scrutiny of the Bill. We will also table a small number of additional amendments where we feel that parts of the Bill need probing further. We will not seek to delay the passage of the Bill, nor will we seek to hold up progress in Committee. Instead, we will seriously engage in detailed scrutiny of the Bill so that we can collectively deliver the best possible piece of legislation.
In that regard, I respectfully pay tribute to the noble and learned Lord, Lord Falconer of Thoroton, for demonstrating his openness to improving the Bill already by tabling amendments that we hope to get to today and which reflect concerns that have been raised by noble Lords. I speak for all my colleagues on the Opposition Front Bench when I say that I look forward to working with him to ensure that we send a better Bill back to the other place.
The amendments in this group relate to the territorial extent of the Bill. My noble friend Lady Coffey is seeking to remove references to Wales in the Bill so that it would apply only to England. While I am not entirely persuaded that making this an England-only Bill is necessary per se, these amendments raise important questions about devolution. The core question for the noble and learned Lord, Lord Falconer of Thoroton, is why the Bill does not apply to the whole of the United Kingdom on the one hand or only to England on the other.
At the heart of this is, as the noble and learned Lord, Lord Thomas of Cwmgiedd, said—although various Acts of Parliament may put us to sleep, a speech by the noble and learned Lord never does; I was listening very carefully—that these amendments speak to the devolution settlement that we work with and the inconsistencies and confusions of that settlement. The noble and learned Lord used the word “complexity”. It is extremely complex. In this area, we have the problem that criminal law is not devolved to Wales whereas health is devolved. To pick up the point made by the noble and learned Lord, with which I respectfully agree, declaring the appropriate interest, Wales should not be regarded as inferior to Scotland. That is a point of general application.
The Scottish Parliament, as noble Lords know, is currently considering its own legislation on this topic. I hope that noble Lords have picked up that the Scottish Bill is significantly different in key ways—most markedly in the definition of terminal illness. In Scotland, it lacks the “six months to live” test which, whatever view we take, is at the heart of the Bill before us. The definition of terminal illness in the Scottish Bill is:
“For the purposes of this Act, a person is terminally ill if they have an advanced and progressive disease, illness or condition from which they are unable to recover and that can reasonably be expected to cause their premature death”.
I am not quite sure about “premature” in that context in all cases, but that is what the text says.
Leaving aside the point that those resident in one part of the United Kingdom will therefore have different rights to assistance under the law from those in another region of the United Kingdom should both Bills pass, I see the point that my noble friend Lady Coffey is making. If the people of Scotland may choose whether to have a law for terminally ill adults who wish to end their lives, why—I ask rhetorically, so to speak, looking forward to the response of the noble and learned Lord, Lord Falconer—should people in Wales not have the same choice? This is the key question that the noble and learned Lord has been presented with by this group of amendments.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, I welcome the opening comments of the noble Lord, Lord Wolfson, which were helpful. I thank noble Lords for this debate.
I want to set out some points about the role of government Ministers. As noble Lords are well aware, the Government remain neutral on the principle of assisted dying and on the passage of this Bill. Whether the law in this area should change is absolutely and rightly a matter for Parliament. I and my noble friend Lady Levitt will speak in Committee as government Ministers responsible for ensuring that the Bill, if passed, is legally robust, effective and workable. To that end, I will not be providing a government view on the merits of proposed changes. Those are rightly a matter for noble Lords to decide. Throughout Committee, my remarks will focus only on amendments where the Government have significant workability concerns. I hope that this will be of assistance to noble Lords in their consideration of amendments. Where no comment is made, any workability concerns are less significant. The Government are unable to confirm at this stage that the current drafting of those amendments is fully workable, effective or enforceable.
Turning to the amendments in this group—
Baroness Merron (Lab)
The noble Lord will be aware, as will your Lordships’ House generally, that Ministers have been absolutely consistent in setting out the right and proper role of officials, as is usual for a Private Member’s Bill. I will refer to that shortly. Also, if noble Lords have individual concerns, they are welcome to raise them with me.
The amendments in this group seek to restrict the eligibility criteria to apply to individuals in England only, rather than in England and Wales, as at present. These amendments would have minimal legal effect unless they are coupled with amendments to later clauses. Clause 1 is largely declaratory. This group of amendments would conflict with later operative provisions in the Bill unless consistent amendments are made to later provisions.
I will pick up a few of the points that have been raised. The noble Baroness, Lady Coffey, raised a number of points about engagement and I would be pleased to write to her further. I have done my very best to ensure that all the questions that she laid have been answered. I hope she will accept my apologies if that is not the case, but I have certainly endeavoured to do so. I will also review points made by other noble Lords in this debate, where they are relevant to the Government.
The noble Baroness, Lady Smith, raised a question regarding legislative consent Motions. As would be expected, UK government officials have discussed these matters with Welsh government officials, and the management of the legislative consent process in the Senedd is, of course, a matter for the Welsh Government.
In closing, I will make a few general comments about engagement.
Baroness Smith of Llanfaes (PC)
On the LCM point, the Legislation, Justice and Constitution Committee in the Senedd has made a statement about it not having received enough information on the conversations between the UK and Welsh Governments about why certain clauses do not engage with the LCM process. Can the Minister respond directly to that point about why this information has not been shared with the Senedd?
Baroness Merron (Lab)
I will certainly look into the matter that the noble Baroness raised and would be pleased to write to her. However, the first point I wanted to make here was about engagement with the Welsh Government. Of course, Ministers themselves have not met with the Welsh Government in relation to this Bill, as again would be expected, as it is not a government Bill. I know that the sponsors have met with the Welsh Government to discuss the policy intent and to negotiate which clauses require a legislative consent Motion.
The sponsors are also leading engagement with Scotland and Northern Ireland while—on the point made earlier by the noble Lord, Lord Harper, and others—UK government officials are providing technical support to support the sponsor and are engaging with Welsh government officials to discuss technical matters in relation to clauses that require a legislative consent Motion or those to which Wales has requested that further changes are made. Officials have regular meetings; they can be as frequent as weekly, as was the case at some points over the last few months.
Baroness Grey-Thompson (CB)
The noble Baroness mentioned that the role of Ministers is to ensure that the Bill is legally robust, effective and workable, but surely safety has to play some part in that as well.
Baroness Merron (Lab)
I am sure it would be expected that safety is absolutely paramount. The point I am making—and I look forward to hearing from my noble and learned friend—is that our position in government here is not to deal with matters of policy. As I have said, we are restricted to areas to which any Government would be restricted.
We will absolutely work with the Welsh Government, NHS England and the NHS in Wales to understand the impact of any changes to the law and the provision of healthcare services in Wales, during the coming stages of the Bill.
Lord Falconer of Thoroton (Lab)
My Lords, I make a declaration of interest: I have an assistant who is funded by Mr Bernard Lewis and who helps me on this Bill. I make a declaration that Dignity in Dying paid for the printing of the material that was circulated to Peers in my name before this process commenced.
I compliment the noble Baroness, Lady Coffey, on the short way that she introduced the important issue. I very much hope that I can put to rest most of the misconceptions that were expressed during this debate.
As everybody agrees, criminal law is not devolved to the Welsh Senedd. Therefore, any change in criminal law has to come from the UK Parliament. You cannot proceed with assisted dying without changing the criminal law. Therefore, the UK Parliament has to provide a legislative change for that.
Healthcare is rightly devolved to the Welsh Ministers and the Senedd. The Bill makes provision in England for Ministers to produce regulations on how assisted dying will be implemented and regulated in England. Clause 42 requires Ministers to produce such regulations. It is wrong, as part of the devolution settlement, to require Welsh Ministers who are responsible for health in Wales to do that. It is for the Welsh Government to decide what provision to make. Unlike Clause 41, which relates to England, Welsh Ministers are given the option to introduce such regulations as they see fit. Those regulations will permit the assisted dying process to be introduced in Wales, in the National Health Service, and for Welsh Ministers and the Welsh Government to provide whatever provision for it in regulations that they see fit.
The noble Lord, Lord Wolfson, asked why we are legislating for England and Wales but not Scotland at the same time. It is because we are doing exactly what the noble Lord, Lord Gove, asked me to do—and I am so glad he did—which is to respect the devolution settlement. Will the noble Lord let me finish? Then I will come back to him.
The way this structure works is that, first, we in this Parliament determine whether the criminal law should be changed. Secondly, the Welsh Government are given the power to introduce regulations. That power should normally be given to Welsh Ministers by an Act of the Senedd. Therefore, a legislative consent Motion has been proffered by the Welsh Government for the Senedd to decide whether it would be willing to give us consent to legislate in an area that would normally be legislated for in the Senedd.
The LCM—legislative consent Motion—in the Welsh Senedd covers the following. I give these details for noble Lords to consider them at their leisure: Clause 40, which gives Welsh Ministers power to issue guidance; Clause 42, which gives Welsh Ministers power to regulate how this is to be introduced in the health service in Wales and with what regulations; Clause 51, which gives the Welsh Government power to talk about and make regulations about the Welsh language; Clause 54, which gives them a general power to make regulations; and Clause 58, which gives the Welsh Ministers and the Welsh Government power to introduce certain of the provisions.
The sponsor in the other place and I have discussed this arrangement with the Welsh Government, and by that I mean Welsh Ministers and Welsh officials. We have done what the Welsh Government would wish us to do to respect devolution. We have taken these powers in the Bill, subject to Parliament, so that there is not a position where, after this Bill is passed, Welsh Ministers lack the power to introduce regulations if they choose to do so.
I have listened to this torrent of points about Wales saying it has not been thought out. I say with suitable humility that we have thought it out and sought to reflect what good devolution practice would require. I do not invite people to come back, but please think about what I have said and consider—
Baroness Coffey (Con)
I would be grateful if any advice that has been given to the noble and learned Lord by officials is shared with the Committee. It is helpful, when determining legislation, to understand that, and it would be especially helpful if the Government, who have said they are getting involved only on legality and practicality, were to express their view. They will not even tell the Welsh Government what their view is, and that is very concerning.
Baroness Merron (Lab)
My Lords, I just emphasise my previous comments. I think it would be extremely helpful for this debate if I were to write to the noble Baroness setting it all out as she requires, following my previous Answers to Written Questions that have been laid.
Baroness Coffey (Con)
I hope that the department will take a better attitude in determining things such as freedom of information requests. We have already had from the Cabinet Office whether it is now in the public interest to declare information that it holds. I hope the Government—I can see that the Deputy Chief Whip is on the Front Bench—will take this away, because it is a serious matter. This is one of the most important Bills that we will consider in this Parliament, and it is important that we have transparency and a full understanding that is shared across the Chamber. With that, I beg leave to withdraw the amendment.
Baroness Berridge (Con)
My Lords, I do not think it is helpful to your Lordships’ House to be going into discussions that included private discussions. The Motion that the House passed did not suggest that. Noble Lords will also know that there are ethical concerns about calling people who are so vulnerable.
Baroness in Waiting/Government Whip (Baroness Anderson of Stoke-on-Trent) (Lab)
I remind your Lordships of the conventions of the House. An intervention on an intervention is not ideal. If we can follow normal conventions, that will be helpful.
Baroness Smith of Newnham (LD)
I thank the noble Baroness. I note that my former tutorial partner from Oxford was intervened on, or interrupted, for speaking for too long beyond 10 minutes. I shall endeavour still to be within 10 minutes despite having been doubly intervened on.
The report noted that the committee had not taken evidence from terminally ill people. I will leave it at that in terms of responding to the noble Baroness, Lady Thornton. However, we took evidence, as we were requested to do, on safeguarding and procedures, and, within the confines of a very brief committee, we took a wide range of evidence. Should we and could we have taken more? Absolutely, but within the confines of what we were able to do I think we did a job. I certainly did not at any point speak or vote against, or indeed take any view on, the idea that we should not take evidence from terminally ill people, so it is unfortunate that that has become a topic of debate.
The reason I rose to speak is that the question of capacity versus ability is hugely important. There are references throughout the Bill to the Mental Capacity Act, but to suggest that this one amendment is not appropriate is an unfortunate legal point. The amendment says that people should have the ability to make the decision, but “ability” reaches far beyond the narrow confines of the Mental Capacity Act. At various points in Committee, we will talk about capacity. The committee took evidence on capacity, and a key thing to bear in mind about the Mental Capacity Act is that it was never designed for a life or death decision. We need to be very clear as a Committee of the whole House and as parliamentarians—
Lord Kennedy of Southwark (Lab Co-op)
As a final point, I agree with the noble Lord. As Government Chief Whip, I take my job very seriously. I love the House, and I want to do this properly. I assure the Committee that I hear noble Lords’ sentiments. I know how long it has taken on the Bill. I know that views are sincerely held on both sides. I will work in the usual channels to deal with these matters.
Baroness Merron (Lab)
My Lords, I am grateful for the insightful contributions that have been made to this debate. I will be very concise on the point. In summary, it is our view that workability concerns are less significant, although the Government are unable to confirm at this stage that the current drafting is fully workable, effective or enforceable. As noble Lords will understand, the amendment has not had technical drafting support from officials.
On this point, if the amendment is passed in isolation, it is likely to have minimal legal effect, as Clause 1 is essentially declaratory rather than operative. The remainder of the Bill would refer to the capacity to make a decision, which, as noble Lords will be aware from the Bill, is to be read in accordance with the Mental Capacity Act 2005.
I anticipate coming later to discussions on amendments to Clause 3, as noble Lords have referred to, as those amendments would change the operation of the Bill. I will comment on proposals when we come to the relevant debate. These issues are, of course, rightly a matter for noble Lords to consider, deciding which test is to be used.
Lord Falconer of Thoroton (Lab)
I will deal first with the central issue in this debate, which is the amendment from the noble Baroness, Lady Finlay. The wording currently mentions:
“A terminally ill person in England or Wales who … has the capacity to make a decision”.
The noble Baroness proposes that “capacity” should be changed to “ability”. From what the noble Lord, Lord Wolfson, says, I understand that we should read that with Amendment 115, although there is another amendment that the noble Baroness proposes in relation to Clause 3. But I accept what the noble Lord says in relation to Amendment 2.
With the greatest respect to the noble Baroness, Lady Finlay, she is suggesting that we remove “capacity” and replace it with “ability”. The noble Lord, Lord Sandhurst, put his finger on it when he said that “capacity” is well known to the law. You could not possibly have a Bill that did not refer to capacity because what it means, in the eyes of the law and of people in practice, is the ability to make the decision. As the noble Lord, Lord Blencathra, said, if you do not have capacity, you cannot make the decision. That applies right across the doings of human beings, and the law recognises that. If, therefore, you replace “capacity”—