(1 month ago)
Lords ChamberMy Lords, not for the first time, I am feeling a bit outclassed and overawed by the legal and judicial expertise in this place that has produced so many excellent speeches. I particularly thank the noble Lord, Lord Farmer, for inviting us to talk about the state of prisons and probation services.
However, I want to start by making some broader points about context. During the week, we have had the extraordinary sight of 92% of the citizens of an Oxford village, Piddington, population 358, voting in a symbolic referendum to become independent from the United Kingdom. In interviews with residents, there has been a common theme: the state is exposing them to danger. Housing 1,250 young male asylum seekers in nearby Bicester garrison means:
“Our safety, our security and our freedoms will be under threat”.
To paraphrase one woman: “If these men need government leaflets to explain that sexually abusing children or raping women is wrong, I’m frightened to go out alone. I will become a prisoner in my own house”. That is my theme, in a way.
The sentiment of being a prisoner in your own house is not confined to leafy villages but is felt in towns and cities throughout the country. It is not confined to asylum policies. One key issue that has been a lightning rod for worries that state policies are indifferent to public safety is the early release scheme—for example, those women who now feel frightened in their own homes as victims of domestic abuse, worried that their early released tormentors may show up on the doorstep. Somehow the law-abiding are unfairly becoming the victims of failed state policies.
I would normally want to use today’s debate to talk in detail about prison reform, because I am passionate especially about improving educational initiatives in prison and I hate the lack of purposeful activity available that has been so well described by other noble Lords—I thought the noble Lord, Lord Farmer, made a magnificent speech—but it is also true that it has become particularly difficult to convince the public that the MoJ should prioritise improving the treatment of prisoners in jail when so many are being released out of jail before they have served their time. Discussing rehabilitation feels meaningless when the very purposes of prisons—at least in the sense of punishment and deprivation of liberty, not cruelty, or of protecting the public, let alone rehabilitation to reduce reoffending—are made a mockery of by successive Governments’ failure to deliver prison expansion and now the makeshift solutions to deal with the fallout.
Early release schemes outsource the problem into our communities, literally dumping it on our streets. The public are rightly furious that criminals will not now serve the sentences that the law, which we make here, thinks is appropriate for their crimes. Recent polling shows that 69% of those questioned are against the early release scheme. More troubling, 68% say they have lost faith in all Governments’ handling of criminal justice per se. At the forthcoming annual Battle of Ideas festival organised by the Academy of Ideas, which I run—I declare an interest—one of the panel debates is entitled: “Letting abusers out early: solving the prisons crisis”. It is proving to be an unexpected festival sell-out hit.
When I talk to people, four recurring themes are raised. There is a perception that the early release scheme, alongside the Sentencing Act, has a presumption against prison in favour of community sentences. With the even further reductions in release dates to a third of sentences served, people just feel that sentencing has become a joke and that it is less a pragmatic response to a lack of prison space than an official ideological turn against incarceration as punishment. This is happening without public debate or consent.
There is also a worry that the prison crisis is diminishing the diligence of policing in pursuing certain crimes. What is the point of arresting shoplifters or burglars if they cannot be threatened with the prospect of prison?
A third concern is that early release is a lazy reaction to the crisis. Why are there no other emergency options—perhaps the prison equivalent of NHS Nightingales? Maybe the thousands of empty prison cells currently out of action could be renovated, or even the shocking facts about those kept on remand, which we heard from the noble and learned Lord, Lord Leveson, in his brilliant maiden speech, could be tackled. It is a disgrace that this is such a large percentage of the prison community.
A final concern is in response to the Government’s reassurance that early release prisoners are not being released freely but will be under close supervision. Yet probation services admit that they are not equipped to cope. The whole paraphernalia of control and surveillance in the community—curfews, electronic tags, formal restriction zones, the wearing of high-vis vests—can only result in whole swathes of local areas feeling more like open-air prisons for all, rather than a free society.
Possibly the only good thing to have come from the prison crisis is Prime Minister Andy Burnham’s commendable announcement that he will, at last, end the injustice of IPP prisoners. I confess that I got emotional hearing an ex-IPP prisoner, Marc Conway from UNGRIPP, declaring that it was,
“a day that thousands of families have spent years fighting for”.
He also stressed that implementing the decision needed to be swift and transparent, and that is where the euphoria is dampened.
Last week, I received this message from Stacey Clough of the Injustice of IPP campaign. It is worth listening to her words. She said:
“I think it’s great what Andy Burnham has said, but he has left IPP prisoners and their families with a different mental torture by not making it clear what it’s going to look like … and they still have no definite date to count down to. My partner said all the IPPs in Wayland have gone downhill, as the hopes were raised by the announcement, but as there’s no time-frame… they’re all worried it’s false hope. What if there’s an election and Labour are voted out—then back to square one. They have now been left with uncertainty. If the Government don’t end it, there is going to be more suicides”.
I gulped at that. Stacey continued:
“The thing is he could order probation to release the recalled prisoners without any new requirements—and no new legislation is needed because of executive powers created in 2012—powers they’ve never used. They should also be recommending that anyone going up for parole, with no new crimes or charges on a recall, should be granted release and have their licence terminated and give them a supervision order instead”.
My advice to the Minister is to recommend to the MoJ that Stacey is given a job, because she has got it all completely right, as far as I am concerned. There are so many inequities in the way in which IPP prisoners continue to be treated. It is not just that we need to have these things happen more quickly. For example, we hear that, even when IPP prisoners are granted parole, they are often kept in prison for months and months, due to a lack of approved accommodation on the outside. There are things that need to be done fast.
While the Minister defended the principle of recall at Questions this week, the fact that the number of IPP prisoners recalled without any criminal charge has gone up from 70% in 2023 to 77% in 2025 should worry him. I hope that noble Lords have a good recess, but I will be at No. 10 North on Monday, along with anti-IPP protestors—
Lord in Waiting/Government Whip (Lord Katz) (Lab)
Order. The time limit is eight minutes.
(1 month, 2 weeks ago)
Lords ChamberThe noble Lord, Lord Carter of Haslemere, and earlier the noble and learned Lord, Lord Bellamy, raise a very important point. There is no point in passing a law under which you have to tell the truth at inquiries if, when the inquiries conclude, nothing happens. That is the problem with just passing laws.
Maybe surprisingly, the one speech by the former Prime Minister and soon to be former MP, Keir Starmer, that I found moving and stirring related to the Hillsborough Bill. He said it was a law for the victims of
“all the countless injustices over the years, suffered by working people at the hands of those who were supposed to serve them”.
I genuinely choked up. He went on to name-check Horizon, Grenfell, infected blood, grooming gangs and Windrush. How depressing that we can all think of so many more examples of truth and justice being concealed behind the closed ranks of the state. The powerful speeches we have heard today reflect this. The idea of politicians admitting to this and even compelling public bodies and officials to be held accountable for state-related harms to ordinary people just feels momentous. Yet I have some qualms about overclaiming and hype, proclaiming that the law will shift the balance of power and lead to a culture change per se, as other noble Lords have noted. It all feels more serious than that, because, to be frank, we are in the midst of a democratic crisis.
Over the Recess I read the UK Extremism and Democratic Resilience Centre’s report, Britain Under Strain—holiday-reading fun. The report details the data showing a chronic erosion of trust in the state that reached “historically low levels” and notes that a lack of faith in effective governance is deeply embedded in public opinion across left and right and all age groups. Shockingly, a growing number of the populace believe that the foundational bargain between the state and citizens is failing. Research and polling show that 61% believe the social contract—that stabilising web of reciprocal obligations that holds society together—is broken. Only 23% think it still works, and it is the state that is in breach of contract, not the public. That perception extends across demographic and socio-economic metrics. In other words, disillusion and collapse of trust have become mainstream—and is it any wonder?
We might all argue about which example was the straw that broke the camel’s back. For me, it was following the oral evidence phase of the Nottingham inquiry. What a display of evasion, incompetence and even indifference. Multiple state agencies that had contact with a high-risk and non-compliant patient with a history of violence, Valdo Calocane, somehow failed to keep him under effective supervision, discharged him unmedicated into the community, failed to execute a live warrant, and on and on. That allowed him to murder Grace O’Malley-Kumar, Barnaby Webber and Ian Coates.
It is unbearable that these were preventable deaths, and it is unbelievable that the exposé of the details—the answers swerved and the interpretation of the legalistic double-speak—became public only because the victims’ families took to social media to tell us what happened in the inquiry. I give a special shout out to Emma Webber, who painstakingly filmed daily updates of the horrors prised open begrudgingly in that inquiry. I still cannot believe that no one has lost their job over it all.
While I despise those weaselly words that we hear, “lessons will be learned”—they rarely are—there actually were lessons from that inquiry about how parliamentary deliberations and the small print of laws that we pass can impact on operational decisions in the real world, sometimes with unintended consequences. For example, in the 2025 Theemis homicide review into Valdo Calocane’s care, it was found that NHS staff were acutely conscious of the legislative debate surrounding the Mental Health Bill about the alleged disproportionate use of coercive detention of Black and Afro-Caribbean patients. So, after Calocane tried to break into a neighbour’s flat, one doctor was leaning towards detention, but the inquiry counsel noted that the clinical team worried over representation of young Black men being sectioned, referencing the Bill, and chose monitoring in the community instead. Hours later, Calocane broke into another flat and a woman was so terrified that she jumped out of the window, sustaining horrible injuries.
There is a cautionary note here: however much we broadly support the spirit of this legislation—and we all do—we have an obligation to raise critical concerns and ensure that the drafting and terminology are tight, clear and unambiguous, and we should not be overly rushed. We must ensure that there are guardrails so that we do not overcriminalise. The Law Society asks whether there is a risk that institutions keen to avoid criminal liability may resort to data dumping. We have to ensure that the criminal offence of misleading the public does not stifle legitimate political disagreement or debate, and that honest mistakes are taken as honest and we do not punish the wrong people.
Finally, those who have emphasised that law change is not enough, and that we need a culture change, are absolutely right. But I worry when culture change is seen as deliverable by codes of conduct. I dread endless training sessions in candour and ethics. HR departments will have a field day, but I do not know what it will achieve. What I remember most vividly from Hillsborough, when growing up, was that the officially endorsed cultural attitude was contempt for football fans, who were talked about as scum. It is sad to say that such visceral snobbery about working class people is still prevalent. We heard it in the vile demonisation of Brexit voters as ignorant, duped deplorables; the name calling doled out at those worried about asylum hotels or HMOs in their areas, who were smeared as racist; the treatment of those who, for years, tried to talk about rape grooming gangs and who were labelled Islamophobic; and the young girls—child victims of gross sexual abuse—who went to the police and were arrested as prostitutes.
Most members of the public have not been stonewalled at inquiries, but they have been gaslit by politicians who evade using candour with voters, and they have been hectored and hounded to dial down their fury for speaking inconvenient truths about state cover-ups. They are the real whistleblowers we should value. The public know when things are going wrong, so taking public concerns seriously is the culture change we need. That is how we will know when things are going wrong at the heart of the state, and we, at the heart of the state, should listen to them, not stonewall them or gaslight them. This Bill is the start, but it is the tip of the iceberg.
(3 months ago)
Lords Chamber
Lord Timpson (Lab)
The noble and learned Lord is incorrect: 896 IPP prisoners have never been released; that is 11% down on last year. My view is that we need to get them into the right prison. Two years ago, only 70% of them were in the right prison; now 91% are in the right prison, and we need to support them so they can get out. Prisons like HMP Grendon, which is a therapeutic community, do good work with IPP prisoners, and HMP Warren Hill has specialist units to support them. I want them to progress as quickly as possible but as safely as possible, so when they are out, they can stay out and do so safely.
My Lords, in his maiden speech in the other place, in relation to the Hillsborough law, Andy Burnham talked passionately about miscarriages of justice, as we have heard. He also commended victims’ families for campaigning for decades against state wrongs. Taking him at his word, will the Minister draw the new Prime Minister’s attention to the IPP scandal and suggest meeting IPP prisoners’ families to hear details of this shameful blight, on their lives and on the criminal justice system, and to hear their frustration when the state unfairly cites dangerousness as an excuse while releasing proven dangerous rapists early to solve an estate mismanagement problem—that is, prison overcrowding? They want to talk to people in power about this; the new Prime Minister is perfect. Please facilitate the introduction.
Lord Timpson (Lab)
I am glad the noble Baroness thinks that the new Prime Minister will be perfect. I was pleased to see the noble Baroness yesterday outside the Ministry of Justice with a number of ex-IPP prisoners and their families. I reiterate the important role that families play in the justice system. There are 193,000 children affected by parental imprisonment and a number of those are children whose parents are on IPP sentences. Some have come home and are then recalled back into custody. One of the key elements for people reforming and not reoffending is family ties. Yes, they need a job and somewhere safe to live, and we want them to be well, but families have a really important role, which is why we need to keep supporting the families of IPP prisoners.
(3 months, 2 weeks ago)
Lords Chamber
Baroness Levitt (Lab)
The noble Lord raises an important point. I am happy to reassure him that we have now reallocated the IPP prisoners. The vast majority—around 95%—are in the appropriate custodial settings, in terms of both the visits and the care that they need, in order to help them to get to a point where we can start looking at release.
My Lords, I will be there on 15 July and urge everybody to go to the MoJ and join in—advert over. The point was made that we see these as trivial offences but some of them are serious, but what is trivialised is the recall. The mother of the prisoner to whom the noble Lord, Lord Moylan, referred recently handed her own son in on a recall after an anonymous malicious complaint. No charges have been made; nothing has happened. The mother says, “This is cruel. It’s torture”. It is a sword of Damocles hanging over families. Will the Minister and her department act with urgency? For IPP prisoners, when recalled for no criminal offences, it is on average 28 months before they can even see a probation officer. That is cruel, that is wrong and the ministry needs to do something about it.
Baroness Levitt (Lab)
Can I make two things clear? First, recall is not used as a punishment for a minor breach of licence. I am afraid that the noble Baroness is wrong about that. It is a means of protecting victims and the public when the Probation Service assesses that it can no longer manage that offender in the community. Recall is an important and swift public protection measure. Also, HMPPS has strengthened the scrutiny and quality assurance of recall decisions. There is a higher threshold for IPP prisoners in relation to recall. There must be not only a breach of their licence conditions such that there is a concern about the risk that they present but a causal link between that breach and the index offence for which they are serving the sentence in the first place.
(5 months ago)
Lords ChamberMy Lords, I want to focus on dilemmas around national security at home. I fear that relevant Bills in the gracious Speech betray some confusion about who the enemy is, and this disorientation can mean laws and policy that punish the wrong people. This was brought home by the points made by the noble Lord, Lord Wolfson, many hours ago now, in relation to the shocking tale of the Nova exhibition in London. I remind noble Lords that this is a commemoration of the massacre of young Jewish festival-goers, yet how morally muddled we are that the police put the onus on the organisers to hide their location and signage to stay safe. It also begs the question, safe from who?
The national security Bill identifies, “escalating threats such as Islamist and extreme right-wing terrorism”, but I must say that I cringe when I hear this overused couplet, for one reason: the Government seem far more at ease proactively taking on the extreme right as the enemy than being tough on the far greater and more serious threat of Islamism. We had a vivid example over the weekend, with the tale of two protests. It is telling that, within days of Labour’s unprecedented electoral defeat, the Prime Minister’s reset speech chose to assert his authority by targeting far-right agitators as enemy number one. He even became tough on border control, block-banning undesirable foreigners—or, rather, 11 international speakers, including European parliamentarians—from speaking at Tommy Robinson’s Unite The Kingdom gathering. We might agree that the views of those banned speakers are deeply unpleasant, and many are, but do we agree that opinions dubbed far-right are now deemed a security risk? How does treating a foundational value of western democracy, free speech, as an enemy make anyone safer?
Last week there was further No. 10 hyperactivity: ministerial denunciations of just one protest and a melodramatic filmed appeal to the nation. The Prime Minister posited that citizens’ attitudes to Robinson’s shindig were
“a fight for the soul of this country”.
This gave organisers far more credibility and free PR than merited. But targeting far-right threats in this one-sided way has backfired. Many decent people took it personally, not because they planned to go to the rally or were fans of Robinson, and certainly not because they are far right—many, to be honest, were working-class Labour voters until recently—but because they resented that their worries about mass migration, Islamist sectarianism, grooming gangs, et cetera, were being scapegoated as “dividing the nation”. Many furiously asked why there was no special broadcast denouncing the other protest, protest number two, down the road on the same day.
That pro-Palestinian hate fest even gained a new moral authority. Taking its cue from the Government, it rebranded itself as “Nakba for Palestine, against the far right”. They even wrote new chants to add to their antisemitic repertoire. To quote one:
“What do we do with Tommy’s crew? … Shoot them in the neck like Charlie Kirk.”
Hearing that bellowed out by a large baying mob should force us to ask, who is the threat or enemy here?
Finally, the national security Bill is also a response to the horrific murders in Southport. Unlike other noble Lords, I am disappointed that the Bill disproportionately falls back on targeting that old favourite enemy, online content: cue more censorship. I worry too that it will be a distraction from tackling offline, preventable violence by the likes of Axel Rudakubana or indeed Valdo Calocane. When we scrutinise this Bill, we must look closely at the evidence of the Nottingham inquiry. Calocane did not butcher Barnaby, Grace or Ian because he spent too much time on TikTok or X. Instead, at least partly, state agencies, from psychiatrists to the police, seem to have interpreted the Mental Health Act that we passed here as a signal to treat dangerous perpetrators as vulnerable and to avoid any action that can be labelled discriminatory or racist. The laws we pass have consequences. We should think of that seriously.
(7 months ago)
Lords ChamberBefore the noble Baroness sits down, is she aware that there are no telemedicine abortifacients available in Northern Ireland? It is not lawful.
My Lords, I wanted to sound really definitive in saying that I oppose Amendment 424 in the name of the noble Baroness, Lady Monckton, which would remove Clause 208, and that I oppose Amendments 425 and 426D. However, the good thing about this place is that I listened to the noble Baroness, Lady Wolf of Dulwich—about whom I am going to say something wonderful. She made me pause and think, and that is what is really useful about this debate. I am absolutely certain on some things, but I am not quite sure about the tangle of amendments that have been proposed. I am therefore going to carry on and voice some of my concerns.
To give a bit of context, abortion in the UK is a safe, normal and common procedure. It is appreciated by women because, when facing an unplanned or unwanted pregnancy, it allows them a legal choice on whether to be a mother—a decision that will alter the whole course of their life. The fact that a third of women in the UK will have a legal and safe abortion at some point in their life—the vast majority of which will happen early on—shows how careful we have to be not to allow this rather fraught, heated and emotional debate impose any unintended barriers to that success story for women’s freedom and rights. I am afraid that some of the well-meaning compromises we have heard about tonight would likely do that. I am particularly worried about undermining telemedicine and pills by post.
I want to reflect on time limits. Many of us will have received a tsunami of emails and letters urging us to oppose Clause 208, stressing emotively—and factually inaccurately—that this clause will legalise abortion until birth, and that that amounts to the state-sanctioned killing of babies, as someone explained to me. We have to restate for the public that this clause does not change the limits for abortion. There is still a 24-week abortion time limit. In fact, abortion itself remains a crime, just as it has been since 1968, unless very stringent conditions are met. I stress again that any medical professional, or anyone else, who assists a woman to get an abortion beyond the legal limit of 24 weeks will be committing a serious crime and will be liable for prosecution.
We have to understand the public backlash, because there is unease about the whole issue of abortion until birth, and time limits per se. As a society, or indeed as a Parliament, we may want to revisit the issue at some stage. For many, the 24-week legal time limit based on viability can feel too arbitrary, especially as surely we all want medical science to make great strides in keeping prematurely born babies alive ever earlier for those women who want their children, but that should not limit the rights of those women who do not want to proceed with their pregnancy.
There are moral issues here about human life—that old chestnut of whether human life starts at conception or birth. There are those who stress that we should focus on the unborn child—we have heard a fair amount of that tonight. They say that, when we talk about more developed foetuses, we are talking about an unborn child, and that the heart that can be seen beating on an ultrasound scan at six weeks is just as much that of an unborn child as one that beats five months later. Is gestational growth a useful guide to the law? Is viability the best guide to what makes us human?
Such difficult discussions should not be shied away from. When you go out and talk to the public about this subject, they talk about time limits and these kinds of issues. Certainly, at the Academy of Ideas, where we work with young people, we consider it is our duty to organise such debates regularly to ensure that new generations rightly ask questions and hear all sides of the argument.
However, Clause 208 is not trying to relitigate the legal time limit debate, even though I welcome the fuller debate we have had tonight. It is important that we acknowledge why it has caused a furore. It removes the threat of criminalisation for a tiny number of women who, for whatever reason, have taken abortion pills to terminate their own pregnancy, but we have to be honest and acknowledge that it brings a risk of abuse—I know that, even though I am supporting it. The notion that decriminalisation will mean that women will gleefully go on a crime spree because it is decriminalised—suggesting that it is only the threat of prosecution that stops women from letting their pregnancies progress carelessly so they can inflict on themselves the horror of self-induced full-term termination —seems far-fetched and lacking in generosity. Legal late abortions are not harmful per se; certainly, they are not more harmful than coercing an unwilling woman to endure a full-time pregnancy and labour against her will.
However, it is also true that late abortions are undoubtedly gruelling for both patient and clinician, which is why the idea that any woman would choose that as an easy or casual option is far-fetched, ludicrous and insulting. The earlier an abortion can be performed, the better it is for women, and that is the reality of the perspective we need for this debate. In 2022, the last year for which figures are available, almost a quarter of a million women in England and Wales had abortions. Almost 90% of those were under 10 weeks and only 1% were at 20 weeks or over. We are not talking about everybody having late abortions or queuing up to have them.
The emergence of telemedicine has allowed access to even earlier abortion. Surely one of the few positives that emerged out of Covid, 2020 and the lockdown was that it changed the abortion regulations to allow medication in early pregnancy to be taken at home. While it is easier, early medical abortion is certainly not a free-for-all or unregulated—it is not like getting a pharmacist to okay your access to Wegovy or Ozempic. It remains regulated under the 1967 Act, which is a hyper-regulated piece of legislation that includes speaking to a doctor and so on. The limit remains at 10 weeks and nothing in Clause 208 changes that. What is positive about pills by post is that it cuts down on the dreaded waiting list times, which means that treatment can be earlier. An insistence on face-to-face appointments, as some of the amendments suggest, would tangle up early abortions in delay, which would undermine the success of 40% of abortions by telemedical methods now being performed at six weeks, versus 25% using traditional access methods.
Finally, one of the arguments used against telemedicine is that it could lead to non-consensual coerced abortions, with abusive men, or even abusive parents, forcing young, vulnerable women to abort. I was glad to hear from the noble Baroness, Lady Neate, about the issue in relation to domestic abuse. Clause 208 does not change the law on this non-consensual coerced abortion. Non-consensual coerced abortion at any gestation remains illegal and is a crime.
However, it is key to note that since telemedicine became legal there has been a major increase in safeguarding disclosures, especially by young women who have felt able to talk about being victims of domestic abuse or sexual violence precisely because they are doing it remotely. It has allowed abortion providers to offer invaluable pastoral intervention beyond abortion services. Telemedicine also enables those vulnerable to coercion to avoid their abusers being involved in the deliberations about their desperate plight of being pregnant.
I will just finish by addressing the right reverend Prelate the Bishop of Leicester. There are many young girls—I appreciate that they are children—from traditional religious communities. Think of the young Catholic girl, the young Muslim girl and so on, as well as those at risk of honour-based violence. Those kinds of young people actually do not need to be asking their dad to drop them round at the clinic so they can get advice. They are sometimes dependent on other people. With telemedicine, they can go with privacy and talk at their own chosen time and place, without having to answer back to a parent or an abusive partner. In other words, telemedicine offers privacy and can help women stay safe.
(7 months ago)
Lords ChamberThe panel has the power. Clause 17(4) says that the panel
“may ask any person appearing to it to have relevant knowledge or experience to report to it on such matters relating to the person to whom the referral relates as it considers appropriate.”
That power would include a power to ask the local authority to provide any information it wants.
I thank the noble and learned Lord for a comprehensive and useful set of answers. I asked a rather more banal question—it was a long time ago—about workforce challenges. What if the social workers or the psychiatrists cannot be found? We are already acutely short of psychiatrists and social workers in general, and that is problematic in particular geographic areas. Could the noble and learned Lord comment on what will happen if the legal expertise, social workers or psychiatrists are not available in one part of the country? Will it be a postcode lottery?
My second question is this. Has the noble and learned Lord consulted the likes of the Royal College of Psychiatrists and the British Association of Social Workers about what the Bill will do to workforce pressures? It seems to me that it will affect workability. If these panels are so important and there are not enough people to sit on them, I am worried that there will be a watering-down, with the grabbing of any old social worker who wanders past. Maybe the noble and learned Lord could clarify that.
If there are not enough people with the requisite expertise to people the panels then there will not be panels to do the job. That is why the broad categories have been adopted in the Bill. The Royal College of Psychiatrists has expressed views in relation to this, as has the British Association of Social Workers. However, it is necessary for us to find people to do this process, because the workability of the scheme depends on it, and we believe it is possible to do that. We recognise the concerns that have been expressed, including by the noble Baroness, who is right to say that if we do not have people who can people the panels then we cannot do the process.
On the broader issue of what happens if we have people in one part of the country but not another, it will be for the voluntary assisted dying commissioner to ensure that, when a panel is required, it can be provided.
My Lords, I will speak to my Amendment 155, which is different to the amendments in the name of the noble Lord, Lord Ahmad, on patients who opt out. My amendment ensures that when a person has previously cancelled the process of obtaining assisted dying—having considered it as an option and then rejected it—they can continue to discuss their terminal illness freely with their medical practitioner without being pressed to reconsider assistance to end their life.
As we are hearing, we have had a great deal of evidence on this issue. In its written evidence, the Association for Palliative Medicine of Great Britain and Ireland observed:
“Doctors influence decisions made by their patients in conscious and unconscious ways and are themselves shaped by their personal and professional life experiences … if the patient clearly rejects AD, they may suspect that other treatments suggested by this doctor are driven by an agenda to shorten their lives or may otherwise result in this. This could lead to patients opting not to engage with palliative care or to the loss of trust in a medical practitioner or in the medical profession at a crucial time in people’s lives”.
There is a clear danger here. If a patient has already considered and rejected assisted dying and their doctor raises it again, it may appear as though the doctor is pursuing an agenda to shorten that person’s life. That risk to trust at the very moment when trust is most needed should not be created by the legislation before us.
I also want to refer to evidence given to the Commons by Dr Vicki Ibbett, an NHS specialty doctor in psychiatry with extensive professional and personal experience of suicidal ideation. She expressed serious concerns about the impact of the Bill on suicide prevention work and highlighted that the voices of people with lived experience of suicidal ideation were not heard in oral evidence sessions. Speaking about terminally ill people who may experience thoughts of not wanting to be alive, Dr Ibbett wrote:
“Thoughts of wanting to die have a known association with being given a cancer diagnosis and learning of being terminally ill … Suicidal ideation may have arisen as part of the response to a new diagnosis with a terminal prognosis. It may, therefore, be part of an ‘adjustment reaction’. Adjustment Disorder often settles without professional intervention. If it persists additional support may be beneficial. Assisted suicide should not be facilitated”.
My Amendment 155 therefore seeks to ensure that a doctor may not raise assisted dying with a patient whose medical records show they have previously cancelled a first or second declaration. When somebody has already walked back from that decision, the law should protect them from renewed pressure, intentional or not.
Finally, I will quote from a recent article by Jim McManus, national director of health and wellbeing at Public Health Wales, writing in a personal capacity. He wrote that
“no end-of-life decision happens in a vacuum. Choices are shaped by many things, and sometimes these are inequality, unmet need, patchy palliative care, and the grinding pressures of an overstretched NHS … People expressing a wish to die may be experiencing treatable depression, loneliness, or feelings of being a burden. The Royal College of Psychiatrists has raised concerns that the Bill’s safeguards are insufficient to protect people in exactly these vulnerable states”.
Amendment 155 is a small but vital safeguard, ensuring that when someone has stepped back from assisted dying, their decision is respected. At such a vulnerable moment, no patient should face renewed pressure; our priority must be to protect, trust and uphold compassionate, high-quality care at the end of life.
My Lords, what influenced me to look positively at a number of amendments in this group, and to table Amendment 150, was that some jurisdictions with assisted dying legislation explicitly prohibit doctors from initiating assisted dying discussions. I know that there was a bit of a row earlier about Australia, South Australia and New Zealand, but the truth is that people who have this legislation thought it was important to say that if a doctor raised this with the patient, it would breach professional misconduct. In fact, South Australia even used the wording “must not … suggest”. That is quite hard.
However, it is very interesting that this group of amendments holds importance for all of us. In other words, it cannot be assumed to be either filibustering or messing around, because we are citing places that have assisted dying, and they think that this is a very good and important safeguard—or that it is at least worth debating.
One reason they do that is the issue of autonomy, which I know is very close to the noble and learned Lord. The concern is that, if a doctor initiates discussions about assisted dying, it undermines the very principle of the Bill’s supporters, which is to ensure that the decision regarding assistance to end your own life is yours taken freely; it is patient-initiated. I was rather surprised to hear the noble Baroness, Lady Blackstone, cite the BMA. What happened to the patient-centric approach? We now have the BMA versus the patient. If a patient wants an assisted death, good—well, not good, but they can initiate the discussion and raise it themselves, if they want to; it is an autonomous decision.
It was so moving to hear the contribution from the noble Baroness, Lady Monckton, and the points that others made about the words that people may hear, including people with learning disabilities. I was reflecting on the evidence we heard at the Select Committee from the National Down Syndrome Policy Group. It is not just the words that people may hear; it is also what they see in front of them. In particular, what was really striking—I had not thought about this—was that even the uniform of the doctor who is having that conversation could suggest a position of authority that someone with a learning disability should show acquiescence to. I thought that was something for us to consider in the light of all these important amendments.
That is very helpful. When I see a uniform, I get a bit quivery as well—
We are obviously at that time of day.
As we have gathered, I do not want doctors to initiate raising assisted dying as a healthcare option at all but, if they do, I do not want there to be any linguistic whitewashing. Sarah Wootton, the chief executive of Dignity in Dying, wrote in her book Last Rights:
“We have to move away from idealised, sanitised, nursery-rhyme accounts of what death can be…towards truthful”,
no-BS—I have abbreviated that—and
“plain-spoken explanations of what could happen”.
Surely these words, which are very powerful, should also apply to conversations about assisted dying or assisted suicide. Let us ensure that, if a doctor is to raise it with patients, there is no attempt to hide behind idealised and sanitised nursery-rhyme accounts of what assisted death would be like.
That is why I was particularly keen to emulate this no-BS approach, which is why I added my name to Amendment 160 in the name of the noble Baroness, Lady Lawlor. This would ensure that, in any discussion that a doctor initiates, they make it clear what is being suggested—namely, that this about ending a person’s life. If a doctor said to you, “Would you like a dignified death?”, that might sound very appealing, but if they say, “Would you like me to give you a lethal drug that means that you can take your own life?”, it might suddenly feel a bit different. We genuinely need to say what we are talking about. A similar concern is raised in Amendment 167 by the noble Baroness, Lady Fraser of Craigmaddie. The doctor must not hide behind opaque language and euphemism that avoids spelling out clearly what they are suggesting and offering, from the first preliminary step to the ending of a patient’s life by, as I said, basically helping them take their own life.
My final point is that we are saving the doctors here. Doctors starting to suggest that you can end people’s lives will completely change the relationship between doctors and patients. You are forcing a doctor to think, “Is it in the best interest of this patient to die, with my help, through the ingestion of a lethal substance?” That must mess up the mind of a doctor, who is trained to keep life going as much as possible. It would erode trust in healthcare relationships moving forward because if, for example, your doctor suggested assisted dying and you said no, you would then have to go back and face the same doctor. I am not entirely convinced that I would be confident enough in the medical practitioner who had told me I would be better off dead to ask, “Can you help me extend my life a bit longer?” I might want to doctor-shop, as they say.
I am perhaps imagining the noble Baroness, Lady Fox, as a quivering wreck. If that is how she feels, you can imagine what it is like for most of us when we face our doctors, so the point was made very strongly.
There are so many good amendments here and I cannot possibly refer to all of them, but I want to drive home, by force of comparison, a point that arises from two things that were said—one by the noble Lord, Lord Rook, and one by the noble Baroness, Lady Hollins, who is no longer in her place. The noble Lord, Lord Rook, said that there is no duty under the Bill to raise assisted dying, which is obviously true. It is very important to pursue what that implies.
The noble Baroness, Lady Hollins, said that by raising assisted dying a doctor is not performing a neutral act, so the question we have to ask is what is going on when a doctor proposes assisted dying. I am saying that if it is not a neutral act it is an ideological act, and that is not something appropriate for a professional.
I shall draw a comparison that will illustrate that point. The Government keep promising to introduce a Bill to ban conversion therapy—and I think that they will do so. The objection to conversion therapy is that it is a form of coercion of the weak and of exploitation, forcing an ideology on people that is considered to be wrong and exploiting their feeling of weakness. That is the danger we face here. Many noble Lords will object, of course—and they will be right—that conversion therapists are quacks whereas doctors are real doctors. In my view, that makes it even more important that the doctors stick to their professional obligations and do not start advocating things they happen to believe are right. If we think about it that way, we will see just how important these amendments are.
(7 months, 3 weeks ago)
Lords ChamberMy Lords, my remarks follow on, very usefully, from those of the noble Baroness, Lady Finlay of Llandaff. She made some points I was going to make, so I will not make them, but I will make some others.
We should consider the interaction between the rather murky world of politics and the role of the commissioner. I would not raise that issue if this role were not entirely, as I understand it, a political gift of the Prime Minister—effectively a patronage office. We surely all know the problems that can create; it has been rather vividly illustrated in recent months. I want to probe what happens if this goes wrong, or rather how we can stop it going wrong in the first place, because there is genuine concern about a lack of accountability and transparency around the appointment process for the commissioner. For that reason, I added my name to Amendment 126 in the name of the noble Lord, Lord Udny-Lister. He is unable to be here today, but he is spot on to suggest that the appointment should be accompanied by a public statement by the Prime Minister, whoever the Prime Minister is, attesting to the suitability, independence and neutrality of the candidate, so that the Prime Minister is ultimately held to account for this appointment and it is clear why they have made it.
The commissioner has a crucial role, with the power to both run and monitor this service, yet the Bill seems to leave the commissioner’s role open to self-definition. They are appointed by the Prime Minister, and that is it; we are all meant to trust it. I do not want to be cynical, but the question of independence and neutrality is important, because this is a controversial and polarising issue. If we did not think it was, we have only to look at the rather testy atmosphere every Friday in this Chamber, let alone on the airwaves in between. We owe it to the public that they feel that they can trust the process if the Bill is made law.
We have to ask what happens if a partisan figure is chosen—how can that be addressed democratically? What is the process if there is a problem with the conduct of this commissioner? Who is accountable for that? That is one of the reasons I added my name to Amendment 913A in the name of the noble Lord, Lord Wolfson of Tredegar, which seeks ways for anyone with concerns about the conduct of the commissioner to make representations to the Prime Minister. The amendment seeks to probe the process by which the commissioner can be held accountable for their conduct.
That takes me back to neutrality and independence. Let us consider: if we leave this appointment, as the Bill seems to, to the Prime Minister, who is given complete discretion about who to appoint, how will we protect the role from political controversy and being seen as possibly partisan? The noble and learned Lord, Lord Falconer, will not want to compromise the role in that way, I am sure, so some of these amendments might be helpful to insulate it from any accusation of bias.
Is the noble Baroness not concerned, as I am, that we are conflating expertise with bias? People think that because somebody is expert, they are independent. It does not necessarily follow. There could be people who are expert but at the same time very biased in their approach to any subject.
I think that is self-evidently true in the real world, if I can put it that way.
I note that the present Prime Minister is himself personally not neutral. As we now well know, he promised Esther Rantzen that assisted dying would be made legal, although that was not a promise made to the British electorate or in the manifesto, but it was certainly made in public with much singing and dancing. Would the Prime Minister’s personal views influence whom he chose as a commissioner? Noble Lords might think that is far too cynical and I am being grubby—that is fair enough. However, I want to know if there is anything in the Bill that guards against such grubby behaviour, because if anyone thinks there is no grubby behaviour in politics, they need to get out more. If the commissioner is perceived—
If I may intervene again, let me say that this is a post which will happen only if the law has been passed by Parliament. I am not aware—but perhaps the noble Baroness can help me—if there is any other public appointment process which says that someone cannot be in favour of the law that they will be in charge of implementing. Is the noble Baroness aware of any others for which that is the case, or is she saying that this should be the only example in which someone cannot be in favour of the law of the land and the job that they have been appointed to do?
I should clarify that I do not anticipate that those who have reservations about assisted dying will be queuing up to be the commissioner. I am not at all arguing that the commissioner could not be an enthusiast, but what happens if they become an activist and an advocate for it, and mission creep follows? That is very different. It is fine if it is somebody who says they voted for it—somebody in this Committee might well be that person, and they might have disagreed with me. How do you stop someone if they say, “Great, I am the commissioner. I am now in charge of monitoring this”, and so on? We have heard good examples so I will not repeat them.
Sorry, I am not sure if the noble Lord, Lord Moylan, wants to intervene, but I am trying to finish.
In response to the question from the noble Lord, Lord Markham, does the noble Baroness agree that senior and significant public appointments always involve an independent assessment panel making a recommendation, but moreover they also involve Select Committees of this House and/or the House of Commons taking evidence? In a recent example from July last year, my successor was questioned interminably, if I can exaggerate a little, by the Women and Equalities Committee over a small donation made years earlier to a campaign group, and she did not win approval from the committee, presumably on that basis. Parliamentary scrutiny and/or the independent panel are profoundly important. Does the noble Baroness agree that these are significant prerequisites?
That is a very helpful intervention. We can therefore see that the process of appointing the commissioner should not simply be in the gift of the Prime Minister and that there are processes—we have illustrated that. The difficulties in relation to accusations of neutrality or partiality and so on will come up in that process. However, at the moment, there is nothing in the Bill that would allow any of that to have come up before the appointment.
I suggest that there are a range of amendments in this group that the noble and learned Lord might want to look at carefully and accept, so that the role can be insulated from party politics, accusations of advocacy and speculation about what if this or that goes wrong. Maybe nothing will go wrong, but if something does go wrong with the commissioner’s conduct or they are seen to be acting as an advocate activist, there is nothing in the Bill that would mean that Parliament could do anything about it. We would just be stuck with it. Can the noble and learned Lord say what checks he sees for impartiality and guardrails against activism in the choice of commissioner and their role? What process will there be to ensure a commissioner’s impartiality in their role, even if not in their personal views? How can we make that guaranteed? How can we hold conduct to the highest account? At the moment, it seems to me there is no mechanism in the Bill to do so. Without that formal oversight, the way the Bill has set out appointing a commissioner is unsafe, and it should be looked at again.
My Lords, I have tried in my contributions, which have been few although I have in fact been present for almost every moment of this Bill, to point out to the noble and learned Lord those occasions when his actions can make a great deal of difference. It seems to me that this is one of those.
I have been pressed by the media to speak about the Bill. I have refused every opportunity because I believe that the Bill should be debated in this Committee and there should be no attempt outside to make it difficult for us to say what we need to say in our proper carrying through of our business. If I had appeared on the radio, I would have said that the problem that we face is that there is so much in this Bill that is uncertain, unexplained and left to Ministers and particular appointees that we do not know how the Bill would work in practice.
This is not a question of whether you are on the side of the Bill or against it. It is that we have a duty to make this Bill work. I do not like the Bill and I do not agree with the principle, but I am not speaking from either of those points of view. I am speaking to try to get this Bill to be a suitable Bill to do the job which the promoters want it to do. I much resent the way in which people attack that, as if one is behaving improperly. There has been some disgraceful behaviour attacking one of the most distinguished Members of this Committee, who is knowledgeable and able, with a history of fighting for rights and the kind of behaviour that we should have for the terminally ill and the ill who need palliative care. I hope that the sponsors of the Bill will apologise publicly for what has been said to the noble Baroness, because it is unacceptable.
Let me say why this is perhaps the most important groups that we have had. Outside, there is genuinely held concern about the mechanisms which will make this Bill the safest Bill there is. The person who does this job is clearly not going to be somebody who is against the whole principle. The noble Lord, Lord Markham, is perfectly right that, if this becomes the law, the law will be carried through. The question is whether the person who is going to do this job is someone who will command the respect and support of the nation as a whole. The amendments before us are simply an attempt to find ways of making sure that happens. They are not suggesting that it should be somebody who is opposed to the principle. I cannot imagine anybody applying for it if they do not believe in the principle—I am certainly not going to apply for it myself. The fact of the matter is that it is going to be somebody who supports the Bill and is prepared to carry it through, but that person must have the respect of the public as a whole, and the appointment therefore becomes very important.
I do not want to tread on sad circumstances, but we do not have a terribly good history of appointments in recent years, on both sides of the House, so this is not a party-political comment. It makes it very important to get it right at this point.
There is no question of filibustering in saying to the noble and learned Lord that this is at the heart of the problem. The Bill is supported in principle by many in the organisations that are going to carry it through, but it is opposed in particular by them all because the Bill has not met their concerns.
My concern is that if you take money out of a healthcare budget that is already in deficit, you will end up with an incentive for people to go down the road of saving money by working towards promoting assisted deaths for patients for whom additional care would mean them no longer feeling in despair in any way and having their quality of life returned to them. The NHS budget appears to be in such a difficult and parlous state that we have to be very careful that we do not spend NHS money on what is not a healthcare treatment.
My Lords, the amendments in the names of the noble Lord, Lord Moylan, and the noble Baroness, Lady Fraser of Craigmaddie, are very useful in making us think about what an assisted dying service would or should look like if the Bill is enacted and what the implications are for funding it—public funding or who is going to pay.
We will come to a more detailed discussion on this in later groups, but I will just raise a few things. As I understand it, and I probably need some clarification from the noble and learned Lord, Lord Falconer, the idea is that integrated care boards will be mandated to provide a fully funded assisted dying service. I would just like to get a sense of what is envisaged. If that is what is envisaged, we have to ask the question: is that reasonable?
As others have said, contrast that with hospices, which receive only a portion of their funding from ICBs and are heavily reliant on donations. I am sure we have all been to those coffee mornings and bought cakes, sold cakes and all the rest of it, trying to raise money for hospices. Meanwhile, palliative care services rely heavily on charity funding, recovering only 30% of their funds from the Government. I understand and note the important caveat from the noble Baroness, Lady Fraser. I am not trying to say that the state should run everything at all times and that anyone who is doing anything in the charitable sector is a problem, but underfunding end-of-life care at the same time as fully funding ending-your-life non-care is a bit peculiar.
The danger is that if the sponsor’s aspirations come to fruition—if I have got them right—funding for assisted dying will start competing with and risks diverting resources away from palliative and end-of-life care, and both will compete for a share of a limited health budget. I note that professional bodies, such as the Royal College of GPs and the Association for Palliative Medicine, argue that the assisted dying service must have distinct funding to avoid such competition.
It was very important that the Health Secretary, Wes Streeting, was frank with us when he noted that
“setting up this service will also take time and money that is in short supply … Politics is about prioritising. It is a daily series of choices and trade-offs”.
I would like to address a couple of questions to the Minister, who I know is confined to discussing workability, to ask how this prioritisation will work. Have the Government considered this? If funding will come from reprioritisation of existing budgets, are we not at this point being asked to legislate a direct conflict of interest, where integrated care boards will have to choose between, for example, funding palliative care and funding assisted dying? If it is not palliative care—I have overused that—which other services will be deprioritised in these choices in order to fund this? It is a limited budget. We keep being told that there is a scarcity of funds, so I want to understand that.
Finally, another reason to raise this—it is not directly to do with funding, but it counts—is that if assisted dying is to be paid for by the public purse and/or associated with the NHS, it could mean that assisted dying is treated as a standard healthcare solution. That surely could have a corrosive impact on trust between patients and clinicians, breaking their “first do no harm” contract with the public and flouting the Hippocratic oath.
Should doctors be expected to incorporate ending life into their routine roles if it is publicly paid for, when the major professional bodies explicitly warn against this? The BMA says that
“our view is that assisted dying should not be part of the standard role of doctors or integrated into existing care pathways—it is not something that a doctor can just add to their usual role.”
That more existential kind of question, or about medical ethics, will obviously be compromised when, if public funding and the taxpayer are paying for assisted death, those taxpayer-funded NHS doctors are surely going to be asked to do something that goes against their ethical code.
My Lords, some intricate and sophisticated schemes have been put forward concerning the nature of the panels. In listening to the noble Lord, Lord Sandhurst, I thought how fascinating it was to hear about the ways in which the Law Society has approached this issue. We have heard a lot of fine speeches challenging everything from the size of the panel to whether it should have investigatory, prosecutorial and even quasi-judicial powers. I suddenly felt like I was in an episode of “CSI” or something; I thought, “They’re only panels”.
At this stage, things are getting so demanding and confusing—and, potentially, overlayered and bureaucratic—that I think we should take a step back. I am very sympathetic to why this has happened. It is driven by a desire for safeguarding and for these panels to have teeth. It is created by the loose wording in the Bill—in my opinion, it is poorly drafted—that means people are asking, “What will these panels be able to do? What should they be able to do? Can we join the dots?”
I want to go back and, more simplistically, if you like, take at face value the panels as they are described by the sponsors of the Bill. They will have three members: a social worker, a legal person, and a psychiatrist or somebody from the psychiatric profession. What will we expect of them? I ask this because just announcing that is not sufficient. Let me say why. I have put my name to Amendment 925A in the name of the noble Lord, Lord Murray of Blidworth, who explained very well what he is trying to do with his amendments. What is needed is a process for how you end up on a panel if you are one of those three people the sponsors want.
Amendment 925A would set up an independent appointments process. It talks about appropriate tests, interviewing people, vetting and so on. That is important, because the one thing we know from all the speeches we have heard is that these panels are going to be important and will make important decisions. You cannot put an ad in the paper saying, “Are you a social worker? Call in”. We have to think about what will be required of them. The noble Lord, Lord Murray, has done us a real service by straightforwardly saying that we need to have a system and that this is necessary, albeit by no means sufficient, to counter any risk of these panels being inadequately staffed by the wrong or inappropriate people and to fulfil the aspirations of the Bill’s sponsors. It is absolutely necessary to counter any notion that the panel members will be just yes-men and yes-women who have turned up. In my opinion, we need to know that they are of the right calibre.
The role of panels is not just crucial in terms of safeguarding for those who go down the assisted dying route. We have heard some important speeches about safeguarding, but we must also consider that a proper process is required to protect panel members themselves from what is potentially likely: the blame game.
I have some qualms about the privacy issue that the noble Lord, Lord Jackson of Peterborough, raised. He conceded that there might be some problems with this. It was another testy exchange with the noble Baroness, Lady Hayter, but we have to consider both sides of that exchange as being valid, because the panels are going to have to take on some difficult issues.
I am sure that the noble and learned Lord, Lord Falconer, will remember what I thought was a tricky exchange on “Newsnight” last year, when he was asked about a situation where a 21 year-old could successfully request an assisted death and their parents would find out about it only after they were dead. Reference has made to the fact that that would happen with suicide, but in this instance, the difference is that heartbroken, grieving mums, dads or other family members would find out not only that their 21 year-old child was dead, but that they had been to a panel of social workers and so on, it had been okayed, and they had not known about it. It is only fair to note that they would want to know exactly on what basis that panel made the decision. They would ask what the qualifications of the people on that panel were. It has to be said that that 21 year-old could have a learning disability, Down syndrome or a previous history of mental illness and had tried to commit suicide in the past. Any people with a similar illness could actually be granted the right to an assisted death by that panel.
You can imagine the multiple scenarios. I thought of that, because I remember in Committee in the other place, Naz Shah, the Labour MP, made an excellent thought-provoking contribution when she said that when such cases happen, the public, including family members of the person who has died, will rightly demand answers and so will the media. They will want to know who the panel members were and why they made the judgment that they did.
There is a lot at stake here. I do not necessarily agree with the view of the noble Lord, Lord Jackson, that everything should be in the public domain, but there will be demands to know what is going on. Is it being hidden away?
The way that Amendment 925A sets up a process will, in the end, protect people, because otherwise, panel members are likely to be on the receiving end of some intrusion whether they like it or not. We have to make sure that the right people are on the panel.
I also just wanted to raise the staffing of these panels. This feels very banal after some of the things people have been talking about, but are there enough social workers and psychiatrists around to go on to the panels? This seems to be a rather practical problem before we get anywhere. At the moment, in terms of professional panellists, there is one psychiatrist on each panel, yet the most recent workforce data shows that one in six consultant psychiatric posts is unfilled. So, that shortfall must cause problems. The Royal College of Psychiatrists has said:
“As things currently stand, mental health services simply do not have the resource required to meet a new range of demands”.
I am just worried that, if the commission struggles to find enough psychiatrists, the temptation will be to appoint anyone available and willing who can be ticked-boxed as a mental health professional. That is a bit nerve-wracking, which is why interviews, qualifications and so on are important.
The same resource deficit challenges exist in terms of legal members who, after all, we are told will replace judges in a way, according to the noble and learned Lord, Lord Falconer. But who are these legal members? Where will they be found, given the immense financial and resource constraints on the justice system that are so bad, we are told, that the Government are embarking on judicial vandalism, in my opinion, in sacrificing jury trials? If there is a problem of scarcity, is the recruitment of real legal expertise to the panel guaranteed?
Finally, on the third panel members, the social workers, given what the British Association of Social Workers have said about the sector being at capacity—and it has noted that the panel proposals are not resource-light—noble Lords can see that there might be a problem. The shortages of all three panel member professionals are not evenly distributed throughout the country, so what does the noble and learned Lord, Lord Falconer, think about a postcode lottery? What if you cannot find the legal expertise, social worker and psychiatrist in one part of the country where there is a great need? Has he consulted, as the sponsor of the Bill, with the likes of the Royal College of Psychiatrists and the British Association of Social Workers about workforce pressures?
My final question is for the Minister, with regard to the panels. What assessment have the Government made of their workability, given the problems raised by the professional bodies of social workers and psychiatrists? If there are not enough people available, surely the panels will not be workable and therefore this part of the Bill needs to be sorted out; otherwise, there is no point passing it as it stands, because it will never happen.
My Lords, I am pleased to follow the noble Baroness, Lady Fox of Buckley, not least because I often do not agree with her but I did agree with several of the things she has just said. She started off by talking about the dangers of intricacy in what we lay down in the Bill—about how the panels should conduct themselves. The more I listened to the speeches and the more I read the amendments, the more worried I was about not only the overly bureaucratic nature of this, and the over-engineering of the processes the noble Baroness referred to, but the invasion of privacy on many levels.
We all recognise the role of the panels in safeguarding against abuse, but there will be a range of people. I was thinking of how I would feel on one of the panels, being interrogated along the lines of some of these amendments. The amendment in the name of the noble Baroness, Lady Gray of Tottenham, says that I must be asked whether I have discussed the request with my next of kin and any other persons I am close to. Where someone has not done so, they will be asked to discuss their reasons for not doing so. That is way too intrusive and well beyond a way of finding out whether I have been coerced in this situation. It goes much too far, is over-engineered and, in the words we started off with today, is not kind to the majority of those who will be seeking help in circumstances they find intolerable. They find the way in which they are dying intolerable; it is not that they want to end their life, but it is because they are dying. I find that the whole tenor of this conversation does not think about the people who are going to be involved in, and subject to, this process. We have to think about them as well, and balance it with the sort of protections that are needed to make sure that bad things do not happen within these processes.
I was also surprised at the level of involvement in the amendment about children and information in the name of the noble Baroness, Lady Finlay—and she and I agree on many things. This is desperately personal stuff within families. The idea that not only should you be consulted on why you have not spoken to a child about this, but that you should have to nominate someone else to report your death, and then you should make sure that there are bereavement services, opens up a whole area. Just like palliative care, bereavement services are very patchy—all over the place—and vary tremendously. Why should this category of parental loss be subject to the obligation of the state to provide bereavement services, as against every other sort of parental loss?
(9 months, 1 week ago)
Lords ChamberMy Lords, I have added my name to two amendments in this case.
Lord Blencathra (Con)
My Lords, could we please first hear from those noble Lords who have tabled and signed amendments before the rest of us speak? I apologise if the noble Baroness is a signatory, but I did not think she was.
I have my name on a number of amendments. I did not know that those rules applied—anyway, they do not.
I have added my name to a number of amendments from the noble Lord, Lord Carter of Haslemere, in this group.
In general, I am glad to support many of the amendments on palliative care in this group. The Bill asks us to accept that assisted dying is a medical intervention, albeit an irreversible life-ending one, which is something I am not entirely happy with. It seems obvious to me that there must be guaranteed input from the best-placed medical experts in end-of-life care: that is, palliative care specialists. That is essential for the informed consent of the patient.
I imagine and hope that the noble and learned Lord, Lord Falconer, is very sensitive to the importance of palliative care. I know that he is in the much-cited Demos Commission, which I will not bother quoting again, and I am hoping that he has not changed his mind. I think the noble Lord, Lord Carter, made a very important point earlier to the sponsor of the Bill about the number of amendments, for which we have all been chastised and finger-pointed at and tut-tutted at. I kept my patience last night, although my blood pressure did go up.
None the less, I genuinely think that the number of amendments could be really slimmed down if the sponsor of the Bill were to go through, for example, all the amendments on palliative care and say to us, “I accept the principle of this and I will come back with my own amendment” or what have you. We would then not have this issue. We are not an organised political grouping; people table amendments and add their names to them in good faith, which is what I have done, and they then speak in good faith. We are not trying to repeat things for the purpose of delaying the Bill but because we think that it matters and is important. That is what we are doing here.
On this group, and the concept of 10 important themes, we need an assurance that real choices will be offered to a patient with a terminal illness and they will be given the option of a palliative care assessment and, hopefully, then, possibly palliative care. That safeguard would really reassure us, and it is a key theme, and so on. One of the reasons why I say that is, under the Bill, GPs can mention palliative care to a patient. I am a great fan of GPs; they are fantastic generalists who do a good job. But very often they do not have all the expertise of a palliative care specialist in knowing how precisely medical intervention can improve a patient’s condition, or indeed change their will to live.
It is important for the Committee to note that research has shown that those who wish to hasten their own death often change their mind when they receive more information. Palliative care can mean that people who want to die then want to live, and that is important if we are going to talk about choice. It is possible that you might want to die, that you are determined you want to die in assisted death terms, having had your terminal diagnosis. But why is it that you want to die? That is the motivation behind the discussion in this group.
One of the things that happens is that many people are frightened and fearful, and one of the things they are fearful of is pain and terrible symptoms, which by the way are often graphically described by supporters of the Bill, and I think that they can scare people. It is the idea that your pain and symptoms cannot be controlled. When I talk to supporters of the Bill—some of my friends, colleagues and members of the public—they are completely compassionate in talking about how the Bill will help people who are suffering intolerably and in excruciating pain. None of us wishes that on anyone—or, indeed, on ourselves. It is a frightening prospect.
That is actually often a fear and a dread that the right kind of care can mean will not be realised. Patients are understandably frightened of being in that kind of pain, so they need to know that. Toby Porter, the CEO of Hospice UK, summed up the way I feel about this. He said:
“An outcome in which someone chose an assisted death because of a real or imagined fear that they could not get pain relief or other symptom alleviation, or because their family would not get support through their illness, would clearly be a moral and practical disgrace to any country”.
That is absolutely right.
We all know family and friends and so on who have died and who have had terminal illnesses. People will say that morphine is simply not enough to control the pain. That is the kind of thing that I would say, because I know nothing about medicine. So, it is a great relief to discover that palliative medicine resident doctors say that morphine is the tip of the iceberg for pain management. There are countless other options available, but to know this requires training and experience, which I have not got. When you are having a chat in the pub with mates—or indeed, when I was in hospital pumping in the morphine—it is good to know that somebody, somewhere, has got the experience. That is the palliative care specialist and every terminally ill patient should at least be offered the option to go to see one. This is a modest but meaningful addition to the Bill and I hope that the noble and learned Lord, in the spirit of listening, accommodating and compromise that we heard about last night, will make changes to the Bill accordingly.
There is also a question for the Government and the Minister here. The noble Baroness, Lady Smith of Newnham, explained this very well. In relation to the point made by the noble Lord, Lord Stevens, yesterday, it was a shocking revelation that the Minister responsible for palliative care said that the Government would not publish their modern framework until after the Bill had passed through Parliament. The noble Lord, Lord Stevens—
With respect, he did not say that. The noble Lord, Lord Stevens, said it would not be done “in effect”, the implication being—I do not disagree with what the noble Baroness is saying—that the Government have given a date which is beyond when this is expected to be law. The Minister did not say, “We’re waiting until after the Bill”. The crucial words of the noble Lord, Lord Stevens, were “in effect”. He was very careful in what he said.
I had thought I was implying that. I was not trying to imply some conspiratorial holding back; it is just that the noble Lord, Lord Stevens, said this was
“a dangerous reversal of the timetable we require”.—[Official Report, 8/1/26; col. 1416.]
That is the point I was really getting to. That is shocking: not because anyone is malignly behaving in this way but because the Government therefore need to commit to bringing forward that report, so it is available before we reach Report. I urge the Minister to reassure us that that is the case.
I will finish off by saying that the noble Baroness, Lady Brown of Silvertown, explained excellently that, for all of the importance of palliative care, hospices and so on, not everyone has equal access to them, which is well documented. I want to see that framework, because this is one of the chilling aspects of the Bill. For those of us who campaign to raise money for hospices, and who are desperately keen that palliative care is well resourced, to hear, as we heard earlier today, from the noble Lord, Lord Carlile, who stated baldly and perfectly reasonably that whichever choice we had in the previous group would cost a lot of money, makes me think, “Oh, spend the money somewhere else”.
My Lords, I had not intended to speak on this group but, as the only nurse present, I want to say that nobody could deny the principles of the amendments that are being discussed today. They are right and proper in respect of good health care for the nation.
I have two concerns, however. One is that we have talked considerably about my medical colleagues, who are absolutely essential, but the vast majority of palliative care is delivered by specialist nurse practitioners. I feel that it is essential I draw the Committee’s attention to that. I want to read from the ICN Code of Ethics for Nurses, which says that nurses—and, I believe, other healthcare professionals—have four fundamental responsibilities, including
“to promote health, to prevent illness, to restore health and to alleviate suffering”.
What we are talking about today is alleviating suffering.
(9 months, 1 week ago)
Lords ChamberMy Lords, I support the amendment in the name of my noble and learned friend Lord Keen, and I wish to echo two points. The first is that it is so important to victims of sexual violence and domestic abuse that they do not fear that their abuser, the perpetrator of those crimes, is somehow automatically going to be back in their community. The reassurance that they would get from knowing that the custodial sentence is available is important to those victims.
The second point is, as my noble and learned friend has raised, the issue of the Government’s mission to halve violence against women and girls and the strategy for violence against women and girls that is being brought forward. May I gently suggest to the Minister that, if the Government are serious about that, then they should accept this amendment? If they do not accept it, then that suggests that they are not as serious about their intentions on violence against women and girls as they are claiming.
My Lords, I too will be brief because I have agreed with everything that has been said so far. It is important to acknowledge that a strategy and policy on violence against women and girls can only mean something if in practice it results in taking that issue seriously. I would expect everybody across the House to agree that this exception is proportionate and correct, but if this amendment is not accepted, then I am afraid it makes me query whether a policy on violence against women and girls is anything other than a piece of paper that does not mean very much and certainly it will be viewed by women and girls with some scepticism.
I also want to draw attention to the fact that sexual offences and domestic abuse are escalating issues. Somebody might do something considered to be quite minor as a sexual offence which therefore may not require the full weight of a custodial sentence, but we know that these particular offences get worse. Ask anybody who has been a victim of them and you will find out that the perpetrators, once found guilty, have built up to what they have done. So we have to have custody as a mechanism for dealing with even the less serious examples of sexual offences and domestic abuse.
I also remind the House that David Lammy, the Secretary of State for Justice, has talked about the importance of taking the issue of pursuing alleged perpetrators of rape and sexual assault so seriously that he is even prepared to sacrifice jury trials. I completely disagree, by the way, with the use of the issue of sexual assault to undermine jury trials—there are empty courts as we speak where people could be being tried, and I do not think this would resolve it—but it does indicate that the Government are prepared to say that they will make exceptions when it comes to such cases where women and girls are victims of heinous crimes. Therefore, I appeal to the Minister to accept this amendment as being perfectly sensible. It will get cheers from around the country, because it is right that we take this particular form of crime very seriously and act on it rather than just using the words and the rhetoric.
My Lords, we on these Benches do not agree with this amendment. That is not because we do not take the issue of sexual offences extremely seriously—we do, just as we do the issues of domestic abuse and domestic violence. That is why we sought to make domestic abuse an aggravated factor in sentencing, and why we have argued for the fact of domestic abuse in an offence to be recorded even in the case of offences that, of themselves, do not imply domestic abuse, such as common assault or assault occasioning actual bodily harm. We fully share and applaud the Government’s determination to halve the number of incidents of violence against women and girls over a decade, and we will do everything we can to help the Government achieve it.
My Lords, it is no fault of the noble Lord, Lord Bach, who has just explained why his amendment should perhaps not be in this group, but I am not going to talk about what he has just said. I want to go back to the purpose of this group, which is to discuss the purpose of prison, and to make a couple of quick points.
One of the problems I have with the whole of this Bill is that sentencing issues were originally motivated and framed as necessary by the Ministry of Justice because of an overcrowding crisis. We were told that we had to reduce sentences or let people out early from sentences because there were too many prisoners in prison and there were not enough prisons, and that it was all the previous Government’s fault and all of that argument.
In a way, that has felt far too pragmatic to me when discussing the very serious issue of who you put in prison and why, and what the purpose of prison is. This small group of amendments indicates that there is an appetite for that kind of discussion. It is one of the reasons I was particularly pleased to see the amendment tabled by the right reverend Prelate the Bishop of Gloucester and supported by the noble Lord, Lord Moylan.
Earlier, in group 2, the noble Lord, Lord Marks of Henley-on-Thames, set aside what we were discussing and said, “By the way, we on these Benches think that too many people are sent to prison for too long, that prison is generally terrible and that it leads to bad results”. That is a caricature, but I am making the point that it is a debate one can have. But this Sentencing Bill was set up as being about how we can reduce the number of people in prison because there are too many prisoners. That has allowed something of a muddle in some of the discussions that have gone on, and that is why I have reservations about it.
The amendments tabled by the noble Baroness, Lady Neville-Rolfe, on purposeful activity are important because it matters what prison is for—it should be considered all the time. We should remove from ourselves this notion that prison is always a horrendous situation. On the one hand, it is not meant to be a holiday camp, but it is not meant to be something so horrendous that we say that we cannot send anyone there—which is effectively what we have done. We have basically said that prison is awful, drowning in criminal activity, with gangs of all ethnicities ganging up against each other, ideological coercion going on—we hear about that all the time in relation to Islamism—and people self-harming. It is so grim. If you read the chief inspector’s reports, you would think that we should never send anyone to prison. That is a disaster. We need a justice system where we can be confident that we can send people to prison and that while they are there purposeful activity will be important.
It is a mistake to imagine that purposeful activity—education, training and so on—is not happening because of overcrowding. For as long as I have been interested in this issue, purposeful activity has not been consistently happening in prisons where there is no overcrowding or other such issues. To say that is a cop-out. I was pleased to see these amendments because they say that this has to be done as it is part of a prison’s job. I would like to see that hardening up, with no excuses given.
I want to slightly challenge the idea of what counts as purposeful activity. It is not only about practical skills, with accredited training, where you can then go off and work in a practical job. Purposeful activity can be, believe it or not, activity of the mind. I have done work on debating competitions in prisons. The point is that it gives people things to think about other than fighting each other or their awful conditions—it can be quite instrumental in that. Being locked in the cells and bored is a recipe for disaster.
One of my favourite initiatives is where prisoners take pups and train them as therapy dogs. It is an expensive activity and it happens only in a limited number of prisons. Often, it is long-term prisoners who may never get out who are doing it. They are doing something useful and practical, and they become completely transformed by the fact that they have a purpose in prison. They spend all their time thinking about how they can rear the dogs, train them and get them ready, as well as writing to the people the dogs get sent to afterwards to see how they are getting on, and so on. Some of them are in for life, but who cares? To me, that is a humane and useful purposeful activity, and one that does not necessarily mean that they will go and work—no disrespect—in Timpson. There is more to life—that is the point I am making. I want people to be trained to get jobs, but I do not think that purposeful activity should be narrowly confined to only that.
To conclude, we need a proper debate in this country about the purpose of prisons. We should not allow the state of prisons to mean that we do not send anyone to prison—that would be disastrous for justice and for public protection. The state should get over its incompetence and sort things out. Further, this Sentencing Bill has relied far too much on the problem of too many people in prison to be seriously trusted when it comes to making decisions about what sentences people should get based on justice, rather than based on pragmatism. That is a mistake.
My Lords, I will speak to Amendments 71 to 73, in my name and those of the right reverend Prelate the Bishop of Gloucester and my noble friend Lady Hamwee, who unfortunately is unable to be here today. I thank them both for their support.
The House will have seen that the amendments call for the establishment of an independent panel on sentencing and reducing reoffending. I will not repeat in detail the arguments that I made in Committee, but I will summarise them. The establishment of such a panel was a firm recommendation of the Gauke review and it is a recommendation that we support. The point made by the review is that it would be of great value to government to have an independent body assembling evidence on what works in punishment and advising government on sentencing policy.
That is, of course, a totally different function from that of the Sentencing Council, which advises sentencers on what sentences they should consider imposing within the context of the law as it stands. Not only would such a panel assist government but it would assist the public in understanding sentencing policy—what works and what does not; what the thinking is behind developments in prison policy, probation and community sentences more widely; and, of course, on the resource implications of policy. The public are entitled to understand how public money is spent and what public expenditure achieves, as well as where that expenditure fails in its objectives. We have suffered for a very long time from popular misunderstanding among press and public of the evidence in these fields, and an independent panel such as the Gauke review recommended would do much to let in light on this difficult area.
Texas, not often regarded as the most liberal of states in the union in many ways, as the Minister has reminded us, has succeeded in closing prisons and reducing crime by minimising reliance on imprisonment and introducing an earned progression model. I suggest that informing the public and advising government, and so ensuring that policy follows the evidence, are important functions of policy generally, nowhere more so than in the field of criminal justice. If Texas can move in that direction, so can we.
I will just say a few words on the other amendments in the group. I fully support the right reverend Prelate the Bishop of Gloucester and the noble Lord, Lord Moylan, on the importance of defining and being very clear about the purposes of imprisonment. Our system accepts the concept of imprisonment without, frankly, our being entirely clear on what the purposes of imprisonment are. In that, I agree with one of the points made by the noble Baroness, Lady Fox. I also agree with her that her portrayal of my arguments earlier this afternoon was a caricature and inaccurate. But I do agree with her that we need to be very clear about what the purposes of prison are. In that context, it is right that we have been reminded by the noble and learned Lord, Lord Garnier, of the work of the late Lord Ramsbotham on the purposes of imprisonment.
I agree with every word the noble Baroness, Lady Neville-Rolfe, said on the importance of education, skills, employment and vocational training. Although I saw some difficulties with her amendments in Committee, she has softened them, as she said, and they are now worthy of complete support—subject, though, I suggest, to Amendments 65 and 67 in the name of the noble Viscount, Lord Hailsham, which have been accepted by the noble Baroness, Lady Neville-Rolfe. The noble and learned Baroness, Lady Butler-Sloss, emphasised the importance of making time in prison meaningful and productive. Of course, prison is intended, and functions, as punishment, but it needs also to be thoroughly and carefully directed at turning offenders’ lives around and so reducing reoffending.
The noble and learned Lord, Lord Garnier, spoke of prisons with a purpose. That is the object that should inform our entire approach to all elements of our penal system. The noble Baroness, Lady Chakrabarti, and the noble Lord, Lord Bach, have both highlighted important injustices—the noble Baroness, Lady Chakrabarti, on remand and the noble Lord, Lord Bach, on legal assistance for foreign offenders before deportation. I close by expressing the hope that the Government will respond to both their very specific but completely justified points with a legitimate response.
My Lords, I stand to support Amendment 74 in particular. Its motivations have been well outlined by the noble and learned Lord, Lord Keen of Elie.
In a letter relating to IPP prisoners that the noble Lord, Lord Timpson, sent to some of us at some point, I noted down that he said—this does relate, by the way—that there must be a clear reason to consider the early release of the prisoner before they have served the sentence imposed on them by the sentencing court. Thousands of open-ended IPP prisoners are incarcerated without a release date, we were told, because they have to convince the Parole Board that they are safe enough to be released, all in the name of public protection. I raise that now because there must be clear reasons to consider whether people are safe before you release them. Yet here we have an early release scheme—an earned release scheme—in which even serious sexual and violent offenders can earn their way out of prison, but you cannot earn your way out of an IPP, which seems rather inconsistent.
We have already heard that earned progression is not going to be earned anyway. If you read what has been written about earned progression, put forward by everyone from the inspector of prisons to concerned prison officers, the unions and so on, then the idea that there is a consistent way to test the earning capacity of prisoners who are inside to check whether they have earned their right to be free is unlikely. It has been agreed that it is going to be automatic.
We have to consider who we are talking about. Earlier on, I spoke about the violence against women and girls strategy and my concern about our being in a situation in which we potentially make an exemption for non-custodial sentences for what some might call minor sexual offences, or stalking or domestic violence. In a way, one was assured that one should not worry and that these were minor events. Whether we like it or not, we are talking here—let us be honest—about the people who are perpetrating, for example, child rape as grooming gang members. We are talking about rapists and people who have been convicted of sexual assault. In total, thousands of offenders who are sent to prison for serious crimes, very often against women and children, will potentially leave prison early. The public, broadly speaking, might find that disconcerting.
I am not opposed to the concept or principle of earning your way out of prison. At least, it is an interesting experimental idea. I do not think it is what will happen in our Prison Service, but I like the notion. I get all that. I am also not arguing in principle against any early releases, although I cannot bear the fact that they have been conducted on the basis that we do not have room for people. I would rather it was based on some kind of principle than saying, “Oh, it’s a bit overcrowded. What can we do?” That seems the wrong approach. I am in no way a mad “lock ’em up and throw away the key” type, but it is perfectly proportionate for this amendment to say that certain categories of crime will simply not be considered for this scheme. That is fair enough, as far as I am concerned.
I genuinely think that the Government should simply accept this. I genuinely hope that Members from other parties, Cross-Benchers, Liberal Democrats and Back-Benchers from wherever will go along with this, because that is what happened down in the other place. I would expect it to happen here, because it is absolutely common sense. It is also very important that we do not undermine trust in the criminal justice system or the prison system by making a mess of this, and therefore not making this exemption work.
My Lords, we cannot accept that this amendment is either necessary or right. The Bill is posited on the earned progression model, which involves a phased system of early releases. It is all very well for the noble Baroness, Lady Fox of Buckley, to say that she cannot stand the idea that there will be early releases because of overcrowding, but the fact is that we have a very serious issue which the Bill seeks to address. I, for one, accept the Government’s position that the Bill would be seriously damaged by abandoning the earned progression model in the cases with which this amendment is concerned.
No one can say that, as a party, the Liberal Democrats are not completely committed to the Government’s target to end violence against women and girls, or at least to halve it within a decade. No one can say that we do not take that commitment seriously. We accept that sexual offences are serious offences, but there are many other serious offences as well. The point that I suggest should weigh with the House very heavily is the concern for the position of victims. If this Bill fails to solve the prison capacity crisis then victims will be the losers, as people cannot be brought to justice or imprisoned because there will simply be no space for them. That is the harsh reality.
The position on early release is exactly the same as the reasons that I gave in respect of the first group about the presumption. It requires us to be tough and to resist the blandishments of the sort of points that the noble Baroness, Lady Fox, made. I do not accept the accuracy of the position taken by the noble and learned Lord, Lord Keen, because we would be left with a dangerous problem that we have to solve, so I shall support the Government in opposing the amendment.