Terminally Ill Adults (End of Life) Bill

Debate between Baroness Lawlor and Baroness Coffey

Committee stage
Friday 23rd January 2026 Lords Chamber

[Baroness Coffey (Con)]

My Lords, I tabled Amendment 43, to which Amendments 312 and 340 are consequential, and Amendment 188A, so I will speak to those. Amendment 43 would bring in the term “demonstrably”. I appreciate that noble Lords may think that this is dancing on the head of a pin, but it is my understanding that the use of “demonstrably” is well known in legal practice, and it effectively requires evidence. I appreciate that there are other aspects of the Bill, when it was first introduced, that were set out in specific forms, but they have been replaced by a variety of regulations and other powers, so I think we just need to be clear about what that really means.

Being informed conceptually is meaningless unless we can establish that the person can demonstrate to healthcare professionals and others that they understand assisted dying, they understand the process and they are absolutely committed to this journey on which they go. The Bill currently requires that certain matters be explained and discussed, but it does not require evidence that the patient has understood them. I appreciate that one of the things about the current Clause 3 of the Bill is that the Mental Capacity Act 2005, which is at the MoJ level but is used in the NHS, requires in effect only a balance, rather than something much firmer, in terms of probabilities of understanding.

It is important to understand the impact of the lethal drugs that people are going to be given, and my noble friend referred to international examples. In Victoria in Australia, and in Oregon in the USA, there are firmer elements of how it can be demonstrably identified and verified that this decision is being made. It should also be recognised that we need to make sure that the doctors setting this out may say, “Your death is actually going to be quite straightforward. It may take longer, but it may not be as painful”. I accept that people on this journey are close to dying, but they need to understand the risks and how that comes about. We have not yet got into the detail of understanding which drugs are going to be used in this process.

One of the reasons I tabled the amendment on Montgomery compliance is that there was a significant ruling to do with liability and negligence. Back in 2015, the Supreme Court effectively made sure that a patient-centred focus became the norm. There was a more recent ruling in the case of McCulloch in 2023. In 1985 the House of Lords judges spoke about the professional basically making the decision, whereas the key ruling in the 2015 case, and the principles behind it, show that case law has helped to evolve what has ended up becoming guidance. We should be clear in this Bill about the exact approach that we want to have. I appreciate that this may seem a bit nebulous to the Minister, but I tabled it as a probing amendment.

In the case of McCulloch, the NHS basically said, “We’re more or less back to Bolam”, which was the original test. I know that the noble Baroness, Lady Freeman of Steventon, had to leave early, but this is one of her key areas of expertise; she teaches this in different places around the country, including in the NHS. One of the presentations that she shared with me shows that the director’s advisory role involves dialogue, the aim of which is to ensure that there is an understanding of the seriousness of a condition. The information provider has to be comprehensible. The doctor’s duty is therefore not fulfilled by bombarding the patient with technical information that they may not reasonably be expected to grasp, let alone by routinely just demanding a signature on a consent form.

I am trying to make sure that, instead of just relying on case law that may change, we end up being very clear about the need for a patient-centred focus and the principles on which we expect this process to happen. The other aspect, which we will get into a bit later, is that I am just trying to explore what this looks like for the person involved, at a pretty scary time of their lives, if we go down this route. I am afraid I have seen it happen too often with things such as DNR: patients are not necessarily given good advice and are told that the doctor knows best. I want to be crystal-clear that somebody who is going through a difficult moment needs to be aware of not only options but risks, and what the balance might be on whether to go with a lethal dose of certain drugs or to take a different route in order to end their life in a good way. That is why I have proposed these amendments.

[Baroness Lawlor (Con)]

My Lords, my Amendments 55, 246, 319, 342, 387, 453 and 513 are all about the same thing. They are designed to ensure that those contemplating assisted suicide fully understand the effects on their bodies of the drugs that they will be given and know about possible complications. As it stands, Clauses 12(2)(c)(iv) and 12(2)(d) merely require that doctors explain how the drug will kill them and that they discuss what ought to be done in the event of complications. The Bill does not require any sort of explanation about what these complications may be or how likely they are to occur.

Employment Rights Bill

Debate between Baroness Lawlor and Baroness Coffey

Committee stage
Tuesday 3rd June 2025 Lords Chamber

[Baroness Lawlor (Con)]

I support my noble friend Lord Hunt of Wirral’s amendment and have little to add to what he and my noble friend Lord Moynihan have said. I emphasise that we ought to support such amendments for reducing the levels of collective consultation for companies involved in insolvency proceedings. We should do so in the interest of reducing the escalating costs to a company as a result of compliance and protracted timing. I support these amendments for that reason.

As we have heard, the Insolvency Act 1986 obliges the administrator to act in the best interests of the creditors. The more time and compliance are demanded of a company, the more it will cost and the less there will be for creditors. These costs will escalate under Clause 27 as drafted. As a result, the creditors will have less available to pay their bills and their employees. We will see a domino effect on companies left short of cash flow and on their ability to pay their bills and their employees. These amendments are very important, because we cannot afford a domino effect, with businesses left short of cash because of the compliance costs and protracted timings posed on companies facing insolvency proceedings. They are suffering anyway; their bills have not been paid. In the end, the less that is available to pay them, the worse the outcome will be for the whole economy, for employment levels as a whole and for the cost of living.

[Baroness Coffey (Con)]

My Lords, I rise to speak on this really quite interesting clause. I have carefully read Hansard from the other place in trying to understand what it is really putting in place. I am concerned by aspects of the comments made by the Minister at the other end, Justin Madders. He said that it really means only that businesses have to consult on their location and only with trade union representatives, and that, “By the way, these things get sorted in legal debate in the courts, and we hope the courts will understand”. That is not good enough when we are writing primary legislation.

In thinking this through, it is important for the Committee to consider what is happening here. Why is this needed? It has apparently been done to reduce the pressure on people with a vulnerability. Let us take the example of a pub chain, which has quite a big estate and has decided that it is going to reduce its number of hours. That could be a consequence of some of the other measures being brought in by the Government or just a trend that is happening. So it starts to think about what it is prepared to do in terms of how many people it employs in its pubs. It may not want to do that straight away; it may want to think about it in different sections and to leave that discretion to local managers. The man or woman in the street would think that that is perfectly sensible.

However, the businesses that gave oral and written evidence to the Bill Committee are worried—which the Minister recognised in saying that they should not worry—because that is exactly what the legislation is saying they will have to do. They could be undertaking consultation at huge expense, right across the country, while recognising that some of those situations could be very localised.

We already have sensible measures in place. When there are going to be significant redundancies across the country, it is already a legal requirement for them to go before Ministers, whether from the Department for Business and Trade or the Department for Work and Pensions, who can then mobilise local jobcentres and the like to prepare for those redundancies. Imagine going back to the business considering the impact of that on what can be quite localised operations. The Explanatory Notes are silent, frankly, which is why I took to reading Hansard from the Commons.

I am concerned and would be grateful to hear from the Minister why this is the right approach and how, despite the uncertainty still left in this legislation, the Government want this to be in place. Instead, they should accept the amendments tabled by my noble friend Lord Hunt to make sure that these situations are well considered and that we do not end up in a situation where, despite the primary legislation, we have to go to an employment tribunal again and again. For that reason, I hope the Minister accepts my noble friend’s amendments.