Terminally Ill Adults (End of Life) Bill

Baroness Porter of Fulwood Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Baroness Porter of Fulwood (Con)]

My Lords, there is nothing easy about confronting mortality or dealing with suffering. The number of us who have chosen to speak at this Second Reading is a reflection of the importance of these issues and how universally relevant they are. Every one of us in this place has been touched and shaped by losing people we have loved and seeing what they have gone through as they reach the end of their lives. Like others, I value deeply the personal stories of so many who have written to me over recent months and hearing from practitioners who work with families at the end of people’s lives.

Whether the law is in the right place today or whether it can be improved is an important discussion to have. This, though, is not the right time to have it. The noble Lord, Lord Stevens, could not have put it better when he said that

“palliative care may not be the answer but it has to be part of the answer, and unfortunately that is just not the case across England and Wales as we speak today”.—[Official Report, 12/9/25; col. 1789.]

Until we are confident that palliative and end-of-life care in the UK is functioning as well as it possibly can be, this debate cannot be had sensibly. It is clear that, if assisted dying were brought in before we had better provision of care, there would be too great a risk that too many people could feel forced into choosing to end their lives prematurely because they believed there to be no reasonable alternative. Too many people who could be supported better at the end of their life today are simply not receiving that care.

Clause 47 obliges the provision of

“an assessment of the availability, quality and distribution of … palliative … care”

within a year of the Bill passing. This is a tacit acknowledgement of this point, but it is the wrong way round: we need to do the work on palliative care provision now, then come back to the Bill and have this discussion later.

Numerous reports and analyses have been published recently showing just how inadequate the current resourcing is. To quote from just one of these, a Marie Curie report was published this time last year and painted a deeply concerning picture:

“Our findings reveal patchy and inconsistent provision of care for people approaching the end of life. While there were examples of excellent care, the overall picture is of overstretched services, with health and care staff lacking enough time to provide care, and where coordination and communication are inadequate. This means that people lack timely management of symptoms and family carers spend precious time struggling to access, navigate, and manage different services, in addition to providing much of the care needed themselves. This leaves carers feeling unprepared, unsupported, traumatised, and let down, which has lasting consequences into bereavement”.


Another report, this time by King’s College academics, called for a comprehensive plan to look at care for people in the final stage of their life. In all aspects of this, from earlier access to palliative care right through to better support for informal carers, it is clear that current provision is woefully inadequate.

Numerous issues with the Bill have already been raised, from the definition of mental capacity to the relatively arbitrary six-month terminal prognosis threshold and the lack of detail around the practicalities of what will be administered or how it will be supervised. That is before we even consider the deeper cultural challenges around how to ensure that such a piece of legislation does not lead to a cultural redefinition of how we view people’s worth. The overseas evidence on people feeling a burden is particularly troublesome.

A mix of some very profound and very practical questions needs to be looked at, but we cannot even begin to have this discussion sensibly until we are confident that people, no matter where they live in this country or what community they are part of, have greater access to support and care as they reach the end of their life than is available to them today.