Women’s Health Strategy

Baroness Royall of Blaisdon Excerpts

Tuesday 16th December 2025 Lords Chamber

[Baroness Merron (Lab)]

This is a very important point. The 10-year health plan restated the aim of eliminating cervical cancer by 2040 through the improved uptake of cervical screening and HPV vaccination. To the specific point, which is such an important one, in June—not many months ago—we announced that screening providers can offer home testing kits to underscreened individuals in the exact groups that the noble Lord refers to. I believe this will help tackle deeply entrenched barriers that keep some people away from life-saving screening. I am sure the whole House will reflect on the wise words and advice of His Majesty the King in imploring us all to take up the screening opportunities that there are. I certainly agree with that.

[Baroness Royall of Blaisdon (Lab)]

My Lords, as noble Lords will know, women over the age of 50 are particularly susceptible to fractures as a result of osteoporosis. The Government have announced that they are going to have fracture liaison services throughout the country by 2030. I wonder whether, as part of the women’s health strategy, the Government could begin the rollout of the fracture liaison services urgently.

[Baroness Merron (Lab)]

As my noble friend rightly observes, the Government have committed to rolling out fracture liaison services across every part of the country by 2030. We already expect musculoskeletal services to be fully incorporated into integrated care planning and decision-making. I am also glad that, since 2022, NICE has recommended two new drugs for treatment. The women’s health strategy will look at what gaps there are in the original strategy, but this is one area in which progress is already committed to.

Resident Doctors: Industrial Action

Baroness Royall of Blaisdon Excerpts

Monday 15th December 2025 Lords Chamber

[Baroness Merron (Lab)]

I certainly understand the noble and right reverend Lord’s point. The offer we made—which covered a number of the areas that the noble and right reverend Lord referred to, plus more—is not applicable because it was not accepted. We put it forward, developed it further and did all we could that was realistic. The noble and right reverend Lord asked whether it is funded, but I will change the tense of his question: it would have been funded, but the offer was rejected and therefore is no longer on the table. That is why it is not going ahead.

On waiting lists, as I mentioned to the noble Baroness, Lady Browning, we have proved that we can maintain a near full programme of elective work, with 95% of planned care being maintained—and, again, let us pay tribute to the NHS staff who have done that. But let us not suggest that there are no effects. It affects the staff who step in to cover for their colleagues. We have an NHS in desperate need of reform. We are turning it around, but these strikes get in our way. As I mentioned, we cannot underestimate the amount of effort, finance, direction and morale—the list could go on—that these strikes take up. I am grateful to the noble and right reverend Lord for raising those points.

[Baroness Royall of Blaisdon (Lab)]

My Lords, I share the outrage, fury and frustration about this industrial action. My noble friend the Minister and others around the Chamber are absolutely right to pay tribute to the workforce, and I give a particular shout-out to nurses. We are always focused on doctors—I hope noble Lords present who are doctors will forgive me—but nurses do a splendid job, and too often we forget that they work for relatively little pay as well.

I was glad that when the Secretary of State was negotiating, he was talking about the training places, because the training bottleneck is absurd. I know many brilliant young resident doctors who are so frustrated and have a terrible deal, so I urge my noble friend to pass on to the Secretary of State my view that, when he is next around the negotiating table, training places should be there in the negotiations.

[Baroness Merron (Lab)]

My noble friend rightly refers, as I did earlier, to the training bottleneck. The Secretary of State was glad to acknowledge the need to tackle training. While he felt that there was no point on pay to be accepted, he certainly felt that the BMA resident doctors committee had a good point on jobs. To be honest, that is why it is so disappointing to be where we are today.

I will pass on my noble friend’s generous comments to the Secretary of State. He offered to introduce emergency legislation in the new year to prioritise UK medical graduates and other doctors with significant experience of working in the NHS in speciality training posts. That would have made a huge difference, but it has been rejected. He also offered to increase the number of training posts over the next three years, from the 1,000 that was originally announced to 4,000, bringing forward 1,000 of those training posts to start next year—that would have made a huge difference. I could go on, but I have made my point.

I agree with my noble friend’s point about acknowledging the role of nurses. In fact, if my noble friend will allow me, I will go further: we are talking about the whole healthcare team. That is another point to the issue on pay: while the BMA doctors committee continues to press for a pay deal far in excess of anything that anyone else is getting, the impact across the NHS, both on staff and on services, continues to be under threat—and we cannot allow that.

Terminally Ill Adults (End of Life) Bill

Baroness Royall of Blaisdon Excerpts

Committee stage
Friday 12th December 2025 Lords Chamber

[Baroness O’Loan (CB)]

My Lords, I have put my name to Amendment 16. I also support Amendments 16A, 114 and 114A because the very general definition in Clause 1 of a terminally ill adult who has the capacity to take their own life does not contain any consideration of those who have been deprived of their liberty under Section 4 of the Mental Capacity Act. It is an unfortunate reality that many of those detained in hospitals or care homes are detained because they lack the capacity to make a decision about their own care or treatment. As the noble Baroness, Lady Finlay, said, in such circumstances it is surely axiomatic that there should be careful consideration of cases involving individuals subject to a DoLS.

As the noble and learned Lord, Lord Falconer, said, even assessing the capacity of someone with dementia or another neurological condition, for example, can be profoundly difficult. This is not just because of the frequent fluctuation of both capacity and the extent to which any identified capacity enables the making of a particular decision; a medical practitioner or social worker who meets a person for the first time may be misled as to the capacity they actually have. As the Royal College of Psychiatrists noted in its written evidence,

“an assessment of a person’s mental capacity to decide to end their own life is an entirely different and more complex determination requiring a higher level of understanding”

than in other assessments of capacity.

In the 1997 case of Re MB, the noble and learned Baroness, Lady Butler-Sloss, said:

“The graver the consequences of the decision, the commensurately greater the level of competence required to take the decision”.


Capacity assessment is not a precise science. The unique context of this Bill makes taking a cautious approach appropriate. It is common sense that there is a likely correlation between incapacity in one area, so extreme that the state must deprive the person of their liberty, and incapacity to decide whether to end one’s own life. People whose incapacity for basic decisions is so severe that they are deprived of their liberty are the most vulnerable members of society.

I want to give your Lordships a brief example. I was aware of a woman in her late 80s who had been assessed and was subject to a DoLS. She objected to it and appealed against it. Intellectually, she was enormously able, possessed of considerable social skills despite her dementia. She was able to persuade those dealing with her appeal that she had capacity despite the very real concerns of her family, who knew the extent of her incapacity. The DoLS was lifted and she went back to her own home. Shortly afterwards, she was found playing golf in the road in her pyjamas at two o’clock in the morning. She was going to the supermarket at 4 am. She was leaving the door unlocked all night for her husband and cooking his dinner every night; he had died some 20 years previously.

That lady was my mother. She certainly would not have understood a suggestion that she should opt for an assisted death. The DoLS was subsequently reinstated. This is not an unusual situation. If the noble and learned Lord, Lord Falconer, rejects these amendments, how does he consider that such vulnerable individuals can be protected from making this final decision, although they may not understand exactly what they are doing?

[Baroness Royall of Blaisdon (Lab)]

My Lords, forgive me. What the noble Baroness is saying is extremely interesting, but the noble and learned Lord, Lord Falconer, has already said that he will seek a meeting with the noble Baroness, Lady Finlay, and all other noble Lords who are interested in this. He is not rejecting the amendments; he is willing to enter into a discussion.

[Baroness O’Loan (CB)]

I thank the noble Baroness for that helpful intervention, but we do not know what the outcome of that meeting will be. I think I have the right to make my remarks.

Terminally Ill Adults (End of Life) Bill

Baroness Royall of Blaisdon Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

It will depend on the circumstances. If, for example, the doctor had a very severe doubt about whether somebody was being coerced, I would expect them to ask very many questions about their domestic circumstances. Suppose, however, it was somebody who was clearly not, on the face of it, at the slightest risk of coercion—a person of 60 in the full flush of his or her pomp, as it were—and who had said, right from the outset, “I can’t bear the thought of this illness”, and the idea that this person has been coerced is not really plausible, then I would expect the doctor to be asking different questions from the sorts of questions that they would be asking if the circumstances of somebody’s home life were completely different. It would obviously depend on what you knew as the doctor, or had found out as the panel, about the circumstances of the individual.

[Baroness Royall of Blaisdon (Lab)]

I apologise for interrupting my noble and learned friend, but I just point out that the BMA itself is very clear that the doctors should be able to make their own judgment in all these cases.

[Lord Falconer of Thoroton (Lab)]

As I understand it, Amendment 222, in the name of the noble Baroness, Lady Hollins, would establish a specialist service to provide psychological assessment and support and then bereavement support for those seeking an assisted death. My noble friend Lady Merron has indicated the difficulties in relation to that. On the question of a psychological assessment, the position is that some work has been done abroad in relation to this. California introduced, in addition to what was required by the law in a particular part of California, a psychiatric assessment for everyone who wanted an assisted death but concluded that that was not necessary because the numbers of psychiatric assessments were producing nothing. It was only where special requirements were required that suggested it was a good thing. So I respect the suggestion but I do not think it is necessary.

Terminally Ill Adults (End of Life) Bill

Baroness Royall of Blaisdon Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Baroness Royall of Blaisdon (Lab)]

My Lords, I support the Bill. I'm grateful to Kim Leadbeater for her work, and to advocates such as my courageous friend Esther Rantzen. I am also grateful to my noble friend Lady Berger for showing us a way forward, in terms of a committee, and for setting out a clear timetable.

While I warmly welcome the compassionate and moderate tone of last week’s debate, from which we learned a lot, like my noble friend Lady Thornton, I was dismayed at the conflation made by some of suicide and assisted dying. This is not just about careless language; it is actively damaging to people who are already suffering. Let us be clear: people who choose assisted dying are not suicidal. They are dying and they want to regain some choice, control and dignity where it has otherwise been stripped away. We should hear the views of terminally ill people, some of whom had a letter published in the Independent this week:

“We are not suicidal – we want to live, and to make the most of the time we have left with the people we love. But we are dying and we have no choice or ability to change that … We are not seeking to make a choice between living and dying but between two kinds of death … To equate choice and control over the timing and manner of inevitable and imminent death with suicide is deeply insensitive to those of us facing this position”.


Australia’s leading suicide prevention organisations have warned that confusing these terms can delay access to suicide prevention services for people in distress, and complicate or delay care for people with terminal illness who are seeking an additional choice at the end of life. When in 2021 I asked the Government to provide data on the number of people who take their own life every year, I did so because this debate needs to be guided by evidence and the lived experience of dying people and their families. The best available evidence estimates that around 300 terminally ill people end their own life at home every year in England. These deaths are recorded as suicides, but it is clear from talking to and listening to bereaved family members that these are not people who wish to end their own life but people who are taking drastic and often violent steps to control an inevitable and imminent death.

There is absolutely no evidence that assisted dying undermines or runs counter to effective suicide prevention strategies, nor is there evidence to suggest that legalised assisted dying leads to a shift in attitudes towards suicide. Figures from Victoria in Australia show a slight decrease in suicide rates since it introduced assisted dying.

In 2021, at Second Reading of the Assisted Dying Bill of the noble Baroness, Lady Meacher, I said:

“The current blanket ban on assisted dying does not eradicate demand for choice at the end of life; it simply forces people to take matters into their own hands in loneliness and in fear”.—[Official Report, 22/10/21; col. 495.]


Those words remain true today. We continue to hear of dying people taking their own life and we continue to hear about the devastating impact this has on their families. It is time to change the law.

I am a humanist. I respect those who believe in the sanctity of life and I subscribe to many of their values, but this Bill will not compel anyone to act against their conscience. It provides agency and choice for people who are near death, with the ability to decide how they spend their final days—whether they have faith or no faith. I am confident that the scrutiny of the Bill will be as robust in your Lordships’ House as it was in the Commons. We will do our work with compassion and diligence, improving the Bill, including by making anorexia outwith the Bill. But we must always be mindful of our duty to respect the primacy of the Commons.

Prostate Cancer

Baroness Royall of Blaisdon Excerpts

Wednesday 3rd September 2025 Lords Chamber

[Baroness Royall of Blaisdon (Lab)]

My Lords, I am grateful for this debate, understanding that when men have prostate cancer and when they die, their loved ones also suffer. I welcome the review by the national screening committee, and I look forward to its conclusions. But in parallel, there must be change in the guidance given to GPs to ensure that men at the highest risk are informed of the risk and offered a PSA test.

If the screening committee decides to recommend targeted screening, which I fervently hope that it will, it will take years to implement. It is crazy that current NHS guidelines prevent GPs discussing the disease with those who are most likely to have it, and late diagnosis of incurable cancer. The system benefits men who are aware of the issue and able to interact with doctors, entrenching biological and societal inequalities. It cannot be right that it is awareness, not risk, that determines who gets tested. This exacerbates inequality and leads to death. Surely, if a GP is in front of a black man or a man with a family history of the disease, they should say, “Have you thought about a test for prostate cancer?” The noble Lord, Lord Patel, and others rightly say that PSA tests are not always accurate. Yes, we need better tests, but, in the meantime, we have PSA tests, so let us use them, because targeted testing saves lives.

Raising awareness is critical. and I pay tribute to the wonderful work of charities such as Prostate Cancer UK, with its great campaigns and whose badge I usually wear. I urge the Minister to work closely with those charities and to embrace the research they are undertaking all the time. I look forward to a positive response from her.