Terminally Ill Adults (End of Life) Bill

Baroness Smith of Llanfaes Excerpts

Friday 14th November 2025 Lords Chamber

[Lord Markham (Con)]

My Lords, I am not an expert on delegated powers, so I must admit to a bit of confusion. I hope that either the Minister or the Bill’s sponsor, the noble and learned Lord, Lord Falconer—or maybe both—can help clear this up.

My understanding of what the Bill is trying to do is to enable the Welsh Senedd to make a choice. If the amendments were to go through as drafted, they would deny that choice, because they would rule out people living in Wales from being able to choose whether they have assisted dying, whereas what I think the Bill is trying to do—I hope that can be clarified in the response—is state that the legislation will enable the Welsh Senedd to decide whether and how it wants to implement the Bill. When the Senedd does that, it can take into account the points that the noble Lord, Lord Harper, made about how the two services could sit alongside each other.

If we were to pass this amendment, we would deny the people of Wales that choice. That cuts right across the principles that the noble Lord, Lord Weir, set out when he said that the decision should be taken in Wales. The amendment would mean that the decision was taken here, which would deny the people of Wales that choice.

[Baroness Smith of Llanfaes (PC)]

My Lords, I thank the noble Baroness, Lady Coffey, for introducing this debate and raising very important questions about devolution, and I look forward to the Minister’s response. I will first address the amendments specifically and then respond to some of the comments raised in the debate.

These amendments, along with a number of others in future groups, would remove Wales from the Bill. Ultimately, I am concerned that this steals the ability of the people of Wales to exercise their choice over how they spend the end of their lives. As was mentioned by the previous speaker, that could create a two-tier system, where people in England can decide while people in Wales are not granted that choice. By removing Wales from the Bill, we leave people in Wales in limbo. That is not the case for Scotland, because Scotland would be able to decide for itself.

It would be irresponsible of us neither to include Wales as part of this legislation nor to allow the Senedd to have the powers to legislate on this important matter. While criminal law remains reserved, health is not. If this Bill shall pass, it will have serious consequences for a completely devolved matter in Wales. This is the situation in which we find ourselves. To address this matter, I have tabled amendments that will be debated in a future group that could resolve this very issue.

As I urged at Second Reading, we must reflect carefully not only on the moral weight of the question before us but on the constitutional responsibility we bear. We must respect and protect the role of devolved Parliaments in matters that are clearly within their responsibility. As noble Lords have mentioned, in a future debate we will discuss giving the Senedd the complete right to legislate in this area. We must not deny people an important choice just because of their postcode.

--- Later in debate ---

[Baroness Merron (Lab)]

The noble Lord will be aware, as will your Lordships’ House generally, that Ministers have been absolutely consistent in setting out the right and proper role of officials, as is usual for a Private Member’s Bill. I will refer to that shortly. Also, if noble Lords have individual concerns, they are welcome to raise them with me.

The amendments in this group seek to restrict the eligibility criteria to apply to individuals in England only, rather than in England and Wales, as at present. These amendments would have minimal legal effect unless they are coupled with amendments to later clauses. Clause 1 is largely declaratory. This group of amendments would conflict with later operative provisions in the Bill unless consistent amendments are made to later provisions. 

I will pick up a few of the points that have been raised. The noble Baroness, Lady Coffey, raised a number of points about engagement and I would be pleased to write to her further. I have done my very best to ensure that all the questions that she laid have been answered. I hope she will accept my apologies if that is not the case, but I have certainly endeavoured to do so. I will also review points made by other noble Lords in this debate, where they are relevant to the Government.

The noble Baroness, Lady Smith, raised a question regarding legislative consent Motions. As would be expected, UK government officials have discussed these matters with Welsh government officials, and the management of the legislative consent process in the Senedd is, of course, a matter for the Welsh Government.

In closing, I will make a few general comments about engagement.

[Baroness Smith of Llanfaes (PC)]

On the LCM point, the Legislation, Justice and Constitution Committee in the Senedd has made a statement about it not having received enough information on the conversations between the UK and Welsh Governments about why certain clauses do not engage with the LCM process. Can the Minister respond directly to that point about why this information has not been shared with the Senedd?

[Baroness Merron (Lab)]

I will certainly look into the matter that the noble Baroness raised and would be pleased to write to her. However, the first point I wanted to make here was about engagement with the Welsh Government. Of course, Ministers themselves have not met with the Welsh Government in relation to this Bill, as again would be expected, as it is not a government Bill. I know that the sponsors have met with the Welsh Government to discuss the policy intent and to negotiate which clauses require a legislative consent Motion.

The sponsors are also leading engagement with Scotland and Northern Ireland while—on the point made earlier by the noble Lord, Lord Harper, and others—UK government officials are providing technical support to support the sponsor and are engaging with Welsh government officials to discuss technical matters in relation to clauses that require a legislative consent Motion or those to which Wales has requested that further changes are made. Officials have regular meetings; they can be as frequent as weekly, as was the case at some points over the last few months.

Artificial Intelligence: Safeguarding

Baroness Smith of Llanfaes Excerpts

Tuesday 4th November 2025 Lords Chamber

[Baroness Merron (Lab)]

The first thing is to ensure the application of the Online Safety Act, and we look to Ofcom in that regard. We will increase access to evidence-based digital interventions, to help patients access treatment in a variety of ways but also potentially to reduce unnecessary GP appointments and A&E attendances, as well as assisting people who are waiting for treatment to wait well.

[Baroness Smith of Llanfaes (PC)]

My Lords, is there not a wider lesson here that many young people are turning to ChatGPT instead of calling their GP for health advice? Have the Government reviewed how they communicate different health information, particularly to the younger generation? Are they talking to the younger generation through the channels that they are using?

[Baroness Merron (Lab)]

Sadly, I cannot say I am young myself, so I cannot testify to this, but the answer to that is yes, the department does that. I refer to the point that the noble Baroness has emphasised: over a third of five to seven year-olds are using social media in 2025, and that proportion rises as young children get older. We ignore this at our peril. I assure the noble Baroness that the Online Safety Act is providing support, as are the digital interventions that we are providing through the NHS, in particular, the improved NHS app.

Terminally Ill Adults (End of Life) Bill

Baroness Smith of Llanfaes Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Baroness Smith of Llanfaes (PC)]

My Lords, I begin by thanking the hundreds of people who have written to many of us about the Bill. Their letters, often deeply personal, deserve our attention and respect: diolch yn fawr iawn—thank you.

I have also listened carefully, last Friday and again today, to the many thoughtful contributions from noble Lords, each informed by personal and professional experiences. As this is a matter of conscience, I will share my own perspective. My view on the principle of the Bill has been shaped in part by my own experiences as a carer for my late father and by the experiences of my friend Claire O’Shea, who recently passed away at the age of 42.

Claire was initially misdiagnosed with IBS and was later diagnosed with terminal gynaecological cancer. In the face of her devastating diagnosis, she founded Claire’s Campaign, turning her own difficult experience into a campaign for change in Wales and building a platform to amplify the voices of women who had long gone unheard. Claire said last November:

“This Bill legislates for people with a terminal diagnosis and 6 months to live. Thankfully there aren’t many of us who are facing those circumstances imminently. So for those of us, who will face this reality sooner rather than later, this bill offers something really important. I have excellent palliative care; but it doesn’t address all of my needs and how I imagine a good death. It’s not just about pain management”.


For many people facing the end of life, simply having the choice, even if they never act on that choice, can bring immense comfort. For those reasons, I support the principle of the Bill.

Clear communication in healthcare is vital, especially when people face complex decisions. That is why I want to highlight the clause in the Bill, secured by my colleague in the other place, Liz Saville-Roberts, which requires that “all reasonable steps” be taken to ensure access to assisted dying services in the Welsh medium. Imagine discussing such sensitive matters with your GP and being unable to use your first language. Welsh speakers must be able to receive care yn eu mamiaith —in their mother tongue.

However, I must raise a serious concern: the constitutional implications of the Bill for Wales. While the criminal law remains reserved, health is not. The Bill, if passed, will have serious consequences on a completely devolved matter in Wales. Just less than a year ago, the Senedd debated assisted dying. The result was 19 in favour and 26 against. Those voting against included the First Minister and the Health Minister. So I ask this House: if the Bill proceeds at Westminster, are we comfortable asking a Welsh Government Minister who has voted against the principle of assisted dying to make the decision on whether to deliver this service within the NHS in Wales? Should the Senedd not have the first say on whether such a service should be introduced at all in Wales? It is the Senedd’s role to scrutinise the delivery of health services in Wales, and the Welsh Government’s budget would fund any new service.

In Committee in the other place, a provision was inserted to reflect the need for devolved consent. Regrettably, this was removed on Report. This is deeply problematic. There is a strong argument that the entirety of the Bill engages devolved responsibilities. Restoring a requirement for the Senedd’s consent makes sense, regardless of what your view is on the Bill’s principle.

As the Bill continues its passage through this House, I urge all noble Lords to reflect carefully on not only the moral weight of the matter before us but the constitutional responsibility we bear. We must respect the role of devolved Parliaments in matters that are clearly their responsibility.

Tobacco and Vapes Bill

Baroness Smith of Llanfaes Excerpts

2nd reading
Wednesday 23rd April 2025 Lords Chamber

[Baroness Smith of Llanfaes (PC)]

My Lords, in the lead-up to today’s Second Reading, I was contacted by several people from Llanfaes, the community where I grew up, who expressed just how important the Bill is to them. One voice in particular stood out—Sylvia Evans’. Sylvia underwent a laryngectomy 26 years ago, after developing cancer of the voice box caused by smoking. At the time, her diagnosis was rare, but today she told me that three others in her local area have received the same operation. If current trends persist, around 350 new cancer cases caused by smoking are expected in Ynys Môn over the next five years. Across Wales, that figure could exceed 15,000 people. That is the reality of inaction.

Smoking remains the leading cause of cancer in the UK. According to Cancer Research UK, more than 40,000 cases have been attributed to smoking since the last general election alone. That is a staggering number, and it is preventable. The Bill offers a historic opportunity to protect future generations from the harms of smoking and sends a clear message: we can and must act now to break this cycle.

A Race for Life volunteer, Trefor Hughes-Morris, recently reached out to me regarding the Bill. He often asks the thousands of participants at his events to raise their hand if they or someone they know has been affected by cancer. He told me that every hand goes up. That is the scale of the challenge and the urgency.

Smoking rates do not fall on their own; they fall when the Government lead. The Bill represents the most significant opportunity in over a decade to prevent cancer before it starts. It secured cross-party support in the other place. Of course, there are concerns, including from Trading Standards Wales, about how realistic it is to believe that people born before January 2009 will be challenged about their age in the future when they are decades older, and about the lack of a strategy for dealing with the legislation’s impact on the illegal tobacco and vapes market. Indeed, this legislation must draw a clear distinction between legal and illegal vapes, which are already posing problems.

When used responsibly, as we have heard, legal vapes can be a powerful tool to help people quit smoking. According to Action on Smoking and Health, over half of those who quit smoking in the last five years used a vape to do so. ASH Wales actively encourages smokers to switch to vaping, based on

“the most up-to-date evidence”.

That said, we urgently need more research into the long-term effects of vaping to better inform regulation as the industry evolves. In the meantime, the lack of clear standards has allowed illegal and non-compliant products to proliferate. Some contain illegally high levels of nicotine or e-liquid, and even dangerous substances such as mercury and lead.

According to Trading Standards, already one in three disposable vapes sold is illegal. This matters because the bright colours and flashy branding of disposable vapes are attracting children and young people. In Wales, 24% of pupils in years 7 to 11 have vaped. Of those who vape regularly, 92% use products containing nicotine. Nearly half report being unable to get through a school day without vaping, impacting on their focus and education. Better regulation of the vape industry is not optional, it is essential.

In the Senedd, Plaid Cymru has long advocated a national mandatory register of all retailers selling tobacco and nicotine products in Wales. This would ensure that only compliant businesses operate and allow for enforcement action against those that break the rules. This proposal is backed by Public Health Wales’s youth vaping response group, which includes leading health charities, trading standards officials and medical professionals. We have also called for and supported Senedd legislation to ban the sale of disposable vapes, which will curb the rise in youth vaping and tackle their detrimental environmental impact.

In conclusion, I support effective, forward-looking legislation that protects people and encourages collaboration across all four nations of the UK. The biggest cause of cancer has no place in our future. While we will work through some concerns in Committee, I urge Members across your Lordships’ House to support the Bill.