Terminally Ill Adults (End of Life) Bill

Lord Mackinlay of Richborough Excerpts

Friday 23rd January 2026 Lords Chamber

The noble and learned Lord, Lord Falconer of Thornton, has argued for a patient-centred, safe system. I put to him now: will he accept that a system which institutionalises speed, creates a dedicated navigator only for assisted death and allows remote assessments cannot credibly claim to be the highest standard of patient protection? If he truly believes in patient choice, will he support amendments that restore time for reflection, parity of support for palliative options and a presumption of face-to-face assessment so that choice is informed, free and real, not the product of a fast-track service designed to deliver one outcome? This is not about denying choice. It is about ensuring that the choice is genuine. I support the amendments tabled by my noble friends Lord Mackinlay of Richborough and Lord Harper.

[Lord Mackinlay of Richborough (Con)]

I apologise to the Committee for not being fully engaged today. I have appointments elsewhere, and my father’s funeral was yesterday. I remember during the Covid period Ministers stood behind a sign reading “Stay home, protect the NHS, save lives”. My real concern now with the thought of a navigator that has only one direction is that will it be—I know it sounds rather flippant—“Save the NHS, choose a navigator, choose death”? That seems to be the chilling direction that the concept of a navigator and one choice only seems to be directing us towards.

[Lord Winston (Lab)]

I feel tempted to try to answer that very quickly. I too will be leaving the Committee before we get to a vote on this or at least some decision from the Minister about what the Minister is going to say. I have to say that this discussion about the cost of treatment is not a reasonable one. The noble Lord, Lord Stevens, did not discuss this in his speech, but I think the speech of the noble Lord, Lord Birt, is overwhelmingly important because it is about the notion of our sensitivity in this situation.

There are many people who go to the health service who do not get treatment. It is not always a treatment. For years, I was pioneering in vitro fertilisation, which was not successful for a very long time. We got 16 babies worldwide in the first four years. There are now millions of happy families as a result, many of them in this House some of the time. The people in this House who opposed in vitro fertilisation—believe me, there were many of them—would probably have refused to accept assisted dying too. The fact of the matter is that the health service develops. It is not static. It changes depending on what the need is. In vitro fertilisation, instead of being an orphan subject, is now a major treatment funded by the health service. Unfortunately, it should be more funded, but we are getting a lot of success doing it in the way we are, and we will increase that.

It is also fair to point out that there are medical treatments developing all the time in the health service, which are not funded at the time when they are developed. Take cancer treatments, which are extremely expensive, very often with the most expensive drugs. Of course, we have to deal with the internal market in the health service, but we persuade the people who understand the need for healthcare, are faced with patients and have to treat them in the best way—