Terminally Ill Adults (End of Life) Bill

Earl Howe Excerpts

Committee stage
Friday 9th January 2026 Lords Chamber

[Baroness Grey-Thompson (CB)]

Oh, absolutely: I think pressure is something incredibly important that we have to assess. Certainly, from the huge number of disabled people I have spoken to, pressure comes in many different ways, and it is very difficult to detect. If we do not take that seriously, I think people will be coerced into thinking that this is their only option, rather than that they have a range of options. That is picked up in some of my other amendments, but I thank the noble Baroness for her intervention.

We talked about the equality impact assessment. We need to look at the impacts on the Crown Court, on health and education committees and on children with SEND, and I think we probably need another version of the equality impact assessment to enable us to make the best decision on the way forward for the Bill. I am minded to support my noble friend Lord Carlile, because I think that what he proposes is much better than the panel currently in the Bill.

Mindful of time, I will leave my last comment to the Medical Defence Union, the leading indemnifiers of UK doctors, which gave evidence to the Commons Bill Committee:

“The involvement of the judiciary is essential. Its absence leaves doctors unduly exposed. Media reports suggest that an alternative safeguard is being mooted”—


noble Lords should understand that this was the context when the evidence was given—

“No ‘independent panel’, however so constituted, can replace the legal authority of a course of action sealed and ratified by a judge. Doctors deserve that certainty when relying upon this Bill to provide the very best for their patients at the most delicate moment of their duty of care”.


This is one group we have not really heard a lot from, and we should be minded of its role in the system as well.

[Earl Howe (Con)]

My Lords, as sizeable as this group of amendments is, the key proposals embodied within it can be described in relatively brief terms. The Committee therefore owes its gratitude to the noble Lord, Lord Carlile, for having given exactly that kind of helpful summary in his opening speech, which set our debate going on a good track. In thanking him for that, what has emerged most clearly to me in this debate is the far-reaching nature of the change to the architecture of the Bill represented by his proposals. In addition, were his proposals to be adopted in their totality, they would, as I read them, have the effect of simplifying very considerably the procedures required to bring about an assisted death.

In combination, those two consequences inevitably open up a range of questions, as we have heard, about how these proposals would work, not just in theory but most particularly in practice. We have, for example, heard questions about the capacity of the family court, about its funding and about the extent of the opportunity costs which the family court would need to sustain. The noble and learned Baroness, Lady Butler-Sloss, and my noble and learned friend Lord Garnier gave us considerable reassurance on some of those issues, as did the noble Lord, Lord Carlile, himself. However, the questions that have been asked are of fundamental significance and I think the Committee should hear from the Minister how the Government view the practical effect of the proposals and their workability.

On the principle of the proposals of the noble Lord, Lord Carlile, we have heard some powerful points in their favour: for example, the established powers vested in the court; the analogous decisions which courts already have to make; the ability of the court to arrive at a reasoned judgment and to be a court of record; the fact that the court-based appeal system is well understood; and indeed the level of public confidence which the court already enjoys.

I would venture to add another, which is that the role for the court envisaged by the noble Lord, Lord Carlile, would be a substantive judicial role, in contrast to the role originally envisaged in the first iteration of the Bill. That came over to me, at least, as more of a tick-box exercise than an exercise of judicial judgment.

However, what I look forward to hearing from the noble and learned Lord, Lord Falconer, are his views on the strand of this debate brought out most ably by the noble Lord, Lord Pannick, my noble friend Lady Berridge and my noble and learned friend Lord Garnier: how he has assessed the merits of the proposals of the noble Lord, Lord Carlile, in comparison to the proposals set out in the Bill. He is on record, some years ago, as having favoured a court-based approach in this area of the law. If his view is that, on balance, he now favours the panel process, as set out in the Bill, what considerations have led him to that conclusion?

[The Parliamentary Under-Secretary of State, Ministry of Justice (Baroness Levitt) (Lab)]

My Lords, I shall respond to the amendments in the names of the noble Lord, Lord Carlile of Berriew, and the noble Baronesses, Lady Grey-Thompson and Lady Coffey. Some of your Lordships may be aware that I know the noble Lord, Lord Carlile, very well. Indeed, the convention of this House is that I refer to him as “my noble kinsman”. This has given rise to a number of jokes outside this Chamber, but there is a serious point to be made here. I reassure your Lordships that this has no effect on the Government’s neutral analysis of the workability of the amendments in question, and although I have the advantage of having advance notice of my noble kinsman’s position, I have engaged with him as to the Government’s response in no different a way from the way I would with any of your Lordships.

As this is the first time a Minister from the Ministry of Justice has spoken in this debate, I reiterate what has been said on many occasions by my noble friend Lady Merron: the Government’s position is that it is a matter for Parliament to decide the policy which underpins this Bill. It follows that I will not be providing a government view on the merits of any of the amendments, nor will I make any observations in a personal capacity.

I will, however, deal with the question asked by a number of your Lordships as to whether the Government would deliver this, were the will of Parliament to be that the general principle contained in the amendments of the noble Lord, Lord Carlile, were to be adopted. The answer is that, given our current workload, it would of course be challenging; I say this because I am in fact the Family Justice Minister, as well as the Lords Minister. But if it is the will of Parliament, then we will work with the judiciary to make sure that we have the resources in place to deliver what Parliament has decided.

This is a large group of amendments, and it is the Government’s view that—

Infected Blood Compensation Scheme Regulations 2024

Earl Howe Excerpts

Monday 21st October 2024 Lords Chamber

[Earl Howe (Con)]

My Lords, I am grateful to the Minister for introducing these regulations, which, as he has explained, fulfil one element of Sir Brian Langstaff’s carefully calibrated recommendations for establishing an infected blood compensation scheme, both as set out in his inquiry report and as amended in the light of the engagement exercise carried out by Sir Robert Francis in June. The regulations we are considering relate specifically to those individuals directly or indirectly infected by contaminated blood, blood products or tissue. Still to come at a future date, as we have heard, are regulations to extend the scheme to those who, in various ways, have been affected by the infected blood disaster; and I shall come back to that issue in a second.

Knowing, as I do, how the detailed architecture of the compensation scheme has been devised, based as it is on Sir Brian’s recommendations, and on the careful and considered advice to Ministers given by Sir Jonathan Montgomery’s expert group, I do not argue for a second with either the appropriateness of the eligibility criteria or the proposed category headings under which compensation is to be awarded. I have some questions, however.

The product of Sir Robert Francis’s engagement exercise was a total of 74 recommendations for modifying the detail of the compensation scheme, as previously announced. Of those 74 recommendations, the Government accepted 69. I have to be candid and say that I was very surprised by how high that number was, since I did not think it likely that either Sir Jonathan Montgomery or my right honourable friend the former Minister for the Cabinet Office would have neglected to take account of any aspect of harm caused by infected blood, or misjudged the appropriateness of the levels of compensation under each category of harm. However, my being surprised is not the same thing as saying that I have any issue with the Government’s decisions on this score: I am quite sure that they will have done the fair and decent thing. In an important sense, the fact that there were so many recommendations for modifying the scheme goes to demonstrate only how worthwhile the engagement exercise was. We can be glad of that.

What nags at me, though, is a worry about complexity. The Secondary Legislation Scrutiny Committee noted this complexity and criticised the Explanatory Memorandum to the regulations for what the Committee saw as a failure to explain clearly either the basis of the compensation scheme or the practical aspects of the compensation arrangements. Those criticisms are regrettable, but to my mind they highlight what I feared might be a consequence of accepting 69 modifications to the scheme, which was that these would serve only to accentuate the complexity already built into the scheme architecture. It is surely axiomatic that the more complex the arrangements, the more likely it is that accurate and timely payment of compensation will be put in jeopardy.

There is one obvious example where this might be the case. The Government have agreed that those people registered with the infected blood support scheme will continue to receive regular support scheme payments for life, running in parallel with compensation payments from the Infected Blood Compensation Authority. On the face of it, having two channels of funding as opposed to a single channel runs the risk of both error and delay in delivering to people the money due to them. What reassurance can the Minister give me on this?

There is another, quite different, example of where delay could occur. Sir Robert Francis’s recommendation 18, which the Government appear to have accepted, was that, under the injury impact award heading, not enough attention had been paid to psychological illness as opposed to emotional distress and anxiety.