Terminally Ill Adults (End of Life) Bill

Debate between Lord Bishop of Gloucester and Baroness Berridge

Committee stage
Friday 12th December 2025 Lords Chamber

[Baroness Berridge (Con)]

My Lords, I will speak to Amendments 30A and 119A in my name, which relate to children and young people who are under an EHCP. I offered to withdraw these two amendments in order to shorten proceedings; by putting that on the record, I will shorten the meeting offered by the noble and learned Lord, Lord Falconer, but not necessarily these proceedings.

I am grateful to my noble friend Lady Coffey for spotting a typo in Amendment 119A—ECHP instead of EHCP. Please may we not create any more quangos with that combination of letters?

The Select Committee heard from Dame Rachel de Souza, the Children’s Commissioner for England, about the basic policy reason behind some vulnerable adolescents and those with additional needs being under her jurisdiction until they are 25: they need the extra support to transition into adulthood. Amendment 30A would remove all young people under an EHCP from the Bill; Amendment 119A on this policy ground would mean them falling under the Act, but with additional conditions. Such an issue may be additional subject matter for the promised meeting. Would these be the right conditions, were we to accept Amendment 119A?

The Children’s Commissioner’s jurisdiction also covers anyone under the age of 25 who has ever been in care. She has a specific responsibility for children up to the age of 25 who have an EHCP. I note that, in law, it is not 18 for all purposes. You cannot adopt children until you are 21. So, at the moment, the Bill does not produce a cliff edge at the age of 18.

Some of the young people on EHCPs may lack capacity and are, therefore, outside the scope of the Bill. As the noble Baroness, Lady Hollins—she is no longer in her place—has often said, assessing the capacity of people with learning disabilities is a complex matter. However, many young people are on an EHCP because of other additional needs or considerable childhood traumas; they will have capacity and will, therefore, come under this Bill. It is again relevant to think of them at 18 years and one day old, and with a life-limiting condition. Sadly, due to the lack of the usual pre-legislative processes of consultation, a White Paper and scrutiny, we are without the data on these vulnerable groups showing how many in the EHCP or under High Court DoLS also have life-limiting conditions. That data would give us an idea as to the priority of conditions for different groups.

In the Select Committee, Ken Ross of the Down’s Syndrome Association stated that people with Down’s syndrome cannot always fully comprehend complex decisions and have very suggestible minds. This is why there are additional safeguards in the EHCP, but if they have capacity, they are under the Bill currently without any additional safeguards.

Again, due to the process of the Private Member’s Bill, it is not clear how this legislation sits with other legislation and safeguards. Has the Bill been considered by the Department for Education, which has responsibility for children under the 1989 Act? Has the noble and learned Lord met with those Ministers? For instance, just to give an array of possible problems, in many cases local authorities legally still have a role for those under an EHCP after the age of 18. How will that fit with the processes outlined for assisted dying? Will there be a clash of decision-making from the EHCP special educational needs panel and the TIA panel?

What legal authority does the local authority have on safeguarding grounds to intervene in the panel’s process for a young adult on an EHCP if it disagrees with the assessment by the panel that the young person is making the request for assisted dying due to peer pressure or, as Ken Ross suggested, an enhanced susceptibility to pressure from white coat syndrome for those with Down’s syndrome? Is it mandatory for the TIA panel to get information from the SEND panel? Can the SEND panel appeal the decision to grant assisted dying? It seems not, so the family and the local authority will be left with the expensive and difficult remedy of judicial review.

Has the noble and learned Lord considered the evidence from the British Association of Social Workers? It states that the panel needs the power to do its own safeguarding assessments, or the power to close a case a local authority is seized of under Section 42 of the Care Act 2014. Otherwise, assisted dying could be granted and there could still be an open safeguarding case at the local authority unless the panel has the power to investigate and close it. These issues would have been flagged on a government write-round or during proper pre-legislative scrutiny. I am disappointed at the lack of meetings so far, as we need a proper process to consider the position of many vulnerable 18 year-olds on the day after their 18th birthday.

Bearing in mind Amendment 22, which the noble Baroness, Lady Grey-Thompson, mentioned, I wonder whether she, the noble and learned Lord or the Minister are aware of whether the policy decisions made for pregnant women in other jurisdictions are based on policy alone or on clinical evidence. If there is clinical evidence that drugs can promote and induce labour, is that why other jurisdictions have taken pregnant women out? That is relevant, because I have amendments later in the Bill about warning relatives of complications, especially if there is going to be a person under 18 present while assisted dying is being given.

Finally, on the points raised at the start of the proceedings by the noble and learned Baroness, Lady Butler-Sloss, I did not have the benefit of listening to the “Today” programme, but we are dealing with so many groups of vulnerable people. That is because of the lack of pre-legislative steps that we usually have. Groups would have been consulted and there would have been a White Paper. I have been exchanging optimistic emails with the noble Lord, Lord Carlile, but for me personally it is an open question, bearing in mind the lack of pre-legislative scrutiny, whether the Private Member’s Bill process actually fix that.

I know that the noble and learned Baroness worked with the noble Baroness and that she is very fair-minded, but I have had cause to look at the evidence from the Jersey States Assembly, a small Parliament. It was drawn to our attention in the Select Committee by Alex Ruck Keene KC that some instructions went to 200 pages, so I asked the Library to do some research and the Jersey parliament’s process is gold-plated. Not only that, but its website is much easier to use than parliament.uk and one can look at the process and timetable from 2021. When the States Assembly approved what it was going to do, the Executive—the Minister for Health and Social Affairs—gave drafting instructions to parliamentary counsel. To write a piece of legislation fit for purpose, they ran to 201 pages. We say that we are the mother of Parliaments in the Commonwealth context, but that is the way to legislate. I keep open in my conscience whether this process can fix the problems with the Bill which are such that none of the royal colleges is currently supporting it.

[The Lord Bishop of Gloucester]

My Lords, I speak to Amendment 22 in the name of the noble Baroness, Lady Grey-Thompson, to which I have also added my name. I declare my interest as Anglican Bishop to prisons in England and Wales.

There are many reasons why I believe that assisted dying may not be a fair choice for the general population, as things stand, but today I am shining a spotlight, as has already been said, on the prison population. I do not think that there has been enough attention in the debate so far on how the Bill would function for those in prison. I do not apologise for having spoken about prisons in the previous group, because this Amendment 22 is about excluding prisoners from the Bill, but the previous group of amendments assumed that prisoners would still be in the Bill. Therefore, we still need to look through that lens when we are discussing issues about GPs and medical records.

The prison population is in worse health than the general population. We have heard that. However, the reports from both the Health and Social Care Select Committee in the other place and the Chief Medical Officer paint a more concerning picture than that. Age-related illnesses, dependency and frailty can begin at an earlier age than in the general population. The prison population is ageing faster, and when I am visiting prisons I never cease to be shocked by the number of extremely elderly and frail people in prison. In most places, the prison system is not able to meet their needs properly—and that is not to criticise the prison staff, who are doing their best.

Nacro reported that, in 2019-20, people in prison missed 42% of scheduled hospital appointments. The Health and Social Care Select Committee goes as far as to say that

“so-called natural cause deaths, the highest cause of mortality in prison, too often reflect serious lapses in care”.

As has been said by the noble Lord, Lord Farmer, there is a lack of palliative and end-of-life care in prisons and, although there are some examples of excellent practice, action to improve this is voluntary and not supported by the commissioning of services.

Noble Lords may well say that prisoners should have equal access to care under the law, including assisted dying but, as has already been said, they do not currently have equal access to care. For me, this is not simply about the prison system and healthcare; it is about the perspectives and sense of well-being among those in prison. I will not rehearse everything that has already been said, but will just reiterate that the prison population experience high levels of hopelessness. We have frequently and rightly spoken about IPP prisoners in this House.

Again and again as I visit prisons, I hear about and see evidence of the high levels of self-harm in our prisons; it is particularly high in the female estate. Self-inflicted deaths in prison are predicted to continue to rise disproportionately compared to the general growth of the prison population. We need to be cognisant of the fact that, during the special Select Committee on the Bill, the Royal College of Psychiatrists talked about how a person’s wish to hasten their death can be impacted by what their life is like.

Although compassionate release is an option, it is rarely taken up. Crucially, according to Macmillan Cancer Support’s A Guide for Prisoners at the End of Life, it also requires a three-month prognosis. How does that interact with the Bill?

Children’s Rights: Digital Environment

Debate between Lord Bishop of Gloucester and Baroness Berridge

Thursday 1st July 2021 Lords Chamber

[Baroness Berridge (Con)]

I am grateful to the noble Baroness for her reference to the exceptional record this country has in protecting and promoting the rights of children, and I am delighted to confirm that a meeting will be arranged for noble Lords, which will be led by my noble friend Lady Barran.

[The Lord Bishop of Gloucester]

My Lords, the online safety Bill talks about protecting

“rights to freedom of expression”,

but nowhere does it refer to children’s rights to grow up in a healthy digital environment. Can the Minister give assurance that this will be addressed?

[Baroness Berridge (Con)]

My Lords, the key point around the protections we are putting in place and why the strongest protections are for children, reflected in the Keeping Children Safe in Education guidance, is that we want children to benefit and flourish using digital technology but to be kept safe online.

Covid-19: Education Attendance

Debate between Lord Bishop of Gloucester and Baroness Berridge

Thursday 1st July 2021 Lords Chamber

[Baroness Berridge (Con)]

My Lords, there has been increased reporting of children being electively home educated through surveys from directors of children’s social care. But there is this other group of children missing an education—those not on the school roll and not being electively home educated. There are specific officers in every local authority who should make inquiries to track down those children and make sure that they have appeared on the school roll in another local authority area in England or one of the other three devolved nations.

[The Lord Bishop of Gloucester]

Throughout the pandemic there has been a noticeable lack of briefings aimed specifically at children and a great absence of their voices. I was glad to host an event for MPs and key leaders in Gloucestershire where all the input came from young people. Can the Minister give an assurance that, in looking at the impact of Covid on the lives of children, it is they who will be asked and heard?

[Baroness Berridge (Con)]

My Lords, one interesting feature of the consultation that we recently conducted on exams was that over 50% of the responses were indeed from students. We have been pleased to hear their voices throughout this and have sought to communicate directly with them. I also draw attention to the very successful Big Ask, run by the Children’s Commissioner, to which over 500,000 children and young people responded.

Covid-19: Early Years Sector

Debate between Lord Bishop of Gloucester and Baroness Berridge

Wednesday 20th January 2021 Lords Chamber

[The Lord Bishop of Gloucester]

To ask Her Majesty’s Government what assessment they have made of the wellbeing of children under five affected by the COVID-19 pandemic; and what steps they are taking to support the early years sector affected by the pandemic.

[The Parliamentary Under-Secretary of State, Department for Education and Department for International Trade (Baroness Berridge) (Con)]

My Lords, the department is monitoring the impact of the pandemic on children and Ofsted has reported on the effects of Covid-19 on the early years sector. Early years are crucial for child development, so the Government are prioritising keeping these settings open. The Chancellor announced a £44 million investment in 2021-22 for local authorities to increase hourly rates paid to childcare providers for the Government’s free childcare entitlement offers.

[The Lord Bishop of Gloucester [V]]

My Lords, I thank the Minister for her Answer. The pandemic has deeply impacted the early years of many children’s lives. Given that pre-pandemic work by the Children’s Commissioner identified a need for strong connection across health, education and social care, will Her Majesty’s Government consider a Minister for children and young people at Cabinet level as a matter of urgency as we emerge from this pandemic?

[Baroness Berridge (Con)]

My Lords, the right reverend Prelate is correct that there is a cross-departmental approach to this. She will be aware of the proposals for family hubs, which should provide families with access to all those services on the ground. I assure her that the Secretary of State for Education is prioritising policy on children at the request of the Prime Minister.