Terminally Ill Adults (End of Life) Bill

Debate between Lord Carlile of Berriew and Lord Stevens of Birmingham

Committee stage
Friday 23rd January 2026 Lords Chamber

[Lord Carlile of Berriew (CB)]

My Lords, my noble friend Lord Birt was, of course, perfectly entitled to refuse my attempt to intervene in his speech. I am, however, disappointed that he chose to defy the determination of this House that we should not have repeated Second Reading speeches. Every one of us here can stand up and make a Second Reading speech on any of these amendments if we defy that determination, and I hope that he will not do it again. I am sure it was a misunderstanding on his part about the way in which he was able to move his amendment.

As to his amendment, I am afraid that I am suspicious about his group of amendments, and I think he gave the game away in the way in which he later turned to and referred to them. It is clear that he is very keen on there being a more extensive provision for assisted suicide—that people far beyond the scope of the noble and learned Lord’s Bill should be able to claim and achieve assisted suicide. Some of his amendments I agree with—I would love to see better care for people who are facing the end of their lives—but behind his amendments is a death service. As the noble Lords, Lord Deben and Lord Harper, said, what he is providing is a way to death, not a way to enjoy and make the most of the rest of your life. I would urge noble Lords not to support these amendments, because I regret that their motivation is not even consistent with that of the sponsor of the Bill.

[Lord Stevens of Birmingham (CB)]

My Lords, I speak specifically against Amendment 771, which would require the Secretary of State to establish an assisted dying help service as part of the National Health Service. I believe that that is a conceptually misplaced proposition in that, if we cast our minds back to last Friday, it was completely evident that the sponsor of the Bill does not intend that only in cases of unbearable pain or suffering would a person be eligible for the assisted dying service. Instead, concerns about your finances or being a burden on your family would be defined as legitimate bases for making the choice to opt for an assisted death.

It is not the proper function of a national health service to deal with financial burdens or pressures on people’s families in that way: that is a category mistake. Indeed, the founding charter for the NHS, the National Health Service Act 1946, is quite clear, and all successive health Acts have laid out the purpose of the NHS, which is

“to promote the establishment … of a comprehensive health service designed to secure improvement in the physical and mental health of the people of England and Wales and the prevention, diagnosis and treatment of illness”.

Assisted dying does not fall within the scope of that purpose. In fact, I think that must be evident indeed to the drafters of the Bill, because somewhat camouflaged at Clause 41(4) is the suggestion that, by regulations, that founding charter for the National Health Service could be amended to include assisted dying. They reference the fact that change is probably required to the most recent iteration, the 2006 Act, to bring that about. I do not think it can be said legitimately that this is a part of the purpose of the National Health Service, and it is unnecessary in practice, organisationally.

Just because doctors, like lawyers and social workers, are proposed to be involved in this, it does not mean it is inherently part of the National Health Service. Doctors do DWP assessments, but that does not mean the National Health Service runs the benefits system. Doctors are involved in driving licence assessments, but that does not mean the National Health Service runs the DVLA. Doctors are involved in the criminal justice system as forensic medical examiners, but that does not mean the NHS needs to run the court system.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Carlile of Berriew and Lord Stevens of Birmingham

Thursday 8th January 2026 Lords Chamber

[Lord Stevens of Birmingham (CB)]

My Lords, I too support the idea that this Bill needs extra time. It is entirely unsurprising that that is the case given that, notwithstanding the fact that it is a Private Member’s Bill, it is dealing with such a matter of substance. For example, if you compare the process that was put before the House for the Mental Health Bill—an important but arguably less significant piece of legislation—by the time we got to the Lords Committee stage, we had already had an independent commission, a White Paper, a public consultation, draft legislation and pre-legislative scrutiny. All of that is in effect being done by your Lordships through this process, so it is not surprising we need extra time. The suggestion that, just because this has been introduced as a Private Member’s Bill, democracy requires that we give it less scrutiny than a government Bill is an unpersuasive argument.

It is also the case that, over the first few days of Committee, some pretty significant matters of substance have arisen. We are not going to rehearse them now, but they are around capacity, choice, vulnerable groups and eligibility. While agreeing with the noble and learned Lord, Lord Falconer, the sponsor, that we need to find a way of coming to some judgments on these questions, what process does he envisage for that? The guidance that those who have put down probing amendments in Committee have got back from the Government—precisely because the Government do not want their fingerprints all over this Bill—has been, shall we say, Delphic or elliptical. The phrasing that Ministers have used time and again has been, “If you are contemplating coming back with an amendment such as that on Report, then you will need to do further work to make sure it is fully workable, effective and enforceable”, but then there is no subsequent work to bring that about. If we are going to have a substantive debate on Report, so we can get these safeguards in place, we are going to need to see that.

Finally, I would like to ask a question of the Government. For those of us who have concerns about the interaction between this legislation and the state of the health service, social care and palliative care, it would be very helpful if we could have more clarity soon from the Government on how they see those interactions happening. Yesterday, in the House of Commons Health and Social Care Committee, the Minister responsible for palliative care said that the Government would not publish their detailed modern framework for palliative care until, in effect, after this Bill had supposedly already passed through Parliament, which seems to me a dangerous reversal of the timetable that we require. It would be excellent to hear from the sponsor of the Bill and from the Government how they can help the House constructively engage on Report on some of the safeguards which are, in my judgment, clearly needed.

[Lord Carlile of Berriew (CB)]

My Lords, I am grateful to the noble Lord, Lord Mohammed, for namechecking me earlier, particularly in the same sentence as my noble friend Lord Pannick. I have the unenviable task tomorrow morning of moving the first amendment and the first group at 10 o’clock and, before I come here, I shall certainly have to reflect on the length of the speech that I intend to make. In fact, I have already prepared a speech that will probably not last more than 12 to 15 minutes, which seems to me be entirely proportionate to the huge group that we will be considering tomorrow.

I came here thinking that I would oppose the noble and learned Lord’s Motion, if it was put to the test. However, in fact I have been particularly influenced by the speech of my noble and learned friend Lady Butler-Sloss, who brings great wisdom to this House and, above all, an example of common sense which is heard often among the senior judiciary, in my view—I had to say that, did I not?

I have one stricture, if it is right to describe it as that, to put to the noble and learned Lord, for whom I have a great deal of respect and with whom I have discussed issues relating to the length of the debates on this Bill. I still believe that we can complete all stages of this Bill in the time that has already been allotted. I believe that if Members of this House were sparing in not making further Second Reading-type speeches, we would achieve that task. However, I say to the noble and learned Lord that we do need a little bit more discussion from his side. I have encouraged him, and there have been meetings to this effect, to look at the main issues on this Bill—I know there are a thousand amendments, but there are about 10 main issues at most—and come and tell us where he is prepared to make concessions, and how we can constructively discuss such concessions. On a Bill like this, if we do not go through that process, actually, the Committee stage becomes futile.

I hope that as a result of this debate—and I will not now vote against this Motion if the opinion of the House is sought—we shall see a more co-operative and speedy approach to the Bill’s Committee stage so that we really can achieve reaching a Third Reading debate.