Compassionate Use Medicine Schemes: VAT

Debate between Lord Deben and Baroness Merron

Tuesday 16th June 2026 Lords Chamber

[Baroness Merron (Lab)]

I am sure that the noble Lord would not want me to be quoted as suggesting that VAT should be charged on chocolates given free in shops, so I will not. The way in which VAT is calculated is a long-standing arrangement that companies are aware of. The medicines are treated as taxable deemed supplies, which means that VAT is applied even when no payment is made. VAT is worked out by calculating the value of those products, but if there is nothing similar, then an assumption is made. This is a usual way of dealing with that. I should also emphasise that VAT is a matter for His Majesty’s Treasury and has been for all these decades.

[Lord Deben (Con)]

Can I bring the noble Baroness back to the last part of my noble friend’s question? It looks as though the VAT department in HMRC is behaving most peculiarly. First, it lost the case about VAT on entry to the Great Yorkshire Show, yet it is fighting every single show rather than giving way to what the law says. Secondly, it lost the case about VAT on charging your EV, but it has been putting off taking that in and will now appeal, against all the interests of the Government. Now we have this case. It is perfectly right for the noble Baroness to say that this is a long-standing thing, but can she join with fellow Ministers and say that it is about time that HMRC recognised that it is a public service, that it ought to look at what it is doing and that it ought not to hold up changes which the law has insisted it makes?

[Baroness Merron (Lab)]

Again, I appreciate the invitation to enter into conversations about VAT more widely, which I will resist. Certainly, HMRC is aware of its role. We are trying to find the right way forward with HMRC while the issues are resolved, because patients are at the heart of this. HMRC is already using its discretion to extend deadlines where appropriate and suspend collection of tax if a taxpayer has requested a statutory review. It does not mean that HMRC has changed its mind on past liabilities, but it does mean that, if taxpayers and companies have concerns, they have a direct line to it. We are working carefully and closely with industry, patients, charities and others to find the right way forward as soon as possible.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Deben and Baroness Merron

Committee stage
Friday 6th February 2026 Lords Chamber

[Baroness Merron (Lab)]

My Lords, I am most grateful to all noble Lords who have contributed to this debate on assessing capacity in care homes. As noble Lords will be aware, my remarks will be limited to areas where the Government have assessed that there may be major technical or operational workability concerns.

I say to the noble Lord, Lord Blencathra, that that will include matters relating to the ECHR. The noble Lord, Lord Carlile, already picked that up in his own characteristic way, but I gently say to the noble Lord, Lord Blencathra—I know he is aware of this because of his experience—that Government Ministers have a duty to advise your Lordships’ House of implications. As I explained in the last group, decisions on the ECHR are ultimately for Parliament. I am sorry to frustrate him with repetition, but it is appropriate to the relevant considerations. I will just ask him not to listen if he feels it is very irritating.

This may be helpful to the noble Lord, Lord Wolfson, as well. Amendments 112 and 111, in the name of the noble Baroness, Lady Eaton, spoken to by the noble Baroness, Lady O’Loan, aim to strengthen safeguards for care and nursing home residents by ensuring that capacity in these cases is established through specialist clinical assessment and that capacity assessments seek to rule out reversible medical causes of impaired or fluctuating capacity. The Government consider that Amendment 111 may be inconsistent with the Mental Capacity Act’s assessment framework, which does not require enhanced assessment for certain groups. I dealt with this in more detail in the last group. By requiring expert psychiatric input before capacity is confirmed, Amendment 112 could create inconsistency with the MCA’s presumption of capacity and the principle of proportionate, decision-specific assessments.

Amendment 110A, tabled by the noble Lord, Lord Blencathra, would affect care home and nursing home residents’ capacity assessments and require expert psychiatric input before capacity is confirmed. Again, this could create inconsistency with the MCA’s presumption of capacity and the principle of proportionate, decision-specific assessments.

If passed, each of these amendments would lead to a difference in treatment between care home and nursing home residents and all other citizens in assessments for assisted dying. That difference in treatment—the noble Lord, Lord Blencathra, may wish to close his ears at this point—could give rise to challenge under the ECHR, particularly Article 8, which refers to respect for private and family life, and Article 14, which concerns the prohibition of discrimination. The differences in treatment would need to be justified, necessary and proportionate.

[Lord Deben (Con)]

If the Committee decided that the conditions in a care home were such that it would be better to have a system there that was slightly different from the one for those who were not in a care home, surely that is justification enough. As the Minister knows, I am entirely in favour of the ECHR and disagree very strongly with my noble friend, but this seems a bit of a red herring, frankly. The fact of the matter is that, if this was the policy that was put forward, I think it very unlikely that anyone would find it possible to stop it under the ECHR.

[Baroness Merron (Lab)]

It would not be possible in any case to stop it in that way, because it would not invalidate legislation. I am just drawing the Committee’s attention to the fact that it would require further work. As the noble Lord will know, if a court finds that primary legislation is incompatible, it may make a declaration of incompatibility. As I said, although it does not invalidate legislation, it is usual practice for the Government to consider and address these matters.