Lord Mawson
Main Page: Lord Mawson (Crossbench - Life peer)
Lord Lemos (Lab)
I apologise but I must remind noble Lords of the guidance of the House, which is that noble Lords should not summarise or repeat others at length. I know I try to find a different way to say this every week, and broadly speaking I fail. I also realise that noble Lords have spent a lot of time preparing their remarks, but it is my duty to remind them of the guidance of the House.
Lord Mawson (CB)
I love your Lordships’ House because it is the place where all this detail comes on to the Floor of the House. Debates like this, even though they are complicated and difficult, are always encouraging to people like me. The people involved in this, even though they take very different positions, I like a lot. I sat in the debate in June down the Corridor, and I heard lots of emotional stories on both sides of the debate, and good points and all that, but it did not have the level of detail that we are dealing with in this House. This is encouraging to me.
My life has been spent in the East End of London on housing estates, dealing with practical issues in a very grey area of the world and often, if I am honest, the dysfunctionality in practice and in detail of the NHS on housing estates. I have had to deal with the GP who is doing female circumcisions in his surgery that none of the systems had even noticed, and the GP who had bought a cheap fridge from B&Q and given out 10,000 illegal injections, and no one had noticed because there was lots of ideology about race that was preventing anyone from coming to terms with the detail of that.
My colleagues and I really got into the health system, as the noble Lord, Lord Deben, knows, following the death of a young woman called Jean Vialls from cancer in appalling circumstances with a disabled mother, a mentally ill dad and two children sleeping in the same bed. The NHS systems, processes and machinery absolutely failed to deal with that stuff. We would not have built the Bromley by Bow Centre, which now has 55,000 patients—it is starting to operate across the country with a whole programme that I now lead—if it had not been for the noble Lord, who, as the then Secretary of State, intervened in a very serious practical matter following a senior-level inquiry at the London hospital and enabled us to build the first working model of an integrated health centre that tried to deal with this complexity.
The NHS, in my experience—I am dealing with it with colleagues across the country—is broken. It is in a great deal of difficulty, in my experience. Our GPs are overwhelmed by bureaucracy and a whole range of things, and they are excellent people. My point in saying this, because I come from the world of practicality—
Lord Lemos (Lab)
I am sorry to intervene again but I invite the noble Lord to address the amendment directly.
Lord Mawson (CB)
I was just going to do that. I address the amendment because I worry that, while the amendment and the idea of a navigator seem very straightforward intellectually, I am trying to suggest that in the real practical world out there, when you engage with it, as my colleagues and I have done over the last 40 years, you see something quite different.
Baroness Coffey (Con)
My Lords, I shall speak to Amendments 287A, 287B and 771ZB. I call the noble Lord, Lord Birt, my noble friend. We went to the same school, although admittedly not at the same time. I am conscious that he has come at this with an approach of a lot of research, as he set out. The noble Lord knows that I disagree with him, but I understand why he is trying to speed up. However, I wonder whether he has taken account of evidence presented already. The noble Baroness, Lady Fox of Buckley, talked about the CEO of Mind, but also Marie Curie spoke about this and indeed the Royal College of Psychiatrists.
I am particularly thinking of the speeding up and that moment of reflection, which is really important. I think the noble Lord is already suggesting in his Amendment 771 that patients should be aware of their right to withdraw from the assistance process at any stage. There is quite a lot in here that sets out a framework that could be done through the NHS. I completely agree with what the noble Lords, Lord Stevens of Birmingham and Lord Mawson, have said: it worries me that, if this ends up in the NHS, it will accelerate in becoming a routine end of life. In my meetings with the Royal College of GPs, it has been clear that it does not want this to be part of the NHS and it would absolutely resist it being part of the NHS contract.
Lord Falconer of Thoroton (Lab)
I listened very carefully to that. I indicated previously, in relation to powers of attorney, for example, that it would be worth putting it in. First, I am not sure what “it” is. Secondly, “it” is there: the key is the words “informed consent”, which nobody has any difficulty in understanding. It may have a particular implication in a particular case, and you have to give people flexibility in relation to what they say, because it will depend on the circumstances. If I knew what “it” was, I would put it in, but it is just not that simple.
Lord Mawson (CB)
My Lords, I said to the noble and learned Lord earlier that in some ways, this feels—from where I have spent a lot of my life, in the East End of London—like quite a white, middle-class conversation. Where I spend my life, one is dealing with every nationality on earth, often with lots of people whose grasp of English, in communication and really understanding what they are saying to each other, is quite complicated. I am just trying—because I am a practical person—to understand how this will work in practice. How will one ensure that, with the panel and the doctors, you will have in that process the people with the language and other capabilities and skills to really know what informed consent is? How much will it cost to ensure that all those elements are in this process?
Lord Falconer of Thoroton (Lab)
The noble Lord makes a good point: how do you, in dealing with a wide range of cultures, establish that it is the informed wish of the individual that they want an assisted death? You cannot prescribe in a Bill how you would do it in every case, but there is absolutely no doubt, as far as the Bill is concerned, that the establishment of that informed wish is the basic foundation before you get there. Therefore, in each case, if it involves a different culture or a different language, that must be gone through before you can be satisfied.