Terminally Ill Adults (End of Life) Bill

Lord McCrea of Magherafelt and Cookstown Excerpts

Friday 27th February 2026 Lords Chamber

I draw attention to the part of my amendment that would require that the number of staff seconded into the organisation is recorded. I have seen this in other places; it is quite a smart way of making organisations look much smaller than they are. Again, this is about providing true transparency. Can the noble and learned Lord give an assurance that the size of the body will be recorded and that that will be transparent?

[Lord McCrea of Magherafelt and Cookstown (DUP)]

My Lords, I follow the noble Baroness in speaking to the issue of the commissioner. The shift from the High Court to a commissioner has been compounded. The Bill originally proposed that a High Court judge would authorise every assisted death—a feature initially championed by the Bill’s sponsor in the other place to make the United Kingdom’s law the safest in the world, with robust safeguards. That has changed dramatically and we now have a new structure, with a commissioner appointed by a Prime Minister.

The voluntary assisted dying commissioner is an important role. They will be given powers both to run and monitor the service. This creates the obvious risks of inadequate public scrutiny and independent review. It is judicial in the broad sense of involving a judge, but it does not appear to have a judicial function. The commissioner will both run the service and monitor it, which means that a highly controversial and important service will be run with little proper oversight. The commissioner will be responsible for establishing the regime and overseeing appeals as well as monitoring and reviewing its operation. In effect, as others have said, this allows the commissioner to mark their own homework.

Dr Luke Geoghegan, policy lead of the British Association of Social Workers, told the Select Committee that an independent regulator for VAD was essential. He said:

“The other thing that I think would give assurance is that no public sector organisation should mark its own homework. The voluntary assisted dying service needs robust external inspection”.


In its written evidence, the Law Society said:

“We recommend the establishment of an Independent Monitor to review and report on the operation of the Act annually”.


The commissioner could be an assisted dying campaigner or someone linked to an advocacy group. Other countries have experienced problems when the assisted dying service is run by an advocate, yet nothing in the Bill prevents this risk of conflict of interest.

In the Constitutional Reform Act 2005, the noble and learned Lord, Lord Falconer, developed a new judicial appointments process designed to guarantee an independent, impartial judicial appointments process and an enshrined statutory duty requiring respect for the independence of the judiciary by Ministers. Yet in the office of the commissioner, we see a potential patronage office in the political gift of the Prime Minister without any internal or external safeguards. Can the noble and learned Lord tell the Committee how the commissioner’s impartiality will be guaranteed? Why has he changed his mind on the importance of statutory guarantees of independence? Will the public have any right to know the commissioner’s views?

Amendment 127, in the name of the noble Lord, Lord Beith, would

“make the Prime Minister’s choice for Commissioner subject to scrutiny and approval by the House of Commons’ Health and Social Care Select Committee”.

There is a lack of accountability and transparency around the commissioner’s appointment process, which is entirely in the gift of the Prime Minister. Therefore, I ask the Minister who will respond to this group: have the Government followed Cabinet Office guidelines regarding appointments? The Cabinet Office Guidance: Pre-appointment Scrutiny by House of Commons Select Committees, published in 2019, requires:

“When establishing a new public body, departments should ensure that they consider whether any public appointments to that body would meet the criteria”


for a pre-appointment hearing. It continues:

“They should seek guidance from the Cabinet Office and also discuss this with the relevant select committee Chair in a timely manner before establishment of the new body”.


Can the Minister confirm whether the Government have discussed the matter of a pre-appointment hearing with the Commons Health and Social Care Select Committee?

[Lord Harper (Con)]

My Lords, I have a couple of points to make on this group of amendments. Let me start on a note of agreement with the Bill’s sponsor, the noble and learned Lord, Lord Falconer, who has in this group Amendment 131A, which would require:

“Before making an appointment under this section, the Prime Minister must consult the Welsh Ministers”.


I think that is a sensible approach. We have had disagreements about whether the Bill should or should not apply to Wales but, given that it does, it is sensible that Welsh Ministers are consulted.

It is worth noting that Welsh Ministers have some views on this matter. Given that we are talking about consulting Welsh Ministers, this is probably the time to note them briefly. In the vote in the Senedd this week, Wales’s Health Minister, one of those who would be consulted, made two points clear. First, he said that the Motion in the Senedd was not a referendum on legalising assisted dying with only this Parliament able to make that decision. He also said—this is important, given that there are those outside this House who pretend that the only people who think this Bill has any flaws are a small number of Peers, when that is not the case—that he voted against the legislative consent Motion because:

“I’m also clear in my own mind that the fundamentals of the bill, as it’s going through Westminster, don’t provide sufficient safeguards for patients”.


The Welsh Health Minister, who would be one of those responsible for helping to implement it, thinks that the Bill currently does not have appropriate safeguards. He went on to say:

“Although the vote yesterday was on the devolved areas ... the net effect is to give powers in Wales to deliver a service that I don’t think I would support if I was operating over the border”.


For all sorts of reasons, it is helpful to consult Welsh Ministers. We have heard from them this week, and they are very clear that this Bill is currently flawed. Therefore, I think we are doing the right thing by scrutinising it, asking questions and putting forward amendments to improve it. We can see that it is not just Members of this House who have concerns; elected Members serving in the Welsh Government also have concerns, and it is worth getting that on the record.

The fundamental thing that I want to talk about is the prime ministerial appointment process in the Bill. I was quite surprised, not particularly that the Prime Minister was making the appointment, but that there was no other process around it. The Bill currently says that the commissioner is to be appointed by the Prime Minister. The one constraint is that:

“The person appointed must hold or have held office as a judge of … the Supreme Court … the Court of Appeal … the High Court”.


Other than that, there is no process set out that the Prime Minister has to follow.

There are two flaws with that. There is the one that the noble Baroness, Lady Fox, set out, which is that, given that this is an area of policy, the Prime Minister may have their own views about the issue and that may influence the person they choose. My noble friend Lord Markham was quite right that the person would simply be implementing the law. The worry is that if you appoint somebody who has a very strong view about the issue and is prepared to use holding this office to prosecute advancing it, which is the concern my noble friend Lord Moylan set out, that is a problem. The concern I have with the Bill as drafted is that the Prime Minister could appoint such a person, and we would have no way of knowing in advance or of testing that person’s views before the appointment was made. We would find out about it only afterwards, and that is a real problem.

Secondly, I am afraid that we have seen examples of the current Prime Minister making staggeringly bad appointments, and the rather obvious one is Lord Mandelson. I see the Minister shaking her head, but it was a shockingly bad appointment. It is an example of a decision being made to appoint somebody and the process being circumvented in order to get the right result. The person appointed to this role is responsible for life and death issues, and as my noble friend Lord Deben said, it is extremely important that they command the confidence of the public—not just people who are in favour of assisted suicide, but those who are against it and who want to see a proper process with proper safeguards, so that that person holds public confidence.