Terminally Ill Adults (End of Life) Bill

Debate between Lord Rook and Lord Falconer of Thoroton
Lord Falconer of Thoroton Portrait Lord Falconer of Thoroton (Lab)
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My Lords, I indicated my position in my intervention. I will summarise my understanding of the amendment, what my response is and next steps. All the amendments in this group seek a requirement in addition to having a GP before you can have an assisted death. My noble friend Lord Rook suggests having a GP for at least 12 months and having seen him twice before the first declaration. The noble Baronesses, Lady O’Loan and Lady Grey-Thompson, refer to having an “established relationship” with a GP. The noble Baroness, Lady Finlay, refers to one consultation and a home visit before the application. The noble Baroness, Lady Lawlor, refers to a two-year relationship, an average number of visits face to face and then a letter that relates to the medical condition, the treatment and the state of mind of the patient.

As I have indicated, the GP, in the structure of the Bill, is not somebody who has to be involved. The noble Earl, Lord Howe, encapsulated perfectly that the GP is somebody who is receiving information. All these provisions for making it necessary to have a better relationship with your GP than just having a GP do not touch the safeguards. Quite separately from that, I support what the noble Lord, Lord Deben, and the noble and learned Baroness, Lady Butler-Sloss, said. These provisions have an air of utter unreality if you are saying that a condition of an assisted death is a particular relationship with a particular GP. I do not think that any of these safeguards work or reflect the current drafting of the Bill.

It is clear from listening to the debate that people who are concerned with the care should form a basis for the decision. It may not necessarily be making the decision—a lot of people would say that they should not be making the approval—but their input is vital. That was the insight of the noble Baroness, Lady Gerada, which was very much reflected around the Committee. I am willing and keen to reflect that insight in the Bill. But the route is not through newness in relation to the GP. It is reflecting the proposition that the multidisciplinary team dealing with the patient must have some input. I do not know whether that satisfies the question asked by the noble Earl, Lord Howe, but that is the purpose of what I am taking away from this very valuable debate.

As for the right reverend Prelate the Bishop of Gloucester, we are going to speak about prisoners on the next group. Can I reserve my position in relation to prisoners to avoid there being too much duplication?

In those circumstances, I invite the noble Lords not to press their amendments.

Lord Rook Portrait Lord Rook (Lab)
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I thank noble Lords for their patience, passion and seriousness in scrutinising this part of the Bill.

My Amendment 19, which started this debate, possibly needs some clarification. Forgive me, as one who is still becoming accustomed to your Lordships’ House, if I should have intervened earlier on this. I am very grateful to the noble Baroness, Lady Gerada, for her remarks. I had the privilege of working with her in a previous life and saw her brilliant healthcare and the provision of many experts—not just healthcare professionals but the wider community—in seeking people’s health and well-being. Her best-case scenario is what we would like to see in all end-of-life care and in assisted dying.

However, to speak to the comments by the noble and learned Baroness, Lady Butler-Sloss, and the noble Lord, Lord Pannick, my amendment is not seeking for a patient to have to see the same GP twice. That is not the amendment that we are trying to make here. We are asking that someone should be registered in a practice for a year and see a GP twice in that year.

I am very grateful to the noble Baroness, Lady Hollins, for her view that this could mean a wider team engagement—it might not be just the GP. I am saying not that it has to be the same GP twice but that a person has to engage with a GP twice in that stage. If any one of us in this Committee, or any one of our loved ones, were facing a serious medical condition right now, I think we would all have the reasonable expectation that in the next 12 months we might see a GP at our practice. Given the importance of this legislation and just what it will do for the state’s relationship to life and the NHS’s relationship to life, someone who is critically facing the end of life and requesting an assisted death should also be afforded the opportunity to see a GP twice in that period.

Dr Michael Mulholland has been quoted a number of times from his remarks to the Select Committee. I will finish with a quote from him. He said:

“We need to be sure that these things are checked on many levels. It is not at a single time and point where you tick something”.


I am grateful to the noble and learned Lord, Lord Falconer of Thoroton, for his willingness to consider this issue. I look forward to seeing how these concerns and conversations might be expressed and reflected in the Bill. With that, I beg leave to withdraw the amendment in my name.