Terminally Ill Adults (End of Life) Bill

Lord Wilson of Sedgefield Excerpts

Friday 24th April 2026 Lords Chamber

[Baroness O'Loan (CB)]

This Bill seeks to provide for individuals to be provided by doctors with fatal drugs to kill themselves. Where those patients cannot self-administer, Clause 25(8) says that

“the coordinating doctor may … assist that person to ingest or otherwise self-administer”

the drug. We have not yet debated this clause at length, but it does raise the spectre of Dr Shipman. What protection is there against a Dr Shipman in these circumstances? What protection exists for those who may be subject to coercion, which will not be identified because of virtual assessments—for example, where the assessing doctor is not in the room with the patient or has no way of knowing who else is there or what is going on? These things had to be identified and discussed and amendments tabled to address them.

In the course of our debates and through the submission of evidence to the Committee, we have identified multiple other serious problems. On many of them there was no engagement by the sponsor, as the noble Baroness, Lady Hollins, said. Following clearly argued criticisms, the noble and learned Lord has accepted a long number of problems with the Bill. However, there are virtually no amendments to address those issues. The legal definition of persons exerting pressure must expressly include bodies corporate, to uncover institutional or organisational abuse. Think of the pressures of bed-blocking and budgets in the NHS.

Regrettably, many of the amendments that the noble and learned Lord tabled weaken safeguards for which the MPs voted—such as explicit domestic abuse training or the mandatory independent advocate presence—under the guise of tidying up the Bill. Often these would save the Government money. The Government’s impact assessment reveals that it almost halves the cost of the assisted dying process if independent advocates or translators do not have to be present. There was provision for independent advocates to assist those who have substantial difficulty in understanding the process. Under the noble and learned Lord’s amendments, the advocate does not have to be physically present during medical assessments—and a person is allowed to entirely waive their right to an advocate.

It is perhaps paradoxical and dangerous to expect someone who qualifies for an advocate, precisely because they struggle to understand information, to independently decide to waive that very protection at the outset. The advocate is introduced only after key clinical and eligibility assessments have been completed, rendering them a box-ticking process. Think of the more than 100 languages spoken in England and Wales and of the problems of people with hearing difficulties, articulated by the noble Baroness, Lady Nicholson, and other communication difficulties.

Doctor-shopping possibilities have expanded as a consequence of the noble and learned Lord’s amendments. Let us be very clear. As is appropriate, our debates have ranged over a large number of issues. We have considered the effect on the NHS, the necessity to revise the NHS constitution, and the effect on practitioners who did not join their professions to kill people and who need protection against involvement. We have yet to debate the existing conscience protection provisions, but we know that they are inadequate. The BMA and the royal colleges asked for an explicit opt-in model, which was rebuffed multiple times in the Commons. The noble and learned Lord finally acknowledged the concern, but his Amendment 669A introduces an opt-in requirement only for training, not for assisted dying as a whole.

The Bill provides some protection for professionals but not for all the other people who enable our NHS to work—the administrators, the porters, the cleaners. The current option of going to an employment tribunal if facing disciplinary action in the context of an unwillingness to engage in any way in assisted dying is just not satisfactory. People need their jobs to pay their rent or mortgage, to feed their children. A system-wide opt-in model is the only way to protect staff from institutional pressure, yet the noble and learned Lord drew the line at protecting administrative staff, to ensure that the NHS runs properly.

Too many issues that should be debated fully in this House are to be left to secondary legislation, which Parliament can only accept or reject but not amend—for example, the approval of lethal drugs and the provision of assisted suicide services in England and Wales, which the DPRRC has said should be removed.

We talk of democracy, yet there is nothing democratic about handing sweeping powers to Ministers rather than to Parliament. There are those who, like me, believe that all life is sacred and to be protected, from conception to natural death. That has not been the subject of our debates over these months. As legislators, some with a religious faith and some with humanist beliefs or maybe no beliefs, we have been through this Bill word by word and clause by clause to see whether it can be improved. We have identified the massive inadequacy in the provision of specialist palliative care and the consequences of that inadequacy; the disparity of access to hospice care; the unique identity of hospices in providing a safe place to live and die without pain and at peace; the huge trust that is fundamental to the doctor-patient relationship in places in which people live and die; and the potential consequences if the Bill is passed for private and public funding arrangements for hospitals and the NHS.

[Lord in Waiting/Government Whip (Lord Wilson of Sedgefield) (Lab)]

The noble Baroness has spoken for over 11 minutes and it is supposed to be 10 minutes. Can she bring her comments to an end?

[Baroness O'Loan (CB)]

I am bringing my comments to an end.

We have tabled amendments to provide some protection for the vulnerable, the weak, the poor, the disabled, the sick, those with suicidal ideation, those with mental health problems and all those whom we have identified. Many of us have concluded that this Bill is not safe and have worked to try to make it safer. As I conclude, I pay tribute to those living with serious illness and disabilities; people such as Pete and George, who have attended every day of our debates and who sit behind me; and all those—

[Lord Wilson of Sedgefield (Lab)]

Can the noble Baroness please bring her remarks to an end now? It is nearly 12 minutes and other noble Lords want to speak.

[Baroness O'Loan (CB)]

The 12 minutes include the interruptions I have suffered.

I pay tribute to all those who have written to encourage us as we fulfil our duties as legislators in your Lordships’ House in scrutinising this flawed and very dangerous Bill.