Terminally Ill Adults (End of Life) Bill

Baroness Butler-Sloss Excerpts

Friday 12th December 2025 Lords Chamber

[Baroness Berger (Lab)]

My Lords, Amendments 16A and 114A, which were tabled by the noble Baroness, Lady Keeley, address the fact that for the last 10 years there has been a substantial backlog of applications for deprivation of liberty safeguards assessments. This backlog grew after there was a Supreme Court ruling in 2014 on Cheshire West. Following that ruling in 2014, the criteria for what constituted a deprivation of liberty assessment led to a surge in applications for DoLS assessments. Back in 2013-14, there were around 13,000 assessments. This grew to over 332,000 applications in 2023-24.

The last reported backlog of deprivation of liberty safeguards assessments back in October of this year was more than 123,000 applications. That is more than 123,000 cases where a person so lacks capacity in one area that an application for a deprivation of liberty safeguards assessment has been made, but our overstretched social workers and local authorities have not been able to process it.

I hope we can all agree that people whose incapacity to make basic decisions is so severe that they are deprived of their liberty, or for whom an application has been made for the deprivation of their liberty, are the most vulnerable members of society, and that the protection of people who lack capacity is a solemn duty. The state looks after their interests because they cannot.

Amendments 16, 16A, 114 and 114A provide a fundamental safeguard to protect this group by excluding them from making a life-and-death decision, both when they have been deprived of their liberty in the last 12 months or—as these amendments particularly seek to achieve—while they are waiting for the assessment to be made to deprive them of their liberty.

In conclusion, while considering these amendments, and in addition to addressing the delays outlined by the noble Baroness, Lady Finlay, we might also reflect that our current social care workforce has struggled so much with the backlog of assessments, as I have described, that the last Government were not able to implement the changes to the deprivation of liberty safeguards assessments contained in the Mental Capacity (Amendment) Act 2019. It is worth pointing out that the Bill seeks to create a new and additional role for social workers on the panels, and in that context, I hope noble Lords will consider these amendments.

[Baroness Butler-Sloss (CB)]

My Lords, for the reasons given by the noble Baronesses, Lady Finlay and the Lady Berger, I support all these amendments.

Perhaps your Lordships, and particularly the Whips, will forgive me if, very briefly, I go slightly wider. I am one of the oldest Members of this House. I do not like the Bill but I am here, like other noble Lords, to try to make it work. It needs scrutiny and improvement. However, we must get it to Third Reading. If we do not, there is a very real danger that the reputation of this House, which not only I but all your Lordships care about deeply, will be irreparably eroded.

This morning I listened to the “Today” programme. I agree with every word of what the noble Baroness, Lady Grey-Thompson, said, but there was a perception that we are being unreasonable. What we can do, perhaps, is not expect to be entitled, exercise self-restraint, deal with the amendments relatively briefly, and not make a point if someone has already spoken on the point you were going to make. We really must get to Third Reading. Forgive me for saying all that.

--- Later in debate ---

[Baroness O’Loan (CB)]

I thank the noble Baroness for her intervention, which is very helpful. All I was trying to say is that we are aware of many situations in which people are subject to coercion and where there are financial and other interests that cause people to be subject to pressure or to think that perhaps they are a burden. The autonomy which currently exists in the Bill in terms of decision-making, where there is no provision for access to police and medical records, does not ensure sufficient protection for a vulnerable individual who is making an application for assisted death. That is why these amendments are important, so that the GP who is faced with dealing with the situation and all those involved can have access to other documents.

[Baroness Butler-Sloss (CB)]

My Lords, I am currently a patient, in a very minor way, at an excellent medical practice where the nurses know me well. There are five GPs; I have met two of them briefly, but they do not really know me. I have huge sympathy with these amendments, but I think this is unrealistic. Over the years that I have been at this excellent practice, I have never got to know a GP, certainly to an extent of more than twice. Since there are five, and I am extremely well looked after, I do not see any problem with it. However, the idea that you should know your GP, or rather that your GP should know you—I just do not think that happens across the country. Going by what the noble Baroness, Lady Gerada, said, that is the reality.

[Baroness O’Loan (CB)]

My Lords, could the noble and learned Baroness possibly accept that there are situations in which patients either cannot get access to GPs or, when they do get access to GPs, have GPs with huge patient loads, which means that they cannot see the patients? While she may be in the privileged position of having five GPs, many doctors’ practices do not have that number, and people quite simply do not get access to the doctor. I am not fabricating anything as I say this, and I ask her to reflect on the fact that it is established in the Government’s equality impact assessment that there are problems with access.

[Baroness Butler-Sloss (CB)]

Yes, I entirely agree. That is the basis of what I am saying. I think it would be admirable if anyone who was seeking assisted dying in fact had the opportunity to be known by the local GP. All I am saying is that, yes, I am lucky, but I do not actually know my GPs. Of course, I accept what the noble Baroness, Lady O’Loan, says: there are many people who never meet their GPs and never have access. That is why it seems to me that what is required cannot be achieved. That is all I am saying.

[Lord Winston (Lab)]

My Lords—

--- Later in debate ---

[Captain of the Honourable Corps of Gentlemen-at-Arms and Chief Whip (Lord Kennedy of Southwark) (Lab Co-op)]

My Lords, before we proceed, I will just say that we are getting to the point where we should begin to think about Front-Bench replies to this group of amendments so we can finish at around 3 pm. I do not want to break mid-group because that, of course, is very difficult for the House, Members and the clerks, as it will have to be recorded. Perhaps your Lordships can just bear that in mind, as I am conscious that the time now is nearly 2.40 pm.

[Baroness Butler-Sloss (CB)]

My Lords, I want to make a practical point. It is obvious that this will be the first Act in relation to assisted dying. Clearly, it is unjust because it does not deal with people with motor neurone disease and so on. Why does the House not accept that the issue of prisoners should be in the next Bill and not the present one?

[Lord Shinkwin (Con)]

My Lords, I will keep my remarks very brief. I rise to speak in support of Amendments 30A and 119A in the name of my noble friend Lady Berridge. I thank her most sincerely for tabling them and thank my noble friend Lady Monckton for her supportive remarks. Disabled people and people with Down’s syndrome should know that this House would never treat them as bottom of the heap.

Given the evidence provided to the Select Committee by the National Down Syndrome Policy Group, the question to my mind is not so much why we would want, but why would we not want to support the provisions in these amendments? We are talking about vulnerable young adults who deserve and need extra protection on account of their disability. I say that as a disabled person who has been involved in championing disability rights for almost 30 years. Such protection as would be afforded by these amendments is neither patronising nor discriminatory. On the contrary, it is our duty to strike the correct balance between rights and protection. I believe these amendments do so.