Terminally Ill Adults (End of Life) Bill

Baroness Royall of Blaisdon Excerpts

Friday 27th March 2026 Lords Chamber

[Lord McCrea of Magherafelt and Cookstown (DUP)]

My Lords, I will speak to the main theme of this group, but particularly to Amendment 679 in the name of the noble Baroness, Lady Grey-Thompson, which I believe is essential if we are to safeguard the valuable work of faith-based hospices and care homes, along with other institutions, that have a conscientious objection to assisted suicide. I speak as a member of a family in which loved ones—more than one—have committed suicide, and I know the pain of what that word entails and means.

I note this particular part of Amendment 679:

“No company, charity, or other organisation shall be required, as a condition of receiving funding or any other benefit from any public body, to participate in, facilitate, or permit on its premises the provision of assistance in accordance with this Act”.


I am seriously concerned that, even after 13 days of consideration in this place, we have still not truly appreciated the scale of the crisis facing the care sector should this Bill fail to provide sufficient protection for conscientious objection. The noble and learned Lord indicated in January that he had discussions with Hospice UK on this matter, but this only scratches the surface of the consultation that ought to take place. A Care England survey in autumn last year found that 84% of care providers have not been consulted on the Bill or its implications. This has caused particular concern within the care sector.

Returning to my point, in lieu of clear protections it is clear that the sector stands on the brink. We cannot ignore the fact that, for many hospices and care homes, provision of assisted suicide on their premises is a red line that they will not cross. Mission Care is a Christian charity providing nursing and residential care in five homes across London and south-east England. Aidan O’Neill KC recently warned on its behalf that should such charities be

“required as a matter of law to allow for the provision of euthanasia or assisted suicide for residents”

within their care, they would

“no longer be able to operate in this sector”.

Mr O’Neill warns that this could

“precipitate a crisis in terms of local authority provision for care homes”.

A report from the Commons Public Accounts Committee just a couple of weeks ago found:

“The NHS is at risk of losing the huge value it gains from independent hospices beyond the provision of statutory palliative and end-of-life care”.


Given that, it is quite shocking that we are risking active withdrawal from the sector. On adult social care services, it has been estimated that faith-based organisations account for 10% to 15% of provision in the United Kingdom. This accounts for around 192,000 people. Should such organisations feel the need to withdraw, it has been estimated that it could cost £8.4 billion annually for the state to fully absorb that cost.

But it is not simply the money; it is also the special approach to care that will be lost. I will focus on Christian care homes, not because I believe they are the only group that recognises the inherent dignity of human life and they are at risk under the Bill— I believe that, deep down, we all in our conscience recognise that being is more important than having—but because, as a Christian minister for over 50 years, I have seen at first hand the distinctive benefits of what these Christian care homes can offer, and what I therefore believe is under threat from the Bill.

To take just one example of a special approach, in addition to the skills of medics and nurses, Christian care homes and hospices often provide the support of on-site chaplains and carers to treat the whole person in response to the total pain of dying. They can also offer a community that, contrary to our modern tendency to pretend that death does not exist, recognises that it does, as a part of the human condition—for we all must needs die, and it is appointed unto men once to die. Of course, that verse continues: “after this the judgment”.

In my time as a minister, it has struck me in visiting such care homes that, for many, they are much more than just the person’s own home. It is not simply a room within a facility; it is a family in which, in embracing the ethos set by the home, people can support one another in prayer, worship and investing in one another’s lives. Openness in conversation about death can be just one part of that, meaning that it is not an issue left exclusively to the person’s individual room.

That is why I struggle with the Government’s argument against care home opt-outs. The argument runs that institutional opt-outs can infringe Article 8 rights of the individual to choose to die in their home. It has been said that it would lead to stress and distress for terminally ill patients if they were forced to move. But this fundamentally fails to recognise the community aspect of life within many care homes, which is predicated on the protection of the ethos. In other words, we also must ask about the stress and distress that could be caused to other residents within the care home should things happen that fail to align with the values they have signed up for. After all, in a way it is their home too. To put it bluntly, many residents would feel a violation of the place they have chosen to be in if an assisted suicide were to take place. Many may have exercised their right under the Health and Social Care Act 2012 and the NHS constitution to actively choose a faith-based place of care because it aligns with their values, and they may not wish to be in an environment where assisted suicide is practised.

What about the impact on care staff? It is vital that we appreciate that for many of the staff working in the care sector, it is not just a job—it is a vocation. It is their life’s calling. Many offer their services free of charge. We should not just suppose that it is as simple as walking away and getting another job. I speak from the perspective of many Christian carers, not because the same depth of feeling is not true of others but because, as my community is a Christian community, I can relate to the depths of feeling. For many Christian carers, this is not a peripheral issue to their faith. Their desire to care and bestow dignity through understanding, support and relationship is driven by their belief that God is inviting man into a special relationship with Him through the giving of His Son, and has bestowed the ultimate meaning and dignity on life, which they must model in their respect, care and giving of themselves for others. In other words, it is rooted in the very heart of the Christian faith. I labour this point—recognising that this is not a perspective that many noble Lords may share—because it is vital that, in discussing conscience protection, we realise just how closely this issue draws to many people’s central identity and their expression of it.

In closing, I appreciate that the noble and learned Lord, Lord Falconer, who is responsible for this Bill, may say that he very much respects those convictions and that that is precisely why he has put protections in the Bill—so they can opt out of the most direct aspects of it. However, I question whether the current provisions are anywhere near sufficient. I do not believe that they are. Does the noble and learned Lord accept that it will be very difficult to extricate care home staff from involvement in assisted suicide were it to take place on their premises? For example, there will be organising appointments connected to the provision of assisted dying, assisting in the organisation and sending documentation connected with the provision of assisted dying, or accommodating the doctor who must remain with, although not necessarily in the same room as, the resident until they die. For many, given the centrality of this issue to their identity, these too are tasks that they may feel unable to perform. Without an explicit provision giving care homes, especially Christian or faith care homes, the option to not allow assisted suicide on their premises, I fear that we will see an exodus from that sector.

[Baroness Royall of Blaisdon (Lab)]

If my noble and learned friend were to introduce into the Bill the provisions that the noble Lord wishes, would he then be in favour of such a Bill?

[Lord McCrea of Magherafelt and Cookstown (DUP)]

I think that the noble Baroness will be under no illusion: I am personally against the Bill, because I do not believe in it. But if there is a Bill, we have to have any protection in it—that is completely different. Therefore, in the context of the suggestion that, because I am personally opposed to it, there should be no protections, I believe that, if the Bill were to pass, we should have the proper protections for people who have faith.