Terminally Ill Adults (End of Life) Bill

Baroness Smith of Llanfaes Excerpts

Friday 19th September 2025 Lords Chamber

[Baroness Smith of Llanfaes (PC)]

My Lords, I begin by thanking the hundreds of people who have written to many of us about the Bill. Their letters, often deeply personal, deserve our attention and respect: diolch yn fawr iawn—thank you.

I have also listened carefully, last Friday and again today, to the many thoughtful contributions from noble Lords, each informed by personal and professional experiences. As this is a matter of conscience, I will share my own perspective. My view on the principle of the Bill has been shaped in part by my own experiences as a carer for my late father and by the experiences of my friend Claire O’Shea, who recently passed away at the age of 42.

Claire was initially misdiagnosed with IBS and was later diagnosed with terminal gynaecological cancer. In the face of her devastating diagnosis, she founded Claire’s Campaign, turning her own difficult experience into a campaign for change in Wales and building a platform to amplify the voices of women who had long gone unheard. Claire said last November:

“This Bill legislates for people with a terminal diagnosis and 6 months to live. Thankfully there aren’t many of us who are facing those circumstances imminently. So for those of us, who will face this reality sooner rather than later, this bill offers something really important. I have excellent palliative care; but it doesn’t address all of my needs and how I imagine a good death. It’s not just about pain management”.


For many people facing the end of life, simply having the choice, even if they never act on that choice, can bring immense comfort. For those reasons, I support the principle of the Bill.

Clear communication in healthcare is vital, especially when people face complex decisions. That is why I want to highlight the clause in the Bill, secured by my colleague in the other place, Liz Saville-Roberts, which requires that “all reasonable steps” be taken to ensure access to assisted dying services in the Welsh medium. Imagine discussing such sensitive matters with your GP and being unable to use your first language. Welsh speakers must be able to receive care yn eu mamiaith —in their mother tongue.

However, I must raise a serious concern: the constitutional implications of the Bill for Wales. While the criminal law remains reserved, health is not. The Bill, if passed, will have serious consequences on a completely devolved matter in Wales. Just less than a year ago, the Senedd debated assisted dying. The result was 19 in favour and 26 against. Those voting against included the First Minister and the Health Minister. So I ask this House: if the Bill proceeds at Westminster, are we comfortable asking a Welsh Government Minister who has voted against the principle of assisted dying to make the decision on whether to deliver this service within the NHS in Wales? Should the Senedd not have the first say on whether such a service should be introduced at all in Wales? It is the Senedd’s role to scrutinise the delivery of health services in Wales, and the Welsh Government’s budget would fund any new service.

In Committee in the other place, a provision was inserted to reflect the need for devolved consent. Regrettably, this was removed on Report. This is deeply problematic. There is a strong argument that the entirety of the Bill engages devolved responsibilities. Restoring a requirement for the Senedd’s consent makes sense, regardless of what your view is on the Bill’s principle.

As the Bill continues its passage through this House, I urge all noble Lords to reflect carefully on not only the moral weight of the matter before us but the constitutional responsibility we bear. We must respect the role of devolved Parliaments in matters that are clearly their responsibility.