Terminally Ill Adults (End of Life) Bill

Calum Miller Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[Dame Siobhain McDonagh]

Its potential is to alter everything in a very undemocratic manner. In this very Chamber, Nye Bevan told us that the NHS would

“lift the shadow from millions of homes...keep very many people alive who might otherwise be dead...relieve suffering...produce higher standards for the medical profession”

and

“be a great contribution towards the wellbeing of the common people”.—[Official Report, 30 April 1946; Vol. 422, c. 63.]

We have a duty in this place to defend that promise. We cannot allow the promise to be reworded without the full voice of Parliament. We owe it to the public, to patients and to the NHS staff who dedicate their lives to this service, to stand firm and protect what is sacred.

The amendment is simple but its impact is profound. It would ensure that any future changes to the core principles of the NHS must be debated openly, transparently and with the full consent of every Member—no short cuts, no sidestepping, no ministerial overreach. I urge colleagues across the House to support amendment 12, to stand with our NHS and with the people it serves. I urge my side—the Labour side—not to allow the assisted dying Bill to be the trojan horse that breaks the NHS, the proudest institution and the proudest measure introduced by our party in 120 years.

[Calum Miller (Bicester and Woodstock) (LD)]

I rise to speak in support of amendments 21, 103, 104 and 42, tabled by my hon. Friend the Member for Twickenham (Munira Wilson), the hon. Member for Newcastle-under-Lyme (Adam Jogee) and my hon. Friend the Member for Wimbledon (Mr Kohler). As other Members have said, this is a deeply consequential Bill. I want to record my thanks to the hon. Member for Spen Valley (Kim Leadbeater), to all members of the Bill Committee, and to all those who have contributed to its careful scrutiny through the tabling of amendments and debates over them.

The Bill is about the end of life. It is an emotive and sometimes painful topic, and I am grateful to the many constituents who have generously shared with me their experiences and opinions. I have also taken some time to consult palliative care practitioners, including those providing hospice care in my constituency. Those conversations reinforced the awe and admiration I hold for these caring professionals. Their expertise and deep commitment are always impressive. Contrary to the points made by the hon. Member for Gosport (Dame Caroline Dinenage), they are adamant that they can provide sufficient pain relief to the vast majority of those receiving end-of-life care. The issue is about not the efficacy of treatment, but access to it. In this, I echo the powerful points of the hon. Member for East Renfrewshire (Blair McDougall) on the present inequality of access to palliative care.

Amendment 21 would ensure that the availability, quality and distribution of palliative and end-of-life care is published within one year of the Act being passed. When assessing the provision of end-of-life care, it is critical that this House and the public can see how palliative care is being delivered. For the measures in the Bill to provide a genuine choice to those at end of life, palliative care must be much more widely available.

The hon. Member for Spen Valley (Kim Leadbeater) argues that there should be no false choice between palliative care and assisted dying, yet she and health Ministers know that there is a choice as resources are limited. When so many hospices have closed beds due to funding shortages and receive more than 70% of their funding from donations, I am concerned that we may see significant expenditures on a new regime for assisted dying, funded by the state as a health treatment, while the palliative care sector and hospices in particular remain chronically underfunded.

[Josh Fenton-Glynn (Calder Valley) (Lab)]

rose—

[Calum Miller]

I will not give way.

Only by having the assessment of the palliative care system that is proposed in amendment 21 can we be confident of knowing whether access to palliative care is sufficient. If we are to provide a true choice at end of life, that is critical.

I also stand in support of amendments 103, 104 and 42. Amendments 103 and 104 would give this House a say over the key decisions that still remain to be taken on the implementation of the Bill. Given the significance of the Bill and the importance of the many questions still to be resolved, these amendments are critical.

Amendment 42 would ensure that we do not career towards the enactment of this Bill in four years whether or not the system is ready to operate safely and fairly. Taken together with amendments 21, 103 and 104, this would ensure that this House has the chance to consider whether those at end of life can access the full range of support, advice and protections intended by the Bill, and which they deserve from palliative care services across the country.

Like so many in this House, I have direct personal experience of the issues addressed by the Bill. My father was diagnosed with stage 4 cancer in May 2002. Over seven weeks, he and my family benefited from the incredible care of our local hospice. Sharing my dad’s life, care and death has shaped me, so I fully understand why so many of my constituents have asked me to vote on this legislation in the light of their and their loved ones’ experience.

Yet our task is to legislate for a new system that will affect thousands of people and society as a whole. However this House votes on this Bill, our debates must result in a new focus on the provision of palliative care, so that all people at end of life truly have options in the management of their care and death.

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

I rise to support amendments 34 to 36 and new clause 6, tabled by my right hon. Friend the Member for Walsall and Bloxwich (Valerie Vaz), who sadly cannot be here today.

Health inequality shapes life expectancy and outcomes —covid deaths illuminated that—but it is absent from the Bill. A younger me would have been 100% behind this Bill. I am very pro body autonomy when it comes to abortion, but 10 years of being an MP has exposed me to coercion, duress, the billionaire price of London property, and elder abuse. It is no coincidence that, like me, the majority of London MPs and of black and minority ethnic MPs oppose the Bill.

Let us look at amendment 34. The experience of my aged parents—now no longer with us—opened my eyes to a world of pills, incontinence pads, hoists, power of attorney, key safe boxes and carer worries. I saw how non-native English-speaking pensioners—I am not talking about Welsh speakers—have their agency denied, perhaps unconsciously, by health professionals in a stretched system. My mum’s GP had a clear contempt for her accented words. At every appointment she would say to her, “One question only”. As my mum grew frailer and began to lose the power of speech, she reverted to her mother tongue and was seen by hospital teams as an annoyance, a time waster, and bed blocker. Similarly, the disabled are often written off. People cannot see beyond the wheelchair or the non-verbal. Amendment 34 would place a duty on the chief medical officer to provide information at every step of the way

Mental Health Bill [Lords]

Calum Miller Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Wes Streeting]

I am extremely grateful to my hon. Friend for sharing such personal lived experience of the issues we are debating this afternoon. I encourage her to take every opportunity to share those experiences directly with Ministers or through the passage of this Bill, which others in a similar situation will also have had, so that we can provide the best possible support for people experiencing a mental health crisis and for their loved ones, who also experience an enormous amount of pain and anxiety in supporting someone going through acute mental illness.

We are also updating the outdated nearest relative provisions to allow patients to choose someone to be their nominated person, which gives that individual important powers to represent the patient’s interests when they cannot represent themselves. One patient explained:

“My mother used to perform this role, but she now has Alzheimer’s and she lacks capacity. Under the current system, I cannot specify who I wish to serve as my nearest relative. The responsibility would automatically go to my oldest sister—a sister I do not get on with”.

Our reforms will ensure that this statutory role is not chosen for the patient, but is rather the choice of the patient.

Advocacy services are often a lifeline for those who find themselves in the vulnerable position of being detained, giving a voice to those who may otherwise feel voiceless. Patients have reported that an advocate can ensure that

“their voice and opinion is valued and listened to. They came to my meetings, valued my opinion and put my views across to other people. People listened to my advocate.”

We are also extending advocacy services to patients who come to hospital voluntarily and making changes to improve advocacy uptake among those who are detained, as well as working to change the culture of our health and care services so that everyone is listened to and so that patients do not have to rely on an advocacy service to get their voice heard.

[Calum Miller (Bicester and Woodstock) (LD)]

I am grateful to the youthful Secretary of State for giving way. In the past few months, I have had a number of constituents describe the difficulties they have had in transitioning from care provided by child and adolescent mental health services to adult mental health services—a critical transition. They specifically faced difficulties in accessing the same medication when they turned 18 that they had previously been reliant on as young people. Can the Secretary of State describe to me how either the Bill or the change in culture for which he is advocating will improve the situation for people like my constituents?

[Wes Streeting]

I am grateful for that intervention. The hon. Gentleman raises what is, frankly, the depressingly familiar issue of the transition from youth and adolescent services to adult services, which applies across such a wide range of public services. It is so frustrating that we are still, in this decade of the 21st century, describing a problem that was prevalent in the ’90s and noughties.

None the less, we are working to improve not just the law, but the performance in this space. Many of the changes we will be looking to make under the auspices of our 10-year plan are about better joining up of data, information and patient records, better care planning for patients and designing services around patients so that everyone—whatever their age or stage of treatment—receives joined-up services, with clinicians having a full picture of that patient’s experience. Hopefully, that will also help to deal with some of the cliff edges and bumps in the road that people can often experience when transitioning from one part of the NHS to another, whether that is from youth and adolescent services to adult services or the interface between primary and secondary care.

Oral Answers to Questions

Calum Miller Excerpts

Tuesday 6th May 2025 Commons Chamber

[Stephen Kinnock]

After years of neglect, this Government have agreed with the sector a record uplift to £3.1 billion for 2025-26 for this vitally important front door to our NHS. We are also supporting pharmacies to operate more efficiently, including enabling hub and spoke dispensing between all pharmacies later this year. I am pleased to say that the legislation for that has been laid. What a contrast that is with the previous 14 years. I am also pleased to see that the National Pharmacy Association has withdrawn its view on taking collective action. We are moving in the right direction, but there is still a lot more to do.

[Calum Miller (Bicester and Woodstock) (LD)]

I welcome today’s announcement of new money for GPs’ surgeries, but GPs in my constituency tell me that they cannot get capital out of the integrated care board and that the Valuation Office Agency consistently undervalues the cost of rents, making future building impossible. Will the Secretary of State agree to meet me, and GPs from my constituency, in order to understand the problem better?

[Wes Streeting]

Thanks to the investment that we have announced, those practices will be upgraded. I advise the hon. Gentleman to engage with his local ICB. We are happy to receive representations if we can help, but let me gently point out that the investment is only possible thanks to the decisions made by the Chancellor, which he opposed.

Hospitals

Calum Miller Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Stephen Kinnock]

My hon. Friend is also a doughty champion for his constituents. With each brick we build in the new hospital programme, I hope that we will start to rebuild some trust between his constituents and this place. He is absolutely right to point out that it is much better to have a realistic programme, rather than one built on smoke and mirrors.

Officials reported on the review in the autumn and set out a range of options for a more realistic timetable for delivery. In January, my right hon. Friend the Secretary of State for Health and Social Care announced five-year waves of investment, backed by up to £15 billion of investment over consecutive five-year waves, averaging £3 billion a year from 2030. Our programme is a balanced portfolio of hospital schemes at different development stages, being delivered now and into the future. It is the most efficient and cost-effective way of giving our NHS the buildings it needs, while also giving the construction sector the certainty that it needs to deliver.

[Calum Miller (Bicester and Woodstock) (LD)]

The Minister referred to the capital needs of the NHS as a whole. As my hon. Friend the Member for North Shropshire (Helen Morgan) mentioned, that applies to many GP surgeries too. In my constituency, we have rapid growth in population. The populations of Woodstock, Heyford Park and Bicester are struggling, because GPs want to expand, but they cannot access the money to do so. Will the Minister look urgently at releasing more funds through integrated care boards so that future revenue can be provided to allow for the capital investment that would give my constituents an expansion in GP surgeries and take some pressure off our much-pressurised hospitals?

[Stephen Kinnock]

I was very pleased to see the £102 million capital investment in GP primary care. I encourage the hon. Gentleman’s ICB to look very carefully at that fund and to explore the potential that it offers. We are in conversation with colleagues in the Ministry of Housing, Communities and Local Government about ensuring that section 106 processes are working properly, so that when there are new developments, there is proper wraparound in the social infrastructure required to make them sustainable. In the space of just nine short months, we have gone from a charade based on smoke and mirrors to a programme based on serious, systematic delivery.

Oral Answers to Questions

Calum Miller Excerpts

Tuesday 7th January 2025 Commons Chamber

[Alistair Strathern (Hitchin) (Lab)]

9. What assessment his Department has made of the adequacy of patient access to primary care services.

[Calum Miller (Bicester and Woodstock) (LD)]

10. What recent steps he has taken to increase access to GP appointments.

[The Secretary of State for Health and Social Care (Wes Streeting)]

Today there are 1,399 fewer full-time equivalent GPs than in 2015, and NHS dentistry is at death’s door. This Government will fix the front door to the NHS. We have announced an additional £889 million in funding for general practice in 2025-26—the biggest boost in years—and we have already started hiring an extra 1,000 GPs on the frontline. Our 10-year health plan will shift the focus of healthcare out of hospital and into the community.

--- Later in debate ---

[Wes Streeting]

My hon. Friend has been raising these issues with me since before he was elected to this place on behalf of the communities he represents. As I said to my hon. Friend the Member for Barking (Nesil Caliskan), we must make sure that additional housing—which is desperately needed—is accompanied by health and care services. The Deputy Prime Minister and I are working together to achieve just that, and thanks to the decisions taken by the Chancellor in the Budget, we are able to invest in the health and care services that this country needs and deserves.

[Calum Miller]

Woodstock surgery in my constituency is not fit for purpose. In September, heavy rain fell and caused the roof to collapse, causing the surgery to close. The nurse literally sees patients in a broom cupboard. The GPs want to increase their capacity to see more patients, but have been unable to access sufficient capital from the integrated care board. Will the Secretary of State meet me and the Woodstock GPs to discuss how the reforms announced yesterday will help them build a new surgery, so that they can see patients faster?

[Wes Streeting]

I am grateful to the hon. Member for that question. I am incredibly sorry about the awful conditions in which staff in that practice are having to see patients and in which the patients it serves are having to be seen—that is the epitome of the broken general practice system that we inherited. Thanks to the decisions taken by the Chancellor in the Budget, we are able to invest in the capital estate need in the NHS. That will take time, and we would be delighted to hear more about that individual case to see how the ICB and the NHS can assist.

--- Later in debate ---

[Andrew Gwynne]

We absolutely want to ensure early detection of these cancers, and I recently met representatives of the Brain Tumour Charity to discuss how we can roll that out. The Government are investing an awful lot of money in tackling cancers, but there is a great deal more that we can do on brain cancer.

[Calum Miller (Bicester and Woodstock) (LD)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Wes Streeting)]

We have been busy announcing investment in hospices, an uplift in funding for general practice, action through disabled facilities grants and a new independent commission on adult social care, and yesterday the Prime Minister announced the elective care reform plan. As I have said, however, the NHS is experiencing a period of significant winter challenge. The number of beds occupied by people with flu has been much higher than the number last year, and is continuing to rise. An average of just over 4,200 beds were occupied by flu patients at the end of December, surpassing the peak of about 2,500 reported last year. We monitor the situation closely, working hand in hand with NHS England and care leaders, and I continue to chair weekly meetings with senior leaders in social care, NHS England and the UK Health Security Agency.

[Calum Miller]

I am sure the Secretary of State will share my shock and anger about the number of young people in my constituency who are waiting more than four years for a first assessment by child and adult mental health services. Can he confirm that yesterday’s commitment by the Prime Minister that patients would not wait more than 18 weeks for a first appointment will apply to CAMHS in Oxfordshire?

[Wes Streeting]

We are determined to improve children and young people’s experience of both mental and physical health services, and we are determined to do more to ensure that mental health and paediatric waits are put under the spotlight and given the same attention as the overall elective backlog. I am sure we will have more to say about that when we publish the 10-year plan.