Terminally Ill Adults (End of Life) Bill

Caroline Dinenage Excerpts

Friday 13th June 2025 Commons Chamber

[Paul Waugh]

I will not; I am short of time.

Just how strong are the Bill’s safeguards? We are not commentators; we are legislators. Our job is to scrutinise, to test and to test again the Bills that come to this place. I spent 26 years up there in the Press Gallery writing about politics, but the big difference between them and us is that we have a vote in this place. With that vote, particularly a free vote, comes responsibility, and there is no greater responsibility than protecting the vulnerable from feeling they have to end their life. That is why I tabled the amendment.

I am not driven by religion, though I do not believe that those with religious faiths should be denigrated or patronised, as they have been during the passage of the Bill. It is worth saying that some of those who passionately support assisted dying have a faith—a devout faith—that their world view is the right one. I am driven instead by my duty as a legislator to get this Bill right, and by what I see as my moral duty to protect the most vulnerable in society.

I believe that my duty is to protect those who do not have celebrity names or campaign groups behind them—the people who do not get heard, who do not want to be a bother, who do not want to make a fuss, and who feel at the end of their lives that they are a burden on their family but may never say so. I worry about the unheard, the unseen, the ignored and the marginalised. Most of all, I worry about the heartbreaking modesty of that phrase we often hear from older people: “I don’t want to be any trouble, love.” We need, for their sakes, to make sure that the safeguards in the Bill are the strongest they can possibly be.

[Dame Caroline Dinenage (Gosport) (Con)]

I intend to speak only briefly. We have to be really honest about where we are, and the current situation under the legal status quo is not working. It is failing terminally ill people who want choice, compassion and control at the end of their lives.

Right now, those with the means are travelling abroad to die, often alone, away from their loved ones, without medical support, and when they can physically make it rather than at a time of their choosing. Those without the means face suffering they do not want, or try to take matters into their own hands here in the UK unsafely and illegally. It is not humane, it is not fair and it is not sustainable.

I spent two years as a Minister in the Department of Health, with palliative care and end-of-life care as part of my portfolio, so this matter came across my desk on a regular basis. I have had a lot of time to think about it. It is not easy to find an answer and a solution, but we owe it to people to try to do that. That is why I support the Bill: it brings the issue out of the shadows and into a framework of regulation with safety and dignity.

[Rachael Maskell (York Central) (Lab/Co-op)]

I do not know whether the hon. Member has yet had time to read the report from the independent commission on palliative and end-of-life care, which goes into how pain and symptoms can be palliated. Ultimately, the problem at the moment is poor care and poor provision of specialist commissioned palliative care services. Will she read that report to understand the difference that palliative medicine can make for all the examples of poor care we have heard about in these debates?

[Dame Caroline Dinenage]

I certainly will read that report. The hon. Member makes an excellent point. Palliative care is really important and needs to be improved. In many cases it makes such a difference, but it is not the solution for everybody. There are the most heartbreaking cases—I have met people in these situations in my constituency—where that form of palliative care would not have made the difference. That is why I support the Bill, and that begins with new clause 13.

[Sir Desmond Swayne (New Forest West) (Con)]

On a point of order, Madam Deputy Speaker. I wonder if you can assist me as I am at a loss as to what amendment we are discussing.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I have no doubt that if the right hon. Member gives the hon. Member for Gosport (Dame Caroline Dinenage) a moment, she will address it quickly, because even Members who are contributing do not have long.

[Dame Caroline Dinenage]

Thank you, Madam Deputy Speaker. I am addressing new clause 13, which provides the strict regulation of life-ending substances and self-administering devices. That means there will be transparency about what substances are used and how they are stored, prescribed and delivered. We owe it to patients, clinicians and the public to ensure that every part of the process is governed by clinical standards and ethical safeguards. For those physically unable to swallow or self-ingest, the new clause ensures that devices to support self-administration can be safely used. Without that, we risk creating a system that excludes some of the very people it is meant to support.

While we must regulate the system properly, we must also reject amendments that would undermine or stall the Bill’s delivery. Amendment 19 proposes adding suicide prevention, the Mental Health Act and deprivation of liberty safeguards to the code of practice. As the Minister who put much of that legislation through, those are really important topics for me, but this is not the legislation to address them. Let us keep the code focused on the Bill’s core function of ensuring a safe, consistent and compassionate assisted dying process.

Amendment 20 would allow non-adherence to the code to be used in civil or criminal proceedings. That is not appropriate. Guidance is meant to help professionals navigate difficult decisions, not become a legal trap. If clinicians act negligently, existing law already applies. We should not be creating new liabilities for those acting in good faith in very difficult conditions.

I also oppose amendments 97 and 27, which would require the MHRA to license drugs specifically for assisted dying and the National Institute for Health and Care Excellence to recommend them. That would make the Bill unworkable.

[Jonathan Davies (Mid Derbyshire) (Lab)]

Does the hon. Member share my concern that the impact assessment associated with the Bill says:

“The safety and efficacy of those substances used for assisted dying is currently difficult to assess”?

[Dame Caroline Dinenage]

I am not entirely sure that I agree with that.

However, I want to talk about the MHRA, which is just not set up to license drugs for ending life. Clinical trials to support such a licence and MHRA requirement would be impossible. However, the substances likely to be used are already tried and tested in other jurisdictions and are MHRA approved for other purposes. New clause 13 already provides us with the strict regulation that we need, without putting prohibitive hurdles along the path to a compassionate and painless death.

Amendment 42 would remove the backstop date for implementation, giving the Government indefinite discretion over when or whether to put this law into effect. That cannot be right. If Parliament passes the Bill, there must be a clear and reasonable timeframe for implementation. The four-year backstop already gives Government more than enough time to get this right. Removing it simply invites delay.

This is a moment to show that we can be both compassionate and competent, and that we can bring an end to the quiet suffering caused by an unjust status quo and replace it with a system that is safe, fair and accountable. Let us support new clause 13, let us reject amendments that would add red tape or stall the Bill’s progress, and let us show dying people that we are ready to treat them with the dignity and trust that they deserve.