Terminally Ill Adults (End of Life) Bill

Debate between Daisy Cooper and Iain Duncan Smith

Report stage
Friday 20th June 2025 Commons Chamber

[Sir Iain Duncan Smith (Chingford and Woodford Green) (Con)]

I have not spoken so far in these debates, but I have listened and attended on pretty much all occasions. I am moved to speak today because I am concerned. This is the point that the hon. Member for Lewisham North (Vicky Foxcroft) made, but what is this debate today about? This debate is not about the principle of what we believe in when it comes to assisted dying—whether we are opposed to it or in favour of it. We had that debate on Second Reading. As the Mother of the House, the right hon. Member for Hackney North and Stoke Newington (Ms Abbott), made very clear—in what I must say was an excellent speech—and as others have too, today’s Third Reading debate is about what we are about to pass on to the House of Lords, which will become law. And the single question we have to ask ourselves is: is this genuinely workable now?

The hon. Member for Spen Valley (Kim Leadbeater), who moved the motion, knows that I have a high regard for her—I have worked with her on other things—but I honestly have to say that I simply cannot see how we in this House can pass this piece of legislation through to the other House, in the vague hope that somehow it will do better than us and make changes such that it will become a workable piece of legislation, and that is because this is a private Member’s Bill. If a Government were to introduce a Bill like this, we would see a great deal more input and a huge amount more checking with all those bodies. For example, we were told on Second Reading that the safeguards and protections we were sending to Committee would somehow become the most robust and strongest in the world. In fact, in Committee they got weakened, not strengthened, and that is the problem in all this.

[Daisy Cooper]

Will the right hon. Gentleman give way on that point?

[Sir Iain Duncan Smith]

If the hon. Lady will forgive me, I understand that many others want to speak, so I am going make a bit of progress if she does not mind.

The other important point, when we think about what our vote today is all about, is the behaviour of the professional bodies that have been consulted on this, which have come out for the most part very strongly opposed to this legislation.

[Daisy Cooper]

Every medical college has retained a neutral position. By my count—[Interruption.] I will go on. By my count, two or three medical colleges have said expressly that they welcome specific amendments to the Bill, and all MPs will have received the letter from senior psychiatrists, who include a former president of the college, who said:

“We believe the draft legislation is workable, safe and compassionate.”

A number of safeguards have been included in the Bill. Does the right hon. Gentleman recognise that additional safeguards have been included and have been welcomed by various royal colleges?

[Sir Iain Duncan Smith]

I simply do not agree with the hon. Lady on that reading. The professional bodies are completely divided, and most have come out in opposition to the nature of this legislation. It is all very well for her to say that, and I appreciate her right to say it, and I hope she gets to speak later, but I just do not agree with it.

As was said earlier in the debate, the whole issue of mental capacity is not dealt with properly in the structure of this Bill. The hon. Member for Spen Valley talked about this earlier, and she was absolutely right. Even the amendments that were proposed were not always accepted, and we are left now with some areas that will be deeply troubling. We simply cannot accept that the Lords must make these changes for us, for we have to make them first. That is the key.

The one big important area here—I absolutely agree with my constituency neighbour the Health Secretary on this—is that we talk a lot about choice in dying, but how is that choice informed if palliative care in the UK is simply not good enough? Again, the Mother of the House spoke about this, and there are so many people affected: the most vulnerable; the people furthest away from institutions; and the ones who understand least how to work the health service or their local authority, and who rely mostly on us to try and break through. They will be faced with this problem more than almost anybody else, because they look in fear on these institutions.

I helped to set up a children’s hospice, which I think was the first in London. There have been many more since, but children’s hospices, as we know, are really badly treated by Government spending, pretty much no matter who is in power. They have less than anybody else. Haven House, which I helped to set up and raise money for, has given a very strong quote, which I think represents much of what most of those hospices have said:

“We would fully agree that a change in the law would have very significant consequences for the delivery of palliative care services and would be challenging given the existing resource pressures that we face. The hospice sector is experiencing significant financial pressures and the exceptional palliative care services we provide are not financially sustainable. The introduction of assisted dying would create new and demanding requirements for palliative care services and hospices in particular. It is therefore vital, whether or not the current legislation is passed, that the government takes urgent action to resolve”

this matter.

That is the case today. We cannot just say, “Well, that’s not our problem. Palliative care can be changed.” The trouble is that we have been unable to make the necessary changes to palliative care because we take such parti pris positions. That is the problem we face.

I will end with this. I will vote against the Bill, mostly because I believe it is fundamentally unworkable and will lead to huge problems. We have seen what has happened elsewhere internationally—Canada, Oregon and various other places—where legislation slides and slides again as more and more amendments have to be made because these things are not workable. To those who have any doubt, I simply say this. This is Third Reading; it is not Second Reading—it is not an “in principle” debate. We had that debate, and now we have to decide whether we should send this unworkable piece of legislation to another place, which is unelected, to make the decision for us because we cannot come to a conclusion. We cannot let this go through.

Health and Care Bill

Debate between Daisy Cooper and Iain Duncan Smith

Consideration of Lords amendments
Monday 25th April 2022 Commons Chamber

[Sir Iain Duncan Smith (Chingford and Woodford Green) (Con)]

I will speak briefly to Government amendment 48A, which is in lieu of amendment 48B. Essentially, it requires the health service to ensure that it does not use products made under forced or slave labour anywhere in the world. That is a big statement by the Health Department, and one that I think we all welcome—I have certainly campaigned on this issue for some time.

In the great sweep of this health legislation, on which there are agreements and disagreements across the board, that may not seem to be something that will directly affect our lives, but in truth it will resonate beyond our shores. It is already resonating among the Uyghur, who have found themselves under distinct pressure, with husbands often separated from wives and families broken apart for forced labour thousands of miles away from their homes. This measure will speak to them; it is, in a way, a sign that Governments in the free world are taking up this real cause and recognising that it is intolerable for us to turn a blind eye and buy equipment, clothing and so on simply because it is cheaper and helps our cost balance. I do not believe that it will in the end; the trade-off between cost and the human rights of those who have suffered so much under the heel of those totalitarian states is an abysmal one.

Child labour is used in rare-earth mines; when we use those rare-earth materials for the manufacture of our computers, we turn a blind eye to it. When slave labour is used in the Xinjiang region to produce the cotton and the cloth for our personal protective equipment, making it quicker and easier to get, we turn a blind eye to it. It is not just done there; it is done in many countries around the world because it is easier and cheaper, and we tolerate it. I therefore welcome that my right hon. Friend the Secretary of State and the Ministers have tabled the amendment. It will speak volumes to those who are oppressed. It will say to them, “The free world has not forgotten you.” I am certain that in due course the rest of this Government will do the same, and other Governments will then follow suit. I congratulate us for making the right decision.

[Daisy Cooper (St Albans) (LD)]

I will speak to the workforce amendment and the amendment on the social care cap.

The Lords have compromised on the workforce amendment—they have now asked for projections every three years instead of every two, and they no longer require independent verification of the projections—so it is deeply disappointing that the Government have not moved to meet them halfway, especially when outside the Government there is so much cross-party consensus that the amendment is badly needed. I know from my constituency of St Albans, as I am sure many Members know from theirs, that our NHS and care staff are burnt out. They are understaffed and overworked. Those people, who continue to turn up every single day, need to know that the cavalry is coming, and without this workforce amendment, they simply will not.

There have been worrying reports that NHS trusts have been silenced when they have tried to talk about the numbers of staff that they need to recruit, so will the Minister address this question in his response: if the Government will not produce workforce planning numbers, will they at least commit to not interfere with or silence any part of the NHS or care sector that decides that it wants to produce its own workforce projections? I look forward to hearing the Minister’s assurances on that point.

When it comes to the social care cap, Ministers have stated time and again that their changes would save the Treasury £900 million a year by 2027-28, but that saving comes at the expense of people with fewer assets and savings, including those who will have been paying five years of increased national insurance contributions, which were put in place partly to fund these care reforms. The Government continue to say that that improves on the current situation, but they conveniently ignore that it is much worse than their original proposal. The social care cap provision does nothing to generate more care; it does nothing to give protections to unpaid carers, who are often on lower incomes but save the Government millions of pounds; and it does nothing to help the social care workforce. I know from my constituency that hospitality, the NHS and social care are all fighting for the same people, and nothing in the Bill will help to improve that situation.