Terminally Ill Adults (End of Life) Bill

Graham Stuart Excerpts

Friday 16th May 2025 Commons Chamber

[Siân Berry (Brighton Pavilion) (Green)]

I will speak only briefly, as I spoke in favour of the Bill on Second Reading in November, my name is on it, and I have long supported the campaigns to change the law, including those of Dignity in Dying and Humanists UK, of which I declare I am a member and patron.

Since the vote on Second Reading, I have met and listened to a range of groups, professionals and individuals, mainly those who have concerns and those who want to see further changes made. In Brighton that has regularly included constituents at my surgery, as well as a group of leaders of local faith groups and charities who provide support to different vulnerable groups, including disabled people.

Today we are debating about half of the more than 100 proposed amendments, led by several tabled by the hon. Member for Spen Valley (Kim Leadbeater), who has set out so well how she put them together based on her own very detailed work with civil servants and her listening, including to opponents. I cannot commend her work and that of the Committee more.

The new amendments from the promoter of the Bill include welcome changes to transparency rules and how the processes and decisions made are reported and scrutinised. Other MPs have also tabled many carefully drafted and clear proposals. On eligibility, I continue to support people with slowly progressive neurological diseases, such as motor neurone disease, as reflected by my support for amendment 4, which I have signed and which was argued for so well by the hon. Member for Harrogate and Knaresborough (Tom Gordon).

I intend not to list lots of amendments, but to set out briefly the approach that I will take to those amendments being debated, before listening to the rest of the debate and then deciding how to vote, because I believe we must end up with the strongest, clearest and fairest process for making decisions, safeguarding against abuse, scrutinising the use of the policy after it becomes law, and providing the very best and most appropriate help to people who want this choice at the end of their lives.

I aim to back strongly the amendments that demand greater reporting and recording of decisions made and that demand transparency, including financial transparency, demographic data and other statistics from those who are supervising decisions and providing the new service, including the new supervising commissioner. The ability to monitor the implementation of this policy, ensure it is working as intended and detect any problems immediately is really important to me. I will also back changes in the process that ask for more training for those taking part in decisions and to ensure fair and effective communication throughout, including new language requirements

However, I am not currently aiming to support amendments that I think place undue, compulsory, additional burdens, hurdles, intrusions or demands on the people applying for permission to make this choice beyond what is in the Bill currently. On the basis of what I have heard, the experiences of many of my constituents and the statistics, the people asking for this choice will, by definition, be at the end of a horrible disease—often terminal cancer—which they will have fought, and fought with their doctors, for a long time. They will now be facing their final months in a situation of potentially huge suffering over which they have no control and that they fear greatly.

We must all remember that only dying people are eligible. In the vast majority of these cases, the person’s eligibility, capacity and reasons will be more than clear to the decision makers. I believe we must enable those cases to be approved in a respectful, caring and compassionate way, and as swiftly as the current Bill process allows.

In other cases, where things are less clear, I agree: many more questions may need to be asked. I believe that the professionals currently tasked in this rigorous process under the Bill will be very well placed to judge when more information, consultation and investigation will be necessary. Under the current rules, along with the amendments and new clauses I support, they will also have to account very clearly for what they ask and what they decide under effective scrutiny.

I cannot, therefore, support proposed changes that would make every applicant subject to additional intrusive steps and interrogation, with somebody appointed to argue against them, extra processes or compulsory psychological investigation.

[Graham Stuart (Beverley and Holderness) (Con)]

Will the hon. Lady give way?

[Siân Berry]

I am sorry, but I am on my last paragraph.

Those measures are effectively barriers to helping eligible people make their own choice for when and how to die at the end of all they have suffered.

I truly believe we must not make the process of gaining permission any harder or more traumatic than we need to. Although I am listening hard to the arguments made, quite a few of the amendments and new clauses cross that line. These momentous decisions about our deaths must be led by compassion, and must not be made to seem like yet another battle for people who have already given their all to staying alive.

--- Later in debate ---

[Stephen Kinnock]

I will make some progress, if I may.

Amendment 87 would require the co-ordinating doctor to “take all reasonable steps” to establish whether a first declaration had previously been made, so it may slow down the process for accessing assisting dying.

Amendment 45 would significantly impact the operability of the Bill. It would duplicate the role of the assisted dying review panel, and place an additional burden on the co-ordinating doctor to convene the clinical panel. It would also require additional NHS and social care resources, particularly palliative care consultants. That could slow down a person’s access to an assisted death, because there is no requirement on when the panel must be convened, and it could take some time to set up, given the demands on health and social care professionals. The amendment does not specify who is to be on the clinical panel in situations where the co-ordinating doctor is neither a GP nor a consultant. Similarly, there is no provision for whether the clinical panel is to make its decisions unanimously or by majority.

Amendment 48 would require significant changes to the functions and focus of the bodies that are proposed to present arguments to the panel as to why a certificate of eligibility could not be granted. Where an official solicitor acts as an advocate to the court, their purpose is to assist the court on a difficult or novel point of law, not to perform an adversarial function. Similarly, there is no precedent for the Attorney General, His Majesty’s Procurator General or the Treasury Solicitor to intervene in a case in the way that is envisaged, as their roles are to act on behalf of, or provide advice to, the Government, and not to represent a specific argument. In the Government’s view, there are no existing public bodies that are well suited to undertaking this adversarial role.

[Graham Stuart]

Has the Minister any sympathy with the point made by my right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright)? The panel might struggle to get the evidence it needs to make a decision, and there is no mechanism to address a situation in which, in the absence of that evidence, the panel makes a decision, but evidence then comes forward that suggests that its decision was incorrect. Does the Minister have any workable ideas for addressing that issue?

[Stephen Kinnock]

Clause 15 sets out the process that the panel must go through. It includes a right for the panel to request information and input from a range of potentially interested people. Clause 15(4)(d) appears already to cater for the intended effect of the amendment in the name of the right hon. and learned Member for Kenilworth and Southam (Sir Jeremy Wright).