Terminally Ill Adults (End of Life) Bill

James Cleverly Excerpts

Friday 20th June 2025 Commons Chamber

[Sir James Cleverly (Braintree) (Con)]

I have no doubt that the vast majority in this House—probably every single hon. and right hon. Member—is sympathetic to the underlying motivation of the Bill, which is to ease suffering in others and try to avoid suffering where possible. For the most part, the debate, both in this Chamber and in Committee, has been good natured and conducted in a way that we can be proud of.

There have been wider questions about the motivations of both the proponents and the opponents of the Bill. Although this is not about any individual one of us, I think it is only fair that, because some questions have been asked, I put a few things on the record about my own position. I do not come at this from a religious point of view—I am an atheist; I am a humanist. My position is driven by my concerns about the practicalities of the Bill, rather than any religious viewpoint.

It has been suggested, particularly when people talk about their experience of talking to people who have lost loved ones or who are themselves terminally ill—this has been said to me on a number of occasions—that if we had seen someone suffering, we would agree with the Bill. I have seen someone suffering. Earlier this year, my closest friend died painfully of oesophageal cancer, and I was with him in the final weeks of his life.

I come at this from a position neither of faith, nor of ignorance, and I hope that the House will take those factors into consideration when I say what I am about to say.

[Jim Shannon (Strangford) (DUP)]

On the TV last night, they did a survey of GPs. The relationship between a GP and a patient is incredibly close. When our children and grandchildren come into the world, our GP is involved. When a GP has to deliver a diagnosis of terminal illness, there is fear not just in the eyes of the patient but in the eyes of the GP—the doctor, the friend we all have. Does the right hon. Gentleman recognise the importance of today’s debate and vote? It will change forever that relationship of trust between the GP and the patient; it will do so in a negative way and it will never change ever again.

[Sir James Cleverly]

I will refer to the hon. Gentleman’s point later in my speech. I will try not to take too many interventions, because many people have not had the chance to speak in the debate and I want to give them the chance to do so.

On Second Reading I made the point that we need to think about the detail of the Bill and not just vote in accordance with the broad principles. I made the point that, because it is a private Member’s Bill, the opportunity to change it fundamentally is limited, and so we have an enhanced duty to get it right first time. We were told on Second Reading that a lot of the concerns, worries and detailed questions would be resolved in Committee. We were promised the gold standard: a judicially underpinned set of protections and safeguards. Those protections did not make it through Committee. I have also heard people say, where there are still problems, issues and concerns, that the Lords will do that work. But none of us should think that it is right to subcontract our job to the other place.

We are making an incredibly important and fundamental change, as the hon. Member for Strangford (Jim Shannon) highlighted, in the relationship between medical professionals and those they serve. If we make that change, we will introduce a small but permanent question mark in the minds of every patient, particularly a patient who is discussing a serious illness or terminal diagnosis: “What is this medical professional expecting of me? What are they thinking? Where is their head?” Whereas, with the situation we have at the moment, the patient knows that the medical professional is dutybound to do no harm, and to preserve life and dignity wherever possible.

[Dame Siobhain McDonagh]

Next Tuesday will be the second anniversary of my sister’s death. Three weeks prior to her death, we took her to hospital because she had a blood infection. Despite agreeing to allow her into intensive care to sort out that blood infection, the consultant then decided that she should not go, because she had a brain tumour and was going to die. She was going to die, but not at that moment. I am sure, Mr Speaker, that you can understand that a very big row ensued. I won that row: she was made well, she came home, and she died peacefully. What does the right hon. Gentleman think would happen in identical circumstances if this Bill passes?

--- Later in debate ---

[Sir James Cleverly]

The hon. Lady asks me to speculate about a set of circumstances that are personal and painful. I suspect that she and I both know that the outcome could have been very different, and that the moments she had with her sister, just like those I had with my dear friend, might have been lost.

We have to recognise that this is an important moment. While I respect the hon. Member for Spen Valley (Kim Leadbeater), I disagree with her assessment that it is now or never; that it is this Bill or no Bill; and that a vote against it on Third Reading is a vote to maintain the status quo. None of those things is true. There will be plenty of opportunities. Indeed, we are dutybound, stimulated by this debate—which is why I do not criticise the hon. Lady for bringing forward the Bill—to have a serious conversation about palliative care. Many people will say that these are not conflicting or contradictory positions. But—and I will crack on because otherwise you will tell me off, Mr Speaker—we know that there could be circumstances where assisted dying would be on a statutory basis and the provision of palliative care would not.

We also have to address the point that we can all pray in aid individuals and institutions to reinforce our positions on this, but we cannot subcontract our decisions. Yes, we can fish around for people to come up with the perfect quote to reinforce our arguments, but another five minutes on Wikipedia, Google, or with friends of ours in the medical profession will find another voice that opposes that. Yes, it is a mixed picture in the medical professions, but I am struck by the number of professional bodies that are neutral on the topic of assisted dying in general but opposed to the provisions within this Bill in particular. We cannot just say, “They are neutral on assisted dying, and therefore this particular vehicle has to progress.”

We carry a responsibility—it is what we are sent here to do—and we need to take it very seriously. We must be rigorous on the specific details in the Bill. Just like the hon. Member for Spen Valley, I do not have time to go through every single argument that was had on Second Reading, in Committee and beyond, but in order to ensure that we are rigorous, there are three fundamental questions that we should ask ourselves—not lean on our friends and colleagues, but ask ourselves—and ensure that we answer fully and honestly.

[Florence Eshalomi (Vauxhall and Camberwell Green) (Lab/Co-op)]

The right hon. Gentleman will remember that, in 2021, he and I worked cross-party on identifying inequalities within certain communities and on getting them to come forward for the covid vaccination. Does he agree that one question we parliamentarians need to ask ourselves is this: how is it right that some communities are denied basic healthcare within the current system; how is it right that some communities do not have access to good palliative care; how is it right that some communities still mistrust the medical profession; and how is it right that we are not listening to their voices?

[Sir James Cleverly]

The hon. Lady makes an incredibly important point, and I will touch on that briefly in my remarks. I am minded to take no more interventions, because otherwise I will be stealing time from others.

There are three questions we need to ask. First, are we happy for this Bill—not for the principle, but for this Bill as drafted—to become law? Many of the elements that I have already discussed are concerning. In the criteria set out, medical professionals do not need to seek deeper motivation. We have said there is not a real choice between palliative care and assisted dying, because one will have a statutory underpinning and the other will not. As I say, the “gold standard” protections were lost in Committee, because a number of professional bodies and—

[Ben Maguire (North Cornwall) (LD)]

Will the right hon. Member give way?

[Sir James Cleverly]

I need to make progress.

A number of professional bodies have said they do not have the capacity. They do not have enough people to fill the slots that this Bill demands of them.

Secondly, in terms of fundamental changes, are hon. and right hon. Members genuinely happy to write the blank cheque that this Bill demands? It is normal for the Secretary of State of a Government Department to decide when a piece of legislation comes into force, and they make their decision based on the state’s ability to deliver that legislation. Commencement dates matter; they are not just some arbitrary dates on a piece of paper. I understand people’s desire to ensure that this cannot be lost down the back of the sofa when it comes to Government work, but when the people on whom we would rely to deliver this Bill say that they are not ready and that they do not feel that they will be ready—they do not have enough people and they do not have enough capacity, so they will have to take resource from current provisions to move across to this provision, which will be driven by a statutory requirement and a locked-in commencement date—we should listen. If the people who are going to make this work—and work as well as we hope it will, if it becomes legislation—say that they are not confident that they can make it happen, we should be very careful about demanding that they prioritise this. That is what this legislation says: they will prioritise this above any other work that they might otherwise do.

Thirdly—the hon. Member for Spen Valley hinted at this, and I mentioned it in an intervention in an earlier stage of the Bill—on coercion, on the pressure that individuals put on themselves and on medical professionals raising the issue, we know that there are inequalities in health provision already, none of which will be addressed by the Bill. There are certain communities, and certain people in those communities, particularly women, who are overly deferential to men and to men in authority. Can we genuinely say that we have no fear whatsoever about a potentially vulnerable woman sitting in front of a medical professional who raises assisted dying? Even if they do not imply that it is the right thing for her to do, the very fact that they bring it up will have a significant influence on that woman’s thinking. We cannot believe that the effect will be completely neutral across all communities.

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

With the safeguards that have been put in the Bill, there will be a panel that looks at those issues and asks questions like, “Has your doctor persuaded you to do this?” Do we honestly think that a social worker, psychiatrist or lawyer is totally incapable of finding coercion? That is exactly what the panel is there to do, and that is exactly what those safeguards will provide.

[Sir James Cleverly]

The hon. Lady makes an important point, but I refer her to my second question. Those bodies say that they do not have the people to populate those panels, yet that is what the commencement date demands. The principle of having a person or group of people to protect against coercion is important—I am talking not just about coercion, but about how people perceive people in authority—but royal colleges and social workers have told us that they do not believe they will be ready to put those guardrails in place by the commencement date. We should listen to them.

This is an important debate that has stimulated an important conversation, which demands our full attention, but I do not believe that the Bill is ready to go to the other place. It is interesting that there are both proponents and opponents of the Bill who hope that the Lords will make significant changes to the Bill. That should surely set off alarm bells.

Ultimately, because the Bill is such a fundamental change, we need to ensure that there is an enhanced level of scrutiny of its detail. We all want to avoid and alleviate suffering wherever possible, but I do not believe that we have had the opportunity to get the Bill into the right shape. That is why I will oppose Third Reading, and I encourage others to do likewise.

[Mr Speaker]

Order. After the two opening speeches, we will now have a five-minute limit, and I hope that Members will restrict themselves to up to five minutes. The Mother of the House will now give us a very good example.