Terminally Ill Adults (End of Life) Bill Debate
Full Debate: Read Full DebateJonathan Davies
Main Page: Jonathan Davies (Labour - Mid Derbyshire)Department Debates - View all Jonathan Davies's debates with the Department of Health and Social Care
(2 days, 14 hours ago)
Commons ChamberThank 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.
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”?
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.
I thank the hon. Member for raising that issue and giving me the opportunity to speak about the detailed evidence given by my constituent Emeritus Professor Sam Ahmedzai, with whom I spoke at length yesterday about precisely this detail. I have reviewed a number of tables of data about this. Any substance has side effects but, as the comments made today have indicated, in reality those substances are being held to a far higher standard than substances routinely used in palliative care.
We have to recognise that there is a huge amount of evidence about the efficacy of the substances that are talked about in relation to assisted dying. There is a huge amount of published, peer-reviewed evidence about the effectiveness of those substances, and people like Professor Ahmedzai, who has 40 years of experience and is a global expert in this area, point out that we know how to assist people to have a peaceful, compassionate death effectively, and that is what the Bill is about: helping people who are terminally ill to die with dignity and to face those final moments with the support, love and care of their family around them; not in agony, but in whatever degree of peace is possible when facing death.
As the hon. Member for West Worcestershire (Dame Harriett Baldwin) said, new clause 14, which relates to advertising, has been developed in consultation, as a result of concerns raised by opponents to the Bill, to try to ensure the crucial fact that assisted dying is not an advertised service. There is a crucial distinction between advertising and information, and this new clause will ensure that assisted dying remains a careful, clinical process and not something that would be promoted commercially. It is a balanced, cross-party safeguard supported by people on all sides of this debate.
I am very short of time, so I think I had better continue.
Turning to new clause 15, which relates to the role of coroners, if the Bill is passed, assisted dying would be a very strictly regulated process—the choice of an individual; not a death caused by others, but by the individual themselves. As Aneez Esmail has pointed out, this would be the most scrutinised type of death in the country, and it therefore makes no sense to require another legal process at the end when there have already been multiple layers of scrutiny before the death.
I rise to speak to my amendment 13, which concerns the appointment of the voluntary assisted dying commissioner. In Committee, it was decided that the Prime Minister would appoint the voluntary assisted dying commissioner, and that the appointee would serve for five years and be responsible for appointing the assisted dying review panels. The commissioner would also oversee the training of panel members, give them guidance on the procedures to be used and, crucially, decide when a case that a panel has refused should be referred to another panel for reconsideration. According to the Bill, the commissioner will not be acting as a judge, but they must be a current or former senior judge of the Supreme Court, Court of Appeal or High Court. However, they are not required to have any expertise in medicine or healthcare.
Importantly, following our considerations in Committee, the Bill no longer requires that the chief medical officer be responsible for monitoring whether or not the assisted dying regime complies with the law. That responsibility has now been transferred to the voluntary assisted dying commissioner, so the person in charge of overseeing the process and setting up the panels will also be the person deciding whether the Act is being administered correctly.
Given the scandals we have seen in healthcare over many years, from infected blood and medicines that should not have been prescribed to what happened at Mid Staffs hospital, it is clear that having that independent, robust oversight from the chief medical officer is a good way forward if people are going to be able to trust this legislation, if it comes into law.