Terminally Ill Adults (End of Life) Bill

Jonathan Davies Excerpts

Friday 13th June 2025 Commons Chamber

[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.

--- Later in debate ---

[Ellie Chowns]

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.

[Jonathan Davies]

Will the hon. Lady give way?

[Ellie Chowns]

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.

--- Later in debate ---

[Patricia Ferguson]

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.

[Jonathan Davies]

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.

Obesity: Food and Diet

Jonathan Davies Excerpts

Monday 20th January 2025 Commons Chamber

[Ben Coleman]

I am grateful for the right hon. Gentleman’s comments. I was not attempting to put together the whole puzzle, but additives are an extremely important part of the puzzle. We do ourselves a disservice if we pretend that sugar, salt and fats—eaten in the quantities they are today—and the ready food that can be bought so cheaply are not poisonous, and not huge problems that we need to address.

I am not wild about the term “obese” because of the negative, pejorative connotations that can make people feel awful about themselves, as has been said, but it is the best term we have at the moment. Over a fifth of children in this country—22.1%—are obese. The figure is even higher in my constituency, which contains some of the country’s richest people, as well as many residents living in poverty. In the London borough of Kensington and Chelsea, 23.4% of reception pupils, aged four to five, are obese. In the borough of Hammersmith and Fulham, 22.4% of reception pupils are classified as obese. This is a problem everywhere, not just in the poorest parts of the country. It is therefore hugely good news that the Government have identified a shift from ill health to prevention as one of the three major objectives of their health mission.

It is even better news that a cross-Government national food strategy is being developed. What would I like to see in that national food strategy? What should be done? I would like us to start by realising that it is time to stop placing excessive emphasis on individual responsibility. That may be hard to swallow for some people, but the Lords report makes it clear that 30 years of policies that rely solely on personal choice, rather than tackling the underlying drivers of unhealthy diets, have failed to shift the dial. Sadly, under successive Governments, these policies have contributed to widening health inequalities.

As my hon. Friend the Member for Bolton South and Walkden (Yasmin Qureshi) noted, the Lords report rightly praised the last Government’s sugar tax on soft drinks. Officially called the soft drinks industry levy, it was a significant public health success—people are consuming less sugar. While obesity remains an overall problem, it has fallen to an extent, particularly among girls aged 10 and 11 in the most deprived areas. Fewer children are having to go to hospital to have their decayed teeth pulled out. That brings me to the lack of dentists after 14 years of Conservative Government, but I will not go there now. The sugar tax has saved millions, possibly billions, of pounds in healthcare costs, as well as a lot of misery. It is a pretty good example to follow, so I support the call by my hon. Friend the Member for Stroud for the levy to be extended to more food products and for similar action to be taken on salt and fats.

I am glad that the Government are delivering on their manifesto pledge to give children the best and healthiest start in life by banning the targeting of junk food at children. Just as advertising restrictions contributed to a decline in the number of smokers, I hope that restricting the advertising of unhealthy foods will contribute to a decline in childhood obesity. I also agree that labelling food better, to distinguish between healthy and less healthy products, is essential. It already works, as allergy sufferers are benefiting from Natasha’s law, which requires food businesses to fully label their ingredients.

However, targeting unhealthy food is not enough. Even unhealthy food is better than no food, for those who cannot afford healthy ingredients, for those who cannot find healthy ingredients or for those who do not know how to cook them. I am not arguing that we should make crap food so expensive that people are forced to go elsewhere to buy even more expensive alternatives. As the hon. Member for Newbury (Mr Dillon) said, it is of fundamental importance that healthy food should be affordable to everyone and widely available wherever they live. At the moment, it is far from either. It is no good badgering people to eat five pieces of fruit and veg a day if they cannot afford to do so or if it is not available locally—that is just patronising.

[Jonathan Davies (Mid Derbyshire) (Lab)]

I am surprised that no one has mentioned the rise of food banks. Does my hon. Friend share my view that, although well-meaning people give produce to food banks, it is often tinned products or ready meals that people need to cook at home, which may be an inadvertent driver of this issue?

[Ben Coleman]

That is a very good point. The poverty in this country now and the cost of energy is causing people in my constituency to go to food banks and ask for foods that they do not have to cook. We are offering people food that might not always be of the best quality, and food banks tell me that a lot of healthy, fresh fruit and veg goes to waste because people are either worried about the cost of energy or simply do not know how to cook. These are addressable problems; these are things that we can do something about if we want to do so.

I strongly back the House of Lords report’s recommendation that the revenue from a salt and sugar reformulation tax should be used to make healthier food cheaper, particularly for those on low incomes. I would like some of the revenue to go to organisations such as Alexandra Rose, a charity operating in my constituency. It makes healthy food affordable and accessible to families on low incomes by handing out vouchers so that pregnant women and the families of children under five can buy fresh fruit and veg at local markets or independent shops.

In the heart of Fulham, 376 families and 587 children have enjoyed £85,200-worth of fresh fruit and veg from our wonderful North End Road market, which has operated since late Victorian times. Alexandra Rose tells me that, six months after starting the project, 64% of children are meeting their five-a-day target, compared with just 7% when it began. As the Government develop their food strategy, I encourage them to consider supporting such charities to extend their work through national action.

Another issue is the accessibility of food, and I do not think this point is addressed enough. Many parts of this country are healthy food deserts. In his annual report, Professor Sir Chris Whitty, the chief medical officer, said that

“families in inner-city areas are less likely to have access to healthy, affordable food options”

and as a result they will have shorter and unhealthier lives. We have to ensure that good food is available at an affordable price. I hope the food strategy will look at that, as well as at teaching basic cookery in schools—that is another important point.

Change will take time, but it can be done. It just needs the political will. I hope we will reach a position where, if Mr Horniman could come back to see us, he would be delighted. After all, we must remember that he took immense pride in the tea his family produced; it was one of the very few to be declared free of chemicals and safe to drink in the 1850s. Let us hope we can say the same about our food in the future.

Puberty-suppressing Hormones

Jonathan Davies Excerpts

Wednesday 11th December 2024 Commons Chamber

[Wes Streeting]

I thank the hon. Member for her question. On the cases of young people who have been on a gender identity pathway and later regret those interventions, whatever those interventions may have been, they are small in number, but they are addressed in the Cass review. It is important that we do not lose sight of those young adults and older adults who may well need the support of health services if they feel they were inappropriately placed on a gender identity pathway or undertook medical interventions that they have later come to regret. We will keep that and other evidence under close review.

[Jonathan Davies (Mid Derbyshire) (Lab)]

I thank the Secretary of State for his statement and the sensitive way in which he has approached this issue, because nothing is more important than our children and young people’s health. A lack of an evidence-based approach may have taken us into a space where some children and young people have received puberty blockers as an appropriate intervention, but others have received that medication when it was not right for them, so can I ask him or his officials to look at how we got ourselves into that space? There may be lessons for us to learn not just about this issue, but about healthcare more generally. Sometimes when we have rushed into things in the past, we have found what appears to be a panacea for an issue, but it has turned out not to be the right thing at all.

[Wes Streeting]

I am grateful to my hon. Friend for his question. This lies at the heart of the dilemma that has plagued clinical leaders and political leaders, particularly since the scandal at the Tavistock clinic was brought into the public eye. There are many people in our country—young people, and young and older adults—who will say, and some have certainly told me in my office, that having access to puberty-suppressing hormones has been completely life-changing and affirming, and has led to a positive outcome for them. Yet we know that the prescription of that medication to this particular group of patients for this particular medical need has not been supported by underpinning evidence in the way that the use of other drugs has been underpinned by effective trials and an evidence base.

That has been the challenge: people with a lived experience saying that this has been positive, while none the less—at the Tavistock clinic, in particular—not only puberty blockers but a whole range of medical interventions were delivered with the best of intentions, but in ways that were inappropriate and clinically unsound. That was the genesis of the Cass review, and it is why I think it is so important that we proceed in an evidence-based way. To do the contrary risks real harm to people and also a lack of trust in the medical profession that will be damaging for our entire country, and particularly for this group of patients.

Tobacco and Vapes Bill

Jonathan Davies Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Wes Streeting]

I am grateful for the intervention, because I anticipate that there will be similar arguments made from the Opposition Benches, particularly from a right-wing libertarian perspective. I want to engage seriously with those arguments.

[Jonathan Davies (Mid Derbyshire) (Lab)]

Will my right hon. Friend give way?

[Wes Streeting]

I will just respond to the point made by the hon. Member for Romford (Andrew Rosindell).

There is no liberty in addiction; there is no freedom in addiction. The logical extension of the libertarian argument the hon. Gentleman puts forward would be the end of the ban on indoor smoking. If we should take a live and let live approach, why not legalise cannabis? Why not legalise cocaine? We prescribe certain harmful substances, and there is, I think, an unanswerable case on tobacco because it is uniquely addictive and uniquely harmful. That is why we will take a tougher approach with this harmful substance than we would with something such as alcohol, or other harms such as gambling.

[Jonathan Davies]

The Secretary of State stole my line when he said that there is no freedom in addiction. I just want to thank him for his pragmatic approach to the hospitality industry, which has made representations to me on this matter. May I also impress on him that vapes are a valuable quitting aid for many adults, but many young people are now taking to vaping when they have never actually smoked at all? Can he say a little bit more about how we will address that?

[Wes Streeting]

I will certainly come on to the action that we are taking on vaping, and the case for it. I welcome the contribution that my hon. Friend has made in his first few months as a Member of this House. He brings enormous expertise and experience, particularly on health, which we very much value here in the Chamber.

One choice would be to continue paying an ever heavier price for failure. That is the road that we were heading down, under the previous Government. Our NHS already takes £4 for every £10 spent by the Government day to day. We are on course to go from being a nation with a national health service to a health service with a nation attached to it. It is projected that by the end of this Parliament, 4.3 million people will be on sickness benefit if we fail to act. Smoking could cause 300,000 patients to be diagnosed with cancer over the next five years, including 3,000 for whom that is the result of exposure to second-hand smoke. That is what happens if we only ever treat the symptoms of ill health. We end up spending more on the NHS than ever before, but with worse care for patients, a ballooning welfare bill due to more and more people being out of work, stagnant economic growth, and the heaviest tax burden in 70 years. In short, we will be paying more, but getting less.

Britain is like a ship with a hole. We are constantly battling to chuck enough water overboard to keep us afloat, as more and more floods in. We must break out of this cycle. Britain can break out of this cycle, but only if we are serious about tackling the causes of ill health, and shift our focus from treating the symptoms to preventing them. Plugging the hole in the ship is how we get back to growth, how we reduce the burden of taxation, and how we ensure that this Government can intrude more lightly on people’s lives.