Terminally Ill Adults (End of Life) Bill

Kit Malthouse Excerpts

Friday 16th May 2025 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

Order. Members will be aware that there are still many who wish to contribute to the debate. May I ask that contributions are kept to five minutes?

[Kit Malthouse (North West Hampshire) (Con)]

I am grateful to you for that guidance, Madam Deputy Speaker. I am also grateful to the promoter of the Bill, the hon. Member for Spen Valley (Kim Leadbeater), for putting me on the Bill Committee where, in my view, we did some excellent work. Although we have heard an awful lot of claims about the process, I think anybody objective who reads the Bill that is now being reported to the House will recognise that it is a strong piece of work that is measured and seeks to strike a balance in a difficult area of complexity, humanity, compassion and morality.

Before I discuss some of the amendments, I want to bring the House back to what we are trying to deal with: a set of people who have been told that their struggle with disease is over, that they are heading towards an inevitable death and that there is nothing more that medical science can do for them. What we are trying to do is to give them the chance to face death on their own terms. That is the simple mission that the House has been set.

The second thing I want Members to contemplate as they look at this slew of amendments is that although it is easy to look at each amendment individually and see its merits or demerits, we must bear in mind the machine we are building as a whole, and the fact that we are putting those people through this process at a time when they are facing the end of that struggle. They are thinking about what the nature of their death will be like and they are talking to their friends and family, putting their affairs in order, and being concerned about when that awful day is going to come. We have to have some compassion in the process as well as compassion in the purpose.

When Members consider some of the amendments I will highlight, I ask them please to keep in mind that we will have to put these people through a possible two-month process at a moment when their time is severely limited, very often to less than six months. For example, new clause 7 and amendment 50, tabled by my hon. Friend the Member for Meriden and Solihull East (Saqib Bhatti), would restrict the number of patients that doctors can deal with in any 12-month period. That will severely restrict access and may mean that patients who are partway through the process have to change suddenly because their doctor is time limited, pushing them out, notwithstanding the multiple safeguards we already have in the process.



My right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright) gave an interesting speech about amendment 47. Again, in that amendment, he would be creating another step, another delay and another set of problems for the dying person to overcome or issues for them to address. In his amendment—I am sure he is a much better lawyer than me—I found it odd that he would effectively be creating an inexhaustive list of individuals who could be called upon in any circumstances who might be “properly interested” in the welfare of that individual. To me, the person who should be the most interested in their future is the person themselves. Any step we take that cuts across their privacy, their autonomy and the alacrity with which they can seek this solution to their impending or perceived agony seems a step too far. I do not understand how, practically, the commission is supposed to ascertain who those individuals are—are they neighbours, friends or just family? What is the definition of family? We need to put that contemplation and how they want to handle their death squarely in the hands of the dying person.

[Jess Asato]

The right hon. Member mentioned that the person is autonomous and should be protected from inquiries about them, but what if they are not autonomous because they are being coercively controlled by a partner? What if that partner has prevented them from reaching out to their family to let them know that they are going to take an assisted death? Would it not be a great safeguard to ensure that the panel and all the doctors around them had ascertained that the family had been told?

[Kit Malthouse]

The hon. Lady makes a good point, and it was a compelling point made in Committee and is certainly one that we recognise. That is why the amendments on training that she tabled in Committee were adopted—specifically to ensure that everybody involved in the process is sensitised to detecting those issues and to make clear that any doctor in the process, and indeed the panel, might want to know why family are not being informed. That is specifically why a social worker was put on the panel: to understand the psychosocial environment in which the person is taking that decision. Fundamentally, in the end, if I am facing my death in a matter of weeks and decide in my capacity that I do not want to inform my family, that is my choice. That is my decision. I may have to explain my reasons to the doctors, but—

[Madam Deputy Speaker (Caroline Nokes)]

Order. On that point, I remind Members that we are very short of time.

[Kit Malthouse]

I am grateful, Madam Deputy Speaker; I will be swift.

That is my choice, and this Bill is rooted in the need to give autonomy to those facing death who have capacity. We should take care to tread carefully upon that right.

On the two amendments tabled by my hon. Friend the Member for Reigate (Rebecca Paul), new clause 16 says that somebody cannot be “substantially motivated” by certain considerations. I do not really understand what “substantially motivated” is meant to mean. To me, this misunderstands the complexity of what it must be like to be told that you are dying. The things that might run through your head—the affairs you might have to deal with, the news you have to break to your family, the impact it will have on your small children—form a cocktail of motivations. But the one thing I have learned over the last 10 years from campaigning for and spending lots of time with dying and bereaved people is that towards the end of their life, they have absolute clarity about what they want, because it becomes clear to them towards the end what their death will be like. At the very least, they want to have this card in their back pocket to play if they require it. Remember: these are people who are facing death, who are struggling with death, and we have to give them the power to advance over it.

[Melanie Ward]

Will the right hon. Member give way?

[Kit Malthouse]

Sorry, but I am conscious of time.

Finally, amendment (a) to new clause 10, which we might divide on this afternoon, is difficult. We debated a similar amendment in Committee. As sponsors of the Bill, we are clear that there should be a conscientious objection clause to allow individuals to opt out, and that is strengthened by new clause 10. But allowing an employer—any employer—to say that any employee in their employment cannot participate if that is what they decide seems to me a step too far, and it could prove to have unintended consequences. First, the board of every healthcare trust in the country will become a battle for control between those who oppose and those who do not. As my right hon. Friend the Member for Gainsborough (Sir Edward Leigh) said, people may suddenly find that they have to uproot themselves, after years of living in a care home, and relocate to get the kind of death that they want. In effect, the amendment prioritises the rights of somebody who is providing accommodation over the rights of the dying. As I said on Second Reading, in my view, as they face their end, we should prioritise the rights of the dying.

[Madam Deputy Speaker (Caroline Nokes)]

It would be unprecedented to put a formal time limit on speeches. Please can Members listen to the stricture that we are very short on time? I call Lizzi Collinge.

--- Later in debate ---

[Stephen Kinnock]

The Government’s position on the relevant clause is that the panel has to be satisfied that the correct steps have been taken, and there is not evidence of the points that the right hon. and learned Gentleman has made. Our view is that the intended effect is already catered for in clause 15.

Amendment 38 would exclude from being provided with assistance a person who is not already terminally ill, as defined under the Bill. The reference to “standard medical treatment” is unclear. This could cause further uncertainty around eligibility, given that treatment could be individually tailored to each patient and their needs.

Amendment 81 would remove the requirement that any references to capacity in the Bill are to be read in accordance with the Mental Capacity Act 2005. That would effectively remove the definition of capacity in the Bill. In the absence of a new definition, the Mental Capacity Act may continue to apply by default. That would, of course, diverge from the familiar concepts in the Mental Capacity Act, which could create confusion for practitioners.

The stated intention of amendment 14 is to exclude a person who would not otherwise meet the definition of “terminally ill” if the person meets that definition solely as a result of voluntarily stopping eating or drinking. Our assessment is that the amendment risks introducing uncertainty over a person’s eligibility for assistance under the Bill. However, the substantive question is a policy choice for Parliament. Recognising the intent of the amendment, we do not believe that it would render the Bill unworkable.

Once again, I thank all hon. Members for their contributions. I hope that these observations have helped them in their consideration of the amendments that have been tabled.

[Kit Malthouse]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

The House proceeded to a Division.

[Mr Speaker]

There is a delay in the No Lobby. Will the Serjeant at Arms please go and inspect?