Terminally Ill Adults (End of Life) Bill

Lord Hamilton of Epsom Excerpts

Committee stage
Friday 9th January 2026 Lords Chamber

[Lord Harper (Con)]

I am aware of that. I want to know whether it will contain detailed costings for the court process. Obviously, I do not know what the noble and learned Lord, Lord Falconer, is going to say, but one of the things discussed yesterday was whether he will accept any of the amendments that have been tabled. The point I am making is that, if he were minded to accept the amendments from the noble Lord, Lord Carlile, which obviously have a cost implication, there is a role for the Government in assessing those costs as well as a role for the sponsors. I am simply asking whether, if the noble and learned Lord were to accept them—he may not, of course—he would also provide the costs to the Committee. At that point, I draw my remarks to a conclusion.

[Lord Hamilton of Epsom (Con)]

My Lords, I will not detain the Committee for very long; the noble Baroness, Lady Hayter, can be reassured that I am not in the business of making a long speech.

I have in the past expressed my concerns to the noble Lord, Lord Carlile, as to whether judges are the best people to make these decisions and whether they can do so against the advice of the contracting doctor. The problem is that the doctor will be absolutely adamant that he is right in his case; I do not see why a judge should be able to overrule that, and I am not at all certain that a panel makes it much better. We should concentrate very much on the question of the contracting doctor; my forthcoming amendments will, I hope, address that point.

The problem is that doctors are sometimes malevolent. I accept that the doctors in this House are dedicated to looking after their patients and the public good, but that is not always the case. There are occasions—the noble Lord, Lord McCrea, referred to them—when doctors get it completely wrong.

I am very pleased that although Esther Rantzen was given six months to live, that was two and a half years ago. She wrote an article in the newspaper saying how much she has enjoyed the extra time that she has been given, although she is an advocate of this Bill. We must accept that doctors get these things wrong, and I think we should be concentrating on the contracting doctor rather than on the process of review.

Terminally Ill Adults (End of Life) Bill

Lord Hamilton of Epsom Excerpts

Committee stage
Friday 16th January 2026 Lords Chamber

[Lord Hamilton of Epsom (Con)]

Does the noble Baroness not share my concerns about the misdiagnosis of six months, when you think of all the people who live for much longer afterwards?

[Baroness Hayter of Kentish Town (Lab)]

While that is absolutely a legitimate thing to discuss, and I would always defer to doctors on that, it makes no difference to this part of the argument of whether we call it dying. The noble Lord may well want to raise the question of whether we can ever be sure that someone is dying, although I have to say that I cannot be the only one who has been with someone where it is jolly clear that they are not going to live till the end of the week. There are times when you absolutely know that someone is going to die. While he may well be right that there are other cases, that is not the issue of this word. This word in the Bill is to give to the public the understanding that we are talking about whether there is a way of helping either the final timing or the way of those final days. We are not talking about someone who just decides to commit suicide for some other reason; we are talking about people who are dying from some sort of terminal illness.

Terminally Ill Adults (End of Life) Bill

Lord Hamilton of Epsom Excerpts

Committee stage
Friday 23rd January 2026 Lords Chamber

[Lord Shinkwin (Con) [V]]

My Lords, I will speak to Amendment 44, so ably introduced by the noble Baroness, Lady Berger, and I thank her for tabling it. Today is an especially important day for me, because it marks exactly 30 years to the day since I had emergency neurosurgery in a desperate attempt to save my life following a terminal diagnosis of only six months. My neurosurgeon could not give me odds on survival, never mind recovery, so the outcome was definitely not a done deal.

The need for this amendment underlines why it is so important that no one assumes that this appallingly drafted Bill is a done deal, either. We keep being told by the Bill’s supporters that it is about people who are already dying. If that is the case, I assume that the amendment will meet with their enthusiastic support, given that it would make incontrovertibly clear in the Bill that a person’s motivation for seeking an assisted death is their terminal illness. Otherwise, as last Friday’s debate showed, we could be in the extremely dangerous situation of other motivations coming into play, such as feeling like a burden; living with a mental disorder, including depression; or living with a disability other than the terminal illness.

In her powerful speech of 12 December, the noble Baroness, Lady Gray of Tottenham, said:

“We do not live in a society where everyone is equally able to make decisions without being constrained by external influences, whether that is in the form of other people or simply follows from one’s own life circumstances”.—[Official Report, 12/12/25; col. 495.]


How right she was.

There was a time when I imagine the noble and learned Lord would have agreed with her, given that own his commission ruled that it was essential to ensure that a decision was not influenced by

“self-imposed pressures that could result from”

people

“feeling themselves to be a burden”.

It is worth asking the question of what has changed in that time. Well, the pressures on the NHS have increased, access to GPs has massively decreased and house prices have rocketed, making owning a home a distant dream for many young people and, thus, making the inheritance from granny even more valuable. Meanwhile, social care costs have gone through the roof, thereby devaluing granny’s legacy—and, of course, as your Lordships’ House highlighted only two days ago, the insidious impact of social media has had an alarming effect on society and, many would argue, on some of its values.

So will the noble and learned Lord agree in his closing remarks that, taken together, these factors only serve to make the case even more compelling for there being a specific requirement in the Bill that the sole reason people can seek an assisted death is their terminal illness? If he does not, let him say so. To his credit, in 2012, he was clear about the danger of someone feeling a burden, and I admire his honesty and clarity then. Will he take the opportunity today to be equally honest and clear and confirm that, in changing his mind, he has moved from viewing burden as a pressure to be safeguarded against to instead viewing it as a legitimate basis of a rational choice to be facilitated? Let me say to the noble and learned Lord that I may not agree with him, but I would applaud his determination to address the question directly.

The question posed by this amendment cannot be dodged, because it goes to the heart of the Bill. Indeed, failing to accept the amendment makes sense only if there is an ulterior motive in rejecting it. I would be grateful if the noble and learned Lord, when he comes to reply, could give the Committee a categorical assurance that there is absolutely no intention by the drafters and promoters of the Bill that anyone should ever be able to cite the Bill as the grounds for saying at a later stage, “On what logical basis would we deny that same choice—assisted dying—to people with depression or those who are chronically ill, for example?” Indeed, would the noble and learned Lord not agree that accepting this amendment would actually help him, at least in part, to dispel the fears of those who suspect that, if autonomy rather than motivation is the metric that really matters here, the Bill would contain the seeds for removing barriers to a Canada-style assisted-dying free-for-all in years to come? After all, if motivation is irrelevant, how could it not?

In conclusion, the noble Baroness does the Committee a great service, because her simple amendment hits the nail on the head. It also indirectly exposes a battle that is under way for the soul of her great party. Its values, not least its commitment to disability rights, for which I have so much respect, cannot simply be suspended for the duration of this Bill. There are hard choices to be made here and now. I hope very much that the noble and learned Lord will recognise the significance of this amendment and choose to accept it.

[Lord Hamilton of Epsom (Con)]

My Lords, I put my name to Amendment 313. My concern is the whole question of misdiagnosis. My noble friend Lord Shinkwin has addressed the fact that he was diagnosed with a terminal illness some time ago. One assumption running through this Bill and through the amendments—I apologise to my noble friends who put down these amendments—is that the medical diagnosis of somebody approaching death is faultless. We know from endless examples given by your Lordships in this Chamber that that is not actually the case. There are a large number of incidents when the medics get it completely wrong. I would like to address the question of them quite innocently getting it wrong. I will deal with more malicious misdiagnosis in later amendments.

The whole basis on which we are discussing this Bill is that there has been a medical diagnosis, which must hold as the whole basis on which assisted dying takes place. We know, however, that all too often people live on for quite a long time. The noble Lord, Lord McCrea, made the point that people have lived on with diagnoses that they were going to die after six months. My wife’s uncle, a distinguished diplomat, was given six months to live and died 18 months later. So much fault is the case here that we should be very worried about how much we are going to lean on medical diagnosis as a basis for judging that somebody should be allowed to die.

Earlier on in the debate, some weeks ago, my noble friend Lord Polak described how he was given six months to live. He is not with us, but I would not describe him as a delicate flower. I would also say that he is probably not prone to bouts of depression or that sort of thing either, but let us hypothesise—

[Lord Harper (Con)]

Just for the avoidance of doubt for anyone watching these proceedings, the noble Lord, Lord Polak, is no longer present in the Chamber, but he is very much still with us.

[Lord Hamilton of Epsom (Con)]

My noble friend Lord Harper is absolutely right: he is still with us, but he is absent for the moment. It might have been that, when he was given his diagnosis that he had six months to live, he was told that his final months would be very grim indeed and he would suffer terribly. He might, if this Bill had been in place, have made the decision to end his life. That was 32 years ago and my noble friend Lord Polak is actually pretty fit and doing a good job in your Lordships’ House. So we have to question medical diagnosis in this case.

I am very concerned and would like to hear from the noble and learned Lord, Lord Falconer, what he thinks about the problems of wrong diagnosis. I am old enough to remember that there was a time when we had capital punishment in this country. One of the reasons why it was abolished was because of the miscarriages of justice and the number of people who were hanged when they were innocent. That was a very serious lever used to get rid of capital punishment. What percentage of misdiagnosis of terminal illness would the noble and learned Lord, Lord Falconer, think would be right before he thought about whether the whole basis of this Bill was to be questioned? I do not think we have any statistics on misdiagnosis—maybe he has some—but it really undermines the whole basis of this Bill if we have doctors who quite innocently say that they think a person has only six months to live but then find that they have not and they live on much longer. This is a matter of tremendous concern to people in this country.

[Baroness Berger (Lab)]

I thank the noble Lord for giving way. It might be helpful, in the context of this conversation, for noble Lords to be aware that the data that the Department for Work and Pensions has on people who are in receipt of a benefit that comes during the six months towards the end of life shows that 23% of people who were given a six-month prognosis are still alive three years later.

[Lord Hamilton of Epsom (Con)]

If I understand the noble Baroness correctly, that is 23% of people who die well beyond the six-month sentence they have been given. That is an extraordinarily large figure, and I am grateful to her for it. I think that makes us question the whole basis of this Bill which is talking about medical diagnosis that gives people a limited life but turns out to be wrong. This could be very disturbing, if we are going to go ahead on the basis of information that could be wrong in quite as many cases as that.

[Baroness Finlay of Llandaff (CB)]

My Lords, the noble Lord asked about data. During the Select Committee that was held on Lord Joffe’s Bill on this subject, the Royal College of Pathologists told us in evidence that, at post-mortem, one in 20 people were found to have died from something different to what was written on the death certificate. That underlines the point that he makes: errors in diagnosis are the fundamental problem, happen quite often and result in the wrong treatment being given—not through malpractice, but just because medicine is a very inexact science.

[Lord Hamilton of Epsom (Con)]

I am very grateful to the noble Baroness. That just illustrates my point that misdiagnosis can very easily be done, and we are putting an enormous weight on it in this Bill and it can so often be wrong. We should be very disturbed and concerned about that because it means that we may be passing legislation which is based on faulty information.

[Lord Blencathra (Con)]

My Lords, this may be a convenient point to speak to two amendments in my name in this group. My Amendment 320ZA complements Amendments 39B and 39C, which I briefly touched on in the last debate, by making explicit that non-medical motivations cannot drive an assisted death. It draws a distinct line between medical suffering and social abandonment. International evidence shows that non-medical motivations dominate assisted dying requests. In Oregon, “being a burden” is cited by nearly half of all applicants. Parliament must decide whether it is comfortable legislating for that. This amendment ensures that England and Wales do not drift into a model in which existential distress, loneliness or, in the words of the noble and learned Lord, “sheer misery” or lack of care become accepted reasons for state-facilitated death. It also responds directly to the Equality and Human Rights Commission, which warned that subtle pressures from lack of services can drive people prematurely towards death. This amendment ensures those pressures are addressed, not endorsed.

My other Amendment 332AA operationalises the “ask why” concession. The noble and learned Lord, Lord Falconer, said he is “attracted” to requiring clinicians to ask why a person wants to die but unless the answer has consequences, the question is meaningless. This amendment ensures that when the answer is, “I am a burden” or “I cannot afford care,” or “I am alone”, “I am fed up” or “I am miserable”, the process pauses and support is provided. It reflects the evidence from the Royal College of Psychiatrists and British Geriatrics Society, both of which emphasise the need for holistic assessment. It ensures that treatable depression, unmet care needs or social pressures are addressed before an irreversible decision is made. This is safeguarding, not obstruction. It ensures that assisted death is not used as a substitute for care.

My amendments matter because, first, they protect genuine choice. A decision driven by lack of heating, housing or social care is not the same as one driven by intractable physical decline. These amendments stop the law becoming a backdoor response to social failure.

Secondly, I believe they are a practical safeguard, not a veto. This is not a blanket ban; it is a procedural pause to address fixable problems—social support, benefits, palliative referrals—before a final medical judgment is made. Thirdly, clinicians need clarity. Doctors must be able to ask why and act on the answer. These amendments would give them a clear statutory duty to do so, reducing moral and legal ambiguity. If the noble and learned Lord, Lord Falconer of Thoroton, truly believes this Bill is about free, informed choice, will he oppose leaving people to die because the state failed to provide basic support or will he back these modest, targeted safeguards?

Terminally Ill Adults (End of Life) Bill

Lord Hamilton of Epsom Excerpts

Committee stage
Friday 30th January 2026 Lords Chamber

[Baroness Berger (Lab)]

My Lords, very briefly, I support the amendment that is calling for face-to-face consultations to take place, rather than only in exceptional cases. I want to reflect on why this matters. We know from other jurisdictions that many of these assessments are being done online. It is a really important question for us to consider whether we would want that in our country—and if not, it should be in the Bill. In addition, my comments are informed by the evidence that we were presented with in the Select Committee and drawn from my experience of meeting a number of elderly constituents over the course of nearly a decade as a Member of Parliament.

I reflect particularly on the women I met in their 70s, 80s and 90s who shared their experiences of domestic abuse. This conversation and these amendments matter because this legislation does not happen in a vacuum. The Labour Government today are rightly concerned with addressing the public health emergency of violence against women and girls in our country and has an important landmark mission and goal of halving violence against women and girls over the next decades. The NHS is playing its part and enhancing its efforts in tackling and violence against women and girls, focusing particularly on early identification. There is a lot of other very important work going on via training and investment, and I commend the work of many colleagues who are dealing with this on a daily basis. It was the experts that told us that to identify coercion, undue influence and pressure, doctors and other professionals need to look at someone’s body language. It is not just the words we say, how we say them, the volume or the tone—it is our non-verbal cues and what our body says. It is what we do not say that often shares an important message.

I listened very carefully to the counterchallenge of noble Lords so far. I do not think there is anything to stop the Bill from stipulating that, in exceptional circumstances, the doctors, or the independent advocates or panel members can visit an individual. But I would much rather that we had legislation that supports the Government’s important aim to reduce violence against women and girls, rather than something that will exacerbate the very serious problem that we know that too many women in our country face, particularly at their most vulnerable moments, which includes the end of life.

[Lord Hamilton of Epsom (Con)]

Can the noble Baroness recall that last week she told the House that 23% of six-months-to-live diagnoses turned out to be wrong and that people lived longer? Does that not make the whole position of face-to-face diagnosis much more important when doctors so often get it wrong?

[Baroness Grey-Thompson (CB)]

My Lords, technology has gone a long way to helping disabled people to lead inclusive and integrated lives in British society, and I generally support the use of it. But for many of us who worked on the coronavirus legislation, where we had to make very quick decisions, the speed with which we went online made it seem as if, as a society, we had moved decades forward from having to meet only in person. Even your Lordships’ Chamber managed to meet and vote online. But that comes with a set of challenges.

We have to look at what happened during Covid and the huge increase in domestic abuse. It was not just because we did not have to ask people to turn their cameras on. It was deemed that would be upsetting, so we could not see if somebody had been domestically abused. The impact of increasing domestic abuse was also because there was more recording. Even when you look at the technology that we have in your Lordships’ Chamber, it is not foolproof. I was on a call yesterday in my office. The system crashed twice, and the people I was speaking to on Teams did not even realise and carried on talking. We have to think very carefully about how we would use technology.

Age UK said that about 2.4 million older people do not have access to technology in this country and just under 2 million do not have a mobile phone, let alone a smartphone, so if we are going to do this, we need to think carefully about what other provisions will be in place. I agree with the noble Baroness, Lady Berger; why can the panel not go and visit the individual? I think there is something about being in their own home. The noble Baroness, Lady Pidgeon, raised rural areas. What if people do not have the technology? What will be put in place to ensure that there is a suitable online option?

--- Later in debate ---

[Baroness Fox of Buckley (Non-Afl)]

My Lords, the Government’s 10-year health plan for England seeks to

“make the NHS the most AI-enabled health system in the world”.

Like others, I think that is an incredibly exciting prospect. I do not want it to be dystopian. I think that the right reverend Prelate the Bishop of Hereford makes an important point in warning us against going completely over the top. I think it is important that this amendment has been tabled, because it makes us think about what the possible problems are, which have been well expressed by others. Despite my excitement about what AI might do, even in terms of treatments—there are wonderful possibilities in terms of helping people to walk, what is happening with the brain, and so on—we do not want to be naive.

The question for the noble and learned Lord, Lord Falconer, is: as the NHS digitises and doctors become increasingly reliant on AI for notes and diagnostics, given that the diagnosis is so important in a life-or-death situation in this instance, how can we ensure that a time-poor doctor does not use AI as an assessment tool or a shortcut? We would be naive to imagine that that does not happen elsewhere; we would only have to think of politics. People now use AI to avoid doing research, in a wide range of instances, and I do not want that to be translated over.

As for the patients, algorithms are supremely impressive and can take things that have happened on Facebook or TikTok, from when you have been on a Teams meeting or Zoom—all sorts of indications—and detect chronic illness conversations. The algorithms can then push pro-assisted dying content such as the Switzerland adverts or positive end-of-life options. Interestingly, when discussing banning social media for under-16s, which I completely disapprove of, or bringing in the Online Safety Act, which I argued against, everybody kept saying, “Algorithms, oh my goodness, they can do all these things”. We should consider not that chatbots are malevolent but that AI tends to agree with people via the algorithms; to quote the title of a piece in Psychology Today, “When Everyone Has a Yes-Man in Their Pocket”. If you say that you are interested in something, they will just say, “Yes, here are your options”. That is something to be concerned about, and it will come up when we discuss advertising.

I finish with that BBC story from August of a Californian couple suing OpenAI over the death of their teenage son. They allege that ChatGPT encouraged him to take his own life, and they have produced the chat logs between Adam, who died last April, and ChatGPT that show him explaining his suicidal thoughts. They argue that the programme validated his most harmful and self-destructive thoughts. I am just saying that AI is a wonderful, man-made solution to many problems, but if we pass a Bill such as this without considering the potential negative possible outcomes, we would be being irresponsible.

[Lord Hamilton of Epsom (Con)]

My Lords, I have supported AI for as long as I can remember, and I think it is the future for this country. If we are looking for improvements in productivity, there is no doubt that we should look to the National Health Service and the public sector, where we can see AI having its greatest effect and improving the health of the economy of this country.

However, we are in early days with AI, although it has been with us for some time. We must be very careful not to rely on it for too many things which should be done by human beings. The noble Lord, Lord Stevens, has already referred to the appalling rate of misdiagnosis. We can look at these statistics and say, “Well, it is only a small number who are misdiagnosed”. Yes, but my noble friend Lord Polack was misdiagnosed as only having six months to live and he is still with us 32 years later. You must think about this, because if you get the situation with misdiagnosis badly wrong, it undermines the basis of this Bill. Therefore, we must be very careful that AI does not contribute to that as well.

I pay tribute to the right reverend Prelate. AI is having a tremendous effect in the health service and helping a large number of people to get better, and it may well be that AI introduces cures for people who are being written off by their doctors—perhaps wrongly. We must not dismiss AI, but we must be very wary about where it leads us. There will be an awful lot of bumps in the road before AI is something in which we can all have complete confidence and believe will deliver better outcomes than human beings.

[Lord McCrea of Magherafelt and Cookstown (DUP)]

My Lords, there are just a few remarks I would like to make. We live in an age where it is hard to get a human to interact with any more. We lift the phone and speak to a voice that says that if you want one thing, press 1, and if you want something else, press 2. I fear that this is what we are heading for: if you want death, just press a button.

I have no doubt that if this legislation is passed as it is, in the near future we will be heading towards AI assessment procedures. My concern is not where we start in this process, but where it leads to and where it ends.

I am informed that, in the Netherlands, it has been proposed to use AI to kill patients in cases where doctors are unwilling to participate. Indeed, it is suggested that AI could be less prone to human error. Surely, in crucial assessments and decision-making processes for a person seeking assisted suicide, AI could not identify subtle coercion and assess nuanced capacity, bearing in mind the irreversible nature of the outcome. There are concerns about the risk of coercion or encouragement by AI. It should be noted that, with the newly developed AI functions and chatbots, there are already cases globally of individuals being coerced into all sorts of different behaviours, practices and decision-making.

Clause 5 allows doctors to direct the person

“to where they can obtain information and have the preliminary discussion”.

That source of information could be AI or a chatbot. Is there anything in the Bill that will prevent this?

AI undermines accountability. If the technology fails, who bears responsibility? Traditionally in the health service, the doctor bears responsibility. If AI is used, who bears responsibility?

Terminally Ill Adults (End of Life) Bill

Lord Hamilton of Epsom Excerpts

Committee stage
Friday 6th February 2026 Lords Chamber

[Lord Hamilton of Epsom (Con)]

The noble and learned Lord kindly agreed to address the issue of inadvertent misdiagnosis and he said that this group of amendments led by Amendment 71 was the time to bring that up. It was pointed out at the time by the noble Baroness, Lady Berger, that 23% of six-month diagnoses of death turned out to be wrong. How does that tie in with the Minister telling us that there had to be an assumption of an 80% chance of somebody dying within six months? Can the noble and learned Lord address that problem before we finish?

[Lord Falconer of Thoroton (Lab)]

First, I am saying that six months is safe for the reasons that Chris Whitty gave: six months is generally about right; it might not be right and it might be five months or seven months, but it is a proper basis on which to proceed. The statistical evidence that the noble Lord, Lord Hamilton, is relying on is about errors that are not of the massive scale that would undermine that proposition. Secondly, having just checked with my noble friend the Minister, she was not saying that it had to be 80% right. She was saying what the amendment said—I think it was in the name of the noble Baroness, Lady Lawlor—and why it was not an appropriate or workable amendment.

--- Later in debate ---

Separately from those issues, the noble Lord, Lord Carlile, raised the effect on, for example, Christian-based care homes and their legitimate entitlement under Clause 31 to withdraw. Perhaps I may deal with that when we get to Clause 31 rather than now, because there are a series of amendments that deal with it.

[Lord Hamilton of Epsom (Con)]

This is the second Friday we have had where the target has been 10 groups of amendments and we have come well below half on both those days. If we go on scrutinising the Bill in the way we have been doing, it is inconceivable that it will ever reach the statute book, so is it not time that the noble and learned Lord really considered what he can salvage from the Bill, where there is agreement on both sides of the Committee, so at least something will get through that improves the lots of people in this country?

[Lord Blencathra (Con)]

My Lords, once again, this has been a good little debate, with more noble Lords participating than I expected. The whole Committee admires the noble Baroness, Lady Hayter, for the way she described her husband’s condition and the extreme care, and possibly good luck, she has had in finding an excellent home for her husband. When we were in the House of Commons, we could never tell these personal stories about our disabilities, because we would be regarded as showing a weakness and therefore not suitable to fight for our constituents. The wonderful thing about these debates over the past few weeks is that noble Lords from all sides have been able to relate stories about their own disabilities, afflictions and illnesses and those of their close relatives, which has added a tremendous amount of wisdom and compassion to our debates.

I say to the noble Baroness that my amendment does not seek to throw anyone out; it does not excuse anyone in a care home from getting treatment. We just want extra care for them. As my noble friend Lord Deben and the noble Lord, Lord Carlile, said, there are good care homes, bad care homes and downright ugly care homes. Our amendments are designed to deal with those that are not quite up to scratch.

The noble Baroness, Lady O’Loan, made the point that dementia sufferers are even more vulnerable. The amendments from me and from my noble friends Lady Eaton and Lady Lawlor are different, but the thrust is still the same: we are suggesting that a bit more care is necessary to determine capacity in care homes.

I must come to the important point made by the noble Lord, Lord Carlile, backed up by my noble friend Lord Deben, about the ECHR. I am a member of the Council of Europe. I have been elected to a specialist committee on observing elections in former Soviet Union countries. I was on the committee that elected judges. I am pleased to say that we elected—I was one of those who voted—a superb English KC, who is just retiring this year, to be a judge. I am also a substitute on the election committee. I totally support the ECHR. What I am critical of are some of the judgments we have had in the United Kingdom from some of our immigration judges, who I do not think have properly read the ECHR. I have no problems with the ECHR itself. I am totally in support of it and the principle—I am just worried about some of the judgments.

The other point that the noble and learned Lord made—he ended with this—is that responsibility for this must not rest with care homes alone, and I agree entirely. The noble Baroness, Lady Finlay, made the point that some care home staff are very worried about operating this. The noble Lord, Lord Carlile, made a point about Mission Care and Christians in care homes feeling that they could not work it either. My noble friend Lady Lawlor made the simple point that a higher bar is necessary for care homes. The noble Baroness, Lady Smith of Newnham—to whom we are grateful for revealing her father’s story—stressed that the vagaries of cognitive decline vary depending on the medication that one is on, and I have experience of that.

The noble Baroness, Lady Fox of Buckley, said that she did not want to talk about some of the horror stories in care homes. None of us wants to do that, although every other month we read about some of the appalling treatment that happens, particularly to those suffering from severe dementia. She said that there is a social care home crisis, and that is right. She was spot on about ticking the food boxes.

A few years ago I was in St Thomas’—early on in my MS days, when I had a relapse—and there was an old boy in a bed in the corner, aged 82. At that time we would tick the boxes for what we wanted the next day. Do Members recall that the Government appointed Mr Loyd Grossman to review menus at NHS hospitals? He did review them, but he just wrote them in fancy language. The choice for one morning was ground beef, suffused with basil and scented with carrot juice—or something—and chopped potatoes. This old boy did not have a clue what it meant. I managed to get to him and say, “It’s mince and tatties”, and he was able to understand it. The nurse said, “Oh, you don’t want anything to eat, Mr Smith”. He just said, “Porridge, porridge”. She said, “Oh, we can’t give you porridge. There is only the choice of mueslis”. I will not labour the point any further, but the same thing can happen in care homes, as the noble Baroness, Lady Fox of Buckley, said. She asked, in conclusion, how can one decide capacity between a patient who is on a good day and a patient who is on a bad day? People in care homes need extra special measures to determine capacity.

My noble friend Lord Wolfson of Tredegar made an excellent point about care homes: there are good ones and bad ones. He asked the Government to spell out what the consequences would be of my noble friend’s amendment and my amendment, and what the Government think about it.

I say to the Minister that I am tempted to put down an amendment to the Animal Welfare Act to protect the poor rabbit that has been pulled out of the Government’s hat to say that all our amendments are contrary to the ECHR.

Finally, I say to the noble and learned Lord, Lord Falconer, that our amendments may not be perfect, but the consensus from all noble Lords who have spoken, apart from the noble Baroness, Lady Hayter, was that something more needs to be done for care homes—a little bit of extra protection is necessary. When we were dealing 18, 21 and 25 year-olds, the noble and learned Lord said that we need to think about a bit of extra protection for them. He was right, and I look forward to seeing his amendment on Report on that matter. But the same goes here. We need a bit of extra protection for people in care homes, for the various reasons advanced by noble Lords. Having said that, I look forward to seeing his amendments on Report—and if not, we will table some ourselves. In the meantime, I beg leave to withdraw my amendment.