Terminally Ill Adults (End of Life) Bill

Lord Rook Excerpts

Friday 19th September 2025 Lords Chamber

[Lord Rook (Lab)]

My Lords, I am grateful to all noble Lords for the sincerity and seriousness of the debate over these two days. It has been illuminating and moving to hear so many family stories and personal testimonies. I note my interest as a carer for my father, Roy, who suffers with dementia.

This time tomorrow, my dad will knock on the door of the care office in his supported living complex to address an issue of singular importance: whether his choice has been registered for the 4 pm fish supper. Dad will have already made this trip four or five times, and Dawn, his ever-kind and patient carer, will smile and affirm once again that he has chosen haddock and chips and paid his £7 bill. My dad will beam back and say, “Thank you. I’ll see you soon”. This will indeed be true; in the hours that follow he will return many times to ask the same question.

I do not make light of my father’s condition: all carers know that we see many dark moments, and some of the lighter moments give us a degree of hope and happiness. But the truth is that my dad’s life is immeasurably improved by the fact that he lives in a loving environment with tailored medical support, endless activity and entertainment and an astonishing team with almost infinite capacity for kindness and compassion. Despite his diminishing and terminal condition, he has a good standard of living. Why? Because he can afford it.

We have heard a great deal about choice in this debate. I believe choice is a good thing; hence my concern, in assessing this legislation, is for those who have less choice than us—those who, unlike my father, cannot subsidise their own care in the final season of life. The most disadvantaged members of our communities already suffer increased mortality rates and the pronounced effects of health inequalities. They find it hard to see a GP, they wait longer for treatment and they struggle to navigate complex health systems. We have heard it said over and over: the NHS is currently able to support only 30% of the palliative care costs of our country. I simply cannot see how the introduction of this legislation will not pressurise those who, unlike my father, are without access to first-rate care and cannot afford to supplement what the NHS struggles to provide, to turn to assisted dying, not as their first choice but as their last and final option.

Noble Lords sceptical of this point should pay attention to states that have gone this way before. In Canada, increasing numbers of patients, many of them disabled, are being driven in the direction of assisted dying, due to poverty and a lack of ability to fund their own care. In Victoria, Australia, Robert Clark, the former Attorney-General, has said that disadvantaged patients are likely seeking assisted dying precisely because of the problems in accessing adequate care. The same is true in the United States. In Washington, the proportion of people choosing assisted dying because of concerns about their finances has risen fivefold, from 2% to 10% of cases. In Oregon, the percentage of patients choosing this route because they fear becoming a burden to their family has climbed from 13% to 52%.

In scrutinising the Bill, I hope that we will learn from these countries and take a different course. Where my own choice is concerned, I have chosen to support my noble friend Lady Berger’s intervention and her proposal to convene a Select Committee. I hope that this will give us an opportunity to listen carefully to voices that have not been heard as much as they should have in the procedures, processes and legislation before us. I look forward to working with noble Lords in Committee for as long as it takes to ensure that we can give a good end for all.