Terminally Ill Adults (End of Life) Bill

Lord Sentamu Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Baroness Scotland of Asthal (Lab)]

I never suggested that they should be alternatives. The truth is that palliative care is not available in all parts of our country, so this has to be a real choice. That is the only element I made.

Also, I hope that all of us would look at the evidence, from wherever it came. We know that we have to make evidence-based decisions, and the best evidence will help us to make the best decisions.

[Lord Sentamu (CB)]

My Lords, I want us to return to the amendment and my contribution will be very brief.

The wonderful joy of the English language is that it is always evolving to meet circumstances that were never perceived before. That is why it will continue to be the language of the world. The word “capacity” is no longer just a psychiatric term to assess people’s mental ability; it now applies to whether a council has the capacity to do one thing or another. The word now is no longer a very narrow word. I am quite surprised when I hear people say that the word has been used for a very long time in the medical circle. But the word “capacity” is not in the rules of the Persians and Medes that can never be changed—words grow.

When we are dealing with a new situation of assisted dying, we need to look at whether the word “capacity” is adequate to deal with the new circumstances we are discussing in our Parliament. Is it adequate for a person who is facing the question of death and saying “I want to end my life now”? What does the word “capacity” mean to them?

The word “ability” would probably come much nearer to the understanding of an ordinary person wanting to make a decision about ending their life medically. Let us not treat the word “capacity” as such a holy word which cannot be changed. Let us not be lazy but work hard and consult a lot of other people in the field who know the most adequate word to describe this. I thank the mover of the amendment. Perhaps it could be put into a melting pot with some other words and out will pop a word that makes sense, and the whole House can rally around it.

[Lord Goodman of Wycombe (Con)]

My Lords, in debating ability and capacity, I will speak briefly as a member not only of the Delegated Powers Committee that considered the Bill but of the Select Committee that also did so. Noble Lords have heard differing views from members of the Select Committee about the various goings on that took place there, but I am sure we can all agree that we heard some very fine evidence.

All I wish to do in intervening here is to quote what Professor Alex Ruck Keene, whom my noble friend Lady Berridge referred to earlier, said about capacity and the role of psychiatrists, as it is extremely relevant to the debate on this clause. He said:

“The point I am trying to make is that, if you simply say, ‘Apply the MCA. Apply the principle of the presumption of capacity. Support the person to have capacity to decide their own life’, I anticipate, if you asked very many psychiatrists, they would go, ‘How am I supposed to think about that?’ That is for a very specific reason. For psychiatrists, most of the time, their job is to secure life. Their job is suicide prevention”.


He concluded:

“We need to know—and one of my real concerns is—how this Bill sits in the wider landscape of the law. I need to be able to tell, because I am going to be one of the people writing the books here and giving the training. I need to be able to say, with absolute crystal clarity, to a psychiatrist, ‘This is the point where you are not in the suicide prevention zone, and if you do not do all steps necessary to try to secure this person’s life, you could be prosecuted or you could be charged in various different ways or be civilly liable’. I need to be able to say, with crystal clarity, ‘You’re no longer in that zone; you’re now in the zone of the Terminally Ill Adults (End of Life) Bill’”.


I quote the professor simply to draw to the Committee’s attention once again the complexity of the issues before us. Although “ability” may be flawed and legally powerless, as the noble Lord, Lord Pannick, suggested, “capacity” is deeply problematic in the context of the Bill.

Terminally Ill Adults (End of Life) Bill

Lord Sentamu Excerpts

Committee stage
Friday 12th December 2025 Lords Chamber

[Lord McCrea of Magherafelt and Cookstown (DUP)]

My Lords, like many noble Lords, I grew up at a time when the family doctor was looked upon as a family friend who could always be depended on whenever you were ill or in a time of crisis. Unfortunately, that is not the situation today. There is a major problem across the United Kingdom: patients desiring to see a GP find themselves sitting on the telephone and ringing the surgery 120 times, perhaps, but still not getting through to someone and giving up at the end of it. That is the reality of the situation in many places.

I am sorry that the noble Lord, Lord Pannick, is not here. He posed a question to the noble Baroness, Lady Lawlor, concerning what happens if your GP retires. Let me give my small experience. My GP was in his late 50s. He was an excellent GP. During Covid, unlike many other practices, he still allowed patients to come to his surgery. Whenever elderly patients could not come, he went out to their houses and visited them in their own homes—unlike many other practices and GPs. Unfortunately, he got cancer and, in his late 50s, just recently, he passed away.

We were left with a practice in our town with several thousands of patients but nobody to take it over. So what happened to us? Our GP died, and so, without any consultation whatever, we were all farmed out to seven or eight practices around the countryside, some of them not even close—just to whoever would take us. It is unrealistic to imagine that somehow a new doctor would have any knowledge of the pressures, the problems or the complex challenges that his new patient was facing; he would not have any continuity of care whatever.

It was even worse than that, because it was several months before the notes went to the next practice that you were farmed out to. You were allotted a practice but the notes concerning any illnesses of the patients did not immediately follow; it was several months before they arrived. What has been suggested in these amendments today strengthens safeguards. Therefore, they are worthy of the support of noble Lords in this House.

[Lord Sentamu (CB)]

My Lords, I agree with the noble and learned Lord about why we are focused on GP practices, because they are the hub of information. Since I arrived in this country, I have had a lot of treatment for all kinds of conditions—I am one of those people—and all the national insurance I have been paying has being paid back to me about a hundred times, so I am a walking miracle.

An amazing thing happened to me recently. When my anaemia was so high—I did not think I would survive it—I went to see a consultant in Newcastle hospital and he called up my records from 1975. It was amazing that, apart from one GP who did not keep the record properly, he had it all; therefore, I was able to get proper treatment. Friends, the record keeping on health in this country—even if some do not do it well —really is amazing. The records are very clear. The GPs who are good will always keep up their information, which is digitalised so that they can send it quickly.

Therefore, for me, the whole picture is not just the GP doing it but GP practices, which are the hub from which a lot of information about anybody can be gathered. You sever that and put it somewhere else, and you may not actually get it. I have every confidence that in my GP practice at the moment, which has nine doctors, they will have access to that information.

I therefore think that noble Lords should stick with what is in the Bill about the GP, because it is the information that you want to get, and you get it now and I am amazed. I am therefore very thankful for the care that I have received and the records that speak about my journey, and I want to thank all those who have been involved in my health.