Terminally Ill Adults (End of Life) Bill

Lord Stevens of Birmingham Excerpts

Friday 27th February 2026 Lords Chamber

[Baroness Maclean of Redditch (Con)]

My Lords, I will speak to Amendments 145 and 439 standing in my name. It is good that I previously gave way to the noble Baroness, Lady O’Loan, who is no longer in her place, because she covered a lot of the points that I was going to make about care homes.

This is the first time I have spoken in Committee, even though I have attended virtually every day of the proceedings. Lots of people spoke earlier about their personal experiences. I do not intend to go into extensive detail, but I want the Committee to know that I have, for the past eight years, had power of attorney for my 88 year-old mother, who has been in a care home for that time. She has advanced dementia. She cannot speak, read or write. She does not know who I am. So, I have first-hand, practical experience of fluctuations in capacity and how that can be dramatic, from one day to the next. I come at this from a very practical, family-based perspective as well. Those of us who are former MPs have seen those family situations in our surgeries. That is where I am coming from. We need to make sure that family and care home staff always have the best interests of patients, such as my mother, at heart, as I know that they would wish to—but we just do not know what those interests are in my mother’s case, given that she simply cannot communicate.

My Amendment 145 is very much in line with what has already been said about the appointment of the very important role of the voluntary assisted dying commissioner. The noble and learned Lord, Lord Garnier, the noble Baroness, Lady Finlay, and others have already mentioned ways in which we can ensure that public trust is commanded by the appointment of this person. It may well be that there are better ways of achieving this than my amendment. I urge the sponsor of the Bill, the noble and learned Lord, Lord Falconer, to come back to the points raised by a good number of us.

I suggest that the Cabinet Office should create and maintain a register of interest for the commissioner’s office and the panel members. This appointment is solely in the authority of the Prime Minister, as the noble Baroness, Lady Fox, remarked. This is very important for public trust. It does not matter which Government are in office; we must have transparency and confidence when this person is appointed. The noble and learned Lord, Lord Garnier, suggested that this should be an appointment by His Majesty. It may be that that is a more effective way of achieving the end result.

My Amendment 439 has not been discussed in detail so far in this group. It would require the commissioner to notify specified and interested parties of a person’s referral to an assisted dying panel. Here, the noble and learned Lord, Lord Falconer, will be aware of practice direction 9B in the Court of Protection Rules. That is where we are coming from with the amendment. It states:

“The applicant must seek to identify at least three persons who are likely to have an interest in being notified that an application form has been issued”.


The direction goes on to make clear it that ordinarily, although there are some exceptions, close family are

“likely to have an interest in being notified”.

This can then enable them, if appropriate, to submit a formal witness statement to the court.

I cannot understand why it should be any different here. Assisted dying panels are given extensive powers to make judgments under the Mental Capacity Act 2005, just like the Court of Protection. Surely the same powers of notification and, for that matter, summoning witnesses should apply. If the sponsor does not agree with this or cannot accept it, perhaps he can explain why he thinks that the panel process should be more secretive than the Court of Protection proceedings.

This brings me to the importance of emphasising how important it is to involve families in these significant decisions. One of the problems with the Bill is that it seems to treat assisted suicide as an entirely autonomous decision that can be considered in isolation from the context of other complex care needs. Those of us who have first-hand experience with loved ones will know that this could well be a patient crying out for further support in some way—with their care needs, how they feel or their emotions in that moment. I raise this because the NHS guidance on complex care planning repeatedly emphasises the involvement of family and how important that is. I quote NHS England’s guidance:

“It is important to involve families and carers in decisions about … someone’s care and support (with permission of the person being cared for) … It is important to be led by the person, with their family, carers or supporters, to make sure they can be involved in decision making”.


Similarly, the statutory guidance under the Care Act promotes a whole-family approach to assessment. That is a principle that I am sure we all recognise—that the provision of care involves several parties, including the family, who also need to be supported. This is significant, because many people who request assisted suicide express the concern that they feel a burden. We have heard that expressed time and again in these proceedings. It may well be that if discussions involved family or carers, which then allowed further support to be offered, that motivation would disappear.

Before I sit down, I will address the objection that there might be circumstances when, it is argued, the family should not be notified, perhaps most obviously in an instance when they express the view that they do not want that. I accept that the Court of Protection Rules I referred to provide a certain degree of discretion as to which relatives are notified, considering who is practically closest to the person. The rules also include a provision that is entirely absent in the Bill:

“Where the applicant chooses not to notify a person listed in paragraph 7 … the evidence in support of the application form must also set out why that person was not notified”.


That same exploration and recording requirement on this point is set out for social workers in the NICE guideline on social work with adults experiencing complex needs, and there are good reasons for this. When a person does not want their next of kin to be involved, it might be a red flag that could indicate coercion, an inheritance dispute or some other significant issue. That should be a material fact that is taken into account by the panel.

This somewhat anticipates Amendment 389 in the name of the noble Baroness, Lady Gray of Tottenham, in another group, which would require the assessing doctor to discuss—although not record—the reasons why a person does not want to notify their family. As it connects to my amendment in this group, I ask the sponsor, if he is not minded to accept my amendment because it does not allow the person to decide whether they want their family involved, why the Bill does not include an explicit recording requirement on their exclusion in line with the usual practice.

[Lord Stevens of Birmingham (CB)]

My Lords, contrary to Amendment 129, I think that the Bill gets it right in requiring, at Clause 4(3), that the voluntary assisted dying commissioner must hold or have held office as a judge of the High Court, the Court of Appeal or the Supreme Court. This is quite clearly not a medical role. Its principal functions are to ensure that the statutory processes and safeguards that Parliament would have established are being adhered to.

However, we have to accept that a postholder having been a judge does not automatically mean that they will not come with personal views about the scope of the law that Parliament has passed. Therefore, the debate that the Committee has just had on how to make sure that there is transparency about the views that such an individual might hold before their appointment is ratified has merit.

For example, I was very struck by an important interview that the noble and learned Baroness, Lady Hale of Richmond, the former President of the Supreme Court, gave in Prospect magazine in December 2024. She recorded that, in the case, for example, of Tony Nicklinson back in 2014, who wanted it to be declared that it was lawful for people to assist him to take his own life because he had a disabling illness but was not terminally ill, two Justices of the Supreme Court

“would have been prepared to make a declaration that the current law on assisting suicide was incompatible with the Human Rights Convention”.

She went on to say:

“There were nine of us on the court. Of that, five of us took the view that when the time was right, the court might make such a declaration of incompatibility. But three of those five thought the time was not yet right”.


I infer from that that—at that particular point in time, anyway—five Justices of the Supreme Court would have taken the view that the Bill before us, if passed by Parliament, would fall foul of their reading of the European convention.

It is helpful to think about the mechanisms by which Parliament could know the views of such judges, were they to be put forward for appointment as the voluntary assisted dying commissioner. The thrust of Amendment 127 in the name of the noble Lord, Lord Beith, therefore has merit. It would require, for example, pre-appointment hearings by one or more Select Committees in the House of Commons, which would give us an opportunity to probe these questions and make sure that a nominee was going to stick to the faithful implementation of the legislation that Parliament, after such careful deliberation, would have produced, rather than, for example, interpreting the role of the voluntary assisted dying commissioner as in some way akin to that of the Children’s Commissioner, which is clearly an advocacy role for the rights of children.

[Baroness Coffey (Con)]

My Lords, this is a really important clause and a really important schedule. This is the one time when a judge, whether they are current or retired, will be involved in any of this process after the Commons chose to strip judges away from the original proposal. I have tabled stand part notices opposing Clause 1 and Schedule 4 because I would prefer a judge-led process; I have a lot of sympathy with what the noble Lord, Lord Carlile, articulated several weeks ago.

Let me say at the start that I disagree completely with the idea from the noble Baroness, Lady Cass, that this role should start to become like that of the Children’s Commissioner, the Victims’ Commissioner or similar. That is simply not the case, and not only because the legal powers in the Bill—in Clause 18, in particular— are where they must make judgments on whether there have been errors of law in the panellists’ determination. I am very keen, which is why I have tabled Amendment 913ZD, for us to get this back in focus, particularly in terms of the commissioner’s role, and to think about this person being a judge, not the Secretary of State.

I agree that it should be the Lord Chancellor so, to some extent, I agree with the noble Lord, Lord Beith, that Select Committees of Parliament should be able to go through this process as well; it should be the Ministry of Justice and the relevant committee in the Commons. There is precedent here. I think it was the noble Lord, Lord Tyrie, who managed to get a determination role for the Treasury Committee so that it had, in law, a power of veto on the appointment of the chair of a body; I think it was the CMA, but I cannot quite recall it right now. So there is a precedent in this regard.

I agree with what the noble Lord, Lord Stevens, just said. The Bill is right, in that it should be a retired judge. There are a lot of views and a variety of opinions on this. So far, only one retired judge, as far as I have been able to ascertain, has come out publicly against the Bill. Those who have expressed views are, as has just been articulated, very much in favour of the Bill; in fact, they think it should go a lot further. So some sensitivity will be required by whoever gets to make the decision on who the commissioner should be.

My noble and learned friend Lord Garnier would like this role to be done by His Majesty. There is a certain irony there. It is good to see so many Lords Spiritual here. I did try to see whether I could table an amendment to strip out, at the very beginning of the Bill,

“with the advice and consent of the Lords Spiritual and Temporal”,

but the Lords Spiritual have already been very clear that they do not, and will not, consent to the Bill. Why, then, should we put the onus to make this appointment on the Supreme Governor of the Church of England? I appreciate that there have been some difficulties with the current Prime Minister and his appointments recently, but I would be surprised if anything quite so careless happened again with future appointments concerning this or other approaches. More broadly, I support their proposals to get this into the public appointments process.

On Amendment 134, I support my noble friend Lord Moylan completely in trying to prevent mission creep. That is a risk, which is why I have tabled Amendments 913ZA to 913ZD and 914A to 914C as probing amendments. Schedule 1 to the Bill says that, basically, the Secretary of State will hand over as much money as they see fit. They will decide on pay and pension arrangements and will give people offices—all the things one might expect of a sole corporation. As far as I can tell, none of the employees will be civil servants, unless they are seconded civil servants.