Surrogacy Law and Legal Parenthood

Rebecca Smith Excerpts

Monday 7th September 2026 Westminster Hall

[Rebecca Smith (South West Devon) (Con)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. I welcome this debate.

As we know, the petition asks for parental orders to be permitted at birth. I believe that Members should approach the proposal with extreme caution. The number of people who have signed the petition—over 113,000, including 226 of my own constituents—is clearly testament to the strength of feeling on the issues. However, the petitioners frame the parental order process as an obstacle to parental rights, but that is fundamentally misleading. The legal process provides important protections for surrogate women and the children they carry. Currently, intended parents can apply for parental orders only after six weeks from the birth, and they must usually do so within six months. That cooling-off period provides a vital safeguard for the surrogate mother, and we should not dispense with it lightly.

I believe we need to take a step back and remember why this House has historically approached surrogacy with so much caution. It is now undeniable that we have moved well beyond the purposes originally used to justify IVF and assisted reproductive technologies. IVF was initially intended to help a childless couple have a child, not to create a contractual market out of pregnancy. That sense of mission creep is also evident when we look at the Surrogacy Arrangements Act 1985. The Warnock committee, whose report led to the Act, did not regard surrogacy as simply another form of fertility treatment. Now, over 40 years later, surrogacy has become just another service routinely offered at clinics across the country. Technology allows us to separate genetic parenthood, gestational motherhood and social parenthood. However, it does not mean those relationships are interchangeable. Technology may give us choices, but it does not absolve us from making ethical judgments about those choices.

It is worth noting that the UK is an outlier in allowing any form of surrogacy at all. Surrogacy is much more strictly limited, or even completely prohibited, in countries including France, Germany, Italy, Spain, Sweden and Switzerland. We know that some of those countries are particularly liberal in other areas, so the fact that they are strong on this gives us reason to question why they take that position. That reflects the serious ethical questions that arise when a child is intentionally separated from the woman who carried them in the womb. Commercial surrogacy is illegal across the EU, where it is classed as a form of child trafficking. Indeed, the UN special rapporteur on violence against women and girls has recommended the global abolition of surrogacy. Last year she described surrogacy as characterised by the exploitation of women and children, including girls.

In any future reforms of surrogacy legislation, the welfare and safety of women and children should remain our paramount concern. I acknowledge that the desire of many people who turn to surrogacy is for a child, and that that is a profound need within them. I think that is something on which we are all able to agree. Some women face infertility or repeated pregnancy loss, and some face medical conditions that make it impossible or even unsafe for them to carry a pregnancy themselves. For some people, surrogacy may seem to be the only path to having a child with a genetic connection to them. I do not question the deep desire for that, nor do I underestimate the pain that can come from wanting a child and being unable to have one. That said, compassion for those experiences cannot require us to overlook the women and children affected by surrogacy. By its very nature, surrogacy involves a woman’s body becoming a means to an end. She is carrying a child for the benefit of another family. My concern is that our efforts to help people to become parents risk constructing a system in which women’s reproductive capacity becomes merely a resource for others to use.

One of my main concerns with the petition is that it implies that surrogacy is closer to natural conception than to adoption; I believe that is again misguided. With adoption we do not pretend that the birth mother is irrelevant simply because she will not raise the child herself. That woman has already nurtured the child in her womb for nine months and the law rightly recognises that her role matters: the original birth record remains in existence and the adopted child can access it later in life, as an adult, if they wish. Similarly, a surrogate may not intend to raise the child she carries, but that does not mean that her role should be legally obliterated at birth.

We should also consider the needs of the child. A baby bonds with their mother in utero regardless of whether the surrogate uses her own egg in the pregnancy. The child’s birth mother is an important person in the child’s story and the law should therefore recognise the birth mother’s indispensable contribution in bringing new life into the world.

I also have concerns about financial incentives. In this country a surrogate mother cannot simply be paid a fee for producing a baby. She may receive reasonable expenses, including for things such as maternity clothing, travel and loss of earnings, but typical reimbursements now reach as much as £25,000. I think we would all agree that that is quite a substantial sum, which should give us pause for thought. There is an important distinction between reimbursement and income. It is one thing if a woman is compensated for genuine expenses, but if pregnancy becomes a source of substantial financial benefit, we need to ask whether we are still talking about altruism or whether we are creating a market in all but name. Pregnancy is not risk-free; it can involve serious medical complications. However, uncertainty about whether a payment is reimbursement of an expense or a fee clouds the situation.

We cannot discuss this issue without considering the wider international picture. Most parental orders for UK parents now involve commercial surrogacy abroad; we have heard a lot about that already. It should concern us all that international surrogacy takes place in jurisdictions where the economic circumstances of surrogate mothers are very different from those in Britain. If wealthy countries normalise the commissioning of pregnancies, there will inevitably be markets that meet that demand. In most cases, the women with the least economic power become the people expected to take the greatest physical risks.

I will finish by reiterating that I have enormous sympathy for people who want children and cannot have them naturally. Their longing is real, but true compassion must extend to everyone involved, including to the women whose bodies bear the burdens of pregnancy and childbirth and to the children they bear. Do the Government remain committed to the parental order process and the safeguards that it provides? Those safeguards are not outdated as the petition suggests; indeed, they are needed now more than ever, especially as international surrogacy arrangements are becoming the norm for intended parents in the UK. The parental order process exists to ensure that a child’s welfare comes first and that a surrogate mother’s consent is freely given. Any reform should strengthen those protections for women and children, not diminish them.

--- Later in debate ---

[Josh Newbury]

Yes, absolutely. I am making the case that where everybody involved—of course, the mother is paramount in that—is happy with the arrangement and wants to go ahead with it, it could happen ahead of time. My personal belief is that there should be a cooling-off period, even if there is a reform, to ensure space for mothers to change their minds. I am making the point that the system could be far more efficient. I am not suggesting that we remove the courts from the process altogether—they should be there when needed—but a properly regulated system could allow straightforward cases to be dealt with before birth while retaining a route to the courts where there is disagreement, a safeguarding concern, consent changes or judicial oversight is required. That would not weaken safeguards; it would allow the courts to focus their time and attention on the cases where their intervention matters most.

[Rebecca Smith]

The hon. Member and I have a great shared interest in fostering and adoption and have spoken about those issues a lot in the past. To clarify, is he saying that there should still be a six-week gap between the birth and the parental order being signed, or that there should not, but that if there was a problem, the courts could still get involved afterwards? That strikes me as clouding the water even more. I appreciate where he is coming from, but I was not 100% clear on what he was saying.

[Josh Newbury]

I am not a legal expert and do not intend to insert myself into that particular legal debate, but my perspective is that if arrangements are made beforehand and a birth mother changes her mind, there should be a route back to the court and that should be built into the system. We have the six-week window that allows time for reflection, but I believe there is a way in the vast majority of cases where everybody will be happy for the arrangements to go forward and for the intended family to move on with their lives, without having to go to court, unless there is a change of heart.

--- Later in debate ---

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. I give credit to all Members, who have participated in this difficult and sensitive debate in a thoughtful and constructive manner, and particularly to my hon. Friend the Member for Lichfield (Dave Robertson) for leading it. I thank Adam and Jamie for starting the petition and the more than 113,000 people who signed it. Many of my constituents asked me to attend the debate today, and I am proud to do so to stand up for families created through surrogacy.

When Adam and Jamie’s daughter was born, they became her dads the moment they held her. They had chosen to become parents and had prepared for their daughter’s arrival. They had so much love to give her, but the law did not recognise them as her parents. Often parents have to go to court to prove that they are the parents of the child they are already loving and caring for. That is just not right for the parents, for the surrogates and, more importantly, for the children, and it does not reflect the reality of the families involved. It creates unnecessary stress and anguish at an already difficult time when people are raising a newborn child.

To suggest that the concept of consent can be questioned after consent has been given is dangerous. No surrogate mother enters into this relationship lightly. It is something that women consider very carefully. I have spoken to friends who would happily be surrogate mums for other families to enable them to have children, because they enjoyed the experience of pregnancy. They would be happy to help in that way, but they would consent to that in the knowledge that they would not be that child’s mum. They would expect that child to have another mother, or mothers, or other fathers. That is the basis on which they give their consent.

To take the concept of consent in legal arguments, when people make wills—they might be vulnerable people or, much of the time, elderly people—there are always questions about whether they were put under undue influence, but there are legal mechanisms to check that that was not the case. Similarly, there are mechanisms to check whether a woman has given consent for sexual intercourse. We need to strengthen checks for consent in surrogacy relationships, but we cannot have a situation where somebody can give consent, which has been adequately checked and monitored, and then withdraw it afterwards. We have to be careful about challenging that, because it goes to the very root of consent, and it is dangerous to do so.

[Rebecca Smith]

Will the hon. Lady give way?

[Rachel Taylor]

I would like to make some progress, and the hon. Lady has made a number of points in her own speech and in other interventions.

Same-sex couples, disabled mums or mums who simply cannot have children have gone through an incredibly demanding process to start a family, and their family is treated differently from the moment their child is born. They can be left in limbo for months while social workers carry out assessments and family courts, with already massively long delays, consider their application for a parental order. That leaves them in limbo if their child is ill, taken into hospital, starts nursery school, or any number of things. Meanwhile, they are changing nappies, comforting their baby through all the sleepless nights and making every decision about their care.

Families should not be penalised because of the gender or sexuality of the people who love and raise that child. Our surrogacy laws are more than 40 years old. Families have changed and society has changed; the law must now change too. That is why the Law Commission’s proposals are so important. They set out a new pathway through which intended parents could be recognised as legal parents from birth, rather than waiting for months to obtain a parental order.

The work has been done, the evidence has been gathered and a draft Bill has already been produced. Will the Minister listen to the families who have shared their experiences, publish the Government’s full response to the Law Commission’s report and set out a clear timetable for reform? Adam and Jamie became dads the moment they held their daughter. It is time the law recognised that reality.

--- Later in debate ---

[Rebecca Smith]

There have been a couple of mentions of the time it takes to get an order, but parents in the UK adoption system have equally long—often much longer—waits to take on parental rights over a child. We are in danger of creating two separate systems, so that putting in an order for a child through a surrogate is a quick option to become a parent, but we are making it harder for people who have gone through the care system to foster or adopt, or who have gone through a long adoption process. I wonder whether we are inadvertently suggesting that there should be a two-tier system. I wonder what the hon. Lady’s thoughts are on that, because I know that she, like me, is a big advocate of fostering and adoption.

[Jess Brown-Fuller]

I am in no way suggesting that we create a two-tier system. Talking about how long the adoption process can take, especially for those who have had fostering responsibilities and are transitioning into adopting those children, and talking about how arduous that process can be, including when making sure that children have up-to-date health records and so on, would be a separate debate. We are clearly talking about health services as well. If a child is born with a health concern, the intended parents who are providing their day-to-day care should have the facility to act on behalf of that child to make sure they are well looked after.

It is also worth pointing out at this stage that, if a heterosexual couple presented in a hospital with a child who is poorly, it is very unlikely that a health professional would ask, “Can you please prove that you are the legal parents?”, but for same-sex couples it is more likely that someone would ask that question. We are creating a two-tier system between heterosexual couples who choose surrogacy and homosexual or same-sex couples who choose surrogacy, and I am not in favour of a two-tier system at all.

The Liberal Democrats also believe that, as with all the issues raised in this debate, any decisions regarding the legal parenthood of a new baby must ensure that the rights and wellbeing of all those involved are balanced and respected. I ask the Minister when the Government intend to respond to the report in full and whether they intend to bring forward any legislation on this issue for Parliament to consider—because, although this is Adam and Jamie’s debate, they represent a much wider group of people.

I will finish by saying that so few people have touchpoints with our Parliament and our political system, and passing the threshold to have an issue debated in Parliament is no mean feat; but it should not be the end of the story. It would be helpful if the Minister could set out what the next steps are, to ensure that the conversation about this issue continues.

--- Later in debate ---

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

It is always a pleasure to serve under your chairmanship, Mr Pritchard. I thank my hon. Friend the Member for Lichfield (Dave Robertson) for his opening speech on behalf of the Petitions Committee. I am pleased to respond to this debate on the proposal, made by a petition signed by over 113,000 members of the public, to change surrogacy law to recognise intended parents from birth. I welcome the shadow Minister, the hon. Member for Solihull West and Shirley (Dr Shastri-Hurst), to his place and congratulate him on his appointment to that role.

This is a well-attended debate, and there have been many valuable contributions. The hon. Member for South West Devon (Rebecca Smith) and my hon. Friend the Member for Edinburgh North and Leith (Tracy Gilbert) both spoke with great passion about the welfare of women and children, including in the international dimension of surrogacy. I wanted to tell my hon. Friend the Member for Bolton West (Phil Brickell), who is no longer in his place, that I was concerned to hear his intervention about his constituents who had a very poor experience going to Mexico with a certain company. The Department is looking into the allegations about My Surrogacy Journey. As part of that assessment, the Department will consider whether it is appropriate for that company to remain on the gov.uk list of agencies.

The hon. Member for Leicester East (Shivani Raja) talked about the rights of the child coming first. My hon. Friend the Member for Mansfield (Steve Yemm) talked about the strength of motherhood and discussed the important issue of consent. The hon. Member for Strangford (Jim Shannon) raised concerns about the commercialisation of surrogacy. My hon. Friend the Member for Cannock Chase (Josh Newbury) talked about his personal experience of becoming a dad. My hon. Friend the Member for North Warwickshire and Bedworth (Rachel Taylor) spoke about the personal experience of Adam and Jamie. She made a strong speech for reform and also spoke about consent. My hon. Friend the Member for Pendle and Clitheroe (Jonathan Hinder) talked about the ethics of surrogacy and referred to the approach taken by other European countries. The hon. Member for Chichester (Jess Brown-Fuller), the spokesperson for the Liberal Democrats, made a typically thoughtful speech that set out the Law Commission’s report in some detail.

It is worth saying from the outset that the Government recognise that surrogacy is a complex and sensitive policy issue where detail matters to all those involved in a surrogacy arrangement. The Government always recommend that anyone considering surrogacy should have a clear understanding of what is required for parenthood to legally transfer to the intended parents and should seek specialist legal advice before beginning the process.

I am grateful for the opportunity to reflect on this area of law. The UK was, of course, one of the first countries to introduce a legislative framework for domestic surrogacy. The Government support surrogacy as part of a range of assisted conception options and recognise the important part it can play in supporting people seeking to start a family. In the Surrogacy Arrangements Act, Parliament decided that altruistic surrogacy arrangements would be legally allowed and that surrogates would be entitled to reasonable expenses. The Act was introduced to prevent surrogacy arrangements from taking place on a commercial basis.

I am grateful to my hon. Friend the Member for Lichfield for his informed contribution. He and my hon. Friend the Member for North Warwickshire and Bedworth set out the issues raised by the petitioners, Adam and Jamie, and shared their experience of starting a family through surrogacy and of the pathway to legal parenthood in the United Kingdom. The Government recognise the difficulties that intended parents may encounter when applying for a parental order. We are very grateful to those with lived experience of this matter who feel able to share their stories.

I will set out the current legal position on parental orders. Under the Human Fertilisation and Embryology Act 2008, the person who gives birth to the child—in this case, the surrogate—is the legal mother when the child is born and has parental responsibility until the courts put in place a parental order. A parental order makes the intended parents the legal parents and permanently removes the surrogate’s legal motherhood. We recognise that the application process for a parental order can be a difficult period for intended parents. Although the safeguarding assessments take time, they are necessary to support the court’s considerations of parental order applications. Each application is carefully considered by the family court on the facts of the individual case, although I note the issues raised about delays in the system.

The debate has highlighted broader questions about whether the current legal framework in the UK continues to reflect modern family formation and contemporary surrogacy practice. The Government acknowledge those concerns and recognise the arguments on both sides—that the law should provide greater clarity, better support and a more streamlined pathway to legal parenthood while maintaining robust safeguards for children, surrogates and intended parents.

There are many reasons why people pursue international surrogacy arrangements. It is a very complex area. The process to bring the child or children to the UK after birth can be long and complicated. Foreign Office guidance makes it clear that if people are considering surrogacy in a foreign country, they are strongly advised to seek specialist independent legal advice in the UK and the relevant country before making any arrangements.

I hear loud and clear the calls for legislative change this afternoon but, given the limited parliamentary time available, the Government are not in a position to bring forward legislation on surrogacy reform immediately. We will, however, continue to consider options for future reform, and we remain engaged with the issues raised by stakeholders, parliamentarians and families with lived experience of surrogacy.

[Rebecca Smith]

I thank the Minister for making a very thoughtful summing-up speech, as ever. Has she had any conversations with her colleagues in the Department for Work and Pensions about providing clarity on whether the expenses that surrogate mothers receive should count towards their benefits? Under legacy benefits, they did, but under the new version of universal credit, they do not count as unearned income. That thorny issue needs to be looked at, particularly given that £25,000 can be paid to women who may be on benefits, but it does not count as income. Has the Minister had that conversation, and can she look into that?

[Dame Diana Johnson]

I am very happy to take that point away and write to the hon. Lady.

Any future reforms need to protect the welfare of children and safeguard those involved in surrogacy arrangements, as well as to maintain public trust. As noted throughout the debate, the Department supported the joint project of the Law Commission for England and Wales and the Scottish Law Commission to review the current surrogacy regime. The Law Commissions consulted widely on this topic, generating a wide diversity of views. The previous Government welcomed the Law Commissions’ 2023 report on surrogacy reform, and this Government will respond in due course as time allows.

I am very grateful to all those who have contributed to both sides of the debate. The contributions made today have highlighted again both the strengths of the current surrogacy framework and the challenges that may be faced when navigating it. The Government are clear that the welfare of children born through surrogacy must remain paramount. We recognise the importance of ensuring that children are protected, intended parents are supported in having families, surrogate mothers are protected and surrogacy arrangements operate within a framework that commands public confidence. I am sure that the Minister in the Lords, who has responsibility for this area, would be happy to meet hon. Members to discuss this further. Once again, I thank my hon. Friend the Member for Lichfield for introducing this important debate and acknowledging the families impacted.

Infants, Parents and Carers Bill

Rebecca Smith Excerpts

2nd reading
Friday 4th September 2026 Commons Chamber

[Rebecca Smith (South West Devon) (Con)]

I join many others today in congratulating my right hon. Friend the Member for New Forest West (Sir Desmond Swayne) on securing this debate and on his choice of topic. There does seem to be an enormous amount of agreement in the Chamber today, and I know that he has secured cross-party support for the Bill, which is excellent.

Like everyone else present, I wholeheartedly welcome the Bill. While I, like many others, do not have my own children, I am an aunt to four, a godmother to four and a friend to many people who have children. I have been looking after my friends’ kids since I was about 18, so I am pretty adept at changing nappies; I know how to get them to smile and how to do all those things. We have heard mention of the value of the wider family and friendship group, and I am very pleased to be able to speak in support of the Bill from that perspective. As a result, I know that there is a reason why we say, “The hand that rocks the cradle is the hand that rules the world”—it is because those earliest years really do matter profoundly.

During the first 1,001-day period, secure attachment is built through a baby’s everyday interactions with their parents, their carer or, indeed, their aunties and uncles. A smile, a cuddle, a comforting voice—those simple moments lay the foundations for emotional wellbeing. I certainly hope that the 24 hours in which I was the only person to provide my 18-month-old nephew with all those things added to his wellbeing, rather than detracting from it—we will see in a few years’ time. I think he generally knows who I am and is happy to see me, so that is fine.

By the age of two, a child’s brain reaches around 80% of its adult size. As Lord Cameron has said,

“mums and dads literally build babies’ brains.”

By supporting parents from the very beginning, we can improve outcomes for children and reduce the need for costly state intervention later down the line. That is why I support the Bill’s intention to put services during pregnancy and early childhood on a stronger statutory footing.

The reporting requirements in the Bill will mean that decisions on funding cannot be made in the dark, ensuring that services such as Best Start family hubs and the healthy babies programme remain a Government priority. Family hubs provide a vital one-stop shop for parents, bringing together practical support under one roof, from breastfeeding advice to work to help to reduce parental conflict.

Plymouth was one of the original 75 local authorities selected to participate in the Conservative Government’s family hubs programme back in 2022. The council has now successfully established a network of 11 hubs. However, interestingly, there have been recent reports about funding changes, and trying to find out information on what is happening, who is responsible and what is going on has been really difficult. Therefore, anything that ensures that that reporting back is done—particularly on funding and sustainability when external agencies are providing those services—will be particularly important. As an advocate for family hubs, when I have constituents come to me and say that people working in those hubs are being made redundant, I want to know what is going on and whether delivery is continuing.

It is important to remind ourselves that the value of family hubs is that they are open to everyone. However, I believe that more could be done to encourage parents to use them. So far, only 16% of parents with a child under five have used a family hub, despite 66% having heard of them, according to a poll from the National Society for the Prevention of Cruelty to Children. It is clear that we need to do more on that.

[Dr Mullan]

One of the other challenges I heard about in the family hub I visited was that, in constituencies like mine, we have towns but also lots of villages that are perhaps very far away. I agree with people having to physically go somewhere, but this is an example of where funding for rural authorities needs to reflect the additional costs involved in providing all sorts of services, including family hubs.

[Rebecca Smith]

I thank my hon. Friend for that good point, which I am particularly passionate about. I have spoken a lot this week about funding for rural services, particularly under local government reorganisation, and that will be really important in the future structure of unitary councils. How can we ensure that villages and smaller towns get access to family hubs and things like them—and whatever else comes about following the Bill—and that people are not reliant on infrequent public services or on having a car to get to them? I am glad he mentioned that, because it gives me even more reason to continue on my journey against local government reorganisation in my constituency.

My hon. Friend also highlights how we want every community to have a family hub. I am considered to be the MP for the slightly well-off bit of Plymouth, so I am incredibly grateful that the city set one up in my constituency, but there are whole communities in my constituency, such as Plymstock where I was a councillor for many years, that do not have a wellbeing hub or a family hub. If we are to do this, we must ensure that we do it properly.

I want to take the opportunity to remind the House that family hubs are a Conservative innovation, grounded in the principle that strong families make for a strong society. I am delighted that the Labour Government have committed to build on our success and roll out family hubs to all local authorities, not just those initial 75. I must also say that they are not merely Sure Start rebranded.

[Pam Cox]

On the historical point—forgive me; I could not stop myself—the Maternity and Child Welfare Act 1918 probably preceded some of the things the hon. Lady is about to say, as well as some of the measures mentioned by the hon. Member for Carshalton and Wallington (Bobby Dean). There is a long history of efforts to introduce child welfare.

[Rebecca Smith]

I thank the hon. Lady. I mentioned to one of my colleagues the other day how this entire debate is catnip for Labour Members, because it is an opportunity for them to highlight that they have cared more about families and children than the Conservatives. I do not believe that; I believe that we have always cared about the vulnerable and ensuring that the right thing is done.

To bring the House back to the point and bring down the temperature in the Chamber, I want to talk about what is good about family hubs and why they are different. The key point is that they are not just Sure Start rebranded. Sure Start did good things, but we felt at the time that it was not necessarily targeted in the right way.

I pay significant tribute to Lord Farmer. If it were not for his work and his personal commitment in all sorts of ways—he effectively trailblazed the family hubs policy—we would not be here today. Family hubs have provided a model that we can replicate. That is not to say that Sure Start did not provide the opportunity to do something similar, but the distinctive thing about what Lord Farmer set up and that we put into practice in government—he is seeking to work with the Government to continue it—is that it is not just for the early years but for people right up to the age of 19. Regardless of what we think about what happened in the past, what family hubs are called and what they do, I think we all agree that we need to provide support right through to when a child is 19 and to give families that opportunity. We have heard many people speaking about the challenges in teenage life if we do not get it right at the beginning.

[Natasha Irons]

To bring us back to the Bill and to take the temperature down—to be fair, nobody on the Government Benches sent it up—the point is that this particular time, the first 1,001 days, has not been protected. I agree that of course we need to take support through to 19, but the challenge when Sure Start was rolled back was that councils found themselves with one pot of funding for the journey from conception to the teenage years, which meant that the youth services that help with later intervention were competing with the early intervention we are talking about today. Protecting this time means that we can invest properly in and hopefully bring down the cost of those youth services later on. I hope the hon. Member can agree on that point.

[Rebecca Smith]

I thank the hon. Member for that contribution. Of course, if we are going to do this properly, we have to make sure that the funding is there, which I think is the entire point of the Bill. I agree with that, but the great thing about family hubs is that they set out an intention right from the start that it is not okay to just ringfence the money until the age of five; we need to ensure that we provide support all the way through. There is a lot more work to be done on both sides of the House to develop what that looks like. I think we are in pretty good agreement on this, whether it is support up to five or beyond. At the end of the day, we want families and young people to have the best start, as the name suggests.

It is worth pointing out that family hubs are required to provide support for children up to the age of 19, or 25 for those with special educational needs and disabilities. There is clearly a lot more thinking to be done. I appreciate that the Bill will specifically ringfence provision for under-fives, but ultimately we do not want there to be a cliff edge—we do not want all this support to suddenly drop off when children get to five because that would not maintain and make the most of the family hub model as it was established.

When I visited the Rees centre family and wellbeing hub in Plympton in my constituency, I was very impressed with what is going on there. It is a brilliant community asset that has been there since the ’60s. There is breastfeeding support, but what is also amazing is that it has a time bank, so there are all these mums bringing in their babies to see the health visitor or to be weighed—all the things that a family hub does for under-fives—but there are also older people from the community coming to meet, socialise and do things together.

When a family hub or a Best Start centre is truly embedded in a community, it has the opportunity to be a place where all sorts of things are delivered, and that combined delivery makes them even better. We do not want them to become centres where only people with children and those who have families go; we should open them up, to do as much as possible within the community, because that is at the heart of what they can do. It is really important that we look at the whole picture, as well as focusing on the first 1,001 days, and I look forward to hearing from the Minister how the Government intend to deliver family hubs right up to the age of 19.

As we discuss earlier support, there is a little elephant in the room. Evidence consistently shows that children under the age of two need to be nurtured by their parents primarily, and I think we are all saying the same thing today, but it is my personal view that parental presence requires childcare choice. More than two thirds of working mothers with pre-school children say that they would work fewer hours if they could afford it, according to the Department for Education, but too often parents feel pushed towards a one-size-fits-all model of formal childcare. We need to explore where we can offer parents more options in the earliest years and free them up to do what they feel is best for them and their family. It is not about telling parents what to do; it is about trusting them to make the right decisions for their family. We must never forget who matters the most to the baby: it is their parents. We should do everything we can to help mums, dads and carers be present as much as possible.

This Bill must be the start of a wholesale reframing of family support. Every stage of childhood matters, and we must back families every step of the way. That is why I am very keen to support the Bill today.

Pathways Study: Puberty Suppression

Rebecca Smith Excerpts

Monday 22nd June 2026 Commons Chamber

[James Murray]

Dr Cass has raised that point a number of times, particularly when she has spoken in public and been interviewed on her concerns about young people accessing equivalent drugs through an unregulated source—through online sources that are not carefully controlled and where there is no monitoring of the effects on young people. That is part of her motivation for recommending the approach that she proposes. As I said earlier, I and the Government want the decisions about what role, if any, such treatments play in the future to be based on the clinical evidence, with the highest possible safeguards in place for children involved in the trials.

[Rebecca Smith (South West Devon) (Con)]

I want to press the Secretary of State a little further on looked-after children in particular. At the beginning of his statement, he said that his bottom line is to protect the safety and wellbeing of children and young people. Given that parental or guardian permission has to be granted for the trial to take place, I am wondering who will give that permission for a child in care. Will it be himself, the Secretary of State? Will it be the foster parent? Will it be a social worker from a local council? We already know that looked-after children are overrepresented within the cohort of children with gender dysphoria. Ultimately, if we are going to protect them and make sure that their safety and wellbeing are at the forefront, we need some clear direction on what that is going to look like.

[James Murray]

I thank the hon. Lady for her question, which highlights the importance we all place on making sure that vulnerable children are protected in the way that the trial proceeds. Perhaps I can offer her some detail which might reassure her by explaining who is on the national multidisciplinary team. As I mentioned earlier, the national multidisciplinary team will have to give permission for young people to be involved in the trial, as will the NHS care team. That national multidisciplinary team has an independent chair and its membership comprises senior clinicians from a range of clinical backgrounds: paediatric endocrinology, general paediatrics, child and adolescent mental health, clinical nursing, safeguarding, adolescent medicine, allied health and service leadership. Those are the specialisms represented in the national multidisciplinary team, which means that those aspects of the child’s wellbeing are all being considered in that process.

Allied Health Professionals

Rebecca Smith Excerpts

Thursday 23rd April 2026 Commons Chamber

[Rebecca Smith (South West Devon) (Con)]

I start by paying tribute to the allied health professionals in my constituency and across the country, who work so hard to help people to regain and maintain their health. Indeed, I count many among my friends. From paramedics to physiotherapists, occupational therapists, speech and language therapists and so many others, I am always amazed at the skill and dedication of these professionals, who often work under intense pressure.

My constituent Jackie Lees-Howes is one of 174 registered physiotherapists living in my constituency. She highlighted several statistics that should give us pause for thought. Two thirds of the population will likely be living with a long-term health condition by 2035. Community waiting times continue to grow and, to make matters worse, the UK has far fewer physiotherapists per head than comparable countries. However, we know that physiotherapy is highly cost-effective, generating an overall return of around £4 for every £1 invested. It can prevent illness and help people recover more quickly, which reduces the strain on health services. Crucially, physios enable people to stay in and return to work. They help people to reduce pain, obesity and inactivity, contributing to a healthier and more productive population. Expanding the physiotherapy workforce alone could save the NHS hundreds of millions of pounds over the next five years.

However, as we have heard, many physios are struggling even to find a job due to recruitment freezes and a lack of entry-level positions, as well as problems with job security. Worryingly, the Government confirmed last year that they had made no estimate of the impact of recruitment freezes on physiotherapists and physiotherapist support workers.

Twenty-three per cent of my South West Devon constituents have at least one long-term condition. Over 18,000 are classed as disabled, slightly higher than the average across England. Relatively speaking, it is an ageing constituency, with 45% of constituents over the age of 50. That makes the role of physios and other allied health professionals in enabling people to prepare for and rehabilitate from things like cancer treatment and surgery even more vital.

I commend the Rehab Legends campaign led by Kate Tantam, an inspirational constituent of mine who works as an intensive care sister at Derriford hospital. Kate has spent years campaigning to ensure that every patient in the UK can access rehabilitation services towards the end of their stay in intensive care, which would end the current patchy provision. People might ask what Rehab Legends is. It is effectively a multidisciplinary team that helps rehabilitate men and women who have been on life support, because they often see deconditioning in the rest of their body. With rehabilitation, they stand a much better chance of moving on from intensive care.

Why is this important? At the moment, the step down from ICU to a normal ward is huge, and if people do not have the physical ability to take that step, their ultimate rehabilitation and ability to get back out into life will be significantly affected. That point has been raised time and again—it came up during the last Parliament in the work done by the all-party parliamentary group on intensive care, which my predecessor, Sir Gary Streeter, chaired—and it needs to be addressed. While that is not entirely about allied health professionals, I am sure the Minister will be aware of it, and it would be interesting to hear what might be done. Ultimately, the role of rehabilitation is good for patients and for society, because we want to enable everyone who has survived intensive care to leave intensive care and leave hospital.

We have heard plenty about occupational therapists and speech and language therapists. The Royal College of Speech and Language Therapists and others have highlighted that the NHS long-term workforce plan is likely to cover only speech and language therapists in the NHS workforce, which overlooks shortages in education and criminal justice settings. As we have heard, there is a real need for a holistic approach to developing the workforce, in recognition of the vital role played by speech and language therapists and others in supporting, in particular, children with special educational needs. Without capacity in the NHS for speech and language therapists, we will not be able to deliver on improving outcomes for some of the most vulnerable in our community, which I am sure we would all want to see.

Finally, I want to mention the work of allied health professionals who assess people for health-related benefits. We know from Department for Work and Pensions data published in January—rather late—that over half of assessors leave in their first year. Assessors describe stressful time constraints and impossible workloads as some of their reasons for leaving.

Under the current Government, one in 10 people in England and Wales is now claiming disability benefits, and the number is only set to increase. I urge the Minister to ensure that all allied health professionals are empowered to assess their patients without undue haste. I worry that otherwise this overstretched system may be incentivising assessors to recommend that a person receives disability benefits without having the appropriate time to thoroughly investigate their needs. Of course, that is in no way a reflection of these professionals themselves, as they are simply doing the job they are there to do with limited time and resources.

Let me finish with three brief requests. First, I urge the Minister to capitalise on the record number of newly qualified physiotherapists. Will she confirm what steps the Department is taking to ensure that newly qualified physiotherapists can be guaranteed an NHS job? Secondly, I urge her to commit to retaining the chief allied health professions officer role to ensure that their clinical expertise is recognised in the Department. Thirdly, a plug for rehabilitation: I would love the Minister to ensure that the role of intensive care rehabilitation is reflected in the NHS workforce plan, and a holistic approach is central to that.

I echo the concerns raised by the Chartered Society of Physiotherapy, which has criticised the Government’s requirement for integrated care boards to reduce their budgets by 50% and the impact that will have on allied health professional leadership roles. Under the previous Conservative Government, NHS England set out to increase our much-needed AHP workforce, as outlined in the 2023 NHS long-term workforce plan. This included an ambition to increase training places by 25% by 2031-32.

We know how critical allied health professions are to prevention and recovery. The Government must ensure that they prioritise them in the revised NHS workforce plan, which is due to be published this spring. The allied health professions are ideally placed to help people help themselves. If we want a healthier country and a more productive society, we must back them all the way.

Puberty Blockers Clinical Trial

Rebecca Smith Excerpts

Monday 23rd March 2026 Westminster Hall

[Rebecca Smith (South West Devon) (Con)]

It is a pleasure to serve under your chairmanship, Mr Mundell. I have strong concerns about artificially delaying puberty, but at the same time, I also want high quality, holistic support for young people who question their gender. The Cass review recommended psychological care as the first port of call for managing gender distress, yet the NHS trial shows a worrying bias towards medicalisation.

As a former corporate parent, I am alarmed that looked-after children were over-represented in referrals to the NHS Gender Identity Development Service. At the time, they made up just under 0.6% of the general population, but 5.9% of referrals. For children in care, the transition to adulthood is already a challenging time. They are often more vulnerable to the suggestion that puberty blockers could solve their problems. Despite that, children in care will still be allowed to enrol in any trial. Who will consent to their treatment? The state itself, represented by a corporate parenting board. That blurs the line between child safeguarding and institutional interest. The state is wearing two hats: legal guardian and trial sponsor.

Another serious issue is that the trial risks treating young lesbians as if they were born in the wrong body. Shortly before GIDS closed, 74% of teenagers referred to the clinic were girls. Most identified as lesbian or bisexual. Almost 70% said that they were attracted only to other girls, and 20% that they were attracted to both sexes. Yet in recent years, some young women have been encouraged to identify as trans rather than lesbian, and my view is that the trial will only reinforce that belief.

Lastly, at least 64 patients from the Tavistock clinic returned to living as their birth sex between 2010 and 2020. Detransitioners face huge social pressure to stay silent about their experiences, so I conclude by quoting the brave detransitioner Keira Bell, who said:

“The state assisted me in destroying my body during a period of distress. I was a tomboy who came out of an abusive, neglectful environment with a lack of positive role models, and I struggled with my sexuality. Stopping children’s brains and bodies from developing is not a solution, nor is it healthcare. It’s like giving Ozempic to an anorexic or alcohol to an alcoholic.”

We need a permanent end to the trial, not just a pause. Otherwise, even more young people will be left asking the same question: why did no one stop me?

GP Contract

Rebecca Smith Excerpts

Monday 16th March 2026 Commons Chamber

[Stephen Kinnock]

My hon. Friend makes such an important point about paying tribute to the incredible work that our GPs and their teams do right across the length and breadth of our country, including in Gedling; he is an excellent champion for his constituency. This is about marrying investment with reform. In addition to the £1.1 billion in the previous contract, the £485 million this year and the measures I mentioned to recruit more GPs to the frontline, there is also very important work happening around the shift from treatment to prevention in the 10-year plan. We are boosting childhood vaccination rates, providing better care for patients living with obesity and requiring GPs to share data with the lung cancer screening programme. This is about incentivising GPs, working with them as partners as we move forward into the modernisation of our health service.

[Rebecca Smith (South West Devon) (Con)]

The new contract has stated that GPs must offer on-the-day appointments for urgent requests—which they already do—and unlimited access during opening hours up to 6.30 pm, with no definition of “urgent”. Katrina, a constituent who messaged me today, said, “This will mean that those with complex needs, like me, will wait longer for appointments.” What reassurance can the Secretary of State offer constituents such as Katrina that this new system will work for everyone, not just those self-diagnosing their sick note as urgent?

[Stephen Kinnock]

The key point here is that GPs are the clinicians whom we trust to define what urgent means. There are, of course, a number of criteria and conditions that will ring an extra alarm bell and ensure that the patient is registered as urgent. It is worth mentioning that 46% of all GP appointments already take place on the same day as contact is made with the surgery—with the majority of those classified as urgent—so performance is already good. This is not something new that we are landing on general practice; it is much more about ensuring that we have a clear line of sight into who the urgent patients are and ensuring that they get treatment on the first day.

Transgender People: Provision of Healthcare

Rebecca Smith Excerpts

Tuesday 16th December 2025 Westminster Hall

[Rachel Taylor]

I thank my hon. Friend for sharing that experience. It reflects the reality for many trans young people and adults in the UK: discrimination from healthcare professionals, waiting lists stretching over years, a complete lack of local provision and a reliance on less well-regulated private providers. That is the state of healthcare for trans people in Britain today. It is woeful and inadequate, and it is letting people down.

The consequences are serious. Almost one in four transgender people avoid going to the doctor altogether for fear of mistreatment. They delay cancer screenings and push aside chronic pain, and their health outcomes worsen as a result.

[Rebecca Smith (South West Devon) (Con)]

The NHS has finally issued a call for evidence regarding a clinical pathway for adults who wish to detransition. Does the hon. Lady agree that that is a welcome and long-overdue first step, and that the NHS must continue making serious efforts to improve care for detransitioners?

[Rachel Taylor]

As I welcome services for trans people, I also welcome services for those people who do not feel happy in the gender that they have acquired. That is only right, but we have to get all those services right.

Trans people are now seeing their health outcomes worsen. Waiting times for gender-affirming healthcare are nothing short of a national scandal. Across the UK as of March 2025, more than 48,000 trans adults remained on waiting lists for that care. We rightly debate NHS waiting lists in this place: a year for a hip replacement; months for cancer screening. Nobody finds those waits acceptable, but freedom of information requests reveal that the average wait for gender services is 12 years in England, two years in Wales, 41 years in Northern Ireland and a staggering 58 years in Scotland. At one Scottish clinic, the wait was three times longer than the average British life expectancy.

--- Later in debate ---

[Rebecca Smith (South West Devon) (Con)]

It is a pleasure to serve under your chairmanship, Mr Turner. I will be brief because we are running out of time. Detransitioners are an often marginalised and misunderstood group. Ritchie Herron is a civil servant who underwent gender surgery in 2018 in order to live as a woman. That involved rearranging tissue in the genital area to create a vaginal opening. When he decided to detransition, he was concerned that specialists were unable to advise him clearly about the correct dosages of hormones that he should take during the process to avoid increasing his risk of osteoporosis. In brief, I simply ask the Minister what her Department is doing to look at how the NHS supports those who are detransitioning? That is not to say that those who are transitioning should not be able to access the support that they need, but what is the NHS doing to support those who want to detransition, especially those who experienced puberty blockers at a young age?

Oral Answers to Questions

Rebecca Smith Excerpts

Tuesday 21st October 2025 Commons Chamber

[Karin Smyth]

The hon. Member makes an excellent point; it was echoed by Lord Darzi in his report about the state of our hospitals, and I know many hon. Members have similar problems. I have visited many such hospitals and would be happy to discuss the matter with him further. I remind him that, of course, the Torbay and South Devon NHS foundation trust has been provided with £7.3 million from the estates safety fund for works at the hospital, and we are absolutely committed to ensuring that it will be developed in line with the programme.

[Rebecca Smith (South West Devon) (Con)]

6. What recent progress he has made on reorganising the NHS.

[The Minister for Secondary Care (Karin Smyth)]

We are putting the final nail in the coffin of the hon. Member’s party’s disastrous Lansley 2012 reorganisation—so bad that it made me become an MP. We are abolishing the world’s biggest quango, NHS England, along with 200 other bodies. The question is: why did the Conservatives not do that when they had the chance?

[Rebecca Smith]

Yesterday I met Lila, a sixth-form student at Coombe Dean school, who raised the issue of long waiting lists for mental health services for children and young people across Devon. What action has been taken as a result of the Government’s policy of reorganising the NHS to reduce the unacceptable delays in mental health diagnosis and treatment for children and young people, particularly in constituencies such as South West Devon?

[Karin Smyth]

All of us as constituency MPs are fully aware of the state of mental health services, particularly for young people, which is why my hon. Friend the Minister for Care is working at pace on our manifesto commitments to support young people, particularly through schools. We also understand the difficulties that her ICB in particular has with its financial situation—something we are also targeting as part of our reforms to ensure that ICBs develop services for local people in line with the expectations that we have set them.

Department of Health and Social Care

Rebecca Smith Excerpts

Tuesday 24th June 2025 Commons Chamber

[Rebecca Smith (South West Devon) (Con)]

We know that a key part of primary care is community pharmacy. Indeed, that was recognised in the Darzi report, which stated:

“One of the great strengths of the health service in England has been the accessibility of community pharmacy.”

The previous Government committed to community pharmacy through the introduction of Pharmacy First. The Darzi report also highlighted that 1,200 pharmacies have shut their doors since 2017, and increased medicine costs and rising national insurance costs will not be helping.

[Mr Richard Holden (Basildon and Billericay) (Con)]

Does my hon. Friend recognise that it is not just community pharmacies that are being hammered in this sector but hospices too, such as St Luke’s hospice in Basildon, which is facing a £450,000 rise in its national insurance costs? Does she also agree that Ministers are putting these costs on to pharmacies and charities that cannot make them back, which is absolutely killing community infrastructure in the health service sector?

--- Later in debate ---

[Rebecca Smith]

I entirely agree with my right hon. Friend. Indeed, St Luke’s hospice in my constituency will be facing exactly the same issues.

At risk of closure is Tubb pharmacy in Newton Ferrers in my constituency, which I have raised in this place before. Pharmacist Esi has been helped massively by an incredibly active community. The pharmacy supported a petition I delivered here in Parliament, and it provides essential services to the two rural villages of Newton Ferrers and Noss Mayo, but it is seeking Government action in order to secure its future.

While the estimates may highlight a commitment to delivering care closer to home, according to Community Pharmacy England there is still no clear path to the sustainable funding and operational model that is required by community pharmacy. It is needed by community pharmacies such as Tubb in Newton Ferrers, and it is needed by community pharmacists such as Esi. It is needed by the whole country to be able to deliver community pharmacy, Pharmacy First and, ultimately, to relieve pressure on primary care. I urge the Minister to provide this substantial funding for community pharmacy. I know that the Minister agrees that this work is incredibly important, and I urge her to ensure that we bring it to the fore as quickly as possible so that there can be a future for community pharmacy across the country.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Due to time constraints, I must now call the Front Benchers, starting with Helen Morgan.

Terminally Ill Adults (End of Life) Bill

Rebecca Smith Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[Dr Sandher]

I will make a bit more progress.

This has been a heated debate, and hon. Members on both sides of the House feel strongly about it. I am grateful to Members who came before me, who made my place here possible and who have spoken so powerfully and movingly in this debate, but I believe—and the evidence shows—that the colour of my skin does not belong in discussion of the Bill.

[Rebecca Smith (South West Devon) (Con)]

I rise to speak to amendment (a) to new clause 15, tabled in my name, which I hope hon. Members will support. Although it may seem technical, it is in fact a simple amendment with a significant impact. It will ensure that there is genuine protection against abuse, proper detection of coercion, and effective scrutiny of how the law works in practice. Simply put, it will ensure that deaths from assisted dying under the Bill will still fall within the coroner’s duty to investigate deaths under section 1 of the Coroners and Justice Act 2009. I will explain why that is important.

Like many hon. Members, I have been deeply concerned from the outset about how the Bill is drafted, its workability, and its impact on the NHS and on the lives of vulnerable people up and down the country. To be clear, my view is that one unintended death as a result of the Bill becoming law is one too many. I humbly ask hon. Members who are still considering their position, or who are minded to support the Bill, to consider this point about my amendment carefully: what is an acceptable error rate?

Based on the figures in the Government’s impact assessment, which I think underestimates the impact, even a 1% error rate would see a minimum of 13 wrongful deaths in year 1, with 45 per year by year 10. A 5% error rate would see 65 deaths in year 1 and 227 in year 10. A 10% error rate would see 131 deaths in year 1 and 455 in year 10. As I say, I think those are low-ball estimates, but they are nevertheless chilling. If this law is passed, it will be exceptionally difficult to say whether there have been errors or instances of abuse; or, at the very least, any errors picked up will be but a fraction of the true picture, as tragically those who would testify to the fact will already be dead. My amendment (a) to new clause 15 directly addresses that issue.

In England and Wales, a coroner will investigate a death when certain legal conditions are met. This duty is primarily governed by section 1 of the Coroners and Justice Act 2009. Judge Thomas Teague KC, who served until 2024 as the chief coroner of England and Wales, notes:

“any death arising as a consequence of the ingestion or administration of a lethal substance constitutes an unnatural death which the local coroner is under a statutory duty to investigate”.

Clearly, assisted dying meets that definition, and it is right that such deaths be afforded the best possible posthumous judicial scrutiny.

[Lizzi Collinge (Morecambe and Lunesdale) (Lab)]

Does the hon. Lady not feel that the provisions in the Bill already have safeguards? Also, and most importantly, does she not feel that putting a family through a coronial process when the death is expected is unfair, unjust and completely beyond the bounds of what coroners are meant to do?

[Rebecca Smith]

On the first point, I do not believe that the Bill is strong enough as it stands. On the second point, we are already dealing with the fact that families are not even guaranteed knowledge of their loved one having an assisted death, so I do not think the hon. Lady’s point is entirely to be considered.

As it stands, the Bill would disapply the duty of the coroner to investigate in the case of an assisted death that has been carried out in accordance with the Bill’s provisions. New clause 15, specifically, would amend the Coroners and Justice Act to clarify that assisted death does not constitute “unnatural death” for the purposes of the Act. I think it takes an extraordinary leap of imagination not to conceive of deliberately self-administering lethal drugs as anything but an unnatural death.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I am grateful to the hon. Lady for giving way; I want to support her in what she is saying. We are going through a process, as we consider the appalling situation of coercive control in domestic abuse cases, where a person who is a victim may not realise they have been a victim until years later. Obviously, a person who has gone through an assisted death will have no years later. Is the amendment not a way of making sure that we guard against the evil of coercive control?

[Rebecca Smith]

I thank the hon. Member for his intervention and I completely agree with him. These are the sorts of safeguards that even the promoter of the Bill is saying should be there. I do not think that they are in the Bill and my amendment to new clause 15 would make them much stronger.

[Simon Hoare]

My hon. Friend is right in what she says. Those of us who are opposed to the death penalty, for example, are against it because we do not believe in the infallibility of the state. The state can get things wrong; professionals can get things wrong—and when they do, there should be a proven, clear path as to how that wrongdoing can be identified, to try to ensure that it does not occur again.

[Rebecca Smith]

I thank my hon. Friend. The statistics I quoted earlier are pretty clear on the point he makes. Let me make some progress.

The work undertaken by the coroner is not a box-ticking exercise or a bureaucratic hurdle. In the context of assisted dying, it is an extremely powerful deterrent against abuse and malpractice. Again, to quote Judge Thomas Teague KC, in a letter to The Times on 7 May this year, he said that the removal of

“any realistic prospect of an effective inquest...would magnify, rather than diminish, the obvious risks of deception and undue influence”.

[Naz Shah]

I thank the hon. Member; she is making a very powerful speech. Does she share my concern about the removal of the coroner, as stated clearly by the Royal College of Pathologists, which speaks to her amendment?

[Rebecca Smith]

I thank the hon. Member and I will come to that point very soon. I will now make some progress; I will not take any further interventions.

I struggle to see how removing automatic oversight of assisted deaths squares with a commitment to enact legislation with the “strongest safeguards in the world”. By doing so, the Bill sets a lower bar for scrutiny and review, and creates an information deficit. Put another way, we simply do not know what we do not know. Implementing a novel piece of legislation such as this without ensuring the most robust possible scrutiny of deaths taking place under the Act is astonishing. Under the Bill, assisted deaths would be the outlier, as any other intentionally procured death would automatically be reviewed by a coroner. Why should deaths under this legislation be any different?

Requiring automatic scrutiny from a coroner for assisted deaths should not be viewed as an add-on at the end of the process or perhaps just a safety net, although it is that.

[Dr Simon Opher (Stroud) (Lab)]

Will the hon. Lady give way?

[Rebecca Smith]

No, I have already said that I am not going take any further interventions. I have been very generous with my time.

It is imperative to consider the whole picture, particularly regarding malpractice or coercion—whether that be on the part of medical professionals, families or third parties. In written evidence to the Committee, Dr Rees Johnson, a legal expert from Essex Law School, highlights that, in some cultures,

“decision-making is a collective process involving family and community members.”

--- Later in debate ---

[Dr Opher]

Will the hon. Lady give way?

[Rebecca Smith]

No.

Beyond coercion, automatic inquests provide vital opportunities to identify other critical issues that may not otherwise be picked up. Without a coroner’s inquest, there would be no post-mortem examination. This is not merely an academic point; studies have shown that autopsy reveals that one in four cases have been misdiagnosed. Without this oversight, as His Honour Judge Thomas Teague KC, the former chief coroner, notes, there is

“no certain means of knowing whether the approved substance has led to a quick and painless death, or a lingering and distressing one, or even whether it had failed to cause death altogether and the deceased had been dispatched by manual asphyxiation or some other unlawful means.”

I am not sure whether that could be more clear. The view of experts in this area—both the Royal College of Pathologists and the former chief coroner of England and Wales—is that this Bill’s proposals, as drafted, are not fit for purpose. I strongly urge hon. Members to support my amendment (a) to new clause 15.

[Several hon. Members rose—]