Terminally Ill Adults (End of Life) Bill

Sadik Al-Hassan Excerpts

Friday 13th June 2025 Commons Chamber

[Sadik Al-Hassan (North Somerset) (Lab)]

Before entering this place last July as the Member for North Somerset, I had been a pharmacist for nearly 20 years. Pharmacists have a unique role in our healthcare system as the group of health professionals who specialise in drug usage and safety. That is where I wish to focus my thoughts today, and on which I offer the House my expertise.

Throughout the passage of the Bill, we have had the great benefit of learning from a number of international examples. In Australia, we have seen a carefully designed countrywide pharmacy system that has delivered self-administered assisted dying safely and with dignity. The evidence from that experience is greatly reassuring. Even in cases where the drug was not fully ingested, every patient who made use of the service died peacefully and without complications, with not a single complaint yet received from any of the families involved.

From Switzerland, we have learned from decades of practice, over which they have refined the substances and processes involved to the point where complications are now nearly unheard of. Their approach demonstrates that with care and rigorous regulation, drugs can offer an effective and compassionate route to end one’s life.

That brings me to new clause 13, introduced by my hon. Friend the Member for Spen Valley (Kim Leadbeater). The clause outlines a comprehensive framework for the oversight and safety of substances involved in assisted dying. As is only right for life-ending drugs, the public expect the highest standards of transparency and the highest standards from manufacture to dispensing. As someone who has been involved in every facet of pharmacy for the past 20 years, I believe that the clause meets all our expectations. By strengthening safeguards and enhancing the workability of the Bill, new clause 13 ensures that healthcare professionals can act with clarity and confidence.

Amendment 72 is similarly important, and I believe it will provide much assurance to those in this place who are uncertain about whether they can support the Bill. By ensuring that all regulations made by the Secretary of State under new clause 13 are subject to the draft affirmative procedure, it will ensure that this place continues to play a central role in overseeing the safe and effective implementation of this legislation for years to come, and through our collective and continued scrutiny, it offers the opportunity for many millions of constituents who have contacted us on this issue to continue to have their voices heard and their concerns answered.

[Dame Harriett Baldwin (West Worcestershire) (Con)]

I rise to speak to new clause 14 and amendments (a) and (b) to that new clause. I am honoured to speak after the hon. Member for Rochdale (Paul Waugh). I also thank the hon. Member for Spen Valley (Kim Leadbeater) for working closely with us on the issue of banning advertising. Whatever our views on assisting terminally ill adults to end their lives—and I remain implacably against the potential harms that arise when our society and our imperfect state are given permission to help people kill themselves—I have to acknowledge that there was a majority on Second Reading in favour of the Bill and a majority for closing down debate in the last sitting on Report.

Thinking ahead to the possibility that this Bill might get on to the statute book, I hope that everyone participating in the debate will recognise that we should not allow the services of the organisations that will arise from the legislation to advertise on television, online, on posters, on TikTok or on any platform that our constituents may see.

We can all imagine a scenario where, if the Bill passes without the House agreeing to new clause 14, independent contractors and not-for-profit firms, and perhaps even the NHS, will be able to advertise to potential customers, for instance on afternoon television. Can you imagine a situation, Madam Deputy Speaker, where, while watching a repeat episode of “One Foot in the Grave”, an advert runs for a funeral plan company, and is then followed by an advert for an organisation offering services to make it easier to have an assisted death?

Members may think the situation I am painting is merely hypothetical, but in Belgium, in fact, the Government themselves are running online adverts featuring young, healthy women at a yoga class talking about how they are worried about granny’s situation, and discussing whether they have considered telling her about the option of assisted dying.

I am grateful to the hon. Member for Spen Valley for tabling new clause 14. It is not perfect, but she and I have had a lot of discussion about the wording. I also support the intention behind amendments (a) and (b) to new clause 14. It is important that Ministers confirm—as we have heard before, and as I hope we will again today—that encouraging assisted dying under the Bill remains a crime under section 2 of the Suicide Act. However, this requires showing intent to encourage, and adverts might be framed so that they are not so intended, so a specific provision on advertising is needed in this legislation.

I am also concerned about the scope of some of the exceptions in unamended new clause 14. I am grateful that the example set out in subsection (2) does not refer to potential service users, but there is nothing preventing the Secretary of State from exercising Henry VIII powers to exempt them, and doing so would negate the point of the prohibition. I would be grateful if the Minister would confirm that the power will not be exercised to create exceptions for adverts targeted at potential service users.

It is the case, as the hon. Member for Rochdale mentioned, that a number of advert bans already exist on the face of legislation, such as the Cancer Act 1939, the Surrogacy Act 1985 and the Tobacco Advertising and Promotion Act 2002. Such bans are set out clearly on the face of those Acts.

I hope the matter can be resolved. I hope the House today will, at a minimum, support new clause 14. I hope that the House will also support the strengthening amendments, which I endorse. I hope that Ministers will confirm that these powers will never be used to create an exemption to section 2 of the Suicide Act in order to partially allow encouragement of assisted dying, as I think it would defeat the whole point of the provision.

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[Gregory Stafford]

I entirely agree. Some of the amendments tabled by my hon. Friend the Member for Gosport (Dame Caroline Dinenage) may address that.

[Sadik Al-Hassan]

Will the hon. Gentleman give way?

[Gregory Stafford]

I will make a little progress, but I will give way to the hon. Gentleman in a moment.

My amendment would require the Secretary of State to prohibit the use of medical devices designed to induce death by the administration of gas, such as the Sarco suicide pod, which has been in the press recently. That device bypasses medical oversight entirely and presents an ethical rupture in our current framework. If the Bill proceeds without safeguarding against such methods, we risk opening the door to a deeply troubling precedent—one that would erode professional accountability and compromise the integrity of end-of-life care.

[Sadik Al-Hassan]

I would like to share my expertise as a pharmacist with the hon. Member. Drugs can be used for many indications and are quite commonly used in unlicensed situations, where there would be less evidence to support them than in the situation that we are discussing today with new clause 13: an idea that is incredibly well researched, practised and evidenced in multiple countries.

[Gregory Stafford]

I thank the hon. Gentleman for his intervention. I do not disagree that drugs are used for different things; that is not the thrust of the argument that I am making. What I am saying—relatively clearly, I hope—is that when the drugs we would potentially use in these situations have been used, there have been unintended consequences and side effects. We must ensure that the drugs we use, if the Bill passes, are absolutely effective in what they are intended to carry out: namely, the end of the life of the individual.

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[Dr Johnson]

I think one of the key problems with this form of intervention, compared with others, is that we cannot ask the patients afterwards how that felt. We cannot get their feedback, because they are dead. If we are going to give them things such as neuromuscular blockers or sedatives, we may not be able to tell what they feel. There are physiological ways in which we can monitor patients and get some idea—perhaps in their heart rate or blood pressure—but we will not be doing that. That is, therefore, one of the reasons for my tabling the amendments, to ensure that the drugs are properly regulated by the MHRA, so that we know that they have been properly tested on the purpose for which they are to be used.

[Sadik Al-Hassan]

Will the hon. Lady give way?

[Lizzi Collinge]

Will the hon. Lady give way?

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[Robin Swann (South Antrim) (UUP)]

I rise to speak in support of amendment (a) to amendment 77, which is in my name. I should also refer to my entry in the Register of Members’ Financial Interests about my involvement with the Royal College of Psychiatrists.

New clause 13, we are told, is a replacement for clause 34; I hope that Members have taken the time to compare the two. New clause 13 contains even more powers than clause 34. It follows the trend of this Bill: instead of more detail being added, more powers are added. It seems to me that the line is, “There are some issues that we’ll sort out later,” but that this place will not be involved in that “later”. What is particularly concerning is that the powers that the Bill creates contain no explicit limit or guiding principle by which they are to be exercised. Nor do we have the benefit of a policy paper from the Secretary of State saying how he intends to exercise those powers or how his successors will.

I believe that the provisions relating to “approved substances”—clause 25 and new clause 13—face a real problem. As Dr Greg Lawton, a barrister and pharmacist, told the Committee in written evidence, the lethal substances intended to end life are not medicinal products within the meaning of the Human Medicines Regulations 2012. That definition is itself derived from EU law, which states that

“the term ‘medicinal product’…must be interpreted as not covering substances whose effects merely modify physiological functions and which are not such as to entail immediate or long term beneficial effects for human health.”

That creates the real problem: if the substances are not medicinal products, why does the Bill provide that pharmacists are to be involved in their preparation and why would doctors be supplying them? New clause 13(4) seeks to get around the problem by giving the power to the Secretary of State to amend the Human Medicines Regulations 2012 so that the substances fit in. The impact assessment tells us that the Government have no plans to conduct or rely on the sort of scientific studies normally done for drug approvals or for the MHRA to be involved.

[Sadik Al-Hassan]

As a pharmacist, I should say that the drugs to be used for assisted dying are commonly used in pharmacy now. It would be obvious for pharmacies to supply those drugs in some way, shape or form. I accept the hon. Member’s point about medicines being used, but he will, I hope, accept my point: how would the same studies used to approve treatments be used to approve their use for death?

[Robin Swann]

I think the hon. Gentleman said in an earlier intervention that those medicines would then be used off licence, to the risk of the prescribing doctor and the person using them. That is where the risk falls back on the individual rather than being covered by anything in the Bill. That is where my regret comes.

I understand the need to treat the substances as medicinal products in England and Wales if it is the will of the House to change the law here; what I cannot understand is why the law should change the situation for the rest of the United Kingdom. That is the basis of my amendment to amendment 77. The House is not voting for assisted dying in Northern Ireland, so it has no locus to change the definition of a medicinal product in Northern Ireland in order to accommodate this Bill, which we have been told applies to England and Wales only. Or is it the intention of the Bill’s sponsor or those behind her to extend it to Northern Ireland at a later date, using some of the Henry VIII regulations in it?

There is a further issue in Northern Ireland. We are still in part subject to EU law, and I would be interested to know whether the Government have considered that aspect. Can the Minister really change, by ministerial diktat, EU law in Northern Ireland when it comes to the use of these substances? If so, why is he not being granted such power in other areas of significance to Northern Ireland? Why only this? Why has so much Government time previously been spent on medicine regulation and supply for Northern Ireland? Why did the right hon. Member for Melton and Syston (Edward Argar), as the Minister of State for Health, and I, as the Minister of Health in Northern Ireland, spend so much time on that? To that extent, I ask the hon. Member for Spen Valley (Kim Leadbeater) and the Minister: what engagement has there been with the Department of Health in Northern Ireland or the chief pharmaceutical officer for Northern Ireland? Or is this another part of the Bill that is being put in to meet the promoter’s needs without any background or engagement?

In conclusion, the application of those provisions to Northern Ireland also has implications for the conscience protection. If, as a result of regulations made under those provisions, pharmacists in Northern Ireland are required to be involved in the manufacture or preparation of such substances, they will not have the benefit of the conscience clause, as that clause has not been extended to Northern Ireland. I therefore oppose the extension of those provisions to Northern Ireland and Scotland. I will also oppose amendment 77 and ask hon. Members to support amendment (a) to amendment 77 in my name.