Terminally Ill Adults (End of Life) Bill

Toby Perkins Excerpts

Friday 16th May 2025 Commons Chamber

[Kim Leadbeater]

There is absolutely nothing in the Bill that has any suggestion that any funding would be impacted by whatever decisions organisations make around assisted dying.

I will make some progress. New clause 10(1) states clearly:

“No person is under any duty to participate in the provision of assistance in accordance with this Act.”

That is something I feel strongly on a personal level. If people do not want to be involved, they should not have to be involved, and those who do, should. Subsection (5) covers pharmacists and pharmacy technicians and new schedule 1 provides comprehensive employment protections, so I hope that whatever colleagues’ views are on assisted dying, they will see the value of these changes and support them.

[Mr Toby Perkins (Chesterfield) (Lab)]

I thank my hon. Friend for these amendments, because a number of people have written to me concerned about the very issue that she is raising. Does she agree that many people will just be opposed to assisted dying in all its forms, and I entirely respect that, but if that is really their objection, they should be honest about that and not pretend that it is only particular amendments they need? They should make the argument that they actually want to make.

[Kim Leadbeater]

I thank my hon. Friend for that intervention, and I agree that we must be respectful, but we must also be honest with each other.

Amendment (a) to new clause 10 was tabled by the hon. Member for Reigate (Rebecca Paul), who I thank for her work on the Bill Committee. I understand the thinking behind the amendment, but I worry about unintended consequences for patient care and protection. I have been advised that that is the case, and I think the Minister will speak to that. I think there is consensus across the House that, in the interests of patient safety, it is vital that there is clear and open communication, and sharing of information, between healthcare professionals in the assisted dying process. If an employer can stop their whole workforce participating in any sort of assisted dying services, it could prevent the sharing of information or the recording of information in a patient’s records. That could relate to safeguarding, and it could put patients at risk as a result of the employer’s decision. Terminally ill patients may be receiving different treatment at different places and from different healthcare professionals, and it would potentially be harmful if they were not able to transfer information or records.

There are also workability issues with amendment (a) to new clause 10. It is not clear how it would work with regard to the requirement in subsection (7) for professionals to provide information to an assessing doctor about a patient—someone whom they may have previously treated—or in relation to information about a specific condition that they may specialise in. That information would need to be provided in the interests of patient care. An employee will always be bound by their contract of employment, but flexibility is needed, as many health and care professionals work for multiple employers. It is not uncommon for clinical staff to have more than one employer—for example, a doctor may be employed by the NHS but also work for a hospice—so it is not a straightforward scenario. Just as it would be wrong for anyone to be compelled to be involved in the process, it would be wrong for anyone to be prevented from doing so, particularly if there was an impact on patient safety.

--- Later in debate ---

[Rebecca Paul]

I wholeheartedly agree.

There is much to discuss today and there is little time, so I will start at the beginning of the Bill, at the point at which the criteria for eligibility for an assisted death are set. It is there that important safeguards are needed to ensure that those who should never be eligible are excluded. We should not make the mistake of assuming that a doctor will always make the right decision or that they are infallible. It is incumbent on us to put in place law that makes it harder for them to get it wrong—that makes it harder for someone vulnerable to fall between the cracks.

[Mr Perkins]

The hon. Lady has just agreed with a point made by the hon. Member for Dewsbury and Batley (Iqbal Mohamed). Exactly the same point was made when this House voted against the Assisted Dying (No. 2) Bill back in 2015. Would she say that in the nine years after the House voted against the Bill, we saw a golden age in palliative care as a result, or does she think that if we wait for palliative care to be perfect we might never vote in favour of assisted dying?

[Rebecca Paul]

The evidence is clear that palliative care does not get better when assisted dying is introduced; we heard that in the Bill Committee. We should absolutely look to address palliative care, because that will benefit more people. I will come to that point later in my speech, so I will not discuss it any further now. I do not want to get ahead of myself.

There are many helpful amendments in this vein—namely, new clause 16, new clause 9 and amendments 80, 14, 38, 81, 24, 30 and 31. In simple terms, they seek to tighten and refine the eligibility criteria for an assisted death by setting out when and for what reasons an assisted death should be allowed, and by ensuring that those who are vulnerable are protected from something that may not be in their best interests.

Interestingly, on Second Reading the argument put forward for assisted death was that those who are dying should be spared unbearable pain. This is an argument that everyone understands and has full sympathy with. No one in this place wants people to endure pain as they come to the end of their life; I certainly would not want that for my loved ones or indeed for myself when my time comes.

But then the arguments being put forward changed. There was less emphasis on pain, and more on choice and autonomy. The word “autonomy” came up again and again in Committee—and autonomy is important, of course, but up to a point. From a proposal to provide a humane end to someone’s pain when it cannot be relieved in the last months of their life, we have moved to a proposal to provide an assisted death service to those who choose it for any reason, even if the pain can be alleviated by palliative care. This approach, however, comes with a cost to others: family, clinicians and broader society. This really is momentous. There is no going back from such a massive shift. A move to autonomy trumping everything else changes everything.