Terminally Ill Adults (End of Life) Bill

Tony Vaughan Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I rise to speak to amendment 3 in my name, which would do the exact opposite of the amendments of the hon. Member for Newcastle-under-Lyme (Adam Jogee)—in fact, it would see the commencement period reduced from four years to three years. As a member of the Bill Committee, when we had the initial conversation about increasing the commencement period from two years to four years, I was the only person to speak against it, and I pushed it to a vote.

What frustrates me about the situation we are in is that, in effect, we are acknowledging that the reason we are here and debating this Bill is that the status quo is not acceptable. People are pushed to taking decisions that they should not be and having to go to foreign countries to have opportunities overseas. Those of us who support the Bill are broadly in agreement on those principles. A number of things frustrate me about the four-year period, principally that the people in office—the Government of the day—will not necessarily be here to implement it. I am really hesitant about supporting a Bill when we do not know who would see through those details.

Amendment 3 would reduce the threshold back down to three years, which would still be more than most jurisdictions around the world. Countries have implemented assisted dying legislation after as short a time as six months, 12 months or 18 months, so three years would still be a substantial increase compared with other countries. We are not innovators or leaders in this field: there is no reason why we cannot take best practice and learn from and speak to colleagues around the world. I believe that this Bill has the strongest safeguards of any, which is why I think an implementation period of three years would more than meet the requirements.

[Tony Vaughan (Folkestone and Hythe) (Lab)]

I want to put on record my sincere thanks to my hon. Friend the Member for Spen Valley (Kim Leadbeater) for the way that she has approached this Bill. Her willingness to listen to concerns from across the House has been evident, not least in new clause 14, brought forward in the names of the hon. Members for Reigate (Rebecca Paul) and for West Worcestershire (Dame Harriett Baldwin). That is a testament to how we can work together on these deeply sensitive issues.

I rise to speak in favour of new clause 14 and against amendment (b) to new clause 14. I absolutely understand the intent behind the amendment in the name of my hon. Friend the Member for Rochdale (Paul Waugh). Nobody in this House wants to see voluntary assisted dying services being advertised in a way that is insensitive, inappropriate or exploitative. We all want to protect individuals, particularly those who may be vulnerable or more easily influenced, so I fully share that concern. Although I respect the principle behind the amendment, however, I do not believe it offers the right solution.

New clause 14 rightly prohibits advertising voluntary assisted dying services to the public, while giving Ministers tightly defined powers to create appropriate exceptions through regulations. That is important, because in a healthcare system as complex as ours, we must be able to draw the line between unethical promotion and responsible professional communication. I think the new clause gets that balance right.

--- Later in debate ---

[Tony Vaughan]

I will press on.

Secondly, the amendment attempts to limit the scope of future regulation by barring any changes to the Suicide Act 1961, but that is already covered by new clause 14, which prevents other changes to this Bill, should it become an Act. The amendment is not only duplicative, but closes off avenues for future clarity that might be needed in the Suicide Act, such as to ensure that offences around coercion or fraudulent practice are properly dealt with.

In short, the amendment does not add clarity; it risks confusion. It does not strengthen the advertising ban; it introduces constraints that could make it harder to enforce with evolving practice.

[David Smith (North Northumberland) (Lab)]

I thank my hon. and learned Friend for giving way, given the time constraints. I have a simple but key question: does an advertisement include a leaflet on a GP’s surgery table or on a door going into the GP? It seems unclear to me what is information and what it advertisement.

[Tony Vaughan]

That will have to be worked out; I do not have the answer at my fingertips, but others might.

I was pleased to hear my hon. Friend the Member for Spen Valley say earlier that she is open to working with my hon. Friend the Member for Rochdale and others in the Lords to find a workable way forward on all these issues. I hope that he will take her up on that offer. This is obviously an area where constructive cross-party work could ensure that strong safeguards are achieved without unintended consequences.

[Several hon. Members rose—]

[Tony Vaughan]

I am essentially finished.

I urge hon. Members to reject amendment (b) to new clause 14 in its current form, not because we oppose its aim, but because we can and must find a better way to achieve it.

[John Glen (Salisbury) (Con)]

I am grateful to have my first opportunity to contribute on this Bill. It would not be appropriate to dilate on my profound anxieties about it, but I approach these amendments in the spirit of constructive engagement. I rise to speak to linked amendments 82 to 86, which would strengthen the panel by giving it some of the features of the High Court safeguard that was, regrettably, removed.

We heard from the hon. Member for Spen Valley (Kim Leadbeater) that the panel will now be stronger because it includes a broader range of expertise. The argument against that, of course, is that the High Court was a stronger safeguard because it has the powers of a court and the independence of the judiciary. My amendments would mean that we do not have to choose between the two: the panel is part of the Bill, but we can have a better panel if we give it some of the features of the High Court, namely its independence, the calibre of its judges, and its powers as a court.

Amendment 82 would require all panel members to be appointed by the Judicial Appointments Commission, which nominates judges in England and Wales. Currently, the selection of panel members is wholly down to the voluntary assisted dying commissioner. Schedule 2 says:

“The Commissioner must make appointments to a list of persons eligible to sit as members of panels.”

I have absolutely no doubt that the commissioner will be someone of great integrity and experience, but he or she will certainly be a strong advocate of assisted dying, as will those who put themselves forward for the panels. That may create an impression that the VAD commission is a self-selecting group with a particular set of institutional views.

If the system is to command public confidence, I believe that appointments would be best administered by an external body, and the Judicial Appointments Commission is the obvious choice. We in this country trust the judiciary, partly because we know that they represent no set of opinions.

Hughes Report: First Anniversary

Tony Vaughan Excerpts

Thursday 27th March 2025 Westminster Hall

[Sir Julian Lewis (New Forest East) (Con)]

I must say, the hon. Member for Leeds South West and Morley (Mark Sewards) has done us all a service by outlining in detail one case out of what are understood to be a minimum of 10,000; some estimates put the number of people damaged by mesh as high as 40,000. We should bear that statistic in mind when we think about the limited redress that people have had so far through the courts.

In the time available, I wish to touch briefly on the topics of research, legal cases, waiting lists and financial support. I make no apology for coming back to the question of research, because as we have heard, the victims of the mesh implant scandal are still suffering today, and there is no definitive gold standard of how to remediate their suffering.

I did table a question in February that drew attention to a particular world-leading expert called Dr Dionysios Veronikis, who, I gather, has developed extremely effective mesh-removal methods in Missouri. I believe that he has, in the past, offered to give the benefits of his research and successful practice to members of the NHS. I would hope that the Minister would take this away and consider whether an effort should be made to reach out to the best practitioners worldwide on mesh removal and take advantage of their expertise.

[Tony Vaughan (Folkestone and Hythe) (Lab)]

On the question of treatment, one of my constituents, who I will call Louise, endured years of pain and suffering due to the complications from mesh implants. After facing delays caused by local hospitals, she had no choice but to pay for private healthcare that would remediate the issue in one operation. That would not have been available on the NHS. She would have had to go through three separate, painful and lengthy procedures. Does the hon. Member agree that her experience underscores the urgent need for investment in urogynaecology services, as well as the justice that everybody is rightly calling for?

[Sir Julian Lewis]

That is exactly right. The problem is that people are going back for partial remediation time and time again, and it is not achieving the desired outcome.

When we move on to the question of how someone can get financial redress other than by virtue of a Government scheme, we find that of the 1,252 legal cases initiated between 2014 and 2024, only 356 were settled in or out of court with damages, but 678 were concluded without any such damages being awarded. I understand that many of those rejected were rejected because they were out of time, which leads me back to a point that I highlighted during the previous debate we had on this, in December 2024, in which it was pointed out that the 10-year limit on initiating action arising out of medical devices needs to be extended because, in this particular case, the limit has often long passed before it can be established that the victim was damaged by mesh in the first place.

I said we should remember that minimum figure of at least 10,000 mesh-damaged women and bear in mind that out of that pretty large figure—and the real figure is probably much larger still—only 1,200 legal actions were initiated. That is hardly surprising because of the extra burden placed on someone initiating a legal action.

I would also like to look at the question of removal centres. There are nine of these specialist centres, and we have established that people who are justifiably extremely worried about going back to one of them that might be run by the very person who inserted the mesh, do have the option of visiting other centres. However, when it comes to waiting times there is a huge variation. The waiting time for Bristol, which has a particularly high reputation, is much longer than for some of the other centres.

Finally, on the question of financial support, we know that the Government have had to take moves to deal with the question of personal independence payments. We hope that will not affect these victims adversely.

Cancer Strategy for England

Tony Vaughan Excerpts

Thursday 31st October 2024 Westminster Hall

[Tony Vaughan (Folkestone and Hythe) (Lab)]

It is always a pleasure to serve under your chairship, Mr Betts. I thank the hon. Member for Wokingham (Clive Jones) for securing this important debate.

I will start by talking about a constituent who emailed me last week. She is a cancer patient, and when she was discharged from hospital she was informed that there is no specialist cancer rehabilitation and recovery support in Folkestone—a town of 52,000 people. She was told that the nearest support could be accessed only in the neighbouring constituency of Dover or in New Romney, which is 14 miles away. However, she does not have a car, and the effects of the cancer treatment make it challenging for her to move around. Folkestone has been allocated a single cancer support nurse, but they are expected to cover the patients at eight GP surgeries in the area of Folkestone and Dover—a town with a population of 116,000. We obviously do not need to be maths geniuses to work out that the ratio of nurses to the population is unacceptable.

Cancer is the UK’s biggest killer, and as we speak more than 3 million people are living with it. Lord Darzi’s recent report highlighted in stark terms that cancer patients are waiting far too long to be diagnosed and treated, and when they leave hospital there is inadequate support for recovery and rehabilitation.

The lack of a national cancer plan correlates with, and is likely to be one of the causes of, the geographical inequalities in access to cancer care and rehabilitation, which affect my constituency. I appreciate that the NHS long-term plan includes important commitments for cancer services, but it does not provide the comprehensive transformation needed across all areas of control, including research and prevention. A critical question for the Government is: what can we do to ensure that a national cancer strategy generates additional capacity in cancer care and rehabilitative support?

The statistics are shocking and a national disgrace. According to Macmillan Cancer Support, in 2023 almost 90,000 people with cancer across the UK waited more than two months from either urgent referral or when the cancer was first suspected to start treatment. The most recent cancer care waiting times for England, to July 2024, showed that only 68% of people received a cancer diagnosis and started treatment within 62 days of an urgent referral. As the hon. Member for Wokingham reminded us, the 85% target has not been met since 2015.

The situation is not inevitable. I agree that we need to start with a comprehensive plan for cancer of the kind that many of our European partners have. When the 10-year NHS plan is published in spring 2025, it should contain a national plan for cancer that focuses especially on how waiting times for diagnoses and treatment can be reduced and on how geographical variations in the quality of cancer treatment and care can be tackled. The plan should focus on how we as a nation can recruit and retain cancer care and rehabilitation specialists; how we can use new technologies and medicines to improve treatment outcomes and increase survival rates; and how we can use our thriving life sciences sector, to which my hon. Friend the Member for York Central (Rachael Maskell) referred, to reduce diagnosis and treatment waiting times.

I fully appreciate the state of the NHS that the Labour Government have inherited—it struggles to recruit and retain, it has been starved of capital investment, and its workforce have had their morale beaten down by successive Conservative Governments—but we can do better. It falls to the Labour Government to lead the way forward so that we have an NHS that can effectively treat, rehabilitate and support patients, and prevent this terrible disease.

I pay tribute to charities such as Macmillan, which do a brilliant job of providing cancer care to patients. We must never forget their compassion, empathy and service; that should inspire us every day in this House.

Mental Health Support

Tony Vaughan Excerpts

Thursday 10th October 2024 Westminster Hall

[Tony Vaughan (Folkestone and Hythe) (Lab)]

It is a pleasure to serve under your chairship, Mr Dowd. I pay tribute to my hon. Friend the Member for Ashford (Sojan Joseph) not only for securing this debate but for his tireless, dedicated work as a mental health nurse in the NHS. I thank him for his service. His analysis of the problems and solutions was masterful, and Parliament is all the stronger for having his expertise and experience in this place.

The issue of mental health support is a policy challenge that goes beyond party political lines. Any civilised society is judged on how it treats its most vulnerable. The state of people’s mental health in our nations is incredibly concerning. As a former trustee of South Kent Mind in my constituency of Folkestone and Hythe, I have seen a downward trajectory in people’s mental health outcomes, particularly in deprived areas, and how mental health services are increasingly under strain. I also pay tribute to the incredible work done by South Kent Mind, which provides invaluable advice and well-run and well-attended classes, such as cookery and exercise classes, which provide local people with a sense of community, togetherness and support. Statistics from Mind have laid bare the reality. Each year, one in four people in England will experience a mental health problem of some kind, and one in six people report experiencing a common mental health problem, such as anxiety and depression. The number of people reporting self-harm went up by 62% between 2000 and 2014, and the number of people reporting suicidal thoughts in the past year went up by 30% between 2000 and 2014.

The mental health of people in this country is undoubtedly deteriorating, and we know that some groups are more likely than others to be impacted by mental health problems, such as the LGBTQIA+ community, black British people and women aged 16 to 24. There are several reasons behind the steep increase in suffering, such as the giant evils of inequality and austerity that have ripped the heart out of our communities. Unemployment and poor housing still plague people’s mental health, just as they did in the age of the Victorian workhouse. There are in addition recent phenomena, such as the rise of social media, creating unprecedented pressures on young people to look a certain way, and the decline in physical health in our communities, especially in de-industrialised areas.

As a society we say that one suicide is too many, and that we want to remove the stigma around mental health. But as we know, the stigma festers in too many houses, homes, offices and sports clubs, particularly with men and boys, for whom talking about feelings or being seen to be vulnerable can be perceived as weak or embarrassing. I sense that I am out of time, so I will sit down.