Danny Kruger MP: speeches 2025

Speeches

• 12 May 2025 · Personal Independence Payment: Eligibility Criteria · Hansard source

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  I look forward to the OBR’s report, and also to its assessment of the impact of the Employment Rights Bill. We know that many tens of thousands of jobs are going to be lost because of the national insurance rise, and we know from the OBR that because of the changes that the Government have introduced and the scrapping of the measures we were introducing, 16,000 fewer people will be in work and almost half a million more will be on long-term sickness benefits. However, let me ask the Minister about disability benefits. Is he aware that half the number of people who receive PIP who have multiple sclerosis will no longer be eligible for that benefit under the plans that the Government are bringing forward? A quarter of people with cerebral palsy and three quarters of people with arthritis will also be ineligible. Is the Minister happy with that, and if not, what hope can he give the hundreds of thousands of people who are being abandoned that the Government will look after them?

• 7 May 2025 · Personal Independence Payment: Disabled People · Hansard source

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  The hon. Gentleman will be gratified to know that we are not in government, so it is not for us to come forward with precise plans. At the end of the previous Parliament, we had a manifesto commitment to reduce benefit spending and reform disability benefits and UC. We are now in a position of policy formulation, so I am afraid I am not able to tell him exactly what we would do. My role is to challenge the Government on why they have taken so long to come forward with an absence of meaningful reform plans. Unlike the hon. Gentleman, I want to see benefit spending reduced. I think we spend too much on welfare in this country, but that is because we have social breakdown and poverty. The answer to that is not simply to cut benefits without reforming the system, but to reduce the drivers of poverty. I recognise many of the problems with PIP, and I understand the imperative for change. Members have powerfully made the case that the system is currently inadequate, particularly for people with fluctuating conditions. We have heard powerful testimony about that in the Work and Pensions Committee—the Chairman and many other members are here. In fact, just this morning we heard powerful evidence from people talking about mental health. People who have a set of very complex, interconnected needs might not reach four points on any one measure, so could lose PIP under the Government’s proposal. I have read evidence from the MS Society that makes the same point: 48% of PIP recipients with MS do not reach four points in any one of the measures, so would be at risk. I am very concerned on behalf of those individuals. I am also concerned that we do not even know how many such people there are. Members made the point that it took a freedom of information request to get the figure of 1.3 million out of the Government. That is not the figure that was officially released. As the hon. Member for Torbay (Steve Darling) said, we are also unclear about the effect on passported benefits, which is a significant question for the Government to answer. Most of all, we do not know what the Government’s announced assessment review will come forward with, yet we are making the cuts before we understand how the method of assessing eligibility will be reformed. I implore the Minister to pause the measures set out in the Green Paper. We need a proper review not just of the assessment but of the way the whole system works. We absolutely need to bring down the benefits bill, but we do that by reducing demand for welfare, and many of the levers for that are of course outside the DWP. Nevertheless, we should redesign the system itself because of the many problems I have identified. As Members said, we should do that with claimants, not to them. People voted for change in 2024, but they are not getting it. The Prime Minister promises more of the same—to go “further and faster” on the course he is already on. I deeply regret what he is doing. I have very great respect for the Minister. Few people have spoken in Parliament with greater authority, conviction and expertise on the subject of welfare in recent times. I have great sympathy with him for having to defend this policy position, which I do not think he would have defended in opposition. I echo the points made by the hon. Member for York Central (Rachael Maskell) and the right hon. Members for Hayes and Harlington (John McDonnell) and for Hackney North and Stoke Newington. They said that Labour should be better than this, and I agree: we should all be better than this. My party will stand with Members who oppose the changes.

• 7 May 2025 · Personal Independence Payment: Disabled People · Hansard source

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  Thank you very much indeed, Dr Allin-Khan, for calling me to speak. It is a pleasure to participate. I acknowledge the powerful speeches made by all Members this afternoon and my deep respect for the right hon. Member for Hackney North and Stoke Newington (Ms Abbott). Nobody speaks with greater sincerity and authority on behalf of people who are marginalised and disadvantaged in our society. I pay tribute to her, to her work and to her contribution today. I want to say a quick word about the history, as mention has been made of the Conservatives’ time in office. I acknowledge that genuine mistakes were made in the design of the welfare system that we have now. The system is clearly not perfect, but it was very much not perfect before: in 2010 the system was extremely complex, with high rates of benefit dependency. The introduction of universal credit and PIP helped to rationalise and bring greater order to the system, and to reward work rather than welfare. Significant improvements were made in that regard, including improvements in the number of disabled people who were able to work and were supported in work. In the last year of our time in government, 300,000 more disabled people were in work than in the year before. There was genuine improvement. Nevertheless, not enough support was given to many welfare recipients; that was the consequence of our fiscal inheritance in 2010 but also of choices made by the coalition Government, which fell particularly hard on local authorities and the DWP. I acknowledge that point, which is often made by hon. Members. Then something else happened, particularly around 2017 or 2018 and even more so after covid. We saw a significant rise in the number of people in receipt of health and disability benefits, including in the higher categories of the universal credit health element. People were stuck on benefits, in many cases indefinitely and forever. What explains the imperative for reform, which the Government are responding to, is that the number of people on the higher rate of UC has increased by a third over the past five years. The PIP budget is growing by 50% in this Parliament alone. The fact is that the benefit bill is unsustainable. However, it is also true that the system can be inhumane and ungenerous. We have a paradox: a system that is bloated and unsustainable overall, leading to the large budgets we are facing, yet on the frontline, in people’s actual experience, the system is starved in terms of the consequence of the inadequacy of benefits for many people. This is a huge opportunity and an imperative for reform—genuine reform, not just the soundbite. I notice that we do not have any Reform MPs in Westminster Hall for this debate. We genuinely need real reform. In 2024, the Government I supported had plans to bring in further reforms to the benefit system; we did not have the opportunity to introduce those reforms, thanks to the public. Labour was elected with a huge majority that includes many Members here. To my regret and surprise, after 14 years of complaints about Government welfare reforms, the Labour party entered Government apparently without any plans to change the system. We have spent eight months waiting for reforms to be introduced, only to get what we have now: a crude and cruel set of cuts, without any reform to the system at all. It is purely in response to what the Chancellor has done to the British economy—induced a fiscal crisis and caused the Treasury to demand of the DWP that swingeing cuts be made to the welfare budget, without any opportunity to reform the system or to reduce demand for welfare. That is, of course, what we should be doing if we want to bring down the bills. There are also, of course, tax increases, including on employers, making it much harder for people to move from welfare into work, which I will not discuss today, and the removal of vital support from pensioners through the winter fuel payment cut.

• 6 May 2025 · Poverty: Glasgow North East · Hansard source

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  May I start by acknowledging the very powerful speeches that we have heard this afternoon from the Members for Glasgow? I would not say that my view is that the people of Glasgow are generally well represented by Scottish Labour, but they have been very well represented in this debate. I pay particular tribute to the hon. Member for Glasgow North East (Maureen Burke) for the way she highlighted the tragedy of low life expectancy and of poverty in general in her constituency. She mentioned Easterhouse, which occupies a particular place in the pantheon of Conservative thinking about welfare because my right hon. Friend the Member for Chingford and Woodford Green (Sir Iain Duncan Smith) visited it 20 years ago and had his epiphany about what she described as the context of poverty. He described the interconnectedness of the different factors that drive poverty, which go so far beyond simple income poverty—issues around welfare itself but also joblessness, family breakdown, addiction and so on. The hon. Member for Glasgow North (Martin Rhodes) talked about the long consequences of deindustrialisation, which are relevant across our country but especially in places such as Glasgow. He also mentioned the consequence of the 2008 global financial crisis. The hon. Member for Glasgow North East mentioned the stagnation of wages in her constituency. Low wage growth has been a problem across the United Kingdom since that time. When my right hon. Friend the Member for Chingford and Woodford Green became the Welfare Secretary in 2010, he introduced reforms that offered real, direct benefits and improvements in welfare and in worklessness. There were 1 million fewer workless households in 2020 than in 2010 and, after housing costs, 1 million fewer people in absolute poverty—100,000 fewer children, 200,000 fewer pensioners and 700,000 fewer working-age people in poverty. The last Government did make a real impact on poverty. Nevertheless, I want to acknowledge some of the points that have been made in this debate. The fact is that the fiscal situation that we inherited and the choices made by the coalition Government meant that insufficient support was given to people who needed it, particularly as a result of cuts to local authority budgets and reforms to the DWP budgets. I echo what the hon. Member for Glasgow North East says about the neglect of Glasgow under the SNP since devolution and over the past decade, but I do not agree with her about the value of the reforms being introduced by the new Government. What we have seen is a rushed effort driven by the imperative to balance the books in consequence of a failed Budget last year, leaving a real crisis in the public finances that is now being felt by the recipients of benefits. The Government are balancing the books on the backs of the people least able to sustain that weight.

• 6 May 2025 · Poverty: Glasgow North East · Hansard source

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  I am not going to defend the mini-Budget to which the hon. Gentleman refers, but I do not accept that the rise in prices that all our constituents have experienced are solely, or even in large part, due to that event. They are a result of wider global events—and since this Government came in, I am afraid to say, of a failed economic policy that has driven the necessity of the disability benefit cuts that have been introduced and the winter fuel payment cut, causing 10 million people to lose a vital part of their income. Since the cut, 100,000 more pensioners have been admitted to A&E and 50,000 children have been plunged into poverty in consequence of what is happening at the DWP. I am very concerned about the announcement of cuts to the benefits regime before the review of the assessment system that gives people the entitlement to benefits. We have a genuine failure at the DWP. In addition to that, jobs are being destroyed by Treasury decisions to raise national insurance on employers, drive up energy costs and introduce a new Bill that will make employers much less keen to take on new workers. My suggestion to the Minister, if she will allow me to make it, is to rethink the changes to winter fuel payments. I am conscious that in Scotland the Scottish Government are taking over responsibility for this area of policy and I echo the point made by the hon. Member for Aberdeen North (Kirsty Blackman) that it would be good to hear from the Minister about how the interaction of the benefits reforms will work in the light of Scottish Government policy. I also hope that the UK Government will rethink the disability benefit cuts until we get the review of the eligibility assessment schemes. We need more support for people who need help to navigate the system and get into work. Let me return to the point I made in response to the reference to Easterhouse by the hon. Member for Glasgow North East. We need to attack the drivers of poverty—the interconnected factors that account for the demand for welfare, which is so high. It is social breakdown rather than purely DWP systems that account for the high— indeed, unsustainable—benefit bills that we have. We need to grow the economy to create jobs—good jobs, as the hon. Lady said, that will be right for Glasgow and right for the UK.

• 8 Apr 2025 · Persecution of Christians · Hansard source

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  It is a pleasure to serve under you, Ms Butler, and to be in a Chamber with so many of my favourite colleagues. I look around and am genuinely so inspired, pleased and gratified to be among this group of parliamentarians of all parties. I do not know what it is that binds us together. Well, I do—we are mostly believers. I pay tribute to everybody here, particularly to the hon. Member for North Northumberland (David Smith); I welcome him to and congratulate him on his very significant appointment. Congratulations too to the hon. Member for Newport West and Islwyn (Ruth Jones), on her championing of this agenda over many years and on calling this debate. I think it is necessary to acknowledge at the outset—in slight contradiction to the hon. Member for North Northumberland, although I hope that this will not be taken as too Christo-chauvinist a perspective, nor as a sort of Christian supremacist principle—the reason that we in this country defend the liberties we do on behalf of all religions and belief systems around the world, as the hon. Gentleman mentioned. It is because of the Christian foundation to our politics. All our liberties, and the principle of political liberty that this country has sporadically, with some success and some failures, helped to export around the world, derive fundamentally from the Christian foundations of our political institutions and political philosophy. What we think of as the intrinsic value of every human being comes only from one place: the Bible. All our laws and what we now call human rights have that origin. Indeed, the very concept of the secular space, in which people are free to believe anything or nothing, derives ultimately from the Christian principle that everybody has value, and that it is not right to pry into the souls of other men or women. I do not agree with the hon. Member for North Northumberland that we derive our legitimacy to speak in this space because of our past sins, as a country or as a civilisation. I recognise those sins, but I think we are speaking on this topic because we are the heirs to a tradition that fundamentally recognises the value of Christianity. His regional patriotism for Northumberland is understandable—think of St Cuthbert and the great saints of those days—but I bring him King Alfred, who defended Wessex, including what is now Wiltshire, against the Vikings, pushed back the tide of paganism, restored Christianity to England and ultimately helped to export it to the world. I think it appropriate to be proud of the Christian basis of our politics in this debate.

• 8 Apr 2025 · Persecution of Christians · Hansard source

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  I absolutely agree. It is of course not just Christians who think that, but it is right that in our country we proudly stand on that ground, and defend the right of everybody to absolute freedom of belief. As I said, I think we do that, ultimately, because the foundation of our politics is Christian. I will refer quickly to the Holy Land, as other hon. Members have. I have become chair of the APPG on Christianity in the Holy Land, which was instigated by our former colleague David Linden, who is a sad loss to the House—at least on this topic, not on others. He encouraged me to take up the role, so I have been having a number of very powerful and moving conversations with Palestinian Christians about the state of the Church in the Holy Land. In fact, I visited many years ago, in the early 2000s during the second intifada, with Canon Andrew White, who was the Church of England’s representative to the Holy Land in those days and a very great man. We visited Bethlehem, and I saw how absolutely desperate the plight of the Church was at that time. As the hon. Member for Ealing Central and Acton (Dr Huq) acknowledged, the situation has got worse and the state of the Church in the Holy Land is now very dire. I acknowledge that that is the consequence of Israeli Government activity. I recognise that and, as a strong supporter of Israel, I recognise how hard it is for Christians in the west bank to worship. On a different trip at around the same time, I visited Iraq with Andrew White, just after the invasion. At that point, we could wander around quite freely. There was a sense that there would be a new flourishing of religious freedom in Iraq. We visited St George’s church, for a service to mark its reopening after the war. It was a wonderful moment, with Iraqi Christians, as well as lots of American and British soldiers, present. It felt like the dawning of something wonderful in Iraq. Of course, within months that church was closed, and many of the Christians we had met were dead. The tragedy of the American-led invasion was that Christianity in Iraq has been severely repressed ever since, and we know about the similar phenomena in Syria and elsewhere since. The tragedy of nation-building in the middle east, often led by Christians, has not been good for the Church. The principal enemy of Christianity globally is not misapplied western liberalism; it is alternative religions and ideologies, in particular Marxism in China, radical Hinduism in India and, of course, radical Islam all over the world. My right hon. Friend the Member for New Forest West (Sir Desmond Swayne) mentioned Nigeria. The situation there is absolutely appalling: 3,000 people a year killed in recent years, and getting on for a quarter of a million people displaced. That is, I think, around half the total global number of those killed and displaced. In Algeria, as the hon. Member for Newport West and Islwyn mentioned, I want to draw particular attention to the Kabyle people, a Berber community in the north of the country who have been resisting the Islamist ideology of the Algerian Government for many years and who have suffered severe persecution. They are attempting self-determination and their slogan is, “In the name of all beliefs”. I want to acknowledge that—going back to my original point—when we defend Christianity, we are defending everybody, and I pay tribute to that campaign. I want to finish by asserting this point. Christianity is established in the west and therefore we think of it as the dominant philosophy, even though in many ways in our country I do not feel it is anymore. It is the shield of minorities everywhere, and I think we need a stronger promotion of the value of Christianity in every society. We should not simply be defensive in debates like this about defending the status quo and defending Christians; we should be supporting those who promote Christianity, sympathetically of course and always peacefully. The promotion of Christianity is a moral good, because wherever Christianity is, life is better. I pay tribute to the hon. Member for Strangford (Jim Shannon). I could not put it better than he did: in an absolute sense, Christianity is good for people. I pay tribute to Fiona Bruce, the hon. Member for North Northumberland’s predecessor as special envoy—a great friend to many of us and a pioneer in this space in the previous Parliament and over many years for her work promoting religious freedom and belief in this country and around the world. It is a great shame that the Bill she was championing fell before the general election. I do not know whether the hon. Member for North Northumberland would have welcomed it, or if the Government have any intention of reviving the measures proposed in it, which were to establish the position of the envoy on a statutory footing, properly resourced, rather than being something that, as it were, exists at the whim of the Government. I regret that the Bill fell, but I pay tribute to her. I pay tribute particularly to the hon. Member for North Northumberland. It is a tremendous thing that he is now in post; he has a great and important role to do. Lastly, to end on a note of hope, there are great things happening in the world. Christianity is not oppressed, downtrodden or downcast. We are seeing very positive signs of growth and revival. In China, the house church movement has won many millions of converts. Here in the UK, I am encouraged. There was a report from the Bible Society and Theos recently called, “The Quiet Revival” which demonstrates that, quietly, we are seeing new growth in our faith in the UK. On that basis, I have confidence in the future.

• 1 Apr 2025 · Eating Disorder Awareness · Hansard source

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  I am grateful to the hon. Lady, and I entirely agree. It is vital to stress that point, and I am sure the Minister agrees. I agree with the hon. Lady and the hon. Member for Salford that we need a complete reformation of the system—I will not repeat the points of the campaign, which I endorse. I am deeply concerned about the prospect of cuts to eating disorder services. It is a great shame that the proportion of NHS spending on mental health is declining. That is very significant. I pay tribute to the sufferers—these amazing people who battle through this awful illness. They are mostly girls but also young men—I know a young man who is still in the grip of the condition. And I pay tribute to their families. I emphasise, as I am sure the hon. Member for Bath would, given her experience, that there is hope. We must not give up on these young people. We must absolutely provide the services that are needed. We need to get our systems and our society right.

• 1 Apr 2025 · Eating Disorder Awareness · Hansard source

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  I acknowledge and thank the hon. Member for Bath (Wera Hobhouse) for her long campaign on this topic, for securing this debate and for all that she has done and will probably have to continue to do on this agenda for a while. I entirely endorse the campaign and the things that need to happen that she and the hon. Member for Salford (Rebecca Long Bailey) have outlined. Eating disorders present an utter tragedy to families and to young people. Last week I met a family in my constituency whose daughter is in the grip of anorexia. We had a long conversation about both the services available and the nature of the illness itself. I asked the simple question, “What is anorexia and where does it come from?” Despite the extent of their experience and all the reading they have done, it was a very difficult question to answer. The answer included that it is like an addiction, or has the qualities of an addiction. There is apparently a genetic component, and a link with autism. As the hon. Member for Bath suggested, there is a clear element of social contagion—her points about social media are extremely important. It strikes me that in many ways anorexia is an illness of modernity. It is a consequence of the pressures that young people and, indeed, older people can face in this very difficult world we live in. That suggests that a multiplicity of responses are appropriate. I pay tribute not just to colleagues here, on the APPG and across the House who campaign on this issue, but to campaigners from outside Parliament, including Chelsea Roff, Hope Virgo, Agnes Ayton and others, whom I have got to know in the last couple of years. I honour their expertise and commitment. As the hon. Member for Bath said, and as cannot be pointed out too often, eating disorders, and anorexia in particular, are treatable illnesses. The services are in absolute crisis, as we have heard, but we should never lose sight of the fact that the illnesses are treatable. There is clearly desperate confusion in the NHS between the physical and mental dimensions, particularly when it comes to the extreme acute phase of anorexia. We know it is the most dangerous mental illness in terms of the tragedy of death. There is clearly a lot to do in reconciling the mental and physical sides of our health service. The hon. Member for Bath and I are on different sides on this, and the Minister and I have been debating it over the last month or so, but I have to acknowledge my concern about the Terminally Ill Adults (End of Life) Bill. Currently, there are patients in our NHS who are diagnosed with eating disorders—anorexia in particular—who are categorised as terminally ill by the system and put on a palliative care pathway, because the system decides that their condition is not in fact treatable. It is scandalous and tragic that people who have a condition that is eminently treatable are categorised as terminally ill. My great concern is that if we were to pass that Bill, we would end up with people being diagnosed as eligible for an assisted death. It is important to acknowledge that in other countries that have assisted dying laws, our understanding is that, in all those jurisdictions, people with anorexia have qualified for and been given an assisted death. In 100% of the cases that we know about, they passed the capacity test that we would apply here in our country. That is my great concern.

• 27 Mar 2025 · PIP Changes: Impact on Carer’s Allowance · Hansard source

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  I congratulate the hon. Member for Torbay (Steve Darling) on bringing this important matter before the House. In government, my party supported carers: we increased carer’s allowance by £1,500 and, with the support of the Liberal Democrats, introduced carer’s leave. We are united again today in dismay at what this Government are doing. The Government had 14 years to prepare their welfare reforms. We had nothing for eight months, and then everything in a rush, because the Chancellor crashed the economy. With growth this year cut in half, inflation rising further, unemployment up, productivity down, debt interest soaring, a record tax burden and 200,000 people being pushed into absolute poverty by the measures taken by this Government, they have had an emergency Budget containing cuts to benefits for disabled people. Perhaps if they were not in such a rush, they would have realised that these crude reforms also impact carers. Some 150,000 people who gave up income to look after a loved one, and who rely on carer’s allowance to make ends meet, are now going to lose it. The Government are balancing the books on the backs of the people least able to take the weight. That is Labour: making other people pay for the fiasco of their Budget. First they came for the farmers, then for the pensioners, and now it is the carers—the most important people in our society, doing the most important job a human being can do, not for the money but for the love. The least the Government can do is to give them our support. That is what we did in government, so why will they not? Can the Minister confirm whether carer’s allowance was a deliberate target of the Government’s reforms, or did they not realise the impact of what they were doing to PIP because of the rush they were in? Do they think that taking £500 million from carers while giving above-inflation pay awards to the trade unions is the right priority, and does the Minister share the Chief Secretary to the Treasury’s view that cutting support for carers and disabled people is like taking pocket money from children? Is that what he believes carer’s allowance is—pocket money?

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-eighth sitting) · Hansard source

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  As ever, the hon. Gentleman is speaking very coherently in support of the Bill and the principles behind it. I think he does regard assisted suicide as another form of healthcare that, as he says, should therefore be completely consistent with the normal duties of every medical professional. I would genuinely like him to help me to understand this. Does he envisage the service being provided by bespoke clinics in the NHS? Would established professionals set themselves up with the purpose of delivering it, or would it genuinely just be something that any general practitioner would provide as part of their services? Does he imagine that there will be specialists in the NHS whose sole job, or most of whose job, would be to provide this service?

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-eighth sitting) · Hansard source

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  This is a very important debate, and my concern is that there is a naive assumption that the innate goodness of doctors will render them impervious to all the incentives in the system. As the hon. Lady suggests, if it were possible, as I think it is under the Bill, for a profit-making organisation—a company—to set itself up to provide an assisted suicide conveyer belt as a pathway through this process, and to earn money publicly or privately according to the volume of the provision it enables, we are setting up incentives that would corrupt the doctors who would be required to sign it off. I regret that my right hon. Friend the Member for North West Hampshire has such an optimistic view of human nature that he thinks that no doctor would respond to the incentives in the way that is clearly enabled through the Bill. There are other medical professionals—ethical doctors—who do respond to incentives, such as those in the cosmetic surgery industry.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-eighth sitting) · Hansard source

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  The hon. Lady is absolutely right. I am not sure that anything in the Bill would preclude a private provider—“Virgin Health” or some such organisation—from providing the whole pathway of the assisted death, including employing, albeit in separate clinics or separate practices, the two doctors who would provide the two assessments. The provider would comply with the Bill, but the doctors might be part of the same organisation even if they work in different practices.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-eighth sitting) · Hansard source

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  It is very good to serve under your chairmanship, Ms McVey, on what is probably our last day in Committee. I fully expect that we will reject clause 32 in due course, so although I want to move my amendment, I have no intention of pushing it or any of the other amendments in this group to a vote, but I do want to take the opportunity to address the clause and to speak to the amendment in my name. Clause 32 was always going to be an important one, because it would have allowed the Government to provide money to fund the assistance to die; it would have allowed the Secretary of State to make financial arrangements to secure the provision of assistance under the Bill. What we might have been debating if we were sticking with this clause—I think it is still worth inviting the hon. Member for Spen Valley and people who support the Bill to speak to this point—is that the Bill will require the Government to fund the provision of assisted suicide services, but it makes no provision to fund the supply of palliative care. I think everyone in this Committee recognises the absolute imperative of a properly supported palliative care sector, and I deeply regret that although the Government are supporting a resourcing of this new service, there is no balancing commitment to provide what we have all acknowledged is the essential corollary of any assisted dying service. What is worse, in clause 32 and in new clause 36, which will replace it, we have something different. Last Wednesday night, just as the Committee rose, the hon. Member for Spen Valley tabled amendment 538, which would remove clause 32 from the Bill. This is the clause that committed the Secretary of State to make the financial commitments—commitments that were debated in principle when the House debated the money resolution on 22 January. Once again, I regret that important undertakings that were made by the Government and by the hon. Lady have, in the course of the debate subsequent to Second Reading and now subsequent to the money resolution, been superseded by further provisions. Amendment 538 is consequential on two new clauses, one of which is new clause 37, which will allow Welsh Ministers to set up a system to implement the Bill in Wales. This will give very wide powers to Welsh Ministers, including the powers to make provision about the service that would be outside the legislative competence of Welsh Ministers. That is significant. Unlike clause 32 and new clause 36, which will replace it, new clause 37 does not make any reference to the health service in Wales. I think it is worth us teasing out the challenge to the devolution settlement that these new clauses represent; I am sure the right hon. Member for Dwyfor Meirionnydd will speak to that. I want to speak briefly, but I hope clearly and powerfully, to the essential challenge. Without getting too involved in the party politics, we all talk about “our NHS”, and in a sense it is our NHS: this nation’s great domestic institution, created in the 20th century in response to the shamefully inequitable provision of healthcare that preceded 1946. Labour rightly claims the credit for having introduced the NHS under the Attlee Government and in fact the Liberals also have a good claim to it—it was a Liberal, Beveridge, who first advocated the provision of a national health service—but what is not enough recognised is that, as I am sure my hon. Friends are proud to say, it was a Conservative Health Secretary who first put before the House of Commons a plan for a national health service: Henry Willink, Health Secretary in the wartime coalition Government. Unfortunately, the public voted us out of power in 1945 and it fell to Labour to implement a slightly different plan. Nevertheless, we can all claim some parentage of this great institution, the NHS. That is why it is so significant that in the new clauses we are debating, a fundamental change to the NHS in England is proposed. The duty on the Secretary of State under the National Health Service Act 1946, as updated in 2006, is to promote “a comprehensive health service designed to secure improvement in the physical and mental health of the people of England…and the prevention, diagnosis and treatment of illness”— that is, physical and mental illness. That has been the purpose of the NHS since 1946. I find it curious that a linguistic sleight of hand is being practised in new clause 36. The new phrase, “voluntary assisted dying services” or “VAD services”, is introduced, and it is used to avoid having to spell out that section 1(1) of the NHS Act 2006 will now include references to “assistance to end” the lives of people in England and Wales—that is the language of the Bill as introduced, in the long title and in nearly every clause up to this point. The explicit language that this is about ending people’s lives is avoided in the new clause. Why? I put it to the Committee that it is a hard thing to do: to take a red pen to Bevan’s legacy, to fundamentally change the NHS from one that is “designed to secure improvement…in the physical and mental health” of the people of England and Wales, and dedicated to “the prevention, diagnosis and treatment of…illness”, and to add to that founding clause “to end” the lives of terminally ill people. I will be blunter than the drafters have been. New clause 36 changes the NHS from being the national health service to the national health and assisted suicide service. That is its direct implication. Furthermore, the new clause is also designed not only to alter fundamentally the national health service, but to enable the private sector to be paid from NHS funds to end the lives of terminally ill people—and not only that, but to do so with a Henry VIII power so broad as to enable any changes in the NHS or any law to facilitate that goal.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-eighth sitting) · Hansard source

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  I beg to move amendment 525, in clause 32, page 19, line 26, leave out subsection (2).

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-eighth sitting) · Hansard source

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  I entirely agree with the hon. Lady. We are all equally ethical and unethical—the point is that we respond to incentives, and incentives have their effect. Does she agree that there is a further concern? If we had a tariff system, which we probably would, that would by definition create a market, if there was the opportunity for private provision, to earn tariffs—to make more money the more assisted deaths one provides. Furthermore, to the point made by the hon. Member for Stroud that this is all perfectly fine and normal, what about the opportunity to top up the public provision—the tariff one gets from the NHS—with one’s own money, therefore definitely creating the opportunity for some sort of upmarket arrangement through the additional fees and services that might be provided? As the hon. Member for Bexleyheath and Crayford said, we could see expos dedicated to providing the most luxury or glamorous forms of assisted death through private providers with NHS funding.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-eighth sitting) · Hansard source

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  No, I fundamentally disagree: end-of-life care is healthcare. It is addresses symptoms and conditions, and it is designed in a way that is completely compatible with the founding principle of the NHS, whereas the Bill—I appreciate the honesty of the drafters in recognising this, even if they do not quite spell it out—and its proposal of an assisted suicide service is not compatible with the founding principle of the NHS. That is why adapting that founding subsection as in the original NHS Act is required. Of course I recognise that end-of-life care is healthcare and completely compatible with what the NHS does. I wish it were more part of the NHS—that is another debate. Palliative care should have been more closely integrated into NHS provision, and it still should be. I want to tease out a tension among the drafters and advocates of the Bill about exactly how the assisted suicide service will be facilitated and provided. We have got a bit closer to it, but some questions remain, which is regrettable when here we are on the very last day of the Committee’s debate. Last month, the hon. Member for Spen Valley told the Committee: “This is not assisted suicide by the state. The state is not involved.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 11 February 2025; c. 318.] I am perplexed by that. I think many members of the public would not agree with that analysis of how the Bill has evolved in Committee. If involving the state in the provision of this service was not intended, then that is not the Bill we have. In contradiction to that, and I think more accurately, the Minister for Care told us that the promoter’s intent—speaking for the hon. Member for Spen Valley—is “to ensure that the assisted dying service is available as an integral part of the NHS. Officials are working on amendments to later clauses to establish the operating model for her consideration.” — [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 5 March 2025; c. 802.] That is clearly what has happened, and it is where we are now. However, I am sorry to say that I do not feel that the operating model is now clear. We still do not have an impact assessment, we do not know how the Government envisage it working in practice, and important information is still lacking for the debate today. We do not know the possible impact on general practice or medical specialists, nor how it might impact money that is available for palliative care. I hope the Minister can tell us more today about how he envisages the service being implemented, especially in the light of the British Medical Association conference earlier this month, which supported the motion that “Assisted dying is not a health activity and it must not take place in NHS or other health facilities”. That is a principle I agree with. On 5 March, the hon. Member for Spen Valley said: “there is no expectation that assisted dying would be set up as a private enterprise or service. It would be delivered within the provision of the NHS.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 5 March 2025; c. 799.] That now agrees with the Minister—fine, interesting; it is to be an NHS service not to be provided privately. But the new clauses do not rule out private provision, nor any profit making by providers or remuneration of people outside the NHS. Indeed, the new clauses refer to “voluntary assisted dying services”, which suggests the hon. Member for Spen Valley is supportive of services outside those that are NHS commissioned, which will be possible under subsections (1), (3) and (7)(a). That will be in line with comments made by my right hon. Friend the Member for North West Hampshire, who made a very coherent case for private provision of assisted suicide if that is what Parliament chooses to legalise; he said that nothing should prevent someone from opting for private provision. In response, the hon. Member for Spen Valley said: “This service, like many others, will be delivered through a range of providers”. –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 5 March 2025; c. 800.] I remain unclear about the extent to which this is an NHS monopoly, as it were, or whether there will be private provision that is privately paid for, or private provision that is publicly paid for. I would be grateful for the hon. Member’s clarification. Lastly, on the question of profit, in an article in The Times that appeared to have some briefing behind it, there was a suggestion that there would be a cap on the profit of private companies providing the service, limiting them to “making a reasonable profit”. Again, there is nothing in the new clauses about limitations on providers’ profits. If the hon. Member could clarify how she envisages the private provision of the service, I would be grateful.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-eighth sitting) · Hansard source

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  I would, but actually I am making an intervention. It may appear that I am making a speech, so I will soon sit down, but I would be interested in the hon. Gentleman’s response to the suggestion that even he —the paragon of virtue that he is—might not be entirely resistant to the economic incentives in the system. That is why we have an NHS that explicitly tries to exclude profit making from the provision of healthcare.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-eighth sitting) · Hansard source

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  Steady on!

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-eighth sitting) · Hansard source

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  I didn’t know it was illegal. [Laughter.]

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-eighth sitting) · Hansard source

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  In response to the hon. Member for Spen Valley, the scenario that she mentions is exactly the problem in many healthcare systems around the world, particularly in America, where doctors are incentivised to deliver volumes of treatments and procedures that are often not strictly necessary. We do have a problem even in our own system with the over-prescription of certain medical treatments, particularly pharmaceuticals, so incentives do apply. Doctors are subject to them, and we do our best to regulate them out of the system. One of the great advantages of the NHS compared with other healthcare systems is that we manage to prevent the over-provision of services in response to economic incentives. That is a founding principle of the NHS that we are overriding with this process.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-eighth sitting) · Hansard source

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  And yet the irony of this measure is that it is not specific to the patient. Genuine healthcare treats the symptoms and condition of the individual patient. This proposed treatment has nothing to do with the individual symptoms or the condition of the patient; it just kills them. It is totally unrelated to the condition, which is why it is not healthcare. The hon. Gentleman suggested earlier that the Bill somehow ensures that the provision and the pathway are deliberately fragmented because the second doctor needs to be independent of the first. Does he agree that, with that single exception, it would be perfectly possible for an independent provider to set up to provide for the whole pathway of assisted death, with the single requirement that the co-ordinating doctor, who would manage the whole process from beginning to end, must get a second opinion from outside their organisation to sign the paperwork for the second assessment? With that single exception, the whole process could be managed by an independent, profit-making provider—commissioned by the NHS or otherwise—entirely on its own.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  I must conclude from that that the promoter of the Bill, the hon. Member for Spen Valley, and the Minister would be content with an arrangement whereby a doctor was paid more for accepting an application and processing it, and for referring a patient—

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  I appreciate that the amendments are necessary for the new design of the Bill, but I want to express my concern that they establish an assisted dying regime that is left to monitor itself. When the person who facilitates these profound decisions is also the one who reviews them, it threatens not just the integrity of the system but the safety and trust of those it serves. Without labouring the point, other jurisdictions have significant problems with reporting and the information being the responsibility of those delivering the service. In Oregon, where assisted dying has been legal since 1997, the state relies on doctors to self-report compliance. We are left trusting that every form filled in will tell the whole story. Robert Clark, the former Attorney-General of Victoria, is very concerned about the operation of the legislation in Australia. He has highlighted how the voluntary assisted dying review board, which is a similar arrangement to the commission proposed here, relies on paperwork from the doctors themselves, with no routine audits or real-time checks. He pointed out that a tiny group of doctors—in fact, only 10—handled 55% of all cases in 2023-24, according to the review board’s data. Many of those doctors were advocates for the legalisation of the programme. I am concerned about the implications of a system that effectively trusts doctors to provide information without any proper review. Lastly, with all due respect to whoever comes in as commissioner, the replacement of the chief medical officer with the commissioner represents a downgrading of the scrutiny the Bill offers. We know that the commissioner is likely to be a retired judge, which is a very distinguished position, but they will not be somebody with the serious political status of the chief medical officer. The CMO role is equivalent to a permanent secretary. I am sure the hon. Member for Spen Valley acknowledges that our current CMO is probably the best-known public servant in the country. It is very significant that we are proposing to downgrade the role fulfilled by the CMO. I do not think a retired High Court judge will have the same status.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  I concur with the points made by the hon. Member for Bradford West. I very much appreciate the presence of clause 35 in the Bill—it is helpful that we ensure a proper review—but, as the hon. Lady said, five years feels too long to wait, so I support the amendment in the name of the hon. Member for York Central, as well as amendments 493 to 495, tabled by the hon. Member for Bexleyheath and Crayford, who has suggested a three-year review period. My simple further point is that we are potentially creating threshold legislation: once we take the step down this road, there is no going back. The Bill leaves so much open for further expansion, I suggest, but certainly for the modification and clarification of the operation of the legislation. There is a lot left for ministerial discretion, guidance and codes of practice, as we have debated, and indeed new powers have been added, including a widening of the Henry VIII power. I think, then, that it is important to bring forward the review period. As my amendment 526 suggests, I also think it is not sufficient simply to undertake a review, even one that is annual or every three years. There must be a guaranteed right to a debate and to hold Ministers to account at the Dispatch Box, which my amendment would insist on. Lastly, on the inherent potential for expansion due to the wide discretion that the Bill still gives future Ministers, my concern is that the review itself might become a Trojan horse for further expansion, because that is what we see in other countries. It is held out as a safeguard, and that is exactly how we should regard it—I hope it will be that. Having a proper debate and proper ministerial accountability will allow us to check the operation of the Bill thoroughly and enable Parliament to keep it under very close scrutiny.