Jack Abbott MP: speeches

Speeches

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Second sitting) · Hansard source

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  Q This might sound like playing devil’s advocate, and I fully appreciate that you do not want to reduce this to a tick-box exercise, as you described it. Some might argue that the risk of what you describe is that it creates a lottery, because you would be relying on doctors to use their personal judgment as to when to have that conversation. For example, if a patient and doctor do not have a particularly close or long-standing relationship, the doctor may not know what the signs are, so the patient, who may need to have that conversation, may never have it. The risk is that you would be reliant on good relationships forming over time and doctors using their intuition, so that some patients will have the conversations they need but others will not. Dr Green: Obviously, it would be great if we worked in a system where doctors had all the time they needed to deal with their patients. I believe that the Bill mentions a duty to provide information from the chief medical officer, and having read the Bill, to me it seems very much like this might be in the form of a website or leaflet. We believe that it is important that patients should be able to access personalised information, and we would like to see an official information service that patients could go to, either as a self-referral or as a recommendation from their GPs or other doctors. That would give them information not just about assisted dying, but about all the other things that bother people at this stage of their life, and it would mention social services support and palliative care. It could be like a navigation service as much as an information service. That might address some of your concerns.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Second sitting) · Hansard source

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  Q Thank you, Professor Whitty and Duncan, for being with us this morning. Professor Whitty, in October you and a number of chief medical officers published an advice note to doctors about a range of guidance on this issue. In it, you said that a couple of things are “unanimous” for medical professionals. I am focusing on the line where it says that “we must not undermine the provision of good end-of-life care for all including the outstanding work done by palliative care clinicians”. Do we take it, by implication, that you are fearful that this Bill could undermine good end-of-life care? In your view, how might we mitigate some of those risks in the Bill? Professor Whitty: I will give a view and then Duncan will be able, as chief nurse, to mention the parallel bit of advice that said similar things. I think all medical, nursing and health professionals very strongly believe that palliative care and pain alleviation, which is not the same as palliative care but overlaps with it, and end-of-life care, which is also not the same but overlaps with it, are essential, and in some areas are not to the high standard that we would hope for. That would be a common view across the medical profession. My own view and hope is that the Bill should not make the situation either better or worse. It changes one particular aspect in a very important way, but it seems to me that on the principle that we should be improving end-of-life discussions, which is where end-of-life care starts from, as well as supporting further the alleviation of symptoms and the provision of palliative care, there would be no disagreement from anybody in the medical or nursing professions, any other professions or the general public. That must be fundamental to how the Bill is thought about—

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Q In your view, and that of the rest of the panel, is there a way to legislate to include them? Sir Nicholas Mostyn: It has been suggested that I want to expand the definition of terminal illness. I do not want to expand it. I want to redefine it so that it is more appropriately focused, in my opinion, on what this Bill should be about, which is the relief of suffering. That is what I believe the Bill should be about. You should get the permission to have an assisted death if you are suffering intolerably within five months of death or seven months of death—there should not be this arbitrary line. Moreover, it should not be open to people who are not suffering, but who happen to have a six-month life expectancy. There are probably quite a few of them, for one reason or another, whose life expectancy is short, but their pain is well-managed. I do not believe that assisted dying should necessarily be available for them. I do believe very strongly—this is not an expansion, but in my view, a more appropriate focused redefinition of terminal illness—that it should be, as in Spain and in Holland, focused on suffering.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Q I will keep my question quite short. Is there anything about the law in either of your jurisdictions where you think there could be improvement, and that we can learn from in drafting our legislation here? Dr Kaan: The thing I have been reading about that is concerning to me is the court approval that you seem to have written into your law. I heard your discussion this morning about how that might be done and whether it is a committee or the High Court and so on. I think that that is really going to limit access to this, and that makes the process a much lengthier one. Again, these are people at the end of their life. People are not looking, by and large, to cut off a huge amount of their life; they are looking to shorten their death, not shorten their life. By making people go through a court appeal in addition to two qualified physicians, as well as the waiting period, I think that you are going to limit access for people who desperately want this option. It seems like that might be baked into your law, but I would say that that is a concerning feature to me. I think that you are going to limit access that way. Dr Spielvogel: Something that it turned out was not in our law, but everyone thought that it was for a few years, and it really limited our practice, was that many people were under the impression that the physician could not bring up assisted dying with the patients, and that the patients had to bring it up themselves. That turned out not to be in our law, but that idea really hampered our ability to take care of patients, so I would strongly recommend that there not be anything like that in your Bill. People cannot make informed decisions for themselves if they do not know what their options are. While this is top of mind for all of you and for the doctors—we all know that this exists—even if this Bill becomes law, the general population is still not going to realise that it is an option. I eat, sleep and breathe this. I am a primary care physician, and when I am going through the options with patients who are newly diagnosed with a serious life-threatening illness, I say, “Okay, here’s what disease-directed treatment would look like. We can continue with your chemo. Here are some side effects and complications that you might have, and here are the benefits of that. Here’s what palliative care or hospice care would look like.” Then I say, “I don’t know if you know this, but in our state we have this other option for people nearing the end of their lives when they have intolerable suffering. You can ask me to fill a lethal prescription for you to help end your suffering sooner.” The number of times that people look at me and say, “You can do that? That’s an option here?” is astounding. I would say that nine out of 10 of patients I have conversations with have no idea that that is even legal. If they do not know it is an option, they are never going to ask for it. For physicians to do their jobs properly and deliver care to people, and for people to actually have a choice, physicians need to be able to discuss it with their patients. Dr Kaan: I will just piggyback on that. I cannot count the number of times I have given a presentation or a talk to communities, and people—usually family members of someone who have died, not using this law—have come up to me afterwards and said, “Thank you for what you said. My loved one was interested in having this information, or wanted to talk to their doctor about it, but their doctor never brought it up, so we weren’t sure if we should be bringing it up.” It is a huge burden to put on patients and their loved ones if they have to bring it up themselves. I would highly caution against any sort of language that requires that, because it is just not fair to them. They are already going through so much and, as Dr Spielvogel said, you cannot have an informed decision-making discussion with a patient if they do not have all the options available for discussion.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Q Sure. That is a really fair argument. Again, what I am driving towards is the point you were trying to make earlier, which is—I think this is fair to say—that countries that do not implement assisted dying improve their palliative care system. Clearly, that did not happen in the UK, so my guess is that that is not direct causation, is it? There are a number of other factors, although I agree that— Dr Cox: The NHS is very different from any other jurisdiction—

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Sorry. I was trying to make a point—

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Q In your view—I think you kind of said it before, and I would hate to put words in your mouth—are you saying that Parkinson’s sufferers and other similar— Sir Nicholas Mostyn: Neurodegenerative.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Yes, so the direct comparison is not necessarily relevant. Is that correct?

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Q The whole panel has painted—and we have heard this previously—a pretty bleak picture of the state of palliative care in the UK. Would you say that it was better or worse than it was, say, 10 years ago? Dr Cox: I suppose it depends who you are. If you live in one of the postcodes where you cannot get palliative care, if you are socially deprived, if you are a member of an ethnic minority or if you have a lung cancer diagnosis, you will not get very good palliative care in this country. I think that is awful.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Yes, those with such conditions. Are they left out of this debate? Sir Nicholas Mostyn: They are.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Q I guess what I am driving towards is that simply not having assisted dying is not necessarily causation for improvement in palliative care. In this country, for example, we have not seen palliative care improve from where it was 10 years ago, the last time this debate came to Parliament. Dr Cox: The position we would ask you to consider is whether this is the right time to bring in a law to give people a choice of assisted dying, when they do not have the choice to have good palliative care.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Q Sir Nicholas, I am going to paraphrase a little bit, but you said people with Parkinson’s will never get a terminal diagnosis, so this Bill is no use to you at all—I think you used stronger language than that when you made your original statement. Sir Nicholas Mostyn: I was sort of taken by surprise when she asked the me the question in the pub, and I would not have phrased it like that in court 50.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Q Dr Cox, may I follow up on one of the things you said earlier? Forgive me if I have misunderstood; I want to be clear. Earlier, I think you said that in the countries that do not have assisted dying, the state of palliative care has improved more quickly than in countries that do. Is that a fair representation of what you said? Dr Cox: In European countries and American states.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Q Sure. Let us phrase it in a different way today. Would you be able to expand on your thinking there? Sir Nicholas Mostyn: Parkinson’s is such a complex condition. The medically qualified amongst you will know this—there are so many symptoms, and with the rate of development and the direction of travel, it is an enormously complex condition to know. That is why it is commonly accepted that you do not die from Parkinson’s, you die with Parkinson’s, and it is almost impossible to give a mortality rate as to when that is likely to happen—almost impossible. When I was doing my research, I was slightly surprised to see that last year 6,000 death certificates had Parkinson’s written on them. They do say that the experts in Parkinson’s are the people with it, but the people you talk to are quite clear that it is impossible to predict and it is a really complex thing. That is why this arbitrary—I use the word technically—six-month period is a problem. If a doctor opines conscientiously and honestly, unless the Parkinson’s patient has already developed pneumonia, sepsis or something of that nature, or complications from falls—the common reasons for death—you will never get that six-month ticket. That is the thing; that is the problem.

• 22 Jan 2025 · Education, Health and Care Plans · Hansard source

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  Thank you, Dr Huq, for your excellent chairship, which has allowed everybody to contribute. This is a national issue, but SEND services in Ipswich and Suffolk have been in a desperate state for more than a decade. Like everywhere else, we need specialist places and specialist professionals. We welcome the massive boost in funding provided by the Government. However, as hon. Members from across the room have said, culture and accountability are crucial. One way in which we can start to inject a bit more accountability and scrutiny into the system is to hold a review of the ombudsman process, which Members have described today as combative, complex and exhausting for so many families. In particular, tribunal hearings are held in public only in exceptional circumstances. Given that around 95% of tribunal hearings, if not more, find in favour of the families, all cases should now be heard in public. I urge the Minister to look not only at the ombudsman process, but at those tribunal hearings.

• 21 Jan 2025 · Terminally Ill Adults (End of Life) Bill (First sitting) · Hansard source

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  I want to briefly address the implication or inference that my hon. Friend the Member for Spen Valley, who is leading the Bill, has not produced an incredibly balanced set of witnesses, or indeed a scrutiny Committee. I put it on record that in principle I am in support of assisted dying, but I did not feel that I could support the Bill on Second Reading, as I had a number of concerns including the strength of the Bill. We will be listening to evidence and discussing the issue not on the basis of principle, but on the basis of the strength of the Bill, the deliverability of the Bill and the number of safeguards, among other things. We are not here to debate the principle—that is a really important point. Points that have been made about the suitability or otherwise of the people coming to speak to us. It is wrong to imply that any of those individuals will use their personal feelings or principles and discount their neutrality. Are we really saying that the British Medical Association, the judges who have been mentioned or the chief medical officer will put their own views in place of their expertise and knowledge? I should say for the public’s benefit, my hon. Friend the Member for Spen Valley ensured that all Committee members were able to submit hundreds of names for consideration. In my view, she has come up with a panel of witnesses who are incredible experts in their field and have long-standing expertise in these areas, and we should absolutely listen to them. I am sympathetic to the right hon. Member for Dwyfor Meirionnydd, who said that we may need extended time to hear from more people. I know that my hon. Friend the Member for Spen Valley would certainly be sympathetic to that and that we can look to do so, if it is necessary. However, the perfect cannot be the enemy of the good. We have to ensure that we move this Committee along at a decent pace and hear from all these people. Our job is to scrutinise the suitability of the Bill, not the principles. On that basis I oppose the amendment, although I am not against some of the names that have been proposed. Maybe there will be an opportunity to hear from them in future, but I do not think that we can get into a situation where we are removing some names and adding others. We would be here all week if we did, so I will be opposing the amendment.

• 26 Nov 2024 · Topical Questions · Hansard source

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  T5. When I met the Ukrainian ambassador to the United Kingdom, General Zaluzhnyi, last month he raised the importance of ensuring that Ukrainian children and young people who have been forced to flee this terrible conflict in their own country receive the support and education that they need, so that they can be the generation that rebuilds Ukraine. What conversations has the Foreign Secretary had with the Ukrainian Government and his ministerial colleagues to ensure that that happens?

• 26 Nov 2024 · Electricity Grid Upgrades · Hansard source

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  The hon. Gentleman says, “Here we go”, but it is absolutely relevant to this debate. Yes, the Conservative Government passed the Banner report—well done. That is the big achievement of the last 14 years. There was a fundamental opportunity over the last decade to recognise where we were going as a country, and what we needed to do. Those decisions were consistently kicked down the line, and now we are here. The window in which we have to operate is incredibly narrow. We essentially have five years to meet the transition, which we have to do. Yes, underground cabling will cost more, but also there is a significant time delay, too. It is not a 2030 timeframe; it is a 2034 one. Let us get over the fantasy of a magical offshore grid connection that will solve everything way more cheaply and quickly. It just does not exist. We have to be honest with people. There will always be opposition to any development. I grew up in Suffolk; I know that there will be opposition to the grid upgrades. There is also opposition to solar farms in the west of the county. Obviously, there is opposition to Sizewell C and things like it, but that cannot get in the way of progress. There is also the Green party bingo card—opposing all the projects; well, we definitely cannot go down that route either. This is about opportunity. There is an opportunity to say that we will be transitioning to renewable energy to fulfil our mission and the guarantee that we made to working people at the election. It is our chance to seize the opportunity for greater energy independence, and for us—including my home county of Suffolk—to seize the opportunity to be world leaders in the energy transition. We cannot keep going around the houses, dithering, delaying and pretending that this stuff will not happen. It might sound good to constituents back home, but I grew up in that area—

• 26 Nov 2024 · Electricity Grid Upgrades · Hansard source

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  I will finish my point because it is directly related to the hon. Gentleman’s constituency of Central Suffolk. We already have pylons running through that part of the world. We have Mendlesham mast, which can be seen from miles around. We also have Eye airfield, big business parks, warehouses and farm buildings. We already have infrastructure in place.

• 26 Nov 2024 · Electricity Grid Upgrades · Hansard source

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  Will the hon. Member give way? That is an important point.

• 26 Nov 2024 · Electricity Grid Upgrades · Hansard source

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  The hon. Gentleman has just made a case for why we must crack on, and stop dithering and delaying. There is a history of doing bad things slowly, and that should never be repeated. It is not an excuse to do nothing now. We cannot afford to keep kicking the can down the road. We cannot keep relying on our constituents to foot the bill for an inefficient, unstable energy system—which is exactly what we have inherited. We can be as bipartisan as we like, but we have to accept the reality. We cannot keep heaping costs on to our constituents and businesses for our failure to invest properly in the system, which we now have five years to do. To conclude—I am conscious that I want to bring my colleagues in—this debate has illustrated the choice we face between two competing visions for the future. We can choose whether or not we are prepared to stand up for Britain’s energy security; we can choose whether or not we are prepared to throw away billions of pounds in taxpayers’ money on fantasies that will never come to pass, or act now to slash bills; and we must choose whether or not we are prepared to destroy vast swathes of land, which underground cabling would do, and commit lasting ecological damage. I know which I would prefer, and which my constituents prefer, and I am unapologetic about choosing opportunity over wasteful fantasy projects.

• 26 Nov 2024 · Electricity Grid Upgrades · Hansard source

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  It is not horror at all; it is infrastructure that people desperately rely on. The right hon. Gentleman might want to live in a fantasy in which costs do not matter and there are no trade-offs. Well, that is not the case. I also say to the hon. Member for Harwich and North Essex: East Anglia and the fenlands, which he mentioned, are critical, because if we do not build the energy transition infrastructure that we need, guess what? There is no landscape. We will be surveying everything from a boat. That is the reality.

• 26 Nov 2024 · Electricity Grid Upgrades · Hansard source

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  I will speak briefly because I know that many of my colleagues also wish to speak. I echo the comments made by the hon. Member for Harwich and North Essex (Sir Bernard Jenkin). This does not have to be a partisan issue, but equally we have to acknowledge the situation as we find it, not the fantasy that we wish it to be. The reality is that we have had 14 years in which decisions could have been made.

• 14 Nov 2024 · Covid-19 Fraud · Hansard source

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  3. What discussions she has had with the Crown Prosecution Service on ensuring the effective prosecution of covid-19 related fraud.

• 14 Nov 2024 · Covid-19 Fraud · Hansard source

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  In 2021, the previous Health Secretary said in relation to covid-19 contracts that “where a contract is not delivered against, we do not intend to pay taxpayers’ money”. —[ Official Report , 23 February 2021; Vol. 689, c. 758.] Judging from the figures that highlight the enormous scale of covid-19-related fraud, that was little more than a promise made and a promise broken by the previous Government. I am pleased that our Government have made it a priority to recoup as much of that money as possible from scammers who profited at taxpayers’ expense. However, four and a half years on from the first lockdown, my constituents in Ipswich, many of whom sacrificed so much during the pandemic, will be wondering why it has taken this long, and a change of Government, to take the issue as seriously as it deserves. Can the Solicitor General tell the House whether that is down to the previous Government’s incompetence or lack of effort, or whether it is symptomatic of their more general recklessness?