Kim Leadbeater MP: speeches

Speeches

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I have nothing to add, other than that I will not be supporting amendments 307 and 308. I associate myself with the comments made by my hon. Friends the Members for Rother Valley, for Stroud and for Sunderland Central.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I think I have responded to the hon. Member for Broxtowe on amendment 407 by saying that the concern will potentially be covered by my new clause 21. On amendment 410, it is also my view that, whether it is the High Court or the panel or whoever we end up having over the course of this Committee, that third layer of scrutiny and safeguarding should be able to hear from other people, not just the patient and the doctor, so I would not support that amendment.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  The point is that it has to happen at every stage, and I think the evidence that we heard was that it does happen. I know from the experiences of family and friends of mine who have had cancer that it does happen. There is a multidisciplinary approach; there is an oncologist, a nursing team and a doctor. That does happen, and nothing in the Bill will take away from that.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I will be brief, because we will come on to this debate when we get to clause 15. To be clear, the circumstances where a proxy would be involved in this process are literally when somebody is so ill that they are unable to sign their own name, so it is a very limited set of circumstances.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  Will my hon. Friend give way on that point?

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I hope I can provide some reassurance. This issue is covered by my new clause 21. The amendment, I think, asks why the High Court would not have heard from the patient. My new clause would ensure that the panel—as it potentially would be—will hear from the patient.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  My hon. Friend is absolutely right, and that is the whole point: Sir James Munby said he did not think that was the job for the judge.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I disagree: they are involved earlier. I have talked about the amendments we have already made around health and social care professionals. We have tabled those amendments, changed the Bill and added that provision on the basis of the evidence we heard. Remember that either doctor can speak to any other health or social care professional they wish. I would say that, actually, a multidisciplinary approach is taken throughout the Bill and, by ending the process with the panel, that is reinforced. The hon. Member for East Wiltshire said in his radio interview on 12 February, “I do welcome”—as he has confirmed today—“the additional role of more experts in the process”. Hopefully, irrespective of our different views, that is something that the idea of the panel can coalesce around. Despite the hon. Gentleman’s opposition to assisted dying, I hope that, in the interests of strengthening the Bill, he will be able to support the amendments today, because that is the job of this Committee—to strengthen the Bill, not to try to stop it, however strongly people may feel about the issue. A significant part of the strengthening is through additional patient-centred safeguards. I firmly believe that the introduction of the assisted dying commission and the addition of the multidisciplinary expertise and oversight provided by the panels are a crucial part of that. The panel will look at the detail of every individual case and scrutinise the doctors’ reports. It must hear from and may question the co-ordinating doctor or the independent doctor; it may hear from and question both; and it must hear from and may question the patient themselves. I mentioned that in relation to the amendment from my hon. Friend the Member for Broxtowe earlier. It is the default. This was a difficult decision. I appreciate that to make the patient undergo another level of personal scrutiny could be viewed as cruel. Indeed, a number of people have said to me that they feel it will be too burdensome on the patient during what is already a deeply emotional, highly personal and stressful time, when they are likely to be in pain and having treatment. I acknowledge that. Again, this is about finding the very difficult balance between avoiding an unduly stressful bureaucratic process and ensuring that the patient is making, as the Bill says, a “clear, settled and informed” decision. There is a very strong argument that in order to do so, the panel should hear from the person themselves. That is the decision I have taken, addressing the concerns of colleagues who have tabled amendments to the same effect. Indeed, Lord Munby said of the Bill as it stands that “the absence of any requirement that the judge ‘must’ hear from and question the patient is a quite extraordinary lacuna.” I appreciate, though, that there will be exceptional circumstances, which we know may be the case if the patient is very ill and in their last few weeks of life. The panel may also ask any person who appears to have relevant knowledge or experience to report to it on such matters relating to the person as it considers appropriate. It can basically ask to hear from anybody it wishes. That would obviously vary from case to case. Every case will be different, as we have discussed, and flexibility is really important. Only if all three members of the panel are satisfied that all the criteria have been met will it issue a certificate of eligibility. It must refuse to do so if it is not satisfied. The decision of the panel has to be unanimous. If there is any doubt from any of the panel members that the criteria have been met, the patient cannot proceed. The patient then enters a 14-day period of reflection, before making their second declaration. It is worth reiterating that, as has been said previously, a significant number of patients get to that stage and never actually continue with an assisted death, but the comfort it provides enables them to live out their final weeks and days with a sense of reassurance. As families have described, a weight is lifted. Indeed, Professor Michael Dooley, who is the director of pharmacy at Alfred Health and the head of Victorian voluntary assisted dying pharmacy services, and who some of us met yesterday, told us that in that state in Australia some 90% of assisted dying patients also still access palliative care. That shows the holistic approach that can be taken. There is of course another very important role for the commission, which is in relation to the monitoring and reporting of cases—something I feel very strongly about. The details are set out in my amendment 455 to clause 34. The commission must produce an annual report, which must include details about the application of the Act. That report must include details in relation to persons who have protected characteristics, and details of any other description of people specified. That would include data on demographics; statistics on the populations and characteristics of the patients who have chosen an assisted death; their age and gender; geographical analysis; data regarding the illnesses and diseases; how many cases were rejected; and how many patients did not complete the process and so on. When completing the annual report, the commissioner must consult the chief medical officers for England and for Wales, and anyone who represents the interests of people with protected characteristics. The Law Society, which is neutral on assisted dying, says that if the law were to change, the system must have “robust, accessible and independent safeguards” as well as “strong independent monitoring and review mechanisms”. I agree. The introduction of a multidisciplinary panel of experts to consider all applications for an assisted death, overseen by a commissioner in the form of a High Court judge, sitting or retired, really does achieve that, and embeds a truly robust, multidisciplinary approach, which I am confident will put patients at the centre of the assisted dying process and provide additional scrutiny, safeguards and protections.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I appreciate that this is slightly difficult to get our heads around, but we have legal expertise—we potentially have a judge, a sitting judge, a retired judge or an eminent KC—but they are not there in their capacity as a judge. I understand that that is tricky for people to understand, but they are there because of their skillset. That is the important distinction.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  The hon. Gentleman makes a good point. It is fair to say that there is a range of views on this subject from the judiciary. Ex-judges have commented, and I will come to those comments shortly. In his evidence, the chief medical officer, Professor Sir Chris Whitty, said that the best safeguards were the simple ones and warned that patients could find themselves in “a bureaucratic thicket” at the end of life if there is too much to navigate. I am very sensitive to that. Responding to his comments, Lord Sumption said: “I do agree with that…one suggestion that I think would make a significant difference…is the removal of the clause 12 stage.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 28 January 2025; c. 182, Q236.] That shows the difference of opinion among former judges.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I will start with amendment 93 tabled by the hon. Member for Solihull West and Shirley. He made a really important point about the language in the clause, and I am very happy to support the amendment. It is quite clear that, across the Committee, there is no disagreement that a terminally ill person requesting assistance to shorten their death should be given all the information necessary to help them make the clear, informed and settled decision the Bill requires. That should include an explanation of the drugs that are likely to be used—bearing in mind that there may be more than one option available to the person when the time comes, depending on their medical circumstances—and how they would be administered. As such, I am minded to support amendment 142, tabled by my hon. Friend the Member for Broxtowe. Amendments 142 and 93 both provide helpful clarity for the Bill. There are good intentions behind amendments 305, 306 and 362, but I am confident that they are already covered by clause 9(2)(b)(iv) and clause 9(2)(c). I do, however, take on board the point made by the hon. Member for Solihull West and Shirley about the concept of side effects. Going forward, it might be helpful to look at that use of language. To conclude, I am minded to support amendments 93 and 142.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I have nothing to add.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Eighteenth sitting) · Hansard source

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  I rise to speak first to my amendments 185 and 186, which would make important changes to impose a duty on the Secretary of State to make regulations about the training, qualifications and experience required to act as the co-ordinating doctor, as the Minister says. Moving from “may” to “must” would make it a legal requirement that such training take place and would thereby strengthen the Bill. In its present form, the Bill gives the Secretary of State that power to make such regulations but does not legally require him or her to do so. Amendment 186 would ensure that regulations must include training about “(a) assessing capacity; (b) assessing whether a person has been coerced or pressured by any other person.” Colleagues will appreciate that it is difficult for me to resist the temptation to put the entire training manual in the Bill—we all want to show the thorough approach that has been taken—but doing so would not make for good, clear legislation and can be limited in terms of flexibility and future-proofing. However, given the importance of the matters of capacity and coercion, I felt that it was important that this level of detail be specified in the Bill, because those issues have been at the heart of so many of our deliberations on this hugely sensitive and important issue. My hon. Friend the Member for Bexleyheath and Crayford, who tabled amendment (a) to my amendment 186, has made a compelling argument, as always. Like my hon. Friend the Member for Penistone and Stocksbridge, I have some concerns that the amendment would limit the number of disabled people who are covered and that it would not cover people with mental disorders, but I understand the concerns around autistic people and those with learning disabilities. I am also mindful, given that people with Down’s syndrome will typically have some form of learning disability, that amendment (a) may help to address some of the concerns that were expressed yesterday about ensuring that the Bill meets their needs and takes them into consideration. I take on board the Minister’s comments about the Health and Care Act 2022, but I am minded to support the amendment and work with my hon. Friend the Member for Bexleyheath and Crayford and others as necessary to make any further changes as the Bill progresses.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Eighteenth sitting) · Hansard source

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  This service, like many others, will be delivered through a range of providers, as alluded to by the right hon. Member for North West Hampshire. I understand the keenness to have this debate now, but we will come on to it further down the line. The hon. Member for East Wiltshire is right that this is really important.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Eighteenth sitting) · Hansard source

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  It will be.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Eighteenth sitting) · Hansard source

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  I just want to provide some reassurance to my hon. Friend the Member for Bradford West. I have met my hon. Friend the Member for Lowestoft and today I will support amendment 20, which she has tabled. I hope that provides some reassurance to my hon. Friend the Member for Bradford West.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Eighteenth sitting) · Hansard source

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  Hopefully the Minister and other colleagues are reassured that, if the Committee agrees to the introduction of the voluntary assisted dying commission, monitoring will be very intense and reporting will be very robust. That might allay some of the fears that have been raised today.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Eighteenth sitting) · Hansard source

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  I welcome this important debate about the impact of this potential legislation on Wales. I thank the right hon. Member for Dwyfor Meirionnydd for her valuable contributions. I also welcome the Minister’s commitment to meet the right hon. Lady and me for discussions with parliamentary counsel and the relevant authorities. This is really important. The criminal justice system covers England and Wales, so it is important for the Bill to do the same, given that it disapplies the Suicide Act in certain very carefully defined circumstances. But health is, of course, devolved and the Welsh Government quite rightly make decisions on the Welsh NHS. I want to make it clear that I recognise that reality and its importance, and I am fully committed to observing the same conventions that the Government would if this were a Government Bill. As has been said, I am working with UK Government officials to ensure that the right steps are taken at the right time, and I would expect to engage colleagues in the Welsh Government as the Bill progresses. Indeed, I really look forward to doing so and would be happy to visit the Senate if appropriate—although, as Members can tell, I need to work on my Welsh a bit. I look forward to continuing these conversations.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Eighteenth sitting) · Hansard source

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  I understand the hon. Gentleman’s keenness to get to the debate on clause 32, on the provision of the service—we will come to that in due course—but this conversation is about the amendment. To be clear, 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.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Eighteenth sitting) · Hansard source

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  My hon. Friend is absolutely right. If the Bill passes, it will be a huge change. We have a duty to the public to show that we are including sufficient detail in the Bill and to provide reassurance in any way we can. To be honest, I would quite like to put the entire training manual in the Bill, but I appreciate that from a legislative perspective that is not possible. However, there are occasions when, for the avoidance of doubt, we should make certain provisions clear on the face of the Bill. That brings me to amendment 20, which was tabled by my hon. Friend the Member for Lowestoft, who has a huge amount of experience and expertise in the field to which it relates. Her amendment states: “Regulations under subsection (3)(a) must specify that training in respect of domestic abuse, including coercive control and financial abuse is mandatory.” At the moment, there are no safeguards for terminally ill victims of domestic abuse, financial abuse or coercive control. That concerns me, and it feeds into the points made by my hon. Friend the Member for Bradford West. If a victim of domestic abuse or coercive control—it is often a woman, as we know—is also terminally ill, I can only imagine what a lonely place that is. At the moment, that person is under no supervision. Sadly, there have been instances in which those people have taken their own life. They will continue to be the victims of their incredibly difficult personal circumstances on top of having a terminal illness, which is an absolute tragedy. Opening up the conversation with doctors and healthcare professionals about their circumstances has to be a good thing. It will shed light and transparency on what must be an incredibly difficult situation.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Eighteenth sitting) · Hansard source

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  Will the hon. Gentleman give way?

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Eighteenth sitting) · Hansard source

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  I can confirm that the chief medical officer for Wales was invited to give evidence. I do not know the circumstances of why he did not. If it is helpful for me or other colleagues to meet him, the offer is definitely open.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Eighteenth sitting) · Hansard source

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  I am in the process of tabling an amendment that would change the panel to that effect, so that it would speak to the patient. Hopefully, that provides some more reassurance for my hon. Friend. I am sure that we are working very effectively through the Committee process to achieve what we all want to see.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Nineteeth sitting) · Hansard source

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  We did not reject proposals for the preliminary discussion not to be taken by people under 18. We actually put a clause into the Bill that would ensure that the preliminary discussion was not taken with someone under 18.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Nineteeth sitting) · Hansard source

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  This is a thought based on the comments by the hon. Member for Reigate. The issue of photographic ID is worth giving consideration. Photo ID is used in multiple settings for different reasons. My slight concern is that some of the people we are thinking about with this Bill would be older and I think of some of my own family members who no longer have driving licences, passports or potentially any form of photographic ID. I would be concerned this could be a barrier for terminally ill people. Considering we are making this a robust process, which I totally agree with, I would be concerned that might present an issue.