Kim Leadbeater MP: speeches 2025

Speeches

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

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  As my hon. Friend the Member for Sunderland Central said, it is common practice in healthcare and in the NHS for services to be commissioned in a range of ways. We would not put such a level of detail in the Bill, but it would be normal practice for the Secretary of State to do that commissioning work. My hon. Friend the Member for Bradford West has her own experience of that, I imagine.

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

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  I would argue that it does.

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

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  We have had some excellent and extremely thorough debates covering all aspects of the Bill since the Committee first met. There has been an unprecedented level of scrutiny, and rightly so, given the gravity of the issue. The clause before us is one of the most important that we will consider. Without it, the Bill’s objective of offering a compassionate and dignified choice to terminally ill adults could not be met. The injustices of the status quo would remain, with too many people travelling abroad to seek an assisted death or taking matters into their own hands here at home, alone and often before they need to, in order to protect their loved ones from the threat of prosecution. Those people would be left, as they are now, with no protections against coercion or pressure to end their life and, crucially, with no ability to choose the manner and timing of their death so that they can say goodbye and be remembered by their loved ones as they would wish. Clearly, some hon. Members do not want those people to have that choice. They are fully entitled to that view. However, if Parliament decides otherwise and gives that choice, it is our responsibility to ensure that it can be exercised without adding constraints and impediments that would serve only to make people’s last days and weeks more traumatic, not less. That is one reason, although not the only reason, why I am clear that the process must be available as part of the range of services available to patients under the NHS and free at the point of need. It must be for the Secretary of State to make provision for the service in England, and for Ministers in Wales to do the same in Wales if the Senedd agrees. The House of Commons must have the opportunity to scrutinise the regulations under the affirmative procedure. Despite the challenges that it faces, the NHS is a trusted institution staffed by some of the best qualified and skilled health professionals anywhere in the world. Not all of them will want to participate, and it is their absolute right not to, but patients and the wider public should be reassured that assisted dying services would be commissioned and regulated in the same way as other services through the NHS, a system with which they are familiar. There is another very important reason why I do not believe that voluntary assisted dying should be a service that is separate from the core responsibilities of the NHS. The hon. Member for East Wiltshire and others have described the decision to request an assisted death as a fork in the road. I fundamentally disagree. “Fork in the road” implies that once someone decides which route they will take, that is it: they have chosen their direction of travel. That goes completely against the principles behind the Bill. The option of an assisted death is just that: it is an option throughout. Right up until the final moment, the person can decide not to exercise that choice. Experience from around the world suggests that consistently 30% to 40% of people do not, but knowing that they have the option has given them the comfort and reassurance that they need to make their final days less stressful and less fearful. It is crucial that the option of a voluntary assisted death remain part of an holistic approach to end-of-life care. If other options—including palliative care or the comfort provided by a hospice or other institution—are working for the individual, they have no need to take it up, but if it remains their clear, settled and informed wish to do so, that is their decision. My belief that a person requesting an assisted death should be guided through the process, in a health and care environment that they trust and are familiar with, extends to private provision. Other commissioned and regulated services are supplied by a range of providers; the same should apply in this context, as my hon. Friend the Member for Sunderland Central said. NHS trusts and ICBs may use private providers in some circumstances, as they already do. This provides flexibility, which is important, but what matters is that the safeguards and protections in this Bill will apply no matter where the service is supplied. The same requirements on doctors will apply, including the need to prepare reports and send them to the commissioner, and the stipulation that a medical practitioner cannot benefit financially or in any material way from the death of a person and can only receive reasonable remuneration for providing the service. My new clauses 36 and 37 make provision for this. The amendments to the new clauses seek to frustrate or delay that intention, and I cannot support them. Perhaps it is the Committee that is at a fork in the road. One route leads towards the correction of an injustice that has already lasted too long, and it offers a safe and compassionate choice at the end of life. The other route is to say that we are okay leaving things as they are, that the status quo is defensible and that people do not deserve to be given that choice.

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

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  I thank the right hon. Member for Dwyfor Meirionnydd for tabling the new clause. She has made extremely valuable points, as she has throughout the Committee, about the importance of respect for the Welsh language. I think she is absolutely right. As the Minister said, there are some issues with the drafting, as to what the implications would be, not just in Wales but in England. It is my understanding that Ministers in the Senedd are happy to meet following the Committee’s proceedings, and I am happy to discuss these issues with them as part of our conversations. It is important that the right hon. Member’s thoughts have been put on record, and we need to look at what we can put in the Bill ahead of Report to address her concerns.

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

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  We are entering deeply philosophical territory, which is welcome and has happened several times before during the Committee’s proceedings. As ever, the hon. Member for East Wiltshire has raised some interesting points, but my view is that his new clause should not be in the Bill. We all have our views on how we frame assisted dying and choice at the end of life, but I do not think that assisted dying should be defined—or rather not defined—in this way in the Bill.

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

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  The purpose of these amendments is to enhance the effectiveness and efficiency of the notification process within the context of the Bill and to ensure that the commissioner, who plays a key role in monitoring and reporting, receives the necessary information to fulfil their duties effectively. The amendments will empower the Secretary of State to make regulations that require registered medical practitioners to notify the commissioner of any events specified. This change is a critical step towards centralising the notification process and will ensure that the commissioner is directly involved in overseeing these events in a manner that supports the broader goals of the Bill. Under the amendments, the Secretary of State will have the authority to make regulations that require medical practitioners to notify the commissioner and that grant the commissioner the power to request information. They are designed to enhance the commissioner’s ability to effectively monitor the operations of the Bill. New clauses 38 and 39 are designed to facilitate the proper and secure exchange of information between the commissioner, various regulatory bodies and the Secretary of State in relation to the voluntary assisted dying framework. These provisions are critical to ensuring that the operation of the Bill is transparent, effective and within a secure, legally compliant framework. New clause 38 seeks to create a structured system for the exchange of information between the commissioner and key bodies involved in healthcare regulation and oversight. This is an essential provision to ensure that all relevant parties can co-operate in the administration of the Bill and that the commissioner has access to the necessary data to fulfil their duties effectively. New clause 39 addresses a critical issue regarding the disclosure of information under the Bill. It will ensure that information can be shared as required without compromising data protection laws or breaching confidentiality obligations; it seeks to ensure that while the Bill facilitates necessary data sharing, it will not override the existing protections for privacy and confidentiality. That is crucial both for the professionals and for the individuals involved in the processes established by the Bill. New clauses 38 and 39 will ensure that the voluntary assisted dying commissioner can effectively share information with key bodies while maintaining strict adherence to confidentiality and data protection laws.

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

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  Amendment 548 is not one that I had hoped to table, but I recognise that it is necessary. It is important to be clear about what it says and what it does not say. It creates a four-year backstop, meaning that the provisions of the Act must be implemented within four years of Royal Assent. What it does not say is that it cannot be implemented sooner than that, and I hope and believe that it can. A backstop is not a deadline. Hon. Members who have been in this House longer than I have will be very familiar with the idea of a backstop. In this, as in previous contexts, it is not intended as the desired outcome but a form of protection. The Bill as originally drafted stated that, if all its provisions had not been brought fully into force after two years, they would come into force at the end of that period. Under the amendment, that period would now be four years. I cannot pretend that I am not disappointed about extending the commencement period, and I know I am not alone. When I started work on the Bill, I thought, “Gosh, two years to implement it. That is a long time to leave the law uncorrected. How many terminally ill people will face the trauma and expense of travelling to Switzerland or feel they have no alternative but to take their own life or suffer a deeply traumatic death as a result of their illness in that time? How many more families will face the possibility of a police investigation, or have the happy memories of their loved ones tainted by their final weeks or days, due to the impact of their terminal illness?” That sat very heavily with me. But I thought then, and still think now, that however difficult it feels at times, this is not a process that should be rushed. It is more important to do this properly than to do it quickly. I am pleased that the Committee has improved the Bill in many ways, and added extra safeguards to what was already the strongest assisted dying legislation in the world—in particular, with the setting up of a new judge-led voluntary assisted dying commission, with multidisciplinary panels to look at every application. Inevitably this will take longer to implement than simply referring cases to the High Court, an institution that already exists. The reporting and monitoring mechanisms and infra-structure, along with the comprehensive training programme that we have rightly discussed at length in Committee, will take time to put together. It is clearly important to dedicate the necessary time to implementing these safeguards, but I also know the upset and disappointment that many people will feel about a potentially longer commencement period, so it is with some reluctance that I ask the Committee to support the amendment. As I have said, four years is very much a backstop, not a target. If the Bill receives Royal Assent, I for one—I know that I will not be alone—will hold the Government’s feet to the fire to ensure that its provisions are put in place as quickly as is practicable and safe to do so. To that end, amendment 547 would ensure that the voluntary assisted dying commissioner will be appointed within 12 months of the Bill passing. New clause 40, as previously debated, would confer a duty on the Secretary of State to report to Parliament at that 12-month point, and every six months thereafter, until it has been fully implemented. Those are important steps to show progress and to demonstrate accountability and transparency. At lunchtime today I met a group of people—many terminally ill themselves—representing thousands of others who are looking to this Parliament to finally offer them or their loved ones the choice and dignity of a better death. I know, because they have told me, that they are disappointed by this change. I said to them that I would not be making it if I had not been persuaded that it was necessary, but I also said that I will do everything I can to not keep them waiting a moment longer than we absolutely have to. I hope that the Committee can support the amendments.

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

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  I beg to move amendment 382, in clause 34, page 20, line 26, leave out “relevant Chief Medical Officer” and insert “Commissioner”. This amendment provides for monitoring, investigation and reporting functions under Clause 34 to be carried out by the Voluntary Assisted Dying Commissioner (instead of the Chief Medical Officers for England and for Wales).

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

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  The Minister is absolutely right. The point is that new clause 36 provides that provision for assisted dying services can be made through the NHS. It gives flexibility: if the NHS Act needed to be amended, it could be, but that is certainly not the intention at this stage. The Act has been amended on numerous occasions, not least by the Health and Social Care Act 2012.

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

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  New clause 9 specifically relates to the advertising of assisted dying services. I fully understand the intent behind it—to prevent the unethical advertising of assisted dying services. I thank the hon. Member for West Worcestershire (Dame Harriett Baldwin) for bringing the issue to the Committee’s attention. However, there are important nuances with the new clause as drafted that need to be addressed, to avoid criminalising individuals or organisations simply for providing information that is essential for those seeking access to those services. I have looked into this issue because it is an important point for the Committee to consider. Section 4 of the Cancer Act 1939, a useful reference point, bans advertising for cancer treatment. It prevents the advertising of any treatments, regardless of whether they are evidence-based. Similarly, as my hon. Friend the Member for Sunderland Central mentioned, the Surrogacy Arrangements Act 1985 prohibits the advertising of surrogacy services. Both Acts are aimed at protecting individuals from misleading or unethical commercial activity. The situation with assisted dying is more complex. The new clause is not about advertising unregulated or unproven services; it is actually about doctors who are offering a legal, regulated service to those who meet the criteria. I therefore have the same concerns as the hon. Member for Solihull West and Shirley. Subsection (3) states: “Distributing an advertisement includes transmitting it in electronic form, participating in doing so, and providing the means of transmission.” That is particularly concerning because it could criminalise doctors involved in the process of simply communicating with their patients, such as by sending an email, if they were seen as participating in the distribution of an advert. The intent is clear: we must prevent the unethical advertising of assisted dying services. However, we must ensure that the new clause does not inadvertently hinder access to legal services by criminalising the actions of doctors who are simply making themselves available in accordance with the law. We must not create barriers for those who need the service, nor should we penalise doctors for providing legitimate, legal services. I recognise the need to prevent the unethical advertising of assisted dying services, especially to avoid commercial exploitation or coercion, but it is essential that we carefully calibrate the clause to ensure that it targets unethical advertising practices without sweeping in legitimate and necessary actions that help people find the care they need in a manner that is lawful and respectful of their autonomy. As such, I am very happy to work with colleagues, including the hon. Member for Reigate, to look at how we can produce something to that effect ahead of Report.

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

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  Am I correct in thinking that this is a standard procedure, and it relates to very minor amendments, such as consequential and transitional provisions? It would be used not for any big changes to the Bill but for small amendments, and it would be burdensome to put such small changes before Parliament every time they needed to be made.

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

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  The approach to reasonable remuneration would be the same as in any other service commissioned by the NHS. There are tariffs for services that doctors provide. That is not for us in Parliament to decide; it would be up to the NHS and the commissioning bodies. I understand that some people might be uncomfortable with private providers. If so, I suggest that they are probably uncomfortable—which might be surprising, given their politics—with the concept of private healthcare provision per se. Whatever our moral view on that is, we cannot take assisted dying out of the system that we currently have. I think it is really important that the choice is given to terminally ill patients within the framework that we have.

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

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  The hon. Member is making some interesting points, but they are not related to the point of this amendment, which talks about the doctor being given more money for approving the request. That is not quite the same point that he is making.

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

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  I beg to move amendment 547, in clause 42, page 24, line 19, at end insert— “(1A) Section (Voluntary Assisted Dying Commissioner), except subsection (4) of that section, and Schedule (The Voluntary Assisted Dying Commissioner) come into force at the end of the period of one year beginning with the day on which this Act is passed.” This amendment provides that the clause and Schedule relating to the Commissioner, except subsection (4) of the clause, come into force one year after Royal Assent.

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

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  It is a pleasure to serve under your chairship, Sir Roger. At the risk of repeating what has already been said before by various members of the Committee, amendments 455 and 456 are important amendments that further strengthen the oversight, transparency and implementation of the Bill, particularly in relation to protected characteristics. Clause 34(1) already establishes the requirement of an annual report to be produced, but amendment 455 goes further by mandating that this report must also include detailed information about how the Bill applies to individuals with protected characteristics. Those are the groups identified in the Equality Act 2010, such as by age, disability, gender reassignment, race, religion and others. Furthermore, the amendment ensures that the report will not only cover those protected characteristics, but any other group that may be specified in regulations set by the Secretary of State, which provides the ability to adapt and to ensure that the Bill is applied fairly to all groups as societal needs and considerations evolve. Amendment 455 also ensures that the commissioner consults relevant stakeholders when preparing the annual report, specifically, the chief medical officers for both England and Wales, along with representatives of groups advocating for those with protected characteristics. This collaborative approach ensures that the report is as comprehensive as possible. Of course, the report will also be supported by additional details and regulations, the doctors’ reports, and the review of the Bill as set out in clause 35. As such, I am confident that the reporting mechanisms set up under these provisions provide a thorough oversight for the assisted dying process. Amendment 450 negatived. Amendments made: 387, in clause 34, page 20, line 34, leave out “relevant Chief Medical Officer’s” and insert “annual”. This amendment is consequential on Amendment 382. Amendment 220, in clause 34, page 20, line 36, leave out paragraphs (a) and (b) and insert— “(a) a report about the first assessment of a person does not contain a statement indicating that the coordinating doctor is satisfied as to all of the matters mentioned in section 7(2)(a) to (g); (b) a report about the second assessment of a person does not contain a statement indicating that the independent doctor is satisfied as to all of the matters mentioned in section 8(2)(a) to (e);” Amendment 388, in clause 34, page 20, line 40, leave out paragraph (c) and insert— “(c) a panel has refused to grant a certificate of eligibility;” . — (Kim Leadbeater.) This amendment is consequential on NC21. Amendment proposed : 451, in clause 34, page 20, line 43, at end insert— “(e) there were complications in the procedure. (2A) The Commissioner’s report must include analysis of the following— (a) information about the patients’ diagnosis/es; (b) information about the patients’ prognosis; (c) any instances where concerns were raised about the patients’ capacity; (d) any instances where concerns raised about the patient being coerced; (e) any concerns raised by the multi-disciplinary panel; (f) any concerns raised by family members; (g) and demographic data on the patients, including socioeconomic data, information on protected characteristics; and (h) data obtained from the recording of the consultation.” — (Naz Shah.) This amendment would require reporting under section 34 to include various information on diagnoses, complications, concerns about capacity and other matters . Question put , That the amendment be made.

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

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  I will speak to my new clause 40 and my amendment 546. The purpose of new clause 40 is to establish a requirement for regular reports on the implementation of the Act until all its provisions are fully implemented. This will ensure continuous oversight and transparency regarding the progress of the Act’s implementation. The new clause will mandate the Secretary of State to prepare, publish and lay before Parliament a report on the implementation and progress of the Act as soon as reasonably practicable after each reporting period. The reports must include the progress made on implementing the Act during the reporting period, and the Secretary of State’s plans for implementing the Act in future periods, including an expected timetable for further implementation. The first report must be issued one year after the Act is passed, and subsequent reports are due every six months. The sixth and final report marks the conclusion of the reporting period. The new clause is linked to amendment 546, which will ensure that new clause 40 will be brought into force immediately upon the passing of the Bill, making the reporting requirements active right from the start. This provision is crucial for maintaining accountability and for ensuring that Parliament is regularly updated on the progress of the Act’s implementation and that any necessary adjustments or future plans are communicated effectively. It provides a structured timeline to track the implementation of the Act until all provisions are fully operational.

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

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  Will the hon. Member give way?

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

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  My hon. Friend makes a really important point, which I will come to in due course, but the thing that we need to analyse is the operation of the Bill. That will not start with the passing of the Bill; it will start with its commencement. It is important that we join the dots between the relevant clauses.

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

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  I beg to move amendment 539, in clause 33, page 19, line 34, leave out subsections (1) and (2) and insert— “(1) The Secretary of State may by regulations make provision requiring a registered medical practitioner to notify the Commissioner of the occurrence of an event of a specified description.” This amendment replaces a power to make regulations requiring practitioners to notify the relevant Chief Medical Officer of certain events, including any events specified in regulations, with a power to make regulations requiring practitioners to notify the Commissioner of any event specified in the regulations.

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

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  I will speak briefly to this clause, because some of what I say will be covered in our debate on other clauses. The title of the clause is “Review of this Act”, so it is important to be clear about what we are reviewing. I am sure members of the Committee agree that it is the operation of the Act that needs to be considered. As such, it is important to join the dots between the relevant clauses of the Bill and differentiate between the passing of this legislation and the commencement of its provisions. I have tabled amendment 548 to clause 42, “Commencement”, which provides that the commencement of the provisions of the Act could be up to four years beginning with the day on which the Bill is passed. I sincerely hope it is sooner than that, but I have tabled the amendment none the less. New clause 40 provides that, until the Act is implemented, the Secretary of State must lay a report before Parliament as soon as reasonably practicable after the first anniversary of the Act being passed, with subsequent reports being laid every six months up to full implementation. It is a comprehensive reporting system, and it is really important to look at what we are reporting on. The reality is that the commencement of the Act could be between two and four years, so a five-year review makes sense. Amendment 452 negatived. Amendment proposed : 493, in clause 35, page 21, line 31, leave out “5-year” and insert “3-year”.— (Daniel Francis.) Question put , That the amendment be made.

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

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  Will the hon. Member give way?

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

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  It is fair to say that we have had a very valuable discussion on the matters relating to these amendments. I thank my hon. Friend the Member for Penistone and Stocksbridge for the considerable amount of hard work that she has put into researching these issues. As always, her approach has been extremely thorough and diligent. I have been on my own journey regarding the need or otherwise to place definitions in the Bill, but having undertaken the valuable discussions we have had through this Committee—I think this genuinely has been the Committee at its best—along with the expert legal input and advice that my hon. Friend and the Committee have had, I think we are in the right place to enable the courts to ensure that the law is as expansive as possible and to ensure that we do not create a scenario in which certain behaviours from those with mal-intent in relation to the Bill are excluded from its scope. I agree that we should allow the courts to do their job with the broadest possible powers to prosecute offences under the Bill. I echo my hon. Friend’s comments to the Minister about the need for the inclusion of details about these issues in guidance and codes of practice, but I thank the Committee for an extremely useful and productive discussion.

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

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  Amendment 382 and the consequential amendments provide for monitoring, investigation and reporting functions under clause 34 to be carried out by the voluntary assisted dying commissioner. The commissioner will submit an annual report to the appropriate national authority—Parliament or the Senedd—on the operation of the Act, as set out in amendment 389. The appropriate national authority must publish any report received under this section, prepare and publish a response to any such report, and lay before Parliament or Senedd Cymru a copy of the report and the response. I think the Committee is in agreement about the importance of reporting and monitoring under the Act, and I hope it can support these amendments.

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

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  These amendments are drafting changes, but they are important drafting changes, in that they are about the definitions of first assessment, first declaration, second assessment, second declaration and preliminary discussion. They are small but important changes and I hope that the Committee will support them.

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

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  I beg to move amendment 223, in clause 39, page 23, line 4, after “purposes” insert “, and (b) incidental, consequential, transitional or saving provision.” This is a standard power for regulations to include the power to make incidental, consequential, transitional or saving provision.