Kim Leadbeater MP: speeches

Speeches

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

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  I do not know the details of the individual cases that the hon. Member speaks about, but he makes a powerful point and we absolutely agree on the importance of recording and monitoring. I know that he voted against the changes at clause 12, but I hope he gets some reassurance from the changes that the commission would bring in. Having the commission and the panels would ensure robust monitoring and reporting. I hope he agrees that that is a positive step.

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

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  The amendment, which would clarify the drafting, speaks for itself. The important point is that the record of cancellation be with the GP practice as soon as is practicable. It is not necessary for that to take place physically at the practice, as that could potentially delay its delivery.

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

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  The hon. Gentleman is making a powerful speech, and I thank him for the respectful way in which he is doing so. He has given an example of a very personal story; it is also important to remember the other personal stories we have all heard. We have with us today in the Public Gallery family members who have lost loved ones. Catie’s mum went to Dignitas in Switzerland for an assisted death, and her daughter could not go with her. As a family they have suffered to this day as a result of that experience. We need to be really careful about the language we use around suicide. We have spoken about this before. The cases we have heard of are not people who want to die. They are people who want to live, but they are terminally ill. We need to be really sensitive to that, having heard so many examples of families who have been through these really difficult situations. But the hon. Gentleman makes a very good point, and I am minded to support his amendment because I think it comes from a good place.

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

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  I beg to move amendment 375, in clause 14, page 10, line 9, at end insert— “(1A) Where notice or an indication is given to the coordinating doctor under subsection (1)(a), the doctor must as soon as practicable notify the Commissioner of the cancellation.” This amendment requires the coordinating doctor to notify the Commissioner of a cancellation of a first or second declaration.

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

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  The hon. Member is making an interesting philosophical point with his biblical references. I think the point he may be making is that there might not be any difference for the individual, as the result is sadly the same, but I put it to him that there is quite a significant difference for the other person. If we think about the autonomy of the medical professionals we ask to be involved in the process, there is a strong argument that it would be very different for them to be more involved in the process. Does that makes sense?

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

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  To allay those fears, perhaps the fundamental answer to the question is that those people do not stop being patients—sadly, they do not stop being terminally ill patients. They have just chosen to cancel the declaration, and they will already have wraparound care. To some degree, the hon. Gentleman answered his own question when he said that doctors have a duty of care. That duty of care does not stop because the person has chosen to take this course of action. They will still be cared for by the professionals looking after them.

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

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  That is the sort of thing that the doctor would explore with the patient. It would happen in a very limited set of circumstances. We have to accommodate people who are physically impaired as a result of their terminal illness, and we have to include that there are a range of circumstances where this might apply. The proxy is being asked not to make any kind of judgment or assessment, but merely to act as an intermediary for the patient if they are unable to sign for themselves. They would have to explain why they are unable to sign for themselves, and the proxy has to be satisfied that the person understands the nature and effect of the making of the declaration. I thought long and hard about who should and should not be accepted as a proxy. As always, I try to imagine how it would be seen by someone with a terminal illness. As we know, no two people are the same, nor are their circumstances. The hon. Member for East Wiltshire said that surely it should be done by someone the patient knows. The clause defines a proxy as someone the patient has known for two years, which is an important inclusion, but not everyone might have known for two years a person who they are comfortable asking to undertake that role. I also appreciate the challenges with the wording “of good standing in the community”. I will let the hon. Member for East Wiltshire and the right hon. Member for North West Hampshire fight that out among themselves. I am sure we all have our own version of what that means. I have explored various options and, contrary to the suggestion of the hon. Member for East Wiltshire, I have spent a huge amount of time on this question, because it is very important. Looking at different lists, there is the list of people who can sign the back of someone’s passport. I do not think that would be appropriate, so I moved away from that. I have also looked at much shorter lists. I do think that this question would be part of a consultation; it is really important to get it right, which is why we must have it as part of a consultation. I am content that having the Secretary of State put it in regulations is the right thing to do. As I said, I am happy to support amendment 321 in the name of my hon. Friend the Member for Bexleyheath and Crayford. It is a sensible amendment that makes the reasons for the use of the proxy more transparent. If amendment 253 in the name of my hon. Friend the Member for Filton and Bradley Stoke (Claire Hazelgrove) is moved, I am happy to support that too. As the Minister said, a cancellation need not be in writing; it can be made orally or through any other form of communication. Amendment 321 agreed to. Amendment made: 473, in clause 15, page 11, line 3, leave out from “person” to end of line and insert “of a description specified in regulations made by the Secretary of State.”— (Kim Leadbeater.) This amendment provides that persons of a description specified in regulations (rather than persons “of good standing in the community”) may be proxies. Amendment made: 253, in clause 15, page 11, line 3, at end insert— “(6) For the purposes of this section “declaration” includes the cancellation of a declaration.”— (Sean Woodcock.) This would allow a cancellation of the first or second declaration to be signed by a proxy. Clause 15, as amended, ordered to stand part of the Bill. Clause 16 Recording of declarations and statements etc Amendments made: 209, in clause 16, page 11, line 8, leave out paragraphs (b) and (c) and insert— “(b) a report about the first assessment of a person is made under section 7; (c) a report about the second assessment of a person is made under section 8;”. This amendment is consequential on Amendments 420 and 421. Amendment 377, in clause 16, page 11, line 12, leave out paragraph (d) and insert— “(d) a certificate of eligibility has been granted in respect of a person; (da) a panel has refused to grant such a certificate;”.— (Kim Leadbeater.) This amendment is consequential on NC21.

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

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  It is a pleasure to serve under you this morning, Ms McVey. My amendments 374 and 471 serve to clarify that the second declaration must be made before it is witnessed—it is a drafting amendment—and to bring clause 13 in line with the reporting requirements elsewhere in the Bill. For the functions of the commissioner to be carried out effectively, including supervising the assisted dying panels and making annual reports on the legislation’s operation, it is essential that all relevant details and reports are made available. I am unable to support amendment 457, in the name of the hon. Member for Richmond Park. As I said when we started discussing the amendment, I do not fully understand why it has been positioned at this stage in the process. The shorter period of reflection is a recognition that a person’s death is expected within a month, so they literally have a few weeks left of life.

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

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  That is why amendment 321 in the name of my hon. Friend the Member for Bexleyheath and Crayford is really important. We have to put the reason down for why there is a proxy. It depends on personal circumstances and what that patient is going through, so we have to have a bit of flexibility, but they have to be unable to sign their name and they have to explain why they are unable to sign their name.

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

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  My hon. Friend makes a powerful point. I certainly have not heard anyone try to diminish the experience of suicidal people. We probably all have our own stories of loved ones who we have either lost to suicide—I know that I do—or who had very severe mental health issues. The point I would make is that the families I have met who have lost loved ones through assisted dying or a harrowing terminal-illness death have said that they desperately wanted to live. That is the distinction I would make, but I appreciate that my hon. Friend is absolutely right that people with suicidal tendencies and ideation also want to live—they just do not feel they have a choice. It is a very delicate debate to have, but please be assured of my sensitivities to it.

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

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  I beg to move amendment 474, in clause 16, page 11, line 17, at end insert— “(1A) In this section ‘recordable event’ means an event mentioned in a paragraph of subsection (1).” This amendment is consequential on amendments 209 and 377.

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

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  I will speak first to my amendment 473. It is important to be clear that the role of the proxy is very specific and would be used only in a very limited number of cases, where the patient is not able to sign their own name. That is, however, important when we are talking about terminally ill people who may be physically impaired, as my hon. Friend the Member for Bexleyheath and Crayford alluded to.

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

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  Will the hon. Member give way?

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

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  I appreciate that; that is helpful and I thank the hon. Member. As the Minister said, a person whose death is approaching may have stopped eating and drinking for a number of reasons. They may simply be too ill. They may be unable to digest food. It may be that they have lost their appetite, or that they will be even more ill if they eat and drink, so it would seem particularly cruel to intervene on that basis at that point, but I appreciate her comments. Amendment 316 in the name of my hon. Friend the Member for York Central seeks to mandate the action a doctor must take if a patient is likely to die within one month. Like other amendments, it goes against the basic principles that underlie the Bill—that the wishes of the person seeking assistance should be respected. Surely that is even more important than ever as they face their final weeks. As the right hon. Member for North West Hampshire said, palliative care will have been discussed at length throughout the assisted dying process. It is also worth noting, as the hon. Member for East Wiltshire said, that evidence from other jurisdictions with similar laws—Australia and America—shows that between 80% and 90% of people who have gone through the assisted dying process are already receiving palliative care, so I am not minded to support the amendment.

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

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  I repeat what I said earlier about what will happen to the patient if they choose to cancel: their care will continue. From a medical practitioner perspective, it is inconceivable that those patients would be abandoned, as the hon. Member for East Wiltshire is suggesting. That would not happen. I understand that cancellation of the second declaration does not need to be included in clause 14(4) because of when in the process it would happen. The first declaration comes much earlier, so clauses 7 to 9 would be applicable; the second declaration comes further down the process, so does not need to be included. However, I am happy to look at that in further detail and come back to the hon. Member on that, if necessary. Amendment 375 agreed to . Amendment made: 376, in clause 14, page 10, line 12, after “doctor” insert “and the Commissioner”.— (Kim Leadbeater.) This amendment requires a practitioner other than the coordinating doctor to notify the Commissioner (as well as the coordinating doctor) of a cancellation of a first or second declaration . Clause 14, as amended, ordered to stand part of the Bill . Clause 15 Signing by proxy

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

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  I have nothing further to add. Amendment 474 agreed to. Amendments made: 475, clause 16, page 11, line 19, leave out from second “the” to “in” in line 21 and insert “occurrence of the recordable event”. This amendment is consequential on amendments 209 and 377. Amendment 476, in clause 16, page 11, line 24, leave out from “the” to “, and” in line 26 and insert “occurrence of the recordable event”. This amendment is consequential on amendments 209 and 377. Amendment 477, in clause 16, page 11, line 27, leave out from “the” to “in” in line 29 and insert “occurrence of the recordable event”. This amendment is consequential on amendments 209 and 377. Amendment 478, in clause 16, page 11, line 30, leave out from second “a” to end of line 32 and insert “declaration, report or statement within subsection (1) must include the original declaration, report or statement.” —(Kim Leadbeater.) This amendment is consequential on amendments 209 and 377. Clause 16, as amended, ordered to stand part of the Bill. Clause 17 Recording of cancellations

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

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  I beg to move amendment 379, in clause 21, page 14, line 10, at end insert— “(3A) The coordinating doctor must, as soon as practicable, give a copy of the final statement to the Commissioner.” This amendment requires the coordinating doctor to give the Commissioner a copy of a final statement.

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

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  I believe that amendment 447, tabled by my hon. Friend the Member for York Central, would change the “may” to a “must”. I am minded to support it for that very reason. Amendment 532, tabled by my hon. Friend the Member for Ipswich, comes from a good place as is meant to be a way of trying to help the doctor, but I worry, as medical colleagues have commented during our deliberations, that it could create more of a problem for the doctor in that it would remove flexibility and the use of their clinical judgment and expertise. It always worries me when we are considering putting that level of detail in the Bill.

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

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  On the hon. Member for Richmond Park’s point, which a couple of people have made, I do not think anyone is saying that this is not a new situation—of course it is, as we are all aware. My hon. Friend the Member for Stroud’s point was that a doctor being with a patient who is dying is not a new situation. That is the important distinction.

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

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  I am very happy to accept amendment 22 from my hon. Friend the Member for Lowestoft, as it follows the theme of the previous amendments.

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

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  Clause 19 applies when the co-ordinating doctor may not be available to provide assistance. They may be out of the country or unavailable due to other personal circumstances, as the hon. Member for Richmond Park articulated beautifully—I associate myself with her comments. Of course the doctor who steps in has to be trained appropriately, and if they are not satisfied of all the matters mentioned in clause 18(4), they must immediately notify the co-ordinating doctor. That is what my amendments 210 and 499 cover. On amendment 408 in the name of my hon. Friend the Member for Broxtowe, who sadly is not with us today, it could be argued—and I take on board the comments by the hon. Member for Solihull West and Shirley—that it is unnecessary because it would be common practice by practitioners to consult. However, I also take on board the fact that the word “consultation” does some heavy lifting, and I think that is an important point, so I am happy to support amendment 408. I have mentioned already in response to my hon. Friend the Member for Bradford West that I am happy to support amendment 22, for the reasons I have given previously in relation to similar amendments.

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

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  I can help my hon. Friend out on this point. There is an expectation in the jurisdictions where assisted dying happens that it happens in different locations, very much centred around the patient’s wishes, which is the approach we should take.

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

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  I have nothing to add other than to respond to the fair point made by the hon. Member for East Wiltshire about complications. The doctor does have to record the final statement in the medical records, and I am confident that they would also record any complications in the medical records. Similarly, we have talked about the code of practice with regard to complications, so there is scope to include what would happen in those instances there. It is, however, a fair point, and it could be something to look at amending on Report, if the hon. Gentleman wants it to be in the Bill. Amendment 379 agreed to. Amendment made: 500, in clause 21, page 14, line 10, at end insert— “(3A) Regulations under subsection (3)(a) must provide that a final statement contains the following information— (a) the person’s full name and last permanent address; (b) the person’s NHS number; (c) the name and address of the person’s GP practice (at the time of death); (d) the coordinating doctor’s full name and work address; (e) the date of each of the following— (i) the first declaration; (ii) the report about the first assessment of the person; (iii) the report about the second assessment of the person; (iv) the certificate of eligibility; (v) the second declaration; (vi) the statement under section 13(5); (f) details of the illness or disease which caused the person to be terminally ill (within the meaning of this Act); (g) the approved substance provided; (h) the date and time of death; (i) the time between use of the approved substance and death.”— (Kim Leadbeater.) This amendment provides that regulations about the form of a final statement must make the provision mentioned in paragraphs (a) to (i). Clause 21, as amended, ordered to stand part of the Bill. Clause 22 Other matters to be recorded in medical records

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

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  The Minister has covered my amendments 497 and 498 very clearly, so I will not speak to them. I am happy to support amendment 462, tabled by the hon. Member for East Wiltshire, about which we had a conversation this morning. I only make the observation that there is already a requirement in clause 18(4)(b) that, at the time the approved substance is provided, the co-ordinating doctor must be satisfied that the person has “a clear, settled and informed wish to end their own life”. Nevertheless, I am happy to support the amendment, because the hon. Member made a very valuable point this morning. I cannot support amendment 463, however. The Bill states that the patient must self-administer the drugs. Clause 18(7) states that “the final act” of self-administering the substance “must be taken by the person to whom the substance has been provided.” That is very clear. The hon. Member for Solihull West and Shirley, with his medical background and expertise, has been clear and helpful on this point: it is a question of passive versus active. We have to be clear that the patient must have an active role in self-administration.

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

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  The amendment would require that if a person has decided not to take the substance or the procedure has failed, the co-ordinating doctor must, as soon as is practicable, notify the commissioner of that. It is fairly straightforward.