Lewis Atkinson MP: speeches

Speeches

• 24 Jun 2025 · Department of Health and Social Care · Hansard source

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  I welcome the estimates and the CSR settlement from the Government —a record settlement for the Department of Health and Social Care and the NHS. Given the time constraints, I will focus on three key points: financial management, underlying demand and the prioritisation of spend in the estimates. We rightly focus on the headline settlements in estimates such as these, but what we do not talk about enough is the importance of good public administration in the Department. In the 19 years that I spent in the NHS before coming to this place, I saw how the previous Government had a sticking-plaster approach not just to politics, but to public administration. Budgets were confirmed at the last minute and planning guidance was outlined at the very last moment of the financial year, meaning that there was no opportunity for NHS leaders and health leaders to plan appropriately for resource spending. I particularly welcome the emphasis the Secretary of State for Health and the new chief executive of NHS England have put on restoring accountability through the foundation trust model and multi-year settlements that mean that, although I am sure NHS colleagues would like more, they at least know and can plan investment and spend-to-save decisions over that period. Secondly, Members have queried why the NHS seemingly continues to require increases. I draw the House’s attention to the Nuffield Trust’s work showing that this is about not health inflation but underlying health demand. The Nuffield Trust estimates that, as a result of population changes—mainly the ageing of the population—there is a 1.1% increase in demand every year. In addition, advances in technology add a further 1.8% increase in healthcare demand, so there is already a 2.9% increase in underlying demand before inflation, which highlights that the Government’s emphasis on reform accompanying investment is critical. Finally, to deliver that reform, the investment going in must be very carefully targeted. The evidence base is clear that investment in primary care—and we are fortunate in this country to have a world-leading gatekeeper system of healthcare through general practice—represents the best return on investment in health. Work done by Michael Wood and the NHS Confederation confirms that. Alongside investment in mental health services and wider public health, this creates the best chance for the health system to live within these estimates and to meet our constituents’ expectations.

• 20 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  It strikes me that the judgment before us today is this: would permitting some terminally ill adults to choose an assisted death reduce suffering without inadvertently creating undue risks to others? I am clear, having worked in the NHS for 19 years, that the Bill absolutely can do that. I know the lengths that the NHS and our hospice movement go to when providing care at the end of life—the beloved pet coming in for the last cuddle, or the compassionate conversation in the middle of the night that calms fears. Some have suggested that our health service could not safely introduce assisted dying for patients who are already in regular contact with the health service because, by definition, they are terminally ill. I know not just the professionalism of NHS staff; I have also seen the thoroughness with which other medico-legal routes—for example, Mental Health Act tribunals, which in many ways are analogous to the provisions of the Bill—are implemented. The NHS has shown over decades that it can safely implement social and legislative changes passed by this Parliament. The Abortion Act 1967 was implemented safely by the NHS, as was the regulation and provision of in vitro fertilisation under the Human Embryology and Fertilisation Act 1990. The Bill has rightly been amended to allow up to four years for commencement to allow all the necessary preparations to take place. The chief medical officer reminded us that the NHS deals with life and death decisions every day. While the processes in the Bill are new, crucially they build on a solid foundation of existing practice. Currently, under the Mental Capacity Act 2005, as others have said, a person with a terminal illness receiving critical care can say, “Doctor, I want to die. Turn off this machine.” We use a simple test under the Act to permit that. Under this Bill, there are rightly further safeguards, but the decision when someone says, “Doctor, I want to die; give me something to drink” is essentially the same. This is absolutely not about the state killing people—these people are dying at the moment. The CMO also gave us evidence, and he stressed that the secondary legislation powers are necessary to permit ongoing safe regulation. Those powers not only require the Secretary of State to ensure that codes of practice and regulation are in place; they also give him the opportunity to react post implementation should there be any concerning cases. It is right that we are thorough in our roles as legislators. I have seen at first hand my hon. Friend the Member for Spen Valley (Kim Leadbeater) sitting with officials from the Department of Health and Social Care and the Ministry of Justice to ensure the workability and safety of these provisions. That is not the case for the status quo, with people dying lonely deaths of suicide or going to Dignitas. For those people, there are no checks on capacity or coercion; there is only trauma. I therefore commend the Bill to the House.

• 12 Jun 2025 · Humanist Marriage · Hansard source

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  It is a pleasure to serve under you, Dame Siobhain. Like others, I commend the hon. Member for Henley and Thame (Freddie van Mierlo) and my hon. Friends the Members for Tamworth (Sarah Edwards) and for Morecambe and Lunesdale (Lizzi Collinge) on securing this debate. In 2009, I got married in the National Glass Centre in my constituency, in a humanist ceremony. Because, as other hon. Members have mentioned, that ceremony was not legally binding, we had to get legally married two days earlier in Sunderland Civic Centre. Choosing a humanist married reflected the shared values of my wife and me. With our humanist celebrant, we thoughtfully worked through what we wanted to say, and the commitments that we wanted to make to each other. I would love to say that every marriage ends in a “happily ever after”. The hon. Member for South Devon (Caroline Voaden) was right to draw attention to the lower divorce rates statistic. Unfortunately, my marriage has resulted in a separation. That is a cause of sadness for me, but the shared humanist values that we committed to when we embarked on our marriage still provide an enduring basis for a positive relationship between my wife and I to co-parent our children. Even if, unfortunately, “happily ever after” is not possible in every marriage, humanist values and celebrations have significant value in bringing children up, as other hon. Members have stated in this debate. I intend to do further work in this Parliament on positive parenting in separated families. For the meat of my contribution, I will highlight how society has changed over the last 12 years, since the Government first gained the power to enact legal recognition of humanist marriages. Others have mentioned the steps made in nations of the UK other than England and Wales. I highlight the ongoing growth in the number of census respondents who are humanist or non-religious. The share of people ticking “no religion” in the census rose from 25% in 2011 to 37% in 2021—a significant rise. Around two thirds of people who get married are between the ages of 25 and 39, and among that group 48% of people ticked that they had “no religion” in the census. The current law essentially means that around half of people of normal marriageable age are being denied the choice of having a legally binding marriage that conforms with their beliefs. More widely, we have seen other advances for humanism in the last 12 years. Humanism is increasingly becoming a recognised part of the school religious education syllabus. Humanists are now officially included in national moments, such as the service of remembrance and Holocaust Memorial Day. They provide input into the moral and ethical issues of our time. I worked in the NHS during the covid pandemic, and humanists were officially consulted on, and contributed to, some of the advice that we received from the Department of Health and Social Care’s moral and ethical advisory group. A lot has happened in 12 years, yet humanist marriages are still not legally recognised. As others have said, it is overdue that we change that. The order is drafted and ready to go. We have had to wait far too long for this already. I look forward to hearing how we can get this done as quickly as possible.

• 1 Apr 2025 · NHS Pensions · Hansard source

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  I declare an interest as a member of the NHS pension scheme. Can the Minister confirm that this issue arose only because the previous Government carried out their NHS pension reforms in a way that was found to be age discriminatory? More widely, does she agree that giving NHS staff the terms and conditions and the reward and recognition that they deserve also requires prompt action each year on agreeing the NHS pay award, which the Conservative party routinely failed to do when in Government?

• 27 Mar 2025 · Prevention of Drug Deaths · Hansard source

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  It is a pleasure to serve under you, Dr Murrison. I pay tribute to the hon. Member for Strangford (Jim Shannon) for securing this debate. As colleagues have said, 5,448 drug-related deaths in England and Wales is truly a public health crisis, and we need a response that meets the urgency of that crisis. When the last Labour Government came into power, we were approaching 2,000 drug-related deaths a year, and that was considered serious enough at the time to implement a new national drug strategy, with funding, and to set up a national treatment agency to provide evidence-based treatment. That was at almost 2,000 deaths a year. The effect of that intervention was that drug-related deaths, which had been inexorably rising for a decade or more, levelled out and stopped rising. Thousands of lives were saved and improved. I know a little bit about that, because it was the privilege of my NHS career to manage NHS drug treatment services in the north-east of England for three years when that strategy and system were in place. A harm-reduction approach was key to treatment, as other colleagues have said. Drug deaths are horrific, and so are the wider harms, including the impact on crime. The amount of acquisitive crime in this country that is driven by addiction is really significant. The Government are focused rightly on tackling crime as well as wider health themes. This is an intervention that meets a lot of the Government’s missions. The harms around children are also significant. Many children are taken into care as a result of parental drug use. A prevention approach would reduce costs for the state by ensuring appropriate drug treatment. Treatment, particularly for opiate use, must focus on substitution therapies. It was disappointing that in the last decade ideology against opiate-substitution treatment trumped the evidence base for it. There are people who could still be alive today if it were not for that ideology. The scale of the treatment gap is significant. In Sunderland, in my constituency, adult mortality from drug causes is about twice the average in England, but around 60% of opiate and crack users are not in treatment today. That must change, and I look forward to hearing the Minister’s response on that. Under the last Labour Government, the policy and health landscape was rather different. As well as the policy urgency, there were clear national levers to pull, with a primary one being the National Treatment Agency for Substance Misuse. Since then, we have moved to a more diffuse system that is not at the centre of Government but commissioned by each council individually through the public health grant. The provider landscape has fragmented. Whereas NHS treatment services used to be the norm, now there is a significant pattern of commissioning—in some cases there is competitive tendering every few years. That has not helped to tackle this issue with the urgency it needs. I look forward to hearing from the Minister. I do not think legislation is required to improve treatment. This issue requires clear political will and focus, and I hope we will hear a lot more of that from the Government today and in the coming months.

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

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  I hope to help the hon. Gentleman with the points I am about to make. What I would say to begin with is that we have talked throughout this Committee about using an opt-in model. There is this idea that everyone will be doing this, but we have rightly set out requirements for specialised training and so on. There will clearly be individual doctors in the NHS, and so on, who decide that they want to provide these services, and specialisms and appropriate regulation will accordingly be developed as part of that. The other thing I would highlight is that the current drafting explicitly requires a range of provision. The second doctor must be independent. Indeed, clause 8(6)(d) requires that they must not be “a partner or colleague in the same practice or clinical team as the coordinating doctor”, so although some are suggesting, perhaps in a positive sense, that there should be one, entirely separate organisation that does all this, that would not meet those requirements. There are those who are trying to instil a fear of one large organisation being set up to take someone from start to finish, but that is not possible under the Bill as drafted.

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

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  No, I am going to finish this point. The hon. Member for East Wiltshire did a good job of reading a Bevan quotation before—although I do not advise him to seek Labour party selection with such gravitas in his voice. However, I think he is the heir not to Bevan, but to Bernard Braine, the Member for South East Essex, who said in the 1967 debate on the David Steel abortion Bill: “The idea has been spread around that it will be available on the National Health Service.” In reference to the waiting lists, Braine went on to ask: “Are our consultant gynaecologists going to make that list longer by making beds available to those who want abortions?” —[ Official Report , 13 July 1967; Vol. 750, c. 1382.] That is the tradition of objection that the hon. Member for East Wiltshire is in. Just because he does not wish to have the option for himself, he does not believe that there should be free-at-the-point-of-use provision on the NHS for anyone else. I will take Bevan back to this side of the Committee Room. He said: “The essence of a satisfactory health service is that the rich and the poor are treated alike, that poverty is not a disability and that wealth is not advantaged”. At the moment, at the end of life, wealth clearly is advantaged. Those who are wealthy and are able to go to Switzerland do have choice at the end of life. Dignity and independence and autonomy should not be based on ability to pay. That is why we need to pass this Bill; that is why the powers to commission in new clause 36 are entirely appropriate and necessary; that is why I support it.

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

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  The hon. Gentleman is providing a masterclass in scaremongering. I know he needs Labour votes to switch before Third Reading, but this service must be explicitly commissioned by the Secretary of State, and it is inconceivable that they would commission that in the way that the hon. Gentleman describes. The co-ordinating doctor is of course one person, and they would be involved in the first assessment and the provision of assistance. Whether that is a doctor employed by the NHS or somebody else, it can only be one individual, but there are the other safeguards we have talked about, such as the panel, which the hon. Gentleman has spoken against. It is absolutely appropriate that the Secretary of State has the powers and the duty to commission the service, and that they will do so from range of providers, reflecting the differences. On the other point that some hon. Members have made about regulation, I remind the Committee that any provider will be regulated not only under this Act, but by the Care Quality Commission, in entirely uniform manner. I am therefore confused by the points made by opponents of the Bill. Some have said there should be no provision of this by the NHS or any public body, some say there should be no provision by charities—including, presumably, local hospices, should they make that decision—while others say there should be no provision by local GP practices to provide continuity of care. Perhaps those different points reflect different ideologies within the Committee that are deeper than this issue, but they perhaps also reflect the fact that opponents of the Bill simply do not want this service to be provided at all.

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

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  The right hon. Gentleman is entirely right. These powers need to provide for that patient-centric nature, in a service that is explicitly commissioned by the Secretary of State, which will vary in different parts of the country, and not just in the provision landscape. The services provided in rural North Northumberland will, by their nature, probably be different from those provided in London, and that is entirely appropriate.

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

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  No, it will not, in the same way that G4S does not suddenly appear and provide treatment through a new cancer service that the Secretary of State decides to commission under specialist powers. I am afraid that some opponents of the Bill are trying to scaremonger about potential provision as a way of altering the way people voted on Second Reading. A number of amendments clearly deal with whether potential providers should be public sector, voluntary or, indeed, private organisations. I emphasise that the overwhelming majority of GP services in this country are private contractors. It is inconsistent for Members to argue that we should maximise continuity of care and have the best safeguards around coercion and capacity by having someone who has known the individual for a long time, while also arguing that the Secretary of State should not be permitted to commission that individual’s GP to play any role. I challenge opponents on that matter.

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

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  It is a pleasure to serve under you this this morning, Ms McVey. I rise in support of new clause 36, which sets out an entirely workable, appropriate and safe set of provisions for the Secretary of State to ensure that these services are provided across England, as well as appropriate powers for Wales, although I am far from being an expert on those matters. The new clause would convey powers to the Secretary of State to commission services free at the point of use, in a way that is entirely analogous to the commissioning of other health services that are provided, as we know, by a range of providers. I came to this place having been an NHS manager for nearly 20 years, and I feel that the debate has sometimes slightly confused elements of commissioning, provision and the way in which the NHS commissions and manages services. My hon. Friend the Member for Banbury said that the state must oversee and regulate the service, and I entirely agree. Commissioning powers sitting with the Secretary of State will ensure that that is the case. The hon. Member for Richmond Park said that the issue is who is commissioning. Again, we are clear that the only person doing any commissioning will be the Secretary of State, potentially delegating this to NHS structures at the time. The NHS and the Secretary of State are not unused to commissioning highly specialised, sensitive services in this way. Indeed, I would be amazed if the Minister and my hon. Friend the Member for Spen Valley do not confirm that the Government were involved in the drafting of this new clause to ensure that it is equivalent to the other powers that the Secretary of State has. This will clearly be a specialist service. It is a new service. At high levels of NHS England and equivalent bodies, there is significant expertise and practice in commissioning specialised services. The importance of the commencement period, which I hope we will discuss later today, is that engagement around the exact service specification will be drawn up in just the same way that it would be for a new cancer treatment or a treatment for a rare disease. It is right that the time will be taken to engage on that. Fundamentally, services have to be commissioned. Some suggest that this will be a free-for-all, that anyone can provide this service and that anyone can be paid for it, but that idea is nonsense. There is no obligation for the Secretary of State to reimburse anyone who decides they want to provide this service. The service must be explicitly commissioned.

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

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  No, I do not agree with the hon. Member, and I will tell her why. The reality is that the shape of the health provider landscape is different in different parts of the country. For example, in Wolverhampton, there has been a significant amount of vertical integration, such that in many cases GP services are part of the NHS provider trust. Therefore, those amendments that would prohibit any public body from participating would explicitly prohibit GPs in Wolverhampton from that provision. Elsewhere, some hospices—a small number—are provided directly by the NHS. Given the history of the hospice sector in the UK, there is clearly a strong voluntary and charitable element of that provision, which is entirely right, but that varies in different parts of the country. To return to the point made by the hon. Member for East Wiltshire, there are some hospices and end-of-life providers who have made it known that, if this law passes, they may wish to explore whether they will provide such services. Equally, others will not. This goes back to the conscience debate that we had last week. There will be no obligation, so a hospice in one part of the country may well say, “Yes, we wish to provide this service as an option to our patients,” whereas a hospice in another part of the country might say, “We do not.” We need to get past this metropolitan mindset, whereby ll the providers are within easy travelling distance from each other.

• 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 chairmanship, Sir Roger. I will be brief. I am in favour of retaining the Bill as it stands. The key thing is the interplay between this clause and clause 42, on commencement. I would have been minded to support changes to the reporting period had the Bill been commencing within two years, as clause 42 as drafted sets out, but my hon. Friend the Member for Spen Valley has tabled an amendment that will change the backstop of the commencement period to four years. The timescales set out in this clause are from the day on which the Bill is passed. It makes no sense to carry out a formal review of the operation of the legislation before the services have come into being. We will have a four-year timetable, potentially, for the backstop of the commencement. Throughout that time, the annual reporting requirement of the commissioner, who will undoubtedly have been appointed in advance, will kick in. I also draw the Committee’s attention to new clause 35, tabled by my hon. Friend the Member for Penistone and Stocksbridge, which speaks to some of the concerns raised by my hon. Friend the Member for Bexleyheath and Crayford. I strongly support the new clause, and the establishment of a disability advisory board to report annually on the effect on disabled people of not just the Act but the implementation. Picking up any concerns or views about its effect on people with disabilities would happen in a timely manner under new clause 35.

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

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  That is exactly right. For those reasons, I think we need to retain the full five-year review period. As my hon. Friend the Member for Rother Valley outlined, the review of the Act by the Secretary of State will be in addition to the annual reporting from the commissioner and, if we accept new clause 35, in addition to annual reports from the disability advisory board. Clearly, over the course of multiple amendments, we will have strengthened the reporting requirements both in advance of and post implementation.

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

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  I understand somewhat where the hon. Member for East Wiltshire is coming from, but as a fundamental matter, people have to be paid for time worked. I feel that an interpretation of his amendment is that people would not be able to be paid for time worked. This is not about performance-related pay, as he suggests in that continuation of his—I suggest—scaremongering theme from before, but about remuneration for time worked. For example, if someone is referred for an additional capacity assessment, it is right that the person doing the assessment is paid for their time worked, not as an incentive, but as a normal payment for time worked. I think that the amendment is poorly drafted and not workable. I will therefore vote no.

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

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  The hon. Member is making an interesting point, particularly in relation to the commissioning of the service. In the NHS, we generally commission on a block basis and a fee-per-activity basis. I can entirely see that that block basis would be appropriate for this commission, and I am happy to work with him on Report to make that the case. That is not what this amendment says, though. It talks about payment for individual doctors, which gets into the issue of people being fairly paid for their time, which he referenced. I invite him to collaborate on the commissioning arrangements on Report, rather than pressing this amendment.

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

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  I rise to speak in support of new clause 40. Given the implementation period that we are talking about, the repeated and routine reporting to Parliament on progress is essential, especially for those who want to see this Bill implemented safely and properly. Nevertheless, there are people—some of whom have joined us in the Public Gallery in recent weeks—for whom that needs to be done with deliberate speed, but without any compromise on the safety and thoroughness of implementation. New clause 40 achieves that, and I commend it. In a different world there would have been a way of us compositing new clause 28 with new clause 40, and I regret that the two are not compatible. My hon. Friend the Member for Bexleyheath and Crayford makes good points around the earlier assessment of palliative care; I do not think that is something that divides the Committee. There have been amendments tabled by many Members over the course of the Committee that have sought to improve and strengthen palliative care as part of a holistic package at the end of life. I wonder if that is something that I could work on with my hon. Friend on Report, even if it is not possible to agree to new clause 28 tonight.

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

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  I have great sympathy with the intent behind the amendment, and I would like us to get it into a workable form. The hon. Member for Reigate may wish to confirm this, but there is a similar offence in the Surrogacy Arrangements Act 1985—the advertising of surrogacy arrangements is an offence. The important difference in the Surrogacy Act is that there are some further caveats beyond those in the draft amendment— for example, to ensure that there is not inadvertent creation of offences of the type that the hon. Member for Solihull West and Shirley mentioned. The Surrogacy Act sets out that resulting prosecutions would be carried out only with the approval of the Director of Public Prosecutions, to ensure that such safeguards were in place. Although I await the Minister’s comments, I do not think it is possible to support new clause 9 in its current form, for the reasons that the hon. Gentleman lays out. We have set out that there will potentially be a small number of doctors providing these services. A GP—not a member of the public—would need to know where to direct their patient. I cannot see how, other than by having some form of electronic directory or email correspondence, it would be possible for such people to become available. I am not able to vote for the new clause at this stage, but I will put it on my notepad of things on which I am keen to work with colleagues on Report, perhaps by learning the lessons from the surrogacy advice and taking advice from Minister. I think we all agree that we should not be advertising to the general public and encouraging these services.

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

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  May I check that the hon. Member’s understanding is the same as mine—that nothing in the Bill compels an organisation to participate in the way that he describes?

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

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  I entirely agree with the hon. Member for Richmond Park and I absolutely expect this information to be collected. My observation, as ever, is that I do not think we should put the exact details in primary legislation. The powers are clearly there for the Secretary of State to specify what information should be collected. I am struggling to find it, but I know that my hon. Friend the Member for Spen Valley will move an amendment to require the Secretary of State, when they make provisions and issues guidance under the Bill, to consult the Equality and Human Rights Commission and others in respect of protected characteristics.

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

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  I agree that we need the data to ensure that we understand how assisted dying operates in relation to different protected characteristics and geographical distribution, but I am not sure that amendment 273 is the way to do that.

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

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  The hon. Gentleman says that he is clear that those actions are assisting suicide and that he thinks that they are illegal. Is it right that members of the public, in the instance to which my hon. Friend the Member for Spen Valley referred, be investigated by the police on their return from trips to Switzerland?

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

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  Does my hon. Friend agree that to keep the list of characteristics on which we have to collect information up to date, we need a level of flexibility—not in primary legislation? Would she comment on the fact that no information regarding sexuality or other protected characteristics is included in the Bill?

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

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  Does the hon. Member accept the distinction that I made between an organisation choosing to provide assisted dying services and the instance he outlined of this being done in someone’s home that happens to be a care home? They are entirely different points, and I fear that, particularly with regard to hospices, he is conflating the two.

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

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  I am afraid I cannot agree. The situation that I set out, in which a hospice makes an organisational decision that it does not wish to provide assisted dying services, is entirely legitimate under the Bill, as drafted. I do not, however, think it should screen which applicants have a certain view, which would be legal under the amendment. The example that the hon. Lady gives is rather different, because it relates to a particular protected characteristic. I am not an expert in the area, so maybe colleagues can help me, but this relates to specific services.