Naz Shah MP: speeches 2025

Speeches

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

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  I will re-read it. It is, “including where the person is in an intimate or family relationship with that other person”. The “family relationship”, I think, means that it is extended to siblings. That was my interpretation. Last week, or the week before, we spoke extensively about suicide, and women in particular. The number of women who have committed suicide, particularly following domestic violence, has increased. Indeed, it was on the front page of The Guardian today. It is defined by our lawmakers as intimate partner violence, but it could be other violence. In those cases, as a Government and as lawmakers, we do define those women who are killed by members of their family or intimate partners. Our Minister for Safeguarding and Violence Against Women and Girls reads out that list.

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

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  That is the exact point I was about to raise. Is another amendment needed to ensure that providers of this service are not given more money if a patient goes through the process than if the process is stopped?

• 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 amendments 172 and 173, tabled by the hon. Member for Reigate, and against amendment 539, moved by my hon. Friend the Member for Spen Valley. Clause 33 currently provides that the Health Secretary “may” bring forward regulations to require a doctor to report any notifiable event to the chief medical officer. That would be either the CMO for England or the CMO for Wales, according to where the assisted death takes place. The clause lists those notifiable events, such as the first declaration, the two statements by the doctors, including when they refuse to make such a statement, and the final statement that follows the person’s death. The weakness in the clause as originally written is its use of the word “may”. It should not be optional for the Secretary of State to make such regulations. Amendment 539 retains that weakness, while adding what I view as a new problem. The new weakness is that the amendment removes the requirement for doctors to notify the CMO of the events. Instead, it specifies that they should notify the voluntary assisted dying commissioner. By all means let us have doctors reporting these events to the commissioner, but they should still be required to report the events to the chief medical officers too. There are at least two good reasons for that. First, the chief medical officers are extremely experienced, senior doctors. They and their staff have the ability to look at this kind of data from a medical and especially a public health perspective. The VAD commissioner will come from a legal, not medical background. They will have other abilities but they will not look at this through the lens that a senior doctor would. Secondly, it cannot be good governance that the only person who must see the data is the commissioner—the official who runs the assisted dying system and who appoints all the panel members.

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

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  I am happy to, Mrs Harris. We should be determined not to see big outsourcing companies bidding for assisted dying contracts and then potentially misusing them the way in which they have misused other public services. That is not because I am opposed to firms operating in a free market or making money when they do their job well; it is because the way we run outsourced Government contracts in this country often has nothing to do with the free market and nothing to do with companies working well. Finally, we need to ask hard questions about how the contracts for assisted dying would be structured. Would companies be paid a fee for each stage of the assisted dying process that they have provided: one fee for providing the first assessment by a doctor, another for a second assessment and so on, up until the final fee for helping the patient take the lethal drugs? As I said this morning, we do not know what the proposal for the structure is. That is why it is important that we explore and understand the risks of every structure. There are Government services that we can safely outsource. Assessing whether people are fit to end their life is not one of them, and neither is helping people to take lethal drugs. These clauses will enable future Governments to open up lucrative contracts for assisted dying that will almost certainly be won by companies that have often been incompetent and have potentially been dishonest. I strongly oppose the new clauses.

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

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  I thank my hon. Friend for her detailed explanation. She makes sense—I would not want to restrict that either. Perhaps she is entirely correct—no doubt she has researched it well—but clause 26 mentions coercion and pressure. It says all of that on the face of the Bill. My hon. Friend wants to leave it in that context— “by dishonesty, coercion and pressure, induces another person to self-administer an approved substance”, which is repeated in clause 26(1) and (2). I would still be minded to put at least something further in the Bill. I am not sure that it would restrict us; it would just be helpful. If my hon. Friend does not press the amendment to a vote, would the Ministers accept that there will be statutory guidance on that? I do not know whether the Ministers can respond now or want to wait until they sum up. I am happy to give way. They are not going to bite; that is fine. Just for the record, I want to talk through the amendments tabled by my hon. Friend the Member for Lowestoft and why she and I feel that they are important. Amendment 518 would put in the Bill a definition of “coercion”. Amendment 520 would do the same for “pressure”. Those amendments give welcome clarity to the Bill on two important issues. Where they talk about a “person or organisation” engaging in coercion or pressure, respectively, my hon. Friend’s amendments would have added, “including where the person is in an intimate or family relationship with that other person”. That would make sure that we covered that.

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

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  While I appreciate that it is not necessarily a duty as defined in law, does the Minister not agree that, given the way our Government operates, we need that data to inform us, in order to improve services elsewhere? We could apply that to this Bill as well.

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

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  When it comes to NHS providers, or any service providers, and contracting or outsourcing, we have legislation in this place for whistleblowing. I raised the subject with the Health Secretary in relation to my local trust only today. With the best will in the world, mistakes happen. We legislated to protect whistleblowers, and that ties in directly to these risks. We must do everything we can to mitigate such risks in the Bill.

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

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  I will come on to that point. As I have said previously, this Bill will not just create a VAD commissioner, but give them the power to assess their own work. That means it is much less likely they will critically assess the data for any signs of a major problem. We all suffer from unconscious bias, even the very senior legal officials who will be eligible to become VAD commissioners. If the data were sent to the chief medical officers as well as the commissioner, that would mean two sets of officials with different perspectives and fields of expertise looking for problems. We would have a much better chance of locating problems earlier that way. Amendment 172 would change the clause so that the Health Secretary must bring forward such regulations. As things stand, regulations brought forward under the clause would be subject to the negative procedure, which, as all hon. Members know, considerably reduces the amount of parliamentary scrutiny they receive. Amendment 173 would make regulations under the clause subject to the affirmative procedure. I honestly try to see the arguments for and against each amendment, but I have real difficulty in seeing what the arguments against these two might be. Clearly, notifiable events are important information that must be collected nationally for a transparent assisted dying system. Equally, they need to be governed by regulations so that all doctors participating in the scheme have a clear picture of their responsibilities. Finally, on such an important matter, Parliament should be required to vote to accept such regulations, as that will increase the scrutiny from both this House and the other place. I appreciate that my hon. Friend the Member for Spen Valley drew my attention to her amendment, which says the commissioner must consult the chief medical officer. However, it does not specify whether the consultation should include data or if it is the beginning of the process; those things are not stated on the face of the Bill. That leaves it open to interpretation, which is why I support the amendments tabled by the hon. Member for Reigate. I thank her for tabling those two very sensible amendments and I urge hon. Members to vote for them. From my perspective, amendment 539 weakens the Bill and we should vote against it.

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

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  I rise to speak to amendment (b) to amendment 518, and amendment (b) to amendment 520. Although I appreciate that my hon. Friend the Member for Penistone and Stocksbridge is not pressing her amendments to a vote, it is important to get a few things on the record. I am speaking to these amendments to her amendments because they were tabled by my hon. Friend the Member for Lowestoft. Before I speak further, my hon. Friend the Member for Spen Valley, the Bill’s promoter, has accepted several amendments tabled by my hon. Friend the Member for Lowestoft before—I do not know what her response is, given that my hon. Friend the Member for Penistone and Stocksbridge is not pressing her amendments to a vote. That has thrown me off track, to be fair, because I was not expecting that. Either way, let us move on. I thank my hon. Friend the Member for Penistone and Stocksbridge for her detailed, interesting presentation to the Committee, though I am not sure I entirely agree with it. Although there might a point, from a legal perspective, where these offences actually do exist in the law, the truth remains, and the facts remain, that when it comes to domestic violence—coercion and so on, which we have debated extensively—we have put the training in, but not putting the offences on the face of the Bill slightly contradicts the conversation we had last week, when my hon. Friend the Member for Spen Valley, the promoter, specified that the sentence for somebody who is found guilty of coercion would be put on the face of the Bill; for example, if a person were found to be guilty of coercing somebody who then died, that would carry a life sentence. My understanding is that there would have been no need for the amendments on that, because we already have those laws in existence for murder, and that would be murder.

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

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  I am surprised by what the Minister says on the cost of the Bill. My understanding from our debates on cost is that, if the Bill is passed, its cost will be footed. Why is there a cost implication to this amendment and not to other provisions?

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

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  From a public health perspective, we have been having a huge debate for weeks and weeks about whether or not this is a health intervention and whether it should be provided in the NHS or elsewhere. When I was a public health commissioner, we collected socioeconomic data to learn about not just protected characteristics but socioeconomic background. There are concerns that disadvantaged groups are more vulnerable. Would it not be appropriate for the Bill to address those safeguarding issues?

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

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  Under the Bill as presented on Second Reading, the Secretary of State would have to report to Parliament on how the assisted dying system was functioning, but they would do so only after the system had been in operation for five years. Under amendment 452, tabled by my hon. Friend the Member for York Central, the Secretary of State would be required to report annually on how the system was working. The Bill’s original provision for a five-yearly report was extremely surprising. The requirement on the Secretary of State to report to Parliament is a major safeguard that will prompt them and their officials to probe all the available data on the system. It will also allow Members of this House and the other place to go over that information and look for problems, should they arise, and ways to resolve them. It could be one way to identify failings in the system early. Given that we are discussing a system to allow people to take lethal drugs, that is surely what we should aim for. We cannot afford to wait through years of media reports and complaints before then having to investigate alleged problems. If the amendment is accepted, it will not be certain that the Secretary of State’s report and the scrutiny of Parliament will identify problems in a timely way, but that possibility will be increased. If we have to wait five years for a report, it is much less likely that we will spot any problems before they have had terrible consequences. I urge Members to vote for the amendment to replace the five-yearly report.

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

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  I beg to move amendment 450, in clause 34, page 20, line 33, at end insert— “(1A) The relevant Chief Medical Officer must produce an annual equality impact assessment of access to both palliative care and assisted dying on the basis of— (a) protected characteristics as set out in the section 4 of the Equality Act 2010, (b) socioeconomic status, (c) geographical location.” This amendment will ensure that a full impact assessment is carried out on the access to both palliative care services and assisted dying services.

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

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  Amendment 447 was tabled by my hon. Friend the Member for York Central; I also speak in support of amendment 523, which was tabled by the hon. Member for East Wiltshire and helpfully clarifies amendment 447. My understanding was that the Bill’s promoter indicated that this was something she would support; I am happy to give way so she can clarify.

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

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  Perfect. I thank my hon. Friend—I like it when we get to amendments that are supported. Amendment 447 would literally change the word “may” to “must” in clause 30. The first four matters that the clause lists are so important that issuing codes of practice cannot be left just as a choice for the Secretary of State; it must be something that the Secretary of State has to do. It is worth pointing out, as I am learning about this new process, that when we leave it to the Secretary of State, that means a Secretary of State under any Government, depending on how long it takes. It is not necessarily just our Government; it could be another Government. I am just pointing that out, because somebody pointed it out very clearly to me, and I was shocked by that detail. The Bill sets out five areas of responsibility that the codes could cover. They include some of the most consequential matters that this Committee is considering, as set out in clause 30. The first four are doctor’s assessments of “whether a person has a clear and settled intention to end their own life,” and whether that person has capacity to do so, accounting for the effect of depression and other mental disorders on decision making; the “treatment or palliative, hospice or other care available to the person”; the provisions for effectively communicating with them; and “the arrangements for providing approved substances to the person… and the assistance which such a person may be given”. They are all vital and I am pleased that this amendment would ensure that the Secretary of State has to issue codes of conduct, rather than being able to decide that they may not do so. If these matters were not covered by codes of practice, they could be left to individual doctors to interpret, which would mean that doctors would face having to make unfamiliar and complex decisions without the clear guidance that a code of practice would give. That could have created—indeed, it would have created—dangers for both doctors and for people seeking assisted dying. The fifth area of responsibility for the Secretary of State, as set out in clause 30, is codes of practice on: “such other matters relating to the operation of this Act as the Secretary of State considers appropriate.” It seems clear to me that, because the Secretary of State will issue codes of practice for the first four areas of responsibility, they must also issue codes for other matters if they see a need for them. I am confident that we all agree on that. Amendment 523 would make it clear that the Secretary of State can issue codes of practice on any other matters as they see appropriate, but they would not have to do so if they thought there were no other matters that needed such codes. That is a sensible clarification that preserves what the Bill drafters were doing when they wrote the clause. If the Bill passes, we will be authorising doctors to depart from centuries of previous practice. They will face decisions that they have not previously had to take. I am pleased that, if the Bill passes, the Government will be able to set out the clearest possible guidelines for medical professionals in accordance with the many provisions in this clause. Doctors in England and Wales have never previously had to assess whether someone has a clear and settled intention, and it is surely unfair to ask them to work out how to make that judgment without clear guidance from a code of practice. A code of practice also mitigates the risk that different doctors will approach this task in widely differing ways. The truth is that the use of the Mental Capacity Act 2005 is untested in relation to assisted death, where a person will take lethal drugs to end their life. Codes of practice will address important and difficult questions of interpretation. Again, that will give us much-needed clarity, including in the area of the provision of palliative care to people considering assisted dying and how doctors advise them. The independent commission on palliative and end of life care found that knowledge of palliative care among doctors is often limited, so the Secretary of State’s intervention will be much appreciated, and the codes will give a settled direction. I am grateful that my hon. Friend the Member for Spen Valley has accepted amendment 447. I look forward to working through the rest of the Bill and getting some more amendments passed.

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

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  I have taken your advice, Mr Dowd, because my points would have made for a long intervention. First, I gently remind my hon. Friend the Member for Rother Valley that we have not used the word “disingenuous” in this Committee, so I sincerely wish that he reflects on that. Regardless of the debate we are having, everyone on the Committee is very committed to what we are doing here. Secondly, my hon. Friend said that we were making a mountain out of a molehill. I refer again to the issue of forced marriage, legislation on which went through the House when police forces already had legislation to prosecute for it. As legislators, we should have ensured that we raised awareness and trained our police officers and communities to apply that—

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

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  I thank the hon. Member for East Wiltshire, who has raised some concerns for me. I rise to speak in support of the amendments, but also to raise some points. I share the hon. Gentleman’s concerns, but let me begin by speaking about the bits that I feel pleased with and able to support. My hon. Friend the Member for Spen Valley has already explained the amendments and may explain them more later. I am pleased that they tidy up errors in the original construction of the Bill. In its original form, subsection (2) rightly states: “A person who, by dishonesty, coercion or pressure, induces another person to self-administer an approved substance provided in accordance with this Act commits an offence.” Unfortunately, in the Bill as drafted, the penalty for such an act is only a prison sentence of 14 years. It is quite right for that to be the penalty for the offence detailed in subsection (1), namely when someone, “by dishonesty, coercion or pressure, induces another person to make a first or second declaration”, but does not actually succeed in getting them to the end of the assisted dying process. However, it is easy to agree that 14 years is an inadequate penalty for successfully coercing or pressurising somebody into an assisted death. I am glad that my hon. Friend the Member for Spen Valley has recognised that problem and has tabled an amendment that would impose a maximum penalty of life imprisonment for such an offence. My hon. Friend the Member for Sunderland Central made a powerful speech in this Committee the other day, in which he said that abusive or coercive people are already likely to be forcing their victims to starve themselves or refuse treatment. That is true, and I thank him for raising that important point. I will welcome all measures to make it harder for abusers to do so and will gladly work with hon. Members to do so. However, I want to sound a strong note of caution. Creating an offence and giving it a strong maximum penalty is only one of the ways to deter abuse and coercion, and perhaps the easiest. As I have mentioned before, the conviction rate for coercion is only about 4%. There are other things that we need to do to deter and prevent abuse. We need the people who may come into contact with it to be aware of what could happen; we need them to be able to spot the signs that it may be happening; we need ways to investigate those signs carefully. Only when we have done those things can we move on to the CPS potentially prosecuting somebody for an offence and, if they are found guilty by the court, to sentencing that person. Those are matters that this clause deals with, and they come at the end of a process. I welcome the amendment tabled by my hon. Friend the Member for Lowestoft (Jess Asato), which makes training in domestic abuse and coercion mandatory for professionals working on assisted dying cases, and which my hon. Friend the Member for Spen Valley has accepted. However, new training on its own will not be enough to make it near-impossible for abusers to succeed. Having unfortunately had lots of experience in the area—having seen it in my own life, the lives of people close to me and the lives of constituents—I know that sometimes abusers are not subtle. Even so, they can be hard to catch, because their victims cannot recognise that they are being abused. The classic—I wish I had a pound for every time I heard it—is “He’s changed.” There are hundreds of justifications and some are very subtle indeed. These people can be very hard to catch, or they may never be caught at all. I have heard hon. Members say—I think my hon. Friend the Member for Spen Valley said it earlier—that the Bill strengthens the safeguards around people who are terminally ill, because those are not there in the first place. I appreciate that idea, but that is just for those people who are terminally ill. I want to strengthen safeguards more generally. In some ways, the Bill offers people a new opportunity to be coercive, controlling and dishonest. That is why I have been banging on about safeguards so much in this Committee; perhaps people find it a bit much, but I do it because abusers are very persistent and clever people and we have to be clever and persistent in how we devise our safeguards against them. Although I welcome the clause and the amendments tabled by my hon. Friend the Member for Spen Valley, I am disappointed that other safeguards have been rejected. I still say that the panel procedure could and should be much tougher. That would not guarantee that abusers would be caught, but it would make it more likely.

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

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  Amendment 273 would strengthen our position to collect that data, which is really important if we are serious about potentially reviewing the legislation by looking at the loopholes and at which communities are taking up assisted dying. The data in other jurisdictions says that it would be people from affluent backgrounds, but the hon. Member for Richmond Park powerfully raised concerns about the risks, as we heard in evidence from people such as Dr Jamilla and others. I strongly support the amendment, but I will also look at the Equality and Human Rights Commission issues that my hon. Friend the Member for Sunderland Central raised; I thank him for raising them.

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

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  I beg to move amendment 447, in clause 30, page 18, line 12, leave out “may” and insert “must”. This amendment requires the Secretary of State to issue Codes of Conduct.

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

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  I am not sure, but I will give it more thought.

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

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  Would the Government’s intention not be to sign this duty over to a regulator?

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

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  I was not intending to speak to this group, but I am now trying to find amendment 500.

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

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  My hon. Friend makes a valid point; that is an issue. If we are going to do this right, are we going to be looking at all six characteristics? That is important, so I agree with him.

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

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  In responding to my hon. Friend the Member for Sunderland Central, I appreciate that we do not want to put too much detail in the Bill, but with some of the commitments that we have made as a Government on collecting data we need to go further. That is for the simple reason that our equality laws are not right when we look at other issues, such as the gender pay gap.

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

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  I apologise, Mr Dowd. I will not refer to them. I come back to the point made by the hon. Member for East Wiltshire about DPP consent. I will be grateful if the Minister picks up some of these queries. In this place, we make laws. My experience of the law on forced marriage—I was a victim of forced marriage—was that we made a law but never got any convictions. Very little moved on it, because we already had laws in place to prosecute that offence. I am not saying that the same is happening here, but I draw the Committee’s attention to the fact that we may be making a law that already exists. If it already exists in the Suicide Act, are we just making a law for the sake of putting something on the statute book or on the face of the Bill? We have talked a lot about how we should not complicate things. The word “complication” has been used quite a lot in this Committee. Are we adding another layer of complication by putting this measure in the Bill, when we are not prepared to do so for other things that people feel strongly about? This is also something that already exists. My understanding is that if we were prosecuting coercion, for which unfortunately the prosecution rate is only 4%, that would not need DPP consent. It would be needed, potentially, for assisting suicide, but not for coercion. Do we need some clarity about the application of the law in this regard? Suppose we had a scenario in which somebody was murdered: it was premeditated, and somebody had thought through how to use this process as an avenue to kill that person. I do not want us to make a law that would allow somebody to literally get away with murder. More thought needs to be given to that. I am not an expert or an eminent lawyer like the Minister, but I am concerned by the comments of the hon. Member for East Wiltshire, having looked more closely at the issue. I would welcome the Minister’s comments.