Rebecca Paul MP: speeches

Speeches

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  I do not think that we are trying to exempt something from the Suicide Act through the Bill; we are decriminalising something that is currently a criminal offence. Right now, it is a criminal offence to assist someone to commit suicide, and clause 24 decriminalises that. I totally support what you have done here, but your Bill does not decriminalise encouragement. I imagine that you have done that for very good reasons, which I support; we do not want people to be able to go round encouraging people to commit suicide. It is vital that there is protection for the vulnerable people we have talked about. You are absolutely right that what constitutes encouragement can be subjective and difficult to determine, but encouragement is already in the law, so we have to deal with it. It is already a criminal offence to encourage a suicide, so it does not make sense not to deal with it in this Bill.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  One of the major concerns that we have heard from members of the public and MPs relates to the importance of ensuring that appropriate safeguards are in place, so that people make genuine choices and do not request an assisted death because somebody else has pushed them towards it. For that reason, it is vital that subsection (2)(b) is as comprehensive as it can be. It currently refers specifically to a person having been “coerced” or “pressured”, which covers only the more direct kinds of influence, not more subtle ones. It seems clear to me that amendments are required to ensure that more subtle kinds of influence are covered adequately, and that clinicians do not just look for obvious signs of coercion or pressure when considering eligibility. In her oral evidence on 29 January, Dr Mullock said: “In terms of the Bill that we are discussing, one possible weakness here is that it identifies, only very obviously, problematic conduct in terms of coercion or pressure exerted by another person, and actually the kind of undue influence that might occur might be very subtle. More needs to be done to recognise that and the subtle encouragement that might take place, where a relative might frame their support for the person seeking to die in terms of, ‘This will be better for you,’ and, ‘Have you considered this?’ That is not necessarily an example of clear abuse, so when the person seeking to die then consults the doctor, they are not going to characterise what has happened to them as coercion or abuse. More needs to be done to discuss with the person whether or not they have been encouraged by the people around them.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 29 January 2025; c. 162, Q204.] Amendment 23 would add the term “unduly influenced” to the clause. It is an important addition, as it is a recognised term in law. It is designed to ensure that relationships of dependence are considered. In some cases, there is no bad intent, but there is a power differential, subtle as it may be, and it is important that we recognise how strong it can be. A child not wanting to disappoint their parent; a wife not wanting to go against her husband’s wishes—there may well be no threats or explicit pressure, and there may be a lot of love shrouding it, but the influence is there and it is strong. That is why the concept is applied in probate cases to test whether someone has faced influence, domination or pressure that prevents them from exercising free and independent volition with regard to the act. It has also been applied in medical decisions, including over a refusal of treatment that can lead to death. For example, there was a case of a Jehovah’s Witness who refused a lifesaving blood transfusion under undue influence from her mother. It is therefore a natural addition to the Bill. In important judgments, the courts have said that undue influence will have more impact on people who are very tired, in pain or depressed, and that “a patient in a weakened condition may be unduly influenced in circumstances in which if he had been fit, he would have resisted the influence sought to be exercised over him.” This legal concept could have been designed for the context of assisted dying. That is why it is important that the amendment is made. In her oral evidence on 28 January, Dr Cox said, “I would say that you cannot always identify coercion. You can identify it when it is very obvious and extreme, but when it is very subtle, we cannot always identify it. After the event, there is nobody to tell us about coercion, so it is very difficult to monitor.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 28 January 2025; c. 73, Q90.] I would also like to point out that California’s law prohibits coercion or undue influence, so there is established precedent in using this phrase in the safeguards of assisted dying law. If we have the ambition for our law—if it is to pass—to be the safest in the world, we need to add the term “undue influence” as a minimum. Even with that additional safeguard, however, Dr Spielvogel rather worryingly said in his oral evidence, “I have seen assisted dying laws go into practice across numerous states and have helped many, many people through this process, and I have never seen a case where I even suspected coercion.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 28 January 2025; c. 101, Q139.] Richard Robinson of Hourglass, in his oral evidence, said, “I think that coercion is underplayed significantly in cases of abuse of older people…One of the biggest issues we face is the fact that we have no idea of the levels of training that healthcare professionals and the judiciary receive to understand and recognise coercion. That leaves us in a situation where medical professionals say that coercion in these circumstances is minimal, but people need to understand what coercion is and how to recognise the signs of it in the first place, especially bearing in mind that the vast majority of cases that we see take place in the home and by family, rather than by professionals.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 29 January 2025; c. 158, Q196.] Additionally, psychiatric and legal experts have said that undue influence is relevant in this context. In written evidence, Professor Allan House refers to undue influence as “coercion in its less overt or threatening forms”. He also draws attention to the great risk of undue influence in the case of couples seeking assisted suicide at the same time. The probate lawyer Tamasin Perkins, in an article on the Bill, says, “Undue influence or coercion is depressingly common in the arena of contested wills and gifts.” She suggests that the current law on undue influence could be usefully incorporated into the Bill. To those who worry that adding undue influence could make things more difficult for clinicians when assessing, I would say that it is absolutely right on something of this gravity that rigorous consideration is given to the possibility of undue influence. I turn to amendment 82, which adds the term “encouraged” to coercion and pressure. This amendment is in line with Dr Mullock’s advice in both her written and oral evidence. It is important to note that encouraging suicide is currently a crime under section 2 of the Suicide Act 1961. It is also important to note that the Bill does not decriminalise encouragement, only assistance. Clause 24 decriminalises only the assistance component, not the encouragement component. Thus, if the Bill were to pass, encouragement of assisted dying would still be a crime. That is absolutely right and something that I fully support. As encouragement of suicide is clearly recognised as a heinous crime, it surely must follow that when considering whether someone is eligible for such assistance to end their life, consideration is given to whether they have been a victim of such a crime. This feels like a rather basic safeguard that is missing from the Bill and must be rectified. As former Attorney General, Victoria Prentis, has written, “maintaining the prohibition on encouraging suicide is key to protecting vulnerable people”. She says it is a problem, though, that “doctors and judges under the bill are not required to check whether the person’s decision is their own or whether they have been encouraged by others.” She goes on to say that she hopes the Committee will support my amendment, and David Hughes—formerly of the Law Commission—says that keeping the offence of “encouragement” would help to prevent “insidious pressure”.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  I absolutely agree that such clarity would be very useful. The hon. Member and I both want to ensure that undue influence is captured somewhere; I am less picky about where. As long as it gets covered somewhere in the Bill, that would be an improvement to the Bill, and I hope that everyone would really welcome that. I think everyone recognises the issue. I am not hearing that people are opposed to this; they recognise that there can be more subtle forms of coercion. If we can work together to find the best place for that to go in the Bill, I am very open to that.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  My interpretation is that it would not.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  My hon. Friend makes the point powerfully. I say to everyone in this Committee—we had this discussion yesterday—that I am not opposed in principle to the concept of assisted dying, but I see my role here as to protect the vulnerable. That is what I am trying to do, and I know everyone here wants to do exactly that. I cannot really see any downside to these amendments. Why would the Committee not want them included, if we want to protect the most vulnerable? Yes, it may put a bit more onus on clinicians, because they would need to look for a lower level of coercion. But that is absolutely right—of course they should have to do that. We are talking about assisted death. It is really important that we have a higher level of consideration.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  I thank the right hon. Lady for that really helpful intervention. That is exactly the kind of advice that is extremely useful to us new MPs undertaking this process. I will have to make the decision on that question in a matter of minutes, and it is very difficult, but I will do my best to make the right decision. New clause 5 seeks to define encouragement for the purposes of the Bill and includes some exclusions. We have already talked about some of the challenges with exactly what encouragement means, and clearly there are certain acts that we do not want to be captured by it. The aim of the clause is just to ensure that it is only intentional, targeted and effective encouragement that is covered. I am very open to working with the Government to ensure that the drafting reflects the intent; it may well be that some other things go in there to address some of the concerns raised by my right hon. Friend the Member for North West Hampshire around support being given by families. No one wants to see that included in this definition—I think we all agree on that. In summary, I hope hon. Members will view these amendments, incorporating undue influence and encouragement into clause 1, favourably, in order to bolster the safeguards in this Bill. It is vital that subtler forms of influence are addressed, to protect patients and to ensure that it is not just the obvious signs of coercion that are looked for. I also welcome amendment 113, tabled by the hon. Member for Broxtowe, which is very much in the same spirit as amendments 23 and 82 and would insert the word “manipulated”. I hope we will debate it because, if accepted, it would certainly improve the safeguards in the Bill.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  My hon. Friend is very knowledgeable about these things and is well qualified on the legal side. I value his contributions on this matter. The reason I want to include “unduly influence” is because it deals with those more subtle forms of coercion. Arguably, it could be included in “coerced or pressured”, but by including “unduly influence” in the Bill it becomes more explicit that a clinician has to be looking for it. In the absence of the language, clinicians will not be required to look for those more subtle forms of influence. The provision is something that is included in the assisted dying laws of other jurisdictions. We have the opportunity here to learn and benefit from jurisdictions that have already implemented it. We heard various witnesses give us very useful evidence during the sessions. For example, California includes “undue influence” in the law. We should recognise that there is value in including it here. It is a well-established legal term that is used in myriad situations, so it is relevant that we include it.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  It is helpful to understand the Government’s position. If the amendment is not made, I hope that the Minister is right, but one thing that I have learned in my time is that different judges will have different views on these things. Personally, I would prefer to see this provision in the Bill, as it would absolutely ensure that the protection is in place. We all know that decisions in the courts can sometimes go a different way from what we expect.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  The hon. Member is absolutely right that the amendment would not make it easier for the clinician. My job is not to make it easier for the clinician to determine that someone is eligible for assisted death. It should be a robust, rigorous and well-considered process.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  Just to clarify, I am not questioning that they were not telling their truth. I completely believe that, from their perspective, they honestly believe they have never seen a case of coercion. Maybe I am more of a glass-half-empty kind of girl than some other people, but I question whether that is really the case. In my 45 years on this planet, I have learned enough about humankind to know that these things do happen, but different people will take different views when it comes to detecting them.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  My hon. Friend’s point goes to the heart of the case, and to the point that I made earlier: it is extremely difficult when the Bill is a moving feast. We are tabling amendments to the Bill as drafted, but if substantial changes are made, that will impact some of what we did earlier.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  I beg to move amendment 23, in clause 1, page 1, line 19, after “coerced” insert “, unduly influenced”. This amendment would include the absence of undue influence for the making of a person’s decision. This reflects the changes proposed in Amendments 24 to 33.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  Forgive me—I hope the hon. Gentleman will bear with me as I seek to understand this; he is obviously very learned in these matters. My understanding is that clause 24 takes out only the assistance piece, not the encouragement piece. I think the hon. Gentleman just said, if I am right, that encouragement now falls under clause 26, but encouragement is also captured in the Suicide Act 1961. That is my non-lawyer interpretation of reading the Bill. I am not saying that is absolutely right, but I would appreciate it if he could clarify that.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  I thank my hon. Friend for that intervention. The point that I would make is about an example that we talked about a lot yesterday, so I know that it resonates for many on the Committee. If someone is making a decision and a treatment is being withdrawn, or life support is being turned off, undue influence is already one of the things they consider, so when we are considering assisted death, surely, in order to be consistent, we would apply undue influence to that as well, rather than having a lower level. Why would we have a lower threshold for assisted dying compared with withdrawal of treatment?

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  As a new MP—there are many in the room today—I am still very much learning the process; we have to contend with not quite understanding how the full process works. In two years’ time, I think that I and many other new colleagues would be in a different position and would fully understand all the interactions and the subtleties of the legislative process. But it is a challenge I have, which is why, right now, I will always table the most robust amendments that I think will safeguard the most vulnerable in our society.

• 12 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Tenth sitting) · Hansard source

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  I completely agree. If we do not incorporate undue influence, we are at a lower threshold compared with withdrawal of life-sustaining treatment. That does not feel to me like the right position, but equally, this is a novel bit of legislation and we need to increase the safeguards further. Obviously, we shall be debating numerous amendments whose purpose is to raise that threshold. It is always very hard—how long is a piece of string?—to know exactly where to set a threshold. Different people have different views. My personal view is that in this Bill the threshold is too low, so we need to raise it by agreeing some of these amendments. So far, none of the amendments that have been suggested has been accepted. I really hope that during this Committee stage we will increase the safeguards.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Eighth sitting) · Hansard source

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  I welcome the hon. Member’s attempt to improve safeguarding in the Bill, which I agree is currently not at the right level. Does she agree that the Mental Capacity Act assumes in the first instance that, if there is no evidence to the contrary, a person has capacity, and that whether a person lacks capacity must be decided on the balance of probabilities? Unwise decision making does not indicate a lack of capacity, and supported decision making is considered to be acceptable. We need all to be clear that that is what the Act says.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Eighth sitting) · Hansard source

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  I would like to understand why my hon. Friend thinks that diabetes could ever be considered reversible. It can be treated and managed, but surely we cannot turn back time.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Eighth sitting) · Hansard source

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  Will the hon. Lady give way?

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Eighth sitting) · Hansard source

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  May I ask how what the Minister has just said interacts with voting? He set out clearly his involvement in the Committee, so how does that impact any votes that he will take part in during it?

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  I think that one of the points being made is the difference between something that is active and something that is passive—for example, someone who chooses not to take that next level of chemotherapy because they have had enough, they have gone through a lot of it or it was painful, and chooses, in the example the hon. Member for Spen Valley just gave, not to eat and drink. That is one case, but it is very different from someone choosing to end their own life, which requires active participation and involves other people too. That would be the key difference, which I wonder if the Member for Bradford West agrees with.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  Some incredibly important points have been made. I would like to give an example. Let us consider someone who is homeless. Perhaps they are staying with friends, as my right hon. Friend said. If they find themselves to be terminally ill, they may well face difficulties in accessing palliative care and getting the right treatments simply because they are homeless. This is about protecting that vulnerable group from choosing assisted dying simply because they are in a precarious and difficult situation and assisted dying seems like the best option in the light of lack of palliative care and their current circumstances. Would my right hon. Friend concede that that is what my hon. Friend the Member for East Wiltshire is trying to address?

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  A very good point has been made about looking at the Mental Capacity Act at different times during the process. However, it does not matter how many times a bad process is applied; if the process is insufficient and does not have a high enough safeguard, it will never give the right answer. We need to ensure that we have the right test. It is absolutely right that we apply it multiple times, but does the hon. Lady agree that we need to consider the quality of what we are applying in the first place?

• 6 Feb 2025 · Financial Education · Hansard source

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  I warmly congratulate my hon. Friend the Member for Broadland and Fakenham (Jerome Mayhew) on securing this important debate, and I commend him for his sustained efforts to drive up the quality and availability of financial education offered to our young people. There is sometimes a tendency in this House—perhaps an understandable one—to gravitate towards short-termism. It is therefore a sincere pleasure to follow my hon. Friend, who, along with his colleagues in the all-party parliamentary group on financial education for young people, has been doing such excellent work to promote reforms that take a longer view and are geared towards boosting the life chances of future generations. Good financial education, delivered not only by schools, but by parents and families and within communities, has the potential to produce a generation wise to the dangers of credit card debt, alert to the practices of predatory payday lenders, and confident in their ability to open a bank account and budget appropriately. I believe that all of us in this place are truly committed to reducing inequality and ensuring that everyone has the best possible start in life, and I can think of few better ideas than ensuring that all young people enter adulthood with a sound grasp of how to manage their money. The British public seem to share that assessment. A research survey of UK adults conducted by Santander revealed that a full 70% felt that better financial education in their younger years would have improved their ability to manage their finances through the ongoing cost of living crisis. Meanwhile, two thirds of young people believe that a lack of financial education has played a role in them amassing the debts that they hold. Indeed, it is not just adults but children who are deeply concerned about financial matters. The London Institute of Banking and Finance reported in 2023 that 68% of children worry about money and their personal finances. That figure is hardly surprising when we consider that today’s children are the most digitally exposed in history; they face a constant barrage of offers to spend money in alluring but wasteful ways. Many of the apps downloaded on to the phones that our children spend so much time on are full of shining icons, inviting them to spend real-world money, with the tap of a finger, in exchange for worthless in-game currencies. Young players of online games are prompted to spend, in some cases, hundreds of pounds on loot boxes or so-called cosmetic items—that is, a virtual in-game weapon, or an outfit that is a slightly different colour from the default option. Financial literacy is clearly a skill that our children and young people need, to protect them and prepare them for the future. Although there is undoubtedly still work to be done, I briefly draw the House’s attention to the solid foundations laid by successive Conservative Governments over the past 14 years. After all, the Conservatives left England as one of the top-performing countries in education. Under the Conservative Government, children in England were named the best in the west for reading, and were ranked best at maths in the western world in the 2023 TIMSS—trends in international mathematics and science study. It was a Conservative Government who created the national network of 40 maths hubs to support schools in improving their mathematics teaching. That network is a partnership between schools, colleges and other organisations that work together to provide support for maths teaching in their regions. The positive impact of those hubs on young people’s ability to manage and understand money and finance is obvious. We were clear that we intended to go further: at the last election, we set out a comprehensive plan to ensure that every child studied maths to the age of 18, so that they would leave school with good numeracy skills. That would help them to navigate their finances with confidence. That is not to suggest that the entire burden of providing robust financial education can or should fall upon our schools. As is so often the case, families also have a central role to play in ensuring that children are imbued with good financial common sense. That does not need to be overly complex; simple measures, such as offering children small amounts of weekly pocket money, can help to normalise good habits such as saving and thinking carefully before making purchases. According to an ING survey of 12,000 parents across Europe, giving children pocket money reduces the risk of them getting into debt as adults.

• 6 Feb 2025 · Financial Education · Hansard source

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  I thank the hon. Member for that great contribution to the debate. I agree that all those small things add up and make a difference to our financial literacy. I am a chartered accountant, but that is not what made me financially literate; it was the lessons I was taught by my family, and the jobs that I did when I was young. Members have given great examples of how they came to understand finance. In an increasingly contactless world, it is important that children and young people physically see and feel cash. That is the way in which value is tangibly understood. To return to schools, financial education is not, as has been noted, a statutory part of the national curriculum in primary schools in England, but in contrast, in Wales, Scotland and Northern Ireland, it is very much embedded at primary level. Given the way in which our children are relentlessly pressured to spend money that they may not even have, and in the light of Cambridge University research suggesting that habits and attitudes towards money are formed by the age of seven, there is much logic to the argument that financial education—whether delivered by schools, parents or even community hubs and other organisations—should not wait for the later years, and should be continuous. Teachers also feel that starting good financial education early is important for the future wellbeing of young people. According to a 2020 survey, 82% of primary teachers consider teaching financial education to be very important. We may hear more about that when the Francis review of the national curriculum is complete. I urge the Minister to answer the question that my hon. Friend the Member for Broadland and Fakenham asked about the Government’s plans for the curriculum. In secondary schools, the picture is somewhat different. In 2014, the then Conservative Government acted to ensure that financial education was placed on a statutory footing in local authority schools. However, the all-party parliamentary group on financial education for young people—which I once again praise as an outstanding example of everything an APPG should aspire to be—noted in its 2023 “Building Beyond Barriers” report that over half of teachers did not know that financial education was part of the curriculum at all. That is a matter of some concern. It is certainly important that the topic of financial education is addressed in the classroom in an appropriate way. I have no doubt that our hard-working teachers are keen to play their part in delivering that content. The same report found that three in four teachers believed that they should play a leading role in imparting financial skills to children. The obstacles were reported to be inadequate training, limited funding and an understandable feeling that there is simply not sufficient time in the school year to deliver those lessons. In government, the Conservatives sought to mitigate the funding issue with an investment of over £1 million to embed and scale teacher training in financial education. The Money and Pensions Service did excellent work developing and testing approaches to supporting teachers, and practitioners working with children and young people in vulnerable circumstances, to deliver financial education. Ultimately, though, we must acknowledge that the school timetable is already under intense pressure, and there are many competing calls on limited time. That is why I would argue that the good financial education that every child deserves is best delivered not only in schools, but in the family setting, in communities, and with the help of valuable resources. I conclude with a simple message, which I hope underscores some of the excellent contributions that we have heard today: financial education is invaluable and transforms life outcomes. Research undertaken by Compare the Market tells us that today, just two fifths of young adults rank as financially literate. We can and must do better. Conservative Members will keep these matters under careful review, and I hope that the Minister will address the questions that have been raised. Once again, I thank all those who have spoken, and in particular my hon. Friend the Member for Broadland and Fakenham.