Rebecca Paul MP: speeches

Speeches

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

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  My hon. Friend is making a powerful point. One of my concerns is about what happens if someone seeks assisted dying privately through a clinic. I see risks with multidisciplinary teams involving social workers continuing in that instance. Does my hon. Friend share my concern?

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

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  I thank the Minister for the very clear way in which she is explaining everything. I completely acknowledge what she has just said. As she rightly said, I alluded to the fact that I tried to make the change at an earlier stage, but was unsuccessful, and I am now trying to put it through here. Can the Minister comment on the meaning of “satisfied”? If we are not going to have “beyond reasonable doubt”, can she expand a little on the meaning of “satisfied” and whether she is comfortable that that is clear enough for these purposes?

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

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  It is a pleasure to serve under your chairmanship, Sir Roger. I rise to speak to my amendment 468 to clause 9, which would ensure that the assessing doctor must “ask the person why they are seeking an assisted death.” We have heard a lot in this Committee about the importance of the patient-doctor relationship. My hon. Friend the Member for Solihull West and Shirley said that we should be “trusting in the judgment of clinicians, who know their patients well” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 26 February 2025; c. 634.] He also said that patients “may want to speak to their GP because they have had a relationship with them over 30 or 40 years” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 25 February 2025; c. 481.] It is therefore worth asking how the Bill shapes the patient-doctor relationship. The Bill asks doctors to do many things to and for patients. It asks doctors to consider whether to raise the subject of assisted suicide; personally, I wish we had agreed to the amendment that would have ensured that it was the patient who brought the subject up first, but we are where we are. The Bill asks doctors to explain the patient’s diagnosis and prognosis and to lay out options for treatment and palliative care, if there is any available; if there is not, the doctor can only state that point and move on. Nevertheless, we are asking the doctor to look into the matter and lay out possibilities. The Bill asks doctors to check for capacity and for coercion, to ascertain whether the patient has a clear, settled and informed wish to end their own life, to witness declarations and, eventually, to give the patient a substance and oversee the patient taking it. In other words, it makes doctors absolutely central to the process, as the facilitators of the process, as the people who accompany the patient and as the professionals with the biggest responsibility for ensuring that the safeguards are followed, yet it never asks doctors to make a simple but vital inquiry: why? That is all that my amendment would add. It would simply require the assessing doctors to ask the person why they are seeking an assisted death. I hope that the Committee will agree that that would be a reasonable and not overly burdensome change. Some hon. Members have suggested that certain amendments embroider the Bill too much, but in this case, the patient-doctor conversation is already embroidered. The Bill makes some very specific demands of the doctor as to what the conversation should cover. Surely it is only natural, amid all the conversations, for the doctor to take a moment—perhaps more than a moment, but a moment at the very least—to help the patient to talk through their reasons. This is a very vulnerable moment in somebody’s life. The simplest of questions can often unlock the most information. In some cases, for the small number who would benefit from the Bill, the answer would probably reassure the doctor, but for those others we worry about, the question would provide another important safeguard. It would be another opportunity to check that this really is in the best interests of the patient. How would the conversation go? I do not think that we can generalise. It might be the briefest exchange or it might lead to a really searching discussion. Doctors know how to take their cue from the patients in these things. Crucially, the doctor’s role is not just to offer advice or information. Even if the doctor says nothing, it may make all the difference for the patient to be able to speak aloud their concerns, their confusion and their hopes and fears. I absolutely accept that many doctors, if not most doctors, would ask the question why anyway, but given its importance, I still urge the Committee to set that out in the Bill. In doing so, we would be affirming that this is more than a bureaucratic exercise; it is about a person and about getting to the truth of what they want and need. I do not think we should not make the mistake of assuming that every doctor has the time, or will take the time, to have the in-depth conversations needed to really understand what is driving a patient’s request. It is up to us to make legislation that keeps standards high at all times. There is currently nothing in the Bill that will guarantee an in-depth conversation. I am afraid that not all doctors believe that that is even a likely outcome. In written evidence, the GP Edward Tulloch states: “To conduct the required assessments outlined in 7.2 and 8.2 of the Bill within a standard GP appointment (lasting 10-15 minutes) is completely unrealistic. It will require multiple appointments to properly carry out such detailed discussions and complete the associated legal paperwork.” We all know what pressure the NHS is currently under. Many of us cannot get a GP appointment. So, how certain are we that adequate time can be allocated to the assisted dying process to ensure the criteria are truly met? By putting the “why” question on the face of the Bill, my amendment would bring us closer to the possibility of real, serious and honest conversations about a patient’s reason for seeking an assisted death. That would be especially helpful for those who have just received a terminal diagnosis. We have received some important written evidence from six palliative care doctors, who state that “our experience is that many patients experience a period of adjustment to ‘bad news’ and may say that they cannot live under these conditions. However, after a period of reflection and adjustment, the majority come to find peace and value in their altered life circumstance, in a way they would not have believed possible.” The consultant psychiatrist Jennifer Bryden provides an especially interesting perspective, as someone who has seen this from both sides: “Having gone through several long episodes of illness, I now know that feeling entirely useless and a burden to everyone is a phase that will pass. For many people a terminal diagnosis will be their first time through the cycle and they will believe those thoughts represent reality. In coming to terms with a severe illness, depression is an expected phase and learning to accept all humans need each other takes time”. Dr Bryden goes on to say that the current cooling-off period is not enough time for people to come to terms with such a diagnosis. Clearly, people may need all the help they can get to understand their new situation. Asking the patient for their reasons is only the beginning of that process, but one that may help them come to terms with their situation and validate, or not, their initial inclination. Finally, asking why can identify those patients who are being coerced or pressured. Nobody should think that that is easy to spot. According to the charity SafeLives, which counters domestic abuse, it takes the average person who experiences violent abuse 2.3 years to access effective help. In the year before they finally get help, 85% of victims will have sought help of some kind from an average of five professionals. Often, sad to say, those who missed the signs will have been healthcare professionals. That is for physical abuse; psychological abuse will be far harder to spot. We cannot put in enough safeguards to ensure that doctors have all the tools they need and all the opportunities they can, to spot those signs.

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

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  The right to say, “It’s none of your business” might be fine when no one else is involved, but if someone seeks an assisted death, that involves multiple members of NHS staff. There is an impact on all those people, who need to be comfortable with what they are doing. Maybe the person needs to accept that they do need to provide some information so that the medical staff feel comfortable about the question of eligibility.

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

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  I wish to clarify that the amendment is about not an additional assessment but merely a simple question. Like many who have spoken, I hope that most good doctors would ask the question anyway and take the answer. It may inform them or it may not but sometimes, as the hon. Member for Bradford West has just discussed so powerfully, it is helpful to remind medical staff, who are under lots of time pressure, that sometimes it is worth stepping back and asking why.

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

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  I just point out that the amendment states that the independent doctor would “inform the person’s usual or treating doctor”, and that is not covered by the paragraph the hon. Gentleman just mentioned. I hope that is helpful.

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

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  I thank the hon. Member for his very good questions. I suggest that it be asked twice, because it makes a lot of sense to ensure that the patient is given the chance to really explain what is driving their decision. It is the simplest of questions, but it is amazing what can sometimes come out of the simplest question. I return to the safeguard against coercion. In a sense, this is not a new safeguard; rather, it confirms and bolsters the other safeguards in the Bill, which are there to explore the reasons for assisted dying. Asking why will help doctors to better understand what is driving a patient’s decision and to give that patient an opportunity to validate that they are truly eligible. It is the simplest of questions, driving the most significant conversation that a doctor and patient can have. I hope that hon. Members will support my amendment.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I will come to that exact point shortly. Members of the Committee will recall that I previously tried to get “undue influence” and “encouragement” added to the Bill explicitly to deal with more subtle forms of influence and pressure, as opposed to those that are more obvious to third parties. When objecting to my amendments, the Minister said that they were unnecessary, because “coercion or pressure” already covered them. I hope that the Minister is proven to be correct. The key point is that those forms of behaviour are not always easily discernible. Dr Mullock told us in oral evidence that “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.] These are the very real consequences of this clause, which undermines the independent doctor safeguard. In written evidence, Mr Michael Vidal hits the nail on the head: “It seems to negate the purpose of having a second opinion if the second opinion can be ignored and a fresh second opinion obtained.” I recognise and welcome the fact that amendment 459 has been accepted. It would mean that the second independent doctor would have the benefit of the report of the first independent doctor. However, this is not a failsafe protection and cannot be relied on entirely. First, the report of the first independent doctor is required to be made available to the patient. In a case such as this, would the first doctor want to spell out exactly what led to that conclusion, knowing that it could place the patient in harm’s way if her husband saw it? Also, he is not 100% sure; does he want to make such accusations in writing without hard evidence? Secondly, even if the report was detailed and available to the second independent doctor, he would still need to make his own assessment, and he might not agree. Or it could be that although he recognises signs of coercion over a long period, he may truly believe that, to the best of his knowledge, the decision made by the patient has not been coerced in that moment. I am afraid therefore that clause 10 is a loophole that will be exploited by domestic abusers, and it is largely women who will pay the price. For that reason, I cannot support it.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I am happy to give way to my hon. Friend.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I rise to speak against clause 10 as it allows doctor shopping in the event that someone does not qualify for assisted dying. “Not happy with the verdict? Just find another doctor!” How many times are we happy for a patient to try again with a different doctor? It is inevitable that at some point the patient will find someone willing to make the statement and put them on their way to an assisted death, even if their eligibility is in doubt. When I put forward the amendments tabled by my hon. Friend the Member for West Worcestershire (Dame Harriett Baldwin), which requested residual discretion for doctors, they were challenged by Committee members on the basis that the whole point of having defined criteria was so that they determined whether a patient was eligible. I run the same argument now: if the process is followed to the hilt and the independent doctor refuses to issue the statement, why on earth would we allow another bite—or even multiple further bites—at the cherry? Surely that is to allow abusers a way to push their victims into an assisted death by re-running the process again and again until they find a less attuned doctor. Imagine the case of an elderly woman who has spent a lifetime under the coercive control of her husband. She is completely done with it all, and sees death as a welcome way to escape this man, who has made her life a misery. The abuse has escalated since she has become ill: because of her ill health, she cannot cook or clean any more, and he hates that. But no one sees. She never wanted the kids to know; she is really good at hiding it. Now, he wants to seek an assisted death, because it is better for them all. She agrees. When asked by a doctor, she is unlikely to say, “My husband is pressuring me into this, and I’m afraid of not doing what he wants,” particularly if she has suffered abuse over many years. Let us say that the first independent doctor does a really thorough job—the kind of job that we hope all doctors would do. Perhaps the doctor manages to discern that the patient is very much controlled and unduly influenced by her husband. The trouble is that it can be very difficult to find hard evidence of coercive control. According to recent figures, only 3.7% of recorded cases of controlling or coercive behaviour result in a charge, and more than half of cases are dropped because of evidential difficulties. The doctor therefore cannot get the police to intervene; his only lever is the power to reject the application. So that is what he does. But the patient does not give up; she is still absolutely sure that the best thing is an assisted death, and her abuser is still whispering in her ear, telling her she is right. The second independent doctor does not have the same emotional intelligence as the first, and he does not see what the first doctor saw. He approves the application.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  That is not what it says.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I thank the Minister for that explanation. What happens if the patient sets out in advance that they want no interventions? What if they have said, under the clause as the Minister laid out, “In the event of complications, if I am vomiting and in distress, I want no interventions”, but when that happens the pain and distress are at a different level and they are begging the doctor to help them? What does the doctor do in that instance?

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I thank the Minister for that clarity. Does he think it would be worth while setting that out in more detail, in order to protect doctors and make it really clear what would happen in such a situation? This would be an unprecedented, unique and very new process, and I can imagine substantial moral injury to doctors from being put in that predicament if we are not very clear about what they are required to do and what they are required not to do.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  I am concerned that maybe I am misunderstanding the debate. For clarity, right now clause 9 says that “in so far as the assessing doctor considers it appropriate,” they should “advise the person to consider discussing the request with their next of kin and other persons they are close to.” It will read very similarly if the amendment is agreed to. Instead, it will say, “unless the assessing doctor has concluded in good faith, that this would not be in the person’s best interests, advise the person to consider discussing the request with their next of kin and other persons they are close to”. That is a very subtle change—it is just a little more encouragement to consider contacting the family. No one here is telling the doctor that they must tell the patient to contact the family; it is just a little bit of strengthening to encourage that. I invite the hon. Gentleman to confirm if I have misinterpreted, but that is my understanding of the clause.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  First, I apologise: I have quite a lot to talk about.

• 11 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty First sitting) · Hansard source

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  As long as I can make another speech, I am comfortable with stopping at this point and giving everyone a break from my voice. Ordered, That the debate be now adjourned. —(Bambos Charalambous.)

• 11 Mar 2025 · Prisons: Urgent Notifications · Hansard source

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  17. What support she has provided to prisons that have received an urgent notification since July 2024.

• 11 Mar 2025 · Prisons: Urgent Notifications · Hansard source

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  I thank the Minister for that answer. Prison officers do an important job, and I thank every officer at Downview Prison in Banstead. It is extremely concerning that the number of assaults on staff at Downview more than doubled between 2023 and 2024. What steps is he taking to ensure that officers are protected in their day-to-day jobs?

• 10 Mar 2025 · Crime and Policing Bill · Hansard source

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  Thank you for giving me the opportunity to speak, Madam Deputy Speaker. I want to thank Surrey police for all they do to keep us safe in Reigate and Banstead. I welcome much of what is in the Bill and I will not repeat what has already been said. Instead, I will focus my remarks on what I believe is required to tackle the scourge of commercial sexual exploitation in this country. It is easy for people to think that sexual exploitation does not affect them and that it does not happen in their neighbourhood, but it is more common than many realise. It is happening behind closed doors on very normal, everyday streets. Sexual exploitation, often of young women, is an awful crime that destroys lives before they have barely had a chance to begin. Exploited repeatedly, day in, day out, those young people are treated as merchandise, with the sole purpose of turning a profit for pimps and traffickers. It is incumbent upon us to break the business model, starting by outlawing the advertising of individuals for prostitution. Classified ad sites, like Vivastreet, are rife with it. They are the Etsy of sexual exploitation, fuelling sex trafficking by providing a convenient centralised platform for sex buyers to access what they want in their local area. Buying sexual services can be as easy as ordering a pizza. Although prostitution is legal, pimping, which is the provision of a prostitute to perform a sex act with a customer for gain, is not. There are often tell-tale signs on the adverts, like the same phone number being used for multiple ads, that the women are not acting freely and willingly, and that they are under the control of a pimp, who is profiting from their exploitation. Such sites have had years to get to grips with it, but still not enough is being done to weed out those adverts. However, we must take some responsibility too. Hon. Members will no doubt be staggered to hear that such advertising of prostitution is entirely legal, because legislation has not kept pace with technology. Advertising prostitution in a phone box is illegal under section 46 of the Criminal Justice and Police Act 2001, yet when the same advert is online, it is not illegal. That is utterly absurd. In 2023, the Home Affairs Committee cited evidence in its report on human trafficking that 75% of victims of trafficking for sexual exploitation are advertised online. The cross-party group concluded: "Websites advertising prostitution significantly facilitate trafficking for sexual exploitation.” I strongly urge Ministers to take this opportunity to close that loophole. There is a similar issue with the regulation of online pornography compared with offline pornography. Our current laws have not been updated quickly enough to recognise the huge shift online and the need to apply the same standards across the board. A survey by the Children’s Commissioner in November 2022 found that one in 10 children had seen pornography by the age of nine, with half having seen it before they turned 13. The impact of that travesty can be clearly seen, with 47% of young people between the ages of 16 and 21 stating that girls “expect” sex to involve aggression. Huge damage is being done to young women and men by this damaging content, which normalises and sexualises the choking and strangling of women during sex—illegal in offline pornography but not online pornography. Although not illegal per se, degrading acts, like spitting on women, are commonplace in online porn, so is it any wonder that we are seeing such disdain for and poor treatment of girls in our society? If we are serious about tackling the issue and halving violence against women and girls, we must crack down on online porn and ensure it is regulated to the same standards as that which is offline. The independent pornography review, led by Baroness Bertin, recommended that there be parity of regulation between online and offline pornography, which I very much welcome. The main statutory regulator of offline pornography is the British Board of Film Classification. It is responsible for classifying pornographic content before it can be published and ensuring it does not contain illegal content. Any such offline illegal content cannot be sold or supplied in the UK, and the same rule should apply online. That simple change could be transformational if effectively executed and properly enforced, although I recognise the technical and practical challenge of trying to regulate the worldwide web. I thank the Secretary of State for listening to my two asks. I look forward to hearing from her whether she is receptive to accepting amendments to ban online prostitution adverts, and to bringing the regulation of online pornography in line with that for offline pornography.

• 7 Mar 2025 · Protection of Children (Digital Safety and Data Protection) Bill · Hansard source

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  I concur with everything my right hon. Friend says. It is completely accessible to all our children, so it is very hard for one child to be kept separate from it. That is why it is important that we address it. However, increasing the digital age of consent is just the first step—we have so much more to do. We also need to ban smartphones in schools for children under the age of 16. On a typical workday, 42% of older teenagers say their smartphone is distracting them from schoolwork, and half say that social media has distracted them enough to impact their grades. Notably, only 11% of schools are genuinely smartphone free, and children at these schools get GCSE results one to two grades higher, so there is clearly a big upside to banning smartphones in schools. I urge the Government to seriously consider implementing this much needed restriction, which would be a game changer, protecting children and improving educational outcomes in one fell swoop. Our schools need this ban in statute, not just in guidance, in order to be able to effectively police and enforce it. I pay tribute to Smartphone Free Childhood for all its work to raise awareness on this important issue. In closing, I hope that Members will support the Bill today, which would move us forward in our mission to protect our children from an increasingly insidious online realm that they are simply not equipped to navigate. I also hope that this is just the beginning, and that in moving forward we will see the digital age of consent raised to 16 and a ban on smartphones in school. The value of those two changes alone would be huge for our society, and would safeguard the wellbeing of this and future generations of children. I cannot think of anything more important.

• 7 Mar 2025 · Protection of Children (Digital Safety and Data Protection) Bill · Hansard source

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  I am pleased to speak in support of the Bill. I must start by declaring an interest: I am a mother of three children who enjoy nothing more than staring at their screens day in, day out—if they could, they would be on them 24/7. No longer are our children clamouring to go out and play or to see their friends; instead, they want to do everything through a screen. They want to watch endless YouTube videos. I never realised that the unpacking of a toy or slime making could hold such interest. It seems that they take their joy in watching others do things online—even, rather bizarrely, playing computer games—instead of actually doing them in the real world. I would be a hypocrite if I did not call out my own behaviour on this front. I, too, am addicted to my phone. Yes, I need it for this job, so I can justify some of my use, but I often find myself endlessly doomscrolling, and I am too embarrassed to tell the House how many hours I spend staring at it every week. At least my addiction started when I was a fully developed adult, after a childhood of play and socialisation when I learned much-needed life skills. This generation of children is not so lucky. The huge amount of time spent online is incredibly damaging in so many ways. It is no coincidence that we see a mental health crisis in our young people at the same time as mass adoption of smartphones and access to social media. Some may underplay the importance of social media and screens in the challenges we face as a society, and indeed it can be difficult to conclusively prove the role of one particular factor in the effects we are seeing, but I suggest that when it comes to our children, we should always err on the side of caution and protect them from potentially harmful influences. In a recent survey, social media and excessive screen time was ranked as the top issue affecting children’s mental wellbeing. To put that in context, it was ranked higher than alcohol and bullying. Another significant risk to mental health is exposure to harmful online content. I am incredibly concerned about that, especially given the proliferation of extreme pornography, harmful content and unrealistic body images. If children spend all their time in this fantasy world that is completely disjointed from reality, of course it will change how they view people, relationships and the world in general. That is supported by Ofcom’s 2024 research, which showed that older teens are finding it harder to distinguish the real from the fake online. The more mundane things in life that do not trigger a dopamine hit seem an even less appealing way to spend time to a child jacked up on likes and shares. Children’s attention spans are getting shorter, and they have an ever-increasing need for higher levels of stimulation. Is it any wonder that our children seem less interested in reading a book or baking a cake nowadays? The evidence from Health Professionals for Safer Screens shows that children who routinely spend extended periods on their smartphones have poorer eyesight, inhibited speech and language development, interrupted sleep, and rising rates of anxiety. We are allowing our children to become addicts. Social media is designed with exactly that in mind. It is meant to be addictive and compelling. It wants users to stay online for prolonged periods and to keep engaging with content. Those of us who use it ourselves know this all to be true, so how on earth do we expect our children to manage and moderate appropriately? Ofcom’s 2024 research showed that the overall use of social media sites or apps among five to seven-year-olds had increased year on year. Online gaming among that group had also increased significantly, as had the watching of livestreamed content. Under current data protection law, the age at which children can access information society services—ISS—is 13. ISS includes most social media platforms and content streaming services. It is important to acknowledge that the Online Safety Act 2023 introduced protections for children by ensuring that online platforms will have to remove illegal content such as child sexual abuse material, prevent children from accessing harmful content—for example, that encouraging suicide, self-harm or bullying—and introduce age-checking measures to restrict access to pornographic material. Those are all very welcome improvements, but they need to be put in place at pace and be effectively enforced. I commend the hon. Member for Whitehaven and Workington (Josh MacAlister) for all his work on this important topic. I will do all I can to support him in making the online world safer for our children. The Bill is an important precursor to the myriad changes needed in this area, and I know that many parents will support him in calling for the digital age of consent to be looked at again. While the Bill does not call for the age limit to be raised to 16, it does call for the UK’s chief medical officer to look at this important issue in detail and, ultimately, issue a statement on whether it should be raised. Some 75% of Brits now back raising the minimum age from 13 to 16, as per a recent survey by More in Common, for all the reasons that have been raised today, and 129,000 people signed an e-petition calling for social media companies to be banned from letting children under 16 create social media accounts. It is past time for tech companies—and Members of this House—to take responsibility for keeping our children and young people safe. I am not normally in favour of blanket bans, and I often talk about the importance of parents and carers taking responsibility for their children. However, in this instance, I deviate a little. As a parent who is wrangling with this exact issue myself, I know how difficult it is to tell a child that they cannot do something that every single other child in their class is doing. If their group of friends interacts only online, what are the consequences for my child if I prohibit them from joining in? Isolation? Loneliness? Loss of self-esteem? There are very real costs that should not be underestimated, which is why the state needs to step in. Members will not often hear me say this, but the state needs to step in and remove the option for all, helping parents across the country who want the best for their children without the downsides.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Eighteenth sitting) · Hansard source

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  I thank the Minister for that useful explanation. Does he agree that the setting of the tariff will be key, because it could either incentivise or disincentivise the provision of the service?

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Eighteenth sitting) · Hansard source

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  Does the Minister not think the word “remuneration” refers to the amount of income received specifically by the doctor, rather than by any organisation or company?

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Nineteeth sitting) · Hansard source

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  That is a “may” rather than a “must”. I hope that we would move to “must” in that event.

• 5 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Nineteeth sitting) · Hansard source

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  I thank the hon. Member for that point. There will absolutely be some occasions where that is the case, but assisted dying is a different pathway—and we have a whole Bill on it, so there will be other formalities and safeguards. We are all here to make sure that rigour is applied to that pathway. With the best will in the world, there will always be more work and pressure, especially time pressure, on doctors. That time pressure will be critical.