Sarah Olney MP: speeches 2025

Speeches

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

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  I thank the hon. Lady for that useful intervention. As I say, socioeconomic status is not currently a protected characteristic under the Equality Act.

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

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  That was the hon. Member’s response when I made my speech on the amendment in the previous sitting. I have reflected on that over the weekend. I still think that the issue of the voluntary stopping of eating and drinking is a very serious one that ought to be reflected somewhere in the legislation, but she is correct that, at this particular point, we are talking about the second period of reflection already being at an end, so it cannot be hastened in any way by such a measure. Therefore, I will be withdrawing the amendment.

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

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  I beg to ask leave to withdraw the amendment. Amendment, by leave, withdrawn. Amendments made: 207, in clause 13, page 9, line 20, leave out “Schedule 4” and insert “regulations made by the Secretary of State”. This amendment provides that the form of a second declaration is to be set out in regulations (rather than in Schedule 4). Amendment 470, in clause 13, page 9, line 26, at end insert— “(3A) Regulations under subsection (3)(a) must provide that a second declaration contains— (a) the following information— (i) the person’s full name and address; (ii) the person’s NHS number; (iii) contact details for the person’s GP practice; (iv) specified information about the certificate of eligibility; (b) the following further declarations by the person— (i) a declaration that they have made a first declaration and have not cancelled it; (ii) a declaration that they understand that they must make a second declaration in order for assistance to be provided under this Act; (iii) a declaration that they are making the second declaration voluntarily and have not been coerced or pressured by any other person into making it; (iv) a declaration that they understand that they may cancel the second declaration at any time. In this subsection “specified” means specified in the regulations.” This amendment provides that regulations about the form of a second declaration must make the provision mentioned in paragraphs (a) and (b). Amendment 471, in clause 13, page 9, line 27, leave out from “if” to “that” in line 28 and insert “the coordinating doctor is satisfied (immediately before witnessing it)”. This amendment removes wording which would suggest that a second declaration is made before it is witnessed. Amendment 208, in clause 13, page 9, line 38, leave out “Schedule 5” and insert “regulations made by the Secretary of State”. This amendment provides that the form of a statement by the coordinating doctor following the making of the second declaration is to be set out in regulations (rather than in Schedule 5). Amendment 472, in clause 13, page 9, line 41, at end insert— “(6A) Regulations under subsection (6)(a) must provide that a statement under subsection (5) contains— (a) the following information— (i) the person’s full name and address; (ii) the person’s NHS number; (iii) the coordinating doctor’s full name and work address; (iv) specified information about the certificate of eligibility; (b) the following declarations by the coordinating doctor (in addition to a declaration that they are satisfied of all of the matters mentioned in subsection (4)(a) to (d))— (i) a declaration that they are satisfied that a certificate of eligibility has been granted in respect of the person; (ii) a declaration that the second declaration was made after the end of the second period for reflection; (iii) if the second declaration was made before the end of the period mentioned in subsection (2)(a), a declaration that they have the belief mentioned in subsection (2)(b); (iv) a declaration that they are satisfied that neither the first declaration nor the second declaration has been cancelled. In this subsection “specified” means specified in the regulations.” This amendment provides that regulations about the form of a statement under subsection (5) must make the provision mentioned in paragraphs (a) and (b). Amendment 374, in clause 13, page 10, line 2, at end insert— “(8) Where the coordinating doctor has— (a) witnessed a second declaration, or (b) made or refused to make a statement under subsection (5), the doctor must notify the Commissioner and give them a copy of the second declaration or (as the case may be) any statement under subsection (5).”— (Kim Leadbeater.) This amendment requires the coordinating doctor to notify the Commissioner of witnessing a second declaration, and of having made or refused to make a statement under clause 13(5). Clause 13, as amended, ordered to stand part of the Bill. Clause 14 Cancellation of declarations

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

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  It is a pleasure to serve under your chairmanship, Sir Roger. I support amendment 429, tabled by the hon. Member for Bexleyheath and Crayford. I do not understand how subsection (9) can require the doctor to remain with the person until they have self-administered and died, or until they have decided not to self-administer, while subsection (10) states that the doctor need not be in the same room. The Bill becomes even less coherent when we consider subsection (11), which requires the doctor to remove the substance immediately if the person decides not to self-administer—how can the doctor do so if they are not in the same room? Amendment 429 would make the scheme more coherent and I support it for that reason. I accept that there are downsides to having the doctor present, especially before the administration, as people have a normal desire for privacy, but that needs to be balanced against the risk of someone else taking the substance or something going wrong in the process of self-administration. In Australia, there is no requirement for the doctor to be present, which has led to some cases of abuse. I understand why the Bill’s promoter has chosen not to go down the Australian route, but the position arrived at in subsection (10) lacks coherence and is unclear. What does it mean to remain with the person without being in the same room? Does it mean being in the corridor just outside the room, but with the door open? What if it is closed? What if, as a result of the door being closed, the doctor is no longer within earshot? I am not the only one who is confused, as so are the doctors who will have to apply the legislation. For example, Dr Janet Menage, a retired GP, told us in written evidence—TIAB 182—that the provisions “are mutually exclusive: doctor ‘must remain with the patient’ but ‘not in the same room’…This makes no sense. In any case, if the attending doctor is not in the same room there could potentially be an intervention by another person to the patient’s detriment. Or the patient may wish to cancel the suicide at the last moment and be unsupported in voicing that decision.” With or without subsection (10), I would like to know whether the Minister has made an assessment of the workforce impact of such a requirement for the doctor to be present. As Dr Rebecca Jones told us: “As the death may take many hours, I’m uncertain of the practicalities of this”.

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

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  I am grateful for the hon. Gentleman’s professional experience, which is extremely helpful. He is absolutely right. Following the point made by the hon. Member for Banbury, we cannot define the circumstances in which a patient will find themselves when this is taking place. That is why it is incumbent on us to make sure we provide very clear guidance on precisely what Parliament intends. As Dr Rebecca Jones told us in written evidence: “As the death may take many hours, I’m uncertain of the practicalities of” doctors remaining with the patient “for many doctors…have competing demands on their time.” In written evidence, Dr Chris Ainsworth asked how this will work in cases where death takes several days, as has happened in Oregon, while Dr Trevor Stammers wrote: “If the doctor is required to be present until the patient’s death, this may require hours of practitioners’ time to fulfil and is unlikely to be adhered to in many cases if the dying process is protracted.” Dr Rachel Fisher said in her written evidence that for Australian doctors, who are not required to be present at the final act, each assisted death requires around 60 hours of professional time. For British doctors, we will need to add the time it takes for the self-administration to result in death. Dr Fisher also raised the real impact on doctors, writing, “imagine the practicalities of those who must deliver it. The GP, motivated by a deep desire to preserve life and relieve suffering arrives at the home of the patient with a cocktail of powerful drugs. What if the patient has symptoms? Who will collect their child from nursery or school if the patient takes a long time to die? How will they know when to decide the death was unsuccessful? Will there be counselling for GPs observing and feeling complicit in a potentially drawn out and symptomatic death?” Finally, Dr Paul Shaw asked in his written evidence: “How will this service be funded? What support will be required from the NHS when things go wrong or death takes longer than expected? Will this be a 0900-1700hrs service? What will be the out of hours arrangements?” A lot of the written evidence touches on the practicalities of a doctor being required to remain with the patient until they die. Amendment 429, in the name of the hon. Member for Bexleyheath and Crayford, seeks to clarify whether “being with the patient” requires the doctor to be physically present in the room.

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

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  I am listening to what the hon. Gentleman is saying, and a lot of what he is talking about in terms of giving doctors discretion makes a lot of sense in a routine medical intervention, but this is not a routine medical intervention. This is a very serious point, and the doctor’s judgment in this case could well fall either side of what is permissible by the law. That is why it is so important that it is really clear. Whether we decide in Committee that it must be on the face of the Bill, or whether we want, as per the hon. Member for Ipswich’s amendment 532, to leave it to the Secretary of State, it must be clear and specific.

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

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  Amendment 408 seeks clarity on a critical aspect of the legislation. Clause 19 allows a co-ordinating doctor to authorise another registered medical practitioner to carry out their functions, providing that the patient consents and that the replacement has completed training, qualifications and experience as specified by the Secretary of State. This is a facilitation clause to smooth the process, and in some cases it might seem like something that we should just nod through. If the co-ordinating doctor becomes unwell, takes leave or faces an emergency that prevents them from fulfilling their duties, they might delegate to ensure continuity of care for the patient. If the patient relocates, perhaps to be closer to family, or if the co-ordinating doctor cannot travel to the patient’s location due to the distance or logistics, a local practitioner could be authorised to step in, provided they meet the specified requirements and the patient consents.

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

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  The hon. Gentleman is absolutely right. It is fundamental that, with this legislation, we provide very clear guidance to the medical practitioners who will be engaged in assisting patients with this matter. This is not only for their peace of mind that what they are doing is acceptable under the law, and accords with what Parliament has decided, but for the protection of patients. It is incumbent on us to be really clear about what we mean, and I do not believe we are as the Bill is currently drafted.

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

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  I beg to move amendment 408, in clause 19, page 13, line 18, after “provided” insert “has been consulted and”. The amendment ensures the person has been consulted before they have given consent for another medical practitioner to be authorised to provide assistance.

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

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  I have nothing to add. Amendment 408 agreed to. Amendments made: 210, in clause 19, page 13, line 22, at end insert— “(2A) Regulations under subsection (2)(b) may in particular provide that the required training, qualifications or experience is to be determined by a person specified in the regulations.” This amendment enables regulations under subsection (2)(b) to provide that the required training, qualifications or experience is to be determined by a person specified in the regulations. Amendment 499, in clause 19, page 13, line 25, at end insert— “(3A) Where a registered medical practitioner who is authorised under subsection (1) is not satisfied of all of the matters mentioned in section 18(4), they must notify the coordinating doctor immediately.” This amendment provides that where a practitioner authorised under clause 19(1) is not satisfied of all of the matters mentioned in clause 18(4), they must immediately notify the coordinating doctor. Amendment 211, in clause 19, page 13, line 31, leave out subsection (5).— (Kim Leadbeater.) See the statement for Amendment 187. Amendment made: 22, in clause 19, page 13, line 32, at end insert— “(5A) Regulations under subsection (2)(b) must specify that training in respect of domestic abuse, including coercive control and financial abuse is mandatory.”— (Naz Shah.) This amendment would require that, in the event of the coordinating doctor authorising another registered medical practitioner to provide assistance under the Act, that other registered medical practitioner must also have undertaken training on domestic abuse, including coercive control and financial abuse. Amendment made: 212, in clause 19, page 13, line 33, leave out subsection (6).— (Kim Leadbeater.) See the statement for Amendment 188. Clause 19, as amended, ordered to stand part of the Bill. Clause 20 Meaning of “approved substance”

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

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  The Minister is talking about somebody making a medical judgment, which would obviously be the right thing to do in the normal course of events, but we are talking about a doctor being left in a position of not knowing whether to take a further step that would end somebody’s life or to take the step that would be natural for a doctor—to try to revive the patient. This is about what the legal position is in that case—it is not a matter for medical judgment.

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

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  Would it not be easier for workers in care homes and other institutions who have a conscientious objection to assisted dying to apply to work in a place where they know it is not going to happen, as opposed to needing to exercise their right to conscientiously object every time it comes up? Is that not a reason to support the amendment?

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

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  I hope the Minister can answer a question for me. I hear what he is saying about concerns with the amendments themselves, which makes a lot of sense, and the policy objectives of the hon. Member for Spen Valley. What I am concerned about is that in the Bill as drafted, notwithstanding that various amendments have been tabled, it is not clear what the doctor should do in the event of complications. There may well have been an earlier conversation with the patient, but the patient’s request may still leave the doctor in the position of committing a criminal offence. I would like to know whose responsibility it is to ensure that doctors are not left in that position, which could come about either because the Bill as drafted is not clear or the amendments do not make the appropriate clarification. The hon. Member for Spen Valley has done a marvellous job, but in terms of policy intention the Bill does not cover this aspect. The Minister is saying that it is his job only to ensure that the amendments are appropriate. I am still very concerned that there is a big gap here and that we are potentially leaving doctors in the very difficult position of not knowing whether or not carrying out the patient’s intentions would leave them in the position of breaking the law. I would like to know whose responsibility it is to ensure that doctors are not left in that situation.

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

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  The hon. Gentleman gives me an opportunity to conclude my remarks. I support amendment 429 because it is important to provide clarity that when we say “with the patient,” we mean in the room. However, I invite the Minister to expand further on the resource requirement of assisted dying. I want the doctor to remain with the patient, which I think is critical. That is why I support amendment 429, but the implication of the Bill is a considerable resource requirement, particularly for GPs, and I would like the Minister to respond to that.

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

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  rose—

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

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  To pick up on what the hon. Member for Spen Valley said, the multidisciplinary panel comes at the very end of the process. She has talked about the different stages, but they all occur in isolation. There is a doctor, then there is another doctor, and then there might be a psychiatric referral. We heard clearly in oral evidence about the value of the multidisciplinary panel referring to each other and taking evidence collectively. The strength of it would be that it occurred at the beginning of the process. I wonder whether the hon. Member will reflect on that.

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

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  I seek clarification. As drafted, in clause 12(1)(c), the High Court would give “a declaration that the requirements of this Act have been met”, but in new clause 21(6)(a), the panel is required to issue a certificate of eligibility, to which the Minister just referred. I seek the Minister’s guidance on whether it is the Government’s view that the High Court declaration has equal weight in law to the certificate of eligibility set out in new clause 21. I ask particularly because that certificate will be relied on for the purposes of suspending the Suicide Act 1961, under which a criminal offence would otherwise have been committed. The certificate of eligibility will need to be relied on to demonstrate that no criminal offence has been committed under that law. Is it the view of the Minister and the Government that a High Court direction, as originally required, can now be fully replaced by, and have equal weight with, a certificate of eligibility?

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

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  I take the point, but I still think it is necessary to have this additional safeguard to close a loophole that means that people could render themselves terminally ill within the space of a month and use the opportunity presented by the additional provision in the Bill for reducing the 14-day waiting period. This is a real concern of people who have reviewed this legislation. There is a possibility, as has been seen in other jurisdictions, that people could—I do not necessarily want to adopt the right hon. Gentleman’s language—hasten their eligibility for assisted dying through this particular method. All I am asking is that we close the loophole so that people will not be tempted to follow that very damaging path. Ordered, That the debate be now adjourned. —(Bambos Charalambous.)

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

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  It is a pleasure to serve under your chairmanship, Sir Roger. I have tabled the amendment to exclude the possibility that somebody could render themselves, if that is the appropriate language, terminally ill by the mechanism of voluntarily stopping eating and drinking. The Bill before us is based on the principle that assisted suicide should be limited to those who are already dying—those with a terminal illness and a prognosis of six months or less—but there is growing evidence that that safeguard could be undermined by a practice known as voluntary stopping of eating and drinking, or VSED. That is when a person with mental capacity deliberately chooses to stop eating and drinking with the intention of hastening death. VSED is sometimes framed as an exercise of choice at the end of life, but in jurisdictions where assisted suicide is legal, it is increasingly being used as a means to an end—a way for individuals who do not meet the legal definition of terminal illness to qualify for lethal drugs. The logic is simple: a person has the right to refuse food and water, and if they do so, their health deteriorates and they may die within six months. Some doctors have accepted this as grounds to certify a patient as terminally ill—not because their underlying condition would have led to imminent death, but because of the self-imposed effects of dehydration and malnutrition. The strategy has become viable only because many jurisdictions have shortened or removed waiting periods for assisted suicide. The loophole works only if the time it takes to obtain lethal drugs is shorter than the time it takes to die from refusal of food and water. Under the Bill, the same loophole exists. Clause 13(2)(b) states that if a doctor “reasonably believes that the person’s death is likely to occur” within one month, the standard 14-day waiting period can be reduced to just 48 hours. If a person stops eating and drinking, their death will almost certainly be likely within one month. In other words, a person who is not terminally ill could make themselves eligible for an assisted death within 48 hours simply by refusing sustenance. Proponents of assisted suicide have been explicit: this is not simply a theoretical possibility—it is a co-ordinated strategy.

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

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  My original question was more about whether it has the same legal force as a High Court direction.

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

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  I am just reflecting on the right hon. Member for North West Hampshire’s intervention. Does the hon. Gentleman not agree that the purpose either of the panel or the High Court judge is to establish beyond all doubt that if a person is assisted in their death, no crime is being committed, and that in order to establish that, we need to apply the highest standards of evidence? Whether an adversarial or an inquisitorial process is used to collect that evidence, there must be some sort of process. That may be uncomfortable for the patient but it is necessary for their friends, relatives and the doctors being asked to assist. That is really what we are trying to achieve.

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

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  I beg to move amendment 457, in clause 13, page 9, line 17, after “made,” insert “and have not voluntarily stopped eating and drinking”.

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

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  I will.

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

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  The point is that they may take the opportunity to use the further provision that exists for people whose death is expected within one month.

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

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  I am trying to clarify this for my own benefit, because I am not familiar with some of these procedures. Is there a difference between a High Court judge leading an inquiry or sitting on a panel, using their legal experience to provide advice or recommendations or give an opinion, and having a judge sitting in the High Court, who, under the original wording of clause 12, would be giving a direction? If there is a difference, have we not crossed from one role to the other by introducing a panel rather than a High Court direction? Does that matter for the purposes of the legislation?