Sarah Olney MP: speeches

Speeches

• 1 Jul 2025 · Parental Leave Review · Hansard source

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  I thank the Minister for advance sight of the statement. The Liberal Democrats welcome the Government’s commitment to the much-needed review on parental leave. Every child deserves the best possible start in life and the opportunity to flourish, no matter their background or personal circumstances. Too often, parents struggle on inadequate parental pay and without good enough access to shared leave. Childcare costs are eye-watering, and the balance between family life and work has only become harder to strike. The Liberal Democrats have been calling for an overhaul of the parental leave system, to give parents a genuine choice about how they manage their responsibilities in the first months of their child’s life. If I could gently correct the shadow Minister, the hon. Member for Mid Buckinghamshire (Greg Smith), it was the Liberal Democrats who were proud to introduce shared parental leave in government. However, years later, millions of parents are still being denied the choice to spend more time at home, with around a quarter of fathers ineligible for paternity pay. As we welcome this review into parental leave, I urge the Government to look more broadly into the prevalent inequality in caring responsibilities. What steps are they taking to support the millions of family carers who are looking after disabled or elderly relatives and who have no paid leave at all? Will they commit to a similar review into provision for unpaid carers and to make carer’s leave paid? Will they commit to reviewing the needs of carers and those of the families who have taken on kinship caring responsibilities? I welcome that commitment in the statement today, but do the Government plan to introduce statutory kinship care leave? We call on the Government to use the review to finally deliver meaningful reforms that address the long-standing concerns of carers and their loved ones, as well as making changes to the circumstances of working families that can make parenting a joy rather than a burden, and end the dilemma of having to choose between work and family.

• 1 Jul 2025 · Hospitality Sector · Hansard source

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  It is a pleasure to serve under your chairmanship, Ms Butler. I thank the hon. Member for Kingswinford and South Staffordshire (Mike Wood) for his work in securing this important debate. It has been a real pleasure to hear from so many of my Liberal Democrat colleagues about their constituencies. That underlines the fact that Liberal Democrats represent all the best places in the UK, and that is why tourism and hospitality is a very important sector for us. I was lucky enough last summer to do a little tour through the constituencies of Inverness, Skye and West Ross-shire; Caithness, Sutherland and Easter Ross; and Orkney and Shetland, so I can very much confirm that all three constituencies have excellent hospitality businesses that are very welcoming to visitors. This Easter, I was lucky enough to spend a few days in West Dorset in the wonderful town of Lyme Regis, and I have spent many happy family holidays in Westmorland and Lonsdale. There are also many hospitality businesses in my constituency of Richmond Park. Just last Friday, I hosted a representative of VisitBritain, who came to see me because Kew Gardens in my constituency is second only to the Tower of London in this year’s list of the most-visited paid attractions in the UK. We had a long conversation about the issues affecting the tourism sector, and I was very interested to find that the Government have recently cut funding for efforts to promote domestic tourism. Those who are not as lucky as I am in having many colleagues who represent constituencies in such wonderful parts of the UK do not know enough about domestic tourism. I would like the Minister to comment on that. As my many wonderful colleagues have already alluded to, the current economic landscape is really challenging for many businesses and industries. Years of dire economic mismanagement by the last Conservative Government have led to businesses facing huge challenges, ranging from recruiting and retaining good staff to soaring energy costs and the increase of trading obstacles following their botched trade agreement with the EU. However, many of those challenges are now being compounded by decisions taken by this Government. Last autumn’s Budget hit the hospitality sector with an extra £3.4 billion of annual costs through the cumulative impact of changes to employer NICs, increases in the national living wage, and the near halving of business rates relief for retail, hospitality and leisure businesses. A recent survey conducted by UKHospitality of its members found that, since the autumn Budget, a third of hospitality businesses are now operating at a loss, with 75% having increased prices, two thirds reducing hours available to staff and six in 10 cutting jobs. Those cuts are a last-ditch attempt by many businesses to stay afloat, as they are crying out for support. The Liberal Democrats welcomed many aspects of last week’s industrial strategy, but very little in it will alleviate the heavy burdens imposed on the hospitality sector by Labour’s tax reforms. The Liberal Democrats have called for the hospitality industry to be exempt from the hikes in NICs announced in the Budget, as we recognise the difficult position that many business owners have been in since the pandemic. Small businesses are the beating heart of our economy and at the centre of our communities, and they create the jobs that we all rely on. We are glad that raising the employment allowance will shield the very smallest employers, but thousands of local businesses, including many in the hospitality sector, will still feel the damaging impact of many of the changes. That is why my Liberal Democrat colleagues and I have voted against the changes to employer NICs at every opportunity, and I once again urge the Government to scrap these measures. More broadly, we will continue to call on the Government to introduce vital reform to the business rates system. In 2019, the previous Conservative Government promised a fundamental review of the business rates system, but failed to deliver it. Meanwhile, the current Government pledged in their manifesto to replace the system, but still no action has been taken. The Liberal Democrats have called for a complete overhaul of the unfair business rates system, replacing it with a commercial landowner levy, which would shift the burden of taxation from tenants to landowners. The current system penalises manufacturers when they invest to become more productive and energy efficient. It leaves pubs and restaurants with disproportionately high tax bills and puts our high street businesses at an unfair disadvantage compared with online retail giants. In too many places, pubs, restaurants and shops are being forced to close, taking with them jobs, opportunities and treasured community spaces. More broadly, this outdated system inhibits business investment, job creation and economic growth, holding back our national economy. It has existed for too long, and it is time that the Government took action. Our proposals for fair reform would cut tax bills, breathe new life into local economies and spur growth. Equally, they would provide long-term certainty for businesses, which is what the economy across the UK needs. With regard to long-term planning, I am glad that the Government introduced the industrial strategy last week. I welcome this commitment to stability, and I am pleased that it will allow businesses to look and plan for the future with more certainty. As the Government unveil their strategies to bring together skills development plans and a long-term industrial strategy to ease the pressures that so many employers face, we have reservations about the cohesion between these schemes. What steps are the Government taking to ensure effective collaboration and transparency across different strategies and public bodies? We welcome last week’s announcement in the industrial strategy that we will see a funding boost for skills and training. However, the announcement stops well short of the fundamental reform that we need to address the workforce shortages that many industries are facing. British businesses must be able to hire the people they need with the skills they need. A key cause of workforce shortages is ill health, and to tackle the problem, the Government must invest in our NHS and social care so that people can get the healthcare they need to rejoin the workforce more quickly. We have called on the Government to fix NHS backlogs, cut ambulance waiting times and raise the minimum wage for care workers by £2 an hour to boost our social care system and get people out of hospital quicker. Any business will tell us that the apprenticeship levy does not work. They cannot get the funding they need to train staff, and hundreds of millions of pounds go unspent. The Liberal Democrats have been calling for the apprenticeship levy to be replaced with a wider skills and training levy that will give businesses more flexibility over how they spend money to train their staff. Will the Minister accelerate the reform of apprenticeships and empower Skills England to act as a properly independent body, with employers at its heart? Finally, as we look more broadly at factors impacting workforce shortages, I once again urge the Government to act with much more urgency in introducing their youth mobility scheme. The changes to the immigration system implemented in April 2024, increasing the minimum salary threshold for skilled worker visas, shrank the talent pool from which hospitality businesses can recruit, contributing to greater staff shortages. Around three quarters of the hospitality workforce is filled by UK citizens, but international talent has always been attracted to work in the UK due to our pedigree for hospitality and developing careers. A 2024 survey of 1,650 employers from across a range of sectors, including hospitality, adult social care and manufacturing, found that 49% of employers with hard-to-fill vacancies said that a reduction in the availability of migrant workers was one of the main causes. At a time when recent Government decisions in the Budget have added to the overall tax burden on hospitality businesses, with many considering whether their business remains viable, we must provide the tools that hospitality needs to help businesses grow so that it can boost the wider economy, including ensuring access to global talent. I have heard from stakeholders in the hospitality sector, including business owners and supply chain managers, who have said that they would welcome proposals that would bring more stability to the sector, allowing them to make longer-term plans as part of a more predictable and robust regulatory framework. Again, will the Minister set out a timeline for the introduction of a youth mobility experience, which would be good for our economy, easing some of the burdens that the hospitality sector is facing?

• 23 Jun 2025 · UK Modern Industrial Strategy · Hansard source

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  The Liberal Democrats have long been champions of the industrial strategy. We are proud that the strategy we introduced in government set out the Green Investment Bank, the British Business Bank and the regional growth fund, and we strongly opposed the Conservative Government’s damaging decision to scrap our country’s industrial plan. We therefore welcome the re-establishment of the industrial strategy and the fact that it focuses on many of the sectors we prioritised in government, including life sciences, professional services and clean energy. On energy, measures to bring down some of the highest industrial prices in the world will be welcome news for our manufacturers and energy-intensive firms, but we cannot forget that businesses across our entire economy struggle with high energy prices, not least our hospitality businesses and small and medium-sized enterprises. What steps is the Secretary of State taking to ensure that small businesses across sectors have access to better energy deals? Will he look to bring forward the industrial competitiveness scheme from its current two-year horizon? On skills, while today’s announcement comes with a welcome funding boost, it stops well short of the fundamental reform that we need, so will the Secretary of State accelerate the reform of apprenticeships and empower Skills England to act as a properly independent body with employers at its heart? One key omission from the strategy is our world-leading agrifood industry, which has been relegated from being a priority sector to receiving only a handful of mentions in the entire document. I hope that the Secretary of State will admit that our farmers and rural communities deserve far better. On trade, if the Government are truly serious about backing British business and going for growth, will they show more ambition on trade with Europe and look to negotiate a new UK-EU customs union, which could put rocket boosters under UK plc? In the extra time that you have kindly granted me, Madam Deputy Speaker, I want to ask the Secretary of State about access to finance and about addressing inequalities in particular. As chairman of the all-party parliamentary group on ethnic minority business owners, I have seen for myself the data on how much more difficult it is for those businesses to access finance, and similar data exists for women entrepreneurs. Addressing those inequalities would add a great deal to growth. Finally, when will we see more details about the National Wealth Fund?

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

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  I am sorry, but I will make progress. We would all have been better served by asking a team of experts to evaluate the evidence, draw on their professional experience and come to a settled consensus among themselves on this point about mental capacity and, likewise, the questions we had about how best to approach anorexia within the context of assisted dying and whether the Bill provides a suitable framework for the provision and control of drugs designed for the ending of a life. These are not political decisions. They have, however, been decided by politicians, and we have approached them in our usual adversarial way, where the right answer is not the one arrived at after careful thought, consideration and consultation, but the one that can muster the most votes. We have therefore reached a most unsatisfactory conclusion. This legislation imposes duties and responsibilities on professionals who do not think them compatible with their expert practice. It was amended in Committee to require that a panel approve an application for assisted dying, and that the panel include a psychiatrist. The Royal College of Psychiatrists has stated that it opposes this legislation.

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

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  I am not giving way. By contrast, many decisions are expressly reserved for politicians. Should the limited resources of the NHS be used to deliver an assisted dying service, or should it be possible to offer the service as a profit-making enterprise? What information should be collected and reported about assisted dying? Who should oversee and regulate its practitioners? Members of Parliament are to have no say over any of those matters at all. Those are all powers to be reserved to the Secretary of State, to be decided behind closed doors. Once again, this legislation grants these responsibilities to people who do not want them. Neither the current Health Secretary nor the current Justice Secretary are supporters of this Bill. After today, the House of Commons will be shut out of further decision making on this Bill, even though many of the decisions still to be made are rightfully ours to make. The lack of professional consensus or acceptance of the requirements of this legislation, coupled with a lack of political scrutiny of many of its more important provisions, creates an unstable foundation upon which to build an assisted dying service. For such a service to succeed, it needs professionals willing to deliver it, who can have confidence that they are acting within the law and will be supported by their professional peers and by society at large. I do not see how this legislation can deliver that. It is instructive to compare this piece of legislation with the Abortion Act 1967. That, too, was a private Member’s Bill, brought to this House by the Liberal MP David Steel, but it was preceded by a medical advisory committee chaired by the president of the Royal College of Obstetricians and Gynaecologists, which approved the Bill. The professionals who would be needed to enact the legislation had indicated their support for the Bill before it reached the Commons. The Bill only delegated one power to the Secretary of State. The legislation was hotly debated then as now, but once it was passed, it came into force within six months. Remarkably, with the exception of amendments required to bring it into line with successive Human Fertilisation and Embryology Acts and to extend its provisions to Northern Ireland, the provisions that the Abortion Act brought into law have remained almost entirely unchanged in 58 years—until just this week, in fact. The careful consideration of the issues that took place before the legislation came to the Commons, combined with the fact that all its provisions were included within the primary legislation to be debated and voted on in one go, has enabled a settled consensus to develop around abortion provision in this country, in contrast to other jurisdictions. It has enabled vulnerable women to seek the help they need and given healthcare workers the confidence and support they require to meet those needs. That is what we need, if we want to deliver a successful assisted dying service, and this legislation cannot deliver that. If Members want assisted dying, vote against this Bill and make the most of the moment to press for a better approach that can deliver a sustainable framework, accepted and supported by the medical profession, and in which the public can have confidence. If people’s lives are going to be ended prematurely as a result of this legislation that we pass, we cannot take risks. We cannot afford to pass this Bill.

• 19 Jun 2025 · UK Infrastructure: 10-year Strategy · Hansard source

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  Last week, the Liberal Democrats welcomed the announcement of investment in public infrastructure and transport projects, which we have long called for. We are glad that today the Government are setting out a 10-year infrastructure plan to realise those projects, and the Liberal Democrats will be closely scrutinising it to ensure that it delivers for communities across the UK. Boosting our infrastructure is vital, given the appalling mismanagement under the last Conservative Government that left our school and hospital buildings crumbling while neglecting critical infrastructure, from transport to renewable energy generation. Today’s plan must draw a line under the disastrous mismanagement of projects such as HS2, which promised to connect our country and communities only to end up another hollow Conservative promise, long delayed and billions over budget. While we welcome the Government’s intention to deliver productive investment, we will closely scrutinise its implementation. I have been concerned that Ministers have been unable to answer questions regarding delegated funding from the structures fund, such as for Hammersmith bridge in my constituency. Will the Minister confirm that specific projects have been selected, and will he ensure that infrastructure funding is distributed fairly for the benefit of all regions? Will he set up a crumbling hospitals taskforce to identify creative funding ideas, speed up construction timelines and put an end to the vicious cycle and false economies of delayed rebuilds, which lead to rising repair costs? As we look carefully at the implementation of these plans, the Government must ensure that we have a workforce equipped with the necessary skills to meet these commitments. Does the Minister therefore agree that it is time to replace the broken apprenticeship levy with a broader, more flexible skills and training levy? Will the Government fulfil their promise to make Skills England an independent body with employers at its heart?

• 12 Jun 2025 · Industrial Strategy · Hansard source

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  The Liberal Democrats welcome yesterday’s announcements from the Chancellor on investment in public infrastructure projects. However, the general secretary of the Prospect trade union has warned that the UK lacks the skilled workers required for the new defence and nuclear projects outlined by the Chancellor. Similarly, Make UK and the Federation of Small Businesses have highlighted that a shortage of skilled workers would be a critical stumbling block for growth. As we continue to await the much-anticipated industrial strategy, why are the Government moving funding away from level 7 apprenticeships, when we know that they support social mobility? More broadly, why did they not seize the opportunity in yesterday’s statement to commit to fixing the apprenticeship levy, to ensure that money is invested in skills and training?

• 22 May 2025 · EU-UK Summit · Hansard source

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  I disagree; it is too little. Whatever the Government have said, it is too little for the Liberal Democrats. We would have gone further, although I certainly welcome the progress that has been made. Times change. We know that joining a customs union would unlock vital new opportunities for British businesses and boost our economy in a meaningful way. In fact, even a deep alignment deal would boost growth by 2.2%, which could result in a £25 billion windfall for the public purse, and that would fall short of the benefits that a customs union would provide. In the years 2020 to 2024, the net change in the number of small and medium-sized enterprises in the UK decreased by 25,495. Since 2019, UK businesses have also had an average closure rate of over 12%, outstripping the rate of new businesses starting up. I have heard about the challenges that businesses have experienced due to Brexit red tape, which is a direct impact of the Conservatives’ pitiful negotiation. Successful high street businesses that have operated for four decades tell me that the last 18 months have been the hardest period that they have experienced, due to the exponential increase in import duties and registration fees. I have also been told time and again by small businesses in my constituency about the damage of Brexit. Far from seeing the freedom promised by the Brexiteers, we have instead seen an exponential increase in bureaucracy, resulting in business-owners spending many arduous hours sorting through additional paperwork, including complex regulatory differences for animal products such as wool. Those are not isolated cases. Over a third of surveyed UK businesses have reported extra costs that are directly related to changes in export regulations due to the end of the EU transition period. We are glad that some of these issues will be addressed with the new trade agreement. However, the Government must be bolder. We will continue to urge them to be much more ambitious with regard to trade and the economy, and we will ask them to use this agreement as a first step in seeking a new customs union with the EU. While we know that the long-term wellbeing of the UK is about being back in the heart of Europe, that requires strengthened trading agreements and a customs union. Closer ties with Europe are also key to our national security. We have long argued for closer alliances on defence in the face of Putin’s imperialism and Trump’s unpredictability, and we welcome the fact that the Government have committed to a defence agreement. However, I hope that the Minister will agree that that must be just the beginning, and that we must be far more ambitious in strengthening our economic and security ties with our nearest neighbours. The Liberal Democrats have also repeatedly pushed the Government for a youth mobility scheme between the UK and the EU, so we are glad that the Government have seen sense and will look to introduce a similar scheme, whatever it might be called. We know that a youth mobility scheme is good for business, good for education and good for opportunity. Polling shows that two thirds of the UK population are in favour of a youth mobility scheme. Red tape at the UK-EU border has prevented schools and children across the country from taking part in overseas educational trips. I think many Members would agree that such trips are a memorable and enriching part of a school career; however, according to the School Travel Forum, between 2019 and 2023 such opportunities reduced in number by 30%. There are so many reasons to welcome and champion a new programme for young people. Given that the scheme the Government have indicated they will support would mirror existing capped arrangements that the UK already has with 13 countries, including Australia, New Zealand and Canada, I urge them to move with more urgency and to bring forward details and a timeframe for the implementation of such a scheme. The Minister and I both know that a youth mobility scheme is not a return to freedom of movement. Will he confirm that the Government, who have shown good intention in introducing such a scheme, will not be sidetracked by scaremongering from the Conservative party and the Reform party, and that he will give his full commitment to the introduction of the scheme? When I asked the Prime Minister on Tuesday for a timeline, he assured me that the Government will move quickly. However, given the thousands of students who hope to travel to Europe to study, the thousands of small hospitality businesses in this country that are struggling to recruit short-term staff and the musicians burdened with huge levels of bureaucratic paperwork, I reiterate my call here today. Will the Minister set out a timeline for the introduction of such a scheme, which will ease travel?

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I will not; I am sorry. The amendment would help to inform the clinical judgment that will need to be made in each individual case and discourage patients from applying to multiple doctors for an assessment. I am proud to support amendment 24, tabled by the hon. Member for Bexleyheath and Crayford (Daniel Francis), which would disapply the presumption in the Mental Capacity Act 2005 that a person has capacity unless the opposite is established. There was a great deal of debate in Committee about the efficacy of the Mental Capacity Act and whether its provisions were sufficient to establish an individual’s capacity to make an informed decision about whether to seek an assisted death. The hon. Member for Bexleyheath and Crayford spoke compellingly in Committee about his experiences of how the Act is not always applied effectively. I am glad that the whole House has had an opportunity to hear him today. The Royal College of Psychiatrists cited the insufficiency of the Mental Capacity Act as one of its nine reasons for opposing the Bill earlier in the week. It said: “The Mental Capacity Act was created to safeguard and support people who do not have the capacity to make decisions about their care or treatment or matters like finances. Should the Bill become law in England and Wales, implications for both the Mental Capacity Act and Mental Health Act need to be considered.” I also support new clauses 1 and 2, tabled by the hon. Member for Hackney South and Shoreditch (Dame Meg Hillier), which would prohibit health professionals from raising the subject of assisted dying with a patient. It is my personal belief that people’s rights to pain relief and palliative care towards a natural end should be prioritised above an assisted dying pathway, and that that should be made available only as the result of a specific request. It is particularly important that young people under the age of 18 should not be thinking about assisted dying as an alternative to continued treatment or palliative care. I was disappointed that during Committee my proposed amendments to safeguard people suffering from eating disorders were rejected. Eating disorders are primarily a mental health condition but have an obvious physical impact, and there is a severe risk that the physical impact of an eating disorder can be diagnosed as a terminal illness, when in fact eating disorders are always treatable. We cannot allow vulnerable sufferers from eating disorders to elect for an assisted death when there remains the possibility of a full recovery and the chance of a happy and fulfilling future. That is why I support amendment 14, in the name of the hon. Member for Bradford West (Naz Shah), who was such an articulate member of the Bill Committee. I was glad to hear that the lead Member, the hon. Member for Spen Valley, will adopt that amendment; I look forward to seeing the further drafting. I also support amendment 16, tabled by the hon. Member for Vauxhall and Camberwell Green (Florence Eshalomi). I welcome the lead Member’s new clause 10, which extends the right to refuse to participate in assisted dying to any person, but it is important also to extend that right to organisations such as hospices and care homes. Assisted dying undermines those institutions’ mission and purpose, and they should have the right to refuse to provide it on their premises if they do not wish to participate in it. Finally, I will speak in favour of amendment 22, tabled by the name of the hon. Member for Shipley (Anna Dixon). There is insufficient provision in the legislation to identify and seek to ameliorate mental health conditions or other factors that may lead people to seek a premature end to their life, which they would not seek if those factors were addressed. Every time a person seeks to end their life prematurely is deeply regrettable, and we have a duty to explore whether preventable factors could be addressed before a request for assisted dying is granted.

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I rise to speak in support of amendment 87, which stands in my name, and in support of various amendments tabled by other Members and also signed by me. Prior to this legislation being laid before the House, I had not held strong feelings about the issue of assisted dying. I listened carefully to the arguments on both sides, including those of the many constituents who wrote to me on the issue, before deciding to vote against the Bill on Second Reading. I made my mind up very late in the day. I continue to be appreciative and respectful of the reasons why people are in favour, but, for me, the fundamental question was whether we were putting vulnerable people at risk by passing this legislation. I resolved that, on balance, we were. The lead Member, the hon. Member for Spen Valley (Kim Leadbeater), was keen to reflect the balance of opinion across the House, as well as within parties, in the make-up of the Bill Committee, and I was happy to volunteer as the sole Liberal Democrat “no” voter, as a service to my party and to the House. It was a privilege to serve on the Committee, and I wish to put on the record my admiration and respect to all Members, Ministers, Chairs and House staff who served alongside me, and my thanks to the many witnesses who gave oral and written evidence on which we came to rely. I regret to say, however, that my experience in Committee has only hardened my opposition to the Bill. My opposition is not rooted in a fundamental objection to the principle of assisted dying, but in the approach taken to framing the legislation. Amendment 87 seeks to tighten up the arrangement around the first declaration, to rule out the possibility of “doctor shopping”. In oral evidence we heard from the chief medical officer, Professor Sir Chris Whitty, that a diagnosis of terminal illness and a prognosis of life expectancy cannot always be made with a high degree of accuracy and that a degree of professional judgment is required on behalf of the co-ordinating doctor, which can result in differences of diagnosis and prognosis. That was backed up by the Royal College of Physicians this week, whose spokesperson was quoted in The Times saying that it is “extremely hard to tell” if somebody has only six months left to live. My amendment seeks to establish whether the patient has already sought and been refused permission to seek an assisted death so that the co-ordinating doctor can consider the reasons for the first refusal and whether the patient’s circumstances have materially changed since that time.

• 31 Mar 2025 · Institute for Apprenticeships and Technical Education (Transfer of Functions etc) Bill [Lords] · Hansard source

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  During their time in government, the Conservatives broke our apprenticeship system and betrayed young people. The Liberal Democrats are thus calling on the Government, if they are serious about growth, to fix the apprenticeship sector by investing in education and training, including by increasing the availability of apprenticeships and career advice for young people. I wish to speak in support of new clause 1, tabled by my hon. Friend the Member for St Neots and Mid Cambridgeshire (Ian Sollom), which would require the Secretary of State to bring forward proposals for the Executive agency to be known as Skills England. There should be greater emphasis on developing sector-specific skills that support the natural abilities and interests of each student. I believe that we should focus on strengthening careers advice and links with employers in schools and colleges to allow students clear alternative steps into a career that does not require them to go to university if that is not the best option. Any business will tell us that the apprenticeship levy does not work. Businesses cannot get the funding that they need to train staff, so hundreds of millions of pounds-worth of funding is returned unspent, only to disappear into the Treasury. If that money were ringfenced to boost the further education budget, it would at least benefit the employers that contribute, but it does not. I am glad that the Government are reforming the current system, but I urge them to accept my hon. Friend’s amendment, which would require a clear plan for their new proposals. We must improve not only the quality of vocational education, including skills for entrepreneurship and self-employment, but pupils’ awareness of such skills as they make initial decisions about their further education and career. I have spoken to young people in my constituency who are undertaking apprenticeships in the hospitality industry. They have spoken positively about the opportunities to develop their skills while earning a wage. However, I have also heard that many apprenticeship jobs do not pay enough for people to meet their living expenses. It is extremely important that young people are provided with a footing solid enough not to discourage them from pursuing apprenticeships in their field of interest. I believe that the lower minimum wage for apprentices should be scrapped. We should ensure that apprentices are paid at least the same minimum wage as other employees their age. I constantly hear from small and medium-sized businesses across my constituency who are struggling with workforce shortages. We need to build capacity in the workforce and within the economy to drive growth and ensure that British businesses can hire people with the correct skills to allow industries to thrive. Apprenticeships have a huge role to play in upskilling. Although I am glad that the Government are taking action to reform the current system, I urge them to accept new clause 1, which would give us proper detail on what the new system will look like. Apprenticeships could play a crucial part in addressing many of the staff shortages that businesses face, by equipping people across the country with the skills that they need to thrive. The Liberal Democrats have called on the Government to truly invest in skills. I urge the Minister to accept the new clause.

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

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  He paid a hefty fine, I think. The efforts of Henry VIII’s descendants to try to enclose the park and maintain the powers for the exclusive benefit of the royal family were defeated by a popular and somewhat genteel uprising of the residents of Richmond. I stand here today as the Member for Richmond Park to do a similar job: to assert the rights of the House of Commons and the Houses of Parliament to determine what legislation is, and not to allow it to be delegated under Henry VIII powers. The normal approach is that legislation made by Ministers is delegated legislation, and such legislation is therefore of subsidiary character to primary legislation. However, there is a type of power, known as a Henry VIII power, that gives Ministers the power to amend even primary legislation. The glossary on Parliament’s website says: “The expression is a reference to King Henry VIII’s supposed preference for legislating directly by proclamation rather than through Parliament.” We may in the course of time start to refer to them as President Trump powers—who knows?—but that is the precedent we act on. The Hansard Society, a non-partisan organisation that is neutral on assisted dying, issued a report that was critical of the power in the Bill. It said this: “little can be deduced about how it is thought this power will be used in practice, beyond the fact that it may, in particular, be used to enable the provision of assisted deaths through the National Health Service. But as the DPRRC”— the Delegated Powers and Regulatory Reform Committee— “has previously stated, where a power provides that delegated legislation may ‘in particular’ include a specified matter, it implies the legislation may deal with matters beyond that specified matter. The explanatory notes shed little more light, except to clarify that the power could be used to make arrangements for the funding of any provision made by the regulations. Could the regulations thus be used to enable the provision of assistance through the private sector on behalf of the health service in England and in Wales? If the intention is that the regulations will be used only to establish an assisted dying service, either within or separately to the NHS, would they require that the service be free at the point of access to the person requesting assistance? A key principle that the House of Lords Constitution Committee has applied to delegated powers is that they ‘should not be framed in such a way that gives little indication of how they should be used.’ The DPRRC’s Guidance to Departments states that the Delegated Powers Memorandum should set out how it is proposed that a power should be exercised. In the current absence of the DPM, MPs may therefore wish to seek clarification from the sponsor of the Bill, Kim Leadbeater, about how she envisages the power being used, and similarly from Ministers how they expect to use this power if it were granted to them.” The drafter of the Bill, Dame Elizabeth Gardiner, appeared on the Hansard Society podcast and gave some further detail on this power and how it arose: “In other areas, like, is it going to be delivered through the National Health Service or in some other way, indeed the regulation of any substances that might be involved, in the time available, we didn’t have time to go into all the detail of how those regimes work and to make the provision on the face of the Bill, and so there are regulation making powers there, which enable that provision to be set out in detail, as you say, when the Government has looked at it and decided how it would implement it.” Given the time available and the constraints of the private Member’s Bill process, the hon. Member for Spen Valley can be forgiven for not including the detail of how assisted dying will be provided on the NHS in the Bill on its introduction, but she and the Government have now had months to think about it. Many people had hoped that clause 32 would be replaced with detailed arrangements for the delivery of the service, to be put on the face of the Bill by way of an amendment, which the Committee could properly scrutinise. On 5 March, the hon. Member for Spen Valley repeatedly said that it would be made clear by clause 32. When the hon. Member for East Wiltshire called for clarity in the Bill as to how the service would be delivered, the hon. Member for Spen Valley said: “It will be.” The Minister said: “Officials are working on amendments to later clauses to establish the operating model for her consideration.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 5 March 2025; c. 802.] This does not appear to have happened, which means Parliament will be limited to a 90-minute debate on this issue when the regulations are eventually made, and such a motion will be unamendable. Surely the issue of how the service is to be delivered is much more important than that and deserves greater scrutiny. It is disappointing to see new clauses 36 and 37 as the replacement clauses. Ideally, instead of the new clauses we would have had a detailed set of amendments to specify exactly how assisted dying is to be delivered. We do not have that; instead, we have a Henry VIII power that provides even more power than the one in clause 32, because the new one includes a power to modify Acts of Parliament passed subsequent to this legislation. New clause 36 provides very little guidance on how the Henry VIII power would be exercised. Will assisted dying be provided by the state? If so, would that be on the NHS or through another body? Subsection (1) one does not specify that it must be on the NHS. Subsection (4) gives the power, but not the duty, to change section 1 of the National Health Service Act 2006—a foundational piece of Labour legislation if there ever was one, as the hon. Member for Banbury said—but subsection (5) requires it to be free at the point of use. The question of whether assisted dying should be provided as part of normal NHS services, or in a parallel service, as requested by both the BMA and the Royal College of General Practitioners, is not answered by new clause 36, although hopefully it can be fleshed out in the debate on the amendments in the name of the hon. Member for East Wiltshire. Alternatively, it would seem that the power can be used to commission private providers to deliver the service on behalf of the state. Instead of deciding between the various models, new clause 36 simply leaves it open. It therefore gives very little indication about how it should be used. When giving the Gray’s Inn reading at Gresham College last year, Lord Falconer said: “The wider the power—because there is less material in primary legislation to define how it should be exercised—the greater the reduction in parliamentary scrutiny, but also the harder”— it would be— “to identify any legal basis of challenge.” He went as far as to suggest that such wide Henry VIII powers were “unconstitutional”. Given his great support for the Bill, it would be interesting to hear the response of the hon. Member for Spen Valley and the Minister to Lord Falconer’s remarks.

• 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.

• 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 will speak to my amendments 458 to 460, which would tighten the process around seeking a determination from a second independent doctor if the first has refused to say that the criteria are met. The amendments relate to clause 10, which I will say more about when we come to it, but they have been selected for debate in this group. The risks of abuse in seeking a second independent doctor’s opinion are well illustrated by the evidence we have received from Dr Sharon Quick, the president of the Physicians for Compassionate Care Education Foundation, who tells us about the experience of Dr Charles Bentz, who refused to provide a second opinion for a physician-assisted suicide for a patient he had referred to an oncologist for cancer treatment. The co-ordinating doctor persisted and clearly found a compliant second opinion, as two weeks later his patient was dead. Dr Charles Bentz said in his testimony: “I was caring for a 76 year-old man who came in with a sore on his arm. The sore was ultimately diagnosed as a malignant melanoma, and I referred him to two cancer specialists for evaluation and therapy. I had known this patient and his wife for over a decade. He was an avid hiker, a popular hobby here in Oregon. As he went through his therapy, he became less able to do this activity, becoming depressed, which was documented in his chart. During this time, my patient expressed a wish for doctor-assisted suicide to one of the cancer specialists. Rather than taking the time and effort to address the question of depression, or ask me to talk with him as his primary care physician and as someone who knew him, the medical oncologist called me and asked me to be the ‘second opinion’ for his suicide. She told me that barbiturate overdoses ‘work very well’ for patients like this, and that she had done this many times before. I told her that assisted-suicide was not appropriate for this patient and that I did not concur. I was very concerned about my patient’s mental state, and I told her that addressing his underlying issues would be better than simply giving him a lethal prescription. Unfortunately, my concerns were ignored, and approximately two weeks later my patient was dead from an overdose prescribed by this doctor. His death certificate, filled out by this doctor, listed the cause of death as melanoma. When I reviewed his chart, the radiation oncologist documented a clear diagnosis of depression. My patient did not die from his cancer, but at the hands of a once-trusted colleague who failed to recognize and treat his depression. This experience has affected me, my practice, and my understanding of what it means to be a physician. What happened to this patient, who was weak and vulnerable, raises several questions that I have had to answer.” I appreciate that, under the Bill, Dr Bentz could not have been the independent doctor as he already knew the patient and was treating him, but in that case that contributed to enhanced safety. Dr Bentz’s example illustrates the real risks of abuse in a person being able to seek the opinion of a second independent doctor. The starting point is that the task of the independent doctor is not that of a normal doctor. It is not to cure the patient or to provide advice about medical treatments: it is to check whether the eligibility requirements are met. It is a decision-making function, not a medical one—albeit, of course, a decision-making function that is informed by medical expertise. In the light of that function, it is not appropriate for someone to seek another decision simply because they do not like the answer that has been given. The independent doctor is asked to apply an objective set of criteria against the evidence in front of them in order to make an assessment. It is not the case—or it should not be—that a different doctor would come to a different assessment based on the same criteria and the same evidence. If we are doing our job properly in the Committee, we should not expect that a second opinion could be arrived at. I have no objection to provision being made for a person to see a second independent doctor if the first did not manage to finish the task. Nor do I object in respect of cases in which there is a change of circumstances—for example, if the patient’s condition deteriorates to such a degree that although the first independent doctor thought the six-month prognosis test was not met, it becomes clear that it is met—which is the point of my amendment 458. In such circumstances, it would make sense to allow the patient to go to a second independent doctor. Although my preference in such a situation would be to go back to the original independent doctor and ask them to reconsider in the light of the change of circumstances, that may not always be possible. Amendment 458 is an attempt to find a middle ground. Amendment 459 seeks to reduce the possibility of abuse by ensuring that the second independent doctor has available the reasons why the first independent doctor concluded that the person was not eligible. That would allow the second independent doctor to approach the assessment with open eyes. Such a report would be particularly useful when it comes to the detection of coercion or pressure, as the first independent doctor might have spotted something that the second independent doctor might not easily see. Let us consider the evidence of Dr Tim Howard, who has been deeply involved in end-of-life palliative care and assisted dying for many years. He has been a non-exec director of a health authority, a member of an ethics committee, a postgraduate teacher and, finally, chair of the General Medical Council fitness to practise tribunals, dealing with complex medico-legal principles and decisions in public. He also helped to set up the Medical Practitioners Tribunal Service, which separated medical standard setting and investigation from adjudication. Dr Howard says: “I remain uncomfortable that when either doctor, the assessing doctor or the independent doctor, declines to agree with a request for” assisted dying, “they take no further action. I feel that the reasons for their refusal should, as well as being given to the patient, be recorded in the patient’s notes, and given to any ‘second opinion’ independent doctor. This is not an attempt to bias; it is a value judgement that criteria are not being met, and as such, is sharing an early warning to be extra careful.” The Committee should note that he has, in his own words, “been a strong proponent of medical assistance in dying…and a member of Dignity in Dying for many years.”

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

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  Let me just reply to the hon. Member’s original point. It is so important—and this is why we need the amendment in the Bill—that if there is any doubt at all that someone is suffering from a treatable mental health condition, they are not allowed to proceed with their request for an assisted death until all avenues of treatment for that condition have been explored. Eating disorders are treatable: people can recover and can, in the fullness of time, recover their zest for life. They can move beyond the stage where their decision whether to eat or not is their entire world. They can rediscover their friends, their employment and their education, and they can look forward to a full life again. But it is imperative that while they are in the grip of that eating disorder, they are not offered the option of an assisted death.

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

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  I will not take up a huge amount of time, because a lot of what I wanted to say has been said in previous sittings, but I return to the issue of people who may request an assisted death who may also be suffering from a mental health condition. Amendment 271 was tabled by the right hon. Member for South West Wiltshire (Dr Murrison), and specifically concerns people who have received their terminal illness diagnosis less than six months ago and whose prognosis is less than 6 months in the future. The amendment specifically addresses the fact that the risk of suicide for people who are suffering from a terminal illness increases when the diagnosis has been made less than six months before. Professor Louis Appleby is a key academic in the area of suicide prevention and advises the Government on it. Research by him and Professor Sleeman found: “Diagnosis of severe conditions was associated with an increased risk of dying by suicide”. In particular, they found: “The increase in risk was more pronounced in the first six months after diagnosis or first treatment.” They concluded that: “A diagnosis of severe physical illness is associated with higher suicide risk. The interaction of physical and mental illness emphasises the importance of collaborative physical and mental health care in these patients.” We talked at length in an earlier sitting about the risk that bringing in an assisted dying law would undermine suicide prevention strategies and efforts to address the issue of suicide. It is important that we return to this issue, and that we look seriously at the amendment in the name of the right hon. Member for South West Wiltshire, because it addresses the specific concern around those people who have had their diagnosis of terminal illness for less than six months and are therefore at a heightened risk of suicide. NICE guidelines say that if someone is at risk of self-harm or suicide, a clinician must ensure that a psychosocial assessment has been carried out either by a mental health specialist or by a trained person in primary care. That should cover the person’s living arrangements, relationships, social support network, mental health disorders, risk factors, safeguarding concerns and so on. Professor Allan House told the Committee in oral evidence that this should be part of the assessment for assisted dying. He said the current assessment only answers the question: “‘Is this person able to make decisions?’…it does not cover the psychological and social assessment.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 29 January 2025; c. 165, Q210.] We have discussed at length the lack of the psychosocial assessment in relation to everybody who makes a request for an assisted death, but the amendment seeks to identify those who are at heightened risk of suicide—those who have received their diagnosis of terminal illness within the last six months—and specifically requires psychosocial assessments for those people. Depression is common among those with terminal illness. Dr Price from the Royal College of Psychiatrists told the Committee that among “people nearing the end of life…depression is…at around 20%—much more common than in the general population. We know that depression is strongly associated with a wish to hasten death” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 30 January 2025; c. 275, Q359.] and that that wish is significantly alleviated if depression is treated, which is an extremely important point for the Committee to consider. The Pathfinders Neuromuscular Alliance, which is a user-led charity for those with muscle-weakening conditions such as muscular dystrophy, have stated in written evidence: “Pathfinders members have outlined how important it is to ensure psychological assessments are part of the process in order to ensure that the individual is in a position to make an informed decision. One member outlined: ‘I’ve been there, I’ve wanted to die, and I’ve been in the position where I would take that option if it was given to me, but looking back I can see I was depressed and now I’m so glad that I didn’t take that option.’” Currently, the Bill does not require anyone to explore any psychosocial factors in respect of someone’s situation. Although the person can be referred to a psychiatrist under clause 9(3), that only covers a capacity assessment. Again, it only answers the question of whether the person is able to make decisions, and addresses none of the other relevant factors. In Oregon, there is more room to explore those factors—the doctor may refer a patient for counselling if the patient may be suffering from a psychiatric or psychological disorder or depression, causing impaired judgment. On addressing the risk of social pressure and internalised feelings of burden, the British Geriatrics Society warned in its written evidence: “There is an established link between frailty and feeling a burden to others, meaning many older people with treatable clinical frailty may choose an assisted death to avoid burdening their family, which we view as unacceptable.” The Committee has already discussed at length the issue of older people or people with a terminal illness wishing to choose an assisted death motivated by the wish to save their family money. Dr Jerram, Dr Wagland and Dr Davis found that attitudes towards assisted dying changed over time. Patients closest to death were least likely to want assisted dying, suggesting that fear of suffering was the driving cause and that it may lessen as end of life care improves. Psychosocial care is fundamental to good end-of-life care. Committee members and witnesses from other jurisdictions have said that palliative care and assisted dying can complement each other, and that assessment should be part of the picture. Glyn Berry told the Committee about the importance of “the psychosocial aspect of palliative and end-of-life care”. –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 28 January 2025; c. 53, Q58.] In its written evidence, the British Association of Social Workers said that “good health care is not just about clinical interventions”, but also about “the wider social context in which a person lives their life…This is particularly pertinent with assisted dying.” That needs to come before the first declaration, because once somebody has signed that declaration, they are already on a pathway. The amendment would provide an opportunity for people’s needs to be met at the first opportunity. In conclusion, I emphasise the importance of a psychosocial intervention, which was stressed by a number of witnesses giving oral evidence to the Committee. We have discussed this issue at length. Earlier amendments have been voted down, but I stress the particular importance of the amendment 271 for that group of people who are in the first months of their diagnosis of a terminal illness and the raised level of risk of suicide that they present.

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

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  I wish to speak briefly to amendment 270, in the name of the right hon. Member for South West Wiltshire, to which I have put my name. It is about the really important issue of assessing suicidal intent as part of the assessment as to whether somebody has capacity to seek an assisted death. It is a really important point. The Bill expressly sets out that the person seeking an assisted death should have “a clear, settled and informed wish to end their own life,”. Amendment 270 seeks to establish that the wish cannot be clear or settled if there is any doubt about whether the person has a suicidal intention instead of seeking an assisted death on the basis that they have a terminal illness. In its current form, the Bill does not require a structured assessment of whether a patient is experiencing remediable suicidal risk factors, such as treatable depression, external pressures or suicidal ideation, before assisted dying is discussed. In the oral evidence, Dr Mulholland said that most people with depression, anxiety and other mental health problems “would have capacity” under the Mental Capacity Act because it would be presumed. It is not necessarily an obstruction to people being referred for anything. It is an important point that someone can have depression and that it can lead them to have suicidal thoughts, but under the Mental Capacity Act they would still be assessed as having capacity to decide that they wanted an assisted death. What is really important is that we have, over some years in this country, developed a suicide prevention strategy. I am sure that every Member in this room has had constituents approach them, as I certainly have, about family members who have committed suicide, where they were able to identify factors that made that suicide preventable. That is why it is so important that the suicide prevention strategy has been developed and continues to be developed, and why leading figures associated with that strategy—and with suicide prevention more widely—are concerned that a Bill for assisted dying may undermine suicide prevention strategies. We should take every care to prevent that in this Bill. The current UK suicide prevention strategy cites early intervention as a priority to implement tangible actions aiming to reduce the risk factors of suicide. In line with that strategy, amendment 270 provides early intervention that aims to identify the symptoms of suicidality in a patient before the initial discussion about assisted dying can take place. At the bare minimum, someone who is severely suicidal will not be allowed to enter into conversations about receiving an assisted death. It is important to reflect that suicidal ideation is not the same as a settled wish to die. Evidence shows that when mental health issues are treated, many patients no longer seek to end their life by suicide. Dr Price, in the oral evidence, said that 20% of terminally ill patients experienced depression, which is strongly associated with the wish to hasten death. When depression is identified and treated, the wish to die often diminishes. It is so important to distinguish and make provision for those people who are experiencing a wish to die as suicidal ideation, as opposed to the “clear, settled and informed wish” specified in the Bill. Research from the Office for National Statistics, King’s College London and the University of Manchester suggests that people diagnosed with a physical terminal illness are at an elevated risk of death by suicide, because of an increase in the psychological distress that can lead to severe depression in many patients, but data from the study shows that it is a more pronounced risk of suicide in the first six months after diagnosis or first treatment and, on average, suicide rates in the first year after a terminal diagnosis were 21.6%. Of course, it is important to reflect on the fact that a diagnosis of a terminal illness can take place some years in advance of the actual prognosis that the person’s death may occur. We are looking at a group of people who are within six months of their death as far as can be established by what is, as we know, uncertain prognosis—yet the incidence of suicide among those with a terminal illness is much more weighted towards those who have just received a diagnosis. These, of course, are not the same group of people; there may well be overlap, but they are definitively not the same. Evidence on the gov.uk website suggests that “over half of men aged 40 to 54 who died by suicide had a physical health condition.” We know that having a physical health condition or any kind of terminal illness has an impact, and that evidence demonstrates the impact that poor physical health has on mental wellbeing. We know that thereDr Louis Appleby, a psychiatrist who leads the national suicide prevention strategy for England and directs the national confidential inquiry into suicide, has expressed concerns that the Bill fundamentally undermines the basis of the suicide prevention strategy. Identifying and diagnosing capacity and mental disorders are easy to put down in writing, but in practice it is much harder for professionals to make a correct judgment straightaway. Where we do not want someone to die, we intervene by offering mental health support, crisis services and what we hope is a comprehensive suicide prevention strategy, but for those who qualify under this Bill, instead of that suite of support, we allow them to progress straight into discussion to end their life. It is really important that we have had a debate today about how the discussion should be initiated and the appropriate way to do that, but what is important about amendment 270 is that it takes into account the specific factor of suicidal ideation. It would mean that whatever the outcome of the decision about how the conversation should be initiated, the possibility that the person wishes to commit suicide is nevertheless taken into account.

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

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  I apologise for arriving late; thank you for calling me to speak anyway, Mr Dowd. I rise to speak in favour of amendment 50, which stands in the name of the hon. Member for Runnymede and Weybridge (Dr Spencer) and to which I have also put my name. I am conscious that we have been through many of the arguments about the Mental Capacity Act today and at an earlier sitting, but I am keen to press the amendment to a vote, because I think it would address some of the issues that have arisen. The point of dispute appears to be whether the Mental Capacity Act, as it is currently operated for all the purposes for which it is used—I have no doubt that it is a very effective piece of legislation that is widely used and understood by clinicians everywhere, as the hon. Member for Stroud says—is the appropriate measure and tool to use for the Bill. This decision that people are embarking on is like no other, so I think it right and proper to consider whether the Act is the appropriate way to measure whether people are able to make it. It is useful to reflect on the experience of the hon. Member for Runnymede and Weybridge, who drafted the amendment. I am conscious of the comments that the hon. Member for Ipswich made yesterday about poorly drafted amendments. My understanding is that the hon. Member for Runnymede and Weybridge has extensive expertise in the area; he is an expert in mental capacity assessment, and I dare say that if he were in the room he would have many useful and interesting things to say. That is why I think his amendment bears greater weight, to the extent that one Member’s amendment should be regarded as any better than another’s. Key to the Mental Capacity Act is the capacity test, which is about the ability to understand, retain, use and weigh the relevant information. The amendment attempts to address what it means to make an informed decision. Dr Annabel Price, who gave oral evidence to the Committee in her role with the Royal College of Psychiatrists, said that people planning to make the decision of seeking an assisted death “would need to be able to understand the impact of the substance they are taking and what the likely positives and negatives of that are…The informed consent process is different from a refusal of treatment, and the informed consent process feeds into the capacity assessment.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 30 January 2025; c. 277, Q361.] The point, which has come up in previous debates, is whether an informed decision to refuse treatment can be regarded as the same as an informed decision to end one’s life. My personal view is that the two things are quite different, and that a different standard of capacity should therefore be brought to bear on the decision. I support amendment 50 because it sets out in detail how the Mental Capacity Act should be used specifically in relation to this decision. As I said in an intervention on the hon. Member for Stroud, it would not change the Act or tamper in any way with how it is currently used; it would merely specify the particular ways in which it should be used in relation to the decision. I hear what the hon. Member said about doctors’ use of the Act, as well as what the chief medical officer said. I am also conscious of what the hon. Member for Bexleyheath and Crayford has said about the variety of experience that he has, as a parent, with professionals’ understanding of the Act. That came across in a lot of the oral evidence. As the hon. Member for East Wiltshire said, the chief medical officer himself had to clarify the remarks that he made to the Committee in oral evidence. The chief medical officer implied that there were different ways of applying the Act depending on the decision to be made, but there are not—that was a very clear clarification. That implies that there is a difference in the way doctors approach the use of the Act. We cannot have a difference of approach when it comes to a decision of such momentous importance as the decision whether someone has the capacity to choose to end their life. The amendment reflects the fact that there is value in attempting to standardise how the Mental Capacity Act should be used in relation to the decision. That is why we should agree to it: it is important that Members of this House make a clear statement in the Bill about what we expect doctors to do as they approach an assessment of capacity. We should specify the minimum understanding of capacity to choose an assisted death, which includes an understanding of the likely process of all treatment options, including non-treatment and prognostic uncertainty. In her evidence, Dr Rachel Clarke said: “I would not be the first person to make the observation that sometimes doctors can be very pleased with their own abilities at a particular practice, and that practice might be having a conversation where you are assessing someone’s capacity.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 28 January 2025; c. 80, Q103.] Doctors have different assessments of their own ability to assess capacity. That is why a standardised approach, as set out in amendment 50, is so important. I stress how important it is that Parliament be the place where the standards for what MPs expect as an assessment of mental capacity are set. We should be the ones to determine them, rather than leaving them to the vagaries of individual clinicians. The assessment of capacity and the explanation of treatment options to the person considering an assisted death need to include the extent of prognostic certainty about their illness or condition. We spoke yesterday about the difficulty of knowing whether someone has six or 12 months left to live, and of knowing the extent to which they are going to deteriorate. We also covered in detail the relevant and available care and treatment, including palliative care, hospice care or other care. That needs to be part of the conversation about somebody’s capacity to make the decision. Amendment 50 states that “a decision to proceed under this Act does not prevent or make unavailable any care and treatment provision that would normally be provided.” It would therefore be clear that somebody had assessed the full range of their options. The amendment makes clear a fundamental issue that I do not think is otherwise covered by the Mental Capacity Act, or at least not to this level of specificity, which is that “the person’s decision to proceed…must be theirs alone and not bound or directed by the views or decisions of others.” We have talked about the importance of that issue in relation to the Bill as a whole, but it would be valuable to include it in the clause as a specific requirement for assessing somebody’s capability. Doubts have been expressed across the Committee about whether the Bill goes far enough in assessing the extent to which somebody might be under duress or coercion. Putting such a provision in the Bill, as part of the capacity assessment, would be an important and essential safeguard. Once someone has made the decision to seek an assisted death, is the doctor or assessing person confident that the person could unmake the decision or change their mind at any stage?

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

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  It is a pleasure to serve under your chairmanship, Ms McVey. I thank the hon. Member for Spen Valley for her opening remarks. I am grateful to be called so early in proceedings, because I believe this is one of the really important issues before us. It is about whether or not somebody “has the capacity to make a decision to end their own life” as is stated in clause 1(1)(a). I believe that the word “capacity” in this context is potentially difficult to define. I note that in clause 3, all reference to mental capacity is assumed to refer to the Mental Capacity Act 2005, but I do not believe that that is sufficient for the purposes of the Bill. We heard plenty of voices to support my point of view during the oral evidence, so I want to reflect on that. I think there are four separate concerns about using the Mental Capacity Act 2005 to judge capacity. The Royal College of Psychiatrists submitted its original written evidence in January, which we have all had sight of, and it said: “Under the Bill as introduced, a person with a co-occurring mental disorder that is impacting their wish to end their own life would not necessarily be deemed ineligible; only those whose mental disorder was deemed to impair their capacity to make a decision to end their own life would be excluded.” That means that an individual could have a terminal illness and also separately have a mental illness, such as depression; that would affect their ability to make a decision as to whether that terminal illness was sufficient for them to ask for assistance with dying.

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

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  The hon. Gentleman puts his finger on the exact point: it allows people to make a decision about whether or not they want to continue treatment; it has not been used in this way before, and it was not intended to be used for that purpose. I understand the hon. Gentleman’s point: he was trying to say that to stop treatment is akin to making a proactive decision to end one’s life, but I would argue that it is not, and that is why the Mental Capacity Act is unsuitable for this purpose. It was interesting to reflect on the oral and written evidence we received on this issue. Professor Sir Chris Whitty, the chief medical officer, stated in his oral evidence: “Issues…around mental capacity…are dealt with every day…every doctor and nurse above a certain level of seniority should be able to do that normally. It may require some slight adjustment.” He acknowledged that “the more serious the decision, the greater the level of capacity that someone needs to have.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 28 January 2025; c. 30, Q13.] However, the Royal College of Psychiatrists said that “an assessment of a person’s mental capacity to decide to end their own life is an entirely different and more complex determination requiring a higher level of understanding.”

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

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  I say to that what I have been saying throughout: a test of mental capacity is not sufficient for this Bill. For example, the Royal College of Psychiatrists states that the Mental Capacity Act “is not sufficient for the purposes of this Bill. Extensive consideration needs to be given to what an assessment of mental capacity should consist of” for decisions relating to assisted dying or assisted suicide— “and, indeed, whether a determination through such an assessment can be reliably arrived at in this novel context.” I believe that what the Royal College of Psychiatrists means by “novel context” is that no legislation of this type has been framed before and we do not have any precedent to guide us in terms of what an appropriate determination of capacity might be.

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

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  The hon. Member for Solihull West and Shirley used an arresting phrase this morning: he said that to abandon the Mental Capacity Act would take us “into tiger country”. The concept appeals greatly to me, but what I would say to him and other Committee members is that it is the Bill itself that takes us into tiger country. It is unprecedented, and this is very new territory for legislation in this country. That is the tiger country, right there. If we are going to let those tigers out into the wild, we need to ensure that the British public, and particularly the most vulnerable members of it, have the right protections. That is what the amendment seeks. There was not a consensus among those who gave oral or written evidence that the Mental Capacity Act is a sufficient safeguard for the purpose proposed in the Bill. I am grateful to the hon. Member for Bexleyheath and Crayford for his speech this morning, which illustrated vividly for all of us how the Mental Capacity Act is used in practice. I particularly thank him for his personal reflection. Let me reiterate what the amendment seeks. The Bill proposes to judge mental capacity for a decision to request assisted dying in relation to the Mental Capacity Act 2005. There are elements of the Mental Capacity Act that are tried and tested, and should be retained in assessments of capacity in relation to this legislation, but as per the written evidence of the Royal College of Psychiatrists, the Mental Capacity Act is not sufficient for the purposes of assisted dying, because it cannot distinguish between those who suffer from a mental disorder and those who do not. It needs to be adapted for the purposes of the Bill. My amendment 34 would therefore substitute “capacity” with “ability” and reserve to the Secretary of State the power to define ability for the purposes of the Bill. To me, that is a pragmatic response. The debate in the Committee Room today reflects the lack of consensus among the experts who gave witness. That is why I think the matter is better resolved by those experts giving advice to the Secretary of the State, so the definition of ability can be expertly decided on. The difference between choosing assisting dying and choosing to end treatment was a big topic of debate both this morning and this afternoon. It goes to the heart of the different approaches that people take towards the Bill. I support the observation from the hon. Member for East Wiltshire that the difference is between dying of an illness itself, or dying of the effects of the approved substance, as laid out in the Bill. To me, that is a substantial and material difference, so our approach to establishing capacity should reflect that. The hon. Member for Reigate made an important point about the difference between a passive and an active choice. That very much reflects what I am trying to achieve through the amendment, which would allow us to strengthen the safeguards around the assessment of capacity. Given that there was not a consensus, among the experts who gave evidence, on whether the Mental Capacity Act is sufficient for the purpose, the pragmatic step is to allow the amendment to create the conditions under which a stronger safeguard can be adopted if necessary. Question put, That the amendment be made.

• 30 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Seventh sitting) · Hansard source

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  Q Dr Price, I am really glad that we are able to have the Royal College of Psychiatrists in front of us today; thank you for making the time. I want to ask you about paragraph 11 of your written evidence, which states that it is the royal college’s view that the Mental Capacity Act “is not sufficient for the purposes of this Bill.” Could you expand a little on that and, if you feel able, make some recommendations as to what you think could be sufficient? Dr Price: Thank you. In answering this, I will also refer back to Professor Gareth Owen’s oral submission, thinking about the purpose that the Mental Capacity Act was drawn up for and the fact that decisions about the ending of life were not one of the originally designed functions of it. We would need to think carefully about how that would then translate into a decision that was specifically about the capacity to end one’s life. We also need to think about how that would work in practice. When we are thinking about capacity assessments, it is usually related to a treatment or a choice about a treatment or about somebody’s life—for example, changing residence. Psychiatrists and doctors and actually lots of professionals are very used to those sorts of decisions and have gathered a lot of knowledge, expertise and experience around it. This particular decision is something that in this country we do not have knowledge, expertise and experience in, and we therefore need to think about how that would look in practice. As for advice to the Committee about what that might look like, I think that we need to gather what evidence we have—it is actually very thin—from other jurisdictions that think about capacity as part of this process. I am thinking about my PhD: I visited Oregon and talked to practitioners who were directly involved in these sorts of assessments. They described the process, but they are not using the Mental Capacity Act as their framework. They described a very interpersonal process, which relied on a relationship with the patient, and the better a patient was known, the more a gut feeling-type assessment was used. We need to think here about whether that would be a sufficient conversation to have. One of the things that I have thought quite a lot about is how we can really understand the workings of a mental capacity assessment, and one of the best ways we can do that is to see who is not permitted to access assisted suicide because of a lack of capacity and what that assessment showed. We do not have data because the assessments for people who were not permitted to do it are not published; we cannot read them, so if this becomes legislation, one of the suggestions that I would have—it is supported by the Royal College of Psychiatrists—is to, with patients’ consent, record capacity assessments to see whether they meet the standard that is necessary. I think it is important to set out the standard necessary and the components needed to be confident about a mental capacity assessment. That will help with standards, but will also help with training, because this is new territory for psychiatry, for medicine, and to be able to think about consistency and reliability, training needs to actually see a transparency in capacity assessments.

• 29 Jan 2025 · Youth Mobility Scheme: EU · Hansard source

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  I am passionate about opportunities for young people; that is why I am talking about a youth mobility scheme in this debate, but we also need to get behind a whole range of policy interventions, including apprenticeships and funding for further education. We need also to look at barriers to employment, particularly for those from more disadvantaged backgrounds, so I agree with what the hon. Gentleman says about apprenticeships. I have heard from stakeholders in the hospitality sector that they would welcome this proposal. The changes to the immigration system implemented in April 2024, which increased the minimum salary threshold for skilled worker visas, shrank the talent pool from which hospitality businesses can recruit and contributed to greater staff shortages. Around three quarters of the hospitality workforce is filled from within the UK, but international talent has always been attracted to the UK because of our pedigree in hospitality and our talent for developing careers. Given that recent Government decisions at the Budget added to the overall tax burden on hospitality businesses—many are now considering whether their businesses remain viable—we must provide the tools that hospitality businesses need to grow, so that they can boost the wider economy. Those tools include ensuring access to global talent.

• 29 Jan 2025 · Youth Mobility Scheme: EU · Hansard source

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  I thank the hon. Gentleman for his very nice words. I totally understand the issues around the specific circumstances in Northern Ireland; all I would say is that instituting a youth mobility scheme would go a long way to improving relations with the EU, and I think it would unlock some of the other issues we are experiencing. We already have youth mobility schemes in place with 13 countries, including Australia, New Zealand and Canada, so why not with EU countries? It would once again allow young people across the UK to be able to spend time with our nearest neighbours without having to navigate Brexit red tape. A youth mobility scheme with the EU would open up opportunities for British young people to learn new skills, languages and cultures and bring all that back with them to benefit our economy and our society.