Stephen Kinnock
MP for Aberafan Maesteg · Labour · United Kingdom
“I thank the shadow Secretary of State for her kind words and look forward to our exchanges across the Dispatch Box. I am ready to engage with her on getting the maximum benefits for the people of Wales.”
“I thank the right hon. Lady and look forward to working with her. My understanding is that there were challenges around the helicopter capability. Decisions were taken by Natural Resources Wales some time ago to change the way that the tendering for helicopter capability works. We certainly need to look at that.”
“I thank my right hon. Friend for his question. Like him, I pay tribute to all those involved in the collective and heroic response to the wildfires.”
“I thank the right hon. Lady for her question. Many of the ideas coming forward for devolving power right across our United Kingdom, beyond Cardiff Bay and Holyrood, are very exciting, and I look forward to exploring them with her.”
“Just to be clear, this is not about staying out of the issue; it is about respecting the devolution settlement, but being prepared to work constructively where we can in partnership with the Welsh Government. The hon.”
“I know about and welcome the right hon. Gentleman’s strong connections to Wales. I recognise the connectivity benefits that WSMR’s proposal could deliver, particularly for passengers in Wales and the west midlands.”
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“That needs to be put into schools through community health, and through working with parents and communities to change the habits of our country. We have a gargantuan challenge ahead of us, but our Government are absolutely committed to facing it, and that prevention strategy will be at the heart of our 10-year plan. It is one of the key shifts from sickness to prevention. That leads me to my closing remarks. We have seen today what a challenging and complex area this is. It is a challenge that requires sustained action on a number of risk factors, but I assure colleagues that this Government will leave no stone unturned in getting premature deaths from heart disease and stroke down by a quarter for people under the age of 75 within the next year.”
“My hon. Friend is right that prevention should focus on as early as possible in the life of our young people. Bad habits form at early ages. That is not helped by the behaviour of some aspects of our economy, and the way in which products are advertised. It is essential that we move to a model of prevention that is a partnership between the Government, our communities and business. We are taking action against the advertisement of certain products before the 9 o’clock watershed. We are also cracking down on energy drinks, which are really pernicious in terms of the amount of sugar, caffeine and other deeply unhealthy components they contain. My hon. Friend is right that we are genuinely all in this together. We need that partnership with the private sector, and a change in mindset around healthy and nutritious food.”
“In addition to the generic risk of additional overlapping terminology causing uncertainty, the inclusion of these amendments would generate specific uncertainty, as it may be difficult to distinguish physical pain from other pain. It is also not clear whether the person needs to be in pain all the time or some of the time. As I said earlier, the Government have taken a neutral position on the substantive policy questions.”
“Amendments 235 to 245 are intended to refine the eligibility criteria of a person seeking assistance to end their life so as to ensure that the primary motivation of that person is to avoid physical pain. Consequential amendments are included to reflect that throughout the entirety of the Bill. If this refinement were to form part of the Bill, amendment 235 could exclude those who are suffering with a terminal illness for which physical pain is not a specific symptom. The likely effect would therefore be to limit those who are eligible to access assisted dying under this legislation to terminally ill persons with conditions that are likely to cause only physical pain.”
“These relevant points include, for example, the assessment of the first doctor—the co-ordinating doctor—and that of the second doctor—the independent doctor. The amendments would provide that declarations set out in the schedules are, in consequence, also amended to reflect this new requirement. With respect to the impact of introducing additional or overlapping terminology alongside the existing terms “coerced or pressured” currently in clause 1 of the Bill, such as “acting for their own sake”, there is a risk that this would cause uncertainty about their interpretation and application by the assessing doctors and the courts. The Minister of State, Ministry of Justice, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), has articulated the Government’s position in her previous contributions.”
“It is a pleasure to serve under your chairship, Ms McVey. This group of amendments focuses on the motivations of an individual who wishes to seek assisted dying services. As before, I will limit my remarks to observations about the legal and operational impact that these changes would have. Amendments 94 to 104 would introduce an additional safeguarding requirement that would require that a person who wishes to be provided with lawful assistance to voluntarily end their own life must be acting for their own sake, not for the benefit of others. These amendments would introduce that new requirement into all the relevant parts of the Bill where a doctor or court or panel must, under the current provisions in the Bill, make an assessment as to whether the person has capacity, a clear and settled wish and is making the declaration voluntarily.”
“I assume that the Committee finds it useful to know what the Government’s position is on those matters. We do not opine on the philosophical, ethical or moral considerations that are at the heart of the Bill.”
“Members of the Committee who are not Ministers are here to debate the philosophical, moral, ethical and, in some cases, legal and perhaps clinical aspects of the Bill. Members of the Committee who are Ministers—namely myself and the Justice Minister, my hon. and learned Friend the Member for Finchley and Golders Green—are here to provide observations on the Bill with regard to its legal, practical, technical and operational impact, to ensure that we are doing our constitutional duty to deliver the objectives I just outlined to my hon. Friend the Member for Bradford West. The answer to the question from my hon. Friend is that when my hon. and learned Friend the Justice Minister and I speak, we focus our remarks exclusively on the legal, practical, technical and operational considerations of the Bill.”
“I thank my hon. Friend for that intervention. I will just take us back to the first principles. This is not a Government Bill; it is the Bill of my hon. Friend the Member for Spen Valley, who came top of the ballot for private Members’ Bills. She chose to bring forward this piece of legislation. The Government had absolutely no role whatsoever in drafting the legislation. The Prime Minister then made it clear that the Government will remain neutral in their position on the Bill. However, it is the constitutional duty of the Government to ensure that every Bill that passes through Parliament and secures Royal Assent is workable, deliverable, viable and coherent in terms of the statute. How does that play into this Bill Committee?”
“Therefore, I will not be offering up a Government view on the merits of any proposed changes put forward by other Members, but I will make brief remarks on an amendment’s legal and practical impact to assist Members in undertaking line-by-line scrutiny.”
“I thank my hon. Friend the Member for Spen Valley for her introductory comments. The Government will continue to remain neutral on the Bill and do not hold a position on assisted dying. I want to make it clear that I, along with the Minister of State, Ministry of Justice, my hon. and learned Friend the Member for Finchley and Golders Green, are speaking in Committee not as Members of Parliament, but as Government Ministers responsible for ensuring that the Bill, if passed, is effective, legally robust and workable. To that end, we have been working closely with the hon. Member for Spen Valley and, where changes have been mutually agreed on by herself and the Government, we will offer a technical, factual explanation for the amendments.”
“Amendment 182 would limit the provision of clause 4(3), where a person indicates to a registered medical practitioner their wish to seek assistance to end their own life, to cases where the person is physically present in England or Wales. It would prevent people who are outside of England or Wales from accessing assistance in accordance with the Act—for example, by online consultations from abroad. As I said earlier, the Government will continue to remain neutral on the substantive policy questions relevant to how the law in this area could be changed. That is, as I have made clear, a matter for the Committee and for Parliament as a whole. However, I hope that these observations are helpful to Members in considering the Bill and the amendments tabled by my hon. Friend the Member for Spen Valley. Amendment 178 agreed to.”
“Amendments 178 and 193 would ensure that only a terminally ill person in England or Wales may be provided with assistance in accordance with the Bill. Further to that, a requirement is placed on the co-ordinating doctor to ascertain whether, in their opinion, the person who made the first declaration is in England and Wales as part of their first assessment. Amendment 179 would limit the assistance that may be provided in accordance with the Bill to assistance in England or Wales only. Amendment 180 would require the steps taken under clauses 5, 7, 8 and 13 that relate to both declarations and both doctors’ assessments to be taken by persons in England or Wales.”
“I am on the Committee as a Member of Parliament and I vote as such. When I speak on the Committee, I speak as a Government Minister in order to provide factual and technical explanations. As the Bill is a matter of conscience, I will be voting with my conscience on all the amendments as they come forward. The amendments that we are now debating have been tabled by my hon. Friend the Member for Spen Valley in consultation with the Government. They relate to the location of the person seeking assistance under the Bill and are designed to ensure that the service can only be accessed by an individual present in England and Wales, with a view to preventing medical tourism. I will take the amendments in turn.”
“After 14 years of Tory neglect and incompetence, we inherited a broken NHS, and nowhere is that more apparent than in our mental health services. Too many people are waiting too long to access the care they need. To fix that, we will recruit 8,500 more mental health workers; provide access to specialist mental health professionals in every school, as the hon. Member has called for; roll out Young Futures hubs in communities; and modernise the Mental Health Act 1983.”
“The hon. Lady will know that the Government’s position on the Terminally Ill Adults (End of Life) Bill is one of neutrality. I am on the Bill Committee simply to speak about the Government’s position on the workability and operationalisation of the Bill. We look forward to seeing the amendment that will be brought forward by my hon. Friend the Member for Spen Valley (Kim Leadbeater). Any comment we make or position we take will be based on the operationalisation of that amendment, should it become part of the Bill and, ultimately, should the Bill gain Royal Assent.”
“My hon. Friend is a doughty campaigner on this issue in her constituency. She is right that the integration of services is crucial to ensuring that we get the best possible outcomes for people who are struggling with their mental health. I would be very happy to discuss with her the possibility of me visiting her constituency.”
“I am not familiar with the detail of the case that the right hon. Gentleman mentions, but it sounds like a positive and interesting development, and I would be happy to consider it further. The Government are committed to delivering the cross-sector suicide prevention strategy for England, published in 2023. The 8,500 new mental health workers who we will recruit will be specially trained to support people at risk.”
“After the disastrous 14 years that we have had, we are facing a very serious situation in terms of mental health provision. It will take some time to get the workforce in place, but we have a clear commitment to having a specialist in every school. The appointment and training of those specialists will take some time. We are also rolling out open-access Young Futures hubs in every community. I am confident that the combination of those two interventions will get us back to having mental health services that this country can be truly proud of.”
“The Chair of the Committee will have seen that we have made an explicit commitment to the mental health investment standard—we are absolutely committed to that. In addition, we have to drive reform in the system so that it is about not just the amount of investment going in, but how we ensure that it is working properly. I am absolutely confident that the commitment to 8,500 new specialists, the Young Futures hubs and having a mental health specialist in every school will facilitate the delivery of services in a far more effective way than is currently the case.”
“We in this Chamber should, whenever possible, pay tribute to the people providing those frontline services, who every day work heroically in very difficult circumstances. My hon. Friend is absolutely right about the pressures on the workforce—we are very conscious of that. We will bring forward a workforce plan in the summer, and we are working at pace to recruit the 8,500 mental health workers.”
“What we know about targets is that if we try to overload a system with too many targets, it causes confusion and ends up with, as the hon. Lady rightly says, perverse outcomes. We are clear that we do not want to have a system based on just making policy by press release, as was the case under the previous Government, putting out press announcements about loads more targets. It all makes for nice front-page headlines, but it does not lead to any serious delivery of the strategy that we need to deliver. I am with her on the point about focus. We are absolutely committed to mental health, as is set out in the planning guidance. It is also one of the priorities in the planning guidance, and we will continue to deliver on that priority.”
“A lack of capacity under this framework means that a person must be unable to understand, use and weigh information relevant to the decision, and that that must be directly caused by “an impairment of, or a disturbance in the functioning of, the mind or brain.” The “ability” proposal, as drafted, deals only with the use and weight of information.”
“New clause 1, which would replace clause 3, and amendments 34 to 47, would collectively introduce the concept of an individual having the ability to make the decision to request assistance to end their life. A person’s ability would be determined by whether they could “fully understand, use and weigh the relevant information in accordance with regulations made by the Secretary of State”. That is intended to replace the term “capacity”, used in the Mental Capacity Act 2005, which provides a very specific definition of what it means to lack capacity in relation to a particular decision.”
“It is a pleasure to serve under your chairship, Sir Roger. As was noted earlier, the Government remain neutral. My role here is not to offer a Government view on the merits of the amendments but to provide a factual explanation of their technical and practical effect, to assist the Committee in its scrutiny. This group of amendments focuses on the concept of mental capacity. As drafted, the Bill, in clause 3, states that “references to a person having capacity are to be read in accordance with the Mental Capacity Act 2005”, with sections 1 to 3 of that Act establishing the principles and criteria for assessing a person’s capacity to make decisions.”
“The fundamental position of the Government is that the Mental Capacity Act as it stands is a known quantity. It provides the legal base for a whole range of measures and interventions, and the Government’s view is that it would be an adequate legal base to operationalise the Bill should it receive Royal Assent. Our position on it goes no further than that; it is simply a matter of fact that there is a piece of legislation that is a known quantity.”
“As I set out from the Dispatch Box when we had the money resolution, the Government will publish an impact assessment before Report. Given that this is a highly dynamic Bill, with a whole range of amendments having been tabled, and that it is not really possible to publish an impact assessment on the basis of a Bill that has not cleared a Bill Committee, there is a simple point of sequencing. That is why we are going to publish the impact assessment after the Bill Committee has completed.”
“I am not entirely clear, but I have undertaken to check the matter with officials. I will get back to the right hon. Lady as soon as possible on that point.”
“I thank the right hon. Member for her intervention. We have had a conversation about the need to ensure that the impact assessment has a clear and specific focus on the impact in Wales. I can absolutely assure her that either there will be a separate impact assessment for Wales, or we will ensure that the impact assessment that we produce is absolutely clear in terms of the impact that it will have in Wales; it will be one of those two. Personally, I am agnostic as to which of those it is. It is simply a question of what works best given the highly integrated nature of the conversation because the criminal justice aspects of it are a reserved competence, while health and care are a devolved competence. What is the best way to present that—having a single document or two separate documents?”
“Member for East Wiltshire asked how we come to that position. It is through the usual process of engaging with officials and experts in the field, and through taking into account all the considerations that the Government need to take into account for the operationalisation of the Bill. The Government then come to a view, and that is the view that I express when I am on the Committee.”
“It is also relatively uncharted territory to have, on a Bill Committee, Ministers who are neutral because the position of the Government is neutral. But that reflects the fact that this is indeed uncharted territory, so that is where we stand. The hon. Gentleman made a point about our own positions on the subject; I speak also for the Minister of State, Ministry of Justice, my hon. and learned Friend the Member for Finchley and Golders Green. It is a matter of public record that I supported the Bill on Second Reading. It is also the case that we vote, as members of the Committee, on the basis of our conscience because this is a matter of conscience; that is why the Government are neutral on it. There is no whipping from the usual channels. At the same time, we are articulating the position of the Government. The hon.”
“The Government choose when to bring forward an impact assessment based on the passage of the Bill through the House. We have had reports today about a very substantial amendment to clause 12 that may well be brought forward by my hon. Friend the Member for Spen Valley, for example. It is not possible for the Government to conduct and publish an impact assessment when quite significant changes are being made. I also gently point out to the hon. Member for East Wiltshire that this is not a Government Bill; it is a private Member’s Bill. It is also worth noting that it is unprecedented, as far as I know, to have oral evidence sessions for a private Member’s Bill, so we are already on relatively uncharted territory.”
“I turn to amendment 202, tabled by my hon. Friend the Member for Spen Valley on the advice of the Government. It ensures that the assessment of “capacity” is utilised by the assessing doctor, and corrects a typographical error in clause 9 to ensure that an assessment of capacity will apply consistently throughout the Bill. As I said earlier, how and whether the law on assisted dying should change is a matter for this Committee and for Parliament as a whole. However, I hope that these observations are helpful to the Committee when considering potential changes put forward.”
“The hon. Member makes an interesting point. I simply reiterate that this is a very dynamic Bill Committee; I believe that 362 amendments have been tabled. Given the Government’s focus on establishing the Bill’s implementability, the coherence of the statute, the legal dimensions and the complexity of what we are dealing with, we took the position that it was better to wait for the Bill to clear Committee stage before producing an impact assessment. To do otherwise could have involved a large amount of second-guessing based on radical changes that might well have come out of the Bill Committee. I reiterate the logic of that sequencing. On the point about the established legal framework, which clinicians have been applying since 2007, “capacity” would still be used for other decisions about care and treatment.”
“The position was also taken that there should be Government Ministers on the Committee who had to speak for the Government with neutrality. It is with those two factors in mind that the Committee was put together. The two functions that my hon. and learned Friend the Member for Finchley and Golders Green and I have reflect the two purposes that were in mind when the Committee was put together.”
“Further to that point of order, Sir Roger. I thank the hon. Member for East Wiltshire for his question. Let us take this back to first principles. This is a private Member’s Bill. A Bill Committee had to be formed. The Committee was formed in discussions between the Member sponsoring the Bill, the Whips and the House authorities. The principle of formulating the Committee was based in large part on the steer given by the debate and the vote on Second Reading, which delivered a majority of 55 in the House. The numerical composition of this Committee was therefore based on that majority of 55, broadly speaking. My hon. Friend the Member for Spen Valley needed to put together a Committee that reflected that.”
“Aside from the right to liberty, article 5 of the European convention on human rights requires that prisoners should have the same rights as those who are not prisoners. The rights engaged by the amendment are article 8 on the right to respect for private and family life and article 14 on the protection from discrimination. Making prisoners ineligible for assisted dying would, on the face of it, lead to a difference in treatment between prisoners and non-prisoners that would need to be objectively and reasonably justified. The justification test requires that the treatment in question is a proportionate means of achieving a legitimate aim.”
“The amendments relate to the criteria that individuals would need to meet to request assistance to die under the Bill. All the amendments seek to amend the eligibility criteria in some manner. To reiterate, the Government have no view on the policy questions pertaining to the amendments, and my role here is to offer observations on the legal and practical impact of amendments tabled. The legal impact of these amendments will be the main focus of my remarks. Amendment 353 seeks to make prisoners ineligible for assisted dying services even if they meet the definition of having a terminal illness. Amendments 354 and 355 are consequential amendments that would make it a requirement for the co-ordinating doctor in the first assessment and the court process to ascertain whether a person seeking assistance to end their own life is a prisoner.”
“I thank my hon. Friend for that intervention. My understanding is that it is termed as a treatment under the law. The Government do not take a view on the semantics of the word; my understanding is that that is how it is classified under the law.”
“Article 14 states that the rights set out in the ECHR should be secured for everyone without discrimination on any ground. This amendment engages article 8 on the right to respect for private and family life. Making those who are homeless ineligible for assisted dying would lead to a difference in treatment that will need to be objectively and reasonably justified. The justification test requires that the treatment in question is a proportionate means of achieving a legitimate aim. I hope these observations may be helpful to Members in considering these amendments and making a determination about who should be eligible for accessing assisted dying services, should the Bill pass.”
“The effect of amendment 356 would be to amend the definition of a “terminally ill person”, as set out in clause 1 of the Bill, to expressly exclude a person who, notwithstanding that they met all the other requirements set out in paragraphs (a) to (d) of subsection (1), was homeless within the meaning of section 175 of the Housing Act 1996. Amendments 357 and 358 seek to make consequential amendments to clause 7 on the first doctor’s assessment and clause 12 on court approval. These amendments would require the co-ordinating doctor and the court to be satisfied that, in their opinion, the person was not homeless within the meaning of section 175 of the Housing Act 1996 before making their statement or declaration to allow the person to proceed to the next stage of the assisted dying process.”
“I apologise; I think I misunderstood the intervention of my hon. Friend the Member for Bradford West, so my comments were not clear. I meant the treatment of this matter under the law. As I said, the justification test requires that the treatment in question is a proportionate means of achieving a legitimate aim. That means the way in which the matter is treated under the law. That is what I meant; I think we got our wires crossed. Finally, let me address amendments 356, 357 and 358, whose purpose is to exclude those who are homeless within the meaning of section 175 of the Housing Act 1996 from the definition of a “terminally ill person”.”
“It would require them both to be satisfied that, in their opinion, the person seeking assistance has demonstrated their understanding of the matters that have been discussed under clause 9(2)(b), (c) and (d). The amendment does not specify in any further detail what the doctors would be required to look for to satisfy themselves that a person has demonstrated their understanding. That would be left to their professional judgment, with training, support and guidance, as with other concepts in the Bill. The amendment would leave it to the co-ordinating and independent doctor’s professional judgment to determine what “demonstrated their understanding” looked like in respect of each individual person. I hope that those observations are helpful to the Committee.”
“The term “demonstrably” would not provide further practical guidance beyond the words already in the Bill and could create uncertainty as to what constitutes being demonstrably informed. I turn to amendment 112. Clause 9 currently provides that the co-ordinating and independent doctors must explain and discuss a number of matters with the person being assessed. These matters are set out in clause 9(2)(b), (c) and (d). In the interests of time, I will not go through each of those matters, but they include an explanation and discussion of the person’s diagnosis and prognosis, any treatment available and the likely effect of it, and the further steps that must be taken before assistance can lawfully be provided to the person under the Act. The amendment would create an additional requirement for the co-ordinating and independent doctors.”
“The amendments in the name of my hon. Friend the Member for Broxtowe relate to an individual who seeks to access assisted dying services demonstrating their wish to end their own life and demonstrating their understanding of the process by which that happens. To support the Committee’s deliberations, I will briefly summarise the Government’s analysis of the effect of the amendments. Amendments 109, 110 and 111 would modify the requirement that the co-ordinating doctor and the independent doctor must undertake an assessment to ascertain whether, in their opinion, the person has a clear, settled and informed wish to end their own life. That would be amended to require the person to have a clear, settled and demonstrably informed wish.”
“Hospices provide vital care and support for patients and their families at the most difficult time. I am very proud that this Government have provided a £100 million capital funding boost for adult and children’s hospices over this year and next. We are currently finalising the delivery mechanism for this funding, and we are pleased that Hospice UK is standing ready to distribute the money to local hospices across England. We are also providing £26 million of revenue funding for children’s hospices in England in 2025-26.”
“I thank my hon. Friend for this important question, and I commend the work of hospices such as Nottinghamshire hospice in his constituency, which I know does a wonderful job for people in his area. The investment I referred to in my earlier answer will help hospices such as Nottinghamshire hospice to provide quality end-of-life care to patients and their families this year and next. It can be used to improve IT systems, make it easier for GPs and hospitals to share vital data on patients, and help to develop and improve outreach services to support people in their own homes, when needed.”
“I thank my hon. Friend for that question. On her point about long-term funding, last week I chaired a roundtable with key stakeholders from the sector, and we were absolutely focused on developing a plan to secure the long-term sustainability of the sector. We cannot go back to the cliff edge that we have had over the last few months, primarily due to the utterly chaotic and shambolic way in which the Conservative party managed our system in the past.”
“I thank my hon. Friend for that question. One of the three shifts that the 10-year plan will deliver is shifting more healthcare out of hospitals and into the community. In the context of the plan, we are having discussions about the long-term sustainability of the palliative and end-of-life care sector, including hospices. As we develop the plan, we will be carefully considering policies in this area, with input from the public, patients, health staff and our stakeholders. As I mentioned in response to my hon. Friend the Member for Edmonton and Winchmore Hill (Kate Osamor), last week I was pleased to chair a roundtable to discuss long-term strategies for hospices to get palliative and end-of-life care, including hospices, on to a more sustainable footing after 14 years of Tory neglect and incompetence.”
“I am once again struck by the fact that Conservative Members seem to welcome the additional investment that the Chancellor has put into our health and care service, but do not seem to have any plan or proposals at all about how the revenue should be generated for that funding. Until we get an answer to that question, we will struggle to get much further in this House, although I note that Toby Porter, the chief executive of Hospice UK, has said that the “funding will allow hospices to continue to reach hundreds of thousands of people every year with high-quality, compassionate care. We look forward to working with the government to make sure everyone approaching the end of life gets the care and support they need”.”