Kit Malthouse
MP for North West Hampshire · Conservative · United Kingdom
“We have heard time and time again that the situation that thousands of our constituents live with every single day is so horrific and appalling that even the best palliative care cannot alleviate their pain. I urge colleagues to consider what their vote may mean today.”
“I will not. Some of those Members had just a few months before been specifically rejected by the electorate and replaced in this House by others, and I am afraid that they cannot be trusted not to do the same thing again. I grant my right hon.”
“The Health and Social Care Committee of the House of Lords found that in territories that have assisted dying, palliative care generally improves, because people become less afraid of talking about death.”
“One of the most affecting people I have met over the last 11 years of campaigning on this issue is Warwick Jackson, who came to our party conference a couple of years ago. Warwick’s wife, Ann, was diagnosed with terminal peritoneal cancer. She basically knew that she was going to die a slow, suffocating death at the end.”
“I respect my right hon. and learned Friend’s expertise in this matter, but, as he has already heard on the Floor of the House, it is perfectly possible for this House to suggest amendments, negotiate them with the promoters of the Bill, place them against the legislation in the House of Lords and then have them come back to this House for…”
“As co-sponsor of the Bill once again, I am acutely conscious that there is more at stake today than merely the fate of those who are facing their end, because the conduct of the other place means that our democracy is also on trial today.”
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“The Minister has laid out with some passion the dystopian hell that Gaza has become and the unfolding and ongoing disaster in the west bank. Why, then, as many Members have asked, has he done the absolute bare minimum? We all know in this House, after the previous rounds of sanctions, that there will be absolutely no difference on the ground for the Palestinians. I said last week—I am sorry to be cynical about it—that I thought the House was being played. My confident prediction now, given this announcement, is that recognition, which was being advertised for the conference next week, is off the table. Can the Minister tell me that I am wrong?”
“If the situation were reversed, we would now, quite rightly, be mobilising the British armed forces as part of an international protection force, so here is my question: what is the difference?”
“As the hon. Member for Liverpool Wavertree (Paula Barker) indicated, we are all frankly getting a bit fed up with the theatrics in this Chamber, and if I am honest with the Minister, it feels like the whole House is being played. He shows up and mouths the words, full of condemnation and saying he is appalled, and very occasionally the Government leak out just enough sanctions in order, frankly—I am afraid to say this, colleagues—to keep the Labour Benches from open revolt. And yet, since the Minister last appeared here, as others have mentioned, 22 new settlements have been announced, and the Israeli Government have replaced the United Nations Relief and Works Agency distribution system with a shooting gallery—an abattoir, where starving people are lured out through combat zones to be shot at.”
“Do those on the Treasury Bench need us to beg for the lives of those Palestinian children before they will trigger that concrete action, whatever it might be? I am urging the Foreign Secretary—I am begging him—to pluck up all his moral authority and courage, stand up in Government against the blockage in Downing Street, and please try to save those children’s lives as soon as possible.”
“The anger and the outrage of the Foreign Secretary is appreciated by us all, and I sense that it is genuine, but he knows as well as I do that the Israelis could not give a damn about what he says in this Chamber or indeed about the statement. As he will know, since that statement was issued, dozens of Palestinians have been killed and there have been voices of defiance from the Israeli Government. The statement mentions the taking of concrete action. I am not quite sure what the trigger for that is. Many of us in this Chamber have been trying to spur the Government into action over the past few months. We have tried anger and outrage and got nowhere, and we have tried shaming Ministers into action and got nowhere, so maybe we need to beg.”
“Further to that point of order, Madam Deputy Speaker. I wonder whether you can remind the House what the processes are for us to obtain an emergency debate under Standing Order No. 24, on the basis that this situation is so dire and so acute that a number of us may wish to apply for such a debate.”
“To me, the person who should be the most interested in their future is the person themselves. Any step we take that cuts across their privacy, their autonomy and the alacrity with which they can seek this solution to their impending or perceived agony seems a step too far. I do not understand how, practically, the commission is supposed to ascertain who those individuals are—are they neighbours, friends or just family? What is the definition of family? We need to put that contemplation and how they want to handle their death squarely in the hands of the dying person.”
“That will severely restrict access and may mean that patients who are partway through the process have to change suddenly because their doctor is time limited, pushing them out, notwithstanding the multiple safeguards we already have in the process. My right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright) gave an interesting speech about amendment 47. Again, in that amendment, he would be creating another step, another delay and another set of problems for the dying person to overcome or issues for them to address. In his amendment—I am sure he is a much better lawyer than me—I found it odd that he would effectively be creating an inexhaustive list of individuals who could be called upon in any circumstances who might be “properly interested” in the welfare of that individual.”
“They are thinking about what the nature of their death will be like and they are talking to their friends and family, putting their affairs in order, and being concerned about when that awful day is going to come. We have to have some compassion in the process as well as compassion in the purpose. When Members consider some of the amendments I will highlight, I ask them please to keep in mind that we will have to put these people through a possible two-month process at a moment when their time is severely limited, very often to less than six months. For example, new clause 7 and amendment 50, tabled by my hon. Friend the Member for Meriden and Solihull East (Saqib Bhatti), would restrict the number of patients that doctors can deal with in any 12-month period.”
“Before I discuss some of the amendments, I want to bring the House back to what we are trying to deal with: a set of people who have been told that their struggle with disease is over, that they are heading towards an inevitable death and that there is nothing more that medical science can do for them. What we are trying to do is to give them the chance to face death on their own terms. That is the simple mission that the House has been set. The second thing I want Members to contemplate as they look at this slew of amendments is that although it is easy to look at each amendment individually and see its merits or demerits, we must bear in mind the machine we are building as a whole, and the fact that we are putting those people through this process at a time when they are facing the end of that struggle.”
“I am grateful to you for that guidance, Madam Deputy Speaker. I am also grateful to the promoter of the Bill, the hon. Member for Spen Valley (Kim Leadbeater), for putting me on the Bill Committee where, in my view, we did some excellent work. Although we have heard an awful lot of claims about the process, I think anybody objective who reads the Bill that is now being reported to the House will recognise that it is a strong piece of work that is measured and seeks to strike a balance in a difficult area of complexity, humanity, compassion and morality.”
“The hon. Lady makes a good point, and it was a compelling point made in Committee and is certainly one that we recognise. That is why the amendments on training that she tabled in Committee were adopted—specifically to ensure that everybody involved in the process is sensitised to detecting those issues and to make clear that any doctor in the process, and indeed the panel, might want to know why family are not being informed. That is specifically why a social worker was put on the panel: to understand the psychosocial environment in which the person is taking that decision. Fundamentally, in the end, if I am facing my death in a matter of weeks and decide in my capacity that I do not want to inform my family, that is my choice. That is my decision. I may have to explain my reasons to the doctors, but—”
“But the one thing I have learned over the last 10 years from campaigning for and spending lots of time with dying and bereaved people is that towards the end of their life, they have absolute clarity about what they want, because it becomes clear to them towards the end what their death will be like. At the very least, they want to have this card in their back pocket to play if they require it. Remember: these are people who are facing death, who are struggling with death, and we have to give them the power to advance over it.”
“I am grateful, Madam Deputy Speaker; I will be swift. That is my choice, and this Bill is rooted in the need to give autonomy to those facing death who have capacity. We should take care to tread carefully upon that right. On the two amendments tabled by my hon. Friend the Member for Reigate (Rebecca Paul), new clause 16 says that somebody cannot be “substantially motivated” by certain considerations. I do not really understand what “substantially motivated” is meant to mean. To me, this misunderstands the complexity of what it must be like to be told that you are dying. The things that might run through your head—the affairs you might have to deal with, the news you have to break to your family, the impact it will have on your small children—form a cocktail of motivations.”
“Friend the Member for Gainsborough (Sir Edward Leigh) said, people may suddenly find that they have to uproot themselves, after years of living in a care home, and relocate to get the kind of death that they want. In effect, the amendment prioritises the rights of somebody who is providing accommodation over the rights of the dying. As I said on Second Reading, in my view, as they face their end, we should prioritise the rights of the dying.”
“Sorry, but I am conscious of time. Finally, amendment (a) to new clause 10, which we might divide on this afternoon, is difficult. We debated a similar amendment in Committee. As sponsors of the Bill, we are clear that there should be a conscientious objection clause to allow individuals to opt out, and that is strengthened by new clause 10. But allowing an employer—any employer—to say that any employee in their employment cannot participate if that is what they decide seems to me a step too far, and it could prove to have unintended consequences. First, the board of every healthcare trust in the country will become a battle for control between those who oppose and those who do not. As my right hon.”
“claimed to move the closure (Standing Order No. 36). Question put forthwith, That the Question be now put. The House proceeded to a Division.”
“What advice has the Minister taken on the liability that will attach to him as a decision maker? Have the Government received advice on whether the Prime Minister, the Foreign Secretary, any senior officials or previous Ministers may be exposed when the reckoning comes?”
“It is becoming increasingly difficult to keep up with the slaughter in Gaza, the brutality and cruelty on the west bank, and starvation as a policy. The crimes come daily, such as the recent killing of Mohammed Bardawil, one of only three key eyewitnesses to the slaughter of rescue workers just a few weeks ago, whose bodies were buried in shallow graves. It is clear to everybody that crimes are being committed daily. As a number of Members have pointed out, the UK is a party to international agreements that provide a positive obligation to act to prevent genocide and torture and protect the rights of others. We have an obligation, as a member of the United Nations Security Council and a state party to the Geneva conventions, to promote peace and security.”
“As a number of Members have said to the Minister, speed is obviously of the essence. I have two questions. First, even though I hear him say that there is a backstop date by which he wants everything to be completed, would it be possible for individual applicants to have a target landing date on which IBCA will contact them? That way, their expectations are managed and people can think about their affairs in due course. Secondly, can the Minister say, hand on heart, that IBCA has enough resources? If it had twice as many people, could it move twice as fast?”
“He is an intelligent man. Can he not see the moral and tactical case for a change in strategy that might bring about peace?”
“After 18 months of the diplomacy that the Minister referred to, it is clear that Israel has not significantly complied once. After watching children being shot in the streets, medics and hospitals consistently targeted, British citizens and rescue workers murdered and their bodies concealed, red lines such as Rafah reduced to rubble, and the hostages still in captivity, we now learn from an Israeli Government Minister that Gaza is to be “entirely destroyed”. We are watching the livestreamed starvation of an entire people. The Minister talked about his anguish, which I know is genuine, but can he not see what the majority of the House can see, which is that he is facing a catastrophic failure of Government policy, for which the Palestinians, the Israelis and the rest of us may well pay a heavy price for many years to come?”
“This is obviously a deeply alarming development, coming as it does off the back of proposed financial penalties for foreign non-governmental organisations that are operational in the Occupied Palestinian Territories, which also bear witness to what is going on there. Will the Minister enlighten us about two things? First, it would be helpful for parliamentarians if, in his discussions with the Israeli Government, he could ask them for a comprehensive list of MPs who will not be permitted to travel to Israel from here on in, so that we get a sense of the scale of their objection to what we say in this House. Secondly, will the Government still be entertaining high-level military delegations from Israel on their premises?”
“I am extremely grateful to the Minister for giving way. He talks about national impact. I wonder what provision there is under this legislation for protected national landscapes. Many of the windiest places in the UK are among our most beautiful, whether it is the hills and mountains of our national parks or the downs of our national landscapes, like the North Wessex downs in my constituency, which was an area of outstanding national beauty but is now a national landscape. Many of my residents are concerned, because the Minister is quite right that the turbines that are now being developed are huge. It is likely to mean that for most of our lifetimes we will lose the landscape to these new developments. Will this system still encompass consideration of protected landscape and make sure that it stays as it is for future generations?”
“I understand that this particular sector is out of fashion with the Government, but one of the other sacrifices is likely to involve Scotland’s, and indeed England’s, precious raptor population. Raptors often suffer as a result of high-density wind farms and are effectively minced as they fly through the air. In California and elsewhere, we see high numbers of bird deaths, particularly birds of prey. Would the Government not be better off, in my hon. Friend’s opinion, putting their time and investment into low-orbit solar, in which the UK, along with Japan, leads the world?”
“As well as the contempt being shown for local communities and consultation, does my hon. Friend lament the lack of imagination? There are plenty of places where many people would welcome solar farms, such as on motorway and railway embankments. They could easily be delineated for such development, and it would not necessarily impact on our landscape. There is also the continuing lack of any compulsion for the inclusion of solar on warehouse roofs. We could probably create exactly the same amount of power as his constituency is likely to create by putting solar panels on the roof of every warehouse in Park Royal to the west of London. Again and again, we look to virgin land first, rather than being imaginative about better solutions.”
“Does my hon. Friend share my concern that the regulations could be of serious detriment to the UK’s synthetic biology research community? Significant effort is going into the creation of engineered bugs that can turn renewable matter, such as sugar cane, into fuel for internal combustion engines. In a circular economy, that would represent a completely renewable source of energy that would be carbon neutral throughout its entire life cycle.”
“We have heard Secretary of State after Secretary of State condemn the increase in settlements and settler violence in the west bank over the last 30 or 40 years and it has made not the slightest bit of difference to their expansion. When will the Foreign Secretary accept that the only thing that the Israelis will respond to—we should not forget that these settlements are sponsored by the Israeli state—is action? When can we expect more sanctions, particularly on violent settlers and their organisations? When can we expect a full trade ban on settlement produce? In particular, will the Secretary of State consider proscribing those settler organisations that are perpetrating terrorism on an innocent Palestinian population?”
“It is good to hear that there is continuing investment in the search for therapies and indeed cures to deal with this horrific disease, but even if therapies do emerge, one of the frustrations in getting them to patients may be the inability of scientists to obtain access to clinical trials. In “Life Sciences Vision”, published in 2021, a number of groups combined to look into access to clinical trials in the UK and the possibility of increasing the number of such trials, but acceleration has not been good. I chair the all-party parliamentary group for life sciences, and one of the comments I hear most frequently in the industry is about the need for a more focused effort in this regard. Would the Minister consider establishing a clinical trials taskforce in her Department to drive this important work forward?”
“I am not clear: is the hon. Lady suggesting that doctors who operate in the private sector are less ethical than doctors who operate in the public sector?”
“I am sorry if I have failed to understand what the hon. Lady is saying, but under the Bill as it stands, every single stage is supervised by a doctor, even the final moments. I fail to see how the motivations that she seems to be applying to the private sector, malign or otherwise, might affect the conduct of the doctors, given that she accepts that doctors are equally ethical in the private and public sectors, unless she thinks that those motivations are pressuring doctors to behave unethically.”
“The hon. Gentleman is making a strong point. Surely what should be at the heart of the organisation’s disposition is consideration of the condition and circumstances of the patient. Whether on the cancer ward, in the hospice or at home, the health service adapts, and has adapted with all sorts of treatments, to dealing with the different circumstances of the patient that it encounters. We must have a system that is flexible enough to allow it to do so for this.”
“I wonder whether the Minister would entertain a suggestion. I think the extension to four years is going to cause some concern and questions in the House on Report and Third Reading. Given that the Minister is committing to reporting on a six-monthly basis, it would be helpful if the House had a broad plan against which the Government were reporting on implementation. Does the Minister think it is a good idea, on Report or Third Reading, to come forward with an outline timetable, worked up as part of the general assessment of the project?”
“Essentially, I was trying to point out that four years is obviously a backstop. It may well be that the Government are able to deliver the service in advance of the four-year deadline. It might be helpful at later stages of the Bill’s progress—certainly in the Lords—if the Government are able to give an indication of what they think the likely timeline might be. Admittedly, there will be flexibility in there, but that might assuage some of the concern raised by the hon. Member for Stroud that four years is quite a long time. The commissioner is going to be appointed at the 12-month mark, and that might accelerate some of the work, but I think having an indication may be helpful for Members.”
“I have seen these clauses in standard legislation before. As I understand it, they are often put in place where new organisations are being established and there may be knock-on effects—for example, where an organisation decides to give itself a particular name or changes its name from the one that is in the Act. It tends to be those small things where powers are vested in the Minister effectively to tinker and sandpaper at the end, to get the organisational structure correct.”
“I am sure the hon. Lady understands that a vote of that nature would not necessarily be binding, or compel the Government to do anything, but there would be other opportunities for the House to consider the legislation in debate and vote on it. She knows that there are a number of ways to do that, including via a Backbench motion or an Opposition day.”
“My hon. Friend is making a good point, but I want to make a constructive suggestion. It might be worth our having a look at Switzerland, where advertising is actually banned but the provision of information is not. It is a fine line, but the Swiss seem to get the balance right.”
“As my hon. Friend rightly pointed out, nature can be effectively compensated for only in certain circumstances, but landscape can never be replaced: once it is gone, it is gone. Does he think there should be scope in this Bill to recognise the special status of protected landscapes—what are now called national landscapes or national parks—to ensure that development in those areas is appropriate and does not permanently damage our precious landscape for future generations?”
“What is it about the Palestinian people that means they are less deserving of that kind of protection?”
“It has been estimated that in the opening salvos of this appalling aggression, the Israelis killed 80 Palestinian children in the space of 51 minutes. There have been reports of children going through amputations without anaesthetics because of the blockade, and that leaflets were dropped across Gaza last night threatening extermination. Surely even for the Government, the Israelis have now crossed a monstrous red line. The Foreign Secretary talks about “equivalence”. I am assuming that he believes that the Palestinian civilians and their lives are equivalent to the lives of Israeli citizens, and are also equivalent to the lives of Ukrainian citizens. This morning, Ministers were on the airwaves offering British troops to keep the peace between Ukraine and Russia.”
“Having said that, there is no institutional objection power in law for abortion: people just do not offer it because they do not have the staff to offer it. It feels to me as though that is what the hon. Gentleman is pointing to.”
“Having also thought about this overnight, I think there is a freedom-of-association argument. If it were a Roman Catholic organisation designed just for Roman Catholics to live in, such as a home for retired priests, or if it were a Jewish organisation just for Jewish residents, I could see that, but that is not a service that is generally on offer to the public. My concern is whether we could see a situation in which the board of trustees of Hampshire hospitals foundation trust has a majority of people who have a strong religious conviction, and they vote that the service shall not be provided across the three hospitals that the trust manages. If the provision is drawn tightly and the freedom-of-association argument could be made, I could see it.”
“This is obviously a difficult and sensitive area, but does the hon. Lady think, for example, that a women’s refuge run by a Catholic foundation should be allowed to evict a woman who wants or has an abortion?”
“The hon. Lady is outlining the issues very effectively. No one, of course, is saying that anybody who works at the hospice that may object has to participate. It may say, “No one here will assist.” We have talked about the importance of place. To a certain extent, I have a right as a tenant in a place where I am resident. It seems that my hon. Friend the Member for East Wiltshire is proposing actively to prevent someone from being able to access this in a place that they choose. That feels to me the wrong balance. I wonder whether that is broadly where she is heading.”
“To clarify my remarks, I was not necessarily saying that they should have the right to deny, but by default they would if they were, in effect, a closed community that was discriminating in favour of like-minded individuals—a home for retired Catholic priests, for example. By default it would be someone who was unlikely to offer those services. The other point to ask is: if I am in a hospice, in my bed at the last with visitors coming to see me, and one of those visitors is the doctor who is coming to administer to me, I am not quite sure how that would be prevented, unless people are willing for there to be a wrestling match at the door of my room.”
“I am wondering about the difference between my own home with my partner, and my care home with lots of people that may or may not be strangers, and why I should have the right in one but not in the other.”
“It would be interesting, if my hon. Friend’s amendments go through, to see the series of plebiscites taking place in care homes and communal situations across the country as to what the residents do and do not want, presumably by a majority. He asserted that there had been a mass exodus of healthcare workers when VAD came in, but I am struggling to find any evidence to support that claim. In fact, the evidence seems to say that that is not the case. Although there have been some resignations, that has largely been because of pay and conditions, as one might expect.”
“Will the hon. Lady respond to the point about injunctions? The Minister might want to respond to this as well. My understanding is that in order to obtain an injunction, someone does not have to establish that there is either a civil wrong or a criminal offence. They have to establish that there is a serious matter to be adjudicated, and that there is a strong likelihood of harm taking place. In those circumstances, a court would consider granting an interim injunction, subject then to a further hearing, ex parte or otherwise. The idea that some kind of civil tort needs to be established is not actually correct in seeking an injunction.”
“As the Minister said, this is not an unusual exercise for the CPS and operates in lots of other areas. For example, the CPS regularly makes decisions about whether to charge someone with grievous bodily harm under section 18 or section 20 of the relevant legislation—they are both forms of GBH. Which one the CPS chooses depends on the circumstances, the seriousness and the level of intent. As she said, the charge naturally—whether it falls under the same Act or a different Act—comes down to the circumstances.”
“I am very sorry to intervene on the same point as the hon. Member for Spen Valley, but clause 28 is not about the formulation of the drugs or their approval; it is about the administration of the issuing of the drugs by a pharmacist or otherwise. I am sorry if I am misconstruing the hon. Gentleman, but I think he might be off on a bit of a tangent, on a debate that, as the hon. Lady said, we had earlier. As I say, this clause is about the bureaucratic process of the issuing the drugs, not about their formulation or approval.”