Sarah Green
MP for Chesham and Amersham · Liberal Democrat · United Kingdom
“Does the hon. Gentleman agree that the closure order powers that we have in this country are not fit for purpose? Until local authorities have the power to act swiftly and decisively, organised criminals will continue to exploit our high streets with impunity.”
“Like local authorities across the country, Buckinghamshire council submitted its SEND improvement plan on 19 June, but it will not receive a decision on deficit relief until 21 September, after the school year has started. With a cumulative deficit of over £45 million already on the books, it is being asked to plan blind.”
“The Secretary of State will know that nearly a third of those who work in the creative industries are self-employed. I have been contacted by creative freelancers in my area who feel that their voice is not always heard.”
“Communities such as Chalfont St Peter have suffered appalling circumstances in recent years, including flooding and sewage bubbling up through the drains. Thames Water has promised capital investment to address these issues.”
“Q8. Yesterday, at an event here in Parliament, I spoke to women whose children suffered avoidable harm after they continued taking the epilepsy drug sodium valproate during pregnancy. Doctors knew the risks and patients were not informed, and that has had devastating consequences.”
“Not only are small businesses facing increasing energy bills, but they are dealing with prohibitive costs in connecting to the grid when they want to expand.”
The complete record
Every one of 329 lines we hold for Sarah Green, in date order, each linked to its source. Free to read, in full, without an account. Page 2 of 7.
“I have too many constituents whose financial abuse is effectively being perpetuated and facilitated by the Child Maintenance Service. I have secured a meeting with the relevant Minister in the other place, but it has been postponed. Could the Minister help me to secure a date for that meeting? I am sure that he would agree that if the system is at fault, it needs to change.”
“It is my belief that it is stronger for having gone through that process. There is one change in particular I would like to speak to, which is the inclusion of social workers on the panel. People in that profession deal with complex, challenging, and sometimes dark family dynamics on a daily basis, and I believe that including them on the panel is the right thing to do. For those reasons, I will be supporting this Bill today, and I hope others will too.”
“I rise to speak in favour of this Bill. First, though, I thank the hon. Member for Spen Valley (Kim Leadbeater) for the way in which she has approached the Bill, and for having engaged with Members across the House on both sides of the argument on their various amendments. I voted in favour of the Bill on Second Reading on principle, but also because of something a constituent said to me about the status quo. She said, “It is cruel”, and I cannot disagree with her. It was definitely cruel for my constituent Ann, who was interviewed by the police for supporting her husband in going to Dignitas. For weeks afterwards, in her grief, she faced the uncertainty of a police investigation. For me, the current system is unsatisfactory, and it was a real privilege to join others to scrutinise this Bill in Committee.”
“I thank the Minister for his response. He will know that some projects are waiting up to 15 years to connect to the grid, and the Secretary of State earlier referred to the zombie waiting list. Could I push him further and ask precisely what concrete steps the Department is taking to drastically cut that waiting list?”
“Link found that Chalfont St Peter did not meet the criteria for a banking hub, yet one in five people there is over the age of 65, and Age UK found that 40% of over-65s with a bank account do not manage their money online. Some of my constituents in more rural areas also face broadband connectivity issues, restricting their access to online banking. My plea to the Minister echoes the calls already stated to review the criteria by which towns are assessed for banking hubs. Accessibility gaps must be considered, including access to broadband, and whether residents have adequate access to not only cash—the current criterion—but in-person banking services.”
“In the last five years, 11 bank branches have closed in my constituency, leaving most towns without traditional banking facilities. For example, two years ago the closure of Barclays in Chalfont St Peter triggered the assessment for a formal banking hub. While I recognise that alternative provision is now delivered by the post office or in small pop-up locations on an appointment-only basis, those alternatives do not go far enough. They are unable to meet all needs, forcing people to travel further afield to find basic banking services and advice on mortgages and debt—and, as the Minister will be all too aware, asking people to rely on a bus network that is increasingly cutting services.”
“My constituent was subject to financial, physical and emotional abuse by her ex. She was also cyber-stalked; her social media accounts were hacked for details of her location, and for information about their children. Despite being granted a non-molestation order and a prohibited steps order, she was unable to compile sufficient evidence of the cyber-stalking to be granted a stalking protection order. Speaking to her, her fear is palpable. What steps is the Secretary of State taking to ensure that victims are supported in compiling the evidence that they need for a stalking protection order?”
“What timeframe is the Department working to? I am not the only Member present who has asked that question, and it would be helpful to get confirmation from the Minister.”
“I accept that the Minister is in a difficult position, because she is presenting the case for the Government’s position and cannot take a position herself. I will just gently ask whether she accepts the weariness of Welsh language speakers and campaigners over generations, who have been faced time and again with the same argument—of operational challenges, whatever that issue may be. I suggest to her that perhaps it is time that the Government stopped using that excuse.”
“It is the language that they dream in, the language they count in and the language that they are most comfortable using, so when it comes to end-of-life conversations it is important that they can use the language in which they are most proficient and fluent. Should an individual choose to access an assisted death through the medium of Welsh, they should be able to do so without the use of an interpreter. Crucially for the panel, that means that where an individual has chosen that route, the panel will need Welsh proficiency. Welsh speakers have had the right to ask for services in Welsh for years now, so assisted dying should be no different. That is why services in Welsh need to be on the face of the Bill. I wholeheartedly support the amendment and will vote for it if the right hon. Member chooses to press it.”
“I rise to speak to two aspects of this group of amendments. The first is the inclusion of social workers. When we first started receiving written evidence, I found the submissions from social workers the most compelling. I agreed with them that their profession has a key role to play in the process. I am pleased that they will feature on the panel: I believe that that will strengthen the safeguards in the Bill. My second point relates to amendment (a) to new schedule 2, in the name of the right hon. Member for Dwyfor Meirionnydd. I was fortunate to grow up in a Welsh-speaking part of rural north Wales. I am a Welsh speaker, and Welsh is the first language of some of my friends, my neighbours and my family members.”
“Chesham grammar school, in my constituency, has received exceptional funding from the Department for some years to facilitate the hire of the neighbouring leisure centre’s sports hall for PE lessons. This year, the school’s application has been denied, despite its circumstances not having changed; it still has no on-site sports hall, and it still needs to fund the £65,000 hiring fees each year. Will the Minister meet me to discuss this particular case to ensure that the students of Chesham grammar school have access to the PE curriculum the school is required to provide come September?”
“We have had a good debate on the amendments in this group. I do not intend to push amendment 278 to a vote, and I have nothing further to add to my previous remarks. I beg to ask leave to withdraw the amendment. Amendment, by leave, withdrawn. Amendment proposed : 8, in clause 4, page 2, line 16, leave out from “practitioner” to end of line 20 and insert “shall raise the subject of the provision of assistance in accordance with this Act with a person who has not indicated to that or another registered medical practitioner that they wish to seek assistance to end their own life”.— (Daniel Francis.) Question put, That the amendment be made.”
“The hon. Lady will know that the Welsh Language Act 1993 put the Welsh language on an equal footing with the English language in Wales. Does she agree that it would be helpful to have clarity on whether the provisions in that Act apply to the Bill?”
“This amendment would prevent a doctor from raising assisted dying with a patient if that patient had previously recorded an advanced decision that they would not in future wish to seek assistance under the Act.”
“I beg to move amendment 278, in clause 4, page 2, line 16, leave out from beginning to “nothing” in line 16 and insert— “(1A) No registered medical practitioner may raise the subject of the provision of assistance in accordance with this Act with a person if that person has made an advanced decision which has been recorded in their medical records that they will not in future wish to seek assistance under this Act. (1B) The provisions in subsection (1A) do not prevent a person indicating to a registered medical practitioner that they wish to change their previous decision and seek assistance under the Act if they have the capacity to do so. (2) Other than the condition in subsection (1A),”.”
“It also allows for such an advance decision to be reversed—it allows for people to change their mind. What is not clear to me is how enforceable this provision would be, or what legal status such an advance decision would have. I have great sympathy with the aim of the amendment, so I am keen to hear from the Minister on the point. It may be that an alternative amendment that achieves a similar aim can be tabled to a later clause, if amendment 278, as drafted, is not workable.”
“I will be brief. Amendment 278, tabled by my hon. Friend the Member for Wells and Mendip Hills (Tessa Munt) has some merit. It seeks to offer a more formal protection to those who are certain that they do not, and will not, want to avail themselves of the choice to end their life if they are terminally ill at any point in the future. It attempts to do so through an advance decision recorded on their medical records. A person’s ability to record their wishes now, as opposed to at some future crisis point, might allay a number of concerns, in particular for those who are fearful of coercion. Being able to say, “This is not for me”, and knowing that it will not be raised with them, might offer some people a degree of reassurance, so I think that the amendment has some merit.”
“I have great sympathy with amendment 11 in particular, which is clearly motivated by a desire to ensure that having a mental illness or disability alone does not qualify someone for an assisted death under the Bill. It is worth saying that clause 2(3) already does that and, therefore, the amendment is not necessary. However, the hon. Member for Spen Valley has tabled amendment 181, which further tightens that language. In my view, amendment 181 strengthens the Bill by simplifying the language to make it absolutely clear that a person is not considered to be terminally ill if they have a mental disorder or a disability alone. The chief medical officer, Professor Whitty, encouraged us to keep this simple, and that is precisely what amendment 181 does. Therefore, I support the amendment.”
“The board’s report states that the statistics and experience of Western Australians “confirms…that voluntary assisted dying is an established and enduring end of life choice”. For that reason, there has been quite a significant awareness that practitioners should be able to bring up voluntary assisted dying with the patient as part of that suite of end-of-life choices. That has been something that the evidence has suggested is very important, because if the practitioners are feeling that they cannot raise it in that context, that is having a detrimental effect on the patients who would like information on it. That has been our experience in Western Australia.”
“Baked into the principles of our legislation is access to palliative care for all citizens of New South Wales. Importantly, throughout our debate, whether Members supported or opposed the reform, our entire Parliament came together to ensure palliative care received an increase in funding and any access issues were addressed. The Australian experience with voluntary assisted dying is that it benefits and strengthens the palliative care system. Professor Blake: Can I can I add to that? The Voluntary Assisted Dying Board in WA, as in all the other jurisdictions, produces a report. The very strong sentiment of the Voluntary Assisted Dying Board, and indeed within the Western Australia community, is that voluntary assisted dying is seen as part of the end-of-life journey.”
“It has been embraced, to be honest. In another five years, I think there will probably be very few palliative care practitioners who do not support this, unless they are true conscientious objectors for their own reasons—I guess, probably religious reasons. Palliative Care Australia and the peak medical bodies in Australia have generally shifted to see this as part of patient choice. Alex Greenwich: The journey to voluntary assisted dying in New South Wales, and indeed across every Australian state, has benefited palliative care access and funding. In New South Wales, 85% of people who have accessed voluntary assisted dying are receiving palliative care. As part of the process, the co-ordinating and consulting practitioners also advise them on palliative care. The doctors are trained on the latest advances in palliative care.”
“Voluntary assisted dying is about end-of-life choices. It is about putting the patient and the individual front and centre, and working with them. That is fundamental to palliative care. We have realised that voluntary assisted dying is a promotion of palliative care and it gives back choices. Probably some of the older palliative care clinicians have not embraced voluntary assisted dying quite as much. That is probably very generalised, but certainly new consultants and new doctors that are coming through really see this as something that they want to do. I do not think that there is any animosity any more between the practitioners that choose to work in this space and those that do not. I get huge amounts of support from other palliative care physicians that do not necessarily act as practitioners. There is no real divide.”
“Q On that point about palliative care, I will direct my question to Dr Furst. What has been the response from palliative care professionals to the introduction of assisted dying in Australia? We have heard evidence from people working in the sector in the UK, but I am keen to hear about your experience in Australia. I understand that Palliative Care Australia’s national workforce survey explicitly looked at this, so I am keen to hear what its findings were. Dr Furst: It has been a journey, certainly. Victoria started their voluntary assisted dying in 2019. I would be lying if I said that the palliative care community were completely on board with it at that point, but over the last five to six years there has been a real shift in mentality. We have seen that they can go hand in hand. Palliative care is about end-of-life choices.”
“There is 20 or 30 years’ worth of data, which we have drawn on in Scotland, and there is four years’ worth of work in Scotland that this Committee and this Parliament could look to. I would also make the point that the data is peer-reviewed and evidence-based. You really have to trust your international colleagues. The data is from Government bodies, from Health Departments, from independent academic peer-reviewed work and from independent review boards. We are now looking at fact rather than at falsehoods or concerns, as we were back in 2010.”
“With the Assisted Dying for Terminally Ill Adults (Scotland) Bill, we have been working with international experts since 2021, and we have had various consultation processes. It is currently with the Health Committee of the Scottish Parliament. We set up a medical advisory group, chaired by Dr Sandesh Gulhane MSP: a group of almost a dozen practitioners in palliative care, mental health experts, geriatricians and other interested stakeholders. It produced a report for us on the medicinal aspects of the Bill. That has been a four-year process. I understand that concerns have been voiced in this Committee that things have proceeded at pace, but I would argue that you are not pioneers.”
“Q Dr Ward, I am keen to hear about your work on the Bill in the Scottish Parliament and about how best practice in other jurisdictions has informed the legislation that is currently going through Holyrood. How has it influenced and informed that draft? Dr Ward: I was the adviser on the previous Bill in Scotland as well, under Margo MacDonald MSP and Patrick Harvie MSP. That was in session 4 of our Parliament; we then did not have a Bill in session 5, which is when we set up things like the cross-party working group on end-of-life choices and I did the PhD. Luckily, we saw a domino effect internationally in session 5; there were various jurisdictions legislating for it. When we came to draft this legislation in 2021, in session 6 of the Parliament, we had decades of data that we had not had when Margo made her first attempt back in 2010.”
“Whether that would be a prudent or an appropriate thing to do, or even what one might describe as a constitutionally appropriate thing to do, is another matter. I think it reinforces the point that there is a significance in making sure that scrutiny of the Bill has a Welsh focus. You might consider, for example, making different provision in Wales. How do you respect what was a democratic vote in the Senedd in Cardiff? Well, you might consider having different commencement provisions—I am not advocating this, it is just an example of what you might do. Commencement of the Bill in Wales might happen in a different way, on the assumption it was passed. You might put that in the hands of Welsh Ministers and the Senedd, just as an example.”
“Q To follow up on what you just said about legislative consent, in October of last year, the Senedd voted against Julie Morgan’s assisted dying motion. In your opinion, what implications does that have for the Bill and its progress? Professor Lewis: A motion was put forward by Julie Morgan that was supported by three or four Members of the Senedd, which was broadly in support not of this specific Bill, but of the purpose of this Bill, and it was defeated, as you say, after a full debate on the Floor of the Senedd. Formally, legally and constitutionally, that is of no consequence, because it was not a legislative consent motion, and of course, as I said earlier, this Parliament is able to do what it likes. It could totally disregard that.”
“We also have guest speakers from national and international viewpoints to continue to educate us as a group, and to ensure that our practice is consistent and in line with local and international standards.”
“They put themselves forwards and do that training, and then that training has to be refreshed and updated every three years. I have five hospitals in my health network, and together with my colleagues I developed a very comprehensive package of training, education and awareness that is tailored for people who may have a role in this at various different levels, from a nurse on the ward all the way through to someone who actively taking part in the process. A very wide range of documents and training packages have also been developed by our Department of Health. In addition, all practitioners who work in this space are invited to become members of our community of practice, where we share peer education and experiences.”
“Not unsurpris-ingly, it includes things like how to assess capacity, how to detect coercion, how to assess for voluntariness, and how to determine the various different eligibility criteria that apply in our Western Australian law. To be able to access that training and become a voluntary assisted dying practitioner, a person already has to be a doctor of quite some standing in their own specialty. They have to be a consultant in a specialty with at least one year of full-time practice under their belt, or a general practitioner with at least 10 years of broad experience. We are not talking about junior doctors being able to offer this; we are talking about doctors of significant clinical standing with a very broad range of patient experiences.”
“Q 157 I am keen to hear about the training, education and clinical supervision you have in place for assisted dying. Perhaps I will address that to Dr Fellingham, but I am sure you could all answer. Dr Fellingham: Certainly. The training is very stringently developed, and very rigorously tested. Our management training practice, which is required of all doctors who want to practice assisted dying, was developed by our colleagues in the Australian Centre for Health Law Research at the Queensland University of Technology. It drew on extensive research that the group had conducted around the world to create an online training package that takes at least a day to complete and covers a huge amount of things that are of great concern.”
“Sometimes, a palliative care team will intervene in those situations, because the professional and legal framework that is meant to guide this practice is just not happening. It is a very fraught and tricky area. If there is one thing that I would say to the Committee regarding making the Bill as robust, strong and safe as possible, it is: please consider seriously the matter of education and training from day one of medical school onwards. Death is at the periphery of a medical school curriculum. Death and dying are not taught. You might get a week of palliative care in five years, and that has knock-on effects all the way through, at every level of seniority in the medical workforce.”
“I would suggest that anybody who pretends that those assessments are easy and routinely done well in the NHS has not got enough experience of observing that happening. I teach capacity assessments to doctors and medical students, and it is often the case that they are very poorly conducted. The doctor often does not understand the criteria for assessing capacity. That is if it happens at all. Sometimes, a paternalistic doctor will decide that a patient is dying, and we should stop their antibiotics because they are clearly now at the end of their life. They have a chat with the family, who say, “Yes, we agree,” and nobody talks to 82-year-old Mrs. Smith and asks her what she feels about it, because they assume that she does not have capacity because she is old. I see that regularly.”
“If consent is not informed—and it is not informed if we are not laying out all the different options to a patient—we are denying patients the opportunity to make decisions for themselves. A patient is always able to refuse every treatment, and in particular every life-prolonging treatment, that they choose to, provided they have capacity. We, as doctors, may think that a decision is unwise, but that is irrelevant, because those days of bad old paternalistic medicine are gone. The patient makes the choice. If a patient says, “I do not want chemotherapy. I do not want to eat. I do not want anything at all—no treatment”, we respect that, unless they lack capacity. The elephant in the room with all of this is the capacity assessments.”
“Q Dr Clarke, what are the existing statutory guidelines on end-of-life practice? How are those decisions logged, recorded and monitored? Dr Clarke: The fundamental principle is always that, by default, the patient has capacity unless there is clear evidence that they do not. We presume that patients have capacity. As doctors, we are obliged to ensure that patients have informed consent when deciding between different treatments. That means we need to lay out the whole array of treatment options, and the risks and benefits of each, to empower individual patients to make decisions for themselves. Regarding the issue that has been alluded to of whether doctors should be prohibited from raising the issue of assisted dying, it is my belief that that would fundamentally alter the doctor-patient relationship.”
“Q I have a follow-up question. The Bill introduces a monitoring and review process, including an annual report by the chief medical officer. Do you have any reflections on whether that needs strengthening? Dr Clarke : Yes, I think that in the spirit of transparency and making this as safe as possible, it needs to be significantly strengthened. I would suggest that there need to be more safeguards in place. For example, if anyone in a hospital—whether staff, patient or family member—has concerns around a particular case, there should be mechanisms for those to be raised in a proactive way. Just as we have guardians of safe working and freedom to speak up guardians in hospitals, those opportunities to assess and appraise the safety in real time once a Bill is in place—I just do not think they are robust enough at all.”
“The Department for Education’s own survey showed that only 63% of classroom teachers felt able to meet the needs of pupils with SEND. I am keen to hear from the Minister on what work is ongoing to help give the current teaching workforce the training and confidence they need to meet the demand in our mainstream schools.”
“Only 49% of children in Buckinghamshire receive their EHCP plan within the statutory limit, which means that more than half are waiting way beyond that time frame. There are hidden impacts to those delays: one family in my constituency faces a three-year waitlist for autism spectrum disorder and ADHD assessments. They have serious concerns about their current accommodation, but the lack of diagnosis for their son is delaying their eligibility for suitable housing. That is three years in unsuitable housing with no additional support. I have spoken to schools in my area that say they have children with EHCPs who would be better served in a specialist setting. The demand for places means that they remain in mainstream education, where, in the words of one local headteacher, that the SENCO workload is unsustainable for staff.”
“The Liberal Democrats welcome the humanitarian support that the Government are giving to Sudan. We also recognise that greater protections are needed for women, children and ethnic minority groups. In the light of the failure of the United Nations to back safe areas, what is the UK doing to create safe zones for schools and hospitals in Sudan?”
“A recent National Audit Office report makes it clear that, without reform, the SEN system is financially unsustainable. The Minister will know that, since 2020, local authorities such as Buckinghamshire council have been able to exclude their dedicated school grant deficits from their main revenue budgets. That statutory override means that local authorities do not breach their duty to set a balanced budget, but it is due to end in March 2026, and there is currently no identified solution. Can the Minister share more on what urgent conversations she is having with colleagues to ensure that local authorities get the certainty they need?”
“T5. What steps are under way to recruit and retain more educational psychologists so that children, including in Chesham and Amersham, do not have to wait as long as they currently are for the assessment they need?”
“In the words of the Patient Safety Commissioner: “it is now urgent for the government to give those families some clarity. Many of them live with pressing financial hardship, as well as physical pain and disability…we must not compound the physical and mental harms experienced by these families by setting and raising false expectations if there is no intention to deliver on redress.””
“After originally rejecting those two recommendations, the Health Minister at the time asked the Patient Safety Commissioner in late 2022 to look at the options for providing redress for those who had been harmed by mesh and valproate. The commissioner’s report—the Hughes report—was published in February. I was present at its launch, and it really felt like a milestone; it felt as though progress had been made. Surely the Department would not commission that work if it had no intention of following through on a redress scheme. That was in February this year. By the summer, when the election was called, the previous Government were still saying that they would respond to the report, so they never gave a formal response. To date, there has been no official response from the new Government to the Hughes report.”
“Carol and others like her were given hope when the Cumberlege review was initiated, and again when it was published in July 2020 with its nine recommendations. I am sorry that to say that not enough progress has been made on those recommendations since. The reality is that only two of the nine recommendations have been implemented in full. The first was an apology, which was given as soon as the report was published. The second was to establish the office of the Patient Safety Commissioner. Beyond that, things have stalled. Recommendations 3 and 4 called for an independent redress agency, and for redress schemes to be established for all three interventions.”
“She had to take long-term sick leave from her job as a doctor and could not remember a day without pain. When she contacted me for help with her visa, she was seriously unwell and had been told that she urgently needed her mesh removed or her prognosis was not good. We managed to get her the visa she needed. She is now mesh-free following a successful removal, and she is the first person in England to have undergone successful rectal mesh removal. She is still suffering, but is no longer in the same danger that she was. She is clear that she was able to look outside the NHS and the UK only because her medical training and personal resources enabled her to find Dr Veronikis, who treated her successfully. I should say at this point that there needs to be more awareness of rectopexy mesh, which affects men, women and children.”
“Let us not forget that the Cumberlege review was called “First Do No Harm”, because at its centre are people who suffered avoidable harm—harm done to them by our health system. I was first introduced to this issue by my constituent Carol. I have shared her story before and remain in awe of her dignity and desire to help others despite having experienced the most devastating medical trauma. She needed her MP to help her get a visa for the United States for urgent medical treatment during the pandemic because of the travel restrictions that hon. Members will remember. She had undergone a hysteropexy and a rectopexy using surgical mesh. Instead of resolving Carol’s pelvic organ prolapse, the procedures left her with a serious autoimmune disease, struggling to walk and unable to continue her normal daily life.”
“Member for Godalming and Ash (Jeremy Hunt), when he was Health and Social Care Secretary, and to the former Member for Maidenhead, when she was Prime Minister, for commissioning the review in the first place in February 2018. Baroness Cumberlege has never stopped giving voice to those she encountered during the two years she led that review. She has gone to great lengths to keep this issue on the agenda. She is due to retire shortly and we will miss her. I would like to say how grateful I am, as I know others will be, not just for her advocacy on this issue but for her encouragement and support of hon. Members in this place to do the same. If I may be so bold, Baroness Cumberlege has played her part. It is now up to us in this place to hold this new Government to account and to ensure that her recommendations are implemented in full.”
“It is a pleasure to serve under your chairmanship, Mr Stringer. I thank the hon. Member for Harlow (Chris Vince) for securing today’s debate. We are here because four years after being published, the Cumberlege review has not been implemented and there is still no redress scheme. I will turn in more detail to the progress made on those recommendations, but first I pay tribute to the many individuals who have campaigned so hard for so long to be heard, for their experiences to be taken seriously, to receive some sort of justice, and to know that the same harm will not be done to others. Some of them are in the Public Gallery today and I thank them for their tireless campaigning. I also pay tribute to the right hon.”