YouSaid · the spoken record
Kim Leadbeater
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On the record 2021–2026
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“I will not go into the amendments in detail, as I know that is not the purpose of this debate, but whether by adding further safeguards and protections for patients through additional training around coercive control, the addition of specialist expertise through the inclusion of multidisciplinary panels, widening the provision for professionals to opt out of the assisted dying process, providing additional employment protections, or prohibiting the advertising of assisted dying, cross-party working has strengthened the Bill.”
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“I am grateful to all colleagues who have studied the detail of the Bill. It is essential that we come to a decision based on the content of what it actually says. I have been pleased to work with Members on all sides of the debate to ensure that the legislation is something that Parliament can be proud of—a cogent, workable Bill that has one simple thread running through it: the need to correct the profound injustices of the status quo and to offer a compassionate and safe choice to terminally ill people who want to make it.”
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“I want to thank you, Mr Speaker, and your team along with the fantastic Clerks and procedural experts who have ensured that parliamentary protocols have been followed and have guided us through the intricacies of what can be a complex parliamentary process—one that is steeped in tradition, but not always easy to follow. Of course, process is important, but it is also important to remember that we are not voting on the merits of parliamentary procedure; we are voting on an issue that matters deeply to our constituents. Indeed, the issue before us is very personal for many people—so many of our constituents, but many of us as well. It is an issue that transcends party politics. I thank colleagues from across the House who have shared their very personal stories with me.”
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“There are good deaths and bad deaths. I, like many, have experienced both. I appreciate that, for some colleagues, the journey to this point has been a difficult one. I want to pay tribute to the way in which the overwhelming majority of Members have approached the subject. Second Reading back in November was quite rightly seen as an example of Parliament at its best. Contributions from across the Chamber were incredibly powerful, the atmosphere was respectful, and people listened with care. I hope that we will see the same today.”
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“I beg to move, That the Bill be now read the Third time. It is an honour and a privilege to open the debate on Third Reading of the Terminally Ill Adults (End of Life) Bill. It has been a long journey to get here, and I do not underestimate the significance of this day. It is not often that we are asked to wrestle with issues of morality, ethics and humanity, but with great privilege in this job comes great responsibility, and never more so than at a time like this. Benjamin Franklin told us that “in this world nothing can be said to be certain, except death and taxes.” In this House we debate the latter incessantly, but here and in the country as a whole discussing death is something that we tend to shy away from, yet it will come to us all and to all those we love. We all have our own experiences of death, loss and grief.”
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“I thank the hon. Gentleman for his intervention. I think what he is saying is that people have got different views, and they do have different views; we have different views in this House, and different people in different professions have different views. Every royal college has a neutral position on assisted dying because of that. I have been pleased to work with Members on all sides of the debate to ensure that this legislation is something that Parliament can be proud of, and the many safeguards in this Bill ensure that only terminally ill patients who are eligible under the strict criteria and want to access assisted dying can do so.”
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“I thank the hon. Member for that intervention, and she is absolutely right; the detail does matter. That is why I am so grateful to colleagues who have engaged in the detail. We know that there are different views within the public, and we have to take on board the concerns of vulnerable groups—that is why the safeguards are so important—but I would also say that there is no one more vulnerable than someone who is dying.”
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“We know from other countries, in no small part due to the 14-month inquiry by the Health and Social Care Committee, that palliative care and assisted dying can and do work side by side to give terminally ill patients the care and choice they deserve in their final days. It should not be an either/or for dying people, and we need to channel our energies into supporting all options for terminally ill people.”
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“I am just going to make some progress. Patients must have “an inevitably progressive illness or disease which cannot be reversed by treatment” and a person is not considered to be terminally ill only because they have a disability or a mental disorder. These clear, strict criteria, plus the multiple capacity assessments, exclude possible serious mental health disorders such as anorexia. I was also very pleased to support the change advocated for by Marie Curie and Hospice UK, which would ensure an assessment of palliative and end-of-life care as part of the first report on the Act.”
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“I thank him for his intervention, but I would say, as I have said previously, that people working in palliative care have a mixed range of views on this subject. I have met with palliative care doctors, and some are very supportive of a change in the law because of the suffering they have seen.”
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“Pamela and Sophie both have terminal breast cancer, and they shared their stories yesterday. Pamela is a proud Christian who just wants to have choice when her time comes. Sophie, who is allergic to opioids, wants to ensure that her beautiful daughter has nothing but happy memories of their time together. Not supporting the Bill today is not a neutral act. It is a vote for the status quo. It fills me with despair to think that MPs could be here in another 10 years’ time hearing the same stories.”
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“Katie waved her mum off as she made the lonely and costly journey to Switzerland, where she had a peaceful and dignified death. But the family had no chance to say a proper goodbye and her dad made the journey home grieving and alone. Others have had to watch their loved ones die harrowing deaths despite receiving excellent end-of-life care. Warwick’s wife Ann, suffering from peritoneal cancer, had the maximum dose of sedative, but it was not enough to stop the choking and suffocation, and she begged him to help her put an end to her suffering. But he did not want her last memory to be of him stood over her with a pillow. There are many, many more such stories. Perhaps most importantly, I have spoken to terminally ill people themselves. We have spent a lot of time talking about them, but not always with them.”
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“I am just going to make some progress, if I may. But, as I was saying, it is an either/or decision for us today: either we vote for the safe, effective, workable reform contained in this Bill, or we say that the status quo is acceptable. Over recent months, I have heard hundreds of stories from people who have lost loved ones in deeply difficult and traumatic circumstances, along with many terminally ill people themselves. I spent some time with some of these families yesterday. They are real people with real stories and they deserve to be heard. Adil’s terminally ill father took his own life by buying drugs on the dark web. It was his third attempt, and Adil found him in a truly desperate state. He and his sister will never get over that night, nor the police investigation that followed.”
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“I think we have covered that point already. These are not homogeneous groups of people; they have different views and opinions. If we look at the inconsistencies in the current law, it just does not make sense. If someone with a terminal illness voluntarily stops eating and drinking, it is legal for them to starve themselves to death. A competent patient has the right to refuse foods and fluids even if they will die. The exercising of that right is sometimes proposed as an alternative to assisted dying. I suppose it could be argued that starving oneself to death is one way of taking control at the end of life, but it is a deeply traumatic experience for the person and their loved ones, and there are people here today who have direct experience of that.”
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“It is legal, yet what is being proposed in this Bill, with so many more safeguards and protections, is not. It simply does not make sense.”
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“I will make some progress. We have a system in which it legal for someone to starve themselves to death, which can take days or weeks, but where it is not legal for someone to seek assistance from a doctor to take an approved substance themselves to end their pain or suffering and take back control in their dying days. It is also legal in this country for someone to discharge themselves from medical care or refuse life-sustaining treatment such as ventilation, CPR or antibiotics, as long as they have the mental capacity to do so and are making the decision of their own accord, without harassment from anyone else. Colleagues might think that is fine, and I agree, but there is no requirement for two doctors, a psychiatrist, and a social worker, and there is no lawyer or judge.”
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“However, I say to colleagues who are supportive of a change in the law but are hesitant about whether now is the time, that if we do not vote for a change in the law today, we will have many more years of heartbreaking stories from terminally ill people and their families, of pain and trauma—”
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“Dr Greg Mewett has 20 years of experience as a GP and 22 years as a palliative care physician, and he spoke about the thorough approach that he has taken to ensure safety and efficacy of the assisted dying process. Perhaps the most stand-out quote from that session came from Dr Jacky Davis, chair of Healthcare Professionals for Assisted Dying, who said that by introducing assisted dying, “no more people will die but far fewer people will suffer”. This is not a choice between living and dying. It is a choice for terminally ill people about how they die. I fully appreciate that some colleagues would never vote for any version of this Bill, and I am respectful of that despite disagreeing with them.”
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“I am not going to take any more interventions, because lots of people want to speak. Then there are the criminal offences that the Bill introduces—none of which exist now—including life imprisonment for anyone who induces another person to take the approved substance, and 14 years in prison for coercion, dishonesty or pressure. It is a robust process that goes further than any other piece of legislation in the world, and it is far safer and significantly more compassionate than what we have now. If we look internationally, there are clear, well-established, safe and compassionate assisted dying laws in existence. On Tuesday I joined doctors from Australia who used three key words repeatedly: choice, control and relief.”
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“There are essentially two ways in which we can look at the situation we are in. We can look at it through a legal lens. As legislators, we have a duty to change the law where it is failing, and when the last four Directors of Public Prosecutions tell us that the law needs to change, surely we have a duty to listen. We need scrutiny before people die, not after. Most importantly, there is the human lens, which is how I approach most things. Giving dying people choice about how they die is about compassion, control, dignity and bodily autonomy. Surely we should all have the right—”
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“I am going to finish. There will be stories of suicide attempts, post-traumatic stress disorder, lonely trips to Switzerland, police investigations, and everything else we have all heard of in recent months. As the Commission on Assisted Dying said in 2011, 14 years ago: “The current legal status of assisted dying [in the UK] is inadequate and incoherent. It outsources a healthcare issue abroad, especially to Dignitas, instead of the Government and Parliament assuming responsibility.” That was 14 years ago, and we are in exactly the same position today. Things have got to change. As the Government’s impact assessment states, the Bill will improve equity of choice, ensuring that terminally ill adults from all socioeconomic backgrounds can access end-of-life options within a regulated and safe framework. I will draw my comments to a close.”
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“I am going to finish shortly. Surely we should all have the right to decide what happens to our bodies and decide when enough is enough. Of course, giving people the right to choose does not take away the right not to choose. Today, we can vote with either our hearts or with our heads, but either way, we should end up in the same Lobby. On a compassionate, human level, and as responsible lawmakers, we should support this desperately needed reform, which is rigorous, practical and safe, and which is rooted in the principles that should underpin any legislation: compassion, justice and human dignity.”
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“Amendment 72 provides that the regulations relating to approved substances would be subject to the affirmative procedure, meaning that they must be laid before Parliament and approved by resolution of both Houses, providing important parliamentary oversight. These measures ensure that the substances used in assisted dying are subject to a specific and appropriate regulatory regime.”
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“Some are technical and drafting amendments, and all are there to strengthen the Bill, so I hope that colleagues will be able to support them, wherever they stand on the principle of assisted dying. I know that many colleagues wish to speak today, so I will endeavour to speak with brevity. I will speak first to the new clauses that stand in my name, starting with new clause 13. This important new clause and the related amendments would create a regulatory framework and safeguards around the approved substances referred to in the Bill by imposing a duty to make regulations about those substances and a power to make regulations about devices for use in connection with their self-administration.”
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“It is a privilege to open today’s debate and to present to the House the amendments tabled in my name, a number of which relate to issues that I promised to return to when they were raised in Committee. All amendments in my name have been drafted with technical advice and expertise from civil servants from the Department of Health and Social Care and the Ministry of Justice, along with the brilliant Government Legal Department and the Office of the Parliamentary Counsel, in order to make the Bill workable and to give coherence to the statute book, as confirmed by the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), and the Minister for Courts and Legal Services, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), in their recent letter to MPs.”
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“I have taken legal advice from Government officials to ensure that devolution is respected at every stage in proceedings. Where legislation that affects other jurisdictions needs to be amended, those conversations have already started and will continue.”
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“No, I am going to make some progress, if that is okay. The substances that would be used would not be new substances. As we know, assisted dying is available in many other jurisdictions, and there are substances that have been used safely and, in some cases, for many years. Their safety and efficacy has been proven around the world, but they do need to be treated differently, which is the purpose of new clause 13.”
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“I am going to make some progress. However, it is most likely that these products are already licensed for other purposes. They could well be regulated through the Medicines and Healthcare products Regulatory Agency and within the Human Medicines Regulations 2012 for the purposes of the Bill, but it is important that time is given—”
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“I thank my hon. Friend for sharing her expertise, along with other colleagues with medical backgrounds who have worked with me on this amendment.”
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“Amendment 73 provides that regulations under new clause 14 would be subject to the affirmative procedure, providing parliamentary oversight.”
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“Given what you have said, Mr Speaker, I will make some progress. [ Interruption. ] A lot of Members wish to speak today. I now turn to new clause 14 and amendment 73. The new clause imposes a duty to make regulations prohibiting advertising of services related to voluntary assisted dying. This issue was discussed in Committee, following an amendment tabled by the hon. Member for West Worcestershire (Dame Harriett Baldwin). It was proposed that there should be no advertising of assisted dying services. I agree, and there was a consensus on that in the Committee. There were some issues with the previous amendment’s workability, so I gave a commitment to return to the matter on Report—hence the inclusion of this new clause.”
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“I thank the hon. Gentleman for the intervention, although I am not sure that it is relevant to the banning of advertising for assisted dying services, which I will try to stay focused on.”
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“I am afraid that I am going to have to make some progress, based on the number of Members who wish to speak today. I thank the hon. Member for West Worcestershire and the hon. Member for Reigate (Rebecca Paul) for working with me on amendment 73, and I am very pleased that they support it.”
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“I will not—sorry. New clause 15 and amendment 54 make changes to the Coroners and Justice Act 2009 that the Bill would necessitate. They would insert a new clause into the Act to provide that deaths that occur in accordance with the Bill will be certified by an attending practitioner and medical examiner and will not be subject to a coronial investigation.”
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“I am afraid not. Coroners investigate suspicious or violent deaths, or situations in which the cause of death is unknown. Assisted deaths would not fall into these categories, and there would therefore be no need for a default coronial investigation. This will ensure that any unnecessary delays and distress for bereaved families are avoided. These are not unexpected deaths; sadly, they were inevitable.”
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“I will not, I am afraid. It is the manner and timing of their death about which the patient will make a legal, informed choice, having been thoroughly assessed. As Professor Aneez Esmail has said, “I cannot think of any death that would be the subject of greater scrutiny in advance of the person dying than an assisted death. The process far exceeds the level of safeguarding that is in place for many of the deaths that are, at present, routinely reviewed by medical examiners and not referred to a coroner.” Of course, anyone can report a death—including an assisted death—to the coroner, or indeed to the police, if they have any concerns that it was not carried out in accordance with the Act, and if any offences have been committed, they will be investigated.”
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“Although the Bill seeks to address what in some respects is a very specific issue in terms of the failings of the current law, it has become part of a much-needed broader conversation about death, dying and end-of-life care. We all have our own experiences of death, loss and grief, and we do not talk about them enough. I am really pleased that the Bill has led to many conversations up and down the country; whatever our views, that has to be a positive thing.”
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“It would also prevent the appointment of the voluntary assisted dying commissioner and create a potential commencement gap between England and Wales. Given that, I have been strongly advised that the amendment would create serious workability issues. I urge colleagues who want an operable Bill to join me in rejecting the amendment. To finish, I am pleased to support amendment 21, tabled by the hon. Member for Twickenham (Munira Wilson). I thank her for her engagement with the Bill and the amendment, which would require the Secretary of State to prepare and publish an assessment of the availability, quality and distribution of palliative and end-of-life care, as part of the first report on the implementation of the Act, mirroring the assessment already required as part of the five-year review.”
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“That concludes the explanations of the amendments tabled in my name. Many colleagues are keen to speak, so I am not going to comment on all the amendments in the group; I will just make two comments about amendments that are not in my name, and allow other people plenty of time to speak. Amendment 42, tabled by my hon. Friend the Member for Newcastle-under-Lyme (Adam Jogee), would not only try to remove the backstop for the provision of assisted dying in England, but create a number of other issues in relation to commencement. If Parliament chooses to give this choice to terminally ill people, there cannot be a clause in the Bill that would prevent that from being available as soon as it was safe and practicable. But the amendment would remove the four-year backstop.”
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“Turning to amendments 76 and 77, as with any Bill, it is important that the amending legislation secures overall coherence with the statute book. As such, the clauses relating to medicines, advertising and employment protections amend, or confer power to amend, other legislation that currently extends to parts of the UK. Of course, this does not mean the provision of assisted dying, but, for example, they extend the prohibition on advertising to the whole of the UK and apply the employment protections in the Bill to Scotland. That is in line with the guidance I have received from legal experts, and as such I hope all colleagues can support these amendments. If the Bill passes, I will, if necessary, work with other devolved Administrations in the same way as I have worked with the Welsh Government to ensure that devolution is respected.”
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“I hope that colleagues across the House can support these new clauses and amendments. I now turn to new clause 21, which makes specific provision about the use of the Welsh language. The conversations that happen at the end of a person’s life are extremely personal and should be handled with the utmost sensitivity. It is very important that they are conducted in the best interests of the patient, and a big part of that is using clear communication. In this respect, language matters, so if a patient in Wales has Welsh as their first or preferred language, all efforts should be made to ensure they can communicate with voluntary assisted dying services in Welsh. I committed to this in Committee, and have made good on that commitment.”
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“I have worked with UK Government officials to ensure that the right steps are taken at the right time by the right people. I have engaged with colleagues in the Welsh Government—I met the Welsh Health Minister in Cardiff, and there have been ongoing detailed discussions between the two teams of Government officials to ensure the workability of the legislation in both jurisdictions, in line with the devolution settlement. Amendments 92 to 95 also ensure that the devolution settlement is respected and adhered to. I thank the right hon. Member for Dwyfor Meirionnydd (Liz Saville Roberts) and the hon. Member for Chesham and Amersham (Sarah Green), not only for their diligent work on the Bill Committee but for working with me on the amendments in relation to Wales, and I thank the Welsh Government for their guidance and support.”
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“I am going to make some progress, I am afraid. The Secretary of State must also consult providers of health and care services, including palliative and end-of-life care. I am really pleased that Hospice UK is supporting this amendment—it is very important that those voices are heard. The Secretary of State can also consult anyone else they feel to be appropriate, creating a flexible and holistic approach. Turning to devolution, this long-overdue reform would apply to England and Wales, which share a criminal justice system. Health is a devolved matter, of course, and I have recognised from the outset that the legislation must respect devolution. I am fully committed to observing the same conventions that the Government would if this were a Government Bill.”
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“Palliative and end-of-life care and assisted dying can and do work side by side to give terminally ill patients the care and choice that they deserve in their final days. Just as there should not be an either/or for dying people, there should also not be an either/or for us as legislators in having to choose between supporting assisted dying or other end-of-life choices. That is why I am supporting amendment 21: to ensure that in this place we channel our energies into supporting all options available to terminally ill people—something that I have always committed to do.”
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“I have nearly finished. I have had many such conversations over recent months with those who support the amendment, including with palliative care doctors, nurses, hospice staff, GPs, Hospice UK and Marie Curie. I thank them all for their constructive engagement with the Bill. I cannot imagine that anyone in this place is not truly grateful for the outstanding work done every day by the wonderful people working in palliative and end-of-life care in every one of our constituencies. Many of us, if not most of us, will have personal experience of the kindness and compassion that those people have shown to our own families and friends. But this is not an either/or conversation.”
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“My hon. Friend is making a powerful point, and there is consensus across the House about banning the advertising of assisted dying services. His amendment, though, would be slightly limited in that it makes just two exceptions. There would probably need to be a broader piece of work on that, but I commit to working with him if he is interested.”
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“I thank the right hon. Gentleman for his constructive engagement, but he did not vote for the Bill when it included a High Court judge, and now he is trying to reintroduce a High Court judge. Is there a version of the Bill that he would vote for if it had some sort of judicial oversight other than a commissioner who is a judge or a retired judge, a deputy commissioner who is a judge or a retired judge, and someone on the panel who is a legal expert?”
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“I thank my hon. and learned Friend for introducing this important debate. Does he agree that at the heart of this discussion are some key principles, such as compassion, which he mentioned, as well as choice and bodily autonomy? Whatever stage we are at in our lives, it is important that we are allowed to make choices about our own bodies, free from the fear of criminalisation or judgment.”
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“That enables the commissioner to carry out their monitoring responsibilities under clause 45. Amendments 57 and 61—”
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“Over recent months, I have heard hundreds of stories from people who have lost loved ones in deeply difficult and traumatic circumstances that show that that is clearly not the case. Too many have seen their terminally-ill loved ones take their own lives out of desperation or make the traumatic, lonely and costly trip to Switzerland, and then face a police investigation while dealing with their grief and loss.”
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