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Showing every spoken contribution, including 12,832 under 12 words. Hide short remarks
I chair the all-party parliamentary group on hospice and end-of-life care, and I wonder whether my hon. Friend shares my concern. Given that an estimated 170,000 people die in this country each year without access to palliative and end-of-life care, there can be no choice until hospice and end-of-life care are properly funded.
Will my hon. Friend give way?
On that point, will my hon. Friend give way?
Will the hon. Member give way?
Thank you for calling me, Madam Deputy Speaker. I mean that sincerely on a day when so many colleagues want to speak. I promise you that my remarks will be brief. Our debate today is about who has choice and agency in our society both in respect of the authority of this elected House of Commons and what limits should exist on the role of the other place, and, more fundamentally, in respect of the right of a terminally ill person to exercise choice at the end of their life and whether the state should be able to override that. We are back here for a Second Reading of the Terminally Ill Adults (End of Life) Bill not because the question before us has changed since November 2024, but due to the actions of a small number of Members of the other place.
I am grateful for my hon. Friend’s intervention. I do not have that number; what I do have is the number of amendments that were proposed. There were 1,286 wrecking amendments. There are many thoughtful and compassionate critics of the Bill who I respect deeply. I want to put on record my admiration for my hon. Friend the Member for West Lancashire (Ashley Dalton) and for her astonishingly brave speech. However, what I cannot condone is the actions of Members of the other place whose motivation in the last Session of Parliament appeared to be to block the democratic process.
The point I was making, which I believe many colleagues will recognise, was that having over 100 hours of debate and more than 1,000 amendments was not conducive to the idea of making serious progress with the Bill; it was, to all intents and purposes, a filibuster. Our role today extends beyond debating the Bill. It is also to reaffirm the will and primacy of the House of Commons.
The right hon. Member for North West Hampshire (Kit Malthouse) made it clear that it is because of the actions of a very small number of peers, and he has no faith—and neither do I—that that would not be repeated this time around.
I am going to make some progress. This is the first time that I have spoken on this subject, and I want to set out briefly why I have consistently supported choice at the end of life. First, there is the simple principle that, faced with a terminal diagnosis, it should be the right of the individual to choose how they leave this world. If we offer the choice of an assisted death in the circumstances detailed in the Bill, as my hon. Friend the Member for Bury St Edmunds and Stowmarket (Dr Prinsley) said in 2024, we will be “shortening death, not life…This is not life or death; this is death or death.”—[Official Report, 29 November 2024; Vol. 757, c. 1048.] Our choice is whether we want people to have the choice of a dignified death or to force some people to endure painful and traumatic last moments, as my hon. Friend the Member for Filton and Bradley Stoke (Claire Hazelgrove) set out in her astonishing speech.
I will not at this moment. My second reason is the medical reality that some conditions are beyond good palliative care. Driving improvements in palliative care should be a moral imperative for all of us in this place, but doing that does not resolve the question before us today. Another doctor, the hon. Member for Hinckley and Bosworth (Dr Evans), again speaking in November 2024, said that there are some conditions for which we “cannot provide” good palliative care. He said that for “the likes of the inoperable neck cancer, eroding away into the carotid artery”, there is “no alternative to that terrifying death.”—[Official Report, 29 November 2024; Vol. 757, c. 1070.] If we fail to pass this Bill, we do so in the knowledge that we are making an active choice to allow people to continue to die in this way, when we know that an alternative is possible. Finally, I cannot support a status quo in which the state decrees that it knows better than a terminally ill person who has expressed their wish. That is the reality today—people who are dying are denied their wish to end their time on this Earth on their terms. I am voting for this Bill today because I believe in the primacy of the elected House of Commons, and above all because I believe that someone who is terminally ill should not have their last moments dictated to them by the state. Just as in life, in death an individual deserves to choose their own path.
Not for the first time this week, I find myself wholeheartedly agreeing with the right hon. Member for East Hampshire (Damian Hinds). He and I agree that we will all act according to our conscience and respect others if they come to a different conclusion. I thank Members on both sides of the debate across the House for their consideration of this legislation and their thoughtful contributions to the debate. By my count, 40 Members have spoken in the debate; I have listened to all that they have said with great interest, and I thank each and every one of them. It has been a difficult debate to speak in at times. We have heard of people’s own family and private experiences, and that is hard to bring to this House. I really thank all colleagues across every corner of this House for doing so. The issue of assisted dying has been subject to extensive and detailed consideration over a number of years, most recently in this House and the other place in the previous Session, as well as outside Parliament. We think today of all those who feel strongly on both sides of this debate and what they are thinking about as they listen to our discussions. We send our care to all those who are struggling with grief. Let me reiterate that the Government are neutral on the question of assisted dying and on the passage of the Bill. As the Prime Minister has said, this is an incredibly important and personal debate, and it is right that it is a matter for Parliament, not Government, to decide whether the Bill should become law. However, the Government have a duty to the statute book. It is on that basis that I am speaking at the Dispatch Box today as the Minister responsible for helping to ensure that the Bill, if passed, is workable and effective. I must explain to Members that in the interests of time, I am going to keep my remarks purposefully brief, and I will not be taking any interventions; I apologise to Members wholeheartedly for that, as I would normally take interventions. I am happy to discuss with Members any issues that they have. I have listened to the entire debate today and heard Members’ views, questions and many interventions, and I want to turn briefly to a couple of important issues. On procedure, like any private Member’s Bill, this Bill will proceed through the usual parliamentary stages, subject to Parliament’s will. With respect to questions to the Government on the Parliament Acts, I refer Members to the Acts themselves, which set out conditions under which legislation may pass without requiring the consent of the House of Lords. That is a matter for Parliament, and it is not for the Government to decide whether to pass this Bill. As is usual with any constitutional questions, Members may approach the Clerks for further advice, as I am sure you would agree, Madam Deputy Speaker.
I have said that I am not going to take any interventions. I am sorry to be discourteous to the hon. Member, but I am going to stick to that. I want to make a few comments on the matter of social care and palliative care, having recently taken over responsibility for these most important issues. In my opinion, social care has been ignored for far too long—both the 1.5 million people, mainly women, who work in it and the families who need it. We have heard that across the House today. The Prime Minister has made social care a personal priority, and I am working with my right hon. Friend the Secretary of State to deliver changes now, alongside the work being done by the Casey commission, which we have expedited by a year. Building a national care service will mean that people know where to turn when they need help and that care workers are given the status and the respect they deserve. We are pushing ahead with workforce changes, including career progression, training and job security, and we have made £4.6 billion of additional funding available for adult social care by the end of this Parliament, including £500 million for the first fair pay agreement for care workers. We will strengthen social care now—we are not just waiting for the Casey commission—and provide greater choice and independence as we do so. Turning to palliative care—
I also respect my hon. Friend and, though it was not a point of order, the House will have heard what she said. I am attempting to address the points that have been raised in the debate, particularly on procedural matters, on social care and palliative care, which I turn to now. Palliative care is extremely important and has been raised many times within the debate. As the Chair of the Select Committee set out, we are developing a modern service framework for palliative and end-of-life care. The framework is clinically led and evidence-based, to support sustained improvements in outcomes for patients and carers, including by systematically identifying, measuring and reducing health inequalities and reducing unwarranted variation in access, in experience and in outcomes. As part of that work, we expect all integrated care boards to complete a needs assessment so that we can get a detailed understanding of their current and future population, including people of all ages with palliative care and end-of-life needs. That is vital in order to commission services that best meet the need while providing value for money. Many hon. Members raised the importance of doing that, and particularly of reducing unwanted variation. I acknowledge that and I will be working with Members across the House to deliver that modern service framework. Members quite rightly mentioned the hospice sector. We provided a £125 million capital boost to funding for adult and children and young people’s hospices. I say to hon. Members that I have heard the points that they have made, and I know we have more to do. Many hon. Members and friends will know that in July, I lost my own mum, so I had a very practical education in this topic, and that experience will shape how I take this work forward. To conclude, I thank all hon. Members once again for all they have said. They will understand how difficult it is when we are sharing personal experience, as many of them have done today, and I am really proud of everybody who has done so, difficult and challenging though this issue is. I thank all Members who have given me their sympathy over recent months and weeks. It has been so appreciated. The Government remain neutral on whether the Bill should become law, but it is our serious responsibility, should Parliament pass it, to ensure effective implementation within the framework provided by the legislation. On that basis, we would provide technical support to the promoter if Parliament chooses to progress the Bill. That said, I will repeat the comments made by the right hon. Member for East Hampshire from the Opposition Dispatch Box, which I now say on behalf of the Government. This is a deeply challenging issue for us all, for the public and for the constituents we represent. In discussing this issue, we must model the best behaviour of this House—having respectful, thoughtful, careful debate, listening to one another and understanding our very different perspectives. I think that we have done that today. I hope that, whatever happens in the Division, we will be able to continue to show those behaviours and give this serious subject the deep respect it deserves.
I pay tribute to the hon. Members for Rochester and Strood (Lauren Edwards) and for Spen Valley (Kim Leadbeater) for their hard work on this Bill and the Bill introduced in the previous Parliament. I was a member of the Bill Committee for the previous Bill, and I tabled many amendments, sometimes much to the frustration of the hon. Member for Spen Valley. I want to talk about a number of people who died without dignity and without choice. As a teenager, I remember my mum telling me the story of her uncle. He was terminally ill, and she cared for him at the end of his life. She went round to his house to check on him, knowing that the end was getting near, and tragically stumbled upon him; he had collapsed on the floor and died. That stuck with her to this day and informs her views, and my views, on assisted dying. The reason I use the words “stumbled” and “collapsed on the floor” is because my mum was led to believe that, in his final moments, he was making his way across the room to pick up the shotgun on the back of the door to end his life. That is the reality for people like my mum’s uncle and many others. A number of years ago, I ended up dealing with a not dissimilar situation. I was living back home with my mum, next door to my gran, when we heard a loud bang. I ran across the road with my gran, and we found the neighbour, John, a pig farmer. He had been suffering unbearably with a chronic life-ending condition, and had decided to take matters into his own hands. That is the status quo—it is the reality for people who are in pain, have unbearable suffering and are terminally ill. We do nothing to protect them. That is why I am in favour of a change in the law. One of the things that has driven me to this place is the conviction that a law like this has to be better than what we have, which offers no safeguards or protections to people in their final moments. No one wants to die—it is not a choice they make—but we can give people a choice about the end of life and how they may see that end. This is not just a choice for terminally ill people, but for people in remission, like my mum. A number of years ago, she had breast cancer. She had two independent tumours—stage 1 and stage 3—in the same breast. In my mid-20s, I faced having to have a conversation with my mum about what would happen if she, a single parent, were to pass away and leave me with my then five or six-year-old sister. That is not a conversation that I will ever forget, and it is one of the things that motivates me to talk about this issue as prominently and as much as I do. My mum made it clear that if the cancer came back and she were to end up with secondary breast cancer, she would not want to go through the ordeal and the trauma of the surgery and the chemotherapy that she faced. She has lasting nerve damage and a reduced quality of life as a result of the original cancer. It is something that causes her great concern every single day. Every time I speak about this issue, either in this Chamber or in Committee, I ring her first and ask for her advice. She has routinely said that when she goes to her breast cancer support meetings with friends who are also in remission, time and again they say that having this choice would bring them great comfort, even if they decided not to use it. That is why I have such clarity on this issue. The people who are living in those circumstances, and who did not have a choice, guide my views on this subject. If we were in that situation, I would fight tooth and nail for my mum to go through with surgery, chemotherapy or radiotherapy—whatever the treatment might be—but I respect that it would be her decision to make, even if I did not like the consequences. As we revisit this conversation and this legislation, let me say that I do not see this as a final say on the Bill. Instead, we are restarting a process that was abruptly ended by those in the other place. We have heard a lot today about amendments not being accepted, but with the greatest respect for the hon. Members for Rochester and Strood, and for Spen Valley, although I am a supporter of the Bill, I consistently tabled amendments to the Bill in the last Parliament, including amendments to make it better reflect the realities of people with neurogenerative diseases. When we look across the globe, we can see that this Bill is the most restrictive and narrow legislation. To suggest that it will somehow cross a new frontier that has never been crossed before is simply untrue. We are lagging behind international comparators, and lagging behind in giving people choice. We know that people who have the means or the money can have that right now by travelling abroad, and we know that, all too often, people who do not have the money tragically have to take actions into their own hands and are robbed of a good death. Today, I encourage all hon. Members, and in particular those who are genuinely undecided or wavering, that a vote for the Bill on Second Reading will continue the debate and allow hon. Members to table amendments on Report. Importantly, one thing that people keep ignoring in the debate is that if the Lords operates in good faith and sends us sensible suggestions, we will end up in ping-pong, where we will be able to pick up amendments that would strengthen the Bill further and allay those fears. The idea that that cannot happen is simply untrue. I encourage all hon. Members to ensure that we can continue the debate, and give opportunity and choice to people at end of life.
Will the hon. Lady give way?
Coercive control is by definition insidious, and we do not find out about it until years later—the victim themselves might not even be aware of it until years later. With assisted dying, a victim of coercive control would have no “years later”, would they?
I begin by thanking the hon. Member for Rochester and Strood (Lauren Edwards) for her courage and compassion in bringing this Bill back before Parliament. The debate in this House, the other place and across the country is profoundly important. “We need to get better at talking more openly about death and what dying well means.” Those were the words of the end-of-life care clinical lead during my last week’s visit to the new dedicated palliative and end-of-life care ward at Addenbrooke’s hospital in my constituency of South Cambridgeshire. It is something my own father said to me many, many times over 40 years ago. He was a family doctor in Hull, in the deprived communities, witnessing the family births and deaths of many patients at home and in hospital. “Love life, live life as much as possible and have a good death.” The last time this Bill came before the House, it encouraged that conversation. There was respectful debate, evidence was examined and safeguards were strengthened. The Commons voted in favour and the Bill was sent to the House of Lords for further scrutiny. What we are doing today is allowing due process to continue by sending the Bill back to the Lords, so it can complete its passage. I am grateful to the many constituents who have written to me on all sides of the debate, sharing deeply personal experiences that have shaped their views and informed my own thinking. Having listened carefully over all our debates—the Bill Committee, the witnesses, the evidence—I continue to support the Bill. There is a need to change the status quo. Receiving a terminal diagnosis, as we have heard, is devastating. It brings a loss of control of the future that many people find deeply frightening. One of those people is my constituent Jodie, who is living with a terminal grade 4 astrocytoma brain tumour. Following lifesaving surgery, she continues treatment aimed at preserving the best quality of life possible. Fiercely independent, she is living every single day. Yet, in her own words, the prospect of the disease eventually taking over her brain, leaving her unable to think clearly, communicate or make decisions, frightens her more than she can express: “None of us know what the future holds, but knowing that the option of assisted death would be available should I ever reach that point…would provide me with enormous comfort and reassurance”. As we have heard today, what we do not talk enough about is the status quo—it is almost as if there is a taboo—which for some terminally ill people is an unsafe and cruel status quo, with hundreds of people already taking matters into their own hands. I want to share the story of my constituent Cath Shepherd. Her sister, Emma Windred, was a keen and active outdoors woman who loved life. Facing the end of that life, she chose the only legally defensible and medically supported route available to her: voluntarily stopping eating and drinking. We know that many medical practitioners feel that that is a grey area, and much more guidance is needed. That should not be the only option. Emma felt robbed of the death she wanted and she campaigned for the law to change until her end came. After Emma’s death, Cath has continued that campaign so that others might have the option of the gentle and dignified death her sister believed she was denied. As we have again heard today, too often assisted dying and palliative care are presented as competing alternatives. They are not. Both are rooted in the same aim: ensuring that people approaching the end of life are treated with dignity, compassion and respect. I am fortunate that Arthur Rank hospice serves my constituency and the wider region. It provides outstanding care and support to patients and families at some of the most difficult moments in their lives. Its staff and volunteers do extraordinary work. Yet, like many hospices around the country, it faces huge cuts and the loss of beds, something that I and many others are campaigning to stop happening. We all know there is a disgraceful crisis in adult social care. Hospices, hospice-at-home services, district nursing and community palliative care are all desperately underfunded. I therefore welcome the Prime Minister’s call for cross-party talks on social care—we all do as Liberal Democrats—but I do not share the premise that assisted dying legislation must wait until palliative care is fully funded and available everywhere. This is not an either/or. This is not a before/until. These are not and should not be competing priorities. My support for the Bill is matched by my belief that we must equally strengthen palliative and end-of-life care. Dying with dignity means access to outstanding palliative care, compassion at every stage of life and the ability to have choice, agency and dignity for those very final days. This Bill will not make a choice for anyone. It will simply allow terminally ill people to make that choice for themselves, safely, challenging the status quo and with their loved ones around them, if they so wish.
This Bill is not safe, and today the responsibility for this Bill falls on us and only us. If we vote yes today, unless the movers, who accepted no critical amendments in Committee last time, have a 180-degree change of heart, we can expect this Bill to become law as it stands. Despite hon. Members saying that they will press their own amendments, we have no assurance from the Government that Government time will be allocated for that. The only question we are left with is not whether we are in favour of the principle of assisted dying; it is whether we are 100% content with this Bill. We no longer have the prospect of the second Chamber making it any safer. As somebody who is against an unelected second Chamber, that is a responsibility that I am determined to accept; but it is a daunting prospect, far more daunting than when we debated this Bill the last time, because the responsibility is now ours and ours alone. We cannot ignore the fact that none of the expert witnesses at the Lords Select Committee could confirm that the Bill was safe—none. Of the warnings, the one that resonated most from me came from the Royal College of Psychiatrists, which stated: “Currently, needs can be identified but not necessarily met”, and that somebody could proceed to an assisted death “where they may have made a different decision had those needs been met.” During the passage of this Bill, two of my siblings, who suffered with poor mental health throughout their lives, have died. I witnessed their struggle and the terrible fear and pain of cancer while their mental health worsened. In both cases, the medical staff could not get their mental health medication right because of poor handover between practitioners—a service design issue; because of the difficulties in assessing the mental health of patients in a palliative state—a clinical issue; and because the psychiatry resource was not available—a resource issue. None of those issues will have been resolved when this Bill becomes law. This Bill is not contingent on making palliative care provision or mental health provision better, and there is no provision in this Bill to assess unmet psychological medical needs at any stage, nor to consult others involved in the patient’s care historically or involved through their life—family members like me, who had seen them failed by systems and processes throughout their life, and was desperately concerned that those systems and processes might also fail them at the end of their life. It is our duty to design the systems and processes that are safe for people like my brother and sister, and on this occasion I do not think that we have done so. Many professional bodies are clearly warning us that we have not. There will be no amendments to protect people like my brother and sister. I would have wanted them protected. It is down to us now. The other place cannot help us or hinder us. The responsibility sits squarely on our shoulders. This is no longer about the principle—we have had that debate. It is about the practice of this Bill, which the movers have shown time and again that they will not permit to be amended. The experts, the clinicians, the groups speaking for the most vulnerable in our society are overwhelmingly telling us that this Bill is not safe. The offer of assisted dying to people in the position my siblings were in is the very opposite of autonomy. Today, we must accept our grave responsibilities as MPs to those most at risk. Today is not about the principle; it is about the practice, and the Bill is not safe. Today, we must vote no.
Will the right hon. Member give way?
Will the hon. Gentleman give way?
Will the hon. Lady give way?
Will the hon. Member give way?
I pay tribute to all the Members who have shared their story; I feel we have learned a bit more today about how the hon. Member for Birmingham Yardley (Jess Phillips) became how she is. I am sure we have all heard so many heartbreaking stories from our constituents, and I want to thank all those who have contacted me, whether or not we agree, because sharing these stories is profoundly difficult. One constituent with incurable cancer contacted me, asking for the freedom to choose when to give up their battle. Her own brother had an incurable melanoma spreading down his neck, which left him barely able to speak to his loved ones. He went out at 2 am in his dressing gown, climbed on to a bridge and jumped on to a motorway below. This was witnessed by two girls who were walking home from a party. My constituent asks: “how many more need to take their own lives in horrific ways because they simply cannot bear the pain, discomfort and hopelessness any more?” She wants the right to decide for herself when enough is enough. Then there is the constituent whose sister went abroad to access assisted dying. The 84-year-old sang to her sister, who ended her life peacefully with her family around her. My constituent said: “It was a painless, peaceful and dignified death at the time of her own choosing. Together with giving birth to my children, it was one of the most beautiful experiences of my long life.” I do not believe that only families with means should be able to have that experience; it should be open to everyone. Let me turn to the issue of palliative care. I pay tribute to the hon. Member for Calder Valley (Josh Fenton-Glynn), who is a fellow member of the Health and Social Care Committee. Although we wrote the reports together, I have come to a different conclusion, with great respect. It is, frankly, a stain on successive Governments that palliative care is in this state. Our Committee’s findings were stark: commissioning variation creates a postcode lottery, bereavement support is frequently inaccessible, services are fragmented, workforce and skill shortages are widespread, and systemic inequalities persist.
No, I shall not. It is worth noting that the NHS has not been meeting its own standards on palliative care for decades. The then Minister for Care, the right hon. Member for Aberafan Maesteg (Stephen Kinnock), appeared before our Committee in the spring, and he mentioned the importance of workforce. I ask again, where is that workforce plan? We need it, but that will not be the whole answer; we also need better data and early identification, clearer guidance and joined-up working with adult social care and local authorities. The Government have said that they will publish a modern service framework for palliative and end-of-life care, and it is very positive that the interim MSF has been published, but let me tell the House how I see it as Chair of the Health and Social Care Committee. I genuinely do not believe that palliative care would have been included in the early batch of MSFs if it were not for this Bill forcing the Government to do so. Furthermore, given all the issues and competing priorities of the NHS, let alone the competing political priorities of this Government or any other that comes after it in the next four years, I do not believe that palliative care will improve as fast as we want it to without the pressure of a Bill like this. I do not believe that this is an either/or proposition. I want palliative care to improve, therefore I will be voting for this Bill. I have to end with one more constituent’s story, and it is the story of Robert. His two parents had different views on this issue: his father did not agree with assisted dying, but his mother did. We are lucky in Oxfordshire that we have some of the best palliative care in the country. He described how her care was exemplary—she died without pain and was well looked after—but he felt that her wishes were not respected while his father’s were, and there were consequences to her not being able to access assisted dying, as her brother could not be there at her bedside when she passed. For those constituents who want a real choice at the end of life, I will tirelessly continue to want to improve palliative care, but I will also be supporting the Bill.
On that point, will the right hon. Gentleman give way?
Will the hon. Member give way?
On that point, will the hon. Lady please give way?
I thank the hon. Member for Rochester and Strood (Lauren Edwards) for reintroducing this Bill and giving us another chance to debate the issue—although part of me regrets, as I will explain, that we have that chance. I respect everyone who has taken the responsibility of coming here today to debate this again, and I particularly respect those who have shared their very moving personal stories with us all. Most of all, though, I respect and I would like to apologise to those who are again going through the trauma of waiting to find out whether they will have the choice. I have huge sympathy for them, because they believed when we originally passed this Bill and sent it to the other place that, if they needed it, in four years’ time they would have the choice. It would be in their hands. That hope has been snatched away from them—and not by us. We fulfilled our responsibility to the electorate. We spent hundreds of hours in Committee, in private discussions, in debates and on Report, going over this Bill in minute detail until we could, with confidence, send to the other place the best Bill we thought possible. Of course, we thought that it would amend it and bring things back, but we had fulfilled our role and respected the will of the British public. Unfortunately, when the Bill went to the other place, that was not what happened. A handful of peers blocked it.
Sorry, I will not take interventions. Those peers did not show the same respect for the repeatedly expressed will of those who face the end of their lives.
I do, but they are each one individual, and each of the professional organisations is neutral, and believe me, I envy them on that. We have the responsibility to make the decision. The majority of us have already said that this is the best Bill we can produce. We—the majority of us—have made that decision once already, and we sent it to the other place. If we do that again today, I hope that those in the other place listen and take that on board and that the handful of peers who blocked it—
I completely agree, and it did the other place no credit at all that they did that. There is something interesting and noticeable about all the experiences we have heard today. I have personal experience, which I admit influences my view. I saw my mother go through a very painful death and wished that she had had the choice. I do not know what she would have done, but I wished that she had had the choice. What is interesting is that we have all taken different things from those experiences. Some of us have said that we cannot do it because of that experience, and others have said that we must do it because of that experience, because we have all made decisions. We all have the right to make decisions for ourselves, and that can surely be no more important than when we face the final decision that we will face. It is for that reason—to respect that choice, to respect a decision that has already been made in this place, to respect the will of the British people—that I ask the House to send this Bill back to the Lords for approval.
It is an honour to be called to speak in this debate. Indeed, it is the first time that I have. I am a sponsor of the Bill and a member of the Health and Social Care Committee. I congratulate the hon. Member for Rochester and Strood (Lauren Edwards) on how she introduced this debate, and the hon. Member for Spen Valley (Kim Leadbeater) on her outstanding work and championing of this issue over all this time. If this Bill is defeated today, it will leave us with a significantly unsatisfactory and dangerous status quo. All the legitimate concerns about safeguards and coercion raised by those who oppose the Bill will simply continue, but problems will probably be increasingly driven behind closed doors, as things will, I fear, only get worse. Defeating the Bill would also reward the worst of the reprehensible behaviour of those in the other place who blocked this legislation last time. If the purpose of the shocking behaviour of a small minority of peers towards this Bill earlier this year was simply to make a powerful case for their own abolition, they certainly hit the jackpot. If we reward them with victory today, we weaken the relationship between the two Houses and cede more power and influence over our democracy than is healthy or wise. A theme that has run through the debate is the implication that the Bill is insufficiently perfect. Indeed, “perfect is the enemy of the good” syndrome runs through this and a lot of our other debates and legislation. As I think my hon. Friend the Member for Esher and Walton (Monica Harding) described it, the concept of a 100% perfect Bill is simply in the minds of those who believe it possible to get to that point. When have we ever had a perfect piece of legislation?
I am sorry, but because of time, I will not. If the hon. Member wants, he can send me a postcard with the answer to my question: when have we ever had a perfect piece of legislation? We would be perpetually restrained from making progress if perfect legislation was the aim, because we only produce compromises, not the utopian perfection that we all want. If we were all sent off at the beginning of this process two years ago to look at how best to handle end-of-life considerations, and given a pen and paper and put in a room without a mobile phone to draft a piece of legislation, we would have 650 “perfect” Bills, written according to the opinions of each of us in this Chamber.
I cannot give way, because of the time constraints. All Bills are necessarily a compromise. That does not mean that we simply have to make do with bad legislation, but the Bill that was sent down to the other place was in fact an excellent compromise that actually achieved all of the matters—
I am sorry to be stirring up Members at this stage of the debate, particularly as time is very short. Another theme is that people somehow believe that there is a binary choice available to us on palliative care: that we should either have 100% palliative care, or can go down the route of backing the Bill—or rather, that we should not support such a Bill until we have 100% perfect wraparound universal palliative care around the country. The Health Committee, of which I am a member, has produced a report on this issue, and it is clear that it will actually help the case for improvements to palliative care if this option is also available—a point a number of Members have made. The point about the limitations of palliative care has been made very strongly by others, as have the points around coercion and safeguarding. After all, the current situation regarding coercion and safeguarding is certainly not satisfactory. The Bill provides safeguards where presently there are none. It is irresponsible and scandalous that some people promote scare stories about risks to disabled people, anorexic children, Down’s syndrome children and the vulnerable, when in fact those risks currently exist, and the Bill actually provides the safeguards that I think many people want. Last time we had a vote on this issue, on Third Reading, I thought it was this Chamber at its very best. There was no choreographing of the response. You could hear a pin drop when the result was announced. It was a very good debate, followed by MPs coming together in silence. People on both sides of debate embraced behind the Chair in tears, because they understood the gravity of the decision. I do not think that was respected by the way the Lords treated the Bill. That is why it is vital that we send the Bill back to the Lords and do not allow them to have the victory that they seek.
I am here because we do need to change the law, so that dying people have the choice of a better death than too many horrible progressive terminal diseases allow for now. I am here because of my own conscience; I am a humanist and a patron of Humanists UK. I am also here with the support of so many of our citizens who desperately want to see a change in the law. Many of my constituents have written to me to tell me their personal story of losing people under the worst circumstances because the status quo did not allow them another choice. Two weeks ago, I heard from my constituent, Julia, who told me about her mother, Jane, and asked me to speak about her case. Faced with a progressive terminal neurological diagnosis at 92 and unable to travel alone for help, Julia’s mother decided in secret to end her life in a very distressing way that I cannot bring myself to describe today. Julia said: “I had no idea that she was going to act on her oft-stated desire, although in retrospect I realise that a phone call we had in the morning of that day she said goodbye in her own way, and she also made sure that it would be her friend and carer who would find her.” That was instead of Julia herself the next morning. Julia continued: “While I miss her terribly, I am proud of her for her determination, and grateful that, the manner of her death apart, she has left me with positive memories of her, rather than the gradual eroding of her self that she (and I, to be honest,) were both dreading… Now I am coming out of the weeds of my grief at her loss, I am determined to help make her legacy the right for people in her situation—when they are faced with losing all agency—to have the choice to take the ultimate act of agency over their life.” That is what we are here for. We are here to make something more humane than the situation that Julia and her mum Jane faced. Examples like these are real people—brave for telling us their stories—who have demonstrably been harmed by the law as it stands. People are raising concern about potential harms if we change things. We have debated this so many times, and now, for every concern I have heard expressed that this new law might be used by someone who is ineligible or by someone who is not choosing freely the way that their terminal illness will play out, I believe we see real safeguards in the Bill before us. They are very, very strict. These requirements will be too much for some dying people, in fact. Some people will be denied the service in this Bill today, but others will benefit, and there is a clear moral case and duty for Parliament as a whole to act to progress this issue. Now, there is not just a moral case for this Bill, which we have debated before, but a democratic case, too. The serious, careful work we started here must be completed in the normal way in the upper House for the democratic process to be complete. Last year, we voted and voted again on the principle, in Committee and on Report. The promoter of the previous Bill, the hon. Member for Spen Valley (Kim Leadbeater), listened and proposed over 100 of her own amendments and accepted more than 30 from opponents who wanted to go maybe further than she or I would have liked. She worked with civil servants to make its workability crystal clear, and a Minister reported back to us that the Bill was workable. Other amendments were voted on in this House on Report. On Third Reading, we debated what we had designed, and voted again. We passed a sound piece of legislation last year, and I believe we sent the Lords a good Bill and a safe Bill—a compassionate and workable change in the law that they could refine if they wished. We must now say to the Lords that they must collectively do as MPs did and consider the Bill with the seriousness it deserves, do their duty in putting their votes on the record—vote, just as we did—and bring it to a conclusion in that place. I ask hon. Members to please vote for this Bill to continue so that its progress and all the work we have done so far to build something better than the status quo for dying people does not end today.
On the specific point of hospices, I absolutely understand what the hon. Lady is saying; I have visited our local hospices, and I have sat beside my father when he was dying, but not in a hospice. The point about palliative care absolutely matters, but the Government do not recognise the funding that the sector needs. There is a postcode lottery, and the Ministers are not even answering written parliamentary questions, so does the hon. Lady agree that until this is fixed, we should not be having this debate?
I am very grateful to the hon. Lady, whose speech is a series of oxymorons: she does not like polling that is against the Bill, but likes it when it is in favour; she feels the Bill should be amended in the House of Lords, but not with amendments that would improve safeguards. On that subject of safeguards, will she explain to the House why the previous legal safeguards to assuage doubts about efficacy were entirely dropped from the Bill?
Will my hon. Friend give way?
The hon. Lady is absolutely right. This debate illustrates a difference across this House. It is a difference between those who feel that individual agency is always supreme, and those who, like her and me and many others, believe in social solidarity and our responsibility, indeed our mission, to protect the very people she describes, who will be at risk. There is no doubt that they will be at risk from this Bill.