5,779 spoken contributions under 12 words (interjections such as “Will the hon. Member give way?”) are hidden. Show them

1. 13 Jun 2025·Parliament·Simon Hoare

   Terminally Ill Adults (End of Life) Bill

   I will not; I am very conscious of time. Madam Deputy Speaker, given that so many right hon. and hon. Members have been constrained in the length of their contributions because of your persistent cough—I say that not as a criticism—and that next week we have a lot of one-line Whips and the following week we have exactly the same, more time really should be given to the Bill. I do wish the Government had taken it on, not as a Government Bill but by finding Government time for Report on the Floor of the House. This is too serious an issue to have as many gaps and lacunae as this Bill has. The founding fathers of the United States worked on the basis that the vague generalities of the constitution would always be adhered to, and that men and women of goodwill would adhere to it. I am pretty certain that they are now beginning posthumously, with the current incarnation, to wonder whether that is true. We should not be legislating to leave it up to Ministers to define regulations and decide how they come forward. We have Bills that have page after page after page which, when people ask themselves, “What is this all about?”, actually amount to very little. The amendments that have been tabled, and which I support, have been tabled in good faith, but I am afraid to say that, in trying to improve the Bill, they are trying to make a silk purse out of a sow’s ear.

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2. 13 Jun 2025·Parliament·Rebecca Smith

   Terminally Ill Adults (End of Life) Bill

   I rise to speak to amendment (a) to new clause 15, tabled in my name, which I hope hon. Members will support. Although it may seem technical, it is in fact a simple amendment with a significant impact. It will ensure that there is genuine protection against abuse, proper detection of coercion, and effective scrutiny of how the law works in practice. Simply put, it will ensure that deaths from assisted dying under the Bill will still fall within the coroner’s duty to investigate deaths under section 1 of the Coroners and Justice Act 2009. I will explain why that is important. Like many hon. Members, I have been deeply concerned from the outset about how the Bill is drafted, its workability, and its impact on the NHS and on the lives of vulnerable people up and down the country. To be clear, my view is that one unintended death as a result of the Bill becoming law is one too many. I humbly ask hon. Members who are still considering their position, or who are minded to support the Bill, to consider this point about my amendment carefully: what is an acceptable error rate? Based on the figures in the Government’s impact assessment, which I think underestimates the impact, even a 1% error rate would see a minimum of 13 wrongful deaths in year 1, with 45 per year by year 10. A 5% error rate would see 65 deaths in year 1 and 227 in year 10. A 10% error rate would see 131 deaths in year 1 and 455 in year 10. As I say, I think those are low-ball estimates, but they are nevertheless chilling. If this law is passed, it will be exceptionally difficult to say whether there have been errors or instances of abuse; or, at the very least, any errors picked up will be but a fraction of the true picture, as tragically those who would testify to the fact will already be dead. My amendment (a) to new clause 15 directly addresses that issue. In England and Wales, a coroner will investigate a death when certain legal conditions are met. This duty is primarily governed by section 1 of the Coroners and Justice Act 2009. Judge Thomas Teague KC, who served until 2024 as the chief coroner of England and Wales, notes: “any death arising as a consequence of the ingestion or administration of a lethal substance constitutes an unnatural death which the local coroner is under a statutory duty to investigate”. Clearly, assisted dying meets that definition, and it is right that such deaths be afforded the best possible posthumous judicial scrutiny.

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3. 13 Jun 2025·Parliament·Rebecca Smith

   Terminally Ill Adults (End of Life) Bill

   On the first point, I do not believe that the Bill is strong enough as it stands. On the second point, we are already dealing with the fact that families are not even guaranteed knowledge of their loved one having an assisted death, so I do not think the hon. Lady’s point is entirely to be considered. As it stands, the Bill would disapply the duty of the coroner to investigate in the case of an assisted death that has been carried out in accordance with the Bill’s provisions. New clause 15, specifically, would amend the Coroners and Justice Act to clarify that assisted death does not constitute “unnatural death” for the purposes of the Act. I think it takes an extraordinary leap of imagination not to conceive of deliberately self-administering lethal drugs as anything but an unnatural death.

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4. 13 Jun 2025·Parliament·Rebecca Smith

   Terminally Ill Adults (End of Life) Bill

   I thank the hon. Member for his intervention and I completely agree with him. These are the sorts of safeguards that even the promoter of the Bill is saying should be there. I do not think that they are in the Bill and my amendment to new clause 15 would make them much stronger.

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5. 13 Jun 2025·Parliament·Rebecca Smith

   Terminally Ill Adults (End of Life) Bill

   I thank my hon. Friend. The statistics I quoted earlier are pretty clear on the point he makes. Let me make some progress. The work undertaken by the coroner is not a box-ticking exercise or a bureaucratic hurdle. In the context of assisted dying, it is an extremely powerful deterrent against abuse and malpractice. Again, to quote Judge Thomas Teague KC, in a letter to The Times on 7 May this year, he said that the removal of “any realistic prospect of an effective inquest...would magnify, rather than diminish, the obvious risks of deception and undue influence”.

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6. 13 Jun 2025·Parliament·Rebecca Smith

   Terminally Ill Adults (End of Life) Bill

   I thank the hon. Member and I will come to that point very soon. I will now make some progress; I will not take any further interventions. I struggle to see how removing automatic oversight of assisted deaths squares with a commitment to enact legislation with the “strongest safeguards in the world”. By doing so, the Bill sets a lower bar for scrutiny and review, and creates an information deficit. Put another way, we simply do not know what we do not know. Implementing a novel piece of legislation such as this without ensuring the most robust possible scrutiny of deaths taking place under the Act is astonishing. Under the Bill, assisted deaths would be the outlier, as any other intentionally procured death would automatically be reviewed by a coroner. Why should deaths under this legislation be any different? Requiring automatic scrutiny from a coroner for assisted deaths should not be viewed as an add-on at the end of the process or perhaps just a safety net, although it is that.

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7. 13 Jun 2025·Parliament·Rebecca Smith

   Terminally Ill Adults (End of Life) Bill

   No, I have already said that I am not going take any further interventions. I have been very generous with my time. It is imperative to consider the whole picture, particularly regarding malpractice or coercion—whether that be on the part of medical professionals, families or third parties. In written evidence to the Committee, Dr Rees Johnson, a legal expert from Essex Law School, highlights that, in some cultures, “decision-making is a collective process involving family and community members.”

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8. 13 Jun 2025·Parliament·Rebecca Smith

   Terminally Ill Adults (End of Life) Bill

   No. Beyond coercion, automatic inquests provide vital opportunities to identify other critical issues that may not otherwise be picked up. Without a coroner’s inquest, there would be no post-mortem examination. This is not merely an academic point; studies have shown that autopsy reveals that one in four cases have been misdiagnosed. Without this oversight, as His Honour Judge Thomas Teague KC, the former chief coroner, notes, there is “no certain means of knowing whether the approved substance has led to a quick and painless death, or a lingering and distressing one, or even whether it had failed to cause death altogether and the deceased had been dispatched by manual asphyxiation or some other unlawful means.” I am not sure whether that could be more clear. The view of experts in this area—both the Royal College of Pathologists and the former chief coroner of England and Wales—is that this Bill’s proposals, as drafted, are not fit for purpose. I strongly urge hon. Members to support my amendment (a) to new clause 15.

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9. 13 Jun 2025·Parliament·Ms Nusrat Ghani

   Terminally Ill Adults (End of Life) Bill

   I have no doubt that if the right hon. Member gives the hon. Member for Gosport (Dame Caroline Dinenage) a moment, she will address it quickly, because even Members who are contributing do not have long.

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10. 13 Jun 2025·Parliament·Ms Nusrat Ghani

    Terminally Ill Adults (End of Life) Bill

    As Mr Speaker has already mentioned, in order for everybody to get in—well, in order for most to get in—we need speeches to be shy of six minutes, and interventions to be short. I call Gregory Stafford.

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11. 13 Jun 2025·Parliament·Ms Nusrat Ghani

    Terminally Ill Adults (End of Life) Bill

    Order. Before Dr Spencer resumes, I note that this has been a well-tempered debate. Let us keep it so. We know our constituents are watching.

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12. 13 Jun 2025·Parliament·Ms Nusrat Ghani

    Terminally Ill Adults (End of Life) Bill

    Order. The hon. Lady has made it clear that she is not taking interventions at this time.

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13. 13 Jun 2025·Parliament·Ms Nusrat Ghani

    Terminally Ill Adults (End of Life) Bill

    Order. Before an intervention is taken, may I put it on the record that Members should not be wandering into the Chamber and then very quickly making an intervention? Lots of Members are waiting to speak and to make interventions. Is that the case? Have you been in the Chamber for a while?

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14. 13 Jun 2025·Parliament·Kit Malthouse

    Terminally Ill Adults (End of Life) Bill

    claimed to move the closure (Standing Order No. 36). Question put forthwith, That the Question be now put. Question put and agreed to. New clause 13 accordingly read a Second time, and added to the Bill. New Clause 14 Prohibition on Advertising “(1) The Secretary of State must by regulations make provision prohibiting— (a) the publication, printing, distribution or designing (anywhere) of advertisements whose purpose or effect is to promote a voluntary assisted dying service; (b) causing the publication, printing, distribution or designing of such advertisements. (2) The regulations may contain exceptions (for example, for the provision of certain information to users or providers of services). (3) Regulations under this section may make any provision that could be made by an Act of Parliament. (4) But regulations under this section— (a) may not amend this Act, and (b) must provide that any offence created by the regulations is punishable with a fine. (5) In this section “voluntary assisted dying service” means— (a) any service for or in connection with the provision of assistance to a person to end their own life in accordance with this Act, or (b) any other service provided for the purposes of any of sections 5 to 27.”—(Kim Leadbeater.) This clause imposes a duty to make regulations prohibiting advertisements to promote services relating to voluntary assisted dying under the Bill. Brought up, and read the First and Second time. Amendment proposed to new clause 14: (b), in subsection (2), leave out from “exceptions” to the end of subsection (3) and insert— “( ) for the following— communication made in reply to a particular request by an individual for information about a voluntary assisted dying service; (b) communication which is— (i) intended for health professionals or providers of voluntary assisted dying services, and (ii) made in a manner and form unlikely to be seen by potential service users. (3) Regulations under this section may make provision that could be made by an Act of Parliament, but may not amend this Act or the Suicide Act 1961.”—(Paul Waugh.) This amendment would limit the exceptions that can be created to the advertising ban set out in NC14 and also provides that regulations cannot amend the Suicide Act 1961, which includes the offence of assisting and encouraging suicide. Question put, That the amendment be made.

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15. 13 Jun 2025·Parliament·John Glen

    Terminally Ill Adults (End of Life) Bill

    I am grateful to have my first opportunity to contribute on this Bill. It would not be appropriate to dilate on my profound anxieties about it, but I approach these amendments in the spirit of constructive engagement. I rise to speak to linked amendments 82 to 86, which would strengthen the panel by giving it some of the features of the High Court safeguard that was, regrettably, removed. We heard from the hon. Member for Spen Valley (Kim Leadbeater) that the panel will now be stronger because it includes a broader range of expertise. The argument against that, of course, is that the High Court was a stronger safeguard because it has the powers of a court and the independence of the judiciary. My amendments would mean that we do not have to choose between the two: the panel is part of the Bill, but we can have a better panel if we give it some of the features of the High Court, namely its independence, the calibre of its judges, and its powers as a court. Amendment 82 would require all panel members to be appointed by the Judicial Appointments Commission, which nominates judges in England and Wales. Currently, the selection of panel members is wholly down to the voluntary assisted dying commissioner. Schedule 2 says: “The Commissioner must make appointments to a list of persons eligible to sit as members of panels.” I have absolutely no doubt that the commissioner will be someone of great integrity and experience, but he or she will certainly be a strong advocate of assisted dying, as will those who put themselves forward for the panels. That may create an impression that the VAD commission is a self-selecting group with a particular set of institutional views. If the system is to command public confidence, I believe that appointments would be best administered by an external body, and the Judicial Appointments Commission is the obvious choice. We in this country trust the judiciary, partly because we know that they represent no set of opinions.

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16. 13 Jun 2025·Parliament·John Glen

    Terminally Ill Adults (End of Life) Bill

    It will not surprise my hon. Friend to hear that I agree wholeheartedly. I recognise that that was a major reason that many colleagues gave at earlier points in our discussions and deliberations.

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17. 13 Jun 2025·Parliament·John Glen

    Terminally Ill Adults (End of Life) Bill

    I have been very clear that I have tabled my amendments in a constructive way to reflect the will that the hon. Lady has expressed, but to recognise the meaningful dilution in the authority of the process and what can reasonably be amended to invigorate it, based on the principles that I think were intended at the outset. I will revert to the point I was making about the judiciary. They have a commitment to uphold the law, and that should be the standard we are looking for when it comes to matters of life and death. The Judicial Appointments Commission already conducts appointments for all tribunals, including lay members. The Government’s impact assessment compared the panel to the mental health tribunal. All appointments to the mental health tribunal, including the non-legal members, are made by the Judicial Appointments Commission, so this would not be a novel function for it. Let me move on to amendment 85, which would ensure that all members of the panel have to take the judicial oath if they have not done so already. If other amendments pass, amendment 85 would be necessary only for the non-legal members, and it is crucial for public confidence that the judicial oath is taken. Amendments 83 and 84 seek to preserve an important element of the Bill as originally presented to the House. They would ensure that the most senior decision-making figure, the chair of the panel, is a High Court judge with all the experience, responsibility and professionalism that that implies. Under these amendments, all High Court judges would be automatically eligible. They would need to be currently serving or at least be below retirement age, and would have to be a judge of the highest authority and not a deputy judge. Members of this House and the public were originally told that this would be a safe Bill precisely because it would have a High Court judge. That was a persuasive promise, and I think there is a way to honour it, even in the new version of the Bill. I will briefly mention the retirement age, because it is important. It used to be 70, but judges can now continue until they are 75. However, there is no age limit for members of the panel. If we are saying that an 80-year-old retired judge is still with it and is able to decide on matters of life and death, why are they too old to help clear the backlog of criminal cases? That seems to be a meaningful anomaly. I have been very clear about the purpose of my amendments. I have tabled them in the spirit of trying to strengthen the Bill and return it to what was intended, so that it can meet the expectations of so many Members who supported it at an earlier point.

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18. 13 Jun 2025·Parliament·Gregory Stafford

    Terminally Ill Adults (End of Life) Bill

    Thank you, Madam Deputy Speaker. I am conscious of those comments and will try to limit my remarks to new clause 13 and some of the amendments to it. The Royal College of Physicians, the Royal College of Psychiatrists, the Royal College of Pathologists, the Association for Palliative Medicine and the British Geriatrics Society have all said that there are problems with this Bill, and I have heard nothing from its sponsor, the hon. Member for Spen Valley (Kim Leadbeater)—despite trying to intervene on her a number of times—about what she has done to ensure that their concerns have been addressed. This brings us directly to a fundamental concern: namely, the means by which assisted death would be carried out under new clause 13. The impact assessment for the Bill recognises that “The safety and efficacy of those substances used for assisted dying is currently difficult to assess”.

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19. 13 Jun 2025·Parliament·Gregory Stafford

    Terminally Ill Adults (End of Life) Bill

    I obviously respect the hon. Gentleman, given his medical background, but as far as I am aware those substances have not yet been used for murdering people, which is what we are going to do here. That leads me neatly on—

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20. 13 Jun 2025·Parliament·Gregory Stafford

    Terminally Ill Adults (End of Life) Bill

    I will make a little progress before taking another intervention. No safeguards can prevent complications from taking medicines. As I am sure the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) knows, there can always be complications. In this case, those could include regurgitation of the drugs, regaining consciousness and seizures.

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21. 13 Jun 2025·Parliament·Gregory Stafford

    Terminally Ill Adults (End of Life) Bill

    Can I just finish this point? During the 27 years that the law in Oregon has been in place, data is available for only about 36% of cases. However, within that, 59 incidents of regurgitation are known to have occurred and nine people are known to have regained consciousness. Different drug protocols have been used in those 27 years but the efficacy and safety of the drugs are unknown, with a time range between ingesting the drugs and death ranging from one minute to nearly six days. The lack of defined protocols for the regulation, supply and administration of life-ending substances is precisely why I have tabled my amendment (c) to new clause 13, tabled by the hon. Member for Spen Valley (Kim Leadbeater).

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22. 13 Jun 2025·Parliament·Gregory Stafford

    Terminally Ill Adults (End of Life) Bill

    I entirely agree. Some of the amendments tabled by my hon. Friend the Member for Gosport (Dame Caroline Dinenage) may address that.

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23. 13 Jun 2025·Parliament·Gregory Stafford

    Terminally Ill Adults (End of Life) Bill

    I will make a little progress, but I will give way to the hon. Gentleman in a moment. My amendment would require the Secretary of State to prohibit the use of medical devices designed to induce death by the administration of gas, such as the Sarco suicide pod, which has been in the press recently. That device bypasses medical oversight entirely and presents an ethical rupture in our current framework. If the Bill proceeds without safeguarding against such methods, we risk opening the door to a deeply troubling precedent—one that would erode professional accountability and compromise the integrity of end-of-life care.

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24. 13 Jun 2025·Parliament·Gregory Stafford

    Terminally Ill Adults (End of Life) Bill

    I thank the hon. Gentleman for his intervention. I do not disagree that drugs are used for different things; that is not the thrust of the argument that I am making. What I am saying—relatively clearly, I hope—is that when the drugs we would potentially use in these situations have been used, there have been unintended consequences and side effects. We must ensure that the drugs we use, if the Bill passes, are absolutely effective in what they are intended to carry out: namely, the end of the life of the individual.

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25. 13 Jun 2025·Parliament·Gregory Stafford

    Terminally Ill Adults (End of Life) Bill

    This is the last intervention that I will take, as I must make progress.

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26. 13 Jun 2025·Parliament·Gregory Stafford

    Terminally Ill Adults (End of Life) Bill

    My right hon. Friend is entirely correct. The Royal College of Physicians has said: “Medicines prescribed and administered in assisted dying must be regulated for safety and efficacy for this use.” If that is a requirement of the Royal College of Physicians, we in the House should take it seriously and put it into the Bill. I will now draw my remarks to a close, but I should say that I also support amendment 99, which would require a report on the drug’s effects before Parliament approves the regulation, as well as a number of the other amendments, which hopefully would remove the wide-ranging Henry VIII powers currently in the Bill. In the light of all that I have said, I remain deeply sceptical as to whether the Bill, in its current state, provides the robust, protective and operationally sound framework that such a profound societal change deserves.

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27. 13 Jun 2025·Parliament·Dr Kieran Mullan

    Terminally Ill Adults (End of Life) Bill

    May I start by offering the condolences of His Majesty’s Opposition to all those affected by the Air India plane crash, including the families of the very many British citizens who, very sadly, lost their lives. Our thoughts are with all of them. As is well understood now, the Opposition remain neutral on the principle of whether assisted dying should be introduced. That will depend on the Bill’s progress through its remaining stages in this and the other place. However, I wish to raise two important matters. First, on the matter of time, all of us understand the considerable challenges that Mr Speaker faces in having to balance the desire of colleagues to speak on this matter with the limited time available for private Members’ Bills—I know that he is doing his best to strike that balance. A number of Members have pointed out that the time being given to this Bill is significant and more than that normally allocated to even quite substantial Government Bills. None the less, it is right to acknowledge that this is far from an ordinary Bill. It is hard to think of a more deeply consequential and highly contentious piece of legislation for our society. The reality is that, both today and in previous sittings, a number of Members have been unable to speak. There has been an informal time limit on speeches, and interventions have necessarily been limited as a result. Debate in this House is important not just because it decides how we vote, but because it is used by the courts to help interpret legislation. A more limited debate limits the scope for that. Ordinarily, a Minister would have significant time at the end of Report to deal with amendments, provide clarification and explain intention, in a way that the promoter of the Bill will not. Again, a majority of Members may be satisfied with that, but very many are not. Although what we decide on the business of the House is ultimately determined by majority vote, how we reach a decision and how we allow alternative views to be explored matters. We should all consider whether we want a debate of such importance to be curtailed in the manner that it has been. I ask the Government to consider assisting Mr Speaker by making more time available for us to ensure that, on Third Reading, we have the fullest debate possible, with every Member having a reasonable opportunity to speak and take interventions in the way that they would like. Secondly, Members will be aware that the Bill, although extensive, is not the full picture. As others have highlighted, significant elements of how assisted dying will operate are due to be determined by future delegated legislation. The Government’s delegated powers memo notes that the Bill contains 38 delegated powers, including Henry VIII powers, and more powers are contained in the promoter’s amendments that are scheduled for decision today. They include matters such as the content, form and thoroughness of doctors’ reports, regulations for replacing a co-ordinating doctor who is unable or unwilling to continue, and decisions on who will be notified of the panel’s decision, which has been raised as an important potential safeguard. Those are not trivial matters. These pieces of legislation cannot be amended and MPs can vote only yes or no. In some cases, they are unlikely to be debated, and they almost certainly will not be on the Floor of the House. It is important for Members to fully understand that. MPs often have to weigh up the consequences of rejecting such legislation when they disagree with it, because it could leave a void. Members are well within their rights to be content to proceed regardless. Certainly, a majority of the Committee have presented a Bill to the House with the composition as described. That is, of course, a legitimate choice for Members to make. We have heard in the debate today about amendments to curtail these powers, and Members will need to decide their views on that. I urge the Government, in the interests of helping Members to have the clearest possible idea of how a scheme they are being asked to vote on will operate, to provide as much detail as possible on what these future regulations might consist of. Although we will not be able to have all the answers, I think most Members would agree that it is better that we vote with more detail, rather than less, even if they are satisfied to support assisted dying in principle. This is something that only the Government can do. I ask that the Minister reflects on that challenge in his closing remarks, alongside giving the Government’s response to those asking for more Government time to allow wider debate with more Members able to speak. I emphasise again that the Opposition remain neutral on whether we should introduce assisted dying, but it is incumbent on us to at least draw attention to matters of procedure that can be addressed only by the Government. I look forward to the Minister addressing the concerns of Members along the lines reflected in my remarks today.

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28. 13 Jun 2025·Parliament·Dr Caroline Johnson

    Terminally Ill Adults (End of Life) Bill

    I refer right hon. and hon. Members to my entry on the Register of Members’ Financial Interests—I am an NHS consultant paediatrician. The debate so far has focused primarily on ethical considerations, legal frameworks and who will be eligible—the who, the when and the why—but I want to focus my remarks on the how. As a doctor, I know that various drugs in different combinations can be fatal; in other words, there is more than one way to kill people. Which would be the best drug, if that is what we wished to do? Which would be the most comfortable, and how do we know? Some forms of assisted dying use neuromuscular blockades, which, in common parlance, means that they paralyse the body. Imagine a situation where someone in a lot of pain is given such a drug; from the outside they would look relaxed and peaceful as their muscles relaxed, but inside they would be in a lot of pain, and unable to express that to anybody else. Do we want people to be comfortable and to know that they are comfortable, or only to appear comfortable to us? Clearly, we want them to be comfortable inside as well. We therefore need to have drugs that are properly understood and regulated for this purpose. Assisted dying is often portrayed as safe, peaceful and controlled, but the reality in comparable countries where it has been legalised so far is more complicated. Technical difficulties frequently arise, leading to complications causing greater suffering, requiring intervention and potentially leading to a prolonged and painful death. A report in The BMJ by Dr Suzy Lishman, former president of the Royal College of Pathologists—who, I should say, works at the same trust as me—showed that there is a lack of reliable data on the effectiveness and safety of the drugs used, largely due to inconsistent reporting in jurisdictions where such dying is legal. In Belgium it is estimated that only 52% of euthanasia cases are reported to the Federal Commission for the Control and Evaluation of Euthanasia. During a Select Committee visit in the last Parliament to Oregon to discuss assisted dying, which I and two other hon. Members from the Labour Benches went on, we heard about the complications being unknown in 71% of cases. No healthcare professional was present when the drugs were given so we could not really know, and we did not even know if the drugs had been taken in some cases. Where we did, we found a history of seizures, vomiting and prolonged deaths. On having been given the drugs, patients in nine cases in Oregon in 2023 had reawakened later. How they felt in the intervening time is difficult for us to know. In Washington, a 2018 report found that 31% of patients took more than 90 minutes to die. I also remind hon. Members that an absence of evidence that things are not going well is not evidence of an absence of things going wrong.

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29. 13 Jun 2025·Parliament·Dr Caroline Johnson

    Terminally Ill Adults (End of Life) Bill

    I think one of the key problems with this form of intervention, compared with others, is that we cannot ask the patients afterwards how that felt. We cannot get their feedback, because they are dead. If we are going to give them things such as neuromuscular blockers or sedatives, we may not be able to tell what they feel. There are physiological ways in which we can monitor patients and get some idea—perhaps in their heart rate or blood pressure—but we will not be doing that. That is, therefore, one of the reasons for my tabling the amendments, to ensure that the drugs are properly regulated by the MHRA, so that we know that they have been properly tested on the purpose for which they are to be used.

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30. 13 Jun 2025·Parliament·Dr Caroline Johnson

    Terminally Ill Adults (End of Life) Bill

    I do not have much time and I do not want Madam Deputy Speaker’s cough to return. [Laughter.] If one examines the litany of drugs involved in other jurisdictions where assisted dying is legal, it makes for troubling reading. It is often an ad hoc cocktail of lethal substances, including sedatives, analgesics, cardiotoxic agents, neuromuscular blockers and antiemetics. There is no internationally agreed drug regime. Jurisdictions such as Oregon, Canada and the Netherlands use varying combinations of barbiturates, sedatives, opioids and antiemetics. In 2020, the official Oregon report stated that, compared with single barbiturates, “All drug combinations have shown longer median times until death”. As the Bill currently stands, doctors will have to consider prescribing untested drugs or drug combinations, which could potentially breach the General Medical Council prescribing guidance that a doctor must be satisfied that the drug serves the patient’s needs. To address some of those concerns, I have tabled several amendments. Amendments 96 and 97 ensure that no drug can be approved under the Act unless there is a scientific consensus that it is effective and does not cause undue pain or side effects, and that it has been specifically licensed for that purpose by the MHRA. I cannot really understand why anyone would disagree with that. Amendment 98 clarifies that the Secretary of State is not compelled to approve any drug if, after consultation, it is concluded that no substance is appropriate or safe enough to meet the standard. Amendment 99, alongside amendment 100, mandates that before any regulations are laid before Parliament, a comprehensive report must be provided. That report must include time to death, possible complications including pain, and any likely side effect of the proposed substances. Again, I cannot see why that would be controversial, because surely we all want everybody to be fully informed and make fully informed decisions, and that is part of making an informed decision. Amendment (b) to new clause 13 requires any medical devices for self-administration be approved by the MHRA and that the Secretary of State consult the MHRA before making any regulations. That is a basic safeguard that we would expect in any medical intervention, and it should be a non-negotiable condition here. Finally, amendment 42 removes a time limit and therefore the pressure on the Secretary of State. I understand other people’s concerns about that. There is often a narrative that it will lead to patients being able to die at a time and in a place of their choosing. However, the regulations in the Bill require the doctor to stay with the patient from the moment the drug is given until they are dead. We have heard that that could take quite a long time. Do we really have enough doctors to do this at people’s homes at a time of their choosing? At the moment, I do not think we do, and I do not see how, in a short period of time, that will be achievable either.

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31. 13 Jun 2025·Parliament·Dr Caroline Johnson

    Terminally Ill Adults (End of Life) Bill

    The advocates of the Bill talk about the point of choice and autonomy in the decision about when and where a person will die. Can the Minister confirm whether we have enough doctors to provide a service for people to die at home at the time of their choosing?

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32. 13 Jun 2025·Parliament·Dr Caroline Johnson

    Flood Prevention: Sleaford and North Hykeham

    Before I start my remarks, I will make a declaration of interest: my husband is a farmer, and we have a small stipend to pay to the internal drainage board in relation to flood risk. My constituents in Sleaford and North Hykeham enjoy some of the most beautiful countryside that the United Kingdom has to offer. Our hard-working farmers reap the benefits of some of the best agricultural land in the country for their crops. Unfortunately, living in this area brings some environmental risks. Many Lincolnshire MPs centuries ago held the office of commissioner of sewers in the county. The job sounds unglamorous but was very important, bringing with it responsibility for managing the county’s waterways and drainage and for protecting lives and livelihoods from the risk of flood damage. I am not suggesting that I take on that role myself, but that historical flood risk has only become more acute in recent years. Land usage has intensified, our climate has become more volatile and greater pressures have started to affect our natural resources. Our county has suffered from flooding caused by overwhelmed drainage systems and excessive river levels. The effects on people have magnified too. Some people whose homes were flooded lost not just possessions, but the ability to live in their home for a long period of time; some did not return home for more than a year. Last week, I had the pleasure of visiting Heighington Millfield primary academy as it formally reopened following significant flood damage last year. The closure had major effects on the children there, who had to be bused to different schools around the county within the trust, and significant measures had to be taken to restore the school. I put on record my thanks to everybody involved in that work. The community really pulled together for those children, and the Department for Education and the Department for Environment, Food and Rural Affairs worked very hard together to ensure not just that the school was repaired, but that flood measures were put in place to try to prevent those things happening again. The school now has flood doors in place so that it can prevent flooding coming in through the doors, and it is having work done over the summer in preparation for the autumn rain to protect the outside environment, which includes bunding around the playing fields and a special garden at the back of the school on higher ground, which will absorb some of the water if the rain overtops the back again. Unfortunately, at the same time that that great work has been going on, new councillors under the direction of Reform have chosen to abolish the county council committee dedicated to managing flood risk. I will have more to say about that later. In opening this debate, I want to make a simple point. My constituents deserve to live in safety and to go about their work and education without severe disruption from climate events. We need to ensure that we are doing everything we can to protect their lives and livelihoods, and that recommendations are being followed up and maintenance work is being done on time. We also need to make the most of local expertise and experience, and not undo the good work started under the previous Government towards fostering collaboration between agencies and local people. Many communities across my constituency have been affected by flooding in recent times, and they deserve to have their experiences shared. In North Scarle, for example, residents faced huge disruption in 2024 when heavy rainfall on to already wet ground caused flooding at Mill Dam dyke. The local authority report on the event found that poor maintenance of the local watercourses had contributed to the flooding, as did problems with the surface drainage system. As I saw when I visited North Scarle in December that year, co-operation among different agencies is key in tackling these kinds of events. Lincolnshire county council is responsible for cleaning gullies and maintaining drainage, while the Environment Agency has responsibility for ongoing maintenance at Mill Dam dyke. Meanwhile, local groups such as Flood Action North Scarle contribute valuable local knowledge and experience. The EA has upheld its end of the shared responsibilities set out in the flooding report, and has engaged the local community by providing maintenance updates. It spent around £71,000 on maintenance in 2023-24. However, since the spending review published this week revealed a 2.7% cut in the DEFRA budget over the review period, can the Minister assure my constituents that the EA will still have the money to continue maintaining these dykes going forward? And what will the Minister do to ensure transparency from councils? Updates from the EA are relatively easy to access, but Lincolnshire county council’s flooding project website simply lists its own actions following each flood report as “ongoing”. My residents need more clarity than that. In Sleaford, residents faced similar problems when Field beck was overtopped in October 2023 and drainage systems again became overwhelmed. I welcome the work that the EA has done here too, with the business case for a major capital scheme approved on 2 June. I am pleased about this investment, which is projected to avoid £188 million in economic damage, deliver £74 million in people-related benefits and protect 604 properties from repeat flood damage. In Leasingham, more work needs to be done. Residents suffered flooding twice in quick succession, including in the school, in October 2023 and January 2024, when agricultural ditches overtopped and Leasingham beck exceeded its capacity. The council’s flood report recommended that the EA and Lincolnshire county council work together to carry out channel condition assessments at Leasingham beck, with the results to be reported back to the Lincolnshire flood risk and water management partnership. However, the inspections have not yet happened. Worse still, even as reports into historical flooding are calling for closer collaboration, the Reform council is undoing the successful partnerships already established. The Lincolnshire flood and water management scrutiny committee did vital work in bringing together key agencies involved in flood management and prevention: the EA, internal drainage boards, Anglian Water, district councils and other key experts. Three weeks ago, Reform abolished the committee, folding it into the generalist environment committee, which does not have the same specialist remit to cover the most important and complex environmental issue facing the county. By rejecting the valuable contributions of IDBs, district councils and local experts, Reform councillors are saying that they know better than local people who have tended the land for generations. All the main parties have opposed the committee’s abolition and have seen it for what it is: politicking with people’s livelihoods. If the Government see these reckless actions being wrought on local communities in Sleaford and North Hykeham and elsewhere in Lincolnshire, what can they do to ensure that councils uphold their responsibilities to residents? Instead of cancelling initiatives, we should be creating new ones. I was encouraged by the excellent work done under the previous Government to advance the water maintenance pilot scheme, which was designed to foster collaboration between farmers and the National Farmers Union, local drainage boards and the EA. The scheme enabled greater co-ordination and common-sense flexibility in the management of waterways—for example, by training local landowners in how to manage watercourses, and then allowing them to carry out their own minor channel clearance and maintenance work for themselves. The scheme helped to avoid the ludicrous, heartbreaking situation in which local people can see a problem with a local watercourse, are aware it is going to flood their farm, land or their home, and have the equipment and the know-how to do something about it, but the law prevents them from doing so. It is illogical. Public sector co-operation agreements already exist to help streamline those schemes and place participants on a clear legal footing. One of the great local successes under that framework was the 2018 silt dredging of the South Forty-Foot drain, a farmland drainage channel dating from the 17th century, under a PSCA between the Black Sluice drainage board and the EA. Why have the lessons of those schemes not been applied more widely? Since the last election, the scheme in my own constituency has ground to a halt, and with it have gone the benefits that were already accruing. Will the Minister commit to supporting those schemes and encouraging their wider roll-out? As she looks to her budgets, it is worth recognising that it is much cheaper for the IDB to clear drains and ditches than for the EA to do so, since the EA’s procurement process is so cumbersome that it becomes significantly more expensive. One of the things that frustrates many local people in my constituency is that they could do the job and get it done much quicker. They are waiting, and places are flooding while it is not getting done. Another thing that the Minister could discuss with the Treasury is that the IDB has been prevented from using red diesel in its pumps. The IDB has told me that the problem is that the pumps are placed in isolated places, and believe it or not, people are stealing the diesel. It is white diesel—it is expensive, so it is worth something—and people are stealing it from the pump, which is putting everyone at risk. The IDB feels that if it were red diesel in those pumps, theft would be much less likely. Brant Broughton is an area in which a number of houses flooded. We have had a less promising update from the Environment Agency in that respect; it says that it was expecting to receive a model of the river system around the summer of 2025.

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33. 13 Jun 2025·Parliament·Dr Caroline Johnson

    Flood Prevention: Sleaford and North Hykeham

    The Minister is nodding—I do not know whether she has an update on what the Environment Agency means by “the summer”. We were expecting the health plan in the spring, and that has been and gone, so if she could help with that, that would be really great. There is some concern about the overall cost-benefit ratio, given the number of houses. I encourage the Minister to remember that although the people who live in rural areas may live in areas that are less densely populated, they have as much right to a safe environment as anybody who lives in a more densely populated part of the country. There are more examples of communities in my constituency that have suffered the impacts of flooding and are crying out for a joined-up and proactive approach that will protect them from repeat occurrences in the future. In Washingborough and Timberland, a familiar story happened in recent floods: heavy rain, overwhelmed drainage and excessive water runoff led to communities being left to suffer. While the EA has carried out some channel clearance and vegetation management, flood reports make clear that responsibility falls between central agencies, the county council, landowners, and stakeholders such as Anglian Water. Once again, it is vital that open communication is at the heart of the strategy, and that politically motivated meddling is not allowed to get in the way. I took the chair of the Environment Agency and the former Minister, my hon. Friend the Member for Keighley and Ilkley (Robbie Moore), to visit the Delph at Washingborough when it was full. It was very clear that the EA’s priority had been to protect the small creatures living in the dyke by not clearing the vegetation out, but of course, once the floods came, those small creatures were no more anyway. It would have been much better for the creatures, the environment, and the wider countryside and the people who live there if those dykes had been cleared properly in the first place. Trees were literally growing in that dyke when we went to see it. There are two final communities facing specific future threats that I would like to highlight. In Ruskington, residents endured flooding in 2023 and 2024 caused by the overflow of Ruskington beck. I understand that the Environment Agency has been conducting bimonthly maintenance and debris removal, and is investigating a capital programme for defences in Ruskington as part of the next five-year funding period. Any scheme will have to meet economic viability criteria and defined cost-benefit metrics, despite future house building plans that will see more land covered, more people in at-risk areas, and more demand on drainage systems. As of December 2024, under the Government’s new targets, the central Lincolnshire partnership—of which North Kesteven forms a part—faces a house building target of 1,552 houses per year over the course of this Parliament, an 47% increase on the previous target. Can the Minister assure me that the cost-benefit analyses deciding the fate of future flood defence schemes will take account of the Government’s rampant house building plans, and will account for all the ways in which flooding impacts a community such as Ruskington, from work hours lost to home damage, insurance claims, watercourse repairs and drainage clearance? Finally, Anwick suffered in the floods of 2023, when the River Slea and its tributaries experienced very high water levels. The EA and Anglian Water have been engaged in positive liaisons to manage risks at the River Slea, Farroway drain and Anwick catchwater, but residents in Anwick contacted me in September 2024 when a sewage processing plant flooded, causing discharge and polluting smells across the area. I met Anglian Water to discuss those constituents’ concerns, but their bigger concerns are now about a biogas digester that may be built immediately next door. In this case too, it is vital that lessons are learned and that we avoid repeating mistakes that will lead to more disruption for local people in the future. Addressing the risks requires the careful allocation of money. A glance at the most recent funding allocations under the flood and coastal erosion risk management grant in aid scheme shows that many dozens of projects appear in the bidding process but receive no funding. The allocation data for the Upper Witham internal drainage board in my constituency shows 15 intended projects listed for completion between 2023 and 2040, but none has any grant funding at all allocated this year. Lincolnshire county council, meanwhile, is due to receive £103,500 in grant funding over 2025-26 for year one of the property flood resilience project. Two smaller projects will receive a total of £52,500 from non-grant public contributions, but 19 other projects will receive no funding at all. The Government have made much of the £2.65 billion in funding for flood defences that was announced in February, but as I have said before, governing effectively is about making choices. Can the Government clarify for my constituents how the EA is expected to prioritise its funding among the many equally important projects that need support, especially in light of cuts to the DEFRA budget? How much money is spent on developing schemes that subsequently do not come to fruition? What is the estimated cost—in household damage, lost output and broader economic terms—of deciding not to act? As I mentioned earlier, the hard-working farmers in my constituency do so much for our local and national economy and for this country’s food security, and it is vital that we remember them. What will become of agricultural productivity in areas left with inadequate flood defences? What will happen to food security when some of our best-quality agricultural land is lost to frequent inundation, and how are farmers meant to prepare for this uncertainty–—in economic and practical terms—when they already face such a heady mix of threats to their livelihoods? Just as farmers have been left to face the family farm tax instituted by the Labour party and have suffered the sudden loss of the sustainable farming incentive, they will also face the threat of flooding, without the help and support they need, if this Government fail to act in the long-term interests of rural communities. We have reached the time for action on flood prevention and resilience. As I noted earlier, the way to manage the risks is with local knowledge, collaborative and long-term management strategies, and proper funding—essentially, with basic common sense. First, we must keep the valuable expertise of local people within the decision-making system. IDBs, local farmers and expert local committees know their land best, and we must give them the tools and authority to manage their own environments. Secondly, we must build on projects such as the water maintenance pilot to foster long-term planning and inter-agency working. We can do more: the creation of a Lincolnshire rivers authority, for example, would provide a structured platform for long-term flood planning that could be tailored to the needs of local people, rather than to the nationwide EA or DEFRA frameworks. Finally, we must ensure that vital projects receive the necessary funding, without being held up by central agencies’ cost-benefit frameworks. Local authorities should hold budgetary power as well as decision-making power to make sure that interventions are made where they are needed most, and in a timely and efficient way. With these measures, we can make sure that local people have control over their own local environment and give them the tools they need to prevent the devastating impacts of flooding, which have blighted some areas of Lincolnshire for too long.

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34. 13 Jun 2025·Parliament·Dr Caroline Johnson

    Flood Prevention: Sleaford and North Hykeham

    When I went around looking at the different areas of flooding in my constituency, I got a consistent message: that the EA had not performed as well as the IDBs and that it was costing more money per activity. In her final few minutes, can the Minister touch on how the IDBs can do more of the work and engage more local people in doing it for themselves?

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35. 13 Jun 2025·Parliament·Dr Ben Spencer

    Terminally Ill Adults (End of Life) Bill

    Before I come to the substantive part of my speech, I would like to pick up on the comments of the hon. Member for North Warwickshire and Bedworth (Rachel Taylor). I have signed the amendments tabled by my right hon. Friend the Member for Salisbury (John Glen). I support them because I think the panel needs strengthening. It is not the case that courts have to be adversarial. Tribunals are set up to be inquisitive. In fact, the mental health tribunal is set up to be inquisitive. That is why, in Committee, I tabled amendments to use a tribunal panel as the mechanism for scrutinising decision making. It has been a real pleasure to listen to the debate, particularly in relation to the prohibition of advertising, because the debate started to move to focus on the issue of suicide promotion and prevention. I have been quite concerned from the beginning that that has not been part of what we have been talking about. Duties to prevent suicide—whether they be doctors’ duties under article 2 of the European convention on human rights, the NHS’s clinical duties around suicide prevention, or duties relating to the Mental Health Act 1983—are a blind spot in the Bill. The reason why the issue has not been focused on until now is that the Bill has been framed as the assisted dying Bill, as opposed to the assisted suicide Bill. I blame myself in part for that, because I started by called it physician-assisted suicide, but then I started using the term “assisted dying” because it was in common parlance and it was what everyone was using. The problem is that it frames it as something else. It frames it as reducing the dying process as opposed to what it is, which is an act to end somebody’s life. That is why the Bill amends the Suicide Act, and it is why I have tabled similar amendments on how it is conceptualised.

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36. 13 Jun 2025·Parliament·Dr Ben Spencer

    Terminally Ill Adults (End of Life) Bill

    I thank the hon. Member for her intervention. Of course there are situations in which a decision to end one’s life is perfectly understandable—indeed, rational. I spent my career looking after people, many of whom presented to me and to medical services with thoughts about wanting to end their life. Many of them had mental illness. Some had terminal illness. The fundamental problem with the Bill is that it has a complete blind spot for those people who are highly vulnerable. It is scandalous that we have got to this point and are still having a debate about the core concepts. The Bill should have been dealt with properly from the start with a royal commission or a review so that we did not get to the point where we are still debating core principles on Report.

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37. 13 Jun 2025·Parliament·Dr Ben Spencer

    Terminally Ill Adults (End of Life) Bill

    I thank the hon. Member for his intervention. Of course, these are difficult things to disentangle. People will say, “You would say this, wouldn’t you, Ben?”, but we should get the person in front of a psychiatrist or a clinical nurse specialist working in psychiatry. This is what psychiatry does; this is what it is about. That is why I tabled amendments to ensure that the person is put in front of a psychiatrist as part of the process to deal with the blind spot. [Interruption.] Apologies, Madam Deputy Speaker; I will finish now. My amendment would ensure that the code of practice clarifies the interaction with services.

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38. 13 Jun 2025·Parliament·Dr Ben Spencer

    Terminally Ill Adults (End of Life) Bill

    I think I am pushing it. I tried to intervene on the hon. Member for Spen Valley (Kim Leadbeater) to ask what she thinks about that. She is welcome to intervene on me now if she has further points to add. Otherwise, I ask the Minister to address those points.

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39. 13 Jun 2025·Parliament·Dr Andrew Murrison

    Terminally Ill Adults (End of Life) Bill

    My hon. Friend was right to table his amendment, which I certainly support. Does he agree that the Medicines and Healthcare products Regulatory Agency would insist that a barbiturate or any other substance used in medicine should be approved for a specific cause? We cannot translate that to a completely different cause or reason for using it. Would he also agree that the way to deal with the issue is for it to be properly regulated through the MHRA?

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40. 13 Jun 2025·Parliament·Dr Andrew Murrison

    Business without Debate

    On a point of order, Madam Deputy Speaker. Mr Speaker said earlier today that a Minister would come to the House on Monday to discuss the middle east. Given the events overnight, which have continued to deteriorate during the course of the day, have you had any indication that a Minister will come to the House in the few minutes left before we rise to discuss the middle east, in particular Israel and Iran, given UK equities in the area and more generally?

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