Kim Leadbeater MP: speeches

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Speeches

18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fourth sitting) · Hansard source
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I repeat what I said earlier about what will happen to the patient if they choose to cancel: their care will continue. From a medical practitioner perspective, it is inconceivable that those patients would be abandoned, as the hon. Member for East Wiltshire is suggesting. That would not happen. I understand that cancellation of the second declaration does not need to be included in clause 14(4) because of when in the process it would happen. The first declaration comes much earlier, so clauses 7 to 9 would be applicable; the second declaration comes further down the process, so does not need to be included. However, I am happy to look at that in further detail and come back to the hon. Member on that, if necessary. Amendment 375 agreed to . Amendment made: 376, in clause 14, page 10, line 12, after “doctor” insert “and the Commissioner”.— (Kim Leadbeater.) This amendment requires a practitioner other than the coordinating doctor to notify the Commissioner (as well as the coordinating doctor) of a cancellation of a first or second declaration . Clause 14, as amended, ordered to stand part of the Bill . Clause 15 Signing by proxy
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fourth sitting) · Hansard source
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I have nothing further to add. Amendment 474 agreed to. Amendments made: 475, clause 16, page 11, line 19, leave out from second “the” to “in” in line 21 and insert “occurrence of the recordable event”. This amendment is consequential on amendments 209 and 377. Amendment 476, in clause 16, page 11, line 24, leave out from “the” to “, and” in line 26 and insert “occurrence of the recordable event”. This amendment is consequential on amendments 209 and 377. Amendment 477, in clause 16, page 11, line 27, leave out from “the” to “in” in line 29 and insert “occurrence of the recordable event”. This amendment is consequential on amendments 209 and 377. Amendment 478, in clause 16, page 11, line 30, leave out from second “a” to end of line 32 and insert “declaration, report or statement within subsection (1) must include the original declaration, report or statement.” —(Kim Leadbeater.) This amendment is consequential on amendments 209 and 377. Clause 16, as amended, ordered to stand part of the Bill. Clause 17 Recording of cancellations
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I beg to move amendment 379, in clause 21, page 14, line 10, at end insert— “(3A) The coordinating doctor must, as soon as practicable, give a copy of the final statement to the Commissioner.” This amendment requires the coordinating doctor to give the Commissioner a copy of a final statement.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I believe that amendment 447, tabled by my hon. Friend the Member for York Central, would change the “may” to a “must”. I am minded to support it for that very reason. Amendment 532, tabled by my hon. Friend the Member for Ipswich, comes from a good place as is meant to be a way of trying to help the doctor, but I worry, as medical colleagues have commented during our deliberations, that it could create more of a problem for the doctor in that it would remove flexibility and the use of their clinical judgment and expertise. It always worries me when we are considering putting that level of detail in the Bill.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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On the hon. Member for Richmond Park’s point, which a couple of people have made, I do not think anyone is saying that this is not a new situation—of course it is, as we are all aware. My hon. Friend the Member for Stroud’s point was that a doctor being with a patient who is dying is not a new situation. That is the important distinction.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I am very happy to accept amendment 22 from my hon. Friend the Member for Lowestoft, as it follows the theme of the previous amendments.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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Clause 19 applies when the co-ordinating doctor may not be available to provide assistance. They may be out of the country or unavailable due to other personal circumstances, as the hon. Member for Richmond Park articulated beautifully—I associate myself with her comments. Of course the doctor who steps in has to be trained appropriately, and if they are not satisfied of all the matters mentioned in clause 18(4), they must immediately notify the co-ordinating doctor. That is what my amendments 210 and 499 cover. On amendment 408 in the name of my hon. Friend the Member for Broxtowe, who sadly is not with us today, it could be argued—and I take on board the comments by the hon. Member for Solihull West and Shirley—that it is unnecessary because it would be common practice by practitioners to consult. However, I also take on board the fact that the word “consultation” does some heavy lifting, and I think that is an important point, so I am happy to support amendment 408. I have mentioned already in response to my hon. Friend the Member for Bradford West that I am happy to support amendment 22, for the reasons I have given previously in relation to similar amendments.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I can help my hon. Friend out on this point. There is an expectation in the jurisdictions where assisted dying happens that it happens in different locations, very much centred around the patient’s wishes, which is the approach we should take.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I have nothing to add other than to respond to the fair point made by the hon. Member for East Wiltshire about complications. The doctor does have to record the final statement in the medical records, and I am confident that they would also record any complications in the medical records. Similarly, we have talked about the code of practice with regard to complications, so there is scope to include what would happen in those instances there. It is, however, a fair point, and it could be something to look at amending on Report, if the hon. Gentleman wants it to be in the Bill. Amendment 379 agreed to. Amendment made: 500, in clause 21, page 14, line 10, at end insert— “(3A) Regulations under subsection (3)(a) must provide that a final statement contains the following information— (a) the person’s full name and last permanent address; (b) the person’s NHS number; (c) the name and address of the person’s GP practice (at the time of death); (d) the coordinating doctor’s full name and work address; (e) the date of each of the following— (i) the first declaration; (ii) the report about the first assessment of the person; (iii) the report about the second assessment of the person; (iv) the certificate of eligibility; (v) the second declaration; (vi) the statement under section 13(5); (f) details of the illness or disease which caused the person to be terminally ill (within the meaning of this Act); (g) the approved substance provided; (h) the date and time of death; (i) the time between use of the approved substance and death.”— (Kim Leadbeater.) This amendment provides that regulations about the form of a final statement must make the provision mentioned in paragraphs (a) to (i). Clause 21, as amended, ordered to stand part of the Bill. Clause 22 Other matters to be recorded in medical records
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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The Minister has covered my amendments 497 and 498 very clearly, so I will not speak to them. I am happy to support amendment 462, tabled by the hon. Member for East Wiltshire, about which we had a conversation this morning. I only make the observation that there is already a requirement in clause 18(4)(b) that, at the time the approved substance is provided, the co-ordinating doctor must be satisfied that the person has “a clear, settled and informed wish to end their own life”. Nevertheless, I am happy to support the amendment, because the hon. Member made a very valuable point this morning. I cannot support amendment 463, however. The Bill states that the patient must self-administer the drugs. Clause 18(7) states that “the final act” of self-administering the substance “must be taken by the person to whom the substance has been provided.” That is very clear. The hon. Member for Solihull West and Shirley, with his medical background and expertise, has been clear and helpful on this point: it is a question of passive versus active. We have to be clear that the patient must have an active role in self-administration.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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The amendment would require that if a person has decided not to take the substance or the procedure has failed, the co-ordinating doctor must, as soon as is practicable, notify the commissioner of that. It is fairly straightforward.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I am just trying to imagine what this would look like in reality. My own grandparents, for example, ended their days in a care home, and that was their home—that was where they lived, that was their address, and they paid to live there. If they had had a terminal diagnosis and had wanted to end their days in their home, having lived there for however long it was—four or five years—it would have felt incredibly cruel to expect them to go somewhere else to do something that was legal.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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The challenge would be in whether the co-ordinating doctor would be able to take actions that were not listed. I worry that a list would be quite restrictive. Amendment 430, which would look at the code of practice, would achieve something in a less restrictive way, which is why I am minded to support it. We have had a really interesting discussion about amendment 533, and we will probably come further down the line to discuss where patients should have the choice to have an assisted death. I am not entirely sure how the amendment would work, which is why I am not minded to support it. I am slightly concerned about the terminology and am not sure what the definition of “disadvantaged and marginalised communities” would be for the purposes of the amendment. I refer my hon. Friend the Member for Ipswich to new clause 8—the duty to consult—bearing in mind that there will be a long period of consultation before the Bill, if it passes, is enacted. The Minister referred to amendment 255, which I think will fall as it refers to a schedule that has been removed from the Bill.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I am speaking to my hon. Friend. The point she raised about “directly” and “indirectly” is a very good one, and subsection (1A) says “In particular”, which is not exclusive. That lack of clarity and certainty concerns me; does she agree?
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I thank colleagues for a thorough discussion of a group of interesting and important amendments. Amendment 429, tabled by my hon. Friend the Member for Bexleyheath and Crayford, would require the doctor to remain in the same room as the person. I respectfully disagree with my hon. Friend on that point. If a person is literally in the last few minutes and moments of their life, it should be up to them to decide who is in the room with them. In some cases, that might be the doctor, but I suspect that in many cases it would be loved ones and close family members. We have had a thorough discussion of the range of amendments that look at how we deal with complications. My view is that amendment 430 would do what needs to be done. We need the Bill to show that this has been considered, and the logical place for that would be clause 30, on codes of practice. I am happy to support that amendment when the time comes to vote on it.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I completely understand where these amendments are coming from. In many jurisdictions where assisted dying laws are in place, this would be an accepted part of the process. However, as I have said repeatedly, our Bill stands in its own right, and its safeguards are stronger than those anywhere else in the world. One of those safeguards is that the line cannot be crossed between a person shortening their own death by administering the drugs themselves and by having another person—in this case the doctor—do it for them. While I am hugely sympathetic to the argument, that is a line that I do not believe the Bill should cross. I concur with the comments of my hon. Friend the Member for Bradford West about Second Reading and what the House voted for, and with those of the hon. Member for Reigate about medical profession levels, which we discussed this morning. I also agree with the Minister’s comments about the concept of an independent witness, and with the comments from the hon. Member for Solihull West and Shirley about the concept of additional assistance. On that basis, I will not be supporting the amendments.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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The hon. Member is making an important point. I would like to get it on the record that I agree with him: there should be no duty on any person to take part in the Bill’s provisions if they choose not to, for whatever reason. I will struggle to support his amendment because there are other issues with it, but on that principle I wholeheartedly agree, and I would be happy to work with him in sorting it out, before Report, to that effect.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I have nothing to add, other than to say that the complications that have been referred to many times today would be covered by the code of practice that we will introduce by agreeing to amendment 430. Amendment 380 agreed to. Amendment proposed : 440, in clause 22, page 14, line 34, at end insert— “(4) For the purposes of subsections (2) and (3)(b), the information recorded must include— (a) any interventions made by a medical practitioner in response to the procedure failing, and (b) the timing of those interventions.” — (Sean Woodcock.) This amendment would specify certain information to be recorded under section 22 when the procedure fails. Question put, That the amendment be made.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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The hon. Lady is making some interesting points, but I am not entirely sure that they are within the scope of the amendments.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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As a matter of clarity, although I appreciate the power that the Minister has just given me, which amendments we vote for is actually the job of the Bill Committee—rather than just my job, I would hope.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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My view is that this is very clearly a matter for the Secretary of State, but with expert clinical and medical guidance. These are the people who should be making the decisions about such drugs. The evidence about this type of medication exists. As part of the commencement period and the consultation period, I anticipate there will be wide consultation about the drugs that are available. I think it is best left with the Secretary of State, so I would leave the clause unamended.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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Amendment 379 would ensure that the co-ordinating doctor provides the commissioner with a copy of their final statement in cases in which the person has successfully been provided with assistance to end their life in accordance with the Bill. That is an important part of the reporting procedures and of the role of the commissioner. If agreed to, the amendment will ensure a robust recording and monitoring process for assisted dying. Amendment 500 provides that regulations about the form of the final statement must make the provision mentioned in paragraphs (a) to (i) of proposed new subsection (3A). It builds on my amendment 214, which would amend subsection (3)(a) to require that the form of the final statement must be set out in “regulations made by the Secretary of State”. This is another way of ensuring robust and thorough reporting.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I do not think that anyone has ruled out discussing complications. Clause 9 makes it clear that the doctor has a very clear discussion with the patient about what will happen if they proceed with an assisted death.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I am not aware of the situation in America, but is the hon. Gentleman not reassured that the evidence from Dignitas, which we all now have access to, says that there have been “no cases of failure at Dignitas using this medication”?
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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If my hon. Friend will give way, in response to the point made by the hon. Gentleman, the drafting of “directly or indirectly” does worry me—

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