Stephen Kinnock MP: speeches

Speeches

• 25 Mar 2025 · Community Pharmacy · Hansard source

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  On the NPA, it has taken us a while to clean up the utter mess that we inherited in community pharmacy. That involved agreeing financial envelopes and getting into negotiations with CPE. Those negotiations have been constructive, and I am delighted to confirm again that we will soon announce the outcome of those negotiations. What we see here is the shadow Minister apparently taking the side of people taking collective action in a premature way that is detrimental to patients. They would be better off waiting for the outcome. The Government are taking industrial relations into the 21st century, as opposed to the performative nonsense that we saw for 14 years.

• 25 Mar 2025 · Community Pharmacy · Hansard source

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  This Government recognise the vital role that community pharmacies play as an integral part of our health system and local community. We are working with Community Pharmacy England on the pharmacy contract, which will start to stabilise the sector and make it fit for the future, and we will announce the outcome very shortly. On hub and spoke dispensing, we intend to lay draft secondary legislation in the coming weeks to come into force later this year.

• 25 Mar 2025 · Community Pharmacy · Hansard source

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  We will publish the economic analysis imminently. He mentioned the National Pharmacy Association, which gives me the opportunity to say that I think that the collective action that it is taking is premature, unnecessary and detrimental to community pharmacy patients. I urge the NPA to reconsider its position and wait for the outcome of our negotiations with the CPE, which will come very shortly. We will announce that very soon.

• 25 Mar 2025 · Community Pharmacy · Hansard source

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  My hon. Friend is right that we inherited a community pharmacy system that had been neglected for far too long, such that over the past two years, on average six pharmacies have been closing every week. A wide range of community pharmacies and representative organisations fed into the public consultation on hub and spoke reform, and I am pleased to confirm that their responses were overwhelmingly positive in support of model 1 of hub and spoke, which we will be going with.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  It is a great pleasure to serve under your chairship this afternoon, Mrs Harris. The Government remain committed to ensuring the legal robustness and workability of all legislation. For that reason, we have worked with my hon. Friend the Member for Spen Valley on some amendments to the Bill. Where changes have been mutually agreed by my hon. Friend and the Government, I will offer a technical, factual explanation and a rationale for the amendments. Amendment 525 would remove the Secretary of State’s explicit power to make regulations enabling the provision of assistance as part of the health service in England and Wales. It might therefore prevent such assistance from being provided by the NHS. The Secretary of State would still have the power to make arrangements for the provision of assistance or to delegate the making of arrangements. However, it is doubtful that those arrangements could be made through the NHS; rather, the Secretary of State could, for example, make arrangements for another body to provide assistance. The effect of amendment 537, as drafted, is potentially ambiguous. However, the Government’s assessment is that it could be interpreted as allowing regulations to enable the provision of assisted dying by a registered charity, while not allowing provision as part of the health service. That could put into doubt whether assisted dying could be provided as part of the NHS in England and Wales. Amendment 528 would prevent any body other than a public authority from being authorised by regulations to provide assistance as set out in the Bill, regardless of whether that body is contracted to do so by a public authority. That would limit the scope of the Secretary of State’s powers to ensure that assistance is available in the absence of a definition. The meaning of “public authority” might be unclear. Amendment 529 would remove the power to amend, revoke or repeal legislation via regulations made under clause 32(1) concerning arrangements for assistance, where passed or made before the end of the Session in which the Bill is passed. That could lead to gaps in the Secretary of State’s regulation-making powers and in other legislation. It could also have an impact on the workability of arrangements for assistance and, ultimately, the Bill. Amendment 530 would add two requirements when making regulations under clause 32, which sets out the Secretary of State’s powers to ensure that assistance is available. The first is that the Secretary of State may not lay regulations before either House under subsection (1) unless an impact assessment of those regulations is also laid before both Houses. The second is that the impact assessment must include an assessment of the impact of the regulations both on the health professional workforce and on the NHS itself. Impact assessments are routinely prepared to accompany secondary legislation. However, the amendment would impose a statutory requirement on the Secretary of State to prepare an impact assessment, which would need to be laid before both Houses. It would therefore create a legal requirement that is not the standard for secondary legislation.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  The Government have worked with my hon. Friend the Member for Spen Valley on amendment 223, which would broaden the regulation-making power using standard legal wording so that any regulations made under the Bill can ensure that it works effectively with other legislation. Amendment 223 agreed to. Amendment proposed : 545, in clause 39, page 23, line 6, leave out subsections (3) to (5) and insert— “(3) The Secretary of State may not make a statutory instrument containing (whether alone or with other provision) regulations under section 5(3A), 8(6A),30(3), (Voluntary assisted dying services: England) or (Voluntary assisted dying services: Wales) unless a draft of the instrument has been laid before, and approved by a resolution of, each House of Parliament. (4) Any other statutory instrument made by the Secretary of State containing regulations under this Act is subject to annulment in pursuance of a resolution of either House of Parliament. (5) The Welsh Ministers may not make a statutory instrument containing regulations under section (Voluntary assisted dying services: Wales) unless a draft of the instrument has been laid before, and approved by a resolution of, Senedd Cymru.”— (Kim Leadbeater.) This amendment brings together the various provisions about the procedure for regulations. It also makes regulations under clauses 5 and 8 about training, qualifications and experience, and regulations under NC36 and NC37, subject to the draft affirmative procedure. Question put, That the amendment be made.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  The new clause would ensure that anyone seeking assistance under the Bill in England or Wales receives any services, reports, declarations or certificates of eligibility in Welsh if that is their first or preferred language. It is linked to the amendments tabled by the promoter to ensure that the form and content of any statement or declaration be set out in regulations, rather in the schedules to the Bill. The new clause would require any regulations made specifying the form and content of declarations or statements required in relation to the first declaration, the co-ordinating and independent doctors’ assessments, the second declaration and the final statement to make provision for those to be provided in both English and Welsh. A legal requirement that all services, as well as reports, declarations or certificates of eligibility, must be provided in Welsh, where an individual’s first or preferred language is Welsh, would go beyond usual practice in England. Such a requirement may lead to operational issues, such as there being a reduced pool of registered medical practitioners or assisted dying panel members who are able to carry out the functions under the Bill. I want to put on record again the Government’s continued commitment to devolution and to working with the devolved Governments. The Government have taken a neutral position on the Bill and on the matter of assisted dying, but we are committed to working together with the Welsh Government to resolve any legal and technical issues, and to discussing constitutional matters that might arise.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  It is a pleasure to serve under your chairship, Sir Roger. Amendments 452 and 453 would amend the review provisions in clause 35. As the Bill stands, clause 35(1) provides that the Secretary of State must undertake a review of the operation of the Bill and lay a report before Parliament. This is a one-off obligation that must take place after a period of five years, beginning from the date the Bill is passed. Amendment 452 would amend that requirement, and instead require the Secretary of State to undertake a review, and prepare and publish a report every 12 months after the passing of the Bill. Amendment 453 would remove the definition of the initial five-year period and is consequential on amendment 452. That increased frequency of reporting would naturally increase the administrative burden and cost of the Bill. It is also noted that there will be an implementation period following Royal Assent. It is unclear if the intention is to require the Secretary of State to undertake a review of the operation of the Bill and prepare a report during this implementation period.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  That is a good description of it. The wording used in the clause is “consequential and transitional provision”, which is another way of saying exactly what the right hon. Gentleman has described. Question put and agreed to. Clause 38, as amended, accordingly ordered to stand part of the Bill. Clause 39 Regulations

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  New clause 36 creates the basis for the provision of assisted dying services, in compliance with all the legislation that defines how the national health service works. If the new clause is agreed by the Committee, and ultimately by Parliament, further amendments and changes will not be required. It will be the basis for the provision of the assisted dying service, within the framework of all the legislation that defines how the NHS works.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  New clause 36 specifies that the Secretary of State will, by regulation, set out the operating framework for the delivery of the assisted dying service. That will be the change to the legislation that is required. I apologise to the hon. Gentleman if I am missing something. I do not know whether we are talking at cross purposes here. What I am saying is that new clause 36 provides the basis for the delivery of the service. I am sorry if I am missing his point, but that is my understanding.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  I make these comments without a value judgment; it is simply a statement of fact that an increase in the amount of reporting, and the time and resource that that would take, would inevitably lead to a cost. I make no value judgment on that; I am merely here to point out to the Committee the Government’s view on all aspects of the Bill’s technical implementation, and the consequences of any changes that the Committee may wish to make to it. Amendments 493 to 495 would change the period after which a review of the Bill is required from five years to three years. As I mentioned, clause 35 provides that the Secretary of State must undertake a review of the operation of the Act and lay a report before Parliament within 12 months of the end of the five-year period after the Bill is passed. The amendments would instead require the review of the operation of the Act and the preparation and laying of the report to take place within 12 months of the end of the three-year period that immediately follows the day on which the Bill is passed. [ Interruption. ]

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  I was cut off in my prime, but I am ready to start again. New clause 37 will give the Welsh Ministers a power to make regulations about voluntary assisted dying services in Wales, including regulations to secure that arrangements are made for voluntary assisted dying services to be provided in Wales. Such regulations can make any provision that could be made by an Act of Senedd Cymru and that would be within the legislative competence of the Senedd if it were contained in such an Act. The Secretary of State will be able to make regulations about such services where this would be outside the legislative competence of Senedd Cymru. Subsection (6) confirms that regulations made under the new clause can make provisions with the same effect as an Act of Parliament, including amending other primary legislation. However, they could not amend the provisions in the Bill. I hope that those observations have been helpful to the Committee.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  The amendment is linked to clauses 5 and 8, which define who can and cannot be a co-ordinating or independent doctor. According to the clauses, a person who benefits financially from the death of the person cannot be a co-ordinating or independent doctor. As the Bill stands, clause 40(4) provides that a registered medical practitioner is not to be regarded as benefiting financially, or in any other material way, from the death of a person by reason only of the practitioner receiving reasonable remuneration for the provision of services in accordance with the Bill. The amendment may broaden what is meant by “benefiting financially”, so that its effect may be to prohibit a person from being a co-ordinating or independent doctor if their remuneration is greater for applications that are accepted than for ones that are rejected. However, as drafted, it is not possible to determine the effect of the amendment with certainty, so further amending is likely to be required at a later stage should the Committee accept the amendment.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  New clause 30 would introduce a duty on medical or other healthcare professionals involved in a person’s care, including assessing doctors, should they receive an indication that the person is seeking assistance to end their own life contemporaneously with one of their family members. The duty has two parts. First, the medical or other healthcare professional who receives the indication must notify the person’s co-ordinating doctor and a registered medical practitioner from the person’s GP practice. Secondly, if an assessing doctor receives notification of that fact, they must refer that person for assessment by a registered medical practitioner specialising in psychiatry and a registered social worker, and must take account of their opinion. The assessing doctor must share that opinion with the other assessing doctor. In the absence of definitions, issues could arise as to who is covered by the term “family member” and as to the meaning of “contemporaneously”. The additional referrals would add to the length of the application process.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  I associate myself with the comments of the hon. Member for East Wiltshire about the amazing work of the staff and the Clerks. May I say thank you very much to everybody? New clause 34 seeks to prevent assisted dying under the Bill from being considered a medical treatment. As drafted, the Bill is silent on the question whether the provision of assistance under the Bill can be considered a treatment. If accepted, the amendment may be interpreted to mean that the term “medical treatment” in any other legislation may not be interpreted to include assisted dying. The term “medical treatment” is used in many different contexts across the statute book and has different meanings according to context. The clause is therefore likely to produce unpredictable and potentially unintended effects.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  The right hon. Lady makes a valid point, although Scotland has a different legal system from the one that governs England and Wales. That takes us back to the legal jurisdiction question versus the devolution of health service delivery. How to make those two work compatibly is a key challenge that the Committee is seeking to address. Amendment (d) to new clause 36 could limit the Secretary of State’s ability to make provision for assisted dying services via the health service in England. For example, it could limit who can commission and regulate assisted dying services, as the Secretary of State will not have the power to amend primary legislation. If the amendment were agreed, the Secretary of State would not be able to make, via regulation, the required amendments to relevant legislation for the purpose of enabling the provision of assisted dying services in England. The Committee may wish to note that the amendment would apply only to England, which could lead to a divergence in provision between England and Wales. Amendment (e) to new clause 36 would add two requirements. First, it would provide that the Secretary of State could not lay regulations concerning the provision of voluntary assisted dying services in England unless an impact assessment of the regulations is also laid before both Houses of Parliament. Secondly, the impact assessment would need to include “an assessment of the impact of such regulations on the workforce of health professionals and on the National Health Service.” An impact assessment is routinely prepared to accompany secondary legislation. The amendment would impose a legal requirement on the Secretary of State to prepare an impact assessment that must be laid before both Houses to assess the impact on the workforce of health professionals and on the NHS in England. Practically, this could cause delays in making regulations under the Bill, by requiring a duplicative impact assessment to accompany each set of regulations, including regulations that make minor or consequential amendments. [ Interruption. ]

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  As drafted, clause 36 sets out individuals who are disqualified from acting as a witness or proxy. Amendment 454 would add to that list and exclude anyone from acting as a witness or proxy who would not themselves have capacity to request to end to their own life under the Bill. This would require there to be an assessment of the capacity of potential witnesses and proxies. There is no corresponding obligation placed on medical practitioners in the Bill to assess the capacity of potential witnesses and proxies, so it is not clear how a person would request, and be provided with, the required capacity assessment.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  That is indeed my understanding. These would be minor changes, rather than major, fundamental changes to the Bill.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  I think we are all moving in a direction where, if this Bill passes, we would like its delivery in England and Wales to be compatible, based on full respect for the devolution settlement and for the legislative consent motions. Divergence in the context of the devolution settlement is what the right hon. Lady is keen to achieve, and I think she is working with my hon. Friend the Member for Spen Valley to achieve that aim. Amendment (b) to new clause 36 would provide that the Secretary of State must, by regulations, make arrangements for the provision of assisted dying services in England. The amendment would remove the provision that regulations under new clause 36 may provide that specified references to the health service in the NHS Act include reference to commissioned assisted dying services. Secondly, it removes subsection (5), which states that regulations under new clause 36 “must provide that section 1(4) of” the NHS Act “applies in relation to commissioned VAD services”, which provides that health services must be free of charge unless exceptions apply. Finally, amendment (b) to new clause 36 explicitly provides that regulations made under subsection (1) “may not amend, modify or repeal section 1 of the National Health Service Act 2006.” If accepted, the proposed amendment may impact the provision of assisted dying services through the health service in England. The effect would be that section 1 of the NHS Act could not be amended, modified or repealed via regulations under new clause 36(1). The proposed amendment applies only to England, and the restriction does not apply to Welsh Ministers. This could result in a divergence between England and Wales in the provision of assisted dying services, as Welsh Ministers could amend section 1 of the National Health Service (Wales) Act 2006. Amendment (c) to new clause 36 would limit the scope of the Secretary of State’s power in subsection (1) of new clause 36 to make regulations that secure arrangements for the provision of voluntary assisted dying services in England. Under this amendment, such regulations cannot authorise the provision of assistance by a body other than a public authority, even if that body is contracted by a public authority to do so. That would effectively prevent the NHS from contracting with private providers to provide assistance. The NHS regularly contracts private providers to provide NHS services. It is possible that being unable to do so here may present operational challenges. The amendment applies only to England, and the restriction does not apply to Welsh Ministers. That could result in a divergence between England and Wales in the provision of voluntary assisted dying services. Amendment (d) to new clause 36 seeks to limit the Secretary of State’s power to amend, revoke or repeal other legislation for the purpose of making provision for assisted dying services.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  The Government have worked with my hon. Friend the Member for Spen Valley on amendment 546 and new clause 40, which are consequential and linked to other amendments to clause 42, relating to the commencement of the legislation. New clause 40 would require the Secretary of State to prepare, publish and lay before Parliament a report about progress made towards implementing the Bill, and the Secretary of State’s plans for implementation in subsequent reporting periods. The reporting periods are one year after Royal Assent, and every six months thereafter, until the sixth and final reporting period. Amendment 546 provides that new clause 40 will come into force on the day the Bill is passed.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  These amendments seek to ensure that the voluntary assisted dying commissioner receives the necessary information to fulfil their functions in monitoring the operation of the Bill. Amendment 539 empowers the Secretary of State to make regulations requiring registered medical practitioners to notify the commissioner, instead of the relevant chief medical officer, of any event specified in such regulations. That could include the events currently listed under clause 33(2), such as where a practitioner carries out a first or second assessment and provides or refuses to provide a supporting statement. Setting out these events in regulations would allow for greater flexibility. Amendment 540 empowers the Secretary of State to make regulations enabling the commissioner to require persons or specified descriptions of persons to provide information. For example, this could be access to medical records to inform panel deliberation. The regulations made by the Secretary of State under amendments 539 and 540 may also provide for how such regulations are to be enforced. The enforcement mechanism would help ensure compliance regarding the notification of provision of information to the commissioner under the regulations. Amendments 541 to 544 are consequential amendments. I turn to amendment 172. As introduced, clause 33(1) provides that “The Secretary of State may, by regulations, require any registered medical practitioner to notify the relevant Chief Medical Officer of any notifiable event.” A list of such events is provided in clause 33(2). The effect of amendment 172 would be that the Secretary of State would instead be required to make regulations under clause 33(1), requiring any registered medical practitioner to notify the CMO of any notifiable event. Amendment 173 would require any regulations under clause 33 to be made under the affirmative procedure, rather than the negative procedure, meaning that they would be laid before and approved by both Houses of Parliament. The purpose of new clause 38 is to allow the sharing of information between the voluntary assisted dying commissioner and certain persons. It would create an information-sharing gateway between the voluntary assisted dying commissioner and the Care Quality Commission, the General Medical Council, the General Pharmaceutical Council and the Nursing and Midwifery Council. The new clause includes a regulation-making power for the Secretary of State to specify any other person that the commissioner may share information with and vice versa. It also creates an information-sharing gateway between the commissioner and the Secretary of State, to enable the sharing of information for the purpose of any function of the commissioner, or any function of the Secretary of State, relating to the operation of the Bill. New clause 39 provides that where there is a disclosure of information that is required or authorised under the Bill, it will not amount to a breach of confidence or any other restrictions placed on the disclosure of information. The new clause makes clear that data protection legislation still applies and will need to be complied with. It is essential that any provisions under the Bill that require data to be shared do not undermine the public’s trust, security and privacy in terms of their personal data. I hope that those observations will be helpful to the Committee. Question put, That the amendment be made.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  That sounds like a sensible approach. New clause 40 sets out the report about progress made towards implementing the Bill. If I have correctly understood what he is saying, the right hon. Gentleman is looking for more flesh on the bones of what that plan should be and look like.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  Amendment 526 would impose a duty on a Minister to arrange for the report on the review of the operation of the Act to be debated by both the House of Commons and the House of Lords within 14 sitting days, beginning with the day after the laying of the report. That goes further than laying the report before Parliament as currently required under clause 35. I hope those observations were helpful.

• 25 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-ninth sitting) · Hansard source

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  I thank my hon. Friend for that clarification. It is very helpful, because I perhaps did not quite understand what the hon. Member for East Wiltshire said. My hon. Friend sets out very clearly the optionality represented in new clause 36. The new clause further ensures that voluntary assisted dying services provided as part of the health service must be free of charge, unless charging is expressly provided for. Subsection (6) confirms that regulations made under this new clause can make provisions with the same effect as an Act of Parliament, including amending other primary legislation. However, they cannot amend the provisions in this Bill. The amendment also defines voluntary assisted dying services. Amendment (a) to new clause 36 would prohibit regulations being made that authorise the provision of voluntary assisted dying services by the NHS in England. The Secretary of State would still have a duty to ensure that arrangements are made for the provision of assistance, but not by the NHS. The Secretary of State could, for example, make arrangements for another body to provide assistance, which would mean that the Secretary of State could not ensure that assistance was provided in accordance with the Bill or through the NHS in England. This would apply only to England, not Wales. Welsh Ministers could still make regulations for the provision of voluntary assisted dying services by the NHS in Wales. This could result in a divergence between England and Wales in the provision of assisted dying services.