Tom Gordon MP: speeches

Speeches

• 29 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Fifth sitting) · Hansard source

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  Q I have a question for Professor Esmail. One of the things that we have talked about with different witnesses is whether we should have a wider panel of people looking at these decisions; that might encompass people from social care, medical or legal backgrounds. I think that that would make sure that some of the issues that we have talked about would, hopefully, be more robustly picked up on. Do you think that by moving towards that in the Bill—were we to have assisted dying—it might provide a more holistic approach to end of life and to giving people that option? How might that influence and change palliative care and other interactions? Professor Esmail: I feel that this Bill will make things much better, in the sense that when you have a conversation with someone, they could sometimes have even as a reassurance, “Look, if things get really bad, I have this option available.” That is important, and it can certainly help in that respect. In terms of holistic care, currently when I look after dying people I never do it on my own; I am with district nurses, Macmillan nurses, or on call to a palliative care consultant. There is already a team of people looking after dying people. Where it works well, it works very well. We should not be burdened by the fact that everyone complains about how terrible everything is. I would say that probably 95% of the time, it is okay. There are issues with social care and so on, but I think that palliative care—the drugs people need, how often they get them and who gives them—works very well and it works in a multidisciplinary way. I think that this legislation will allow a much more open discussion and proper monitoring. It will improve training, guidance and everything else. People say that it will enhance palliative care, and that is what I think will happen.

• 29 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Fourth sitting) · Hansard source

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  Q One of the things that we have heard from other people and other jurisdictions is about moving away from a High Court judge, and having a multidisciplinary team and panel. Do you think that would further strengthen the Bill, and would you support that? Professor Shakespeare: I think the law is only one of the influences that might be involved. There is also physical health, mental health and social wellbeing. I think a multidisciplinary panel might be a better way of finding out. But I bow to my friend Mr Amin, who has a lot more experience of legal panels than I have.

• 29 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Fourth sitting) · Hansard source

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  Q One of the things that we have heard from other countries that have assisted dying is that this is one of the strongest and most robust laws. I wonder whether Professor Shakespeare has any more views on how we could make the Bill even tighter, and provide support and further peace of mind to people who might be worried about it? Professor Shakespeare: When I read the Bill, I thought that it did have many safeguards. It has, for example, five opportunities for a conversation with doctors or other supporters. That is a good safeguard. I think it makes a criminal offence of dishonesty, coercion or pressure, so that would scare off people. Miro is quite right—there are people who might put influence on somebody, but I hope that they would be covered under clause 26 as having committed an offence. That would scare people who may have a particular view against assisted dying. How can we make it stronger? We could have more of an advocate for the person who is requesting assisted dying—somebody who will support them, within the law, to make that decision or to think about their decision. We are trying to make sure that everybody who is thinking that this is for them has the opportunity to talk about it and to think about it. The time and the conversations are all about that, but maybe an advocate also would be the person who is requesting this step, who is not a beneficiary in any way of that death, and they could be a neutral party to give advice. I am not sure. However, there is a lot here. There are five conversations. I am not surprised that people thought it was strong. I think it is a strong Bill. There is scope for doctors and other medical practitioners to act on their conscience and to withdraw from this. Miro made a useful point, which is that we do not want any disabled person frightened of their doctor or worried that their doctor, who has been supporting somebody else to die, might do that with them. In conversation, Marie, we have talked about an assisted dying service as being a part of the NHS, but I wonder whether it might be specifically around this. I think that it is worth considering whether the average doctor is the person to whom a person should take a concern or a wish to die. So this is about advocacy and maybe having a specific service for people who want to go down that route. However, I think it is a strong Bill as it stands.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Second sitting) · Hansard source

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  That was a really comprehensive answer. I think the key point that you touched on is the multidisciplinary approach.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Second sitting) · Hansard source

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  Q That is really helpful. I wonder how people like you and organisations like yours see your role in the assisted dying process. Do you think it might be better if you were further involved? Glyn Berry: In our association, we have a list of recommendations. We are very conscious that the Bill is very heavy from a clinical perspective. There are a number of things. We do not feel that the decision and assessment should be all on the shoulders of a health professional, the clinician. Some clinicians are fantastic with assessing capacity and being aware of the safeguarding aspects of situations, but not all are, and we feel that our expertise lies in that particular area. When we look at the overview of the process set out in the Bill, it is very, very clinical. Nowhere does it talk about the clinician exploring the other aspects of a person’s life; it is very much around the clinical aspect, and quite rightly so, because these are experienced clinicians. We feel that we should be involved in these decisions from the capacity and safeguarding aspect, but also in seeing whether there are things we can do to help the person make a more informed choice. If their decision to take their life is based on the fact that they do not have secure housing, that their benefits or finances are all over the place, that they do not want to be a burden on their friends or family, or indeed that they have nobody at all, those are areas that are very familiar to us in our daily practice. We therefore feel that we are well placed to support the clinicians in the whole process.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Second sitting) · Hansard source

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  Q In its current form, the Bill looks quite heavily at medical professionals; we have already heard from lots of experts in that area. In social care and palliative care, you often deal with those difficult conversations. What lessons and advice might you be able to give? How might you feed into the process? Glyn Berry: We work very closely with clinicians and other health professionals. We talk about a multidisciplinary approach, because a person is not just two-dimensional; everything about their life needs the input of others in these situations. As social workers, our expertise and strength is in being able to ask difficult questions and really dig into people’s thoughts, feelings and opinions, giving them an opportunity to say things that sometimes they have never said in a whole lifetime. Other areas are around assessing capacity and giving people the option of knowing that there is not just one way of doing things. I have worked in a hospice setting for the last six or seven years. I see daily how social workers contribute to the wider MD team in terms of safeguarding, capacity and applications for deprivation of liberty, but we also do the psychosocial aspect of palliative and end-of-life care. We sit and talk with patients, we do advance care planning and we deal with practical aspects such as supporting the arrangement of funerals. For families in which the parent or primary caregiver is the person who is ill, we will work with external statutory agencies like local authorities to give support where there may be children or vulnerable adults who are being cared for by the patient, to have provision put in place for after the death of the person. We also provide pre-bereavement support for both the patient and the family, and post-bereavement support for the family. We have quite an extensive skills catalogue to support patients and families, but one of our biggest skills we have is in communication and in not being afraid to go where other professionals may feel uncomfortable going. Having conversations about people wishing to end their life is not a new thing: we have those conversations quite regularly.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Q What further steps do we need to take to improve palliative care? How do you define when palliative care is sufficient to allow assisted dying? I am struggling with how we say we have reached that threshold. Is there ever going to be a point where we can say we have got the best palliative care? Dr Cox: I will give you some examples. We need to make sure that the 75% to 90% of people who are dying and need palliative care are getting it. We need to make sure that there is not inequity in palliative care, so that you do not have to be white and rich and have cancer to get good palliative care. We need to make sure that hospitals have seven-day services. Seven-day-a-week cover is unavailable at 40% of hospitals. We need to make sure that communities have telephone advice services at night. One in three do not have any advice overnight for patients and their families to access. There are some concrete things that we could change to demonstrate that we are delivering a good service. But currently we are not.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Q It was suggested by people who gave evidence earlier today that people might start exploring the option of assisted dying for fear of feeling a burden, and that the law cannot adequately deal with people who might be self-pressurising. Is that something that you have seen and witnessed? How do you address that motivation with your patients? Dr Spielvogel: People often feel that at the end of life, just in general. I think that conscientious people will often think about their family and how their situation is affecting their family and loved ones. That is something that many people go through, so that is something that comes up relatively frequently. It is usually embedded within a laundry list of reasons that people are looking for assisted dying. When people bring it up with me, it is more of a commentary on what they do not like about their dying processes—that they are also feeling like a burden on their family. That is a red flag for me, though: when I ask someone, “Why are you reaching for this?”, and they say, “Well, I am a burden to my family,” it is a red flag for me as a physician. This goes back to the argument about capacity and coercion, because we are trained professionals who listen for these things. This is not a rubber-stamp evaluation. When we ask people why they are looking for this, we really want to assess their judgment and see what their reasoning is. If they are saying, “I’m suffering intolerably. I’ve tried all the things that palliative care and my regular physician are offered me, but I’m still suffering irrevocably. Also, there is this other piece: I see what this is doing to my family,” that is totally valid. That is something that any of my dying patients might say, whether or not they are seeking an assisted death. If that is the only reason, that is going to lead me to ask a lot of probing questions. It would be a red flag for me, but it is incredibly rare that something like that would be the only reason. Dying is a very complex process, and people’s thought processes during their own dying are equally complex. There are a lot of things that people think about during that time. Dr Kaan: I echo Dr Spielvogel. It is common that among the lists of things that people mention as reasons, they may mention not wanting to be a burden on their families or not wanting to put their families through an onerous and prolonged dying process. Obviously, if that is the only thing that they are mentioning, it will definitely get them further discussion and exploration into what is going on and what other resources we can point them to, such as connecting them with social workers and available community resources for helping with caregiving. However, I hear most commonly that people’s desire to save their families from a prolonged dying process comes from lived experience, where they themselves went through the process with a loved one such as a mother or father: they were caregivers, sometimes for years, and felt that it was a burden on them, although they were happy to do so and it was loving. They have that lived experience and they are looking to save their family from what their experience was. I think it is common that people feel some element of that when they are in a situation where they require heavy caregiving. I think it also goes back to autonomy. People who are in their right mind and have the capacity to make this decision should have the autonomy to have their reasons and their value systems respected, whether or not we share them or see it in the exact same way.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Q Since the assisted dying Bill had its Second Reading, we have seen announcements from the Government about investment into palliative care. Obviously that is mostly capital and we need to see more long-term funding. Do you feel we are already seeing increases as a result of this conversation? Is there any reason why that should not continue? Dr Cox: I would love to see it continue. I am part of the commission on palliative and end of life care. There is no guarantee that the recommendations of that commission will be funded, and that is what concerns me. I would love to see that happen. Would it not be great if the two could happen simultaneously? But there is no guarantee that that will happen. James Sanderson: I want to come in on your point and agree with Sarah’s points. Obviously, we welcomed the Government’s announcement of the additional funding for the hospice sector, but the Committee will be aware that the hospice sector currently receives only about 30% of its funding from statutory sources. We are therefore reliant on the good will of the population to raise money and support us in various ways, and through retail and other ventures that we have. On the point about universality of service, we have in the Health and Care Act 2022 a requirement for integrated care boards to commission palliative care services that meet the needs of their population, but although there is guidance as to what that should look like, there is not universal take-up of that guidance and delivery of all of the stated services. Although that is outside the scope of this Bill, it comes back to the context of how much the overall position can be strengthened across the country. The context for anybody looking to make a decision is within the same space. As Dr Clarke said in respect of informed choice, if the context is the same for everybody, we can have more confidence that that informed choice is made at the right level.

• 28 Jan 2025 · Terminally Ill Adults (End of Life) Bill (Third sitting) · Hansard source

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  Q To build on that point—which is pretty much what I was going to ask and what I am trying to get to—Sue Ryder’s evidence to the Health and Social Care Committee inquiry into assisted dying gave examples of exactly that: cases where increases in the funding of palliative care came alongside the introduction of assisted dying. You talk about people not being able to have an informed choice unless palliative care is fixed, but do you accept that improvements can run in parallel for both assisted dying and palliative care, and that the small number of people for whom palliative care cannot help and cannot reduce their suffering are currently left without a choice? Dr Cox: I accept that there will be people even with a very good palliative care system who would still choose assisted dying. We do not currently have the very good palliative care system that we need. That is the thing that concerns me.

• 27 Jan 2025 · Topical Questions · Hansard source

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  I recently visited a school in my constituency in a building that is hundreds of years old. Its school condition allocation does not cover the work needed to keep the school warm, safe and up to date. What steps are the Government taking to ensure that classrooms in older buildings are fitted out?

• 23 Jan 2025 · ECO4 and Insulation Schemes · Hansard source

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  I am sure the Minister will recall our intimate Adjournment debate before the House rose for the Christmas recess—it was just her and me here. [ Interruption. ] Yes, and it was the day after our Christmas party, so it was an interesting debate. I sincerely welcome the steps that the Minister has outlined for solid wall insulation. The problem I have is that, fundamentally, all these issues apply to spray foam insulation, as I said in my Adjournment debate. There are blanket bans by some mortgage providers: research by the BBC showed that one in three of the top 12 mortgage lenders have such policies. I am more than happy to send on that information again. There is a real issue of fairness and justice here. It is right that we are seeking to get this right for people done wrong by those who have not installed insulation to spec, but the same must be true for those who are victims of the spray foam insulation scandal, including my constituents Tom and Norma in Knaresborough. The Minister has acknowledged in her statement that there are systemic issues, that TrustMark is not doing its work and that there are to be audits of solid wall insulation. However, when I asked whether there was an understanding of how many people had been impacted by spray foam insulation, I was told that there was not a number. How can it be that we are counting how much of one sort of insulation has been installed, but not another? Some 250,000 people have been affected by spray foam insulation. Will she give justice to them, too?

• 23 Jan 2025 · Business of the House · Hansard source

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  A year ago today, the former MPs Theresa May and Sir George Howarth launched their inquiry report into type 1 diabetes and disordered eating. The report made a number of recommendations to ensure the funding and continuation of the T1DE pilot services that have been started around the country. Since then, two services have shut down, in London and on the south coast in Bournemouth, and the remaining five pilot sites, including in the Humber and North Yorkshire, are set to run out of funding in March. If that happens, vulnerable patients will be put at risk. Will the Leader of the House allow a debate in Government time on this issue as a matter of urgency?

• 21 Jan 2025 · Terminally Ill Adults (End of Life) Bill (First sitting) · Hansard source

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  I want to touch on a few bits of language that have been used so far that just worry me slightly. When we talk about the value that experts can add to this process, it is not necessarily helpful for someone to try to say that some experts would be better than others in that regard. The phrase “best person” was used in one particular instance and there were comments about whether or not experts would add balance. The list that has been collated has taken the lead sponsoring Member of the Bill a number of weeks and months to produce. Everyone had the opportunity to feed into that process over a period of time. And on balance, it is a list that captures a wide spread of views and different organisations. During this sitting a number of points of order have been made to correct the record. In the spirit of the Second Reading debate on the Bill in the House of Commons, we need to try to make sure that we are mindful of any comment we make, so that we do not seem to try to say things that are not necessarily accurate. The point that was made earlier about eight witnesses coming from foreign jurisdictions is important. My understanding of this whole process is that it is not about our trying to decide whether the Bill should go ahead or not; it is about trying to understand what would be workable. So, hearing from people in places that have already implemented assisted dying is far more useful than hearing from people in countries that have not done so. We have also heard from Members about which of those countries are more comparable to us. It does not necessarily help us if someone takes us round in circles and talks about the point rather than trying to get on with the work. I fear that that is where we are at with these amendments. If we are now trying to rejig who will give evidence and at what time, that stops us from doing the important job of scrutinising the legislation and hearing from the expert witnesses that we want to call. These amendments are not minor changes. Regarding the list that has already been collated, I know that it has taken a lot of time to establish when the witnesses on it are free and available to give evidence. I am not sure that those witnesses referred to in the amendment have the same level of availability in their diaries. So, on balance, we should proceed as the lead Member has been putting it, and putting it so well.

• 21 Jan 2025 · Terminally Ill Adults (End of Life) Bill (First sitting) · Hansard source

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  Will the hon. Member give way?

• 20 Jan 2025 · Family Visas: Income Requirement · Hansard source

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  The Conservative spokesperson, the hon. Member for Weald of Kent (Katie Lam), mentioned the point about personal independence payments. Obviously, not everybody who has a disability is eligible for every benefit; there are certain thresholds and requirements in order to get those statuses, and the conditions of people with disabilities might vary and change. How does that factor into what the Minister is saying?

• 20 Jan 2025 · Family Visas: Income Requirement · Hansard source

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  We have heard a lot about sector-specific issues, and about regional inequalities and inequalities of race and gender, but does my hon. Friend agree that there is also an issue for people with disabilities? My constituent is an armed forces veteran who now suffers from PTSD and a range of other disabilities that leave him able to work only part time, which would massively hamper his ability to hit any threshold. Does my hon. Friend agree that we need to ensure that the system that works for everyone and gives back to the people who have served our country?

• 20 Jan 2025 · Family Visas: Income Requirement · Hansard source

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  I am slightly surprised. The hon. Lady raised a number of points about her own Government’s record and what they were unable to deliver, so does she not find it a little jarring that she is now preaching to this Government about what they should do?

• 16 Jan 2025 · Business of the House · Hansard source

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  Last week, I met representatives of the Environment Agency at Knaresborough lido, which was granted bathing water status last year thanks to the hard work of local campaigners and the former MP, Andrew Jones. The Environment Agency has said that, unlike other rivers with sewage and pollution issues, which are usually due to adverse weather events and heavy rain, the issue on the River Nidd looks to be continuous, regardless of the weather. It is particularly bad during dry spells, which leads the Environment Agency to believe that it is down to housing developments that might be inadvertently, or deliberately in some cases, tapping into existing sewerage networks. Will the Leader of the House speak with her colleagues in the relevant Department to ensure that, when we look at the issue of water quality, we also consider how it is affected by housing development?

• 15 Jan 2025 · Local Government Reorganisation · Hansard source

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  My constituents in Harrogate and Knaresborough recently underwent local government reorganisation. As part of that, the North Yorkshire (Structural Changes) Order 2022 granted five years to develop a new North Yorkshire council-wide local plan. Work on local district plans halted to prioritise that new plan, which has now been compromised by the introduction of new housing targets under the national planning policy framework. Will councils undergoing new rounds of local government reorganisation receive transitional arrangements, or will they fall into the same trap as Harrogate and Knaresborough and North Yorkshire, where speculative planning applications will see endless concreting over the green belt and issues with getting housing where we actually need it, rather than where we want it? Will the Minister meet me to discuss the legacy issues of that local government reorganisation, and outline what lessons have been learned from previous reorganisations?

• 7 Jan 2025 · Pro-democracy Campaigners: Arrests · Hansard source

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  Harrogate and Knaresborough is blessed to have a small but thriving group of Hongkongers who have made it their home and opened up a number of local businesses, adding to the fabric of our towns. My worry is that, with the latest arrest warrants and transnational repression, Hongkongers will not want to be visible in public, playing that part in our communities. What tangible steps will this Government take to get the message down to people on the ground that this is not something we will stand for and that we will stand by and support them?

• 7 Jan 2025 · Employer National Insurance Contributions: Charities · Hansard source

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  I thank the hon. Member for Isle of Wight East (Joe Robertson) for bringing this debate forward. I want to mention two charities that I have interacted with in my constituency of Harrogate and Knaresborough. The first provides support to unpaid carers, who are now facing £90,000 in additional employer national insurance contributions. That will completely pull the rug out from underneath them and have a massive impact on people providing those services to their loved ones. Secondly, Harrogate is home to one of the two police treatment centres in the UK. They help to rehabilitate police who have been injured in the course of their duties, and we know that every pound spent saves the taxpayer £3.80 in rehabilitation and mental health and wellbeing provision. Obviously, the impact of NICs on them is going to be huge—£160,000 of employer NICs will be passed on to them. It is really clear that, although the Government are hoping to raise some tax in the process, the additional costs are going to end up costing them a lot more in the long run. They need to rethink this.

• 7 Jan 2025 · Mental Health Services · Hansard source

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  8. What steps his Department is taking to improve access to mental health services.

• 7 Jan 2025 · Mental Health Services · Hansard source

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  In my constituency of Harrogate and Knaresborough we have heard harrowing stories from people who have tried to reach out and get access to mental health services before they reach crisis point. Often, people end up facing months-long if not years-long waiting lists. When all too often they reach a crisis point, they end up having to access services as far away as Newcastle or Manchester. What are the Government doing to make sure that we can root local community mental health facilities in communities such as Harrogate and Knaresborough?

• 18 Dec 2024 · Provisional Local Government Finance Settlement · Hansard source

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  We have heard a lot from colleagues about the delivery of rural services. Harrogate and Knaresborough was one of the areas that saw local government reorganisation, and we are now geographically the largest council in England. So what reassurances will there be on making sure that rural services can be provided? One of the biggest barriers the council faces is being able to deliver home to school transport, the cost of which has gone from £5 million just a few years ago to what is expected to be over £25 million this year.