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Mrs. Joan Humble (Blackpool, North and Fleetwood) (Lab): I am concerned. I am following four measured contributions from hon. Members on both sides of the House, all of whom spoke coherently and cogently, whose interpretations of the Bill are not the same as mine. My hon. Friend the Member for Crosby (Mrs. Curtis-Thomas) recounted her heart-rending personal story—heart-rending, but in many ways uplifting, when she spoke of the positive impact of her mother's illness. I am deeply concerned that the legislation can be interpreted in such different ways, and I say to my hon. Friend the Minister that he must examine that problem.

I asked the Minister at the start of his speech to confirm that the Bill will not introduce euthanasia. I accept what he said, as do the Front-Bench spokesmen
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for the main Opposition parties, but, like many hon. Members, I have been receiving correspondence from constituents who do not accept that, and this evening I have listened to speeches from MPs who do not accept it.The Bill has been amended. Clause 58 has been inserted to make it clear that the Bill will not introduce euthanasia—and it does make it clear to me, yet still we have heard about individuals who do not accept that. The message for the Government has to be that the issue must be taken away and examined. All legislation must be clear in its purpose and intent, but this Bill more than any other has to be very clear indeed.

Having had the privilege of serving on the Joint Committee that scrutinised the draft Bill, I fully support the aims of the legislation. I see it as helping the 2 million people about whom the Making Decisions Alliance talks. There are many people who have been campaigning for many years to get legislation in the form of the Bill on the statute book. We should use our best endeavours to protect those people who lack capacity to make decisions. We also need to give reassurances to those who have genuine concerns.

Mr. Lammy: I am grateful to my hon. Friend for the clarity with which she sets out the position. Does she agree with me that all doctors take the Hippocratic oath, which is an important oath, and all doctors have a duty of care? Any doctor seeking to end life would be in breach of that duty of care and would have carefully to consider the risk of charges of manslaughter and gross negligence. My hon. Friend will have heard hon. Members who take a strong position on the Bland decision. She will have heard me saying that the Bill does not seek to alter common law. In the Bland case—I was involved in many cases following Bland in my early legal career—and in others, extremely difficult decisions are made around personal autonomy, quality of life and dignity of life in the end stages. Hon. Members will have strong opinions on that. That, however, is the issue that remains between us.

Mrs. Humble: I thank the Minister for his intervention. I agree with his statements about the role of the doctor. Members of the Joint Committee have received assurances that we are not changing the law. Common law has already been set in respect of advance statements and so-called living wills with regard to treatment through artificial nutrition and hydration.

I still receive letters on these matters. I am speaking against euthanasia. I would not vote for a Bill that brought in euthanasia. Yet my constituents are still writing to me and they become increasingly angry when I say that the Bill is not about euthanasia. They say to me, "Yes, it is." The Minister has a difficult job to do.

Andrew Selous: Has not the hon. Lady touched on the entire problem? Given that there is such widely differing interpretation of the Bill, to which she has quite rightly referred, surely we need to ensure that the Bill is so clear that there cannot be differing interpretations. That is clearly not where we are at at present.
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Mrs. Humble: I shall make some suggestions later. During the passage of the Bill, the Government will have to consider some amendments, especially in the light of the more recent court cases. When the Joint Committee was sitting a year ago the situation was different, and hon. Members have referred to the Burke case. We have also had the case of the little baby. Although the Bill does not affect children there is the interface with the Children Act 1989. Hon. Members have talked about 16 and 17-year-olds, but we know that a piece of legislation that deals with people who lack capacity may also have an impact on other pieces of legislation. That being so, it is important that the Bill is clarified during its passage through the House.

The Bill refers to the individual being protected by the letter P. P does not stand for patient; it stands for person. The Bill is about real people living real lives in the community, few of whom will be patients in hospital. I remember that in the course of our deliberations as members of the Joint Committee, we took oral evidence from Catholic bishops and Catholic doctors. A lawyer represented Catholic doctors. In his evidence he was constantly referring to patients, and I interrupted him. I asked whether he would recognise that this draft legislation, as it was then, was about people, most of whom are living their lives in the community in their own homes, care homes or nursing homes, but not in hospital. He said that I had identified a lacuna in existing legislation. That is why we are talking about these matters. That gap in legislation to protect vulnerable people in the community has been there for many years. That is why so many representatives of the disability groups want us to consider the Bill, protect people who lack capacity and consider the best interests of those who have varying capacity.

Hon. Members have talked about the proposed legislation opening the way to many judicial challenges. I see the Bill as opening the way for a change of attitude towards people who lack capacity, so that instead of assuming that somebody, because of their illness, mental state or disability, cannot make decisions, we will assume that they can. It will have to be proved that they lack capacity before someone else can make a decision on their behalf. That will be a major job for government. The Bill is about changing attitudes as much as about changing the law.

In a previous incarnation, prior to 1997, I chaired Lancashire's social services committee, and I met many people with a range of disabilities. The one thing that they said to me was, "Listen to us. Listen to our voice." Interestingly, they would sometimes say, "Don't listen to our parents or to our professional carers, listen to us." That will be a key to the proposed legislation.

Ms Meg Munn (Sheffield, Heeley) (Lab/Co-op): Does my hon. Friend agree that fundamental to the whole process is the need to ensure that where people have capacity, although they may lack capacity for certain decisions, they are empowered to make decisions and to have that capacity recognised?

Mrs. Humble: I agree entirely. My hon. Friend's question brings me on to an issue that I want to explore in a little more detail, and that is advocacy services. I am the president of Blackpool Advocacy. When I was a Lancashire county councillor and chaired the social
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services committee, I set up the Lancashire advocacy development service. I believe passionately that individuals, who for whatever reason cannot express themselves, need to be heard. When the Joint Committee sat, we explored in great detail the issue of advocacy.

Advocacy can help at so many different levels, and not just when there is a serious dispute. If advocacy is introduced in a preventive way at the beginning, it can sort out many problems. When we were debating independent advocacy as members of the Joint Committee it was clear that people had different ideas about what advocacy meant. Some members had a legal interpretation of it. Others saw existing advocacy services as being there only to represent the interests of the local social services department, and queried their independence.

As someone who has been deeply involved with Blackpool advocacy services, I recognise their independence and professionalism and see how they have given a voice to so many people who cannot speak for themselves. They have encouraged those people to speak for themselves. They have engaged with professionals who have cared for individuals and have ensured that the right decision is made on their behalf.

There will be an annual general meeting in a couple of weeks' time, and I have been swotting up on the work that has been done during the past year. Those involved have even facilitated the marriage of two couples who have learning disability. Their parents did not want them to get married, their carers did not want them to get married and social services did not want them to get married. The advocacy service came in and listened to these people. It was convinced that marriage was what they wanted. They needed a package of support to help them to do that. Advocacy services can be vital.

I am concerned about the appointment of independent consultees, which is set out in clause 34. I am not convinced that the independent consultees, as outlined in the Bill, will fulfil the role that independent advocacy services provide. I am not sure whether the Bill should specify in such detail the times at which the independent consultees should intervene. I know from personal experience that there needs to be flexibility in the system.

Will the Minister look again at the role of the independent consultees? Will they be rivals to the existing advocacy services? Who will fund them? Who will train them? Where will they be recruited from? Why are they to be consultees and not advocates? I hope that the Minister will forgive me for pointing out that he said that an independent consultee would be brought in if the person without capacity did not have family or friends to represent them. Advocacy services get involved even when people do have family and friends, because the family and friends do not always agree with the person being represented. I must make it clear that I am not undermining the huge role that informal carers play in our society. They take on enormous responsibilities, but sometimes what they want for their adult son or daughter is not what that adult son or daughter wants. A properly trained, independent advocate can be of
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enormous help in such circumstances. I therefore ask my hon. Friend to look again at the role of independent advocacy.

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