All our horizons will narrow as we get older. Someone who was hill walking when they were 20 might not manage to do so when they are 80. I have seen patients who are grateful to be at home being wheeled out on to the patio in the sun and having a good blether with their

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son who has come home from London. They consider that a good day. We might consider it horrific, looking at it in advance, but when we get there we will have changed. We should support letting people live every day of their life until the end, and make sure that, as legislators, we provide the means for them to live and die with dignity and comfort. We should not say, “When you can’t thole it, take the black capsule.” We should vote for life and dignity, not for death.

12.12 pm

Karl McCartney (Lincoln) (Con): I should like to inform the House that I am the president of the Lincolnshire branch of the Motor Neurone Disease Association. I commend the hon. Member for Central Ayrshire (Dr Whitford) for her moving speech, and all those who have spoken this morning. I also commend the hon. Member for Wolverhampton South West (Rob Marris) for choosing an emotive issue for his private Member’s Bill. It is no small achievement to have populated the House so well on a Friday, but my praise for him stops there.

Many of us fear that the Bill will induce uncertainty and suspicion and have the potential to fracture the doctor-patient relationship at the most critical time, when patients with the most severe illnesses are at their most vulnerable and in desperate need of sympathetic encouragement. Further, assisted dying would devalue any extra development or funding for advances in palliative care, reducing the quality of care that those wishing to receive it could and should receive at the end of their life.

Rev. Ian Silk of St George’s church in Swallowbeck in my constituency is a good friend of the Bishop of Carlisle, who is leading on this issue in the other House. The bishop believes that a change in the law would come at the cost of placing many thousands of vulnerable people at risk, and he has stated:

“Terminally ill people deserve to be surrounded with love, compassion and care, not called to make a choice between dying prematurely and being a burden. The only effective safeguard against this pressure is to keep the law as it is.”

Bob Stewart (Beckenham) (Con): I have one comment to make to my hon. Friend. If there is just one mistake, and one person dies who should not have done, this House will have failed in its duty.

Karl McCartney: I thank my hon. and gallant Friend for that intervention.

Many hon. Members consider the Bill to be misguided and dangerous. Baroness Campbell has observed that for the Bill

“to pass into law would be a triumph of despair over hope. It says, don’t try to make things better—that’s just too difficult and, anyway, would be futile. It is far better to die now. It will be better for you, your family and society. You are defined by your diagnosis, which is also your death warrant. Society doesn’t want you around any more.”

Like the good baroness, I do not want to live in that kind of society, and I hope that the majority of Members do not want to do so either.

Several hon. Members rose—

Madam Deputy Speaker (Mrs Eleanor Laing): I call John Woodcock.

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12.15 pm

John Woodcock (Barrow and Furness) (Lab/Co-op): I have not put my name down to speak, Madam Deputy Speaker, and I did not stand up to catch your eye. I have been listening to the debate carefully, however.

Madam Deputy Speaker: If the hon. Gentleman would care to wait, that is all right with the Chair.

John Woodcock: I am delighted to be called. This is the first time in my parliamentary career that I have been genuinely undecided when coming into the Chamber and I therefore wanted to listen to the entire debate. I have listened to every contribution so far, and I am still undecided.

I have been affected by the views of my constituents on both sides of the argument, and by the people who have spoken today. I have been particularly privileged to spend time with Clare Coulston, who is listening to the debate today. Her husband Paul died of motor neurone disease just two weeks ago, and she herself is in remission from a serious cancer and has two young children. She believes passionately that this Bill should pass, and has stated her views with wonderful eloquence, given the grief that she is suffering now. It would be easy for me to say that I of course agree with her, because she is my friend, but I am still utterly torn and still struggling. Thank you for calling me to speak, Madam Deputy Speaker, but I will let others who have prepared a speech take the Floor now.

12.17 pm

Maria Caulfield (Lewes) (Con): I come to this debate as a nurse with more than 20 years’ experience in the NHS, most of which time was spent working in cancer care. I have looked after many patients with metastatic disease and many who needed end-of-life care. As a result, it has been my humble privilege to share the last few days, hours and minutes of many people’s lives and, on numerous occasions, I have held the hand of someone as they have breathed their last.

Having experienced dying at first hand, I can say that death can be one of the most rewarding parts of life. It does not have to be as painful or distressing as the supporters of the Bill have described. The reason behind my positive experience of death is the availability of good palliative care, which tackles symptoms such as pain and enables people to have a good quality of life right up to the end. In the field of cancer care, we are fortunate to have access to some of the best palliative care in the world. However, many patients living with other illnesses are not so fortunate. Patients with cardiac failure, multiple sclerosis and Parkinson’s—to name but a few—often have little or no access to palliative medicine, but instead of tackling the lack of palliative care, the Bill promotes assisted dying as a solution. Death today has become medicalised, and it is seen as a failure or as something to be feared instead of as a normal part of life. The reality is that a natural death can be a moving and peaceful experience for all involved.

Therefore, not only do I disagree with the rationale behind this Bill, but I have severe concerns about the lack of safeguards it contains. The first relates to its requirement to give someone a diagnosis of less than six months to live. It is almost impossible accurately to

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predict a person’s prognosis in months. In my experience, that is not something a consultant would readily do, as someone’s prognosis can vary greatly according to their disease, general health and response to treatment. This part of the Bill gives the false impression that having a terminal illness means life is over—nothing could be further from the truth.

If assisted dying becomes law, it will remove the incentive for science and medicine to find treatments for illnesses. Metastatic prostate cancer was a terminal illness 10 years ago but is now a chronic disease, whereby men, although not curable, are treatable and often die of other causes long before their prostate cancer ever becomes a problem. The same is true of metastatic breast cancer, with many women now able to live long and healthy lives even though they cannot be cured. HIV used to be a death sentence, but thanks to advances in medicine it is now a chronic illness that people live with, rather than die of. Would these treatments have been discovered if assisted dying had been legalised 10 or 20 years ago?

My third concern is that with so many doctors against legalising assisted dying—the Royal College of Surgeons, the British Medical Association, the Royal College of Physicians and the Association for Palliative Medicine are almost unanimous in their opposition—who will be left to assess the patients who wish to discuss assisted dying? The Bill requires both the attending doctor and the independent doctor to advise a patient on diagnosis, prognosis and treatment alternatives to assisted dying before giving consent. Most general doctors, however, would struggle to provide such specialist information. Are we certain that if we change the law, this will be carried out properly?

My final concern relates to the experience of places where assisted dying is already law. If the death rate in Oregon, where assisted dying is legal, were transposed to this country, 1,500 deaths a year would occur here from assisted dying. In Oregon, patients with lung cancer and prostate cancer are already being denied treatment on their state health insurance plan and are instead being offered assisted dying, as we have heard today. Is that what we want for patients in this country? Do we want them to be denied cancer treatment but offered assisted dying as an alternative?

Before we change the law to legalise assisted dying, we need to see serious evidence to prove, first, that the current law is not fit for purpose and, secondly, that what is being proposed would be better. On neither account has any convincing evidence been presented. Our current law is not perfect, but it does what it is designed to do: it holds penalties in reserve to deter malicious assistance, while allowing discretion not to prosecute, where appropriate. What is needed is not a change in the law, but better access to palliative care for all.

12.23 pm

John Pugh (Southport) (LD): I am unpersuaded by the promoter of the Bill. I agonise over this issue, because death and the manner of our death should trouble us all. I do not entirely trust my own instincts on this, so I took the trouble of going to my local hospice, Queenscourt hospice, to hear from staff there what their advice was on this Bill. After all, they see death on

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a regular basis—daily, hourly, weekly. They oppose this Bill strongly, emphatically and definitely, and endorse the stance I shall be taking.

The thing we must recognise is that we all have a terminal disease called life. None of us get out of here alive, and some of us are nearer the door than others. It is hard to imagine how we would feel if the exact timing or manner of our death became more clear. We must admit that there are, perhaps rarely, bad deaths and troubling deaths, although, as anyone in medical practice will tell us, they are decreasing and are far less in evidence than they used to be. But the weakness of the Bill is that it provides no real solutions to the issues that concern most people and it creates a raft of other problems we do not currently have.

It is a misnomer to refer to the Bill as proposing assisted dying. Dying is legally assisted in a range of ways every day—physically, emotionally and spiritually, and specifically by the hospice movement. The Bill is about assisted suicide. My intervention on the hon. Member for Wolverhampton South West (Rob Marris) was not trivial, because the language is crucial here. If we are to understand the moral facts and look reality in the face, we have to call things by their proper name. I am reminded of the Americans in Vietnam referring to dead civilians as “collateral damage”. We are talking about assisted suicide, and there is no essential right for people to demand of the state that it assists them with their suicide. In fact, it is the policy of Governments to reduce the number of suicides, and normally it is our moral duty to discourage suicide.

Lucy Allan (Telford) (Con): Does the hon. Gentleman agree that anyone who has any knowledge of suicide sees it as a desperate and tragic act, committed by somebody in extreme emotional distress? It is usually committed alone, leaving families and loved ones devastated. The desire of a dying person for a peaceful death is so different from what I have just described, and anyone who has any knowledge of suicide would share that view. I believe the hon. Gentleman’s argument to be null and void on that point about suicide.

John Pugh: The default position is to discourage people from committing suicide, because suicide is most frequently the action of desperate people who are not getting the help they require. I believe that is acknowledged by the sponsors of the Bill, because they are suggesting that assisted suicide should take place only in special, carefully defined circumstances. Their Bill would put in place a series of provisions, which we have all read, to explain how we can be sure that these conditions actually apply. They are talking about this being a relatively limited exception and it is seemingly tightly drawn.

Let me make some huge, bold assumptions that I would not naturally make. Let me assume that these provisions, although not so far fully defined, would work perfectly, without abuse or uncertainty, and that this Bill is all that its sponsors want or are contriving. Therefore, this will not be like what happens in Switzerland, Belgium or Holland, and people will still have to go to Switzerland if they feel that their life is intolerable, unless they are likely to die anyway within six months. People may also still die undignified and unfortunate deaths, regardless of their prior wishes, if they cannot display current mental capacity. Those would be the

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consequences of the Bill. Paradoxically, the more likely it is that someone’s end would be undignified, the less likely it is that they will be judged to have the capacity to comply with the legislation. In reality, what this Bill permits is for a strictly limited number of people to have their suicides assisted, regardless of whether their anticipated end is painless or pain-free, dignified or not. That is what the proposals actually amount to.

Tom Tugendhat (Tonbridge and Malling) (Con): Does the hon. Gentleman also recognise that except for in its exclusion, the Bill does not contain any recognition of the patient’s family? Therefore, this Bill would do exactly what we are seeking not to do: it would force the individual to be on their own and the family to be excluded.

John Pugh: It is fair to say that regardless of what people may expect of this Bill—we saw some mistakes in the contribution made by the hon. and learned Member for Holborn and St Pancras (Keir Starmer)—what it will do is not what most of the supporters of the Bill expect it to do. What it will do is generate certain very obvious risks, which have been well highlighted by other Members and so I will not go over them again. The risks are simply that the elderly and infirm will be pressured, doctors’ motives will be questioned or confused, palliative care will be progressed less and suicide will be seen as a solution more, and life will be treated more casually—more as a disposable commodity. The social consequences are, to say the least, incalculable; we cannot be certain about them. But even if there is just one poor old soul—and, strangely enough, it is usually the old who die—who, under pressure, seeks a quick dispatch, it does matter. The hon. Member for Wolverhampton South West could not rule out that possibility, and clearly recognised that that could be a consequence.

In conclusion, this week started for most of us with the haunting picture of a single child drowned on a beach. It was just one life and it affected the whole country. The consequence that can be drawn is that, as a civilisation, we cannot be casual about life without becoming a different sort of civilisation.

Several hon. Members rose—

Madam Deputy Speaker (Mrs Eleanor Laing): Order. Before I call the next speaker, let me say that it will be obvious to the House that there are well over 50 Members who still wish to speak. We have had some heavyweight speeches. I am sure that the whole House appreciates that sometimes it takes some time to make a complicated and difficult argument, but I challenge Members of the House this afternoon to try to test their powers of rhetoric and see whether they can make their arguments in two or three minutes. I can assure individual Members that anyone who manages to make their arguments in two or three minutes rather than five minutes will be considered a much better orator for it. I know that we will have an excellent example from the next person to speak. I call Sir David Amess.

12.31 pm

Sir David Amess (Southend West) (Con): It has been a privilege to listen to so many fine speeches this afternoon. Undoubtedly, this is the House at its best. As far as we

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are concerned, deciding whether to legalise someone assisting another person to take their life is the most profound issue that we could debate.

I congratulate the Bill’s promoter, the hon. Member for Wolverhampton South West (Rob Marris), on his good fortune. In 2000, I had a similar success and the Warm Homes and Energy Conservation Bill is now an Act of Parliament. I empathise with him on the difficult course that he is following. None the less, I must say that as a long serving Member, I have heard all these arguments before, because we have debated the issue very many times. Indeed, in 1950, the Lord Chancellor in the other place made the two-minute speech that I am about to make now.

At the heart of all this is the concept of a good death. Colleagues who have been present when someone has died have told us how they feel about a good death. For my part, I say that a good death is dying peacefully.

The proposer of the Bill is making three points. The first one is about choice. We all have the choice over whether to commit suicide. Sadly, in the time that I have been here, a handful of colleagues have committed suicide. I wish that we could have done something to dissuade them from that action. I am against legalising another person in assisting someone to take their own life.

The second point is about compassion. I so agreed with the comments on compassion and palliative care made by my hon. Friend the Member for Totnes (Dr Wollaston) and the hon. Member for Central Ayrshire (Dr Whitford). All Members have been pressurised by hospices in their own area, and I believe that the House should concentrate on the delivery of good quality palliative care.

The final point concerns safeguards. I am not persuaded by the arguments of the experiences in Switzerland and in the state of Oregon. I remember only too well when, in 2000, the House heard about Harold Shipman who had murdered 15 of his patients, never mind how many more. I am not at all persuaded by this Bill when I think about the bureaucracy that will be involved.

We applaud the medical profession whose very work is to help people to live. We all came into politics to help improve people’s lives. I, along with all colleagues, want to assist people to live, so I urge the House to reject this Bill.

12.34 pm

Robert Flello (Stoke-on-Trent South) (Lab): Madam Deputy Speaker, I have dispatched three quarters of my speech, and will try to keep to your time requirements. First, let me pick up on something that my hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer) said. He did not allow interventions, which was a shame because we could have teased this matter out. The cases he cited would not be covered by this Bill. The people would therefore still be going to Dignitas, and would still come across the desk of the DPP for decisions on whether to prosecute. Secondly, in the Oregon example, the drugs are issued to the people wishing to take them, but it is amateurs who are around when they are administered. I would love to have had a proper debate with him about this, but, sadly, time is against us.

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Before I get into the detail of the arguments, it is important to highlight exactly what we are talking about with assisted suicide. Members can call it assisted death if they wish, but we should be specific. Not surprisingly, more than half the people polled think that assisted suicide involves no pain or discomfort. Well, assisted suicide can take two forms. The first, which this Bill says it advocates, is as follows. The person is given a powerful medication to stop them from being sick. That is because the barbiturates that are used to kill them are a powerful emetic. The urge to throw up is strong and can be distressing and uncomfortable. The barbiturates are then dissolved in a tumbler full of water and have to be drunk. It takes between one minute and 38 minutes until the person falls into a coma. In around 7% of cases, the person suffers from vomiting or spasms. In one in every 10 cases there can be problems with administering the barbiturates. In Oregon, it takes, on average, 25 minutes for the person to die. But the longest period before someone died was four days. In addition, in about 1% of cases, the person has woken up.

In the Netherlands, where an injection is administered to end life, it normally takes the form of thiopental or similar to put the patient to sleep followed by pancuronium, which is used to kill the person. Most terrifyingly of all, the person at this point is completely paralysed so cannot communicate if they are still awake or in distress. They then suffocate to death. How can either of those be described as a dignified death? That is not putting someone to sleep or easing their passing. It is wrong to say that it involves no pain or discomfort and it is not necessarily quick—it is up to an hour on average before the person dies.

I know that the people who are promoting this Bill are motivated by the desire to alleviate suffering and by compassion, and we have heard some very powerful speeches on both sides of the argument today. Of course we are all moved and saddened by what we hear and want to act with compassion, but that compassion is misguided if we think that by prematurely ending someone’s life, we are alleviating suffering. There are ways to alleviate physical, mental and emotional suffering and they are done extremely well in this country. We hear those in favour of helping someone to commit suicide say that they do not want themselves or their loved ones to die in pain, but that fear should galvanise us to ensure that there is good quality palliative care not just from hospices but from across the whole health and social care system. That does not exist at the moment, and the report in 2011 highlighted that.

What does the law say about suicide? The 1961 Suicide Act as amended said that it was no longer a crime to commit suicide, and that was for a very good reason. It is not because society now thinks that everyone should have the right to commit suicide, but because society rightly thinks that someone who has tried to commit suicide needs help and support, not criminal punishment. But the Act quickly goes on to make the point that if someone helps another to take their life, then that is tantamount to murder, punishable by sentence of up to 14 years. There is a very important caveat. As the law wants to ensure that people are kept safe, it imposes that threat of severe punishment, but at the same time

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it wants to be merciful, which is why the DPP will decide whether a case goes to court. That is an important point.

Let me conclude with a letter from Jane, one of my constituents. Her husband, Richard, was diagnosed with cancer in 2012. On 11 September 2013—two years ago today—he passed away. She said:

“I was able to care for him and the last few weeks we had together helped us to come to terms a little with the inevitable…At one stage because I was caring for him seven days a week, Richard began to feel he was a burden to everyone to which I assured him he was not a burden. I can understand totally where he was coming from. I think changing the law would place pressure on vulnerable people. Those who are elderly, disabled, sick or depressed could feel an obligation to agree to end their lives for fear of being a burden on others. From the bottom of my heart, Mr Flello, I would ask that you could be there…to oppose this piece of legislation.”

That is one constituent of mine. I know that others have written to me, asking me to support the Bill, but for Jane’s case, we cannot let it go through.

12.39 pm

Ben Howlett (Bath) (Con): I must admit, Madam Deputy Speaker, that this will be a test of my oratory skills, as I have changed my speech three or four times based on some of the speeches that have been made and it is now unrecognisable. I admit that I came into the House thinking that I would support the Bill, but listening to the speeches made by other Members, particularly the hon. Member for Central Ayrshire (Dr Whitford) and my hon. Friend the Member for Totnes (Dr Wollaston), has completely changed my mind. I must say to those constituents who have got in touch with me on this issue over the past few weeks that listening to the arguments in this place has lain heavily on my shoulders.

It is clear that this is an enormously emotive issue. I watched my grandmother pass away after eight years of having dementia and strokes. I understand that the Bill would not have applied to her, but I could not look into the eyes of someone in her shoes and expect them to go through the pain and suffering that has been discussed, based on the evidence we have been shown.

My brother is a palliative care registrar. He wrote to me recently from New Zealand, saying that every time he is asked whether there is a way of speeding up the dying process the question normally comes from patients who have never seen a palliative care specialist. He normally says that he will help to improve the symptoms and the question of assisted suicide ends up dissipating.

I have a number of serious concerns about the Bill after what I have heard today. I have two key concerns that I hope will be considered before the suggestion is put before the House again. First, if an individual is reasonably expected to die within six months, I hope that the hon. Member for Wolverhampton South West (Rob Marris) will clarify whether a voluntary, clear, settled and informed wish as well as a two-week wait for the High Court judgment and a two-week wait for the administration of the medicine will be enough to enable the individual to have a dignified end of life. I hope that he will realise that that is an awful lot to squeeze into a very short period of time.

My second concern relates to the code of practice and the individual’s mental health. If someone has just been given a terminal diagnosis and only six months to

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live, are we suggesting that they will have neither depression nor any other psychological disorders that might impair their decision making?

After listening to the arguments made today by many people who are much more experienced in this field than I am, I have to say that I will oppose the Bill.

12.42 pm

Albert Owen (Ynys Môn) (Lab): It is the convention in this House on a Friday morning to congratulate the promoter of the Bill on coming top in the ballot. Although I disagree with the Bill being proposed by the hon. Member for Wolverhampton South West (Rob Marris), we owe him a debt of gratitude for this debate. I want the debate to continue.

It is interesting to hear the different views that have been expressed today and in the lead-up to the debate from leading legal and medical experts, and I pay tribute to them. Today, those views have been echoed in this Chamber by people with huge amounts of experience, whether in the legal field, like my hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer), or the medical, like the hon. Member for Central Ayrshire (Dr Whitford). This House is at its best when it debates like this and when we others—I include myself in this category as I am not an expert—have the opportunity to add our weight to the debate on behalf of our constituents.

None of us has the right to say that we are more compassionate than others, whether we are for or against the Bill. We all want to see dignity in end-of-life care. That is important, and that argument has been echoed in this Chamber today. We need to turn the debate into a positive. Those of us who will never support assisted dying, assisted suicide or euthanasia and have a strong and principled view on that need to be joined by those who want to alleviate suffering, whether or not they have a different opinion on the Bill. We must channel that energy into improving palliative care. We must talk about the national health service as being from cradle to grave. In doing that, we have to be brave and we have to say that palliative care is patchy in this country and that young people and older people do not get the care or dignity they deserve. We must channel money and resources into training people to help in end-of-life care in the future. Our health service must merge prevention and care; social care and health must come together to help young people and those who have terminal illnesses. We must do that in a positive way.

Conor McGinn (St Helens North) (Lab): We have rightly heard today of the concerns of medical professionals about how the Bill would fundamentally change their relationship with those in their care. Does my hon. Friend agree that those concerns are reciprocated by many patients? We trust and rely on doctors and nurses to improve the quality of life, not to bring it to a premature end.

Albert Owen: Absolutely, and that has been eloquently spoken of by many people, including those with huge experience in the medical profession.

I believe that if the Bill is passed today, it will be a slippery slope. People would come back, not solely because we have the legislation in this House but, as has

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been said by my hon. Friend the Member for Warrington North (Helen Jones), who is no longer in her place, because the case law would be altered to reflect the wishes of society. We are here as representatives to reflect both sides of the argument. I do not accept that a snapshot poll showing 82% support reflects the will of the British people, and I do not think we will get an accurate poll. We have to make up our own minds and base our decision on the evidence and on compassion. Let us together improve the national health system from cradle to grave to help those in an impossible situation alleviate pain and improve long-term care. I thank my hon. Friend the Member for Wolverhampton South West for giving us the opportunity to have this debate. Let us move forward in a positive way.

12.46 pm

Mr Nigel Evans (Ribble Valley) (Con): It is a privilege to follow the hon. Member for Ynys Môn (Albert Owen), and I agree with everything he has just said. I believe in dignity in death, but I also believe in the sanctity of life. We have heard powerful speeches from both sides today and we have all received many emails from constituents arguing both sides. We cannot agree with both sides. I remember that the hon. Member for Barrow and Furness (John Woodcock) said that he was torn, but we must finally take a decision.

Like my hon. Friend the Member for Bath (Ben Howlett), I found the speeches of the hon. Member for Central Ayrshire (Dr Whitford) and my hon. Friend the Member for Totnes (Dr Wollaston), who both spoke with experience and authority, incredibly powerful. It is rare for people to be swayed in this Chamber—they come in with their minds made up—but my goodness me, what powerful speeches. I am sure that they have had an effect today.

When my father was diagnosed with cancer in 1978, the family watched him die a painful death. It was a bad death, and when he died, I said, “Thank God he has died.” As the hon. Member for Ynys Môn has just said, we should be putting far more resources into palliative care. We should admit that it is patchy and that some people have bad deaths, though that is not acceptable. I know that we put many resources into finding a cure for all sorts of diseases and conditions, but at times we have to recognise that a cure might be some time off and sufficient resources ought to be put in to ensuring absolutely the right amount of palliative care so that when people come to the end of their lives they are not in unnecessary pain. We must remember the relatives around them and the pain they feel in seeing someone who has looked after them for all their lives—their father, a strapping person—wasting away over a period of months and then dying. I went to get his last shot of morphine and I am absolutely certain that that was what pushed him over the edge, but at least he did it without unnecessary pain at that final juncture.

We say that people should not be put under undue pressure or feel they are burdens on their family. They should not feel, “Well, I have the choice, perhaps I should exercise that choice.” It is almost impossible to say that people with terminal conditions will not be pushed into an earlier death simply because they have that choice. At the moment, they do not. It is impossible to calculate how many people will say towards the end of their lives, “I think I am going to take that poisonous

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cocktail because I do not want to be a burden on my family and because it is costing them to keep me in a nursing home, with all that that entails.”

I pay tribute to Macmillan nurses, Marie Curie nurses and the hospice care in this country. I do not believe that Dignitas brings dignity to death; I think it brings a speedier death, and I ask the best minds that we have in the world: is that the best that we can offer?

12.50 pm

Barbara Keeley (Worsley and Eccles South) (Lab): I do not support the Bill. We should maintain the clear principle that this Government, the justice system and the medical profession have upheld for many years—that we do not encourage or help people to commit suicide, and that we should work to prevent all forms of suicide. The Assisted Dying (No. 2) Bill would be a departure from that principle, and I believe that we would start to see people in very difficult circumstances becoming even more vulnerable if the Bill were passed.

Clearly at present—we have heard a former DPP, my hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer), lay out the current situation—committing suicide is not illegal but encouraging someone to commit suicide is illegal, and I firmly believe that that protects us all, and that that basic principle against suicide should be upheld. Wednesday was world suicide prevention day. Many moving messages appeared on social media about the importance of preventing suicide, so it is ironic that we should today be debating a Bill that drives our society in the opposite direction.

I have significant concerns about the detail of the Bill, and whether any regulatory regime surrounding the introduction of assisted suicide would be fit for purpose. I would argue, as others have done in this debate, that making assisted suicide legal creates a pressure on people to take their own lives rather than giving them greater choice, because it creates a fundamental shift in people’s perception—that our society accepts suicide. One of the major risks in the Bill has been eloquently outlined by my hon. Friend the Member for West Ham (Lyn Brown), and it is that people will feel under pressure to take their own life if they feel they are becoming a burden to their family or society. That would grow from an illness-related reason to encompass financial ones and even mental health reasons. People in my constituency have written to me about their concerns, saying:

“If this Bill is passed it will put greater pressure on vulnerable people, the elderly and the sick, who will increasingly see themselves as a burden to society. I don’t want to see that.”

Stuart Andrew (Pudsey) (Con) rose—

Barbara Keeley: If we are to live in a society that values and cares for each individual regardless of the state of their health and disability, it is difficult to see why we should be relaxing our stance on suicide. The Not Dead Yet UK network of disabled and terminally ill people tells us that not one organisation of disabled people supports assisted suicide, and Richard Hawkes, the former CEO of Scope, has said:

“Why is it that when people who are not disabled want to commit suicide, we try to talk them out of it, but when a disabled person wants to commit suicide we focus on how we can make that possible?”

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The campaign to legalise assisted suicide reinforces deep-seated beliefs that the lives of disabled people are not worth as much as other people’s.

We must also consider the question of the involvement, through the Bill, of the doctors who would have to assess the person and administer the drugs to assist their suicide. The British Medical Association has a clear policy against physician-assisted suicide and the Bill before us, as do the college of GPs and the college of physicians. The BMA says that it opposes all forms of assisted dying, supports the current legal framework, which allows compassionate and ethical care for the dying, and supports the establishment of a comprehensive, high-quality palliative care service. Many of us here today have spoken very strongly about our support for palliative care, and the hon. Members for Totnes (Dr Wollaston) and for Central Ayrshire (Dr Whitford) have given us their reasons, as a former GP and former surgeon.

I want to end on that point about social care, because much of my work here has been focused on social care and carers. I believe I agree with the hon. Member for Totnes: improving palliative care is a real alternative to the Bill. We should bring in free social care at the end of life, because the denial of care should not be driving people to take their own lives.

I want to make a final point about the last implications of changing this law. At the moment, it is clear that we want to prevent people from committing suicide and that society should help and support those reaching the end of their life. Passing the Bill would change that and set a dangerous precedent.

12.54

Andrew Bridgen (North West Leicestershire) (Con): It is a great honour to speak in a debate, as brief as it is, on a matter of life or death. It is one of the hardest things for this Parliament to deal with, because the passions of the speakers and the strength of the arguments on both sides are compelling.

I have been lobbied about assisted dying since my very first month in this Parliament, and consistently. I have listened to all the speeches today on both sides of the argument, but I will vote against the Bill because I am very concerned about coercion. Any Member of this House who does not consider that coercion could happen, forcing vulnerable people to take their own lives, has perhaps an over-optimistic view of the human nature of a small but significant section of our society.

I spoke to an A&E consultant in my constituency who raised concerns about his Hippocratic oath and the change in the doctor-patient relationship that the Bill could engender. He had a shocking experience when he was resuscitating an elderly lady in A&E while her relatives were sharing out her assets at the foot of the bed. When the old lady was resuscitated, he saw the look in the relatives’ eyes, and he would certainly not be in favour of assisted dying legislation whereby vulnerable old people could be coerced into taking their own lives by unscrupulous or heartless relatives or beneficiaries.

The safeguards in the Bill are inadequate, and as a responsible parliamentarian I cannot bring myself to support a change in the law with such gaping holes in it. It is a blank cheque, as has been mentioned.

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Stuart Andrew: Will my hon. Friend give way?

Andrew Bridgen: I will not, if my hon. Friend does not mind.

Supporters of the Bill have said that 80% of the public favour medically assisted suicide. I am not sure how much understanding those respondents had at that time, but when participants are exposed to the counter-arguments to legalisation, support wavers, in one poll dropping from 73% to only 43%, and among palliative care doctors 90% oppose the Bill.

I am a trustee of a local hospice charity, Hospice Hope, in Ashby de la Zouch. I am a great supporter of and believer in the hospice movement and palliative care sector. I would like to quote Dr Robert Twycross, a retired palliative care specialist, who recently stated that

“despite upsetting ‘horror stories’…palliative care does not…leave patients to suffer unbearably. In extreme situations, increasing the dose of symptom relief and sedative drugs is already permissible as a ‘last resort option’. The most appropriate response to horror stories is to increase the availability of specialist palliative care”—

not to kill people.

As has been said, many people are desperate when first diagnosed with a terminal illness. It is completely understandable, and it is easy to make a rash decision. Many feel a burden on their family and wish to die to alleviate that burden, when actually that family love them, want to care for them and do not want them to die. The way to alleviate distress in dying people and their families is to care for them properly with good palliative care, not to murder them.

I am aware of time pressures. I would ask hon. Members to bear it in mind that we fund, to a huge extent, the national health service. It is not the national death service. In a recent survey in May of 1,000 GPs, only one in seven was willing to get involved with this Bill. I feel that for vulnerable people the right to die will quickly become the obligation to die. The only thing that deserves a quick death is this Bill and I shall vote against it.

12.58 pm

Kate Green (Stretford and Urmston) (Lab): I shall make a few brief points in the light of the many conversations I had over the summer with disability organisations and disabled people. They are well aware that I support the Bill and will vote for it this afternoon, but I want them to know that I have listened very carefully to some of the concerns that they have expressed.

Of course, not all disabled people are terminally ill—we should not equate the two—but it is true that when we become terminally ill, we will almost all by definition fall within the terms of the Equality Act’s description of disability. It is also true that the social context in which disabled people live their lives today means that they suffer inequalities and injustice, and that accompanying the Bill must be a whole-hearted commitment by the House to address that structural inequality and to make the right to an assisted life equal to that of assisted death.

I was a little horrified to hear the Second Church Estates Commissioner, the right hon. Member for Meriden (Mrs Spelman), for whom I have enormous respect, imply, I think, that she would prefer such deaths as already take place to do so outwith the law, rather than

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to shed the light of regulation on a situation that we live with today. I would prefer to see this difficult situation governed by legislation—legislation for which we as legislators take responsibility.

To the disabled people who have raised issues with me, I would say that I am very open to hearing suggestions for further safeguards to be placed in the Bill. Having listened to the debate this morning, I am sceptical about the role of the High Court in this matter and we may have to look at this again. I invite the proposers of the Bill to amplify what sort of audit process and regulatory framework they think can properly protect people, and I echo the calls all around the House for proper investment in both palliative care and mental health care to address the very important point that at the end of their lives many people will suffer also from severe depression.

1 pm

Glyn Davies (Montgomeryshire) (Con): I had written a 40-minute speech for today’s debate, Madam Deputy Speaker, but you will be pleased to know that I have no intention of having you stop me five minutes into that. [Hon. Members: “Two minutes.”] Indeed, two minutes.

I am very opposed to the Bill. I shall make two general points and then give one or two more reasons why I oppose it. First, it is important for us to realise that this is not a competition in compassion. Both sides of the debate are driven by compassion and what we are looking for is the best solution for those who are approaching the end of life. End-of-life care is not satisfactory and we need to find ways of improving it.

The second issue relates to the Bill itself. When it came top of the ballot of private Members’ Bills, I was disappointed that we would be debating the topic again. I have changed my mind about that, because it is hugely important that we as a nation take palliative care much more seriously. The Bill has probably helped to achieve that. I am still opposed to it, but the interest in the wider public and among MPs will lead to a greater awareness of what we need to do in that field.

The three main reasons that I oppose the Bill are, first, the normalisation of suicide. Society disapproves of suicide, and if it becomes normalised it becomes an issue of debate for everyone who reaches the end of life. The speech from the hon. Member for West Ham (Lyn Brown) made a great impact on me when she talked about her own experiences. It is true that there may be issues of coercion and malevolence, but the real concern is the self-imposed pressure—people asking themselves, “Is my life over? Should I remove myself from society?” That is my biggest worry.

The second worry that I have about the Bill is that it puts different values on the lives of some members of society—the people approaching the end of life, the terminally ill, the mentally disabled, the severely mentally disabled and the severely disabled. We have never put different values on the lives of different people; I think the Bill does that. The third reason that I oppose it is that it inevitably changes the relationship between doctors and their patients. A doctor’s job has always been to do no harm. People go to the doctor because they want the doctor to help them and make them well. If assisted dying will always be part of their discussions, it will interfere with their relationship for ever. For those three reasons I oppose the Bill.

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1.3 pm

Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op): I cannot support the Bill and I intend to vote against it. In doing so, let me first recognise the good intent and the compassion of those who support the Bill and who have brought it here today. Their motivations are honourable and I appreciate that considerable numbers of people in this country want these issues to be discussed. Many constituents on both sides of the argument, as I am sure is the case for all Members of the House, have shared incredibly personal stories with me—stories of great courage and of great pain—and I am extremely grateful for that, but I do not believe that the change in the law that is proposed in the Bill is either desirable or necessary.

There is a right to die under UK law. Any of us has the right to refuse further medical treatment in such a way as to bring our lives to a natural end. Furthermore, a person making that decision can usually obtain pain relief to ease their suffering. However, the Bill proposes a fundamental change, for the first time allowing medical practitioners to prescribe drugs that would enable the person actively to end their life. I believe that once we crossed that Rubicon, we would have radically changed our conception of life and of the rights and responsibilities of individuals and of society at large. We would have fundamentally changed the role of the medical profession and we could never truly ensure that there were sufficient safeguards to prevent abuse.

I am sure the House will appreciate that the prospect of doctors legally prescribing fatal doses of drugs causes considerable distress in my constituency, where the majority of the families of the victims of Harold Shipman reside. This proposal would for ever change the nature of the medical profession in the UK, and I note that the British Medical Association is fundamentally opposed to it.

Many people who are in favour of the Bill have made the case to me that in situations where the Bill would apply, the quality of life of the people affected by it is so poor that it justifies such a change. I understand that point. The levels of funding for social care in this country are a disgrace. The wages, conditions and zero-hours contracts of some of the people who are asked to care for our loved ones near the end are a disgrace, but to move towards a system of assisted suicide justified on the basis of that poor care and provision would also be a disgrace. We can offer people dignity and comfort at the end if we are willing to devote sufficient political and financial capital to that end.

Any legislation of this kind changes the way we as a society see the elderly and makes the limitations that come with age and illness something avoidable. It will become selfish to be old or ill, to be asking things of people or to be in need, whereas this time should be a time of great importance, of healing relationships and of saying thank you for everything that has been given to us in the lives we have led.

Another argument cited in favour of the Bill is that it merely codifies the existing guidelines of the Director of Public Prosecutions, but there is no way in which we can ever sufficiently codify the circumstances that these guidelines cover. There are situations where there is no public interest in prosecuting a person for breaking the law, but that does not mean that we as parliamentarians should change the law to legalise that behaviour in future. Hard cases make for bad law.

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Finally, all the evidence I have seen from Holland and elsewhere suggests that this is one of those occasions where the slippery slope argument holds true. Just as in the UK, in Holland everyone was promised that there would be a specific and narrow application of the law, but now that is not the case and it is often used for very narrow reasons. None of the safeguards promised in the Bill could ever be sufficient. We will keep on revisiting them and weakening them, and practice will constantly push at them too. So let us oppose the Bill today. Let us reaffirm our determination to find better solutions to the problems that we have discussed today, but let us keep the fundamental respect for and sanctity of human life and the protection of the vulnerable that are rightly at the heart of the current legal position.

1.6 pm

Tim Loughton (East Worthing and Shoreham) (Con): Debating issues such as this is one of the most challenging things we have to do as MPs. We are expected to exercise the judgment of Solomon on behalf of our constituents. Indeed, many speakers on both sides have made speeches worthy of Solomon today.

I will come to the point quickly. I oppose the Bill because I have fears about the safeguards against the pressures from family members or friends with their own agendas and different priorities. There are difficulties over the definition of mental competency. Are we placing too great a responsibility on our doctors to play God? That would change the whole dynamic of that doctor-patient relationship. My prime concern, and why I will vote against the Bill, is that we risk engendering guilt among elderly people and those with serious disabilities about being a burden on their families, their carers or society. Bringing a Dignitas-style solution to their doorstep implies that that is what is expected of them and the most unselfish course of action to take. As our population lives longer, that pressure will become greater.

Rather than re-rehearsing the arguments, I want to close on a very personal story. My mother was diagnosed with cancer at the end of 2013. At the beginning of January 2014 she reacted badly to her chemotherapy and became very poorly. She was taken to hospital and after a few days doctors decided that there was little they could do for her and she was transferred to the new St Wilfrid’s hospice in Eastbourne. Staff there were brilliant and we cannot thank them enough. As a patron of St Barnabas House hospice in Worthing, I know of the fantastic work that hospices do. Doctors told us that our mother would be unlikely to make the weekend. It was a shock that it had happened so quickly when she apparently had been receiving good treatment.

My brother, my sister and I mounted a vigil. She was in great pain and discomfort but my mother kept telling us that she really did not want to be a burden, and that if she had known that things would turn out like this, she would have taken herself off to Dignitas to make sure she was not a burden. I do not know whether she would have gone through with that, but she was convinced that she did not want to be a burden. We will never know what she might actually have done.

The weekend came and, incredibly, my mother was still there. Fortified by a range of exotic fruits and fruit juices to quench her thirst, she actually started to improve. A few weeks later, she was still there. She had rallied

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sufficiently that she was deemed to be too fit to stay in the hospice and so was evicted. It was a great triumph for her; people are not normally evicted from hospices. We found her the most wonderful nursing home in Eastbourne, the Queen Alexandra Cottage home. Far from being a burden, she played an active role in helping the staff of the nursing home. She was looked after brilliantly. Her quality of life was excellent. My brother, sister and I spent much quality time with her and enjoyed trips out to favourite family places, and at family get-togethers she was surrounded by her grandchildren.

Sadly, my mother died last October, but eight months after leaving the hospice. She died peacefully and comfortably, and with her family around her, a few days short of her 77th birthday. Those bonus eight months were some of the happiest times we enjoyed with my mother, despite her illness and the limitations it placed on her. It was quality time that allowed her and us to prepare for the inevitable, but in a positive and organised way—my mother was very organised.

For my part, those eight months were just a small compensation for the missed opportunities and family neglect that the job of being an MP inevitably entails. If things had gone differently and my mother had chosen another route, completely oblivious of what was actually to happen, and if that alternative option had been readily available and state-approved, she and we would have missed out on a lot. We were lucky to have that valuable extra time, and she valued it greatly.

That is just one example, and I know that many other people’s experiences will lead them to other conclusions, but it is a major personal reason why I think that the risks and the potential loss of human experience and sensitivity outweigh the potential advantages that some people might enjoy from a change in the law, and that is why I shall be voting against the Bill.

1.11 pm

Mark Durkan (Foyle) (SDLP): We have heard many compassionate and compelling words today, and the voice of conscience has come through on both sides of the debate, just as it has come through on both sides of the correspondence we have all received from our constituents. I will be opposing the Bill. Some of the constituents who have written to me have suggested that I am being Church-whipped. I am no more Church-whipped in opposing this Bill’s Second Reading than I was when I voted for the Second and Third Readings of the marriage equality Bill.

Like all Members, I come here today as a conscientious legislator dealing with difficult issues. I acknowledge the sincerity of the Members proposing the Bill, but as a legislator I cannot satisfy myself that the compassion with which it has been proposed is adequate to allow it to pass. I am not convinced by the so-called safeguards that it is claimed to have, and I do not believe that it would be enough to rely on codes of practice that might or might not be introduced in future.

In that regard I am moved by what I have heard directly from many medical professionals. We have been privileged to hear today from Members with medical experience and insights about some of the difficulties that they see arising from the Bill. They are concerned about not only the professional compromises that would be created, but the pernicious conditioning effect that

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would result. Many Members have rightly raised concerns about incidents of coercion arising in the discharge of this legislation, but there are also concerns about the wider conditioning effect, and many medical professionals have voiced those to me. They are concerned that it would affect their relationship not only with patients, but with colleagues and other professionals, because of the quandaries and difficulties that would arise.

I am also not convinced by people making the case for the Bill by focusing on what would not be covered by it. I cannot take from them the assurance that the Bill draws a line and could not be used to take us on a travelator towards more legislation. If the compelling cases which motivated Members to propose the Bill would not be covered by it, I find it hard to see how those same cases would not be used to take us on a further journey, so I accept the slippery slope argument.

It has been suggested that relying on the prosecution guidance as adequate would be a dereliction of duty on our part as legislators, but let us remember that those who are proposing the Bill would still be relying on the guidance for all the cases that fall outside the scope of the Bill. If it is okay for people to rely on that guidance for cases that fall outside the scope of the Bill, why would it be wrong for those of us who oppose the Bill to rely on it as well for people in that situation?

I do not claim that we have moral superiority over anyone in the decisions that we take today, but as legislators we are compelled to make those choices. I know that the choice I make as a legislator might not be the choice I would make as a terminally ill patient, or as someone who receives a strong and emotional request from a loved one who is terminally ill, or as a juror if a prosecution took place at some time; I must make the decision today as a legislator. That is why I must vote against what I regard as poor and dangerous legislation.

1.15 pm

Mr David Jones (Clwyd West) (Con): I have the most profound concerns about the Bill, most of which have already been rehearsed by other hon. Members. In view of the shortness of time, I do not intend to repeat them. However, I also consider it to be a deeply flawed Bill. I will focus on three concerns that I believe are sufficient to persuade hon. Members not to support it.

First, although clause 1 provides that the person seeking the consent of the court must have

“a voluntary, clear, settled and informed wish to end his or her own life”,

the Bill is completely silent on what inquiries should be undertaken to establish how that wish has been arrived at. The right hon. Member for Knowsley (Mr Howarth) made the perfectly reasonable point that it is possible to come to a rational decision that one does not wish to be a burden on one’s family. Equally, it is possible to be coerced, cajoled and browbeaten into that position, and the Bill provides no safeguards in that respect.

Andy McDonald (Middlesbrough) (Lab) rose—

Mr Jones: I will not give way, as we have very little time.

Secondly, the Bill provides that the person seeking the order should have a terminal illness and

“as a consequence of that terminal illness, is reasonably expected to die within six months.”

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Medical experts have pointed out that it is very difficult to ascertain whether an individual will die within three months. One is reminded of the Scottish case of Abdelbaset al-Megrahi, who was convicted of the Lockerbie bombing and discharged from prison on compassionate grounds because he was not expected to survive a further three months, and that was on the evidence of highly respected oncologists. In fact, he survived a further two years and nine months. Irrespective of the merits of the release, that illustrates how difficult it is to assess how long a patient might live.

Thirdly, the Bill is totally silent about what inquiries should be made by the court on whether an order should be made. I intervened on the hon. Member for Wolverhampton South West (Rob Marris) on that point, and he replied that it was a matter for the court. I venture to suggest that when one is talking about whether or not a declaration permitting assisted dying is to be made, there should be strong guidance in the Bill on how the court is to make that decision. In other words, it looks very much like a rubber-stamping operation, which cannot be right.

Ethical questions are notoriously difficult, and most of us here in this House are not medical professionals. We therefore have to rely on medical ethicists and on medical practitioners and clinicians. We should all have regard to what the BMA and the royal colleges have to say. We should listen to hospices such as St David’s and St Kentigern, which serve my constituency. In this House, we should listen to people such as the hon. Member for Central Ayrshire (Dr Whitford) and my hon. Friend the Member for Totnes (Dr Wollaston), who clearly understand the issues. I urge all hon. Members to oppose the Bill.

1.18 pm

Mr Gordon Marsden (Blackpool South) (Lab): We debate this subject on the anniversary of 9/11, the day on which over 3,000 people had their lives snuffed out in an instant, so it is not surprising that we are debating many deaths and citing our personal experiences, such as my experiences with my parents at the end of their lives and of seeing people in Trinity hospice in Blackpool, and so many other individual examples. Of course there are good intentions on all sides, but good intentions are not enough. The balance of probability that my hon. Friend the Member for Wolverhampton South West (Rob Marris) mentioned is not enough to prevent us from going down a road not to hell but to dangerous and difficult decisions.

I listened with great respect to the comments of the former DPP, my hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer), but drew a very different conclusion—that hard cases may make bad law, but they do not necessarily make bad individual judgments. That is the point. It is not right, in my view, that we should assume that we should just accept the right of Parliament to delegate to the DPP these difficult decisions where the detail has to be tried and tested to a generic principle.

The issue of capacity is clearly worrying many people here, and rightly so. I was a Parliamentary Private Secretary in the Lord Chancellor’s Department when that was brought up. It is a fluctuating issue, and that is why Scope and Mencap are very concerned about it.

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We have already heard about the large proportion of medical professionals who would not be prepared to take forward the procedures in this Bill, even if they were not flawed. What does that say about the small pool of people who will have to deal with this? Words matter, as George Orwell said, so we should be using the appropriate terms. This is about assisted suicide, not assisted dying. It is not about medication—I am not going to use the word “poison”—but administering something to someone that will kill them. These are important issues.

John Donne famously said,

“No man is an island”—

and no woman, for that matter. It has been suggested today that the decision that we make is simply for the individual. It is not simply for the individual—it is for the families who are impacted by it, for the doctors who have to go through agony trying to decide what to do about it, and for all of us in society who will take the consequences on board. That is why I shall vote against the Bill.

1.21 pm

Lucy Allan (Telford) (Con): I am very grateful to the hon. Member for Wolverhampton South West (Rob Marris) for bringing this Bill to the House today. It is incredibly important that we are discussing this issue. I have been incredibly moved by many of the speeches that we have heard. This is a matter of public interest. We all know from our postbags that there are passionately held views on all sides. I am also very grateful to all Members of the House for the manner in which the debate has been conducted. It is a very sensitive, difficult issue, and people have dealt with it with respect. That is absolutely the way in which the debate should be conducted.

I am in favour of the Bill. Parliament may decide today to kick it into the long grass, but even if debate is closed down on the issue of assisted dying, we cannot make it go away. People will go on taking their loved ones to Dignitas. Doctors will go on giving just that little bit more morphine to a dying patient to relieve unbearable pain, knowing that it could lead to death. Ex post facto, the Director of Public Prosecutions will continue to be able to exercise discretion if they so choose.

I believe that is wrong. We need legal clarity on this issue. The law needs to be brought up to date to reflect modern, contemporary Britain and the way in which advances in medical care have accelerated and social attitudes have changed.

Rachael Maskell (York Central) (Lab/Co-op): Will the hon. Lady give way?

Lucy Allan: No, I am sorry—I only have two minutes.

A vote against this Bill will not stop assisted dying; it will simply send the message that we in Parliament will not debate the issue further.

I want to add something from a constituent that I found particularly moving. She is talking about her dying mother, and she says:

“It broke my heart on a daily basis watching her suffer…My darling Mom would scream from morning till night ‘please Lord, help me, let me die, please take me’. She was in so much pain, her tiny body was racked, worn and exhausted…I prayed that God would make me strong enough to gently place a pillow over her face to end her torture, but, sadly, I could not as I loved her too

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much, and selfishly wanted her to stay…it destroyed me because my Mom was my world, and I could see and feel her pain yet could do nothing.

Although it has been 3 years since Mom’s passing, I cannot move on or forget because all I see, and all I remember is her terrible suffering…It is impossible to erase her last days as they were horrific, no human being should EVER have to endure.”

This Bill is about principle: it is about freedom and choice. Although I respect the views of everybody who has spoken today, it is not for us to deny people a say in how they die. It is their life, not ours.

1.25 pm

Ian Paisley (North Antrim) (DUP): I believe that Parliament should be in the business of giving people reason to live, not of creating laws that facilitate and accelerate people’s death. I say that with respect to those who have today given their own personal, trying and solemn examples, but I believe that the balance is all wrong in this Bill and that is why I will vote against it.

We all know that it is not necessary to change the law in order to have dignity in death. That has existed from the very beginning of time. Indeed, it is in the natural order of things.

I understand what pastoral care is like. I grew up in a manse. People would come every day to my father’s manse and witness people with illnesses and sicknesses who needed to be comforted.

I also have a more personal story to tell. A year ago to this day, my father passed away, and tomorrow we will celebrate his anniversary. Eighteen months prior to that, he had been in hospital. He had suffered a very serious illness and ended up on a life support machine. On his fifth day on that life support machine, the doctors indicated to us, “Look, your father’s probably going to die in the early hours of the morning. You should prepare yourselves and be ready for the eventuality.” We did. We prepared his funeral. We sat as a family and talked about what we should do over the next few days.

That night, amazingly, my dad sat up in bed and demanded a cup of tea. He went on to enjoy another hearty year, and we went on to enjoy his company and lovely presence for another year. We planned his funeral with him, and it was a very different plan—it was noted publicly for being very different—from ours. Some people may say, “We have a right to do this and to tell people, ‘It’s now time: this person is now a burden on society’,” but that is not what we as legislators and as a Parliament should be doing. We should be taking stock and saying, in his voice, “No.”

1.27 pm

Mark Field (Cities of London and Westminster) (Con): So much has been said by those who, like me, oppose the Bill, and we have heard some profound and personal stories, so I do not want to go over all that ground.

Fundamentally, I believe that the way in which any society looks after its most disabled, most vulnerable and the elderly says something about it. I fundamentally worry that we are starting down a path of saying, in essence, that the lives of those who are profoundly disabled and who are getting old and are a burden are worth less than those of others. That is an incredibly dangerous path to go down.

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I am a former lawyer, albeit a rather less distinguished lawyer than the hon. and learned Member for Holborn and St Pancras (Keir Starmer), whom I first came across in a college library in Oxford about 30 years ago. I am now a legislator and I profoundly believe that the law’s empire should not be extended into this highly contentious sphere. We should let common sense prevail. Perhaps we are living in a much more litigious society. That is regrettable in many ways, because we need to let guidelines cover the ground that perhaps the former Director of Public Prosecutions was reluctant to cover. I think it is fair to say that close friends and relatives of those who are terminally ill instinctively know the wishes and desires of their nearest and dearest. They should be protected by compassionate understanding rather than by delusory legal safeguards.

I am not a terribly religious person and I certainly do not stand behind many of the religious aspects that influence many colleagues who have spoken, but when all is fundamentally said and done, I instinctively believe that to support assisted dying or euthanasia is simply wrong.

1.29 pm

Mrs Madeleine Moon (Bridgend) (Lab): The Motor Neurone Disease Association holds no stance on the Bill. I speak as the chair of the all-party group on motor neurone disease.

I am also the chair of the all-party group on suicide and self-harm prevention. I must say that grave offence will have been caused today to the many people who have lost loved ones to suicide. To talk of this as a suicide-prevention Bill when people have lost loved ones who had much to live for is harmful and hurtful. To use the term “commit” is to wound people who have lost loved ones to suicide. I ask Members never to use the word “commit” in relation to suicide. Suicide is not a crime. You commit murder or you commit an act against the law, but suicide is not against the law.

There has been much talk about how individuals affected by the Bill may be a burden on their families, but nothing about how life may be a burden on those who are dying. I cared for my husband for the last five years, while he was dying, and I saw when life changed to being a burden. He had no capacity to speak, to lift a hand to his mouth or to get on a train or a plane to go to Switzerland, so the Bill would not have affected him in the way that a letter that came to me affected me when somebody said that I should vote for the Bill because of my husband.

I believe that it is Parliament’s job to look at the will of the people and to consider the difficult choices in front of society. Therefore, consideration of the Bill should not be ended in the Chamber today; it must go into Committee and be debated. We must be honest with the people and have a full and frank debate.

I am aware of the time, Madam Deputy Speaker, but my one concern about the Bill is in relation to the DS1500. For those who are looking confused, the DS1500 is the form that your GP gives you that says you are terminally ill. It is a passport to benefits that are absolutely critical for the dying. Do not allow GPs who are opposed to the legislation to use it as a way of withholding those benefits from people who desperately need them. We must find something else.

We must have this debate, and we must carry it on.

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1.33 pm

Chloe Smith (Norwich North) (Con): I think I speak for the whole House when I say that it is an honour to follow the highly personal statement by the hon. Member for Bridgend (Mrs Moon).

I am proud to take part in this debate. I, too, favour the Bill. We are thinking about what we would want for our loved ones or, indeed, for ourselves, although, professionally speaking, our personal views are not the prime focus of this debate. In part, I am speaking to express a few of my constituents’ views.

One constituent who is in favour of the Bill, said:

“I am a nurse and believe everyone has the right to die when they feel it is right for them”.

Another constituent spoke to me about his father’s death from a brain tumour. He said that his father was, in his words, “fogged by morphine”, and he wished that his father had been able to have a more meaningful time with the family. Other constituents have told me of their concerns about the measurement of terminal illness, the pressures in the NHS, the concept of utilitarianism and—as other hon. Members have mentioned—the respect accorded to palliative care. One constituent said:

“Please will you allow these real concerns to be heard in the debate?”

Our duty today is to listen well, think carefully, and clearly explain our decisions.

The current law is unclear and often people are forced to take hidden, undignified and desperate action. Some relatives and loved ones are risking criminal prosecution. Ethical problems exist today, whether for the patient, doctor or family—they are not invented by the Bill. We should aim to bring those dreadful ethical choices into the light, giving people dignity and support. We do not have to make carers risk a murder or manslaughter charge alongside their grief.

Most of all, I believe in a person’s right to determine their own life and the manner of ending it, as that is a sovereign principle. We each own our lives and no one else defines that for us. Indeed, that concept is already quite deep within the NHS when we speak of , “No decision about me without me”. I also want better palliative care, and I appreciated hearing the factual evidence provided by the National Council for Palliative Care. However, I have concerns about one ethical opinion that was implied among its facts. While explaining that doctors and nurses are

“ill-placed to make judgements on whether a request for assistance to end life prematurely stems from a clear and settled intent”

it stated that such matters are

“better decided by the courts.”

Those words forget the one person whose choice it really is—the patient. This is not about forcing someone, or indeed everyone, to do something; this is about ceasing to force an individual to do something that they no longer wish to do, which is to live.

Many make arguments about ethical issues and say that society is what matters, and I say that the human being is what matters most. The Church of England stated in its briefing for this debate that while an individual’s sense of personal worth is an “important consideration”, it

“cannot take the place of the intrinsic value of every person’s life.”

11 Sep 2015 : Column 716

In other words, someone else gets to define the value of our life for us.

We all squeal when someone defines a person as worth less than we may think, but the more respectful and free response should be to resist defining a person in any way other than how that person wishes. We should trust people’s choices. This debate is not only about an individual’s wish to die but about the limits that ought to be placed on others, and the Church has been right to highlight that latter point. In my view, because the drugs in this Bill would only ever be self-administered, that aspect is controlled by what we are scrutinising today. Just as importantly, we should not be criminalising grieving families and friends. This right cannot mutate of its own accord. It is to give a small number of people who are suffering terribly, and their carers, the freedom not to suffer according to their stated wishes.

I cannot walk in everybody’s shoes—none of us can—but our job is to listen and to try to empathise and bring those points to the Chamber. The law must allow for different people’s positions. It is a matter of compassion, so let us have the courage to do that today.

1.38 pm

Karin Smyth (Bristol South) (Lab): We all come to the House in our different capacities today, and we have heard some emotional and impressive personal experiences. Our purpose here is as legislators, and as such we cannot continue to turn a blind eye to a situation where people with financial resources can make a choice about how and when they die, and travel to Switzerland, while those without resources cannot. My view has been profoundly influenced by my work as a manager in the national health service. A few years ago I worked on a project with some excellent doctors and nurses who were trying to build, improve and develop their communication skills and those of patients, in order to talk about and get a better understanding of respiratory disease. They were committed to helping patients understand how to live with their disease, and eventually how to die with it.

I learned a huge amount, especially from patients, particularly about how poorly equipped they were to talk about how to die with dignity, and how lonely it becomes when it is nobody’s role to talk to them about dying. That insight into how little choice and control patients have, as well as the minefield being navigated by our clinicians, opened my eyes to the need for society to open this debate and acknowledge that death is a part of life. We need to end the taboo that surrounds death in our society. It also highlighted to me the need to be more open about how we respond with compassion to the knowledge of imminent and inevitable death.

In subsequent work I have done on end-of-life and palliative care services, I became more aware of the huge variability of service provision. Supporters of the Bill are not opponents of palliative care. In my parliamentary career, I will continue to work for better awareness of the need to talk about death and dying, and for better palliative care and end-of-life services. I am delighted to hear so many Members today speak about the need for better palliative care services, but at a time—this is not a party political point—when we

11 Sep 2015 : Column 717

know there will be £22 billion of cuts in our health services, I worry that that is not going to be possible in the next five years.

People who wish to choose the time of their death can do so now, but must rely on Switzerland to manage the consequences. It cannot be right that some of my constituents can afford to go to Switzerland, but the majority cannot. I respect and understand people who are worried about vulnerability, old age and disability, and I respect the concerns about safeguards, but we do deal with many similar issues. As the hon. Member for Reigate (Crispin Blunt) said, many of them would, and should, be considered in Committee. I also respect the reluctance to make what feels like a big decision to take a leap into a new area, but the Rubicon has been crossed, the train has already left the station and Parliament cannot keep turning a blind eye. Our purpose is to establish the principle that terminally ill people can be afforded choice and dignity.

1.41 pm

Kit Malthouse (North West Hampshire) (Con): I shall keep my remarks short. I did not expect to be pitched, so early in my parliamentary career, into a conflict of morality, philosophy and the mundanity of legislation, but here we are. I have listened very carefully to many of the powerful speeches today, quite a lot of which, I am afraid to say, have been guilty of a cultural romanticisation of death. That is no surprise in a society in which many centuries of art, literature and religion have underlined that romanticism, creating a sense of nobility and grace about death. Even the murder and torture of Christ is referred to as the Passion. The reality for many people, of course, is nothing of the sort. It is anything but noble. The death bed is a place of misery, torture and degradation, a reign of blood, vomit and tears. It is often hard to see the compassion and the beauty in that.

The truth, as the hon. Member for Bristol South (Karin Smyth) said, is that the reality is already here. Doctors are hastening and helping people to their deaths every day. The Liverpool Care Pathway, and what remains of it, was about exactly that. Many people show up at hospital to find that awful acronym DNR hoisted above the bed of their relatives. The machines are turned off on a regular basis. As the hon. and learned Member for Holborn and St Pancras (Keir Starmer) underlined, the Rubicon has already been crossed with regards to compassionate assisted suicide. This is not something from which we in this House can shy away. As the hon. Lady has just said, we already have a business class carriage to a dignified death—if anyone has the money, they can go to Switzerland to achieve it. The reality is here and we should not abrogate our responsibilities to regulate, control or have some view on it.

A number of Members have raised questions about worth. I can understand and respect those with a religious belief who believe that the spark of life, however long and whatever the quality, is worth preserving. I would, however, ask people to question the notion of longevity versus quality. When my wife’s sister was in the final throes of breast cancer four years ago, my wife was very frustrated and angered by her unwillingness to participate in clinical trials. She had reached the end of her life and really did not want to prolong what had been an agonising and painful five years. She was focused on the quality of her life rather than on its longevity.

11 Sep 2015 : Column 718

Finally, we have to start at the right end of the telescope in this argument. I am with my hon. Friend the Member for Reigate (Crispin Blunt) and the right hon. Member for North Norfolk (Norman Lamb) in believing we have to start with human rights. If we decide that someone else has dominion over my body when I am in extremis, in pain, in the final months of my life, the argument is settled and everything else becomes rhetorical. If we do not, it is for the House to find solutions to the problems that might emanate from that decision. That is why I will be supporting the Bill into its next stage. We need to have that debate to come to those decisions, if we decide that I have dominion over my body in the final stages of my life.

1.45 pm

Colleen Fletcher (Coventry North East) (Lab): The Bill deals with the most profound and emotive issues. It was notable that many of those who wrote urging me to support the Bill acknowledged—presumably because they recognised the legal and ethical significance of what they advocated—that I might have concerns about changing the law in this area. They are absolutely right.

I intend to focus my comments on three specific areas, all relating to the inadequacy of the so-called safeguards in the Bill. First and foremost, I am concerned that irrespective of how robust the safeguards are perceived to be, they can never be completely effective in protecting vulnerable people against undue coercion or duress. Acts of coercion or duress are, by their very nature, exerted opaquely and in a targeted, underhand way, leaving the victim unable or unwilling to speak out for fear of what they perceive the consequences might be, particularly if they are wholly dependent for their care needs on their oppressor. In such circumstances, how are the two registered medical practitioners and the judge able to satisfy themselves that the decision to end life

“has been reached voluntarily, on an informed basis and without coercion or duress”?

Clearly, they cannot. As a result, the Bill does not adequately safeguard against the terminally ill being manipulated by those with an ulterior motive and forced into making a decision that they do not want to take or is not in their best interests.

Secondly, I am concerned that the definition of a terminally ill person for the purposes of the Bill is someone who

“is reasonably expected to die within six months”.

It is of course impossible, as experts in end-of-life care will affirm, to know definitively how long a person will live. We are, after all, dealing with a prognosis, which is by definition surrounded by inaccuracy. This has been proven many times before by those who have outlived their prognosis, sometimes by many years. Under the terms of the Bill, we would be asking doctors to make life or death decisions about matters about which there can be absolutely no clinical certainty.

Thirdly and finally, I am concerned that the Bill does not provide adequate safeguards or an appropriate legal framework to establish whether an individual

“has the capacity to make the decision to end his or her own life”.

There is no stipulation in the Bill for a mandatory psychological assessment of a patient by a medical practitioner who is registered in the specialty of psychiatry. Instead, the Bill puts the onus for establishing psychological

11 Sep 2015 : Column 719

wellbeing and capacity on the attending doctor and the independent doctor, both of whom are principally focused on, and trained to deal with, the state of health rather than the state of mind. With those who request assistance to die, there is an association with clinical depression and hopelessness, and a concern that their capacity to make rational decisions is diminished or impaired as a result.

The Bill does not make such provision and in my opinion cannot therefore be said to contain the appropriate, strong safeguards required. People say that we do not do death well in this country. We need to talk about it, but I do not want this Bill to be the start of that conversation.

1.49 pm

Huw Merriman (Bexhill and Battle) (Con): I will be voting in favour of the Bill. Having today reached my decision, I want to set out briefly the factors that made the merits of the Bill outweigh my concerns. I have heard it argued that the Bill will not help those who are locked in a coma and are without the capacity to administer their own death. This argument holds true, and I would be unable to vote for the Bill if its scope were so wide, as there would not be enough safeguards. However, the Bill is limited in its applicability.

I have heard it said that this Bill will be subject to a much wider interpretation by the courts than that which I have described. I do not discount that, but I have greater faith in both the wording of the Bill, particularly over the need for the prognosis to be terminal and for death to occur within six months, and in the reluctance of our courts to make law where the drafting is already clear and settled.

I have also heard the argument that enacting the Bill today would make it easier for future Parliaments to amend and broaden the applicability beyond those with terminal illness perhaps to those suffering from mental illness. I hope that that does not occur, but I have grappled with the persuasive argument that if this House opens the door and leaves it ajar, it will make it easier to open the door wide thereafter. If this House failed to legislate on the basis that a future House could broaden legislation, we would never produce laws at all. Ultimately, I concluded that I should make my decision based on the Bill before me, not on a hypothetical draft that may never be read.

The crux of my reasoning, which ultimately allows me to weigh up the arguments and vote in favour of the Bill, is the desire to grant a right to those who may require it and will be impacted by exercising it. This right is not for those who wrote to me, often citing religious reasons why life should not be capable of being ended prematurely. This right is not for those who will see out their final days of a terminal illness and rely on excellent palliative care. Those people would not utilise this law. This Bill is for the smaller number of people who wish to exercise their right to die earlier in their final six months—before they fade away in front of their family, before they enter a desperate period that they feel they cannot face, before they believe they will lose their dignity. It is for those people, with their own individual reasons, that I will cast my vote today to allow them this right.

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1.51 pm

Gavin Robinson (Belfast East) (DUP): As this debate draws close to a close, it is appropriate to commend the right hon. Member for Meriden (Mrs Spelman) for the tone she struck in opposing the Bill at the start of the debate, as well as the Herculean efforts of the hon. Member for Congleton (Fiona Bruce) in respect of everything that has gone on over recent months.

The most pronounced part of the debate this morning and into this afternoon has been the personal reflections of Members throughout the House. I was touched by those on both sides of the argument—whether it be listening to the hon. Member for Gainsborough (Sir Edward Leigh), or the hon. Members for Newport West (Paul Flynn), for Bridgend (Mrs Moon), for Central Ayrshire (Dr Whitford) or indeed for Poplar and Limehouse (Jim Fitzpatrick). They all touched me, but I have to say that from the outset of this proposal, my heart has been against it.

Although I cannot defend myself to my constituents on the basis of my heart alone, I have taken the time to consider the detailed proposals in the Bill and the plethora of information we have received over the last few months. My head and my heart are therefore at one on this issue.

Clause 1 says that nobody can initiate the process for a patient, but that does not exclude assisted dying becoming part of the panoply of options for a patient, which I think is a failing in the provisions. The figures for Oregon, much referred to today, show that if extrapolated to the UK, 17 people a year would take the prescribed medicine—yet still regain consciousness because their systems would not hold it. What an invidious position the Bill puts medical professionals in. I do not think we should remove those options, with no protection for the patient and no final assessment of capacity after the cooling-off period. The Bill is not appropriate and not proportionate; it does not have my support.

1.53 pm

Mary Robinson (Cheadle) (Con): It has been a privilege to be here and listen to both sides of the debate, which has been based on personal and moving experience. It has been a wonderful debate. I fully recognise the deeply held moral and practical views and the differences of opinion on this issue, which, although diverging in their approach to assisted dying, acknowledge and respect the responsibility of our society to show compassion.

Good intentions, however, do not always yield good results. Legislation that allows the taking of a life should not do so at the expense of vulnerable people. One of my principal concerns about the Bill remains the possibility that pressure could be put on vulnerable people to request assisted suicide. I am particularly thinking of situations where people may feel an unbearable pressure to commit suicide for fear of becoming a burden on loved ones. One of my constituents wrote to me on this point and I would like to share her comments with the House. She said:

“If I was unable to be independent, I would immediately be under pressure to go. My only daughter is fully employed and I have been a widow for over 50 years—there is no one else I could call on. As soon as I ask help of my daughter, I put pressure on her already-busy life. She would not deliberately wish me out of the way but adding the burden of mother-care would make it very hard for her to cope.”

11 Sep 2015 : Column 721

She goes on to say:

“How could I NOT feel under pressure to get out of the way? I would be unable stubbornly to stay alive when I knew I was being the last straw in her busy life.”

If this Bill becomes law there would be hundreds, if not thousands, of people who would feel themselves to be in this position.

There is a further difficulty, which is the definition of “reasonable”. That has been talked about so I will not go into it again, but I will say the debate on both sides of this issue has been grounded in compassion, but the right to die, although argued for well, is not greater than the right of vulnerable people to live.

1.56 pm

Andy Slaughter (Hammersmith) (Lab): The Government’s position, as set out by Lord Faulks in the Second Reading debate on the predecessor Bill in the other place, is that

“any change in the law in this emotive area is an issue of individual conscience. In our view, it is rightly a matter for Parliament to decide rather than government policy.”—[Official Report, House of Lords, 18 July 2014; Vol. 755, c. 919.]

No doubt the Minister will confirm that today. The Opposition also believe that it is a matter for individual conscience, and it is right therefore that Front-Bench comments have been constrained to allow the maximum number of Back-Bench contributions.

We have not yet had 85 speeches, let alone the 133 speeches over 10 hours the other place devoted to the subject last year, but the number and quality of speeches we have heard today leave no doubt that this is a matter of great weight and controversy. We reflect, as we should, the views of our constituents; like, I am sure, all Members, I have had hundreds of representations making a passionate and compelling case on both sides of the argument.

I warmly and sincerely thank my hon. Friend the Member for Wolverhampton South West (Rob Marris) for bringing this issue before the House after 18 years. He has had something of a rollercoaster ride of defeat and victory over the last two elections and he could have chosen a less controversial and easier life. Instead, he is totting up his staffing budget to see whether he can afford the additional assistance to deal with his engorged postbag. His aim, in his own words, is to do better for dying people.

Let me also acknowledge the work of Lord Falconer, who chaired the Commission on Assisted Dying and piloted the predecessor Bill through Second Reading and into Committee in the Lords.

There are many, including some who have spoken today, for whom the principle of assisted dying or the slippery slope argument are the start and end of their consideration. The current Archbishop of Canterbury has said that we are crossing a “legal and moral Rubicon” today, but that side of the argument does not enjoy monopoly support even among archbishops. Lord Carey has said:

“Some people have said on the issue of compassion that actually pain is a noble thing, to bear pain and to say that we are suffering with you is, in my view, a very poor argument indeed.

There is nothing noble about excruciating pain and I think we need as a nation to give people the right to decide their own fate.”

11 Sep 2015 : Column 722

Many Members have expressed concern as to the role of the medical profession, saying that there would be a fundamental change in the doctor-patient relationship. Indeed that is an important consideration, but I equally take on board the comments of my hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer), who says there is currently an inconsistency in the law as a result of his own guidelines. There is an opt-out for medical practitioners, and some would say that that heralds a more mature relationship between doctors and patients. My hon. and learned Friend explained with his customary precision the limits that he was able to achieve even with the excellent guidelines he introduced as Director of Public Prosecutions.

That brings me to my concluding point and, I think, the salient point for us to bear in mind today. Other bodies have tried to address this issue. The Director of Public Prosecutions has tried, as has the Supreme Court. We should bear in mind the words of the President of the Supreme Court, Lord Neuberger, who said that it was

“institutionally inappropriate at this juncture”

for the Court to declare that clause 2 was incompatible with article 8, as opposed to giving Parliament the opportunity to consider the position without a declaration. Lord Sumption referred to the “inherent difficulty” of the question, and to

“the fact that there is much to be said on both sides”—

for making—

“Parliament the proper organ for deciding it.”

Without drawing a conclusion on the rightness or wrongness of the Bill, I urge the House to take the same course that the other place took last year, which was not to vote down the Bill at this stage but to allow it to go forward into Committee where these matters could be debated further. That was the cogently expressed view of a strong opponent of the Bill in the other place, Lord Mackay of Clashfern, who stated:

“I am deeply opposed to the Bill but strongly in favour of it being afforded a Second Reading so that we may have the opportunity to discuss the many vitally important issues that it raises.”—[Official Report, House of Lords, 18 July 2014; Vol. 755, c. 778.]

We abdicate our responsibility if, after 18 years, we do not fully discuss these matters in detail and look at the safeguards and the possibilities in the Bill. It is wrong that those of our constituents who can afford to do so have the option to go to Switzerland when others do not have such options. We at least owe them the courtesy of discussing these matters more fully. I personally will support the Bill’s Second Reading, but I will be doing so in order to have a stronger, fuller debate.

Robert Flello: On a point of order, Madam Deputy Speaker. Is it in order for my hon. Friend the Member for Hammersmith (Andy Slaughter) to give his personal views at the Dispatch Box, when he is there in a party position?

Madam Deputy Speaker (Natascha Engel): The hon. Member for Hammersmith is entitled to say what he likes from the Dispatch Box. It is up to him, and my understanding is that this is a free vote anyway. With that, I call Mike Penning.

11 Sep 2015 : Column 723

2.1 pm

The Minister for Policing, Crime and Criminal Justice (Mike Penning): It is an honour and a privilege to be standing at the Dispatch Box today as we show the rest of the country and the world what a Parliament should be doing. We have debated this important subject with passion but shown that we all have respect for each other. It is a shame that it has been 18 years since this matter was last debated, and I congratulate the hon. Member for Wolverhampton South West (Rob Marris) on bringing it here today. We have heard some unbelievably passionate speeches.

The House has also shown that it is not just full of lawyers and professional politicians. There are people here who bring experience of their previous professions. Some of them went off to university, some of us went off into the fire service—including me and the hon. Member for Poplar and Limehouse (Jim Fitzpatrick)—and some went into the Army. This debate has shown what we in the Chamber can do when the electorate elect people who are representative of their communities.

It is rare for a Minister to be able to stand at the Dispatch Box and get rid of their ministerial folder, but the Government do not hold a position on this Bill. They will respect the view of the House. That is exactly what happened in the other place last year, when Lord Falconer made the position quite clear, and the position is quite clear here today. I will therefore speak from the Dispatch Box in a personal capacity, which is also unusual.

When I was 17, I was a young soldier and I had just passed out of training. I got a message from the adjutant that my grandmother had collapsed and that I had been granted compassionate leave because she was terminally ill. People do not get compassionate leave from the armed forces unless the situation is really serious. I went home and Nan was in hospital. She had had a massive stroke and was paralysed from the neck down. I am a man of faith, and that night I prayed that Nan would not make it through the night. She was in great discomfort and she was conscious most of the time. The doctors said they did not think she would make it. She saw me and she cried, as I did.

Nan lived for another 20 years. She was a feisty girl. She smoked 60 a day, which is why she had the stroke, and she had a huge mass on her lungs. She used to cough in a way that I never thought anybody could cough, and she could swear at me when she saw me smoking, even though she smoked 60 a day. The point I am trying to make is that those in the medical profession are simply fantastic people and they do fantastic things for us, day in, day out—we heard much about that from the hon. Member for Central Ayrshire (Dr Whitford), who told us not only about her work, but about the work that has been done in other areas—but they get it wrong, and the will of the human being to decide when it is right for them to go, no matter what pain they are in, is something that we should not take lightly.

Nan was not in pain when she eventually got home. Strokes are horrible things; Nan was bed-bound and my grandfather nursed her for 20 years. Interestingly, I was best man for my grandfather when he remarried at the age of 71, which is also an experience. Sadly, I lost my step-grandmother only a couple of weeks ago, when she

11 Sep 2015 : Column 724

was 99. She was just as feisty as Nan, so in many ways he bought silly twice, because she very much ruled the roost.

When Nan was so ill, a group of nurses came in to help her. This was right at the start of the hospice movement, and ever since I have been involved in the hospice movement—I declare that interest. I am patron of the Hospice of St Francis and of Iain Rennie Hospice and Grove House, which are amalgamated under Rennie Grove Hospice Care. The Peace Hospice, just outside my constituency, does fantastic work, and Keech Hospice, a children’s hospice in Luton which looks after terminally ill children in my constituency, also does fantastic work.

My reasons for voting against this Bill this afternoon are twofold. First, I do not think it should be an excuse that we cannot control pain in the 21st century for people who are so ill. Secondly, I am, frankly, against suicide. I have been to too many suicides, as has the hon. Member for Poplar and Limehouse, where we have seen the aftermath. People who wish to commit suicide need help—we should help them, not assist in killing them.

Jonathan Reynolds: claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Question put accordingly, That the Bill be now read a Second time.

The House proceeded to a Division.

Mr Nigel Evans: On a point of order, Madam Deputy Speaker. Some Members will have sat throughout the debate today and will have decided that they will not register a vote as they cannot make up their minds. Will you confirm that outside of voting in both Lobbies, which is strongly discouraged, there is no way in which a Member of Parliament can register an abstention following a debate?

Madam Deputy Speaker (Natascha Engel): It is indeed the case that voting in both Lobbies is discouraged, so it is not possible to register an abstention. I thank the hon. Gentleman for making that point and putting it on the record.

The House having divided:

Ayes 118, Noes 330.

Division No. 69]

[

2.7 pm

AYES

Allan, Lucy

Allen, Mr Graham

Bailey, Mr Adrian

Barron, rh Kevin

Barwell, Gavin

Benn, rh Hilary

Betts, Mr Clive

Bingham, Andrew

Blackman, Kirsty

Blomfield, Paul

Blunt, Crispin

Brake, rh Tom

Brown, Alan

Brown, rh Mr Nicholas

Buck, Ms Karen

Burden, Richard

Cadbury, Ruth

Carmichael, rh Mr Alistair

Champion, Sarah

Clark, rh Greg

Coffey, Ann

Cowan, Ronnie

Cox, Jo

Creasy, Stella

Crouch, Tracey

David, Wayne

Davies, Geraint

Donaldson, Stuart

Eagle, Ms Angela

Eagle, Maria

Fitzpatrick, Jim

Flint, rh Caroline

Flynn, Paul

Foxcroft, Vicky

Frazer, Lucy

Gibb, Mr Nick

Godsiff, Mr Roger

Goldsmith, Zac

Goodman, Helen

Green, Kate

Greenwood, Lilian

Haigh, Louise

Harman, rh Ms Harriet

Harris, Carolyn

Heaton-Jones, Peter

Hodge, rh Dame Margaret

Hollinrake, Kevin

Hopkins, Kelvin

Howarth, rh Mr George

Huq, Dr Rupa

Jenrick, Robert

Johnson, Joseph

Kendall, Liz

Kerevan, George

Kerr, Calum

Kinnock, Stephen

Kyle, Peter

Lamb, rh Norman

Law, Chris

Lewis, Clive

Lucas, Caroline

Lynch, Holly

Malthouse, Kit

Mann, John

Mann, Scott

Marris, Rob

Mathias, Dr Tania

McCaig, Callum

McCarthy, Kerry

McDonald, Stewart Malcolm

McFadden, rh Mr Pat

Merriman, Huw

Miliband, rh Edward

Mills, Nigel

Mitchell, rh Mr Andrew

Monaghan, Dr Paul

Moon, Mrs Madeleine

Mullin, Roger

Murray, Ian

Nicolson, John

Onn, Melanie

Opperman, Guy

Pennycook, Matthew

Perry, Claire

Phillips, Jess

Philp, Chris

Powell, Lucy

Reed, Mr Jamie

Rees, Christina

Reynolds, Emma

Robinson, Mr Geoffrey

Scully, Paul

Sheppard, Tommy

Sherriff, Paula

Siddiq, Tulip

Slaughter, Andy

Smith, Cat

Smith, Chloe

Smith, Jeff

Smith, Owen

Smyth, Karin

Soubry, rh Anna

Starmer, Keir

Stevens, Jo

Streeting, Wes

Stride, Mel

Turley, Anna

Turner, Karl

Twigg, Stephen

Umunna, Mr Chuka

Warman, Matt

West, Catherine

Wilson, Corri

Wilson, Phil

Winnick, Mr David

Winterton, rh Ms Rosie

Wright, Mr Iain

Zeichner, Daniel

Tellers for the Ayes:

Heidi Alexander

and

Nusrat Ghani

NOES

Abrahams, Debbie

Aldous, Peter

Ali, Rushanara

Amess, Sir David

Anderson, Mr David

Andrew, Stuart

Ansell, Caroline

Argar, Edward

Arkless, Richard

Ashworth, Jonathan

Bacon, Mr Richard

Baker, Mr Steve

Baldwin, Harriett

Barclay, Stephen

Bebb, Guto

Bellingham, Mr Henry

Benyon, Richard

Berry, Jake

Berry, James

Blackford, Ian

Blackman, Bob

Blackwood, Nicola

Blenkinsop, Tom

Bone, Mr Peter

Borwick, Victoria

Bottomley, Sir Peter

Bradley, Karen

Brady, Mr Graham

Brazier, Mr Julian

Bridgen, Andrew

Brine, Steve

Brokenshire, rh James

Brown, Lyn

Bruce, Fiona

Bryant, Chris

Buckland, Robert

Burgon, Richard

Burns, Conor

Burns, rh Sir Simon

Burrowes, Mr David

Butler, Dawn

Cairns, Alun

Cameron, Dr Lisa

Campbell, rh Mr Alan

Campbell, Mr Gregory

Carmichael, Neil

Carswell, Mr Douglas

Cartlidge, James

Cash, Sir William

Caulfield, Maria

Chalk, Alex

Chishti, Rehman

Chope, Mr Christopher

Churchill, Jo

Clarke, rh Mr Kenneth

Clegg, rh Mr Nick

Cleverly, James

Clifton-Brown, Geoffrey

Clwyd, rh Ann

Coffey, Dr Thérèse

Colvile, Oliver

Cooper, Rosie

Costa, Alberto

Cox, Mr Geoffrey

Coyle, Neil

Crabb, rh Stephen

Crausby, Mr David

Creagh, Mary

Cruddas, Jon

Cummins, Judith

Cunningham, Mr Jim

Davies, Byron

Davies, Chris

Davies, David T. C.

Davies, Glyn

Davies, Dr James

Davies, Mims

Davies, Philip

Dodds, rh Mr Nigel

Donaldson, rh Mr Jeffrey M.

Donelan, Michelle

Dorries, Nadine

Double, Steve

Doughty, Stephen

Dowd, Jim

Dowd, Peter

Doyle-Price, Jackie

Drummond, Mrs Flick

Duncan Smith, rh Mr Iain

Durkan, Mark

Efford, Clive

Elliott, Julie

Elliott, Tom

Ellis, Michael

Ellison, Jane

Elphicke, Charlie

Esterson, Bill

Eustice, George

Evans, Chris

Evans, Graham

Evans, Mr Nigel

Evennett, rh Mr David

Fallon, rh Michael

Fellows, Marion

Fernandes, Suella

Ferrier, Margaret

Field, rh Frank

Field, rh Mark

Flello, Robert

Fletcher, Colleen

Foster, Kevin

Fox, rh Dr Liam

Francois, rh Mr Mark

Freeman, George

Fuller, Richard

Fysh, Marcus

Gale, Sir Roger

Gardiner, Barry

Garnier, rh Sir Edward

Gillan, rh Mrs Cheryl

Glass, Pat

Glen, John

Glindon, Mary

Goodwill, Mr Robert

Gove, rh Michael

Grady, Patrick

Gray, Mr James

Grayling, rh Chris

Green, Chris

Green, rh Damian

Greening, rh Justine

Greenwood, Margaret

Grieve, rh Mr Dominic

Griffith, Nia

Griffiths, Andrew

Gummer, Ben

Gyimah, Mr Sam

Halfon, rh Robert

Hall, Luke

Hammond, Stephen

Hands, rh Greg

Hanson, rh Mr David

Harper, rh Mr Mark

Haselhurst, rh Sir Alan

Hayes, Helen

Hayes, rh Mr John

Hayman, Sue

Heald, Sir Oliver

Heappey, James

Hepburn, Mr Stephen

Herbert, rh Nick

Hermon, Lady

Hillier, Meg

Hinds, Damian

Hoare, Simon

Hodgson, Mrs Sharon

Hoey, Kate

Hollobone, Mr Philip

Holloway, Mr Adam

Hopkins, Kris

Howlett, Ben

Hunt, rh Mr Jeremy

Huq, Dr Rupa

Hussain, Imran

Jackson, Mr Stewart

James, Margot

Jayawardena, Mr Ranil

Jenkin, Mr Bernard

Jenkyns, Andrea

Johnson, rh Alan

Johnson, Boris

Johnson, Gareth

Jones, Andrew

Jones, rh Mr David

Jones, Gerald

Jones, Helen

Jones, Mr Marcus

Jones, Susan Elan

Kane, Mike

Kaufman, rh Sir Gerald

Keeley, Barbara

Kennedy, Seema

Kirby, Simon

Knight, rh Sir Greg

Knight, Julian

Lammy, rh Mr David

Lancaster, Mark

Leadsom, Andrea

Lee, Dr Phillip

Lefroy, Jeremy

Leigh, Sir Edward

Letwin, rh Mr Oliver

Lewell-Buck, Mrs Emma

Lewis, Mr Ivan

Lewis, rh Dr Julian

Lidington, rh Mr David

Long Bailey, Rebecca

Loughton, Tim

Lucas, Ian C.

Mackintosh, David

Madders, Justin

Mahmood, Shabana

Main, Mrs Anne

Mak, Mr Alan

Malhotra, Seema

Marsden, Mr Gordon

Maskell, Rachael

Matheson, Christian

May, rh Mrs Theresa

Maynard, Paul

McCabe, Steve

McCartney, Karl

McDonagh, Siobhain

McDonald, Andy

McDonnell, Dr Alasdair

McGinn, Conor

McInnes, Liz

McKinnell, Catherine

McLoughlin, rh Mr Patrick

McPartland, Stephen

Menzies, Mark

Mercer, Johnny

Metcalfe, Stephen

Miller, rh Mrs Maria

Milling, Amanda

Milton, rh Anne

Monaghan, Carol

Morris, Grahame M.

Morris, James

Morton, Wendy

Mundell, rh David

Murrison, Dr Andrew

Newlands, Gavin

Newton, Sarah

Nokes, Caroline

Nuttall, Mr David

O'Hara, Brendan

Offord, Dr Matthew

Osamor, Kate

Owen, Albert

Paisley, Ian

Parish, Neil

Paterson, rh Mr Owen

Pawsey, Mark

Pearce, Teresa

Penning, rh Mike

Percy, Andrew

Perkins, Toby

Phillips, Stephen

Phillipson, Bridget

Pickles, rh Sir Eric

Pincher, Christopher

Pound, Stephen

Pow, Rebecca

Prentis, Victoria

Prisk, Mr Mark

Pugh, John

Pursglove, Tom

Quin, Jeremy

Quince, Will

Qureshi, Yasmin

Rayner, Angela

Redwood, rh John

Rees-Mogg, Mr Jacob

Reynolds, Jonathan

Rimmer, Marie

Ritchie, Ms Margaret

Robertson, Mr Laurence

Robinson, Gavin

Robinson, Mary

Rutley, David

Sandbach, Antoinette

Selous, Andrew

Shannon, Jim

Sharma, Mr Virendra

Sheerman, Mr Barry

Shelbrooke, Alec

Shuker, Mr Gavin

Simpson, David

Simpson, rh Mr Keith

Skinner, Mr Dennis

Smith, rh Mr Andrew

Smith, Julian

Smith, Royston

Soames, rh Sir Nicholas

Solloway, Amanda

Spellar, rh Mr John

Spelman, rh Mrs Caroline

Stephens, Chris

Stewart, Bob

Stewart, Iain

Streeter, Mr Gary

Stringer, Graham

Stuart, Ms Gisela

Swayne, rh Mr Desmond

Syms, Mr Robert

Tami, Mark

Thomas, Derek

Thomas-Symonds, Nick

Throup, Maggie

Timms, rh Stephen

Tolhurst, Kelly

Tomlinson, Michael

Tracey, Craig

Trevelyan, Mrs Anne-Marie

Tugendhat, Tom

Turner, Mr Andrew

Twigg, Derek

Vaizey, Mr Edward

Vara, Mr Shailesh

Vaz, rh Keith

Vaz, Valerie

Vickers, Martin

Villiers, rh Mrs Theresa

Walker, Mr Robin

Wallace, Mr Ben

Warburton, David

Wharton, James

Whately, Helen

Whitford, Dr Philippa

Williams, Craig

Williams, Mr Mark

Williamson, rh Gavin

Wilson, Mr Rob

Wilson, Sammy

Wollaston, Dr Sarah

Wood, Mike

Woodcock, John

Wragg, William

Wright, rh Jeremy

Tellers for the Noes:

Joan Ryan

and

Mr Charles Walker

Question accordingly negatived.

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Representation of the People (Young Persons’ Enfranchisement and Education) Bill

Second Reading

2.22 pm

Vicky Foxcroft (Lewisham, Deptford) (Lab): I beg to move, That the Bill be now read a Second time.

It is a great pleasure to follow such a high-quality debate—so much passion from Members on both sides. I know that many young people would have strong views on the positions taken in that important debate, and if they are able to engage on issues like that, surely they should be given the vote, allowing them the chance to decide who represents them. But it is not just on that subject that young people have strong views. Let us take the Scottish referendum. Young people were engaged: 75% of young people who were registered to vote did so. And when I visit schools in my constituency, the young people I speak to are motivated, enthusiastic and passionate. They are worried about their future. They are worried about what is happening around them—cuts to youth service provision, cuts to police numbers and about safety in their area. They want to have a say over their future education. They have a voice; they want to be heard. I have been told this time and time again. The strength of feeling among the young people that I have spoken to is clear, and it is for that reason that I chose to introduce the Bill.

While debating the EU referendum, this House had the opportunity to introduce votes for 16 and 17-year-olds, and it is such a shame that it did not. Many Members contributed to those debates, including many Conservative Members. For example, the hon. Member for Kingswood (Chris Skidmore) said that

“surely it is better that a constitutional issue that is so important that it affects all elections should be fully debated by the House as a separate matter.”—[Official Report, 18 July 2015; Vol. 597, c. 509.]

And the Secretary of State for Foreign and Commonwealth Affairs said:

“I concede that there are those in the House who will wish to debate whether that franchise itself should be extended to 16 and 17-year-olds, but the Government are not persuaded and that is a debate for another day.”—[Official Report, 9 June 2015; Vol. 596, c. 1053.]

Well, this is that day. The Bill has an added plus—improved citizenship education, giving pupils the knowledge, skills and confidence to prepare them for the responsibilities of voting and the opportunities to become politically active.

Mr Peter Bone (Wellingborough) (Con): Will the hon. Lady give way?

Vicky Foxcroft: No, I do not have time.

Some say that young people cannot make informed decisions, that they are not educated enough in politics and that they lack the life experience to be able to vote. To those people I say this: you are wrong and you are scared. Young people are a lot more informed and clued-up than they are given credit for. They are a lot more informed and clued-up than—dare I say it—some hon. Members here.

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Whenever change takes place, people are often afraid of what that means, but once delivered it can become the norm, as in 1919, when the Representation of the People Act gave women over 30 the right to vote, or in 1928, when the Equal Franchise Act finally gave women the same voting rights as men. That was nearly 100 years ago, when we did not have a single female Member of Parliament. In 1919 Nancy Astor, the first female MP, was elected to Parliament. By 1945 there were still only 24 female MPs. It took a Labour victory in 1997 for a huge increase to take place in female representation. In that election 120 female MPs were elected, 101 of whom were Labour.

The House may wonder why I am talking about female representation when I am putting forward a Bill for votes for 16 and 17-year-olds. I am highlighting the fact that progress can be slow, but that does not mean that it is not the right thing to do. Just as Parliament has been enhanced by women’s participation, the political system can be improved by young people’s votes.

The issues that matter to young people need to be at the heart of our politics. Young people tell me they are concerned about further education, university funding, apprenticeships, jobs and the minimum wage for young people. They want the education maintenance allowance back. They are concerned about housing and whether they will be able to afford to buy a property or even to rent one.

Mr David Nuttall (Bury North) (Con): Will the hon. Lady give way?

Vicky Foxcroft: Let me give a little more historical analysis, specifically on young people. Back in 1969 it was felt that people under 21 were too young to vote. Many of the arguments used then are arguments that I continue to hear today, so I shall quote the words of James Callaghan when debating lowering the voting age to 18. He said:

“It will become increasingly difficult to explain to young people why for all social purposes they are entitled to regard themselves as adult at the age of 18, except on the question of the vote. I believe that this would be an anomaly that would become increasingly difficult to explain.—[Official Report, 26 November 1968; Vol. 774, c. 624.]

Why is it that at 16 young people can give full consent to medical treatment, pay income tax and national insurance, obtain tax credits and welfare benefits in

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their own right, consent to sexual relationships, get married or enter a civil partnership, change their name by deed poll, become a director of a company or even serve in the armed forces, but they cannot vote? Over the past month Labour party members from the age of 15 have been voting in our leadership election. Young Conservatives can also vote in elections, though I hope in their own. Our deadline has now passed.

In closing, let me quote one of the strongest advocates of votes at 16 and what he wants—the ability to vote in the Mayor of London election and the upcoming EU referendum. The young mayor of Lewisham, Liam Islam, is one of the most passionate, articulate young people I have ever met, and he is not alone. There are so many Liams out there who are desperate to have their voice reflected at the ballot box. Let us be part of that historic change today. I urge all Members to support the Bill and ensure that young people’s voices are reflected in politics. I commend the Bill to the House.

2.30 pm

The debate stood adjourned (Standing Order No. 11(2)).

Ordered, That the debate be resumed on Friday 23 October.

Business without Debate

Crown Tenancies Bill

Motion made, That the Bill be now read a Second time.

Hon. Members: Object.

Bill to be read a Second time on Friday 6 November.