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Lord Taverne: My Lords, I am not sure that the Minister is up to date. The latest report, which has just been published, as I mentioned, shows that 54 per cent of cases are reported—a considerable increase on the previous report.

Baroness Andrews: My Lords, I take the point, and I am sorry that I misheard the noble Lord during his speech. But there are still a considerable number of cases that are not reported.

Finally, the Royal College of Physicians has advised that we should not walk away because we cannot accept this Bill. There is a moral obligation not to view this as the only alternative. Although the Bill is a humane response to unalleviated suffering associated with incurable, progressive and terminal illness, it is not the only way to ease the passage of patients in terminal states.

The Government will not walk away from the alternatives. We are very committed to improving the extent, the quality and the effect of palliative care. We have put additional investment into it. We want to ensure that the whole of the NHS learns from best practice in palliative care. We believe in leading the way. We have a responsibility to ensure that, as well as to ensure that in all our policies for elderly people we are giving them the priority of the care and the value that they deserve and need. Our investment will enable patients to have greater access to palliative care services.

I shall not speak any longer, tempted as I am to talk about our plans for palliative care and for improved services for elderly people. Perhaps I may conclude by thanking the noble Lord again and by thanking all noble Lords who have spoken and made this such an exceptional debate. What is proposed is a profound shift in public policy. We cannot be too careful before taking such a step that will have such far-reaching consequences for ourselves and the whole of society.

5.51 p.m.

Lord Joffe: My Lords, I am immensely grateful to those of your Lordships who have spoken in this debate and to those who have come to listen. I also thank the Minister for her careful and balanced

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analysis of the case for and the case against patient-assisted dying. It was encouraging to hear of the commitment of the Government to palliative care. That is something which we all totally support.

The subject of assisted dying is one which arouses great passions and is an issue on which the opinion of the House is so clearly divided. I have learnt a great deal from both those who spoke in favour and those who spoke against the Bill. I shall just pause for one moment to say that I was deeply hurt by the linking made by the noble Lord, Lord McColl, of this Bill with what happened in Nazi Germany. I think that it is unacceptable.

Lord McColl of Dulwich: My Lords, I thank the noble Lord for giving way. I did not say Germany.

A noble Lord: 1939.

Lord McColl of Dulwich: I said, "in the 1930s" and I did not mention Germany.

Lord Joffe: My Lords, if that is so, to what was the noble Lord referring?

Noble Lords: Europe.

Earl Russell: My Lords, these practices were indulged in by Mussolini—

Lord Joffe: My Lords, the time is late and I am grateful that noble Lords have stayed so long. Accordingly, I shall try to be very brief and certainly not more than five minutes. I shall not seek to reply to the individual points made by so many of your Lordships. The views expressed against the Bill have been countered by those in favour of the Bill, and conversely. There is nothing at this stage that I should wish to add, except to deal with the generality of what I believe is the main thrust of the opposition to the Bill; namely, the concern that vulnerable members of society may be put at risk. Of course, I share that concern. My whole background is concerned with seeking to avoid suffering and with justice.

Naturally, this opposition has to be based on speculation as to what may happen, rather than on factual evidence. As it happens, the only real evidence

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is that of Oregon and the Netherlands, where there has been virtually no evidence of abuse or breakdown of trust between doctors and patients. If patient-assisted dying works well in other countries where it is allowed, why should it not work at least as well in the United Kingdom? As I have said, the main concern about possible abuse is speculative. On the other hand, the suffering of those which the Bill is designed to help is real and there is no shortage of evidence about that reality.

The Bill is the solution to that suffering and to contend that people should continue to suffer terribly because there is a danger that vulnerable people may be placed at risk is, I suggest, the wrong starting point. Having identified the danger of abuse as a result of taking steps to reduce suffering, action should be taken to prevent that danger. To state that it is impossible to prevent abuse is not really acceptable. If it was, social progress in this country would seldom have taken place because there are risks in almost every step forward.

The focus must be on finding ways of protecting the vulnerable. This Bill contains an array of safeguards intended to do that. If practical amendments are proposed which would close any gaps, I would welcome them. One practical step which requires further consideration and to which I am sympathetic and want to consider and reflect on is the proposal of the noble Baroness, Lady Jay, for a Select Committee. However, I need more time to consider that. I also support very much the comment of the noble Baroness, Lady Flather, that we need to undertake a great deal more research into these issues. Incidentally, although I think it may have been missed in the speeches of other noble Lords, the noble Baroness was also a member of the Select Committee.

What supporters of this Bill would not welcome would be a decision by this House which, while recognising that many patients are suffering unbearably, concludes that it cannot do anything about it and that such patients must just continue to suffer unbearably.

I am grateful to all noble Lords for their patience. I ask the House to give the Bill a Second Reading.

On Question, Bill read a second time.

        House adjourned at three minutes before six o'clock.

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