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Points of Order
Huw Irranca-Davies (Ogmore) (Lab): On a point of order, Mr Speaker. I will try to emulate that example. On 1 March, in response to questions about attacks by dangerous dogs, the Minister of State, Department for Environment, Food and Rural Affairs made an explicit and welcome promise at the Dispatch Box:
“If a Minister stands at the Dispatch Box and says that something will happen very shortly, it means precisely that. It certainly means before the House rises for Easter.”—[Official Report, 1 March 2012; Vol. 541, c. 415.]
That deadline expires today, 27 March, yet there is silence from the Department and the Government, nearly two years after the consultation ended. Nearly 100 people are treated in hospital every week. Kennelling costs are now spiralling out of control, and people in all parts of the House are rightly sickened by attacks by aggressive and uncontrolled dogs. Our sympathies go out to the five police officers from Newham who were injured in the latest attack. Dog bite incidents in the UK have risen by 79% in London and 43% nationally in recent years, according to figures from the Kennel Club. Have you received any late indication, Mr Speaker, of the Government’s intention to make a statement today? Do you have any powers, as Speaker and defender of the rights of this House, to summon the Minister to explain why the Government have broken their promise again?
Fiona O'Donnell (East Lothian) (Lab): On a point of order, Mr Speaker. This House, business and environmental organisations have been waiting for a statement from the Secretary of State for Environment, Food and Rural Affairs since last autumn on mandatory carbon reporting. We read in the Financial Times this morning that the Government have abandoned their commitment to MCR. We also learn that Michael Hintze, a well known climate change sceptic and funder of Lord Lawson’s climate think-tank, was one of the Tory donors who had dinner at No. 10 with the Prime Minister. Surely Members of this House should have had the opportunity to question the Secretary of State about the further delay in the Government making a statement. There has been no written ministerial statement or oral statement, and a report has only just been laid in the Table Office. I would appreciate your guidance, Mr Speaker; otherwise Members of this House will be left wondering what this Secretary of State has to hide.
Mr Speaker: Those on the Front Bench will have heard what the hon. Lady has to say. She will know—and the House can testify—that I attach great importance to Ministers making statements of new policy to the House, but statements arise when—[ Interruption. ] Order. I do not require any assistance. [ Interruption. ] Order. Such statements arise when, and only when, there is a new policy to announce. There is not a matter that engages the Chair today, but the hon. Lady has placed her concerns on the record, and I thank her for doing so.
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which arises from a question I asked the Leader of the House last Thursday about the publication of a response to the Select Committee on Science and Technology report on alcohol guidelines. I raised the matter because of a leak from the Home Office. It now appears that the leak was correct, yet the Government chose, for whatever reasons, not to separate the publication of their strategy and their response to the Select Committee, which was delayed by over a month. That is not the right way to treat a Select Committee that is doing serious work on such matters. Although the Leader of the House clearly did not mislead me, he did not tell me the full story. Will you use your good offices, Mr Speaker, to ensure that this kind of incident does not happen again, because it undermines the work of Select Committees?
Mr Speaker: I note what the hon. Gentleman says. He should be encouraged by the presence on the Treasury Bench of the Deputy Leader of the House, who will have listened to him. The gravamen of his complaint appears to relate to the relationship between the Science and Technology Committee and, in this case, the Home Office, but perhaps the Government more generally. I can say only that these are not matters of order on which the Chair can rule. The Select Committee should pursue these questions with the Government, and if the Committee is dissatisfied with the response, it should in the first instance take the matter up with the Liaison Committee.
Mr Christopher Chope (Christchurch) (Con): On a point of order, Mr Speaker. I hope you will be able to guide the House on what we shall do with the Finance Bill when we get back. Two days—Wednesday and Thursday immediately after Easter—have been set aside for a Committee of the whole House, but the Bill has not yet been published. Today’s Order Paper provides that amendments to the Bill may be tabled in advance of Second Reading, but we do not yet know what subjects will be considered on the Wednesday and Thursday. Those subjects are usually agreed by the Opposition and the Government, and I am party to neither. When will we find out what those subjects will be?
What can you do through your good offices, Mr Speaker, to ensure a timely response to questions that are pertinent to the Finance Bill? I have tabled priority notice questions that have a direct bearing on the issue of child benefit, yet they have remained unanswered for over a week. What can you do to ensure that Ministers respond to them quickly?
Mr Speaker: I am grateful to the hon. Gentleman for his point of order. I shall make two points in response. First, I should imagine that it is the responsibility of the Government to table a committal motion in regard to the consideration of the Finance Bill, and to do so before the rise of the House tonight. On the assumption that the hon. Gentleman remains as keenly interested in the matter throughout the day as he is at the moment—that is a confident expectation on my part—I suspect he will be beetling into the Table Office to discover at what point the Government have tabled that motion. I hope that that offers him some reassurance.
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heard what he has said. It is important that there should be timely and substantive responses to parliamentary questions from colleagues, and I would say only to the hon. Gentleman in the friendliest possible spirit that not to provide timely responses to the hon. Member for Christchurch (Mr Chope) is almost as hazardous a mission for any Minister as to treat in a similar way the right hon. Member for Manchester, Gorton (Sir Gerald Kaufman).
Ian Paisley (North Antrim) (DUP): On a point of order, Mr Speaker. It has been brought to my attention today that the right hon. Member for Neath (Mr Hain) has been charged with contempt of court because of comments he made in daring to criticise a judge in Northern Ireland. I understand, however, that that law is obsolete and no longer applies in England and Wales, and that the right hon. Gentleman will be charged in Northern Ireland. Have you been informed of this matter, Mr Speaker, and if not, why not? Are you able to make a ruling or to comment on it?
Mr Speaker: I am grateful to the hon. Gentleman for his point of order. The short answer is that I had not been informed of the matter to which he refers. Ordinarily, the Speaker would be informed only in the case of an arrest of a Member, and that is not what is involved here. Beyond that, I would say that I understand the seriousness with which the hon. Gentleman treats this issue, and how perturbed he is by what he has learned, but the interest and authority of the Chair would be engaged only if the comments concerned had been made in the Chamber. My understanding is that the comments by the right hon. Member for Neath (Mr Hain) were made outside the Chamber. I cannot say more than that at this stage, but if the hon. Member for North Antrim wishes to communicate with me further on this matter outside the Chamber, I will always be interested in what he has to say.
Ian Lucas (Wrexham) (Lab): On a point of order, Mr Speaker. Have you had any indication that a Minister from the Department for Work and Pensions will be coming to the House to talk about the new policy of means-testing access to cheaper postage at Christmas? Today, we have received notification by e-mail from Royal Mail of a 20% hike in postal prices. We also understand that a concessionary scheme will be introduced, but that it will apply only to pensioners in receipt of means-tested benefits, who will receive cheaper stamps at Christmas. This clearly involves benefits, and it merits a statement to the House to enable Ministers to explain how they will prevent large-scale fraud through individuals buying the cheap stamps and reselling them at a lower rate than the full price. This is a serious matter, and a Minister ought to have come to the House to make a statement.
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Small Business Administration
That leave be given to bring in a Bill to establish a Small Business Administration with the remit of acting as an ombudsman and advocate within government for small businesses, promoting a regulatory environment appropriate for small businesses, providing advice to those wishing to set up small businesses, improving access to finance for small businesses, developing and monitoring small business-friendly procurement policies and working with small firms to assist their export potential; and for connected purposes.
Before I start, I had better declare an interest: I run a farm in my constituency, so I am a small business owner and I understand the challenges involved in establishing and growing a small business.
Let us start with some statistics. There are 4.5 million small businesses in the UK. In Wales alone, we have 210,000 businesses, of which 45,000 are incorporated and 165,000 are non-incorporated. Small and medium-sized enterprises employ an estimated 13.8 million people and have an estimated combined annual turnover of £1,500 billion. As we can see from those numbers, small businesses are the lifeblood of our economy, and they will drive our economic growth.
I commend the Government for their work in this area. The Secretary of State for Business, Innovation and Skills, my right hon. Friend the Member for Twickenham (Vince Cable) and the Minister of State, Department for Business, Innovation and Skills, my hon. Friend the Member for Hertford and Stortford (Mr Prisk), have already done sterling work for small and medium-sized enterprises. Just last week, the Business Secretary announced a £125 million advanced manufacturing supply chain initiative, which will open for applications from 29 March, and a new Focus on Enforcement campaign to identify any inappropriate or excessive enforcement of regulation that is holding companies back. The Government have also helped business by lowering corporation tax again, but we must not forget the many non-incorporated businesses that will not benefit from that measure. We need to bring forward measures to help those businesses as well.
Despite such measures, the Federation of Small Businesses argues that successive Government Administrations have failed to appreciate the particular needs of the UK’s small businesses, and it has proposed the creation of a small business administration—a department to champion small firms at the heart of Government. That proposal is based on a United States model that has proved incredibly successful in reducing burdens on small business through its role as an advocate and ombudsman. In 2011, it stripped out $11.7 billion of costs that would have been incurred by businesses in their first year of existence, and created ongoing savings of $10.7 billion annually by reducing the burden of regulation. Through its many programmes, small businesses have grown to become household names: Nike, Staples, Apple, FedEx, Ben and Jerry’s, Outback Steakhouse and Hewlett Packard, to name but a few.
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The UK small business administration would help to reduce Government burdens on small businesses by having two roles. First, it would be an advocate in Government for small businesses’ needs. It would act as an ombudsman when problems arose with other Government Departments. As with the US model, the UK small business administration would operate in five core areas, all of which are already Government priorities. In the first instance, it would help with access to finance. Small firms in the UK are still struggling to get the finance that they need to grow. The small business administration would be able to give assistance to small businesses by offering a facility of loans and venture capital.
Credit easing is a welcome step that will make credit less expensive for many businesses, but above all we need to improve access. Alongside measures to support competition within the banking sector, support for non-bank models such as community development finance initiatives, peer-to-peer lending, asset finance and an SME bond market, the small business administration would be better placed to look beyond the big banks and to provide finance in a way that would make it accessible to small companies.
Secondly, the administration would give advice on business start-ups. During my time in Parliament, many constituents have told me that they have great business ideas but do not know how to go about turning them into reality. Obtaining the right advice at the start of a business is crucial to its survival. The administration would provide mentoring and training through a network of partners.
Thirdly, the administration would encourage exports. While I commend the Government for their work in supporting UK exports—for instance, we are a net exporter of red meat for the first time in many years, and exports are rising in many sectors—we can and must do more. The administration would be devoted to promoting exports and supporting the interests of small businesses in trade negotiations.
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businesses to gain 25% of Government contracts. I welcome that, but we have more to do if that is to be achieved. The administration would help businesses to reach the target, and could also help to ensure that small business-friendly policies were embedded throughout the public procurement process.
Finally, the administration would have a crucial role in the distribution of funds to small businesses at times of special need such as natural disasters. That would be invaluable during flooding or severe weather, and would have been useful in rebuilding business communities after the terrible riots that we saw last summer.
“A single brand and delivery agency to increase awareness and enhance delivery of the government’s range of SME finance”.
The last time I presented a ten-minute rule Bill, I did so from the Opposition Benches. Six months later the Government had implemented my idea, and I hope to achieve a similar success from the Government Benches. There is nothing ground-breaking or radical in this Bill, which brings together many strands of Government that already do some of the work involved, and provides common-sense measures to give small businesses the best possible chance of flourishing—for if they flourish, so will our economy.
That Roger Williams, Loreley Burt, Anne Marie Morris, Gordon Banks, Mr Mark Williams, Stephen Lloyd, Mark Durkan, Brandon Lewis, Stephen Williams, Annette Brooke, Caroline Lucas and Julian Smith present the Bill.
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Mr Speaker: Before I call the hon. Member for Croydon South (Richard Ottaway) to move the motion, it may be useful for the House to know that I have selected amendments (a) and (b), and that Dame Joan Ruddock will be invited to move amendment (a) during the debate. I should warn the House that it will be possible for amendment (b) to be moved only if it is reached before 7 pm, after the House has disposed of amendment (a). That warning is for the benefit of the House. The House can make its own judgment in the handling of these matters.
Members will be aware that, because of the huge interest in speaking in the debate, I have imposed a five-minute limit on Back-Bench speeches, which will apply after the proposer and seconder of the motion have spoken.
That this House welcomes the Director of Public Prosecutions’ Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide, published in February 2010.
The fact that the debate is taking place today is significant, and reflects the willingness of Parliament to address society’s concerns in this area. It is more than 40 years since the subject was debated on a substantive motion, and I am extremely grateful to the Backbench Business Committee, without which I strongly suspect today’s debate would not be taking place.
This very sensitive area of law evokes deep emotions. I take the firm view that, in these circumstances, Parliament and not the courts should have the last word on prosecuting policy and the criminal law. I think it appropriate to put on record at this point that I have the highest regard for Mr Keir Starmer QC, the current Director of Public Prosecutions, who drew up the policy that we are debating as he was asked to do by the Law Lords.
Let me begin by explaining what the debate is not about. The motion welcomes the DPP’s “Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide”. This is not a debate on the recently published report of the Commission on Assisted Dying. The House is not being asked to express a view on voluntary euthanasia, which requires a change in the law of murder, and it is not being asked to support assisted dying for the terminally ill, which requires a change in the law on assisted suicide. Whatever our views, the debate is not about the application of Mr Tony Nicklinson to the High Court for assistance in ending his life, and whatever the outcome of the debate, assisted suicide will remain a criminal offence. This is a debate about the application of the existing law of England, Wales and Northern Ireland. There is not an exact equivalent in Scotland, which has an offence of culpable homicide and no guidelines.
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In the wider debate, there are many differing positions. There are those who support a change in the law to allow some form of doctor-assisted dying within up-front safeguards. Equally vocal are those who do not favour a change. Between those differing positions is the pressing issue of how the current law is applied by the DPP and the courts.
Ian Paisley (North Antrim) (DUP): The hon. Gentleman has listed the matters that the debate is not about. Does he acknowledge that a letter was sent to Members indicating that he would welcome comments on all those matters during the debate? Has not the debate been rather confused by his own note about it?
Richard Ottaway: Let me say to the hon. Gentleman—for whom I have the highest regard—that it would be slightly naïve to think that the House will focus precisely on assisted suicide for five hours. One or two Members may stray on to the subject of assisted dying or voluntary euthanasia, if only within the scope of the amendment on palliative care, with which I shall deal shortly.
Mr David Burrowes (Enfield, Southgate) (Con): My hon. Friend opened the debate by saying, quite properly, that this was an issue not just for courts but for Parliament. To what extent is the discretion of the DPP to prosecute an issue for Parliament?
Richard Ottaway: The guidelines—about which I shall say more in a moment—are a model of clarity. They reflect the way in which the DPP is applying the existing law. I hope that, if a majority in Parliament endorses the guidelines today, they will be strengthened because the debate has taken place.
Until the Suicide Act 1961, suicide was a criminal offence, and some of those who attempted suicide were prosecuted. Most were discharged, but the records show that in 1956 some 33 were sent to prison. In 1961, Parliament caught up with public sentiment, and both suicide and attempted suicide were decriminalised. That was done not to condone suicide, but to recognise that it was primarily a medical rather than a legal issue, and therefore better dealt with by healthcare professionals than by the police. Assisted suicide was a new offence, designed to protect against abuse. It created a unique legal precedent in that this was a criminal offence of being an accessory to a non-criminal act. It carries a sentence of up to 14 years in prison.
What our predecessors did not do, however, was to distinguish between the types of assistance—between the person who irresponsibly and maliciously encourages a suicidal person, and the loving spouse who fulfils a dying partner’s request for help to die. This is the question we are addressing today: should both actions be treated equally under the law?
The problem was, in part, recognised by the 1961 Act, which gave the DPP discretion, so that even when sufficient evidence existed, prosecution would not automatically occur. That recognises the delicate balance that needs to be struck in respect of motive, compassion, coercion and circumstance.
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some of us support people in situations like that of Diane Pretty, my former constituent, who died 10 years ago? She went to the highest courts possible—the House of Lords and the European Court of Human Rights—to seek the right to assisted suicide and was refused, but there was massive public support for her at that time. Does the hon. Gentleman agree that that public support should be taken into account in our deliberations?
Turning to the policy itself, records show that more than 180 Britons have travelled to Switzerland to die in the last 10 years. No one has been prosecuted for accompanying them or assisting them with their arrangements, even when there has been sufficient evidence to prosecute. However, before the 2010 policy document, precisely what criteria were used was never published—until Debbie Purdy asked for clarity.
Debbie Purdy has primary progressive multiple sclerosis. In 2009, she took her case to the Judicial Committee of the House of Lords. She wanted to know whether her husband would be prosecuted if he accompanied her to Dignitas in Switzerland. In their judgment, the Law Lords instructed the DPP to make clear the factors he took into account when reaching a decision on whether or not to prosecute. Lord Brown’s judgment made it perfectly clear what was required. He said that we need a custom-built policy,
“designed to distinguish between those situations in which, however tempted to assist, the prospective aider and abettor should refrain from doing so, and those situations in which he or she may fairly hope to be...forgiven, rather than condemned, for giving assistance.”
In February 2010, following extensive consultation, the DPP published the guidance. I have sent a copy to every Member of this House. The policy recognises the reality of prosecuting practice in cases of assisted suicide: that in certain circumstances, compassionately motivated assisters will not be prosecuted.
There are 16 factors weighing in favour of prosecution, including the assisted person not having mental capacity, and if the assister is a doctor or other professional caring for the assisted person. There are six factors weighing against prosecution, including that the assisted person made a voluntary, informed decision—in other words, they were of sound mind—as well as that the actions were of only minor encouragement or assistance, and that the suicide was reported to the police. The policy reiterates that there can be no immunity from prosecution before a crime is committed.
Mr Laurence Robertson (Tewkesbury) (Con): The guidance lists six circumstances in which prosecution would not take place. How does my hon. Friend reconcile that with his statement that this does not represent a change in the law? Surely it does?
Richard Ottaway: That is a fair point, and some people think it does represent a change in the law. However, the guidelines are set out as offering clarity on the application of the existing law, and not as changing the law. In the Purdy case, the House of Lords asked the DPP to set out how the existing law would be applied.
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Richard Graham (Gloucester) (Con): As my hon. Friend has pointed out, what we are debating is simply an interpretation of the law by the DPP that distinguishes between wholly compassionate assistance and malicious assistance, which will continue to be prosecuted. We are being asked to endorse a reasoned, rational approach that many of our constituents support.
Richard Ottaway: My hon. Friend is absolutely right. That approach is supported by many of our constituents. Compassion is at the heart of this debate. The key question is whether someone should be prosecuted for minor assistance, within the terms of the guidelines.
Richard Ottaway: As far as I am aware, there have been no prosecutions for escorting someone to Dignitas in Switzerland. I shall have to write to my hon. Friend with a precise answer to his question, but I am not aware of any prosecutions for assisting suicide in recent years.
Steve Brine (Winchester) (Con): I shall support the motion; indeed, I am a signatory to it. The DPP is merely doing his job. This House passed the 1961 Act, which explicitly states that a person may be prosecuted for assisting suicide only
“by or with the consent of the Director of Public Prosecutions”,
who must decide whether or not prosecution is in the public interest. He was asked to draw up these guidelines, and he has done so. He is not acting outside his statutory obligation; he is merely following it.
Richard Ottaway: That is right. Returning to the point made by my hon. Friend the Member for Tewkesbury (Mr Robertson), every single case is investigated by the police, and there has been no derogation from the existing law of assisted suicide.
I invite the House to address how we as legislators should approach this difficult subject. When a person makes the decision to end their life, that draws on the depths of human experience and is intensely personal. The responsibility on parliamentarians to make a judgment on the rights and wrongs of assistance in such decisions is enormous.
“with a clear, settled and informed”
The same question is before the House today: should someone who is wholly motivated by compassion, and who has behaved within the parameters of the DPP’s policy, be prosecuted for assisting a person of sound mind who has made a clear and settled decision to end their life? Is it right to prosecute Judy Johnson, whose husband, Ken, was diagnosed with terminal cancer and, after a long battle, decided to end his life? Judy helped Ken make the arrangements and, with his three children, travelled with him to Switzerland. Is it right to
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prosecute Susan McArthur, who sat with Duncan, her loving husband of 42 years, and held his hand as he ended his life? Duncan had motor neurone disease, and decided to take control of his death while he still had the physical capability to do so. In my heart, I cannot believe it is in society’s interest to prosecute them and to convict them of a criminal offence, and to give them a prison sentence. It is not in the public interest to do so. That has been the approach taken by the DPP for many years, and I believe it should be supported by the House.
Richard Ottaway: At the end of the day, that has to be a judgment made by the police and the prosecuting authorities. I have confidence in their ability to make that judgment. Of course there is a human element to that, but the guidelines are perfectly clear, and there is plenty of guidance on the approach taken by the prosecuting authorities.
Mr John Baron (Basildon and Billericay) (Con): My hon. Friend is introducing the debate in a very measured way. I support greater patient choice at the end of life. It is absolutely right that there should be parliamentary oversight of prosecuting and sentencing policy, but does he agree that we must never leave far behind the notion that at the core of the debate is compassion, both for the patient and their immediate family? We must not lose sight of that.
Richard Ottaway: Yes, it is about compassion for those facing an experience that, obviously, none of us has had. This is the most difficult of subjects, which is possibly why Parliament has been resistant to debating it for many years.
May I turn to the amendment by the right hon. Member for Lewisham, Deptford (Dame Joan Ruddock), which calls on the Government to consult on whether the code should be put on a statutory basis? The law is clear: if someone assists a person in ending their life, it is a criminal offence. However, the Director of Public Prosecutions has made it clear that in a narrowly defined set of circumstances, he will not prosecute. The crux of the point is that it is quite possible that, sometime in the future, the guidance will be changed without parliamentary approval. Parliament should be consulted before any further change, and the amendment ensures that.
There is another point: putting the policy on a statutory basis would address the charge that this debate is the thin end of the wedge, or the slippery slope. It is the complete opposite. The policy exists, and can be amended without parliamentary scrutiny. If we enshrine the policy in statute, it would take another statute to amend the law. Members will have their say on all sides of the debate, and will then vote. That is how we make laws in Parliament, and the public expect no less. In my opinion, the amendment deserves support.
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Sir Peter Bottomley: I am grateful to my hon. Friend, and may I say how much I welcome what is on his website, which explains some of the issues? On the motion and amendment (a), the original motion that the House thought it was to consider included a reference to putting matters on a statutory basis. The motion was changed, and the amendment was brought forward. The first, and possibly only, vote this evening may put back into the motion what was taken out and put in amendment (a). Is that coincidence, or clever parliamentary practice?
Richard Ottaway: I make no secret of the fact that the original motion included the words in the amendment, but in discussion with colleagues on both sides of the argument, people rightly pointed out that there were two separate arguments in the motion, and one part might be successful, and the other defeated. The part that people agreed with might be defeated because of the bit that they did not agree with. It seemed perfectly sensible to separate the two bits. I confess that I had a conversation with the right hon. Member for Lewisham, Deptford, and she has bravely undertaken to move amendment (a) today.
I turn to the other amendment selected—amendment (b), on palliative care, in the name of my hon. Friend the Member for Congleton (Fiona Bruce). I am happy to accept the amendment. I would have signed it, if it would not have looked odd to sign an amendment to my own motion. I pay tribute to those working in the area of palliative care, and in particular to St Christopher’s hospice in south London, which works closely with a number of people in my constituency.
The previous and current Governments deserve credit for the progress that they have made towards greater access to care, notably through the end-of-life care strategy. We all recognise the first-class palliative care services provided by hospices, and we should be united in hoping that it can be replicated across all care settings. I give a warm welcome to the additional funding for end-of-life care announced last week by the Secretary of State for Health at the Marie Curie Cancer Care reception, but we should recognise that—as was acknowledged by Baroness Finlay, the renowned palliative care professor and passionate campaigner against a change in the law on assisted dying—such care is not a panacea to all the suffering that the dying process can cause.
Some people, regardless of the care available to them, will seek to control the time and manner of their death. Melanie Reid wrote about that in a moving column in The Times today, which I commend to the House. She is not terminally ill; she is a tetraplegic, following a riding accident. She admits to contemplating ending her life regularly. She wrote:
“Knowing that I have a choice is a huge comfort to me; it sustains me on the days when I make the mistake of looking too far in the future. But the point is, I am blessed precisely because I have a choice.”
In other words, even if we can provide universal access to good-quality end-of-life care, some Britons will still seek to end their lives. The law must be equipped to deal with such cases and to help the vulnerable.
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I was struck by a recent debate in the other place on the DPP’s policy, secured by the former Leader of the House of Lords, Baroness Jay. In that debate, there was a clear division between speakers on whether the law should change to allow doctor-assisted dying, but there was unanimous support for the DPP’s approach, with Baroness Finlay describing the policy as “clear, firm and compassionate.” Furthermore, in a recent Synod debate that overwhelmingly rejected a change in the law, the Archbishop of Canterbury, who has repeatedly made clear his opposition to a change in the law, said:
“We can be realistic, we can be compassionate in the application of the existing law”.
If there is a majority in the House in favour of this motion, we will have done the nation a service. If there is a majority against it, we will have a problem, as the DPP and 82% of the public will be saying one thing, and the people’s elected representatives another. I urge the House to support the motion and show compassion to those facing this terrible dilemma.
Mr David Winnick (Walsall North) (Lab): It gives me much pleasure to second the motion moved by the hon. Member for Croydon South (Richard Ottaway). I welcome the debate. It has been a very long time since the House of Commons debated the whole issue, and whatever view we take, it is only right and proper that the House should have an opportunity to debate the subject. The guidelines are a considerable advance on what happened before.
The hon. Gentleman mentioned Debbie Purdy. I pay tribute to the way that she, faced with a terminal illness, was determined to fight through the courts to find out what the position would be if her husband accompanied her to Switzerland should she at some stage want to go there. For someone without influence—a private individual without a private income—to do what she did, albeit with the help of an organisation and sympathisers, is remarkable. Even those opposed to a change in the law would agree that she should be praised for her sheer determination and will-power in fighting her campaign.
Of course, there were others before Debbie. My hon. Friend the Member for Luton North (Kelvin Hopkins) mentioned one of his constituents who, unfortunately, is no longer alive—Diane Pretty. She did not want to end her life in a way that was painful and humiliating, and did not want to be in a situation where she was almost suffocating. She did not succeed in her aim; she had the painful illness, and the ending that she so desperately wanted to avoid.
There were other such people. There are some whose cases we do not know; they, and their loved ones, would not wish their case to be publicised. One case that was particularly publicised was that of Dr Anne Turner, a medical doctor who knew full well from her work what was in store for her. Apart from anything else, her late husband, by a terrible coincidence, died from the same sort of illness that she faced, which would deprive her of all movement; at the end, she would not even be able to
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swallow. Dr Turner was determined that she was not going to end her life in the same way as her husband. Understandably, her children tried to change her mind, but in the end she decided—I believe she had already tried unsuccessfully to commit suicide—to make the journey to Switzerland. In order to publicise her plight and other such cases she invited the BBC to film her journey to Switzerland, and a film was made later about her position.
I can understand the situation that Dr Turner faced. Let me say straight away that I am a late convert to this position. There was a ten-minute rule Bill on euthanasia in April 1970, and had there been a vote nearly 42 years ago, I would have voted no. Indeed, I would have voted against such a Bill not only then, but today, because I am against euthanasia as such. If I was not, I would say so. I do not normally conceal my views, however much they may be in a minority. I am in favour of a change in the law, but only a very sharply defined change and one that is certainly very different from euthanasia, which, to some degree, occurs in Belgium and the Netherlands.
It is sometimes said that those of us who want a change in the law are doing a disservice to the disabled. It is pretty obvious that that is about the last thing I want to do. I have no desire to encourage disabled people in any way whatsoever to end their lives. At every stage in my parliamentary life, I have, obviously, supported every measure to support the disabled—it would be odd if it were otherwise. I believe that that would be the position of all Members of the House, regardless of where they stand on any change in the law.
Paul Maynard (Blackpool North and Cleveleys) (Con): The hon. Gentleman is making the point that one particular disabled individual should be given the right to make this judgment. Is he not, by definition, therefore making the case that a particular form of disability inevitably makes a life not worth living? Is that not a dangerous utilitarian judgment to make?
Mr Winnick: That is the very opposite of my view. As I said, I have supported every move to support the disabled in every conceivable way. It is an advance for the House of Commons that we have disabled Members and that we do not just represent disabled people who happen to be constituents. One of my colleagues is confined to a wheelchair and it is right and proper that she should be here. There is an idea that, in some way, those of us who want a change in the law would wish to harm the disabled, but the very opposite is the truth. However, I take the point that to the extent that disabled people—or, at least, the organisations that speak on their behalf—have concerns about any change in the law, people such as me, who want a change in the legislation, should certainly bear that very much in mind.
Paul Goggins (Wythenshawe and Sale East) (Lab): On five separate occasions my hon. Friend has talked about changing the law and about his desire to do so. Will he confirm, for the sake of everybody in the House this afternoon, that support for the motion is not support for a change in the law, but an acknowledgment that the Director of Public Prosecutions has done his job?
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Mr Winnick: Absolutely. I prefaced my remarks by saying that the DPP guidelines can be supported—the debate is actually titled “Assisted Suicide”— by those who are very much in favour of the existing law and by those who are opposed. No contradiction is involved, and I am glad that my right hon. Friend has had the opportunity to make the point.
Sir Peter Bottomley: That response to that last intervention was helpful to the House. May I ask the hon. Gentleman kindly to give the House a little more help? He is arguing that he would like to see the law changed. An amendment is to be moved which says that the guidance should be put on a statutory basis—it talks about “whether” that should happen, but it, in effect, proposes that it should. Will he be supporting that amendment or is he against it, given that he wants the law changed?
If I were asked what sort of change I would like, if change were to occur, I would reply that it would be very much along the lines of what happens in Oregon in the United States. In Oregon, which has all the necessary safeguards in place, those with a terminal illness who wish to end their lives—they must have a terminal illness—are allowed to do so. Some may argue that that is a sliding slope, but palliative care was mentioned by the hon. Member for Croydon South and we should bear in mind what has happened in Oregon, where assisted dying has existed since 1994. The number of people who have died naturally in hospices has actually doubled there. So the argument that hundreds or thousands of people would go to their deaths if we were to change the law and allow assisted dying for the terminally ill is a total fiction.
It is a point that the hon. Lady, a medical doctor herself, has made with great sincerity. The British Medical Association makes the same point, but presumably there are other doctors who take a different view from her. I do not know how many of them there are, but, as we know, there must obviously be certain doctors whose view is that, out of compassion,
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the law should not prevent them from doing what they consider to be appropriate. Of course, that would all be debated at length and in detail if any measure were to change the law as such.
Paul Flynn (Newport West) (Lab): Many of us have had the experience, as have many people in other countries, of doctors saying to them when their loved ones are suffering greatly that they will make sure that she or he “will not suffer”. What does my hon. Friend think doctors mean by that?
Mr Winnick: I think that we could all come to the same conclusion. Are we to take it that doctors in Oregon, Belgium or the Netherlands are not concerned about their patients, that they are potential Shipmans and that they could not care less whether or not their patients die? Although I accept the sincerity of the hon. Member for Totnes (Dr Wollaston), I must, as my hon. Friend has indicated, accept that some doctors, however much they may be in a minority, take a different view.
I simply say to the House that whether or not we agree to any change in the law, this issue will not go away. The hon. Member for Croydon South said that more than 180 British citizens have gone to Switzerland in these circumstances. Perhaps there are others who would like to go, for they do not want to face an unbearable death, but do not have the financial means to do so. I hope that the House will not only agree to the guidelines, but be willing to explore the dilemma faced by these people. This could happen to any of us, as nobody is exempt from the possibility of having a severe illness of the sort that Anne Turner was facing and was determined to avoid at all costs, and which resulted in her going to the clinic in Switzerland. I hope that we will have a very good debate. The issues are very important and I hope that at the end of it the guidelines which the Law Lords instructed the DPP to produce will be fully supported on all sides and by all the opinions in this House.
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‘and invites the Government to consult as to whether to put the guidance on a statutory basis.’.
I very much welcome this debate and the fact that the Backbench Business Committee has found time for it. I congratulate the hon. Member for Croydon South (Richard Ottaway) on the very considered way in which he presented the motion. The amendment, which stands in my name and those of the hon. Members for Amber Valley (Nigel Mills) and for Solihull (Lorely Burt), invites the Government to consult as to whether to put the policy on a statutory basis. I believe the time has come to give the public and stakeholders an opportunity to comment on the Director of Public Prosecutions’ policy in practice. The amendment invites the Government to place the DPP’s policy on a statutory footing but does not demand that.
The final version of the policy on assisted suicide has now been in place for more than two years. The draft policy was the subject of heated debate, particularly in relation to the health or disability status of the assisted person, the actions of health care professionals and the relative weight to be given to the motivation of the assister. However, there are still some areas of concern in relation to the policy, most notably its impact on doctors where there is less clarity. A patient with a terminal condition may wish to discuss with a health care professional their desire for assistance to end their life. Similarly, a patient who has come to a decision may wish to obtain their medical records in order to be assisted to die overseas.
If the Government were to hold a consultation on whether the DPP’s policy on assisted suicide should be placed in statute, I am confident that we would learn much from the response of the public and the stakeholders working with the DPP’s policy. Essentially, placing the policy in statute would reinforce not only that the DPP has discretion in deciding on prosecutions in assisted suicide cases, which is already plain in the wording of the Suicide Act 1961, but also the factors that must be considered in taking these decisions. Placing the policy in statute would signal in the strongest possible way that Parliament agrees that those who maliciously or irresponsibly encourage suicide should be prosecuted, but that it is not normally in the public interest to prosecute an otherwise law-abiding citizen who helps a loved one to die on compassionate grounds.
Dame Joan Ruddock: Clearly, if the existing guidelines were put into statute they would lie alongside existing statute. I will go on to explain why I think it is very important that they should be in statute.
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amend the code? It would drive a coach and horses through section 10 of the Prosecution of Offences Act 1985, which gives the DPP complete discretion to draft his own codes.
Dame Joan Ruddock: I completely disagree. First, the amendment invites the Government to consult, which could not possibly contravene an Act in itself. Furthermore, the Act that gives the discretion is not overturned by putting the guidelines into statute. What the statute would then say is, “These are the circumstances…” but it would not remove from the DPP the discretion he has in existing statute.
There is also a question of accountability to consider. The DPP is, of course, answerable to the Attorney-General and in this way is accountable to Parliament, but we as Members of Parliament are accountable to our constituents. Public interest in the law on assisted suicide and related issues is extremely high. As the hon. Member for Croydon South has told us, a YouGov poll in 2010 for The Daily Telegraph asked 2,000 people whether they agreed with the DPP’s policy. For the benefit of the House, let me repeat the outcome of that poll: 82% agreed with the compassionate treatment of people as laid out in the DPP’s guidelines, only 11% disagreed and 8% said they did not know.
As it stands, the policy could be changed by the DPP, who is after all an individual who holds the role of DPP for a term of five years. It is unlikely that a future DPP would make significant changes to the policy, but it is always possible. That is why placing the DPP’s policy on a statutory footing would mean that this sensible, humane and popular policy could be changed only by Parliament. In conclusion, I welcome the DPP’s policy and this debate. The policy is sensible, humane and provides clarity on how the law is applied in assisted suicide cases. The public strongly support that approach, which is why I believe the Government should consult on whether they want the clarity provided by the policy to be placed on a statutory footing. I have always known that in compelling circumstances I would assist a loved one to die. That is why I think it is so important that the DPP’s policy should be placed in statute. I urge hon. Members to support this amendment and the motion.
Mr Deputy Speaker (Mr Lindsay Hoyle): Order. I am now going to call Fiona Bruce to speak to amendment (b), but it will not be moved at this stage. I remind hon. Members that there is a limit of five minutes for all Back Benchers.
Fiona Bruce (Congleton) (Con):
Thank you, Mr Deputy Speaker, for calling me to speak to my amendment. I understand that although I am not able to move it yet, other Members may speak to it throughout the afternoon.
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I support the motion in the name of my hon. Friend the Member for Croydon South (Richard Ottaway) and I oppose the amendment in the name of the right hon. Member for Lewisham, Deptford (Dame Joan Ruddock).
Britain has been ranked first in the world for quality end-of-life care in a survey by T he Economist intelligence unit of 40 OECD and non-OECD countries, including the USA, the Netherlands, Germany and France. We should be proud of and support services that are providing care to enable patients to live as well as possible, while accepting natural death and doing everything to keep patients comfortable during dying.
Mr Robert Buckland (South Swindon) (Con): Will my hon. Friend join me in paying tribute to organisations such as the Prospect hospice in my constituency, which offers world-class palliative care, not only in-house but within the community that it serves?
Fiona Bruce: I will, and I pay tribute to the entire hospice movement in this country. The care and treatment of patients provided by such services embodies the culture that we have in this nation of prioritising care at the end of life, and does not prioritise foreshortening life by months or years at the end-of-life stage.
The DPP has said that the guidelines that he operates are working well; indeed they are. Prosecutorial discretion is part of our criminal law and applies across a wide range of crimes. We cannot fetter it in law because each case is different. The law gives a clear message that one person should not encourage or assist another’s suicide.
Robert Halfon (Harlow) (Con): I am proud to be supporting my hon. Friend’s amendment today. Does she agree that this is not about choice, but is about people being forced to make choices? Does she also agree that rather than having debates about assisted dying it would be much better if we had more debates and discussions about how we could improve palliative care?
If encouragement or assistance is given for others to commit suicide, individuals are answerable for their actions, but when appropriate, the law takes a compassionate approach. Patients at the end of life are very vulnerable to influence, particularly from those providing care. Just yesterday a specialist consultant in palliative care told me of his concerns about any change in the law in this area. He told me of an incident which, he said, was not isolated, but typical. He said: “I had a single male patient who was dying of cancer. Life was difficult for him; he had an estranged daughter who confided in me that her father had asked to be taken to Switzerland because his life was not worth living. His daughter had left home quite early in life and they had lost all contact. I talked with him and he told me how proud he
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was that she had become a head teacher, he himself having been a teacher earlier in his life. I encouraged him to get to know his daughter again, to tell her he loved her, and that he was proud of her. They did so and they spent the last two weeks of his life together in the hospice having these conversations, which meant so much to both of them.” Is not that the approach that we should take towards those at the end of their life?
The consultant continued, “We”—that is, doctors—“have real concerns that it would place us in a very difficult position if the law is changed, since at the heart of what we do is the tenet that we should do no harm to our patients. So for someone to have their life terminated would place our relationship on a very different footing.” Doctors do not want the relationship of trust between doctor and patients fractured. That surely is why the DPP guidelines tend towards prosecution if assistance with suicide is given by a doctor or nurse as part of their clinical relationship with the patient.
Several disability groups have told me that they would be extremely concerned should there be any change in the law—that is, in this relationship—a change which could well occur should doctors, such as the consultant I mentioned, have the “option to kill”—as he put it—their patients as one of their choices.
Unlike Oregon, where assisted suicide was made legal in 1997, we have specialist palliative care in the UK, with a full four-year training programme. Oregon has had a four and a half-fold rise in assisted suicides since it legalised the practice in 1997, a practice that would result in over 1,100 assisted suicides in this country on a population basis. And Oregon’s safeguards are paper-thin. The Royal College of Physicians has stated that physician assisted suicide
“would fundamentally alter the role of the doctor and their relationship with their patient. Medical attendants should be present to preserve and improve life—if they are also involved in the taking of life, this creates a conflict that is potentially very damaging.”
“It is right that actions by a care professional are treated differently from actions by a friend or family member”.
“wouldn’t just apply to the terminally ill, no matter what the campaigners may say. It would affect disabled people too, not to mention the elderly. A change in the law. . . would alter the mindset of the medical and social care professions, persuading more and more people that actually the prospect of an ‘easy’ way out is what people such as me really want. Well, the vast majority of us do not.”
The Solicitor-General (Mr Edward Garnier): I begin by congratulating my hon. Friend the Member for Croydon South (Richard Ottaway) on initiating this debate. His motion and the amendments tabled to it reveal not so much a political issue as a legal and an ethical or moral question, but either way it is here in Parliament, a place that must be at the very centre of our country’s political deliberations, that we should debate these questions and shape the laws that provide the background to and the boundaries of the criminal law.
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Parliament makes our laws and has a vital role when the courts can no longer develop or reveal the common law. When a Government take the initiative to change the law, when Parliament on its own initiative decides to change the law or when the judges in our higher courts can no longer develop the common law, we come here, to Parliament, to deliberate on what the law should be and, where appropriate, to make the necessary changes to our law.
Let me make a few preliminary points. First, it is the position of the Government that the substantive law on assisted suicide is a matter of conscience and not a matter of party political controversy. If the House divides today, right hon. and hon. Members on the Government Benches will vote—or abstain—as their conscience dictates and not in response to the advice of the Government Whips. I dare say the same applies on the Opposition Benches.
Secondly, I acknowledge the variety of views held on assisted suicide, euthanasia, and the care of the terminally ill, and quite understand that many will use this debate to express their opinion on matters that may be outside the strict confines of the DPP’s guidelines on assisted suicide prosecutions. I do not intend to express any personal views this afternoon. Rather, I shall make some dispassionate points about the role of the DPP and of prosecutors under his leadership and about the law on assisted suicide.
Thirdly, as a Law Officer, I want to emphasise the importance of the independence of prosecutors and the undesirability of statutory guidelines for prosecutors in any area of law, not least this one. Fourthly, I repeat what I said a moment ago—that ultimately Parliament is supreme and may legislate in this area if it wishes to do so. Fifthly, I will briefly outline the Government’s strategy for end-of-life care. A good many right hon. and hon. Members from all parts of the House have added their names to the amendment tabled by my hon. Friend the Member for Congleton (Fiona Bruce) to encourage the development of specialist palliative care and hospice provision.
No doubt every Member of Parliament knows of a hospice that is deserving of particular praise for the work its staff do in bringing care and sensitivity to the dying and the bereaved, and of doctors and other medical staff who specialise in palliative care. In Leicestershire we are fortunate to have the LOROS hospice for adults and the Rainbows hospice for children, both of which do so much to help their patients and the families, and I cannot commend them highly enough.
Let me now turn to the Suicide Act 1961. Until that Act was passed, suicide, and thus attempted suicide, were crimes. As late as the 1950s, as my hon. Friend the Member for Croydon South told us, a few people who had failed in their attempt to commit suicide were imprisoned. The 1961 Act decriminalised the act of suicide, but section 2 of the Act made it an offence to assist the suicide or attempted suicide of another person. It is, therefore, a highly unusual offence. I cannot think of another example where it is a crime to assist someone in doing something which is not itself a crime, but given that assisting another person to commit suicide is an area potentially open to a good deal of abuse, it was thought right to make it a criminal offence.
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Dame Joan Ruddock: I am grateful to the Minister. I want to take him up on that point, because he has made the seminal point that this is a very unusual—perhaps unique—circumstance, in which assisting is a criminal offence, but suicide is not an offence. Because it is such an unusual case, it may be reasonable for the Government to consult on whether the guidelines should go into statute.
Assisting or encouraging suicide is an offence and the maximum penalty for it is 14 years. It should not be thought that the law is not clear. We are talking about the application of the law when it comes to a decision about whether or not to prosecute. Those are discrete issues.
It cannot be acceptable to permit people to encourage others to kill themselves. Most often the people concerned would know each other, but the growth in suicide websites means that the person doing the encouraging could well be wholly unknown to, and not even present with, the person being assisted or encouraged to kill himself. To clarify the position the Coroners and Justice Act 2009 updated section 2 of the 1961 Act. That change was made amid growing concern about misuse of the internet to promote suicide and suicide methods, and to reassure the public that the internet was not outside the law. It is now clear in that 2009 Act that it is not necessary for a person committing the offence of assisted suicide to know the person whom he is encouraging to commit suicide, or even to be able to identify him. The change to section 2 came about via the Coroners and Justice Act, and any further changes to the law must, I suggest, be a matter for Parliament to decide.
Although today’s motion does not call for a change in the substantive law, and the amendment tabled by the right hon. Member for Lewisham, Deptford (Dame Joan Ruddock) calls for the DPP’s guidance to be put on a statutory basis—no doubt following consultation, but I think I can paraphrase in that acceptable way—she does not ask for a change in the statute itself. I have no doubt that some may suggest during this debate that there should be a change in the criminal law relating to assisting or encouraging suicide. I do not advocate a change in the law, nor do I think it sensible to place the DPP’s guidance on a statutory footing.
Alun Michael (Cardiff South and Penarth) (Lab/Co-op): The Solicitor-General has come to a point that concerns me. Does he agree that passing the amendment would appear to be doing something that is very close to changing the law, and it would be a pity to give that impression?
The Solicitor-General: I think that I am entitled to look at the amendment proposed by the right hon. Lady on its face value, and it proposes to change the current arrangements. It proposes that there should be a consultation as to whether the policy and the guidelines should be placed on a statutory footing. However, I think that I am entitled to infer from that that those who support that aspect of the amendment wish the DPP’s guidelines to be on a statutory footing. I disagree with that. I do not think that that is sensible.
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The Solicitor-General: I do not think that I will answer that question, because, to be honest, I am not entirely sure I understand it. I apologise if my failure to understand is entirely my own fault.
The DPP’s guidance relates to the framework within which prosecutors apply the law as it currently stands, and I suggest that that is a framework that should remain in place as it currently stands. As Law Officers, it is for the Attorney-General and for me to superintend the Crown Prosecution Service and to account to this House for its activities and performance, but prosecutors have always had discretion to consider what the public interest might be when they bring criminal proceedings, and it is for prosecutors to decide how to exercise that discretion.
That is set out in the code for Crown prosecutors, the document issued by the DPP that provides guidance on the principles that prosecutors should apply when making decisions on whether to prosecute in any particular case. The test requires—I paraphrase—the prosecutor to be satisfied that there is sufficient evidence to convict and that it would be in the public interest to prosecute. Sometimes a statute requires that either the DPP or the Attorney-General—for these purposes that means the Solicitor-General as well—must consent to the prosecution, and in the case of a prosecution under the Suicide Act 1961, as amended by the Coroners and Justice Act 2009, it is the DPP who has to consent to the bringing of criminal proceedings.
However, it has been clear for many years that it is not in every case where the evidential test is passed that a prosecution must be advanced. In 1951 in the House, the then Attorney-General, Sir Hartley Shawcross, said:
“It has never been the rule in this country—I hope it never will be—that suspected criminal offences must automatically be the subject of prosecution.”—[Official Report, 29 January 1951; Vol. 483, c. 681.]
Those words underscore the essential independence of our prosecutors from Government, from Parliament, from newspapers and their readers, from religious leaders, from the expert and ignorant, and from all who would seek to interfere in their discretion and independence. As Law Officers, the Attorney-General and I support and protect the independence of prosecutors in their decision making. With that in mind, I will turn to the DPP’s policy document.
Guy Opperman (Hexham) (Con): I make a declaration as a former criminal prosecutor. It was frequently said that we were often consulted but often ignored. In these particular circumstances, given that there may be a presiding view of the Government, what is to be lost by having a consultation and finding out what is the view of the people?
I suppose that it is a matter of attitude. I happen to think that the Government were elected to take decisions. I have expressed my view on the matter. No damage will be done to the constitution, and the world will not come to an end, if we consult on this issue. I happen to be of the view that we do not
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need to put this policy into statutory form. It will create a form of sclerosis and lead to all sorts of problems that may not be intended. Therefore the better position is to leave the thing as it is. If my hon. Friend, either as a Member of Parliament or as a private citizen, be he a former prosecutor or a former defender, wishes to advocate the consultation process, he should go ahead. I will not stop him. I will just simply not support him.
Steve Baker (Wycombe) (Con): Whereas the guidance at paragraph 6 is clear that it does not decriminalise the offence, if the remainder of the guidance were put in statute, would that not therefore decriminalise assisted suicide, and is not that the crucial difference?
The Solicitor-General: There is a growing confusion—perhaps it was there already—between the guidelines, which are the DPP’s policy statement on when it is and is not thought appropriate to prosecute and the factors that he will consider, and the substantive law that is set out in section 2 of the Suicide Act. The two are quite different. As I mentioned to the right hon. Lady, it is a criminal offence to encourage or assist the suicide of another, and if people are prosecuted and convicted, they are very likely to receive a prison sentence measured in years, the maximum being 14 years. But the DPP’s guidelines are not the law. They are a public document that informs us how it is that he considers whether or not it is right to bring a prosecution in any given case.
I agree with my hon. Friend the Member for Croydon South in commending the DPP for producing a document that is notable for both its clarity and its compassion. The House is fully entitled to consider the way the criminal law it enacts is applied in practice, but I hope that by considering the guidelines, the House will not only commend them, but also note that they are based on the principle of independent prosecutors exercising their discretion in their decision making, which, ultimately, must be in all our interests.
Dame Joan Ruddock: I am really grateful to the Solicitor-General for giving way. Will he just acknowledge that a future DPP could overturn the guidelines, and does he think that that would acceptable?
The Solicitor-General: If a future DPP overturned the guidelines, he would be judicially reviewed for behaving in a rather whimsical way. I also suspect that the right hon. Lady would be one of the first to stand up in the House and censor him for doing so. I can assure her that placing things in statute will not assist her cause. She and I share the view that the DPP’s guidelines are a good thing. Why not leave them where they are and let them remain a good thing?
As I said, I hope that by considering the guidelines the House will not only commend them but also note that they are based on the principle of independent prosecutors exercising their discretion in their decision making, which, ultimately, is in all our interests. The guidelines inform others how he will exercise his discretion, but as with any guidance or policy issued by the DPP, it is subservient to the law of Parliament and the decisions of the higher courts. If the law changes, any relevant prosecutor’s guidance must also change. It will change the more flexibly if it is not ossified in statute.
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I make a trite point, but the law cannot do everything. We need flexibility in its application, and to be able to apply the law and to make decisions about whether or not to prosecute on the facts and the surrounding circumstances of each case and on a case-by-case basis. In this area of law, perhaps almost if not exclusively above all others, we need to approach the question of whether to prosecute with sensitivity and with care. Indeed, the High Court, in its judgment on 29 October 2008 in the Purdy case—the very action that, once it had been considered by the House of Lords in 2009, gave rise to the guidelines—said that the nature of the offence created by section 2(1) of the Suicide Act is such that
“the variety of facts which may give rise to the commission of that offence, and therefore which may result in a person being prosecuted, is almost infinite”.
The section 2 offence is very widely drawn. It covers all situations and creates no exceptions, which is why, I suggest, the DPP’s consent to a prosecution is so necessary, and why the House of Lords directed the DPP to publish the policy that we now have before us.
Guidelines or a policy statement are not required in every criminal case, but I invite the House to consider that such guidelines are best issued by prosecutors and for prosecutors, although available for public inspection and comment. Quite apart from the propriety of guidelines for prosecutors being a matter for prosecutors, there are some practical considerations to guidelines remaining on a non-statutory basis. Surely to place them in statute would be to attempt to confine the infinite. Policies and guidance are there to provide practical assistance to prosecutors on how particular categories of cases should be approached and the internal processes that should be followed. Therefore, there needs to be a certain amount of flexibility, not least because, as case law develops and public opinion and our collective moral view alter, the law changes and these guidelines and the policies will need to change in response, often quickly.
I therefore urge the House, as a matter of good practice, to conclude that the current flexible and—I admit—pragmatic approach should be retained. That said, we are all entitled, inside and outside the House, to comment on the guidelines themselves or on a decision to prosecute or not prosecute in any given case, subject to any temporary constraints imposed by the law of contempt and defamation. We should not build into the process a sclerotic arrangement that will not improve the application of the law from year to year.
The CPS has published a number of policies and guidance documents over the years. They are available on its website and are there to help the public understand how decisions are taken by prosecutors. During the past two years or so, that has included policies on prosecuting human trafficking cases, public protest cases and cases about perverting the course of justice when victims in rape and domestic violence cases make false retractions. Should these policies be codified, too? Should they be placed on a statutory footing? As my noble Friend Baroness Berridge said in the other place when this matter was debated last month:
“It is imperative that DPP policy and decisions are free from, and seen to be free from, Government interference…If the House were asking how the Government are assessing the application of DPP policy for prosecutions in cases of phone-hacking, constitutional alarm bells would, I believe, have gone off immediately.”—[Official Report, House of Lords, 13 February 2012; Vol. 735, c. 629.]
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My hon. Friend the Member for Croydon South said that the application of the existing law and, by implication, the application of the guidelines in this area is a pressing issue. It is not so much the application of the existing law that is the issue, but what the substance of the existing law is. I leave others to decide how pressing the issue might be. At the risk of repeating myself, I will say that if Parliament wishes to change the law in this area, that is a matter for Parliament, but we should not confuse the way prosecutors apply the law with what the law is or should be.
As I draw my remarks to a close, I will briefly address the amendment tabled by my hon. Friend the Member for Congleton and supported by a great many right hon. and hon. Members. She is encouraging—I assume—the Government to develop specialist palliative care and hospice provision further and, in responding, I transmogrify my role as a desiccated, boring and apolitical Law Officer to that of a thoroughly exciting political Minister.
The Government recognise that many people, their families and carers do not receive the quality of end-of-life care that we would all wish to receive. Hardly a month passes without our reading in the national or local press or hearing in the broadcast media of some terrible episode of personal suffering endured by an elderly person at the end of their life. Every such story demands of us that something more should be done to ensure that the care of the terminally ill, no matter what age they are, should be improved. The Government are committed to developing and supporting end-of-life and palliative care services to ensure that the care people receive, whatever their diagnosis, is compassionate, appropriate, of good quality and permits the exercise of choice by patients. That choice is, of course, within the current legal framework. For many, that means being able to choose to be cared for and to die at home, or in a care home when that has become someone’s home. However, we know that most people die in hospital, the place where they would least prefer to be.
Although realistically many people will continue to die in hospital, we know that more people could be cared for and die at home. We want services to be set up to help people make that choice, and commissioners and providers need to ensure that the right services are available in the right places and at the right time. Much needs to be done to make that happen, and we will review progress in 2013 to see how close we are to being able to offer that choice. It is very much part of the work to implement the Department of Health’s end-of-life care strategy. Published in 2008 under the previous Government, the strategy received cross-party support. It aims to improve care for people approaching the end of life, whatever their diagnosis and wherever they are, including enabling more people to be cared for and to die at home.
Fiona Bruce: I am extremely pleased to hear my hon. and learned Friend say that. It will build on what is a very high standard of care in many parts of the country, as I have already mentioned. The point I was seeking to emphasis, in particular, was that evidence shows that where there is a high standard of palliative and end-of-life care, there are fewer requests for assisted suicide. That is why it is so important that we focus on supporting and developing further end-of-life care specialism and treatment in this country.
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If we are to continue to provide care where and how people want it, to expand this work into the community and to care for people with conditions other than cancer, hospices and other providers of palliative care need the right support and the right funding. We need a funding system that can last, that provides stability and security in the long term and that actively encourages community-based palliative care so that people can stay at home or in a care home as they wish. Of course, this has to be affordable within the constraints of the current financial climate.
The independent palliative care funding review looked at options to ensure that the funding of hospices and other palliative care providers is fair and covers both adult and children’s services. When it reported last summer, it recommended that a number of pilots be set up to collect data so it could refine its proposals, because of the lack of reliable data currently available. Last week, my right hon. Friend the Secretary of State for Health announced the seven adult and one children’s palliative care funding pilots selected for this important work. They will start in April and run for two years, and our aim is to have a new funding system in place by 2015, a year sooner than the palliative care funding review proposed.
I did not wish to be rude to my hon. Friend the Member for Congleton. I do not know whether there is a correlation or a causative link between the two points she drew to our attention in her intervention. None the less, if the matter comes to a Division, I urge the House to accept the motion moved by my hon. Friend the Member for Croydon South, to be deeply sceptical about the amendment tabled by the right hon. Member for Lewisham, Deptford and to look with interest and care on the matter proposed by my hon. Friend the Member for Congleton.
Emily Thornberry (Islington South and Finsbury) (Lab): I begin by congratulating the hon. Member for Croydon South (Richard Ottaway) not only on persuading the Backbench Business Committee to make time for this debate, for which I am grateful, but on his thoughtful contribution, which set the tone for the debate. I also congratulate my right hon. Friend the Member for Lewisham, Deptford (Dame Joan Ruddock) and the hon. Member for Congleton (Fiona Bruce) on their contributions. In my view, the debate is one of the highlights of this parliamentary term, and it is such a shame that there is unlikely to be a great deal of interest from the media, as I think that the debate shows the House at its best.
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suspicious of those who believe that there is a ready answer. The issue is perhaps made more difficult by the fact that, as politicians in a democracy, it is our job to reflect public opinion, and when it comes to such issues the public far too often behave like ostriches, wanting to bury their heads and forget about it. No one wants to believe that they or those whom they love would ever be so ill that they would want to die. The truth, however, is that many of us will find ourselves in that situation.
Despite the fact that we have an increasingly ageing population, we also fail to address additional, related problems, such as the problems of pensions and long-term care, which have led to the social care crisis. Again, that is because none of us wants to believe that we will have difficulties in old age or that we will be seriously ill and need assistance. Therefore, it is not terribly surprising that we have failed to address the issue of how we ought to have a good death. Some of us will die peacefully in our sleep, but many of us will not. With advances in medicine, many of us will live with a medical condition that, even 10 years ago, we would have been unlikely to survive, and which would likely have resulted in a speedy death, so many of us are likely to live longer.
Many of us, however, are likely to live with a painful, debilitating disease that will shorten our lives. Some of us believe that that is the will of God; some of us believe that life comes from God and it is for God to take that life away; many of us believe that Pope John Paul II was an inspiration, given the dignity he showed in dealing with his Parkinson’s; and some of us—I am one of them—believe that if more hospice and palliative care was available to those coming towards the end of their lives, they would wish to live as long as they could, so long as they could remain pain-free and continue to live with dignity. I was very moved when I went to Trinity hospice, and I would consider myself fortunate, if necessary, to see out the end of my days in such a hospice.
Others, however, do not believe that such an approach is sufficient. Diane Pretty and Debbie Purdy, for example, do not wish, even with the greatest assistance, to live until the time when God, if there is a God, takes that life away; they wish to have some control over the end of their life.
Caroline Lucas (Brighton, Pavilion) (Green): Does the hon. Lady agree, however, that the essence of the Director of Public Prosecution’s advice is to give dying people the ability to live? It is precisely the knowledge that they have control over when they are able to die that allows them to live more fully and, often, for longer.
Emily Thornberry: I am grateful to the hon. Lady, who in fact takes me to my next point, which is that no one could fail to be struck by the clearly unaffected joy of Debbie Purdy and her caring husband, Omar Puente, when they believed that there had been clarification of the stage at which they might jointly have been able to decide when she could die. The fact that they seemed to be overjoyed by that showed an essential truth in relation to them and to the decisions that they personally needed and wanted to make—and wanted the law to allow them to make.
Having rattled through the difficulties in relation to the issue, may I move on to the motion and to the amendments before the House? The motion welcomes the Director of Public Prosecution’s guidance on cases
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of encouraging or assisting suicide, and it is certainly my view that, as others have said, the guidelines are sensible and proportionate. The hon. Member for Croydon South rightly said that they are compassionate, and many members of the public believe that they are.
When the public saw that Diane Pretty, despite all her efforts, eventually did suffocate—exactly what she did not want, because she wanted to be able to end her life before that with assistance, if necessary—they found the DPP’s response to the case of Debbie Purdy a few years later was proportionate, and it had their broad support. The motion does not seek to change the law.
“invites the Government to consult as to whether to put the guidance on a statutory basis.”
When looking at amendments and at quasi-legal documents, I think that the safest way to interpret them is to interpret what they say as meaning what they say, and the amendment simply asks the Government to consult on whether the DPP’s guidance should be put on a statutory basis.
Sir Peter Bottomley: The hon. Lady is helping the debate. If the Government were forced to hold such a consultation, would it be based precisely on the DPP’s guidelines as they are, or would it open up the debate to state that some of the guidelines are wrong, that there should be not just assisted suicide but death on request, or that the situation ought to involve the chronically ill and some of the physically handicapped? Would the consultation be constricted, because if it were not, why would we hold it?
Emily Thornberry: The hon. Gentleman, too, anticipates what I am going to say next, because having clarified what I believe to be the purpose of amendment (a), which is to invite the Government to consult, I believe also that it would invite the public to become involved in a debate, and no one in this House, given the difficulties in relation to the issue, should be afraid of that.
There are issues related to the current guidance, but there are wider issues, too, and we should not be afraid of debating them. There are the results of the Commission on Assisted Dying, which recommended permitting a doctor to assist suicide for the terminally ill and defined who the terminally ill are, and there is the issue of whether that recommendation would assist people who suffer from locked-in syndrome, or even Debbie Purdy, who suffered from multiple sclerosis but might not have been considered terminally ill. We should not run away from debating those issues, and it is important in these circumstances that there be a debate. That is why there is some good sense in amendment (a).
I do not wish to apportion any motives one way or the other to people who want to be involved in the debate; it is best that we have the debate and that the public are encouraged to be involved. The DPP has, in my view, come up with very sensible
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guidelines on when a prosecution for assisted suicide should begin, because it is appropriate for the Crown Prosecution Service and the DPP to be informed by a wider public debate.
For the reasons that I set out at the beginning of my remarks, I believe that the public would not necessarily like to have a debate, unless they have coming up in front of them cases such as Debbie Purdy’s, which they cannot avoid, but it is our responsibility as elected representatives to listen to the public and to encourage and engender debate, and that is the good sense behind amendment (a).
Glenda Jackson (Hampstead and Kilburn) (Lab): I entirely agree with my hon. Friend, but equally she should not attribute too much to the Commission on Assisted Dying, as it was a self-appointed commission that was funded mainly by a pressure group that holds a very clear view of the existing law and how it wishes to see it changed. I also point out to my hon. Friend that this House at the very beginning of this Session argued for e-petitions, and that the same House is now arguing that e-petitions should be abolished because they produce absolutely nothing other than hundreds and thousands of e-mails.
Emily Thornberry: I take on board the points that my hon. Friend makes, but they do not sway me from my path, which is to argue that we should encourage a real debate with and among the public, and that we should learn from their views.
Amendment (b) is clearly nothing but good sense and very important. The vast majority of the public wish to die at home, but on the whole people do not do so because they are afraid that there is insufficient support for them to die pain-free and supported there. If I may step away from being a desiccated lawyer for a moment, I must say that it was such a shame that the Health and Social Care Bill spent so little time dealing with that vital issue, and instead dealt with many other issues that the public did not want.
In a more general debate, another issue that could come up is that of giving information to members of the public who might want to know how they could kill themselves or assist others to kill themselves. Again, that is controversial, but it is important that we politicians are informed by the public’s views on the matter.
For those and other reasons I welcome this debate, and I congratulate the hon. Member for Croydon South on having ensured that we hold it here. Let us hope that it spreads to involve people outside this place.
In 1961 the act of suicide was legalised, for whatever reason but in a wholly unqualified way, and, cutting through the fine words, what we are considering is legalising not a person killing themselves but, under defined circumstances, a person participating in the killing of another. This debate, to some extent, is a proxy for that, but, we seem to be arguing around and, possibly, avoiding arguing about whether an individual can claim a right in law to request that someone, possibly
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a state agency or a private individual, assists them in ending their life. It is not clear whether giving people this right puts anyone under an obligation, but it is clear that anyone acting in a way that enables a person to exercise the right would not be committing a crime if the law was changed, just as there are people in Switzerland who kill and volunteer to kill many people but are clearly distinguishable from murderers.
The legality of suicide, as presented in the law, is unqualified, but I think that we would all accept that the right to assist suicide has to be qualified to distinguish it from more heinous behaviour. I do not believe that there is any satisfactory way of doing that in law, and there is no evidence that it has ever been done satisfactorily in practice, because the right to assisted suicide is qualified in different ways in different countries—for very good reasons, but normally in an unsatisfactory fashion. In my view, there is no way in which we can qualify this right that will make the potential benefits outweigh the potential harm, even if we set aside the wider potential alleged social harms that may come from embodying euthanasia in our society, such as pressure on the elderly and diminishing respect for disabled people and for life itself.
Those are very persuasive arguments, but I would like to concentrate specifically on whether we can free assisted suicide, as a proposition, from all taint of harm, however we qualify it. Most people vigorously assert that consent must be a condition, and there are obviously cases in which it would be nonsense to deny that a person does not fully and knowingly consent. However, it is also abundantly clear that free consent is never a sufficient condition to claim the right for assisted suicide, nor to excuse a person who assisted them. Otherwise, we would tolerate assisted suicide in cases of people who enjoyed tolerable health but may have a range of reasons for wishing to be dead, not all of them laudable. Euthanasia on demand is not, I think, a proposition that anybody in this House cares to advance. In fact, we would all agree that it would be a wholly inappropriate response for people who are mentally ill or temporarily depressed.
Consent by itself is never a sufficient condition unless it is coupled with something else, which is usually the possibility of suffering or loss of dignity that an individual is unwilling to bear. It is also usually anticipated as being something that occurs in the last stages of terminal disease, but logically it need not be so. One cannot support euthanasia on the grounds that a level of indignity and suffering characterises a short period before death, and not support it if a lifetime of similar indignity and suffering lies ahead. One cannot easily argue for euthanasia for the terminally ill and not, at the same time, for euthanasia for those who are permanently suffering. It is the character and the extent of the suffering and indignity that counts, not where it is placed in someone’s life cycle.
Thus, free consent plus great suffering would, on the face of it, appear to make a minimum case for a civilised version of euthanasia. However, there is a sting in the tail. If we allow euthanasia for those who are either in great pain or unwilling to face the probability of great pain, why should those who are, for whatever reason, incapable of giving consent be denied mercy if they are thought to endure exactly parallel circumstances?
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In other words, why privilege those who are compos mentis—those fortunate enough to have their wits about them? Thus, by force of argument, one moves from being unsure about whether consent is a sufficient condition to being unsure about whether it is a necessary condition.
Jim Dobbin (Heywood and Middleton) (Lab/Co-op): Let me say at the outset that I am prepared to accept the motion tabled by the hon. Member for Croydon South (Richard Ottaway), particularly because he indicated that he might be prepared to accept the amendment tabled by the hon. Member for Congleton (Fiona Bruce). I cannot support the amendment tabled by my right hon. Friend the Member for Lewisham, Deptford (Dame Joan Ruddock), particularly because of the advice from the Minister, which I have received on a previous occasion.
I am vice-chairman of the all-party group on dying well, which is chaired by Baroness Ilora Finlay of Llandaff, who is professor of palliative care at Cardiff university and a former president of the Royal Society of Medicine. I am totally opposed to the legalisation of euthanasia, assisted suicide or assisted dying—whatever one calls it. It is referred to at the moment as assisted dying. I say “at the moment” because over the past few years full-blown and up-front debates on euthanasia have been held in the House of Lords, led by Lord Joffe. The campaign has changed from being one on euthanasia to one on assisted suicide, and it is now known as assisted dying. The trick, so often, is to soften the language throughout the campaign to gain public support. Therein lies a strategy.
I welcome the DPP’s revision of his guidelines for prosecuting in cases of assisted suicide. As we know, this follows a lengthy consultation. The new guidelines are focused more on public safety and, to my mind, on the protection of people with disability and serious illness, who are, as the guidelines say, of equal worth and therefore must have equal protection under the law. I highlight the issue of elder abuse within families and remind the House that not all families are loving or empathetic. It hardly needs to be stated that vulnerabilities such as physical dependence or mental health problems are not a reason for assisting suicide.
Although there is much to welcome in the guidelines, they leave me with some concerns. The use of judgmental aspects on individual cases is inherently problematic. There needs to be complete transparency over decisions to prosecute or not to prosecute. Without this, we will fail to protect the people who care for those who are dying and leave the person who is dependent and ill in a very vulnerable position. The guidelines make it clear that immunity from prosecution is not guaranteed for assistors of suicide. The danger is that the parts of the guidelines that have been published, plus the spin given in the media by those who support assisted dying, could well lead to people getting involved in illegal acts. Having said all that, there is a general welcome for some aspects of the DPP’s guidelines.
In the context of the amendment tabled by the hon. Member for Congleton, I now put the case for the antidote to assisted suicide. I do so by declaring that two of my grandsons live with serious disabilities. They are brothers, and they have a neurological muscle weakness that is controlled by medication. They are both wheelchair
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bound and require one-to-one support at home and in their education. From time to time, they have required life support systems. I do not want them, or any other person living with a disability, to experience pressure in a system whose law suggests that their lives might not be worth living. That important point was made in the Lords debate by Baroness Campbell of Surbiton and others who spoke on behalf of those with disabilities.
As I have said, the antidote to assisted suicide is palliative care for people suffering from terminal illness. I include all types of terminal illness in that. In 2006, I introduced a private Member’s Bill on palliative care for the terminally ill. That is another reason why I support the amendment tabled by the hon. Member for Congleton, of which I am a signatory. Palliative care is about enhancing quality of life and—
Stephen Metcalfe (South Basildon and East Thurrock) (Con): Thank you, Mr Deputy Speaker, for inviting me to speak so early in this important debate, which was secured by my hon. Friend the Member for Croydon South (Richard Ottaway).
I never thought that I would speak in a debate in support of some form of assisted suicide. However, I have been on a journey and would like to share a little of it with the House. I have a very good friend called Nicky, whom I have known for 30 years. She is in the Gallery today with her husband, David, whom I have also known for 30 years. During that time, Nicky has developed secondary progressive multiple sclerosis. Although at this point it is not terminal, at some point it will be. For many years, Nicky has expressed the view that in the future she will want the right to choose the time and manner of her death. She wants dignity in dying.
Nicky and I have disagreed about that issue for many years and have had many heated debates. However, I am a pragmatist. I want to support my friend in her desire to choose the time and manner of her death, but I also want safeguards. I know Nicky and David well. I believe that I know what Nicky’s wishes are. I know that if she were to take her own life, with the assistance of David, she would be doing so of her own free will. I would be able to vouch for David and say with confidence that his only motivation was compassion, but how can I be assured of that in other cases, perhaps involving people more vulnerable than Nicky? I cannot be assured, and so we have the law. At times, though, the law can be a blunt instrument. They say that justice is blind. On occasions, perhaps the blindfold should be lifted just a little, so that justice can see that the same actions may have different motives.
I fully support the development of palliative care provision and I welcome amendment (b). I also recognise that such care, no matter how much we wish, cannot remove all suffering at the end of life. There will always be people, such as Nicky, who may request the assistance of loved ones, such as David, to help them end their lives. That would be an act of compassion, not malice. I therefore welcome the common-sense approach taken by the Director of Public Prosecutions and prosecutors
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in distinguishing between wholly compassionate assistance, which is highly unlikely to be prosecuted, and malicious assistance, which will be prosecuted. That policy provides clarity and peace of mind for people who are facing such difficult decisions. It also allows them to focus on living now.
“because people will not have to act prematurely, knowing that they can be helped… I don’t have a death wish, I just want the right to a dignified death, when I wish that to happen.”
That is what is so crucial about the policy. It gives people a degree of security in the choices that they can make, and gives them a sense of control over their own lives. It means that they can enjoy the present. As Nicky says, it is not about wanting to die, but about wanting to live with the comfort of knowing that a choice is available.
I reiterate that this debate is not about changing the law. It is about providing much-needed clarity on the application of existing legislation. The DPP’s policy sensibly distinguishes between malicious and compassionate assistance. However, it is important to note that it does not grant immunity. If there is evidence of malicious or irresponsible practice, it can and should be prosecuted.
Finally, as a committed Christian, I believe strongly in the sanctity of human life. I believe that human life is intrinsically valuable. Although I recognise the importance of debates such as this, I have many concerns regarding a wider change in the law. I keep an open mind and do not believe that it is for me to force my beliefs on others. I wholeheartedly appreciate that for many people dealing with a terminal illness, life becomes intolerable. Until we can guarantee that we can achieve the correct balance between allowing personal choice and providing complete protection, I am happy to accept the DPP’s guidance, but not further changes to the law.
I congratulate the hon. Member for Croydon South (Richard Ottaway) on securing the debate and the Backbench Business Committee on allowing it to take place. I also congratulate the hon. Gentleman on his excellent speech. I do not think that we have agreed on much over the years in this place, but on this we are of one mind. More importantly, I congratulate the Director of Public Prosecutions, Keir Starmer, on publishing the guidance and the balance of public interest test that the hon. Gentleman covered in his speech.
I welcome the debate, and the mood of the House seems clearly supportive of the motion, if not yet of amendment (a), tabled by my right hon. Friend the Member for Lewisham, Deptford (Dame Joan Ruddock), although there is still time to persuade colleagues. Even supporting the motion will demonstrate that we are in tune with public opinion. Just as the hon. Member for Croydon South said that the House caught up with public opinion in 1961 by passing the Suicide Act, it will catch up by agreeing to his motion today, whether or not it approves amendment (a). Amendment (b) will obviously command universal support.
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“My life, my choice, at the end of my life”,
and “end” is underlined. The emphasis is on personal choice to end not only suffering and loss of dignity but the deterioration in quality of life when individuals know that the end is near and want to be in control of their own death. I say “they”, and our decisions here always have an impact on our fellow citizens, but this is also about us. We need to ask ourselves, what if it were our loved one seeking a less harrowing end to their life? Would we welcome the DPP’s common sense more or less? Would we want them to have the chance to choose?
I believe strongly that it needs to be recognised that there is some pain, some misery and some indignity that cannot be ameliorated or made more bearable by palliative care, and that being reduced to a vegetative state by increasing recourse to continuous sedation is not how some people want to end their lives. They want their own choice, and they do not want loved ones to suffer because of that choice. The DPP’s guidelines are helpful in offering both victim and family some protection.
Anna Soubry (Broxtowe) (Con): I agree with much of what the hon. Gentleman says. Does he agree that there are some people who, by virtue of their affliction, illness or disease, do not have the choice of ending their lives because they physically cannot do anything for themselves? Are not those people a very important consideration in this debate?
Jim Fitzpatrick: The hon. Lady makes a powerful point. I am sure all Members in the Chamber will have read the briefings by a variety of organisations and testimony from family members who have been worried even about filling in the forms to send their loved ones to Dignitas, if they could afford it. They have been worried about whether that constitutes illegality which could lead to their being prosecuted.
The Debbie Purdy case in 2009 helped us get here today. As the hon. Member for Croydon South mentioned, we owe her and her family a great debt. She did not want her husband prosecuted for helping her along the lines that the hon. Member for Broxtowe (Anna Soubry) has just mentioned, and I do not believe most opponents of assisted dying in any form want loved ones prosecuted for a one-off, compassionately motivated act. I believe and hope that the DPP guidance will bring common sense to bear.
I personally believe that we need a change in the law to allow assisted dying for terminally ill, mentally competent adults in specific circumstances, so I support amendment (a). Let me personalise the matter. Most colleagues know that I was in the London fire brigade before being elected here. Every firefighter from the 1970s and before, but not after the early 1980s, used asbestos equipment. Asbestos was and is known for its heat-resistant properties, but it has been lethal for many thousands of people. Tens of thousands of people, if not hundreds of thousands, in other industries and businesses have also been exposed to it.
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ones and the medical staff who have to treat them. I have been with colleagues and families who have been through that. The issue, therefore, is this: what kind of end?
The DPP’s policy provides much-needed clarity and, as many colleagues have said, sensibly distinguishes between malicious and compassionate assistance. It does not give immunity. The public interest criteria safeguard the public interest and provide to some degree that there should be a right to choose. Therefore, I support the motion and amendment (a), as well as amendment (b), because the latter is not at all in conflict. As the hon. Member for Congleton (Fiona Bruce) said, most people who go into decent palliative care would choose to extend their life for as long as possible, but not everyone. Those who do not want to stay to the bitter end, and who think that they have a better option for a more dignified end, should have the right to choose.
Mark Menzies (Fylde) (Con): I did not originally plan to take part in today’s debate, but such is the range of emotion and also the quality of some of the contributions that many hon. Members have made—in the columns of the press and in debate—I felt it important to make a contribution. I am not someone who has ever worked closely with the hospice movement, but I appreciate the work that it puts in. That is why I was heartened to see the amendment tabled by my hon. Friend the Member for Congleton (Fiona Bruce).
Palliative care should not just be an option when it comes to the decision to seek assisted dying. Instead, it must be at the heart of how we look after those who are nearing the end of their lives. In Fylde, we have several nursing homes that adopt what they refer to as the golden pathway. Every time I visit I leave feeling distressed, having seen people who are clearly getting to the end of their lives, some of whom do not have the benefit of loved ones to take care of them. However, they receive the highest level of nursing care possible in that environment to ensure that when they do leave this earth, they do so with as much dignity and as little pain as possible.
Anyone who knows someone in the harrowing situation of facing terminal illness, which—as we know—can come in many forms, knows that it is important that such care is available in whatever form we can give it. That should be not just through the work of the hospice movement, excellent as it is, but through care in the community and allowing people, where at all possible, to live in their home and to die with dignity in as pain-free and comfortable a way possible.
Naomi Long (Belfast East) (Alliance): I had the privilege of nursing my mother at home with the help of Marie Curie and the Macmillan nurse service. Two weeks before she died, there was still dispute among her medical team as to whether her condition was terminal. Some people have made the point that this applies only at the end of life, but who can determine the end of life?
The hon. Lady makes a very important point and, when she was nursing her mother and was in a state of distress, the last thing she needed was the pressure and the uncertainty of questions about whether it was the end of life or something else. Every step of
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the way, we have to ensure that the care that is provided is of the highest quality, especially for those people whom we think may be entering the end of life. I commend the hon. Lady on the care that she gave to her mother.
I also ask that when we think of palliative care, we also think of the carers. Some people have a relative or loved one in a hospice, for example, and want to visit as often as possible, sometimes more than once a day, but they are trying to juggle family commitments, looking after children or other dependent relatives, and trying to hold down a job. When we consider amendment (b) we should think not only of those reaching end of life, but of those caring for them.
We also have to recognise the work that doctors do, and I know that many hon. Members who have been in the medical profession have reservations about anything that looks as though it moves us closer to assisted dying, because they do not want doctors to have the pressure and burden of being the person who instigates the act of bringing someone a step closer to death.
Many other right hon. and hon. Members wish to speak and I do not wish to take any more time, other than to say that I am very proud to be a signatory to amendment (b). I will continue to listen to the debate and I may well support amendment (c), but I cannot support the amendment tabled by the right hon. Member for Lewisham, Deptford (Dame Joan Ruddock).
Ian Paisley (North Antrim) (DUP): I agree with the comments made by the hon. Member for Islington South and Finsbury (Emily Thornberry), when she rightly said that the House is at its best today. The view of the House in the public eye over the past 24 hours is one thing, but today the House has risen to its very best when debating an issue—a solemn issue and one that touches on the hearts of everyone.
We have to start by declaring boldly and clearly that this House is not God. The House does not have the right to determine and should not take upon itself the right to determine what God determines—when life begins and ends. The House would be foolish to take that role, that desire and that power upon itself. This debate sets on its course the notion that we, this Parliament, can put in place a law that will determine when people in this nation should lose their lives. Think of it! Think of how foolish the House is, in the great scheme of things, when it puts itself in that God-like position! It is not God.
The law “works well in practice”. Those are not my words but the words of the DPP, who has spelt out clearly that the law is compassionate when it has to be compassionate. The guidelines from the DPP demonstrate that the law is independent, as it has to be, and flexible when it has to be flexible. We should recognise that that is the norm and accept that the guidelines do everything they need to do without the House taking it upon itself to unbolt the door and open the floodgates to euthanasia. That, essentially, is what we are trying to do, or at least what some in the House are trying to do.
Let us consider what happened across the sea after Holland decided to change its law and encourage euthanasia. We now have reports that it has specialised roving medical teams that take upon themselves the
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right to go and help patients end their lives. Since they have done this, they have assisted in more than 3,100 deaths a year. The number is more than 10,000 at present. We are opening a floodgate tonight, and we should draw back from turning the key and opening that gate by supporting something that will allow for this law to be introduced. That is exactly where it would take us.
We are told by some Members that change is necessary because it will put the patient in control. The hon. Member for Belfast East (Naomi Long) put her finger on it: we are not actually in control of these circumstances. Indeed, the practice of medicine is well called a practice because it is exactly that—a practice, not an art. I want to quote from a letter from Patrick Pullicino, professor of clinical neurosciences at the university of Kent:
“The crux of its problem”—
“is that it is not possible, even for an experienced specialist, to diagnose with any accuracy when someone’s illness is imminently going to be fatal.”
We should recognise that we cannot give the patient what they want and put them in control because we do not know—we, this House, this people are not in control of the circumstances. We should sharpen up and wake up to our own humanity. Many people are right in what they have said about their own personal circumstances. I had the honour of nursing my father-in-law seven months ago, as I watched life ebb from him. I count it an honour to have been there with him and to have watched him die with dignity, but not to have encouraged it. The House should recognise that we are not God and we do not have the right to do this.
Nadine Dorries (Mid Bedfordshire) (Con): It is a pleasure to follow the hon. Member for North Antrim (Ian Paisley) and to listen to him speak with the same passion with which his father frequently spoke, and from exactly the same place in the Chamber.
It is not the Government’s job to micro-manage the Director of Public Prosecutions. We make the laws; it is the job of the DPP, and the DPP alone, to decide whether to prosecute. As it stands, the law has a stern face and a kind heart. It tempers justice with mercy. The current system is clear-cut and easy to understand. The law works to ensure that the most vulnerable are protected. The power that the DPP holds in reserve acts as a powerful deterrent against those who would wish to exploit or abuse, while providing him with the ability to moderate justice with mercy.
It is interesting to note that at the time of the Purdy ruling, there were 20 recorded cases a year of people travelling abroad to clinics such as Dignitas to take their own lives with assistance. At the time, those seeking to liberate the law predicted and hoped that the number would increase. In fact, two years on, the figure remains 20 a year. It has not increased at all; what has increased is the number of people being reported to the DPP, which clearly shows the level of public concern about this issue.
At the moment there is a definite, clear line between where the law begins and where it ends, and it is managed by the DPP. It might not be as clear as some would like, and as amendment (a) would make it. One of my colleagues —I think it might have been the Solicitor-General—
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described the law as one of those wonderful things, a great British muddle, but it works well in the interests of everybody concerned. Over the last three years, two British Parliaments have refused to change the law, for two simple reasons: to protect the vulnerable and to acknowledge the fact that doctors frequently get it wrong: they often make the wrong judgment. In support of that, I cite the case of Stephen Hawking, who was given a few months to live when he was first diagnosed with motor neurone disease, but who has just passed his 70th birthday, having contributed a vast amount to the total knowledge of mankind over his lifetime. Indeed, there may have been periods of illness over the course of his life when he might have been deemed to be nearing the end of his life, but from which he in fact went on to contribute even more.
Sentiment is beginning to grow around the concept of a loving family member assisting in the final act of a loved one. However, those at the end of their lives do not always have a relative or a loved one; indeed, the “loved one” may, in fact, be the state or the care home, or wherever they are being cared for. No matter how we dress it up, there are people across this country in nursing homes being cared for—disabled people, vulnerable people—who feel very protected by the law as it stands. If it were changed, they would suddenly feel very vulnerable, because they could imagine a point in time when they are aware of what they cost the NHS, the state or wherever they are being cared for. At the moment they may feel a burden, but they know that they are protected. However, there may come a point when they become depressed because of their illness and feel that one day the state will adopt the role of the person assisting in their suicide. As one disabled lady said to me about three years ago, “I can see the day when a doctor comes to me with a little pink cocktail and says, ‘You know you’re costing the state about £10,000 a week at the moment? Would you like to end your life?” We may think that is ridiculous, but to people who are disabled and vulnerable it does not seem quite so ridiculous.
I fully support amendment (b), in the name of my hon. Friend the Member for Congleton (Fiona Bruce), on palliative care, which is an area that I would have liked to talk about if we had more time. However, I think that the law as it stands and the DPP’s role in interpreting it should be left exactly as they are.
Alun Michael (Cardiff South and Penarth) (Lab/Co-op): My starting point is that I want our law and our legal practice to be clear but flexible. In his excellent introduction to the debate, the hon. Member for Croydon South (Richard Ottaway) said that decisions about the law should be made by Parliament and not by the courts, but these decisions are not court decisions. They relate to how to decide whether it is right, necessary or humane to pursue a prosecution according to the circumstances of a particular case.
I support the motion, but I regard the amendment as an unfortunate attempt to hijack the debate. It is a Trojan horse attempting to change the law, and I do not want the law to be changed in either direction. There is a certain amount of pull from people on either side who are often, understandably, informed by specific cases,
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to reinforce a point of view that comes from that specific case. The fact remains, however, that we cannot avoid the need for people to make a judgment in difficult circumstances. The doctor, the relative, or the person who must decide whether his or her moral responsibility is to assist another or to take a particular course of action, are the only people who can weigh all the facts and come to a judgment, balancing the sanctity of human life with the suffering and the personal wishes of the individual concerned.
After the event, another judgment has to be made as to whether the individual involved broke the law, and whether there ought to be a prosecution. There was a case in my constituency of a mother who killed her severely disabled son. The public reporting of that case suggested to me that nothing was gained by the prosecution; it simply served to make even more painful, in public, the period of intense suffering that she experienced over a long period. We cannot legislate against that, but we can offer guidance on how a judgment should be made on whether to prosecute. That is what the Director of Public Prosecutions has done, and in my view he has got it right. This is an issue of judgment, which is absolutely crucial.
I shall make a comparison with data protection. People often want a safe haven, which is expressed as “If in doubt, don’t share data”, when in fact there is a legal responsibility to consider the public interest and to balance the pros and cons of sharing specific data. A judgment has to be made in accordance with the law. Indeed, the law requires a judgment to be made. That is why we bring the balance of judgment required into a single judgment by talking about data management, rather than about data protection or data sharing. I hope that that helps to illustrate the fact that, in relation to assisted dying, to say “Never prosecute” or “Always prosecute” would be equally wrong.
The motion does not seek to change the law, but the amendment would take us further down that road by suggesting that the guidance should be subject to a decision of Parliament. Surely the hidden agenda is that we could disapprove guidance in the future, or even require a change in the guidance by resolution. That would be wrong. I have had letters from people who believe that the guidance is already subject to Parliament, but it is not. Some have implied that passing this motion would make subsequent changes to the guidance subject to Parliament, but that would be wrong. The guidance tells prosecutors how they should seek to make an appropriate judgment within the law, and we should not interfere with that. If we wanted to change the law, that would be a matter for Parliament, but the interpretation of the law is something that we should note—perhaps with approval, as the motion does—but not seek to determine. Let us leave it there.
On both sides of the argument about whether we should go further or be more restrictive, people argue from a point of view of compassion, and I respect the opinions on both sides. Newspapers and hon. Members who are dealing with individual cases argue for compassion for an individual in a particular set of circumstances, but our laws have to be universal and they therefore have to allow room for compassion and for the protection of the vulnerable. That means that the law should not be too specific or inflexible. I believe that the courts have been right in reflecting the decisions of this House
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on what the law should be. I also believe that the Director of Public Prosecutions, in responding to the pressure on him to produce guidance, has got it right within the law.
I am happy to support the motion, and to endorse the policy set out by the Director of Public Prosecutions. The present policy appropriately protects those who want to act out of compassion in helping the terminally ill while safeguarding against the dangerous prospect of legalising assisted dying or putting pressure on the ill and the vulnerable.
Glyn Davies (Montgomeryshire) (Con): Thank you, Mr Speaker, for calling me to speak in this very important debate. It is a pleasure to follow the right hon. Member for Cardiff South and Penarth (Alun Michael). We do not always agree, but I agreed with every word that he said on this occasion. I also congratulate my hon. Friend the Member for Croydon South (Richard Ottaway) on the tone that he adopted: I thought it just right for the introduction of such an important debate.
I should declare an interest. I am a member of the board of Living and Dying Well, an organisation that commissions evidence-based research into end-of-life care. I have regular conversations with Lord Carlile, who chairs it, and with Baroness Finlay, who has already been mentioned today.
I too have received several letters from members of Dignity in Dying. I write back disagreeing, but I always do so with a great deal of respect, because—like other Members who have spoken—I think that opinions on both sides of the debate are motivated by compassion, and I do not think it right to be critical of those who take a different view if compassion is what motivates them.
I am rather concerned about some of the media coverage that appeared before today’s debate, which seemed to suggest that we were contemplating, and perhaps moving towards, a change in the law. That is not the case. All that we are discussing today is a reaffirmation of the current position in law, which is why I am happy to support the motion.
I am probably unusual here in having had an interest in assisted suicide for as long as it has been an offence. I was 17 in 1961, and an active member of my young farmers club. As young farmers clubs do, we discussed the issues of the day in debating competitions, and I supported the decriminalisation of suicide. A key point, however, is that that simply would not have happened without the inclusion in the Suicide Act 1961 of section 2, which introduced the offence of assisting a suicide and was seen as an absolute protection allowing the offence of suicide itself to be abolished.
My view remains exactly the same today. Over the last few days I have received many representations and briefings, as have many other Members, and over the months during which I have been a member of Living and Dying Well, we have commissioned several research papers. There so much information that it is almost impossible to engage one’s mind clearly with all of it, and because the time limit on speeches today is so tight, I shall make just one fundamental point.