Lord Young of Acton (Con)

My Lords, the noble and learned Lord, Lord Falconer, suggested that the effect of the Bill on palliative care would be to improve it. That is not the view of my sister, an NHS nurse who has spent much of her career working in palliative care. It is her reservations about the Bill that I want to share with your Lordships. Like many noble Lords, she is concerned about the shortage of GPs and other qualified medical practitioners to see patients who want to avail themselves of the assisted dying service, and the shortage of psychiatrists to refer those patients to if there is any doubt about their capacity. The noble Baroness, Lady Meacher, in outlining the reasons for introducing the Bill, said that this law would provide reassurance to those living with a terminal illness that this option will be available to them if the worst should happen. However, as my sister points out, not all terminally ill patients will have that option, because patients will have to self-administer the life-ending drugs. As my noble friend Lady Fraser said, some terminal patients will be unable to do this if they are suffering from a neurological illness like motor neurone disease or Parkinson’s. My sister asks the reasonable question whether terminal patients will still be eligible for treatments designed to prolong their lives, such as oncology treatments, palliative chemo, immunotherapy and hormone treatments, if they have expressed a desire to die and have already embarked on the pathway set out in the Bill. Would those patients be reluctant to undergo treatments designed to prolong their lives if they knew that they have to secure a prognosis of having less than six months to live to be eligible for the service? How are palliative care doctors and nurses supposed to help those terminal patients who have an incentive to reject their advice? My sister acknowledges that, at some point, most palliative care patients express a wish to die, whether because of pain, nausea or extreme fatigue, because they are anxious about dying at home without adequate care or support, or because they feel they have become a burden on their families. However, in her experience, most of those patients change their minds when help does come, solutions are proposed and symptoms are alleviated, and they are grateful for the opportunity to spend extra time with their loved ones. It is providing terminally ill patients with these opportunities that makes the work of people in hospices so rewarding. It is why many of them do it. Their sense of vocation comes from wanting to improve the health and extend the life of their patients, not from accelerating their deaths. My sister also makes the point that many terminally ill patients have considerably less than six months to live. Would there be a statutory minimum amount of time patients are expected to live for, alongside the six-month statutory maximum? Even if there is no statutory minimum, the time it will take to jump through all the hoops before a patient is prescribed life-ending drugs will mean that there is a minimum, in effect, if not in law. What is my sister to say to those patients want to end their own lives but have no realistic chance of being approved by a panel in the time they have left? More generally, my sister is concerned that any attempt to integrate an assisted dying service into one of the most overstretched parts of the NHS, with the inevitable bureaucracy and delays, the forms incorrectly filled in, the unreturned phone calls and the missed appointments, will end up making the lives of terminally ill patients even more miserable. She says that her job often feels like working in a war zone, and fears that the Bill, particularly as currently drafted, will only make things worse.