Lords Probe Wales Devolution, Safeguards in Assisted Dying Bill

High-Level Summary

The House of Lords continued Committee stage scrutiny of the Terminally Ill Adults (End of Life) Bill. Peers focused on devolution issues for Wales (and references to Scotland), the scope of ministerial powers, and how responsibilities would divide between Westminster and Welsh Ministers. Further debate examined communication and safeguarding for patients with language, sensory or cognitive barriers, the role and design of independent advocates, and a suggested “neutral adviser” model when GPs decline to hold preliminary discussions. Later, the Committee discussed how prognoses should be explained; several probing amendments across the day were withdrawn and no divisions took place.

Detailed Summary

Arrangement of Business – announcement

Lord Kennedy of Southwark thanked staff and set the sitting parameters, stating: “I will adjourn proceedings today at around 6 pm”, with “a short 40-minute lunch break”. Noting the approach of Easter Recess, he added he would “seek to adjourn the House at around 3 pm” the following Friday. No decisions were required.

Terminally Ill Adults (End of Life) Bill – Wales, devolution and ministerial powers (Amendment 165 group)

Baroness Coffey moved to remove references to Wales, arguing the Senedd’s consent had been constrained and that Clause 42 would allow UK Ministers to regulate services in Wales. She cited the Senedd debate where Jeremy Miles said sponsors “would seek to remove clause 42 from the Bill” if consent were withheld, and Members complained: “We are being asked to vote in the dark”. Baroness Finlay highlighted the Delegated Powers and Regulatory Reform Committee’s concerns that the powers were “highly inappropriate” and “unknowably broad”.

The Bill’s sponsor, Lord Falconer of Thoroton, said criminal law changes are for Westminster, while health service delivery is for Wales: “this Parliament must deal with the criminal law and Welsh Ministers must be left to deal with the decisions about how it is introduced”. On the Secretary of State’s regulation‑making power, he said: “I do not have an adequate answer … so I should go back and think about how I can appropriately limit that power”. On implementation choices, he agreed that, if Welsh Ministers did not lay regulations, assisted dying could be lawful but not provided by NHS Wales, replying “That is right” to the proposition that it would be “a private service in Wales while it was an NHS service in England”. From the Government Front Bench, it was noted that excluding Wales would risk “a significant divergence in homicide- and suicide-related offences” and create cross‑border complexities. Amendment 165 was withdrawn.

Communication, interpreters and accessibility safeguards (Amendments 167, 171, 174 and related)

Baroness Fraser of Craigmaddie sought stronger protections for people with speech, language and communication needs at the preliminary discussion stage, noting Clause 5 currently requires adjustments “including the use of interpreters”. Baroness Berridge probed requiring adult interpreters, proposing they be “aged 18 … or over”, while Baroness Nicholson proposed adding “hearing or visual impairments”. Bishops and others highlighted cultural and religious barriers and the need to guard against coercion.

Lord Falconer said he had tabled amendments to strengthen duties so clinicians must “take all reasonable steps to ensure that there is effective communication”, and to extend eligibility for an independent advocate to those with substantial difficulty “communicating their views, wishes or feelings (whether by talking, using sign language or any other means)”. He resisted a statutory ban on under‑18 interpreters—“I am not in favour of a mandatory bar on any young person”—preferring guidance. The Government raised workability issues with some proposals (for example, that duties “may prove difficult for doctors to discharge”) without a wider policy commitment. Amendment 167 was withdrawn.

Independent advocates and proposals for neutral advisers (Amendment 168 group and new clauses)

Baroness Grey‑Thompson sought to require an independent advocate to be present at the preliminary discussion and questioned whether the sponsor’s redrafted clauses weakened safeguards, saying: “The new provisions can be optional or waived”. Lord Falconer outlined his replacement clauses: relevant practitioners must consider advocacy, and qualifying persons (including those with substantial difficulty communicating) would be supported by an advocate to “understand the options available” or assist with “anything done under this Act”. He added: “The Secretary of State must by regulations make provision about independent advocates”. Ministers cautioned that some proposals (e.g., parental consent for 18–25s) “may raise Article 8 ECHR issues”, and flagged ambiguity and resourcing risks.

Separately, Lord Gove (speaking to amendments tabled by Lord Frost) proposed a scheme of “neutral advisers” when a GP is unwilling to conduct a preliminary discussion, pointing to Clause 5’s requirement that doctors “must ensure that the person is directed to where they can obtain information”. Lord Falconer opposed creating a new adviser network as unnecessary, since the statutory preliminary discussion “must refer to all the options, the prognosis and the treatment”. Amendment 168 was withdrawn.

Explaining prognosis and the six‑month criterion (Amendments 175 and 384)

Lord Moylan proposed requiring doctors to explain the distribution of underlying survival data where a prognosis uses a median life expectancy, to avoid patients interpreting “six months” as a precise prediction. The Government observed: “It is rare for a clinician to base prognosis on a median life expectancy” and explaining such data “is not common clinical practice”. Lord Falconer pointed to Clause 5’s existing requirement for a detailed discussion of “diagnosis and prognosis”, available treatments, and “all appropriate palliative, hospice or other care”. Members also highlighted the risk of outliers and misestimates—for example, a case where a six‑month prognosis extended far longer. The amendments were withdrawn.