Assisted Dying for the Terminally Ill Bill [HL]

My Lords, some hours ago, the right reverend Prelate the Bishop of St Albans referred to Alice in Wonderland, and as I have sat through this wonderful but gruelling debate, I have felt a bit like the Cheshire Cat’s grin; when I looked at my speech it was fading by the moment. I will say a word or two about palliative care, picking up the point that has just been made. Palliative care has been mentioned in this debate almost as if the supporters of the Bill were against it. I, and I am sure the noble Lord, Lord Joffe, take that quite hard. The noble Lord, Lord Joffe, and I signed a minority report to the Royal Commission on Long Term Care for the Elderly. The majority report wanted a large sum of money to be spent on paying for care for the better off, and they had a very good case. The noble Lord, Lord Joffe, and I said, ““No, we cannot go along with that, because the priority at the moment is better services for the elderly, not paying for care for the better off””. That is a controversial view, but that was the view that we took, and of course we included palliative care in that. I am sure that no one inadvertently will think that we are against palliative care because we are in favour of this Bill. To me, palliative care and assisted suicide are not alternatives. They are complementary; we need both. We need much more palliative care, so that wherever possible people want to live; and we need assisted suicide for the small minority of cases where people, despite palliative care, are suffering unbearably. If the proponents of palliative care are honest, and I know that they are, they will admit that there are some conditions, particularly neurological conditions, where palliative care really cannot prevent unbearable suffering. I would go further. Contrary to the view expressed by the noble Lord, Lord Elton, and my noble friend Lord MacKenzie of Culkein, and as someone who has written a great deal on public expenditure, I am absolutely confident that if this Bill goes through we shall get more spent on palliative care by the Government than if it does not. This is for two reasons. First, it would concentrate public attention on end-of-life issues, which most people like to ignore, and therefore create a demand for palliative care and for the Government to pay for it. Secondly, once Parliament has passed such a law, the Government would have to spend more on palliative care, if only to avoid vulnerability to the charge, fatuous though it may be, that they have permitted the change only to save money. The evidence of the improvement in palliative services in Oregon is proof of that pudding in the eating.