Assisted Dying (No.2) Bill

Fiona Bruce (Congleton) (Con): The hon. Member for Wolverhampton South West (Rob Marris) says that there has been a lot of misunderstanding about the Bill. There is no misunderstanding at all: the Bill would authorise doctors to provide a lethal substance for people to kill themselves with. That substance is not a “medicine”, as the Bill disingenuously describes it, but a poison. No wonder doctors oppose it, and we in this House should do so too.

The hon. Member for Wolverhampton South West says that the Bill sets out a clear procedure with multiple safeguards. What clear procedure? What safeguards? Let us look at the Bill. It states that doctors must be satisfied that a patient has a settled and voluntary intent to end his or her life. How should doctors be satisfied that the intent is settled? The Bill does not say. Would they need to see the patient once or twice, or over what period of time? The Bill is silent. What steps should doctors take to be satisfied that the intent is voluntary, and that there is no coercion behind the patient’s request? The Bill is silent. Given that Action on Elder Abuse reports that there are over half a million reported incidents of physical and emotional elder abuse in the UK each year, the Bill should be clear on that critical issue, but it is not.

Simon Hoare: It is actually worse than my hon. Friend suggests. Given the very low number of GPs who have indicated that they would seek a licence, it is more than likely that both doctors seeking to make the certification would not know the patient and therefore would not be able to tell whether they were more or less depressed or to assess their rate of degeneration. That is the fundamental weakness of the Bill.

Fiona Bruce: My hon. Friend is absolutely right. Those doctors could not be sure, and they would not be able to assess the even more subtle internal pressure that an individual might feel to express a wish to end their life because they feel a burden. What special procedure is there in the Bill for the particularly vulnerable in our society, such as those with mental health or learning difficulties? There is none. No wonder Mencap and Scope oppose it.

The hon. Member for Wolverhampton South West speaks of multiple safeguards. Where are they in the Bill? I do not see them. Does he mean the provision that 

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the decision should be referred to a High Court judge? If this was not so serious, it would be laughable. The judge would not have to meet the patient; they would only have to confirm the doctors’ decision, and in a time frame of 14 days, making independent scrutiny all but impossible. Absent will be the detailed, rigorous examination that the family court gives to life and death issues, such as turning off a life-support system. Gone will be the investigative powers of the Director of Public Prosecutions under the current legislation to rigorously investigate cases of assisted suicide referred to him. Removed will be the strong deterrent against malicious behaviour that the current law provides.

Gareth Johnson (Dartford) (Con): The Bill would require the dying person to make a declaration, and that declaration would have to be witnessed. Quite rightly, the witness cannot be a member of the dying person’s family, but they can be a beneficiary of their will. Is my hon. Friend as concerned about that as I am?

Fiona Bruce: I am extremely concerned about that “conflict of interest”, as we in this place might call it.

Vulnerable patients would be left in a weaker position than they are now. The inclusion of a judge to effectively countersign a form confirming the doctors’ decision adds no protective value whatsoever. But wait; here in clause 8 is a provision that would allow the Secretary of State to issue at some future date—not before we have passed the Bill—a code of practice. A code of practice would relate to such critical matters as assessing a patient’s capacity or what counselling should be given, or recognising that depression might impair a patient’s judgment.

In other words, the Bill says to us, “Parliament, decide now and sign this blank cheque, and at some future date as yet unknown some safeguards may be considered.” That is wholly unsatisfactory. That will be too late. The deed will have been done. We will have changed the law. We will have crossed the Rubicon, from killing people being illegal to killing people being legal. That is not doing justice. We are here to protect the most vulnerable in our society, not to legislate to kill them. This Bill is not merely flawed; legally and ethically it is totally unacceptable and we must reject it.

Sustainable Development Goals

Fiona Bruce (Congleton) (Con): I welcome the SDGs. They take a more holistic approach to development, addressing the root causes of poverty and inequality to bring transformative change that will leave no one behind. Significant achievements have been made on many of the MDG targets, but progress has been uneven. As the UN Millennium Development Goals report of 2015 states:

“Although significant achievements have been made on many of the MDG targets worldwide, progress has been uneven across regions and countries, leaving significant gaps. Millions of people are being left behind, especially the poorest and those disadvantaged because of their sex, age, disability, ethnicity or geographic location.”

It is really important that we concentrate on the poorest of the poor wherever they live in the world. I am thinking here of the Dalits, who are below caste level. One of the many jobs that they undertake is to go out at night—they are not even allowed to go out during the 

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day—and clean up human excreta with their hands. I am talking about those kinds of people who are the poorest of the poor. We must not leave behind those in middle-income countries—the minorities and the ethnic groups.

Before I turn to the specific points that I want to draw to the Minister’s attention, I want to comment on how encouraged I was this week during a meeting of the International Development Committee where witnesses from international non-governmental organisations and civil society and campaigning representatives voiced such strong support and enthusiasm for the SDGs and for the process by which they have been developed. The wide consultation seems to have brought about a real buy-in for the approach that the SDGs encourage. I am talking about joint working between donor and donee countries, NGOs and civil society, and the real focus on addressing the underlying causes of poverty. That focus is both people and planet-centred and promotes economic growth while ensuring that development is sustainable for the earth’s resources. It is about how the world can work together and it is really exciting. I pay tribute to all those in our Government who are involved in those negotiations.

I wish to raise two specific points that I mentioned earlier—I am sure the Minister did not leave the Chamber just because of that. DFID is undergoing a review of how it structures grants and its relationship with civil society. I wish to highlight the advantage of rebalancing more funding away from large international, institutional NGOs towards those that operate at local partnering level. The power of local groups to mobilise communities, shape people’s values and build a sense of identity is immense, and there is growing understanding that in certain communities, granting aid to large organisations can sometimes—not always—harm rather than help.

A study of one community in Pakistan by Masooda Bano points to the fact that large grants to non-native organisations can, on occasion, disincentivise a community from using resources that it already has, and effectively weaken the latent energy and initiative that can be a community’s greatest weapon. The way that funding is structured can make a significant difference to its effectiveness. There are areas where small grants over a long period of time could be preferred over up-front large grants. Creating more flexibility for how aid is structured can bring better returns for fewer resources invested.

For example, Tearfund has told me about a community in Okulonyo in northern Uganda where a local faith-based charity launched a project of advocacy training and community mobilisation in 2011. The community has been transformed and empowered. It has mobilised and lobbied its Government for much needed aid and infrastructure projects including health services, water pumps and roads. For an investment of $330,000 it has been calculated that a benefit of almost $10 million has been received by that community. That is a return of $30 dollars for every $1 put in—even Warren Buffet would be pleased at that.

I have already spoken to DFID Ministers about how much value for money small grants to small organisations can provide, and I urge Ministers to look again at that. I hope the Minister will confirm that small organisations are being engaged in DFID’s civil society review, just as larger ones are. In the past DFID has perhaps not 

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worked as much with local, embedded partners as I would like it to do in the future, and that is important. Yes, oversight is harder and the risks might be greater, but the gains can be disproportionately beneficial. I urge DFID to be entrepreneurial about that.

Let me turn to the importance of leaving no one behind. Earlier, I read out a list of causes for which people can be left behind, whether due to gender, geography or those in ethnic minority groups such as the Dalits. This is a paradigm shift: leave no one behind regardless of their ethnicity, gender, geography, disability, race or other status. That is admirable.

However, I believe that one word and cause of inequality is missing from that group: belief. No one should be left behind because of what they believe, whether they have any faith or none. Ministers know that I have raised on a number of occasions my concern that an underlying cause of poverty is a lack of freedom of belief, freedom of thought or the freedom of speech that can follow, resulting in conflict, violence, loss of opportunities, homelessness, displacement and more. If we are determined to tackle the underlying causes of poverty, we cannot leave that behind. Fostering religious freedom should be seen as a priority not only for tackling conflict once it has happened, but to prevent it before it takes place and to promote stability.

As Brian Grim argues in his book, “The Price of Freedom Denied”, religious freedom fosters respect towards others with a different belief in the same society, therefore reducing tensions. I would go further than that, because I think it will contribute to the achievement of our SDGs. For example, goal 5 promotes the rights of girls and women. So much harassment of women is linked to religious discrimination against women—the respected report by the Pew Research Centre states that such discrimination takes place in 32% of countries. Goal 8 is about economic welfare, and employment discrimination as a result of someone being involved in a faith group is rife, as we see in countries such as Iran.

Let me give another example—sustainable development goal 16, the promotion of peace, as well as sustainable development goal 8, economic growth. In countries where freedom of belief is not respected, conflict disrupts economic activity. Foreign and local investors become reluctant to invest, jeopardising sustainable development and economic growth. As businesses corroborate, an opportunity to invest, conduct normal business practice and prevent industries from struggling is weakened. Egypt’s tourism industry, for example, has faced such challenges. By promoting and practising freedom of belief, a path to security and economic well-being can be laid.

I urge Ministers to consider this and to engage faith groups in their civil society review. Is it not time to review the Department’s faith partnership principles? Finally, would DFID consider engaging in the joint learning initiatives on faith and development instituted by some of the major international NGOs working on poverty relief, such as Tearfund, CAFOD and World Vision?