My Lords, it is a pleasure to follow the noble Viscount and the noble Lord. I rise briefly to voice my support for the Bill and its aims.
Lasting powers of attorney are invaluable tools for people who are likely to lose capacity and the ability to convey their wishes, allowing them to have control over their future lives. We talk about keeping our affairs in order most frequently through the lens of our finances and property; there is much to be done in terms of safeguarding against fraud and financial abuse, and the Bill will do much to address those concerns. However, we do not talk often enough about the equally important—but, I expect, somewhat less well known—option of a lasting power of attorney for health and welfare. Just as you can nominate someone to make decisions about your finance and property if you lose capacity, you can nominate someone to make those same decisions in health and care settings. My sister and I had to do that for our mother, and it was very successful, because she had thought long-term in advance.
The provisions in the Bill that allow for LPAs to be completely digital are important, as they will remove barriers to completing them by streamlining the process. It will reduce the time it takes to complete the process and for the Office of the Public Guardian to complete its necessary checks, which will also give people greater confidence in the process.
While the Bill is necessarily focused on the reform of powers of attorney, I want to highlight a related issue that is also in need of a modest but important digital reform. Living wills, known officially as advance
decisions to refuse treatment, allow a person to say now if there are treatments that they do not wish to be given in the future, should they lose the capacity to communicate. Like LPAs, they were formalised by the Mental Capacity Act 2005 and, under the law at present, must be signed using a so-called wet signature. This prevents them being fully digital, which in turn makes these important documents very difficult to share across care settings and to be visible when it matters most.
The impact of this is clear. Many people are going to great lengths to consider and record their end-of-life wishes but, very sadly, often they are not known about due to the paper forms being lost or not properly uploaded to a medical record, or due to their local area’s digital record systems not allowing them to be shared. This can be of particular concern when a person’s records might be shared between GPs, hospitals, community care, ambulance services or care homes, for example. In real and simple terms, it means that sometimes people are given treatments that they would not want, all because the system by which records are shared has let them down.
The impact for the individual can be catastrophic and result in a much more complicated bereavement for loved ones. Compassion in Dying, a charity that supports people at the end of life to record, discuss and communicate their wishes, has asked me to raise this point at Second Reading. It too is fully supportive of the moves to reform powers of attorney, but urges us as legislators to consider making similar moves in the near future to ensure that living wills can benefit from the same reforms and so make it easier for our wishes to be respected if we ever lose the ability to make or communicate those wishes for ourselves.
According to the people supported by Compassion in Dying, the very fact that living wills are difficult to share, and the concern that they might not be available to healthcare professionals when they are needed most, is a barrier to even starting the process. Compassion in Dying says:
“We are convinced that enabling digital signatures on Living Wills in a safeguarded way would transform the experiences of thousands of dying people in the UK. Being able to know what matters to each person is a central part of high-quality care: allowing for fully-digital Living Wills would make this so much easier for so many”.
I welcome this Bill and its noble effects, and hope that the separate but equally important issue of living wills can be addressed in the very near future.
1.43 pm