[Relevant documents: Fifth report from the Science and Technology Committee, Session 2004-05, HC7, on Human reproductive Technologies and the Law and the Government’s response thereto, Cm 6641; Eighth Special Report from the Science and Technology Committee, Session 2004-05, HC 491, on the Inquiry into Human Reproductive Technologies and the Law; the Department of Health departmental report 2005, Cm 6524.]
This Estimate is to be considered in so far as it relates to a grant-in-aid to the Human Fertilisation and Embryology Authority (Resolution of 27 June).
Motion made, and Question proposed,
That, for the year ending with 31st March 2007, for expenditure by the Department of Health—
(1) further resources, not exceeding £37,417,520,000, be authorised for use as set out in HC 1035,
(2) a further sum, not exceeding £38,276,451,000, be granted to Her Majesty out of the Consolidated Fund to meet the costs as so set out, and
(3) limits as so set out be set on appropriations in aid. —[Liz Blackman.]
I welcome the opportunity to debate this important and topical issue on the Floor of the House. I once again pay tribute to the former Chairman of the Science and Technology Committee, the hon. Member for Norwich, North (Dr. Gibson), and members of the previous Committee on producing an extremely thorough and thoughtful report shortly before the 2005 general election.
Few areas of medical and social policy command greater interest or promote greater controversy than research and clinical practice in the area of human reproductive technologies. Producing the report was in itself a considerable challenge. It is no secret that at least half the membership of the Committee disagreed with the report. Well, some people disagreed with it, and it was a real challenge to agree on a final report to bring before the House. That reflects the divisions not only in the Committee but in society on these issues. There would have been something strange about an all-party Committee that did not have significant disagreements on this subject.
In spite of the difficulties in arriving at a consensus, the Committee was right to tackle the question. It is surely the job of Parliament to lead debate and not to shy away from key issues of public concern, however divisive they may prove to be. I would argue that this is a good example of the Select Committee system in operation: not simply scrutinising but helping to influence policy.
The Committee’s inquiry began in late 2003. It began because the Committee had serious concerns about the Human Fertilisation and Embryology Authority. The Government said that they would keep the HFEA under review. The Science and Technology Committee thought that that was not good enough. The Chairman said that the HFEA should be reconnected with the 1990 legislation. That was one of the reasons behind the inquiry. A year later, in 2004, the Department of Health announced its own review of the Human Fertilisation and Embryology Act 1990. The Department sensibly waited for the Committee to produce its report before issuing a consultation alongside its response in August 2005.
The results of the consultation were published in March of this year, and further announcements are promised for the summer. The Government should be commended for the way in which they have responded to the Committee’s work. However, after a lengthy period of consultation—it is well over a year now—I think that the time has come for the Government to come forward with firm proposals, and, I hope, to produce a Bill in draft form.
A Bill is required anyhow to facilitate the creation of the new regulatory authority for tissue and embryos—RATE—from the Human Fertilisation and Embryology Authority and the Human Tissue Authority, which the Government have pledged to do by 2008. I commend to the Minister a draft Bill which would give the House an opportunity to debate and scrutinise some of the recommendations that will emerge from the Government’s consultation. I hope that today’s debate, and the Minister’s appearance before the Science and Technology Committee next week, will stimulate some decision making on the role of the new authority and related issues.
Before tackling some of the more controversial aspects of the Committee’s report, I shall outline the boundaries of the debate. I shall do so by stressing areas of agreement on the fundamental issues, which are unlikely to change. Both the Government and the Committee agreed with the gradualist approach to the status of the embryo adopted by the original Warnock Committee. I acknowledge that there are those who may disagree with this approach. However, I do not think that there is any realistic chance of it being dropped now for the purpose of legislation—so I think that we must start with the premise of the gradualist approach.
I think that there is general agreement that assisted reproduction is a legitimate area of interest for the state. It is only the extent of that interest that is in question. That in vitro fertilisation is now a common clinical procedure is not in question. The Government agree that legislation should take account of consequent changes in public perception, and that is what the debate is all about. The question is: how far are we prepared to accept assisted reproduction being regulated like other medical procedures, and what additional safeguards are required to protect the human embryo and the future child?
Other points on which the Government agree with the Committee are that there is a need for greater clarity in the policy-making functions of HFEA, and that legislation covering abortion should be removed from the Human Fertilisation and Embryology Act. I will return to that point later. The Government also agree with the Committee that there is a need for some rationalisation of existing bodies. These areas of broad agreement provide a solid foundation for debate on other matters of principle, such as the extent and nature of Government intervention in reproductive health.
There are, of course, areas of disagreement. That is not surprising. The Committee made 104 recommendations. It is interesting that the Government rejected very few of them outright. Indeed, rather than do so, the Government chose instead to consult more widely to gauge professional and public opinion. Not surprisingly, there was disagreement over the Government’s use of the precautionary principle. I am rather pleased that my hon. Friend the Member for Oxford, West and Abingdon (Dr. Harris) is not here to make a speech. He is delayed and has sent his apologies to the House. We have just spent a considerable amount of time discussing the precautionary principle in a new inquiry, and we have not come to any sensible conclusion. The hon. Member for Braintree (Mr. Newmark) nods from a sedentary position. The Committee’s recommendation to include the Human Genetics Commission in the new regulatory body was a rationalisation too far for the Government, but I am sure that the hon. Member for Norwich, North would like to take up that issue later, because it was a fundamental proposal in the Committee’s report.
My hon. Friend the Member for Oxford, West and Abingdon is in Committee at the moment and there was a vote at 4 o’clock, which is why he is delayed. I know that he has given his apologies to Members—in case there was some concern over his health.
The Government disagreed with the Committee’s argument that there was a mismatch between the protection afforded by legislation to an embryo created in vitro before implantation and one at a later stage of development. The Committee was pointing out that allowing the greater use of pre-implantation genetic diagnosis, or PGD, may mean that the demand for abortions falls—particularly in the case of abortion on the grounds of foetal sex, which is technically illegal but difficult to police. Perhaps the greatest area of disagreement was over the future role of Parliament in regulation. I will return to that a little later.
The Committee made it absolutely clear that it is important for children to be brought up in a loving environment. A significant number of children are brought up in incredibly abusive and unhappy environments. I would not wish to speculate on a child being brought up in a single household, but I agree with the hon. Gentleman in that, where possible, my personal view is that I would like there to be two parents—a male and female—within the household bringing a child up. That does not preclude other methods of rearing, which are perfectly satisfactory and which have proved to be helpful in terms of developing good human beings as far as society is concerned. I will return to that issue later.
On many of the key issues, the Government agreed to consult further. The results of that exercise were published in March 2006 as a summary of the views expressed, with no accompanying explanation of lessons drawn. I am looking forward to hearing from the Minister how helpful the exercise was, although if my interpretation of the volume of the published responses—there were 535—is correct, it would be fair to say that a variety of views were expressed. It was very difficult to draw firm conclusions, but perhaps the Minister will add her comments later.
Judging from the views expressed in Committee, I suggest that the extent of disagreement was never in doubt. However, disagreement should not be an excuse for inaction. Sooner or later the Government must take a view and convince Parliament and the public of the merits of their proposals. There were issues of concern to members of the Committee, and I am sure that right hon. and hon. Members will highlight their own, so I will not attempt to raise anything other than what I consider to be one or two crucial areas, for which Government proposals must be forthcoming.
First is the issue of sex selection for social reasons, which is highly contentious. I am sure that hon. Members on both sides of the House will have different views about it. The Committee could find no adequate justification for prohibiting the use of sex selection for family balancing, but sensibly called for further work to establish the demographic input of such a policy. The HFEA has also consulted on the issue and advised against it. The Government invited views but announced no plans to change their position.
I confess that the Government might be right on this occasion, and that such a policy might well give rise to unforeseen difficulties, so I would want to see convincing evidence of the potential impact before being convinced of the need for change. I suspect that the demand for sex selection is actually quite low—much lower than many hon. Members believe. We should not forget that it currently requires people to go through incredibly difficult and costly treatments to get a child. However, we have to plan for a time when there is a pill that destroys male sperm or ensures that a male embryo could not implant, so the Government need to be clear about how they would prevent sex selection, and they cannot dodge the issue in any draft Bill, or when they bring their conclusions from the consultation before the House.
A second area of contention between the Committee and the Government surrounds the welfare of the child provision in the Human Fertilisation and Embryology Act 1990. The Committee argued that the requirement for those providing fertility treatment to have regard for the welfare of the child, including the need for a father, was unjustified. It held that the provision was not only discriminatory towards the infertile and some sections of society, but that it was
“impossible to implement and…of questionable practical value in protecting the interests of children born as a result of assisted reproduction.”
Quite apart from the difficulty of interpreting what the welfare of the child means in practice, I cannot see a case for the state interfering in the reproductive decisions of parents because they happen to be infertile, when it makes no such attempt in respect of anyone else. For example, there is no welfare of the child provision for other fertility treatment such as vasectomy reversal. So, if the Government are committed to maintaining a welfare of the child provision, I hope that they are prepared to spell out exactly how it should be applied in practice. I look forward to hearing the Government’s latest thinking on what is, admittedly, a very difficult issue.
A third area is the allowable use of pre-implantation genetic diagnosis—PGD—and this needs serious clarification. At present, it is the responsibility of the HFEA, but paragraph 251 of the Committee’s report describes the authority’s policies and licensing decisions on pre-implantation tissue typing as “highly unsatisfactory”. Lord Winston, I suspect, used more graphic language. Certainly, no evidence was produced by the HFEA to support its claim that PGD would be used for “trivial” purposes, and the fact that the Government have agreed that it would be preferable if the parameters for PGD were more clearly set out in law is a tacit admission that the Committee was right.
For many, PGD provides a welcome opportunity for parents to reduce or eliminate the risks of passing on hereditary conditions and diseases such as Duchenne muscular dystrophy, Huntington’s and cystic fibrosis. The Committee argued in line with the gradualist approach that if an embryo is to be destroyed because it may carry a serious disease, it is better to do so when it is just a few days old than at 24 weeks. However, I fully accept that those who believe that all abortion is illegal and wrong would not subscribe to that view.
The crucial point to emphasise is that new technologies are developing quickly and, as a consequence, the HFEA is being required to take decisions with an ethnical dimension and with serious consequences. For example, the HFEA recently ruled that PGD could be extended to testing for certain types of cancer, and only last month we heard about a new technique developed at Guy’s and St. Thomas’ hospital in London that may enable thousands of diseases to be screened for as existing tests are improved significantly. The key change is that whereas the original PGD screening was for known diseases or hereditary conditions, the new screening is for possible development of conditions later in life, and that requires a substantially different approach from the present one.
I have enormous sympathy with that point. I spent much of my professional life working with children who had sensory impairment and physical disabilities. All of them were precious to their parents, despite the fact that many had huge problems in managing their condition. However, I suspect that many of those parents, if they had had the opportunity to screen out some of those difficulties, would have done so. The question that the Committee rightly asked, and that the Government have to answer, is: should parents in that situation have the choice? We hope that the Government will adopt a fair position on that question.
Is the hon. Gentleman not concerned? Once we start down that slippery slope, where does it all end? I am sure that parents would much rather have a very intelligent child. Many would hate to have a child who grows up to be a politician. They might want a child with blue eyes. That is getting into the realm of eugenics—producing the perfect child that the parent wants. I do not want a world that has no one with any sort of disability, because such people have all been screened out and denied the chance to live.
Few hon. Members would disagree with the hon. Lady. I would go further and say that what we have seen in parts of the United States, where deformities, in particular deafness, have been screened in because the parents want their child to mirror their own condition, is absolutely horrendous.
Science is getting to the point where we have an amazing number of techniques and can do amazing things, but at that point we have to stop and to ask, “Is this what we want?” The Committee was right to ask some of the questions and it was right to say to the Government that we simply cannot let such matters drift on. The Government are there to make some of those decisions. The Committee’s recommendation about a bioethics committee is relevant. The hon. Lady is correct: not everyone is comfortable with the new possibilities or with the fact that it is the HFEA, which has only limited input from professional ethicists, that is taking those decisions. That worries me. In my view that is the job of Parliament—but I know that many people would disagree.
The new treatments bring their own ethical dilemmas. The value or rights of an embryo have to be weighed against the potential benefits of avoiding certain conditions; equally, the impact of such activity on existing people with such conditions must be taken into account. Although there are arguments over what diseases and conditions are serious enough to warrant screening, there is a more fundamental argument about who should make those decisions. The Committee argued that Parliament should set the ethical parameters for the use of PGD and other such procedures, and that regulators should then be responsible for ensuring the highest possible clinical standards.
I fundamentally agree with that position. Parliament, rather than unelected regulators, should have responsibility for establishing the ethical framework for the use of PGD and other procedures and for endorsing guidelines as necessary. The Committee proposes a new parliamentary Standing Committee on bioethics that would make recommendations on the need for legislative changes and scrutinise any secondary legislation in the field. Such a system has been adopted throughout Europe and I commend the principle to the Minister for serious consideration.
Of course, such an approach to bioethics would necessitate changes to the existing regulatory framework, which is a fourth area of contention between the Committee and the Government. The Committee recommended a three-pronged approach on a new regulatory framework to give greater clarity to existing legislation and thus allow medical professionals to get on with their jobs without the bureaucratic burden of frequent applications to the regulators.
The Committee’s call for a new human genetics, fertility and human tissue commission to replace the HFEA, the Human Tissue Authority and the Human Genetics Commission appears to have been rejected in favour of a model that combines the HFEA with the HTA. That body will retain the HFEA’s licensing responsibility, although that is a matter about which the Committee was critical. I hope that the House will debate the two sides of that argument today.
My final point is about abortion time limits. Paragraph 308 of the Committee’s report recommended that a Joint Committee of both Houses should be established
“to consider the scientific, medical and social changes in relation to abortion that have taken place since 1967, with a view to presenting options for new legislation.”
It is more than 15 years since the legislation was last reviewed by Parliament. We now know a lot more about the foetus and have gained more evidence about the factors underpinning the 24-week limit. There is growing pressure from those on both sides of the abortion debate to look again at developments since 1990 to determine whether a change to the existing legislation is warranted.
Early-day motion 2379 was tabled by the hon. Member for Morecambe and Lunesdale (Geraldine Smith) in support of that, and it had been signed by 59 Members at the last count. Its signatories have all viewpoints; indeed, I signed it myself. The head of the Catholic Church, Cardinal Cormac Murphy-O’Connor, has recently called for the time limit to be reviewed. All that shows that there is a feeling in the House and the country that we should at least review the scientific evidence and put it before the House, rather than simply pretending that things are as they were in 1990—or, indeed, 1967.
Does the hon. Gentleman agree that the matter goes much wider than just the Catholic Church? There is a feeling among people in the country and MPs that a debate should take place. The Government should be leading the debate and putting legislation before us.
I agree that the matter goes much further than the Catholic Church. I am not a practising Catholic and do not come from that particular lobby, although I have a strong Christian background. However, this is not about religion. When I become Chairman of the Science and Technology Committee, one of the first things that we did was to ask the House of Lords to fulfil the recommendation of the former Committee by setting up a Joint Committee to review the science and determine where we were on that.
With the greatest respect to the hon. Gentleman, I do not know the answer to that. Does the fact that we now have better imaging of the foetus at 24 weeks represent a substantial change from the situation 10 or 20 years ago? Of course, people such as Lord Winston claim that the foetus is exactly the same at 24 weeks as it was 20, 30, or 40 years ago. However, medical technology, and our ability to maintain life at 24 weeks, have changed. The purpose of having an inquiry was to examine such matters and to try to ensure that we put on the table the question of where the science and technology were, and how we could tackle the key ethical questions so that Parliament could debate and discuss that and the Government could take action, if necessary. That is what Parliament should be doing.
Does the hon. Gentleman not appreciate—I am sure that he does—that many people are deeply concerned about the idea of one operating theatre struggling to keep alive a 24-week-old foetus child, while in another operating theatre down the corridor, a 24-week-old foetus baby is being terminated and perhaps left to die on the operating table? That causes great concern to many people across the political and the religious spectrum.
I have deliberately tried not to enter into a debate of pure emotion—[Interruption.] That may well be fact, but the hon. Gentleman does not know the circumstances behind either of those cases. To hold that view is grossly unfair when one is unable to examine the circumstances behind why a woman is aborting at 24 weeks. If the hon. Gentleman believes that any woman does that lightly, I am sorry, but I profoundly disagree with him. It is important to examine the core issues, rather than just stating our own personal, emotive views.
I fundamentally agree. At the end of the day, it is certainly not for white, middle-class males in Parliament to tell a lady in Birmingham, Brighton or Newcastle what she should do in such difficult circumstances. What the Committee and I are saying is that, given that this issue has not been examined for 16 years, is it not time to examine the science and the technology and put it objectively before Parliament? This issue may well be dealt with through a private Member’s Bill, but I point out, with the greatest respect, that it commands huge interest in the country, so it is up to the Government to take a lead on it, rather than an individual Member. Such a Member might introduce an ill-considered Bill that is purely emotive and does not deal with facts.
But does the hon. Gentleman not agree that the unborn life has an equal right to that of the mother, and that that must therefore be taken into consideration? However, it is important that we focus on the technology. Technology has improved in the past 16 years, which is why the House should consider reducing the age of termination from 24 weeks to 20 or 18 weeks. We should investigate this issue through technology and science.
I am grateful to the hon. Gentleman for that intervention, and I hope that he will forgive me if I do not stray into a debate on ethics with him. One wise Committee recommendation was that the House should have a bioethics Committee. We are moving into territory that, even five years ago, we did not believe we would enter. It is important that some of these issues be discussed within that framework.
Our Committee suggested to the House of Lords that we examine the science. It said “no”, and that it would prefer to have the matter dealt with by an ad hoc Committee of the whole House. I approached the then Leader of the House to ask for such a Committee, but was refused. This issue will not go away. It is important that the Government think again and at least set up an ad hoc Committee of the whole House to look at the facts and put them before Parliament. At that point, we can bring in the ethical, as well as the scientific, debate in an effort to resolve these issues.
I commend this excellent report to the House, and I look forward to the remainder of the debate.
I welcome this extremely important debate. The matters before us are complex and they raise numerous deep moral and ethical principles that are highly emotive, as we have already seen, controversial and often divisive—so much so that the Science and Technology Committee was split down the middle when it discussed the report. Five members were for the report and five were against. I was unable to support many of the report’s recommendations. In their response, the Government adopted a much more measured and cautious approach, which I welcome.
I find the attitude adopted by some representatives of the scientific community quite chilling. They appear to believe that the only restrictions that should be placed on their activities are the limitations imposed by their own scientific capabilities. They display a total lack of concern for the moral, ethical, religious and social issues involved, and view those who seek to restrict their activities as modern-day luddites out to wreck their scientific looms. In return, I view those people as 21st century Dr. Frankensteins. They reaffirm my conviction that we must have a strict regulatory regime in place to govern their activities.
I said earlier that this is an important debate. We are discussing the creation, the scientific manipulation and the taking of human life, and the laws applicable to those activities. I shall restrict my remarks to one aspect of the report, which I feel has not been adequately dealt with by the Select Committee or the Government in their response. There is so much in the report that I could speak for three hours on the various recommendations, but I choose to restrict my comments to one area about which I have concerns—the destruction of human life by means of abortion.
Let me make my personal position clear. I would never have an abortion, or I hope I never would, but I do not want to drive women back to back-street abortions. I realise that one cannot have simplistic views; the issue can be complex. Women can be under huge pressures to have abortions. Sometimes it is not an informed choice. It is not the woman’s right to choose. She is often under pressure to have an abortion.
As has been said, there is growing concern about the abortion law in the UK. Our current law is out of date and is in urgent need of reform. I know that there is widespread public support across the country for that view, not least among those in the medical profession who have the task of killing perfectly formed, healthy foetuses, particularly when they perform abortions close to the 24-week limit.
Yes, there was so much to discuss. We see today the emotions that are aroused when abortion is mentioned. It is sometimes difficult to have a sensible debate because the pro and anti-abortionists are at each other’s throat, but it is time to have that debate.
The legalised taking of human life under the current legislation has not been debated or amended for the past 16 years. Recommendation 77—
Does my hon. Friend agree that this debate concerns human reproductive therapies and the law, not abortion? Abortion is covered by entirely separate legislation. It is fine to debate abortion, but it is a separate debate and should be kept quite separate.
I will come to my reasons for mentioning abortion. Recommendation 77 of the Select Committee, on which my hon. Friend served, states:
“We call on both Houses in the new Parliament to set up a joint committee to consider the scientific, medical and social changes . . . that have taken place since 1967, with a view to presenting options for new legislation. This committee should be broadly based and should include nominees from the Commons Select Committees for Science and Technology and Health and the Lords Science and Technology Committee.”
Recommendation 78 states:
“We recommend that any new legislation introduced to amend the HFE Act should not include abortion, which should be dealt with by a separate Bill.”
I have no problem with that. However, I think it fair that I should comment, given that we mentioned abortion and the need for a Joint Committee in our report.
The Government say in paragraph 106 of their response that they accept recommendation 78, but their response to recommendation 77 is unsatisfactory. Paragraph 105 states:
“The Government has no plans to change the law on abortion. If a joint committee is set up to look at this issue, the Government will consider its recommendations. However, it is accepted Parliamentary practice that proposals for changes in the law on abortion have to come from back bench members and that decisions are made on the basis of free votes, with members and peers voting according to their beliefs and values.”
The hon. Lady might remember that the initial legislation, the Abortion Act 1967, was introduced as a private Member’s Bill, but the Government of the day gave it time in order that it could be enacted. Does she accept that during the passage of that Bill and of the Human Fertilisation and Embryology Act 1990, huge pressure was put on people on both sides to come to a certain conclusion?
I think that the Government should be leading this debate, because there is concern across the country. It is not just about allowing parliamentary time if a private Member’s Bill comes up—they should be making time properly to discuss the issue. Before doing so, they should of course have all the available scientific and medical evidence on the changes that have taken place in society since the Abortion Act 1967 and the most recent amendment to the legislation in 1990.
The current law on abortions was established in the Abortion Act, with a time limit for abortion set at the 28th week of pregnancy. That was reduced to the 24th week by amendment to section 37 of the Human Fertilisation and Embryology Act. The central criterion underpinning the time span was that the foetus would not be able to survive outside the mother’s womb at that stage of its development. Following advances in technology and medical care, there is now strong evidence that foetuses are far more developed at a much earlier stage than was previously thought, so that they are able to survive outside their mother’s womb as early as 18 weeks. That undermines the key principle in relation to the formulation of the time limits. When life can be carried on independently of the mother, surely the foetus, or baby, has human rights of its own.
The Government state in their response, however, that they have
“no plans to change the law on abortion.”
Does that mean they have already considered the available evidence and concluded that they are perfectly happy with the current legislation and see no need for change? If so, they should be honest and say so, giving their reasons for reaching such a conclusion. Or do they believe that all the issues surrounding this matter need to be more fully examined? If so, why have not they supported the Committee’s recommendation on the establishment of a Joint Committee? Or do they believe, as they seem to suggest at the end of paragraph 105 of their response, that this is nothing to do with them and that it is up to Back Benchers to sort it out because that is what happened in the past? If so, I would accuse them of abrogating their responsibilities on this issue. While they are correct in their judgment that it is a matter of personal belief and conscience, and must therefore be decided by a free vote in both Houses, that does not absolve them of their responsibilities and prevent them from leading the debate.
I am sure that Ministers and Back Benchers are well aware that this issue will not go away and that pressure for a review of the law on abortion will continue to grow. I would welcome the Minister’s response to the points that I have outlined.
I am grateful to be called in the debate, which takes me back to 1990 and all the issues that were debated then. I went underground for the next 10 years, having had rather too much of them because they were exceptionally difficult and took a lot out of one as well as much time. However, they are exceptionally important and evergreen.
I want to focus on two issues in relation to the Science and Technology Committee’s consultation and report. I begin by commending the fact that the consultation’s terms of reference were comprehensive and rigorous. The Committee consulted extensively— online, through oral submissions and by encouraging written submissions. It was a truly committed initiative, which extended far beyond the usual time schedules involved in such consultation exercises. A little bird told me that the Committee even went to Rome to consult the Vatican. I thought that that was a good move, and I do not speak as a Roman Catholic. It must have been the first time in history that a Select Committee took evidence from the Vatican.
The report is, sadly, not to be universally celebrated and it is worth remembering from the start the amount of internal and public disquiet that surrounded its publication. The Committee was split down the middle, as the hon. Member for Morecambe and Lunesdale (Geraldine Smith) said. I commend her bravery in raising an issue that perhaps other hon. Members would have preferred her not to raise. It was right and proper that she did so. Only the vote of the distinguished Chairman, the hon. Member for Norwich, North (Dr. Gibson)—
To add further clarification, the vote on the report took place in the last days of the previous Parliament, in the run-up to the general election. Many of the members who opposed the report could not be present at the vote. I am sure that the Chairman accepts that five members supported the report and five opposed it.
Again, I am grateful to the hon. Lady. We all know what pressures are on Committees to reach a conclusion, and the period just before a general election is perhaps not the best time to do so. The hon. Lady has made what happened clear.
The formal minutes of the meetings that cover the approval of the report are a record of the dissent. In the days that followed its publication, the nation and media were almost unanimously up in arms over issues such as animal-human hybrids, germ-line manipulation, reproductive cloning, social sex selection and other hugely controversial proposals, which form part of the report’s recommendations.
Further to the validity of the recommendations—104 in all—the next point to consider is the extent to which they reflected the thrust of the evidence that the Committee received during its year’s extended consultation. For those who attended the oral evidence sessions—I am the first to admit that I did not—read the written evidence and followed the online consultation, it is impossible to accept that the Committee’s controversial recommendations relate in any way to the evidence that it received from the vast majority of participants.
A trio of postgraduate students took time to analyse the material and concluded that the weight of evidence was, for the greater part, conservative in its content and in favour of maintaining the status quo, not deviating significantly from the consensus reached in 1990 on the Human Fertilisation and Embryology Act. The rationale behind the report was the intention to bring the Act up to date in the light of scientific advances. Technology might move fast, but that does not mean that our ethical concerns or the philosophical underpinnings of society and the law have altered radically—as the report would have us believe—if, indeed, they have altered at all. The Act needs to be reconnected not with modern science but with the interests and values of society at large. Some would even argue that those values have become more restrictive than they were at the time of the Warnock report, not least because many developments that were not anticipated at the time have been received with huge distaste by the public. Social sex selection is a classic example. While it attracts support in the maverick Science and Technology Committee report, 85 per cent. of public opinion polls register total opposition to such a proposal.
Warnock is cited by the report, but defended on a cherry-picking basis. The protection for the embryo enshrined in the original Act, for example, has been completely bypassed. On what justification? It is on the opinion of five Members of Parliament. Cherry-picking is applied even more openly to ethical opinions and citations. The continued references to John Harris, Julian Savulescu, Emily Jackson and others who hold similar beliefs are nothing more than a blatant endorsement of libertarian minority opinions.
The philosophical basis of the report is a selective mixture of some rights and harm principles. The rights, however, are limited to the reproductive rights of the adult, and leave little space for the rights of children, let alone the broader rights of society as a whole. The harm principle is limited exclusively to physical harms, and there is no wish to engage with broader, deeper concerns. That is to be regretted.
I wish to speak about the rights and welfare of children, not least because the matter has been in the news recently, perhaps because of the publicity given to the statements made by the hon. Member for Oxford, West and Abingdon (Dr. Harris), who is now in his place, having not been present earlier in the debate. I understand that he wishes to remove from the Act part of section 13(5), which refers to the welfare of the child. I have to admit that I was one of those responsible for the inclusion in the original Act of the need of a child for a father, and I shall read that subsection to the House:
“A woman shall not be provided with treatment services unless account has been taken of the welfare of any child who may be born as a result of the treatment (including the need of that child for a father), and of any other child who may be affected by the birth.”
It was I who encouraged my hon. Friend the Member for Spelthorne (Mr. Wilshire) to table a very small amendment on that issue. It was the only one that we on this side of the argument managed to get accepted by the House on that occasion. I might add that that was the only time that I have been a Teller and been on the winning side. In fact, from that point of view, the whole of my parliamentary career has been an absolute disaster. However, I was very proud of that one small amendment, because it meant a great deal.
Perhaps that is why the hon. Member for Oxford, West and Abingdon is now trying to get the provision removed. He is, in effect, recommending the deliberate creation of fatherless children, whether to single or lesbian women, on the basis that
“including the need of that child for a father”
is a discriminatory phrase that should not have been included in the Act in the first place. However, it was obvious, when the Act was passed, that the wise intention of Parliament was to place the welfare of the child at the centre of our focus. The welfare of the child obviously extended to his or her right to a father. That is what the House voted on and for in those days.
I am sure that the hon. Lady was not chastising me for not being present in the Chamber, as I had told both Front Benches and the Speaker’s office that I was voting in a Select Committee. What evidence does she have that the welfare of the child is protected by this measure? Can she cite studies that show that children of lesbian couples, conceived by donor insemination, or of solo parents—women who specifically seek pregnancy when they do not have a partner—are damaged in that way? The Select Committee found that the evidence was on the other side, and that the provision was therefore unnecessary.
I thank my hon. Friend. I am grateful, however, that the hon. Gentleman has made his position clear. I could produce evidence, and evidence has been provided, but I do not have it with me this afternoon. As a mother of three and grandmother of seven, I, like most of my constituents and the majority of people in the United Kingdom, believe that it is better and right that a child has a mother and a father wherever possible, and that it is wrong to create a new life artificially without a mother and a father who will be in that child’s life from the very beginning. We all know of examples of children who have been brought up by single parents, either male or female, who have done a splendid job, and I do not knock that in any way. However, the artificial creation of such a situation is wrong. As we are allowed to express our view in the House, I hope that I have done so clearly.
I believe that the child is discriminated against by writing out the need for a father. Were we to take the hon. Gentleman’s position to its extreme, it could be argued that a preference for a mother is also discriminatory. Will we also see attempts to write out the child’s need for a mother from the Act? Will we next ask for the reproductive rights of single men to be protected? Do they, too, have a right to have children, without the need for a mother? I ask all those questions with my tongue in cheek.
Does the hon. Lady agree that it is not just a question of evidence but of common sense? Most people in the country would think that it makes sense to start a child’s life with a mother and a father. Of course, there are terrific single parents who do a wonderful job. If we are looking for a basis to create a child, however, surely it should start with two parents—a mother and a father.
Does my hon. Friend agree that there is a deep strain of antipathy towards co-parenting on the Government Benches? When we debated the Children and Adoption Bill some weeks ago, the Government set their face completely against the principle of co-parenting, even when we argued strongly for the paramountcy of the welfare of the child. From birth through to adulthood, co-parenting is being opposed by the Liberal Democrats and the Government.
Will the hon. Lady correct the suggestion that the points of view that she expresses in this regard are confined to the Conservative Benches? Such views also find voice on the Labour Benches, and the picture is not as simplistic as the hon. Member for Peterborough (Mr. Jackson) suggests.
I agree 100 per cent. As the hon. Gentleman knows, we have worked closely on these issues for a long time. I was chairman of the all-party pro-life group for 10 years, which is a genuinely all-party group. These matters go far beyond party politics. I hope that that reassures the hon. Gentleman.
We must move outside the parameters of absurd political correctness and gratuitous gender politics, and acknowledge once and for all that a child benefits from the security of a father and a mother within a stable family environment. The original Human Fertilisation and Embryology Act enshrined many concerns about the welfare of children in that regard.
Is not the main requirement for the welfare of children, which is paramount, that they be born into a loving family—that they be wanted children, eagerly anticipated? Is it not true that children have the best chance in life, whatever the type of home into which they are born, if they are born into a home that wants them?
Of course that is true, but people who do not believe in what I am saying usually go on to say that if those conditions are not in place, it is better for children to be aborted: that they are better off dead. I would say that not all those conditions can be in place in every single case. We know of children—in our own family circles and in wider circles—who have had unhappy childhoods, but have grown up to be excellent adults and have played their part in society. We cannot guarantee those elements in anyone’s life, because life is not perfect, but if they are there, that is a tremendous bonus.
As I was saying, the original Act enshrined many concerns about the welfare of children. Many of the recommendations of the Science and Technology Committee attempt to lessen the impact of those concerns. I believe that we should resist those recommendations, and insist that the provisions in the Act are reinforced.
It is important that we are having this debate on an Estimates day. The subject is complex. The report from the Science and Technology Committee contains many chapters and much material that needs to be debated, and in the short time available today we shall not be able to do it justice. Let me say to the Minister that I hope this will be the first of many debates on the subject before we change the legislation, as we must.
When we embarked on the debate, I hoped that it would not be hijacked by the abortion issue. That is not because I do not consider the issue important. The Committee deliberately avoided debating it, however, because it had been debated so often in Government time on the Floor of the House and elsewhere in the Palace of Westminster. I rather hoped that today we would concentrate on other issues, which are not aired as frequently as they should be.
I regard my membership of the Select Committee as one of the most important duties that I perform in this place on behalf of my constituents. The Committee’s members believe that they have influenced Government thinking in a number of policy areas, and have also influenced organisations outside the House. A number of debates are taking place at present, of which this is only one.
During my time in the Committee disagreement has been rare, but the fifth report of the 2004-05 Session was an exception. It resulted in the eighth special report of that Session, which makes it clear that five of the 11 Committee members disagreed with the publication of the fifth report. That probably reflects the divided views of Members across the House, which is why we are given free votes on most of these difficult issues.
After a lengthy inquiry and prolonged discussions, the Committee met again on 14 March last year, faced with 130 further amendments to an already amended report. It was clear to me then that the report would not see the light of day, especially as we knew that Parliament was shortly to be dissolved. A great deal of effort had gone into compiling the report. It had also cost a lot of money, particularly because of visits to Stockholm and Rome—including a visit to the health ministry and the Vatican—and to clinics in various parts of this country. We collected a large amount of evidence, and the inquiry lasted for an entire year. If the report had dropped out of sight, it would have been costly for Parliament, and it would have been a shame in the context of today’s debate. Therefore, I did an unusual thing in a Select Committee: I moved a guillotine. That caused quite a rumpus. On that day, the meeting began at 3.30 in the afternoon and the guillotine was for 8.30 in the evening. Even though it upset some of my colleagues on the Committee, I do not regret taking that action, because if we had not taken it, we would not be having the debate on this important report this afternoon.
Our report states:
“the evidence suggests that the scale of intrusion into the private choices of individuals seeking to have a family can no longer be justified. We do, however, accept that the research uses of the embryo of the human species remain a legitimate interest of the State.”
Other members of the Committee felt that that was too liberal a statement and they moved an amendment against the libertarian approach of certain members of the Committee, but the majority prevailed and the report was published.
I accept that these issues are difficult to grasp and even more difficult to legislate for, but it is now generally accepted that the Human Fertilisation and Embryology Act 1990 is in need of review and I believe that our report forms an excellent platform for that review to take place. As in many other areas, advances in technology in this field are racing ahead of our ability to consider reform of existing legislation.
As I have said, the Committee deliberately excluded abortion from its inquiry and it excluded surrogacy, too. I want to touch on one or two aspects in the report. On the status of the embryo, we agreed with the Warnock view that embryos should have special status. As the present Chairman of the Committee has pointed out, we took the “gradualist approach” that a human being is not created at the point of natural fertilisation but emerges gradually towards birth. However, we respect the 14-day rule that allows research to be carried out on an embryo during the period before the primitive streak emerges, which is the first sign that the nervous system, the spinal cord and the brain are beginning to develop. It is my personal view that no change to the law should be made in that respect, although there are arguments being advanced both to reduce that 14-day limit and to increase it to 20 days, or even beyond that. Baroness Warnock has admitted that that time scale of 14 days is “arbitrary” and it is based on the reasoning that I have already given.
The 1990 Act defines an embryo in section 1(1) as:
“a live human embryo where fertilisation is complete”
“an egg in the process of fertilisation”.
The term “gamete” covers live human eggs or sperm, but not eggs in the process of fertilisation.
Today, that definition is inadequate because artificially created gametes can be produced and embryos can be created through the process of cell nuclear replacement, or cloning, the process used to give birth to Dolly the sheep at the Roslin institute nearly 10 years ago. Our Committee believes that attempts to define an embryo in any new Act would be counter-productive because it would lead to legal challenges, as the definition of the embryo in the present Act has led to legal challenges.
On sex selection, I agree with the majority of our report’s recommendations, but not all. I spoke against sex selection for non-medical reasons—Members have used the phrase “for social reasons”—either by sperm sorting or by pre-implantation genetic diagnosis. However, for the avoidance of sex-related disorders, I do support sex selection.
Some communities value boys more than girls; India and China are examples. I believe sex selection to be discriminatory and that it should not be sanctioned in this country. The policy of the two countries that I mentioned has serious demographic consequences. However, I recognise that there are arguments for family balancing, especially when a mother has given birth to a significant number of children of the same sex. Alan and Louise Masterton, who have four sons, lost their three-year-old daughter Nicole in 1999 in a domestic accident and campaigned for the right to rebuild their family with a daughter. If families cannot achieve what they want in this country, they will probably go abroad to achieve their ends. That applies to other areas of this debate as well as sex selection, but I have no ready answers to “reproductive tourism”. We have to face the fact that if people cannot get what they want in this country and it is legally available in other countries, they will go there to have that treatment, possibly under less safe conditions than would apply in this country.
No, I did not say that. We want high moral standards in this country. We do not want to force people to go to other countries with lower moral and ethical standards. For example, the Mastertons had to go to Italy for treatment. Tragically, that resulted in only one male embryo, which was donated to an infertile couple.
Sex selection by PGD or sperm sorting is far preferable to sex selection by selective termination of pregnancy or by infanticide. Sex selection by sperm sorting is not covered by the human fertilisation and embryology legislation and, in my view, it should be.
No, I am saying that in some other countries infanticide is used to achieve what people want. I have mentioned two countries in which it might happen.
The Committee found
“no adequate justification for prohibiting the use of sex selection for family balancing”.
Sex selection in the UK would probably work both ways and the demographic impact would, therefore, probably be imperceptible.
The concept of selection is one on which we need a full debate—fuller than we can have this afternoon—especially if we want to allow selection as a means of achieving greater intelligence or beauty, a certain hair or eye colour, increased memory capacity, or other factors. Science will make all those choices available. I do not say that I am in favour of them, but I am saying that we will have to debate the issue in this House at some point.
The birth of Louise Brown in 1976 at Oldham and district hospital as a result of in vitro fertilisation was a milestone in medical history. Unfortunately, today, only 1.5 per cent. of all live births in the UK are a result of IVF treatment and, considering that the UK gave birth to IVF treatment, it is not pleasing that we were ranked 12th out of 15 countries in Europe that offer IVF treatment in a report published a few days ago by the European Society of Human Reproduction and Embryology. Denmark offers 2,031 cycles per million population, but the UK figure is only 633. In Israel, where there is an active policy to encourage childbirth, the figure is 3,000 and 7 per cent. of treatments lead to a live birth. In comparison, the figure in Denmark is 3.9 per cent.
The Committee formed the view that IVF treatment has become such a routine medical procedure that its regulation can become part of mainstream clinical regulation. That is not to say, however, that there should not be continued inspection of clinics offering the treatment, both in the public and private sectors.
I represent a constituency with some of the poorest estates in Britain and it concerns me that my constituents have such poor access to IVF treatment. Indeed, only a few years ago, our local NHS would not fund IVF treatment. Nationally, only 25 per cent. of IVF treatments are obtained in the NHS. The rich get the most treatment, because they can afford to go to the private clinics. Unless we make IVF treatment more readily available on the NHS, my constituents—poor as many of them are—will continue to be discriminated against because they live in the wrong place.
However, the question is not just the availability of IVF, but the quality of the services on offer. I believe that the success rates of public and private-sector clinics offering that treatment should be published, although clinicians are sceptical about doing so, because their success rates depend on a number of factors; the main one, incidentally, is the age of the woman presenting herself for IVF treatment. However, it is important that people can judge the success rates of clinics, and in taking evidence our Committee found that those rates differed spectacularly.
In February 2004, the National Institute for Health and Clinical Excellence published guidelines on IVF treatment. It recommended the implantation of only two embryos per cycle to avoid the risks that we know are associated with multiple pregnancies. It also recommended that three cycles be offered to infertile women, which would have a considerable cost implication for the NHS. The Government, of course, have asked primary care trusts to offer only one cycle. Again, the House needs to have a proper debate on the NICE proposals. In Italy, the position is different; the Italian Government have insisted that three embryos be implanted per cycle. There was considerable opposition to that proposal, as the Committee found when we visited Rome.
There is a rising trend of infertility in the richer nations. One in seven couples now experience problems with infertility; we need to invest far more in research to find out why. Some blame pollution of our environment by certain chemicals—so-called endocrine disruptors—but that is by no means proven. We should all remember that that trend comes at a time when the demographic make-up of our population is skewed towards the older end. We need more live births to make our demographic spectrum as it was in previous years. It costs an estimated £13,000 for every baby born by NHS IVF treatment, but we should remember that that baby will contribute an estimated £147,138 to the Exchequer throughout its lifetime, so it makes economic sense to support IVF treatment.
Spare embryos can be destroyed, donated, stored for future use by the woman or others, or donated for research. Many people believe that, once created, embryos should never be destroyed, despite the fact that 70 per cent. of embryos fail to implant and are merely washed down the loo. Is it not preferable to use spare embryos for important medical research? I was pleased when Parliament decided to debate stem cell research a few years ago, and to allow it to proceed in this country, admittedly under tight regulation. There is now a reverse brain drain in this country; people are actually coming from the United States of America to conduct much-needed stem cell research in Britain.
There are widespread concerns—shared by me, incidentally—about the principles and practicality of the welfare-of-the-child provision in the 1990 Act. Section 13(5) requires that
“A woman shall not be provided with treatment services unless account has been taken of the welfare of any child who may be born as a result of the treatment (including the need of that child for a father), and of any other child who may be affected by the birth.”
Although most of us have freedom of sexual reproduction, less fortunate individuals who need assisted reproduction actually have to be judged by others, mainly from the middle classes—general practitioners and people on various ethics committees. That is not right. Those people are not in touch, in my opinion, with some of the people on poorer estates in my constituency who are desperate to have children but who are infertile. I do not believe that they should be judged in the pursuit of having a child, and that is one of the reasons why I am against that welfare-of-the-child provision. It is highly discriminatory, especially to people who are leading non-conventional lives.
Our committee heard lots of evidence from professionals, such as GPs and clinicians, who are expected to implement that procedure, but they find it almost impossible to do so. How well does a GP know all the women who are on his or her books? Can they judge? The evidence that we took was that they cannot judge in the majority of cases. The medical profession wants the welfare-of-the-child provision in the 1990 Act to be abandoned. Our Committee also felt that adequate mechanisms are already in place to ensure that any child born in an assisted manner will be protected. Of course we must remember that, since that legislation was passed, we have passed the Children and Adoption Act 2006, which also gives the born child a great deal of protection.
I wish to mention just one more thing: the insemination of single women. It seems ironic that, when we produced the report, the people in the media who wanted to do radio and television interviews with me—I think that it was the same for other members of the Committee—focused on one thing: sex selection, not on IVF, PGD or many of the other things in the report, not all bad and mostly good. Today, with me, they have been focusing on the insemination of single women. Why do not the media get real, look at the whole report and judge it across the spectrum?
During our inquiry we visited the Harley street office of a business called Man Not Included, which offers an internet service to collect and deliver fresh sperm to single women, including lesbians. As it deals in fresh sperm, its services are not covered by the 1990 Act. In my opinion, those internet services need regulating. I have two concerns, one of which is on grounds of safety? How can we be sure that sexually transmitted diseases are not being transmitted from the donor of the sperm to the recipient woman? That needs regulating.
I am also concerned that, whereas the Human Fertilisation and Embryology Authority has a register that lists all the donors of gametes and all the recipients of gametes, those internet services do not have to register donors or recipients on the central register. We are very keen for that to happen now that children, some time in their future, can find out exactly where their parentage is based, but those services will not allow any of the children born as a result of using their services to trace their parentage.
I am in favour of PGD because it will eliminate some of the most difficult diseases that we are facing. I am also in favour of the creation of a parliamentary bioethical committee, on which lay members and professionals from the industry could serve—it need not be made up only of parliamentarians—but what really gets to me is the fact that a quango, the HFEA, is making important decisions without reference to elected Members of Parliament, and it is about time that those important decisions were brought into the Chamber and our Committees, so that we can debate them properly.
It would be a brave person who could predict where these areas of research will take us next, but one thing is sure, they will always be controversial and we will always need to debate them in parliamentary time. I have many other comments to make, but in fairness to other hon. Members, I will sit down soon. Let me finish by saying that our report contains 104 recommendations and, alas, it impossible to touch on most of them this afternoon.
Order. I offer guidance to the House and seek the co-operation of hon. Members. There are two subjects for debate today. I must try to protect the interests of those who wish to speak on the subject that is before us and also of those who hope to have an opportunity to speak on the second subject. I hope that a measure of rationing will come into the remarks that are made if I am to call everyone who is seeking to catch my eye in this debate.
I shall endeavour to speak as briefly as I can, as I am the only Member on the Opposition Benches, apart from the hon. Member for Oxford, West and Abingdon (Dr. Harris), who served on the Committee. I have a few things to say, but what I say will be much shorter because I can simply say that I agree with all 104 recommendations produced by the Committee.
I support the motion, which aims to supply funds and grant-in-aid for the Human Fertilisation and Embryology Authority. I congratulate Dame Suzi Leather on the work that she and her colleagues do on a remarkable committee. I think that there will probably be a need for more resources in future, not fewer.
I speak also as one of only two Members in the Chamber today who served on the Committee that considered what became the Human Fertilisation and Embryology Act 1990. I think it is true to say that my hon. Friend the Member for Congleton (Ann Winterton) and I agree on almost everything, and have done for almost 23 years, except on this issue. We have disagreed with each other for 23 years about some of the important issues that are now before us. I strongly respect her views although I disagree with them.
We are dealing with a report that was produced in the previous Parliament. It was undoubtedly the most interesting and significant Select Committee that I served on for 23 years, despite my having served on five Select Committees. I thank the hon. Member for Harrogate and Knaresborough (Mr. Willis), who is the current Chairman of the Committee, for his thoughtful contribution to the debate. I thank particularly the hon. Member for Norwich, North (Dr. Gibson), who throughout all the trials and tribulations of a remarkable Committee managed to lead us to a conclusion and to get a report published when it was the wish of some that that should not happen. It would have done a great disservice to the House if a report had not been published.
We are dealing with some of the last great taboos. That is why it is important to tackle them head on. To know what we should do about human reproductive technology, we should start by understanding and appreciating the widely differing views that people hold about the nature of the human embryo.
A young man living in a Jewish community about 2,000 years ago would probably have accepted the traditional Jewish position on the status of the embryo—it is not a person but must be treated with the respect due to a form of human life. That is surely something with which most of us could agree.
In the fourth century, teaching in Roman north Africa, St. Augustine of Hippo believed that the human embryo did not have a soul because it was not sentient. Writing in 13th century Naples, St. Thomas Aquinas rekindled Aristotlean philosophy and decided that humanity began with ensoulment at 40 days for a male foetus and 90 days for a female foetus. Was not that progress?
The Bishop of Rochester advised our Committee last year that the gradual emergence of a person was the usual approach in the Christian tradition until 1869, when Pope Pius XI abolished the distinction between early and late abortions. By 1984 the Warnock committee had concluded, rather in the Christian tradition, that a human embryo develops over time. It said that a human embryo cannot be thought of as a person or even as a potential person; it is simply a collection of cells which, unless it implants in a human uterine environment, has no potential for development.
I do not think that a human being is created at the moment of conception. That is the moment that takes the egg and the sperm a step nearer to implantation, with humanity commencing at 14 days with the appearance of the primitive streak, the precursor to the spinal chord, signifying cell differentiation and the beginning of sentience. I believe that life is a continuum with a genetic line moving ever onwards, unless it dies out through lack of procreation. That, surely, is why we humans are so interested in our ancestors and, indeed, the fortunes of our children.
There is a huge problem now. Only 30 per cent. of fertilised eggs of embryos implant. What about the rest: the spare embryos? The Church of England Mission and Public Affairs Council said in its report on embryo research:
“The superabundance of embryos, seventy per cent of which do not implant in the womb, is echoed throughout nature… Seed or eggs which do not reproduce are frequently sources of food for other creatures.”
The former Bishops of Oxford and Salisbury, in the other place, have in the past both talked of the problems that arise if all human embryos are regarded as having full human status from the moment of conception. If 70 per cent. of embryos are destroyed, do we believe that they are ensouled human beings and does that mean that heaven is largely populated by embryos? I do not know. I look forward to someone helping with that problem.
Research on human embryos can be undertaken without compromising their special status, but the research must have proper legal and ethical oversight. I also believe that it is right to create embryos for research purposes, always insisting on the 14-day rule. The hon. Member for Harrogate and Knaresborough said that Parliament sometimes had to tell scientists to stop that process. We cannot stop science or prevent progress. Science is moving onwards at a fast pace all the time. The report suggests that both Houses of Parliament should have a role in listening to all the arguments, in representing the different views in the legislative process and in deciding what should be legal for the time being—because what is legal now was not legal 20 years ago.
I am grateful to the hon. Gentleman for his clarification. The problem is that reproductive technology is moving way ahead of us as legislators. That was always going to happen. I remember saying in the Chamber during the Third Reading debate on the 1990 Act, “They will be back.” I am quite surprised that it has taken the scientific community and the Government so long to come back to the House. I support the Select Committee’s call for parliamentary oversight and a new parliamentary Standing Committee on bioethics. Only then will all sides have the chance to be heard and will there be an opportunity for the evidence to be weighed.
I wonder how many Members and how many of our constituents are familiar with the complexities of reproductive cloning, hybrids and chimeras, pre-implantation genetic diagnosis, embryo splitting, parthenogenesis, cell nuclear transplants, sperm sorting and haploidisation. Those things are happening around us, for our constituents, in our constituencies, every day of the year. They are real. They are happening today. We cannot ignore them. We cannot say that we wish that they did not happen, because they are happening.
For that reason, I was surprised by the announcement from the Vatican last week, as reported in The Daily Telegraph. The headline was:
“Vatican vows to expel stem cell scientists from Church”.
When the Committee visited the Vatican, it was a huge privilege to be invited to visit the archbishops and bishops and their medical advisers and experts, who did us great courtesy and showed us great respect, as we did them. They will be reading this debate—if not watching it in the Vatican. I would like, therefore, to put on record my thanks to them for putting up with us when we challenged them with some very difficult ideas—perhaps of a nature with which they were not familiar. Perhaps they were not used to being confronted by parliamentarians, because the politics of Italy are different and the role of the Church in Italy is different.
I am sorry that the Vatican made that announcement last week and that Cardinal Alfonso Lopez Trujillo said, in an interview with Famiglia Christiana, an official Vatican magazine:
“Excommunication will be applied to the women, doctors and researchers who eliminate embryos”
and to the
“politicians that approve the law.”
I therefore commend the courage of the Italian senator, Paola Binetti, a member of Opus Dei and a prominent campaigner for Catholic rights, who said:
“I am upset and stunned,”
“It is a mistake to give out the idea that God is angry with Man because he is not in agreement with him.”
I agree with that. The Vatican’s reaction looks a bit like panic.
I want to make a few comments about the question of so-called eugenics and designer babies. The whole argument is tainted by our memory of the appalling atrocity of Nazism and all that happened then. The word “eugenics” is Greek and simply means well bred and well-being—a good baby. Of course, that is not how it is usually applied. Surely there is a great difference between seeking to create a child with particular characteristics such as blue eyes—or a child who is sporty or musical—to make a master race, and trying to filter out the damaging parts of this fragile human life where that is humanly possible. I have wrestled with that problem for years.
I recall that when the Human Fertilisation and Embryology Bill was going through the House in 1989 and 1990, I asked my bishop, John Baker, whether he would help. On 20 February 1990, he wrote this to me:
“Where nature itself spontaneously aborts a good many embryos in these very early stages of life, it is hard to feel that to do so deliberately for good reason is contrary to God’s own mind, so far as that is revealed in his created order. Moreover, if we are to be realistic, we human beings are not spiritually, psychologically and socially all so marvellous that we can promise the spina bifida or cystic fibrosis sufferer a quality and fulfilment of life that will make the burden of their sufferings worthwhile. On the whole if you can choose to launch either a life without these such handicaps or one with them, it seems morally better to choose the former. Many parents must pray for a disease-free child; when we are given the power to bring that about ourselves, what does it say about our prayer if we refuse to use that power?”
That puts that argument rather powerfully, and it is as true now as it was.
It is very important, therefore, to be careful when we are talking about designer babies to be clear that we are not talking about designing something to our own wish or to our own vision of a perfect child, but using science, which in my view is God-given, to enable us to use our brains to stop suffering as far as we may. I also feel—the hon. Member for Bolton, South-East (Dr. Iddon) said this eloquently, and I agree with everything that he said—that within the law, families should make decisions on their reproduction and not the state. The state does have a role, but we need to rebalance the arguments.
Finally, I want to say a quick word about abortion, because we cannot ignore it; it is part of the issue, and our report said what we thought we should be doing about it. If we want less abortion, we must look very carefully at the figures. Of the 185,000 abortions a year, just 124 occur after 24 weeks. If we are seeking to reduce the quantity of abortions in this country, does it make sense to vilify the tiny number of extremely vulnerable women in the most difficult and terrible circumstances who are in that category, and to say that they are somehow doing something unspeakable? I think not.
Let us look at the other end of the scale, too. Frequently we are told how awful it is that there are so many teenage pregnancies. I asked the Office for National Statistics for the figures, and in my constituency in the past 10 years the number of abortions among girls under 16 was 14. The ONS refused to set the figures out by year because it said that that would break confidentiality. We are talking very small numbers. The highest proportion of abortions in this country are performed on single women and those who have had abortions before. Perhaps that is where we should be considering education; something is wrong there. The hon. Member for Morecambe and Lunesdale (Geraldine Smith), who, sadly, is no longer present, used the word “Frankensteins”, but the proportion of abortions on the grounds of chromosomal abnormality is one third of 1 per cent.—that is all. If we want fewer abortions in our country—and, God knows, I am sure we all do—we will need more human reproductive technology and much more education.
I quake a little when somebody says that we should have these debates in Parliament, because we will need about six weeks to go through the many issues that reflect our consciences and beliefs. It was not easy chairing the Committee—delightful bunch of people as they are; men and women united, just for a minute. I assure the House that I would much rather take penalties in the last minute than have to chair a Committee that was so severely divided. My attitude was, “Let’s just stay here all night”, and without my hon. Friend the Member for Bolton, South-East (Dr. Iddon) moving a guillotine motion—nasty man—we could have debated the issues for hours and hours. That reflects the problems.
We have come a long way in science from the days when we believed that only one parent was responsible for the creation of an individual. One was either an ovist or a spermist—there are pictures of sperm with young people within them—and that was how it all happened. It is not so long ago that we believed that. It is not so long ago, too, that we did not believe in genes and DNA—in fact, science in the Soviet Union was based on that for many years. In this area, knowledge moves on and beliefs change, and they do so pretty fast.
We as a Parliament need to regulate and legislate in respect of many of the processes that we have been discussing. However, we have to do more than that: we have to think about why we are regulating or legislating. In industry, there is continuous debate about whether legislation inhibits productivity, industrial growth, and so on. Sometimes we do nothing and sometimes we overreact, but I think that we in this country do nothing rather well. We do not get caught up in regulation, yet the world does not crumble about us. The same is true in the field that we are debating now, and that was the spirit in our Committee: we wanted to examine what was happening and make sure that we got legislation where it is needed. We were told at the beginning of our inquiry that nothing needed to happen—that we should leave the subject alone. Well, 104 recommendations suggest that something needs to change.
One has to ask whether the purpose of regulation should be to provide legal protection for the embryo, or to provide some regulation of assisted reproduction, or both. In fact, a regulator is not needed to protect the embryo. If the law says that a person cannot clone an embryo and someone does, one just calls 999 and gets the police in. Regulating IVF treatment is different, of course. IVF treatment is increasing and will continue to do so. Endocrine disruptors, which we have heard about, and many other factors are lowering sperm counts and otherwise making people infertile, but the desire to have a baby is an innate human characteristic, so there will be more pressure on IVF provision. The hon. Member for Congleton (Ann Winterton) will remember that when IVF was first introduced, people said that it was a pariah that would destroy the world and that it must not happen, but now it is a standard technique, even though there is not enough of it in the health service, and it is improving all the time. Should the regulator regulate only for technical standards, or do we want it to enforce directions on how treatment is administered, or so on? The spirit of our recommendations was not dogmatic: we were trying to help the new science to develop.
The HFEA was an extremely important addition under the 1990 Act. Regulation was extremely important to building public confidence in that legislation. However, events have moved on. We are not all old Labour—despite what some believe, we know that changes have to happen. We have to move on and the HFEA and its functions need to be examined seriously. For example, does it have the right people on it? It would not worry me at all if pro-life people had places on the authority, which they have been denied. We should get them in, have those arguments and not restrict them, because that diminishes the authority and makes people suspicious.
Is the HFEA rigorous enough about licensing and inspection? The HFEA has a triple role—regulator, policy maker and Government adviser—but it is not possible to fulfil all three functions. That is why the Committee said that we should try to separate them and why we said that Parliament’s role was extremely important. There is a plethora of knowledgeable, concerned people present in the Chamber and many more outside. I believe that the public would welcome involvement in the debate.
The HFEA is to merge with the Human Tissue Authority. We wonder whether that is a political move. The virtues of such a merger have to be explained, because—of course—the British Medical Association is none too happy at the prospect. We could think about merging the HFEA and the Human Genetics Commission—Baroness Kennedy’s group, which examines many issues, such as the new genetic science and its effect on disabled people. The bodies could all work together in harmony much better than they do.
We have heard about the problems of reproductive tourism. I think that it will be hard to stop both that and reproductive cloning, which someone will carry out successfully some day. I remember when people said that we could not clone a sheep or cat, but we have done that, so humans will be in the wings. We thus need to think about the regulation that we will need for inspecting that.
Do we need a national bioethics committee? The public now want a consideration of morality and their views to be put in the relevant arena. Everyone else seems to have such a committee, but we do not. Is that because such committees are perceived as expensive talking shops? Could we establish a body that was really meaningful? Will Parliament really be the best place to make the big decisions? Should we stop giving such issues to quangos?
Judgments are also made by local ethical committees. Are the decisions that are made at local level tough enough, or is it the case that just the great and the good—the local vicar and so on—are appointed to those committees and that they have a nice afternoon cup of tea and a biscuit and then go home? The question of how we achieve localism in such decisions is serious.
Things will never stand still in this area because new, unforeseen possibilities will arise and be combined with market forces and new dilemmas that emerge. As many hon. Members have said, regulation must keep up with that without inhibiting research—even if one thinks that that could be stopped. I accept that scientists can be arrogant and think that they can rule the world, but that is why they must engage with the political process and be brought into that arena. If they are kept out, they will have that opinion. We should not really start from where we are now, but think about starting all over again, given all the new developments that have taken place.
It is lovely if there is a mum, dad and child. It is lovely when a man meets a girl and they fall in love, before there is the question of having children, and they then live happily ever after and everything is perfect in God’s perfect land, as Neil Young would say. However, sadly, it does not always work like that for some people, and there are other types of relationships. The world has moved on to accept such people and be disciplined about them. We must incorporate that in our thinking. The problem is not major, but we must take it seriously. Nothing is really sacred, not even the Human Fertilisation and Embryology Act 1990—but gosh, to hear some people talk, one would think that it had to be protected at all costs.
Thank you, Mr. Deputy Speaker, for calling me to speak in this important debate. I will try not to inject too much emotion into it, but when we talk about human life, emotion is not always misplaced. I hope that the hon. Member for Harrogate and Knaresborough (Mr. Willis), my hon. Friend the Member for Salisbury (Robert Key) and others will bear with me.
I am a little concerned that the subject has been broached by the Science and Technology Committee, because it sounds rather abstract to talk about human reproduction in terms of science and technology; that is a rather sterile heading. Nevertheless, that is the Committee that has considered the matter.
Forgive my naivety, but I would have thought that this could have been considered by the Health Committee. Perhaps it would be a good start if we were revolutionary and established a Select Committee on the family. However, the subject rests with the Science and Technology Committee; those are the terms of our debate.
I share a growing concern with many of my constituents that children are often seen as the ultimate accessory. People used to have Gucci handbags or high-pedigree Dalmatians, but now it seems that people express their individuality by going around having children. On that basis, the child’s welfare is important. Not everyone has the right to have a child. I believe, although it might be unfashionable to do so, that children are a gift. I have spoken to many people in the homosexual community about the lifestyle that they choose to lead. Many of them are perfectly comfortable with the idea that their lifestyle choice excludes them from having children. Therefore, before we go down the road of supporting the idea that same-sex couples should have access to IVF, we should realise that it is the minority of such couples who are looking to do that.
Not in the slightest. I made the lifestyle choice of getting married and having children. People make such choices. If one chooses to live in a same-sex relationship, it is difficult to have children naturally. I have a good friend who is a homosexual. He and his homosexual partner found a surrogate mother and had a child. Those two men are excellent parents and I am fond of them both, but that does not mean that I believe that children’s best interests are served, in the main, by having two fathers, or that I subscribe to the idea that gay couples should automatically have the right to have children.
The scientific community seems to have its own agenda. We read in the newspapers today that Britain is about to have its oldest mother because a woman of 60—I believe—is about to have a child. Whose interests will that serve—those of the child who is born, the woman having the child, or the scientific community? What will happen next year? Will a woman of 70 or 80 be Britain’s oldest mother? The House needs to exercise control over what the scientific community is doing in this area, because the child’s welfare should be absolutely paramount.
Absolutely not, because as the hon. Gentleman knows full well, men are biologically able to go on having children into their 70s and 80s. However, what is proved by deliberately taking a woman who is past her point of fertility—perhaps 15 or 20 years past—and impregnating her?
If the hon. Gentleman really believes that giving 60, 70 or 80-year-old women the choice of having children is a good thing that will benefit the welfare of those children, I am afraid that we will have to disagree. Where we will disagree, time and time again, is about the idea that the welfare of the children should be paramount, and the fact that it is probably not in the interests of a one or two-year-old to have a 70 or 80-year-old mother.
When we have debates on reproduction in the future, I hope that we will remember that children live with the consequences of decisions made by adults. They do not ask to be born, but they will be with us for a long time. I also hope that we can have a bit of emotion in such debates, because when we talk about human life and small people, it is perfectly reasonable to get emotional about their future and their welfare.
I will try to bring the debate back to the mainstream of the subject. We should remember the context in which we start. On the whole, the Human Fertilisation and Embryology Act 1990 and the system of regulation have served us well for the past 15 or 16 years. But time moves on, the science has moved on at a great pace, and the time has naturally come to start reviewing the situation. The Government had already decided that it was an apt time to do that, and so had we, especially as several controversial decisions were coming up. It was a natural time to look into the matter.
We need to continue our history over the past 16 years of having a framework that provides good clinical services for those who need infertility treatment, and a good research environment that is well regulated so that researchers know clearly what they can and cannot do. For that reason—the fact that we have a working environment that is safe and well controlled—more than any other, we lead the world in matters such as embryology research and embryological stem cell research.
In other countries there is not necessarily such an environment. There have been plenty of examples of that. Where have the threats to clone human beings been coming from? They have come not from our own regulated environment, but from countries where, for whatever reason, the Government have not been able to get to grips with the issues.
Those issues seem to come back to questions of religion and ethics. That was apparent when the Committee went to Scandinavia and then to the Vatican. The Scandinavian attitude was pragmatic. Basically, it boiled down to this: if there is no demonstrable harm to the child, it must by okay and things should be left alone. However, the Vatican had a very different attitude. In his refreshingly sane contribution, the hon. Member for Salisbury (Robert Key) described the theological progress on this issue. The Vatican position is that human life starts at the moment of fertilisation, and that even the zygote has the full rights of a human being.
That creates a great cultural limitation on what can be done, and for a long time Italy was totally unregulated and had no legislation on in vitro fertilisation. The consequence of that was some awful practice. One man was threatening to perform human cloning, and finally Italy legislated, but its legislation in this area, which it introduced just a few months before we did, was very imperfect. For instance, it demanded that all embryos should be immediately implanted once they were produced, and that they could not be stored frozen. That meant that there was a much greater risk of harm, both to the child and the mother, because it was not possible to screen out unhealthy embryos, to do pre-implantation genetic diagnosis—PGD—or to eliminate the possibility of implanting an embryo that was very genetically defective. The net result is a higher incidence of multiple births and birth defects, and greater harm, because the legislation is not sensible and has not grasped the nettles that needed to be grasped. We in this country have grasped them in the past, and we need to continue to do so.
Let us look at a few examples of the problems that arise, which mean that we must carefully re-examine the legislation. One problem is the PGD issue. At present, that is strictly limited to serious life-terminating genetic diseases, but the science has moved on so dramatically that a vast range of diseases can now be diagnosed in the embryo—and to a far greater extent than it is currently licensable to use that technique. We must take stock and ask, “Is it reasonable to avoid using the embryo that would produce a type 1 juvenile diabetic, for instance, and to use the one that would not?” There are many such diseases, which are survivable but clearly undesirable. That matter must be discussed sanely and rationally. Such borders need constantly to be revisited.
Let me give another example. In the context of tissue typing, there was the Hashmi case: the Human Fertilisation and Embryology Authority licensed an application to produce a baby who could be a tissue donor for its sibling, who already existed but had thalassemia and did not have much of a life expectancy. Tissue typing was essential; otherwise the stem cells would have been rejected.
That case has led to a succession of legal challenges, because the HFEA was working right at the policy limits of the legislation. Effectively, it was almost making law. Was it within its statutory limits or not? The High Court said no, but the Appeal Court overturned that judgment, and the case went to the House of Lords; I do not know what its decision was. We should not determine such issues through the courts. We need to make sure that the regulations and laws that we set down in this place are clear enough to keep lawyers out of this area, so that it can be left to doctors and would-be parents.
I have given two examples, but there are others. I am thinking now of mitochondrial diseases. At present, cell nuclear replacement can be used only for research purposes, but the time will come when it will be technically possible to use it therapeutically. That is not currently legal, but why should it be illegal?
As for cloning, we as a society are totally opposed to human reproductive cloning, and our report—contrary to what some people might suggest—does not suggest for one moment that we should do anything more. Therapeutic cloning is a totally different issue; that is absolutely essential if we are to pursue the production of new embryonic stem cell lines. But in 20 or 30 years, if techniques of reproductive cloning have become demonstrably safe, it is perfectly possible that Parliament and the public might want a different outcome. That is certainly not true at present, but the question needs to be revisited from time to time.
This House should play a central role in determining these issues. It should not be left to the HFEA to make policy in these difficult areas. It has enough of a job to do with its licensing and regulatory functions. I strongly subscribe to our recommendation that there should be a House bioethics Committee that should keep this area under constant review, make annual reports to Parliament, recommend amendments to legislation when it feels them to be appropriate, and conduct pre-legislative scrutiny of draft legislation as it emerges. Such a body should be the key actor in the future, but the whole of Parliament should have a vote on its recommendations. That way, we will take full responsibility for them.
As a society, we are increasingly uncomfortable with the existence of received wisdom and moral certainties. It is probably also true to say that we are becoming uncomfortable even with the principles of secular morality—be it utilitarian or libertarian. Such secular morality is increasingly branded as an extension of “public interest”, so that it need not appear to be morality at all. The Warnock report proposed that the putative regulatory body for biotechnology should not be
“exclusively, or even primarily, a medical or scientific body. It is concerned essentially with broader matters and the protection of the public interest.”
It is perhaps fitting that a body that exists to deal with, among other things, the ethical dilemmas posed by genetic hybrids and chimeras, should be similarly heterogeneous. But it is true that scientific evidence and more traditional moral yardsticks must continue to complement one another. The ascendancy of science untrammelled by other concerns leads us into dark places.
The Committee’s investigation of eugenics and pre-implantation genetic diagnosis, for example, touched on the potential disaster of social objectives triumphing over ethical objections. Perhaps that is the danger implicit in conflating ethical, clinical and political judgments, which is why I believe that the Human Fertilisation and Embryology Authority might no longer be fit for purpose. There must now be a solid case for reconsidering its remit—and, consequently, its composition—from the ground up.
The intention to merge the HFEA and the Human Tissue Authority into a new regulatory authority provides an important opportunity to address the fundamental concerns about the biotechnology regulatory regime that the Committee expressed. The fact that the new authority will no longer be called the regulatory authority for fertility and tissue does not mean that it cannot become a “RAFT” in troubled ethical waters. The HFEA’s most important failings are not those related to the practical problems that, to some extent, afflict all Government organisations. It is no surprise that the Committee’s recommendation 66 highlights critical failings in the agency’s data management policies. Nor is it a surprise, for example, that the Government’s response lays the blame on the goose that has so often failed to lay a golden egg: IT infrastructure.
I was, however, more struck by the Committee’s findings on the HFEA’s inadequate expertise. I want to focus my remarks on recommendation 47, and particularly the following statement:
“We believe that ultimate authority on issues of public concern should lie outside of the scientific and medical communities.”
That is a sound principle, although many would argue that the scientific and medical communities do not harbour nefarious intentions of the kind that would make them incapable of self-regulation by their various professional bodies. But even if the status quo of lay dominance over day-to-day decisions is to be preserved, it is indefensible for the HFEA to lack a sound basis of scientific expertise; that must be corrected in any new body.
My concern is that insufficient parliamentary time is given to these complex ethical decisions, which are based on a rapidly evolving scientific evidence base. The introduction to the Committee’s report notes the statement, made during an earlier inquiry, that, after 12 years of the Human Fertilisation and Embryology Act 1990, it was necessary to
“reconnect the Act with modern science.”
It also reiterated earlier criticism of the complacency of certain members of the HFEA, and the Department of Health’s “limp response” regarding a policy of constant review. If the HFEA is not keeping abreast of a rapidly advancing field because it has insufficient expertise or organisational capacity, it is clearly necessary to do one of two things.
The first option is to return regulation to the relevant professional bodies. The Royal College of Obstetricians and Gynaecologists stated in evidence that
“the body regulating this area should have sufficient expertise in its make up to tackle some of the difficult clinical, scientific and ethical issues presented to it”.
Does that description not include the professional bodies themselves? We should at least be asking whether regulation can safely be left in the hands of the royal colleges or the British Medical Association, safe in the knowledge that they are deemed capable of engaging with other complex areas of medical ethics. After all, the Committee made a number of recommendations concerning professional bodies’ increased involvement in the management of clinical and laboratory standards. It is only a small step from that position to professional bodies’ wholesale involvement in the development and review of an appropriate regulatory regime. It is only the Warnock principle of lay primacy over these ethical questions that holds us back.
Alternatively, we must establish a regime of regular statutory review by Parliament. It is time to turn our backs on a generation of ad hoc, laissez-faire intervention by Parliament, which relies on the initiative of Back Benchers to ensure that the law is kept in touch with science. That is particularly apposite in the case of the law relating to abortion. I am not an expert on accepted parliamentary practice concerning Back-Bench initiation of legislation, but it seems in this instance to be a convenient caveat to justify the Government’s inertia.
I do not want to go too far off piste and into the dangerous territory of advocating a review of the time limit applicable to abortion, about which we have heard much already. The decision whether to allow abortion up to 24 weeks, 20 weeks or even 18 weeks should be based on the available scientific evidence and should, if anything, err on the side of caution when it comes to the protection of a potentially viable foetus—in other words, a potential life. But, above all, I do not believe that the Government should absolve themselves, or Parliament, from the responsibility of regularly engaging in the ethical debate on the regulation of human reproductive technology. I believe that Parliament, not the HFEA, is the only crucible in which these questions can be discussed fully, because we are uniquely placed to respond to the scientific evidence, as well as to ethical problems and public opinion. The HFEA is quite wrong to view its role as insulating Parliament from difficult ethical choices.
I am heartened by the strength of support of witnesses called by the Committee for Parliament’s increased participation in difficult ethical situations. The Committee’s recommendations about parliamentary involvement are very welcome, particularly on the need for Parliament to be able to revisit contentious issues. But more than that, I am pleased that the Committee recognises the benefit of the increased public confidence that stems from greater parliamentary involvement in difficult ethical questions. It is, after all, easy to lobby a Member of Parliament on a free vote—and much less plausible that anyone should lobby the HFEA.
The HFEA is an unhappy compromise between scientific, evidence-based decision making and the Warnock principle governing the primacy of lay ethical opinion. If that primacy is still required, its proper forum is Parliament—a point that the hon. Member for Bolton, South-East (Dr. Iddon) alluded to earlier. The Government must now take steps to see that Parliament is entrusted with the regular review of the legislation governing biotechnology. Only Parliament has the resources to co-ordinate and balance the available scientific evidence, the ethical concerns, and the vagaries and inconsistencies of public opinion that are vital to this area of law. More importantly, only Parliament has the moral authority to ensure that the law keeps pace with scientific advances, without exceeding ethical boundaries or failing to meet public expectation.
I appreciate the opportunity to address the House on recommendation 77 of the Science and Technology Committee, which calls on both Houses
“ to set up a joint committee to consider the scientific, medical and social changes in relation to abortion that have taken place since 1967, with a view to presenting options for new legislation.”
I take the opportunity to examine that recommendation, and particularly the suggestion that there might be a case for reducing the time limit. I want to put on record some facts about how many late abortions there are, and I want to consider whether there really have been scientific, medical or social changes of sufficient importance to warrant serious consideration of changes in the law. I do not believe that there have been.
It is important to recognise the passion that is provoked by the subject. It confronts many people’s core beliefs, and that includes me. It is one of my core beliefs that it is important for every woman to be able to control her fertility. Without such a basic right, women have no chance of equality. No contraceptive method is 100 per cent. effective, and no woman should be forced to carry and bear a child that she profoundly does not want. Abortions must therefore be available. It is right for everyone involved in the debate to declare their own interests, not in the Alda Barry sense of declaring an interest, but as regards their core beliefs.
It is important that those on the other side of the debate make it clear where they are coming from on the issue. One of the reasons the argument for restricting the time limit is so unconvincing is that it is often put by people who themselves are not convinced by it, and who take the pragmatic stance that if they cannot make abortion illegal or criminal, they will do their best to restrict access as much as they can.
The hon. Lady says that all women should have the right to have an abortion. What about the right of the father if he desperately wants to have a child and does not want his partner to have an abortion? What rights does he have?
The right is fundamentally that of the woman who carries and bears the child. We are not going to agree on that, just as I am not likely to agree with Cardinal Keith O’Brien who, as I understand it, is arguing for a restriction on the time during which abortion would be possible I presume that he believes that abortion should be illegal and that there should be no abortions, yet he joins the debate. I believe it is women, not Parliament or the Church, who should be making such decisions.
On the question whether there have been sufficient scientific or medical changes to support a change in the law, let me start with a few facts about late abortions. No one wants to have a late abortion if there is any other realistic option. Less than 1 per cent. of abortions take place after 22 weeks, and 87 per cent. of abortions take place before 13 weeks.
Yes. Women who have abortions late are very young, or women going through the menopause, women who do not speak English, women who come across the one fifth of GPs who say they are broadly anti-abortion, women who have had difficulty accessing services and women who are scared, ill educated or marginalised. It is those people who are confronted with such a decision and who, with the assistance and support of medical services, make that extremely difficult decision. It is for them and not for the hon. Gentleman to make that decision.
There have not been any dramatic scientific breakthroughs in recent years. The survival rates are still very low for babies born before 24 weeks, and those that do survive frequently survive with severe disabilities. Last June, doctors at the annual conference of the British Medical Association overwhelmingly rejected a motion calling for the upper limit to be cut from 24 to 20 weeks—77 per cent. of doctors voted against it.
The spark that has reignited the debate on time limits is not medical advances, but the beautiful and highly emotive 4D images of foetuses offered by Professor Campbell in his private London clinic. Foetuses can be seen opening their eyes, kicking their legs and sucking their thumbs, but as Allan Templeton, the secretary of the Royal College of Obstetricians and Gynaecologists has said, the images add little to the science. If we want a debate about the science, let us talk about the science. He says:
“Observing these developments and physiological movements is not changing anything about the time of viability. These images however have given rise again to the question as to whether or not there should be a reduction in the time limit of 24 weeks. It is distressing that so much of the comment has been so ill-informed.”
I am advised that there was a full report of the matter in the Evening Standard. I am grateful to my hon. Friend the Member for Norwich, North (Dr. Gibson). I do not have with me a copy of that well known scientific journal. The point is that there has not been a breakthrough in the science to prompt the Committee to claim that we should re-examine the matter.
At the beginning of the debate, the hon. Member for Harrogate and Knaresborough (Mr. Willis) was asked what particular medical or scientific changes his Committee refers to when it recommends reconsidering legislation. As I understand it from his response, there is none.
My response was that I do not know of any such changes. That is different. The purpose of an inquiry would be to put the issue to bed. If the hon. Lady is right and there is no new scientific evidence, that would come out in such an inquiry and would be laid before the House. If she is wrong and there is new evidence, that would come out in the inquiry and be laid before the House. For the life of me I cannot understand why the hon. Lady should even question the principle of re-examining the evidence after 16 years.
My central point is this: if we want to have a cool and rational debate on the subject and we want it to be prompted by the science, come to us with the science. If not, the debate descends into raw emotion and prejudice. I stated my position at the beginning. We have heard from other hon. Members what their position is. In the end, the decision often comes down to emotion, how people feel and their own sense of what is right or wrong. That is why I believe it is for individual women to make the decision, because it is a profoundly personal decision.
The Marie Stopes International study on late abortion provides many of the figures and stories that I have quoted. I will be happy to provide the hon. Member for Harrogate and Knaresborough with a copy. There have been studies about why women have late abortions and the circumstances that provoke those late abortions.
Every time I have been pregnant, I have had the great good fortune that my children were wanted and we eagerly anticipated them. It is difficult to imagine how it must be for women who profoundly do not want to be pregnant, who do not know what to do, who do not speak English, who may be 14, or who may be 48 and already have four grown-up children. Abortion is already so stigmatised that we must be very careful when we tread down this path.
In the end, although we have many disagreements, I presume we all agree that every abortion is a tragedy, and that every child should be born into a home that wants it and loves it. At least we can all agree with the hon. Member for Salisbury (Robert Key) when he said that if we want to try to make life easier for families, the most important thing for us to do is to improve sex education in schools and relationship education so that people treat one another with respect, so that young girls know that they do not need to sleep with their boyfriends in order to be important and in order for their boyfriends to love them, and so that people have respect for themselves and one another. That should be comprehensively taught in our schools, and we should also ensure that people have access to abortion and to information, so that we can all aspire together to ensure that when a child is born, it is wanted and loved.
With 104 recommendations, the report by the Science and Technology Committee is as deep as it is wide. As a current member of the Committee, I did not play a part in its production. Given its size, I am quite glad about that. I thank the original members of the Committee, especially its former Chairman, the hon. Member for Norwich, North (Dr. Gibson), for the inquiry and for the clear report and recommendations.
The report rightly and necessarily challenges our emotional, ethical and religious boundaries. In the field of human fertilisation and embryology, scientific advances, developments and possibilities arise almost daily. I am concerned about the group of people who donate in order to help childless couples to conceive and have children. Recommendation 33 criticises the Government in relation to the removal of anonymity for those donors. It states:
“We regret the Department’s poor use of evidence in policy-making and its failure to commission and have published the necessary research underpinning its decision on the removal of donor anonymity.”
One could argue that there is now a threat to the flow of donors who have been giving willingly. In their response, the Government reject the recommendation on the basis that they used questionnaires, consultations and surveys to discover the views of interested parties. However, discoveries in social, behavioural and economic science often require concerted effort through research or the commissioning of research for science-based evidence.
My question to the Minister—if she would please listen—is this: what scientific evidence was used to inform the Government’s decision completely and retrospectively to change the policy on the disclosure of information on donors? The service provided by donors to couples struggling to conceive is undeniable and self-evident. If the policy is not based on appropriate evidence, the Government may undermine the supply of donors and create a great deal of unhappiness for childless couples in future.
It is a pleasure to speak in this debate. I tried to catch your eye for several reasons, Mr. Deputy Speaker. I have a long-standing interest in this issue. I was mentioned several times earlier in the debate. I was a member of the Science and Technology Committee that worked on the report—work being the operative word—and I am a current member of the Committee. I am a member of the British Medical Association’s ethics committee, having been re-elected by doctors last week. In addition to all that, I am the Front-Bench spokesman.
The introductory speech by my hon. Friend the Member for Harrogate and Knaresborough (Mr. Willis) was all-encompassing of the main points of the report and a very fair version of it. He inherited the report and cannot claim that it is his baby, to coin a phrase, but he described it well.
The hon. Member for Norwich, North (Dr. Gibson), who chaired the Committee, did a fantastic job in difficult circumstances. I hugely admire his commitment to science and to his work in the Committee. I extend those remarks to the hon. Member for Salisbury (Robert Key), for whom I have huge admiration that increased, were that possible, as I listened to his speech.
Producing the report was difficult, because five people supported many of the recommendations and five people opposed them. The difficulty faced by those of us in the notional majority was that when it came to debating and voting on the recommendations, the minority had found it difficult to turn up because of the pressures that have been described. It is hard to develop coherence when people vote four against one in some sittings and five against five in others.
I do not accept that the report is libertarian. It is liberalising. However, it does not argue for a change in the 14-day limit, which is the fundamental limit in the 1990 settlement and in Warnock; it does not argue against the Warnock consensus on the gradual acquisition of rights in consideration of the interests of the embryo and the foetus; and it does not argue, as it could have done, for liberalisation of abortion law. It was not extremist or libertarian, but it is fair to say that it was brave.
The Human Fertilisation and Embryology Authority felt that it was attacked in the report, but it was not, as the hon. Member for Braintree (Mr. Newmark) explained. I must be careful about the HFEA, because two of its last three chairs are constituents of mine. The estimable Ruth Deech and the estimable Bishop of Oxford, recently retired, are extremely senior people in their field and brook no unjustified criticism. However, the report should not be seen as a criticism of the HFEA, which does a difficult job using a law that is 16 years old and creaking at the seams and should not be dragged through the courts.
I greatly enjoyed the speech by the hon. Member for Congleton (Ann Winterton). Although I disagree with her, she speaks for many people. She made several points that are worth responding to, including some in which she mentioned me. She talked about society’s distaste for some of the report’s recommendations, although she did not provide data to back that up, except in the case of sex selection, which I accept that a majority of people currently oppose. However, it is not good enough for us to base our law and lawmaking on the yuck factor, particularly when it involves fundamental rights such as the reproductive rights of other adult human beings. That is why the Government were right to legislate to permit gay adoption although a majority of people found that distasteful and something that they did not understand. I am fairly sure that the hon. Lady voted against permitting adoption of children by gay couples. The Conservative approach is usually to argue for less state intervention in private lives unless there is good evidence of harm that requires it. That is a reasonable position. However, it was suggested in several well reasoned contributions that the instinct on some of these issues is to regulate and to legislate to restrict freedom, in which case it is necessary to provide the relevant evidence.
Much has been said about abortion and whether we should debate it. Recommendation 77 argues for a future debate after a review of the law. The hon. Members for Brighton, Kemptown (Dr. Turner) and for Bolton, South-East (Dr. Iddon), who are assiduous members of the Committee, spoke well and clearly on the subject. I do not agree with the hon. Member for Bolton, South-East that there have been lots of debates on abortion, in Government time or otherwise. There have not. We had the Abortion Act 1967 and the Human Fertilisation and Embryology Act 1990, and last July I called an Adjournment debate on abortion time limits. Other than that, I can find no record of parliamentary time devoted specifically to abortion, other than on ten-minute Bills. We need to have such a debate in order to retain public confidence.
The hon. Member for Islington, South and Finsbury (Emily Thornberry) gave a full-blooded pro-choice speech that I greatly enjoyed. It is important that that view, which reflects the majority view in the country, is heard. We do not often hear it because the other side is well organised and feels equally strongly about such matters. However, the hon. Lady must acknowledge that her argument—and the reasons that she gave and that the Stopes report set out—that the individual decisions are for women to make applies at 25 weeks as well as 24, and that Parliament must set a limit. The question is how Parliament determines that limit.
In 1990, the limit was based on viability at 24 weeks. If that period has reduced, the hon. Lady may continue to vote for 24 weeks as a practical limit, and I might support her, having listened to the arguments for why any such reduction should cut across the rights of women in difficult positions. However, as my hon. Friend the Member for Harrogate and Knaresborough said, Parliament must debate that and make its decision: for a practical limit of 24 weeks, a viability limit of 24 weeks or a lower limit, if it believes, on the basis of scientific evidence, that the limit on which viability was previously based has reduced.
I share the hon. Lady’s scepticism about whether medical advances have reduced the time on which viability is based—if we believe that to mean a reasonable chance of surviving a reasonable length of time without unreasonable disability—from 24 weeks. However, like my hon. Friend the Member for Harrogate and Knaresborough, I do not know the answer and Parliament should have an opportunity of examining the science before deciding.
Our recommendation in the report went beyond viability and considered other issues, including medical and social advances that suggest that, for example, access to early medical abortion, which is an easier way to have abortions—if we are to accept abortions, we should not force women to go through more difficulty than necessary—reduces later abortions. There is a good argument for making access to early medical abortion easier.
The hon. Member for Bolton, South-East set out why we believed that sex selection for social reasons might be considered, and that good arguments against it would have to be made. He also clearly set out our reasons for supporting research.
It has been said that I have strong views on the suggested welfare of the child provision. That also applies to the rest of the Committee. I believe that a provision for considering the welfare of a potential child when dealing with the creation of families by the small group of people who are infertile is discriminatory. It is the wrong way to protect the welfare of the child, which we must do. Social services and child protection bodies are best placed, when a child is born, to make a risk assessment, especially if they have had a warning when someone began the treatment process that there was some anxiety. Experts should make such an assessment, not gynaecologists or general practitioners who hardly know their patients and are not in a good position to make such decisions. We heard evidence in Committee that such intervention was pointless because it was ineffective and ignored, and that the birth of only 10 children a year was avoided through the process. They could be looked after through the other means that I described. Do we want state regulation of fertility? I do not believe that we do, certainly not without good evidence that it would be better to do that. Are we genuinely arguing that it is better not to be born than to take such steps?
On the need for a father, I believe that it is discriminatory and restrictive to subject some women to such a test. The state must have good reason for intervening in such matters and there is no good evidence to show that the children of lesbian parents or single women who specifically seek reproductive treatment are any the worse off for that background. Evidence exists to show that children born to poor families do worse than those born to rich families. Would hon. Members call for clinics to check on the need for cash in the family before offering fertility treatment? No, of course we would not do that. That would also be discriminatory, even though there is more evidence of poor welfare in those circumstances.
Providing for the need for a father creates a market for internet services such as Man Not Included. If we start regulating those services, women will turn to strangers to be impregnated, and there is no protection in such cases. I do not believe that it is a matter of common sense because one person’s common sense is another’s prejudice.
The hon. Gentleman says that we should not discriminate against lesbian couples but, unfortunately, life is discriminatory. The Almighty decided that children would be made through intercourse between a man and a woman. That is nature’s way of creating children. Why does he discount that?
We could have a philosophical debate about what God intended and how much of medical science is playing God and going against what nature intended. Treatment for erectile dysfunction also interferes with what God intended but we do not hear many men arguing against access to such treatment.
I shall not take the hon. Gentleman up on that in the debate because I must finish my speech quickly.
The hon. Member for Windsor (Adam Afriyie) made a good point about the Government’s evidence for the removal of donor anonymity. He may know that one of the problems with that is that families who use donors choose not to tell the child because they do not want that to be discovered. That means that fewer children have access to such knowledge. There was no good evidence of harm in the current circumstances or of any benefit from following the suggested path. However, there was good evidence of the threat to gamete supply, which has been affected by donor anonymity. I feel strongly about the use of the precautionary principle, which my hon. Friend the Member for Harrogate and Knaresborough mentioned.
When there is clear evidence of benefit or likely potential benefit, the rule should be that there should be good evidence of serious harm before closing down research options. As the hon. Member for Salisbury said, there is a moral imperative to do good. We should try to maximise the benefits of the treatment. There is a moral imperative to treat infertile women and couples, to conduct research using stem cells to cure disease, and to develop new technologies.
There is a question about what constitutes the moral rights of the unborn child and where they come in. We had the debate about the 14-day limit and that on the limit on viability. We are considering those matters. There is a balance to be struck.
The report is not a slippery slope. If there is a slope, it goes upwards. I do not speak for my colleagues, but allowing people to take advantage of the technologies and helping people when there is no evidence of harm constitutes an upward moral slope. In any event, we are not considering a slope but a step. That hard-earned legislative step is considered every 16 years at least. That is why we have confidence in proposing that we go down the path that the report suggests.
On the abortion limit and a debate and vote on viability, The Sunday Telegraph reported during the general election campaign:
“Harriet Harman, the Solicitor General, said: ‘This has always been a matter of individual conscience. If something is a free vote it cannot be in a general election campaign… We can debate it later.’”
The Government rightly acknowledge that they do not have a mandate for the status quo for ever and that they should give Parliament the opportunity, through a review and a debate, either to keep the status quo or to change the law. We must have that opportunity.
I congratulate all those who contributed to the excellent debate. I hope that it greatly improves the understanding of those who have listened to it and those who read it of a range of issues that will—I hope—come before the House and that require, as the hon. Member for Norwich, North (Dr. Gibson) said, a great deal of debate,
I thank the hon. Member for Norwich, North and the Committee for the excellent report. I do not have to agree with all of it to realise that it is an important piece of work. As the hon. Member for Harrogate and Knaresborough (Mr. Willis) said, it shows the work of Select Committees at their best. It does not simply hold the Government to account, which is important, but tries to enhance Parliament’s role in the discussion and shaping of policy. That is especially apt in circumstances in which the House has responsibility not only to review the law but to make decisions in future about the shape of legislation on the subject—on a free vote.
The hon. Member for Oxford, West and Abingdon (Dr. Harris) mentioned the two important words “free vote.” Before I venture into the subject of the report, I emphasise that point. Hon. Members who were present during the passage of the Human Fertilisation and Embryology Act 1990 will recall that, two years before the measure was introduced, the Conservative Government said that such issues would be considered on a free vote. So they were. It is one of the Committee’s recommendations that the Government should make it clear that the passage of any legislation on this matter will be conducted on a free vote basis. That would certainly be true for the Conservatives, among whom there are different views that it is legitimate for any hon. Member to express.
The hon. Member for Harrogate and Knaresborough did a marvellous job of encapsulating many recommendations in a number of key themes. I prepared a set of notes for this debate containing all the issues that I thought we should discuss, but I have discarded them because, in the course of the debate, each of those issues has been raised. That is the mark of an excellent debate that has covered all the necessary ground extremely well. Some might think that it has covered more ground than was desirable, but I believe that we have done the subject real justice.
The hon. Gentleman touched on a matter of considerable importance, namely the procedure involved in taking this subject forward. I also want to emphasise that point before the Minister responds to the debate. On the strength of the consultations that have been carried out, I believe that we have reached a point at which the Government could come forward with proposals. Bearing in mind what happened during the passage of the Human Tissue Act 2004, I believe that the Committee is right to call for pre-legislative scrutiny of any proposed legislation. I hope that the Government will therefore publish a draft Bill for that purpose. I also hope that the Minister will confirm that that process will be conducted on a free vote basis. These are obviously matters for the House as a whole, rather than solely for Front Benchers.
The need for a Select Committee on bioethics merits further discussion. We have discussed a range of issues this afternoon, and there are others, such as surrogacy, that have not been mentioned. The need for discussion on other matters, including the use of gene therapies and genetic research, demonstrates the desirability of having a body of continuing expertise to be developed in the House, on which we could all rely. The Science and Technology Committee has done a marvellous job in producing this report, but we cannot ask it to be responsible for continuously updating Parliament’s views on these issues.
We say that we have had no legislation on these issues since 1990, but we have returned to them from time to time. I recall that, when we debated stem cell research four or five years ago, many Members felt as though they were suddenly being asked to consider the matter without having had the opportunity to do so before. The same applies to the issue of abortion, which, as the hon. Member for Oxford, West and Abingdon said, does not get debated if we are not considering legislation on the matter. A Select Committee would offer greater opportunities to debate all these issues.
The hon. Member for Morecambe and Lunesdale (Geraldine Smith) made a powerful case for the need for a debate on abortion. Taking a very different tack, the hon. Member for Islington, South and Finsbury (Emily Thornberry) argued her case on the issue. I want to echo what the hon. Member for Oxford, West and Abingdon said on the issue. We cannot decide here and now whether there is sufficient evidence to justify the view that 24 weeks is too late a point—based on the viability of a foetus—for abortions to take place except in the most exceptional circumstances. The Committee makes a perfectly reasonable case for that subject to be examined. Although such an examination would not necessarily lead to the introduction of legislation, there are proposals about access to early terminations of pregnancy—involving a nurse carrying out the procedure, for example—that might require legislative reform.
My personal view is that it would probably be unwise for that issue to be wrapped up in the reform of the Human Fertilisation and Embryology Act 1990. I would not want hon. Members to have to take a view on the desirability or otherwise of a whole piece of legislation on the ground of their strongly held views on abortion, when the bulk of the legislation ought to be able to proceed without having to deal with that issue. In that respect, it would be helpful if Ministers would make it clear that those issues will be considered separately, and that, if a Committee of the House were to propose options for the reform of the law on abortion, the Government will do as a previous Government did and make parliamentary time available for the House to conclude any such discussions.
My hon. Friend the Member for Congleton (Ann Winterton) took us into the question of the welfare of the child, on which the Committee made a number of recommendations. The way in which the Committee did that was rather curious, because it suggested that the welfare of the child, as currently expressed in the legislation, should be abandoned, but then went on to say that it should still be considered if there were a risk of significant harm to a child, and that there should be a threshold in such circumstances. I cannot see how a legislative framework that requires third parties to intervene to bring a child into the world cannot consider the welfare of the child.
The Select Committee’s report states, on page 46, that
“if the welfare of the child provision is to be retained in any revised legislation it should be based on the principle that the state has a role in determining who can have fertility based on their personal history and circumstances.”
We also stated, in relation to medical treatment, that doctors are required to have regard to these issues without an extra layer of regulation. We do not need a specific provision that allows clinics to discriminate, because having regard to the welfare of the child is already embedded in good clinical practice.
I understand that, but unless there is wholesale deregulation of assisted reproductive technologies, those who carry out fertility treatments must take responsibility within a specific regulatory framework. It would send the wrong message if we were to abandon a particular aspect of that framework. If we were to go down a much more deregulatory path, however, the situation might be different.
My hon. Friends the Members for Congleton and for Broxbourne (Mr. Walker) expressed a view that is shared by many people about the best circumstances in which to bring a child into the world. I do not think that we have any doubts about what they said; I hope that we do not. However, when we ask whom we should prevent from having the opportunity to provide a loving home to a child, that is a different question. The argument was put to the Committee that the Human Fertilisation and Embryology Act 1990 was out of kilter with the Adoption and Children Act 2002, but it is not. Under the Adoption and Children Act, social services considering a child for adoption have to consider the child’s welfare very carefully, and to decide whether it will be cared for and given a loving home. That is a perfectly reasonable test. The issue is not whether the welfare of the child should be considered in any proposed legislation but whether we should preclude providing artificial reproductive technologies to lesbian or gay couples.
Does my hon. Friend agree that the hon. Member for Oxford, West and Abingdon (Dr. Harris) was getting slightly confused when he talked about male erectile dysfunction? This is a serious point. If a man is treated for erectile dysfunction to improve his sex life, that is one thing, and I hope that, if two lesbians were having problems in their sex life, they would receive the necessary treatment. However, we are not talking about erectile dysfunction and sex lives here. We are talking about having children. I think that the hon. Member for Oxford, West and Abingdon was confusing the two issues.
I am grateful to my hon. Friend. We are, of course, talking about children, and about the circumstances in which couples, and in some cases single people, have access to help to become a parent. From my point of view, a gay couple who go through the process of surrogacy are capable, and in some circumstances entirely capable, of providing a long-term loving home for a child. If a lesbian couple or a single woman wish to have fertility treatment—rather than, for example, donor insemination—that is a perfectly acceptable way of proceeding. Personally—I emphasise that I speak entirely personally—I would prefer that, legislatively, we enabled children to be brought into the world to parents who want to give them a loving home, using the welfare of the child as a continuing measure, rather than trying to restrict that. Too few children are being brought into loving homes, and too many are being brought into unhappy homes where they are not loved and not looked after.
The hon. Member for Norwich, North, who should take pride in ownership, with his Committee, of this report, said that he would rather take penalties in the last minute than go through this again. We would all prefer that, as he might succeed. He touched on the whole question of the HFEA’s role. I confess that I do not understand why the Committee concluded that the HFEA’s tasks of policy interpretation and of inspection and maintenance of standards are necessarily incompatible or subject to a conflict of interest. I think that its understanding of the role that fertility clinics play and of developments in technology—and its interface with clinical practitioners—are an essential part of informing policy. I accept his point that by dint of working with 1990 legislation the HFEA must increasingly make policy decisions that were not anticipated in 1990 and which legislators at the time would have expected to be brought back to Parliament for consideration. That is one of the reasons why we must have legislation, which I hope might establish a slightly more flexible structure that allowed Parliament to take more of the policy decisions, a decade or two hence, rather than leaving such matters entirely to the HFEA.
In passing, as the hon. Member for Oxford, West and Abingdon spoke well of HFEA members, let me say that I have been impressed by their work in my dealings with them. I know that the Committee has had criticisms of them, not least in the past. I am grateful for the work that Dame Suzi Leather has done as chairman. She is now moving on, and although I do not necessarily agree with every one of her statements, I think that she has helped tremendously and tackled some difficult issues extremely well in a public context.
My hon. Friends the Members for Salisbury (Robert Key) and for Braintree (Mr. Newmark) touched on the contest between scientific capability and the framework in which it should be exercised. I am not sure that I could ever help my hon. Friend the Member for Salisbury with his question about what heaven might consist of, and I doubt that he was asking my advice on the subject. However, his comments about not stopping science are terribly important, and pre-implementation genetic diagnosis is a good example. We are clear that there are circumstances in which we would not want PGD to be used. For example, would we expect it to be used to try to eliminate a small increased risk of a certain disease later in life? No, I do not think so. In that area, however, the legislation will introduce not broad prohibitions, but a range of criteria, which will have to be determined over time and as science develops. That is one of the compelling reasons for having an interface between lay and scientific views. As the Committee made clear, however, that interface should not just take place in the HFEA but in a dialogue between the HFEA, the scientific and medical community and Parliament. It is important for that to dialogue to continue.
To echo a point that was implied by my hon. Friend the Member for Braintree’s comments, science may continue to change, but science does not drive ethics. As we have in part set out to do, we must make clear not just the ethical framework but the ethical standards that apply to this area of technology. Reproductive cloning is a good example. I cavil slightly at the argument that reproductive cloning technology might have changed in 20 years’ time, which of course it might—human reproductive cloning might even have been achieved in other parts of the world. However, I cannot for the life of me see why this country’s legislative framework should do anything other than say clearly that we are against it and that it will not happen here. I do not subscribe to the view that because science changes, our law must change. On some matters, we must be quite clear. The legislation will contain both broad prohibitions and sets of criteria in certain areas, and we must be clear about the distinction between the two.
The hon. Member for Brighton, Kemptown (Dr. Turner) referred to clearer legislation on sex selection criteria, which is a good example. We must make clear where those boundaries are to be set. The Committee was right that, for instance, the criteria for the use of human-animal chimera, PGD and pre-implantation tissue typing must be set out to a greater degree in the new legislation.
My hon. Friend the Member for Windsor (Adam Afriyie) made an important point about donor anonymity. In Committee, we made precisely that point, and voted against the regulations on those grounds. I am disappointed that the Minister brought forward legislation and whipped it through without a free vote. The Committee noted that, and subsequently discovered that the legislation was drafted on the basis of poor evidence. As a consequence, those providing fertility treatments are suffering.
The hon. Member for Bolton, South-East (Dr. Iddon) made an important comment, which I echo, about the availability of fertility treatments. I declare a sort of interest, although not a personal one. While Louise Brown may have been born in Oldham, the scientific work was undertaken at Bourn Hall clinic in my constituency, and I am vice-chair of the all-party infertility group. Two years ago, the Prime Minister said that the NICE guidelines, especially on the availability of three cycles of IVF, should be achieved, and that the Government would make clear further progress on that. More than two years later, that has not happened. As a consequence, there are still serious inequalities in the availability of treatment. With regard to my constituents, from last September to this spring, my primary care trust stopped making fertility treatments available. It has now started to make them available, but it has limited the number of contracts to 200, which means that fewer couples are gaining access to fertility treatment than are coming on to the waiting list. Some PCTs are setting perverse criteria, such as not making fertility treatment available until women are 36 years old, whereas the NICE guidelines were designed to optimise the cost-effectiveness of fertility treatments provided through the national health service.
The hon. Member for Bolton, South-East took an admirably utilitarian view of fertility treatments, and said that they contributed to the country’s economy as a whole, which is no doubt true. From my point of view, I just meet couples who want to provide a loving home to children and who, in my view, should be given the opportunity of having their physical impairment remedied by the NHS, as it remedies many other diseases. Infertility is a disease, and it has a big impact on people’s lives. Bringing loved children into a loving home would have an enormously positive impact on those lives, and would do a great deal for society.
My hon. Friend says, from a sedentary position, that it is a condition. Something that causes people considerable distress is a disease, and it can be a consequence of what is clearly a disease. For example, one of the reasons we are fighting chlamydia is that in later life it will lead to an increased incidence of infertility. Members may say that infertility is a subsequent condition arising from a particular disease, but that is splitting hairs, and I do not want to split hairs in this context. We are dealing with couples who want to provide a loving home, and I think that one of our responsibilities as a society is to increase the number of such opportunities..
We have had a good debate. We have heard a variety of speeches from Back Benchers—12, I believe—in three hours or so, reflecting the complexity and diversity of opinions on what we have been able to discuss today, let alone other aspects of the report that there has not been time to mention.
I welcome the report, and thank my hon. Friend the Member for Norwich, North (Dr. Gibson), who chaired the Committee that produced it. He passed the gauntlet—if that is the right word—to the hon. Member for Harrogate and Knaresborough (Mr. Willis). As he said, I am due to appear before the Committee next week, and I am sure that it will explore many of the issues raised today in much more depth.
We have benefited from a number of authoritative reports produced by a variety of Select Committees of both Houses in recent years, but I think it fair to say that few have been as extensive as the one that we are debating today, or have produced such wide-ranging recommendations. The report followed a year-long inquiry involving written evidence gathering, examination of witnesses and, as we have heard today, fact-finding missions abroad. The result of that process has been very thought-provoking. It has led to analysis and to a set of recommendations which—although we may not all agree with them—prompt questions that need to be put, given the pace of change in both science and technology and social issues over the past decade or so in this area of public policy.
Those who read the report, regardless of whether they agree with its proposals, will be compelled to examine their own reasoning and rationale in regard to a host of fundamental legal, ethical and social questions and dilemmas, many of which go to the heart of no lesser questions than what it means to be human and what are the proper limits of toleration in a modern pluralistic society. It is hardly surprising that the report did not have an easy gestation, or that the Committee could not reach unanimity on underlying principles. I should refer at this point to the special report that records the dissent of five Committee members. That too has been reflected in the speeches we have heard, particularly that of the hon. Member for Congleton (Ann Winterton).
I do not think, however, that a lack of unanimity is necessarily to be regretted. It illustrates the complexity and depth of feeling that surrounds these issues, and opens them up to wider debate. Certainly our consultation, whose findings we published earlier in the year, revealed a wide range of views. It would be unfair to suggest, as some Members may have been inclined to suggest today, that there is only one view in the scientific community, or that it does not take the issues seriously. The feedback that I have received suggests that, far from having a “go fast” attitude, many in that community want the issues to be aired fully. They want a full discussion, because they want to feel that there is confidence in their professionalism and their approach to the important matters that have been raised today.
I do not believe that any of the issues we have discussed are easy or admit of a simple solution, or at any rate a solution that can be reached by a simple or easy route. In January 2004 we announced our intention of reviewing the 1990 Act—a process that would include a public consultation exercise in 2005. The Select Committee’s report provided an excellent starting point. We took up many of the issues raised and suggestions made by the Committee, and signalled our willingness to consider potential changes. I hope that our response also identified points on which we agreed with the Committee, and showed that when we did not agree we took on board some of the points that have been made again today. I am thinking of, for instance, the regulatory and policy-making role of the HFEA and the question of where Government oversight should lie.
It is right for us to take time to think through the issues and develop our response properly. As I have said, we made clear our agreement with some of the report’s recommendations, and made plain our intention to gather views on others from a wider audience. In common with the Committee, we concluded that the basic foundations of the 1990 Act, as rooted in the earlier report from the Warnock committee of inquiry, remained sound.
I think we should all be very proud of the legislation. Yes, science has moved on, but I think we should be proud of the basic foundation that has served the country so well, not just nationally but internationally. My hon. Friend the Member for Brighton, Kemptown (Dr. Turner) made a good point: that in not being prepared to explore some of the issues that we have explored, those in other countries have allowed the creation of an atmosphere in which it has been possible to develop some of the worst examples of what we do not wish to see. That has often brought into question practices in our own country, but our debates on the issue, and our underpinning legislation, have stood us in good stead and protected us from some of the wider and scarier practices overseas.
The foundations of the report include the idea of a special status applicable to the human embryo, the need for active monitoring and regulation, and a clearly defined time limit on the development of embryos in vitro for research. When we announced our review of the Act, we made clear that several aspects of the current law and scheme of regulation would not be reopened for debate. We felt that those aspects had been conclusively, and in some cases very recently, resolved by Parliament, or the Government had already made clear their established policy intentions. They include the removal of donor anonymity. The hon. Members for South Cambridgeshire (Mr. Lansley) and for Windsor (Adam Afriyie) have expressed concerns about its removal, but children’s organisations and others have said that they consider it right. We have talked a great deal about family and identity today. The view has been expressed that children conceived by means of donors have a right to receive information about those who allowed them to be created in the first place.
As I have said, on the whole the 1990 Act has stood the test of time, and is a tribute to the foresight of its creators. It resulted from an extensive process of deliberation and consultation over several years. It established the principle of independent oversight of an area of medical practice, and I believe it has proved to be remarkably robust in the face of legal challenges. I also believe that it has promoted public confidence in assisted reproduction treatment, and has played a large part in enabling the United Kingdom to move to the forefront of cutting-edge developments in scientific and medical research.
There has been criticism of the HFEA, but I think that it continues to do a very good job in dealing with the novel and complex issues that inevitably come its way. I agree to an extent with the hon. Member for South Cambridgeshire, who said that it was difficult for organisations to look purely at regulation without examining issues relating to policy development as they see it, in the context of their inspection and regulatory processes. I join the hon. Gentleman in thanking Dame Suzi Leather for her leadership and steering of the HFEA. I also thank all members of the board, who constitute a mix of professional and lay people.
Law and regulation have not stood still since 1990. The House has passed both primary and secondary legislation, either in response to developments or to seize new opportunities. Nevertheless, the Committee and the Government have agreed that there is a growing need to revisit the law, particularly given the rise of new technologies. The Committee had previously expressed that view as a need to
“reconnect the Act with modern science”.
There can be no doubt that developments are moving fast. They include technological breakthroughs in the screening of embryos for hereditary diseases, and we have seen the number of babies conceived through IVF worldwide pass the 3 million mark. That figure includes 100,000 children born in the UK. We need to establish a framework that is broadly acceptable to society, and fit for purpose in the 21st century.
We should remember this, too. It comes from the Warnock report, and it has the same resonance today as when it was first written:
“the law must not outrage the feelings of too many people, but it cannot reflect the feelings of them all.”
That is an important quote today, as it was then. The report continued:
“It must therefore be drawn with a view to the common good".
I believe that a consultative and deliberative approach is key. As we have said, we are keen to continue to explore how wide-ranging a debate we can have and to continue to provide opportunities for more involvement and more debate.
There were 535 responses to our consultation; more than 100 organisations took part. We saw the wide diversity of views. None the less, the ultimate basis for regulation in this area is the public good, and commonly acceptable limits and boundaries. Therefore, the considered views of society as a whole, identified through exercises such as the consultation, the Select Committee report, this debate and debate in the months ahead, are crucial to making sure that we end up with a law as successful as the original law on which it will be founded.
It is clear that responses generally favour measures such as a ban on non-medical sex selection, and retention of a “welfare of the child” consideration in some form. I will talk a bit more about that later. Respondees were generally less convinced of the need to make changes to the scope of permissible embryo research. It will be for Parliament to weigh those arguments, opinions and evidence in its consideration of any proposals to change the law that the Government may bring forward.
There has been much discussion about the role of the HFEA. Some take the view that Parliament could take more of a role not only on that matter but on that movable feast, the way in which science and society develop. In our response to the Committee, we did not feel that a bioethics committee was necessarily the right way forward. We took that view on the basis that the present distributed model of advisory bodies with more specific briefs remained the best option, as it enables specific bioethical issues to be addressed by dedicated groups with the appropriate expertise and sufficient time to devote to the issue. However, we share the Committee’s view that airing and debating bioethical issues in Parliament is important, and we are willing to give further consideration to the appropriate level of parliamentary control over delegated powers under legislation. We accept the benefit of wide consultation. As I have said, I am looking to explore how much further we can develop that debate in the months ahead.
Establishing a regulatory authority for tissue and embryos is not just a costcutting exercise, as some people have suggested, or just a neat joining of two organisations. We believe that, through bringing the HFEA and the Human Tissue Authority together, we can have a single competent authority acting as a regulator under the blood, tissue and cells directives, which will reduce any risk of overlap and duplication. We also think that RATE will be better able to work with other regulators such as the Healthcare Commission to ensure common standards and practices. Having a single source of authoritative guidance on all issues related to the use of human tissues of all kinds will be helpful in one organisation. Again, that will help to ensure good practice and guidance established on common principles in those related areas.
My hon. Friend the Member for Bolton, South-East (Dr. Iddon), the hon. Member for Harrogate and Knaresborough and other colleagues talked about the sex selection of offspring. That issue is a good example of why we have chosen to review existing law and regulation. It is established policy that the selection of embryos on the grounds of sex, other than for serious medical reasons, should not be allowed. That position is maintained by the HFEA, which has undertaken extensive public consultation and surveys. That was complemented by the response to our own consultation. However, there is not an explicit statutory ban in law, and nor does the HFEA's policy apply to treatments that fall outside its remit. The rise of new technologies, such as sperm sorting, could therefore allow sex selection to take place in settings outside the scope of regulation.
We consulted on options, including a ban, or a partial ban in line with the Committee's recommendation to allow sex selection for non-medical reasons in order to “balance” a family. It is clear from responses to our consultation that people favoured an explicit ban with no exception for family-balancing, and a range of other surveys have shown widespread public antipathy to sex selection for social reasons.
We must give serious consideration to how a statutory ban could work in practice. As I have said, services on the internet are one factor. My hon. Friend the Member for Bolton, South-East asked whether the Government would regulate internet sperm providers. We have said in our consultation document that we intend to make the operation of internet services involving supply subject to regulation. We have sought views on the detail of that, but clearly, we can apply it only in the UK. We cannot necessarily apply it to overseas practices.
The welfare of the child and the need for a father are another social concern. Concerns about the general welfare of children underpin many aspects of the current legislation. For example, concern about the psychological well-being of the child is a key reason for the ban on human reproductive cloning. However, the extent to which the law should intervene in decisions to provide treatment in individual cases, or impose “social” criteria for assisted reproduction clinics is less clear-cut. Whatever view we take individually on the merits of different family forms, the issue is about whether it is the state's role to impose a view. I listened carefully to the comments of the hon. Member for South Cambridgeshire
In 1990, Parliament chose to require clinics to take account of the welfare of the child, including the need of the child for a father; any change to that position will again be a matter for Parliament. The Committee's report is very clear. What emerged from the consultation, interestingly—and, on this occasion, it contradicts the comments of my hon. Friend the Member for Bolton, South-East—is that the medical profession, as represented by the royal colleges and the BMA, feels that there needs to be something that recognises the welfare of the child. The BMA wants a general welfare of the child provision to be retained, and the Royal College of Obstetricians and Gynaecologists wants to subsume those considerations within good medical practice. Therefore, there is a view that the welfare of the child is still an important consideration to be taken into account.
The question of the “need for a father” has again been aired. It is not a straightforward matter. The requirement to take account of the need for a father is not a prohibition as it currently stands. The HFEA is required to give clinics guidance on taking account of the welfare of the child. On that point it says:
“Where the child will have no legal father, the treatment centre is expected to assess the prospective mother's ability to meet the child's/children's needs and the ability of other persons within the family or social circle willing to share responsibility for those needs."
We are looking at the response to our consultation on the issue. I am sure that there will be further discussion. Again, we felt it important to put those questions in our consultation because we wanted to reflect the fact that perhaps over time opinions had changed, and the emphasis on the welfare of the child should be paramount in relation to decisions on the issue.
PGD has concentrated colleagues’ minds. The hon. Member for Salisbury (Robert Key) and my hon. Friend the Member for Brighton, Kemptown both spoke about the issue. The screening and selection of embryos, and the grounds on which that may be undertaken, feature heavily in the Committee's report and have done so in preceding reports. Indeed, I believe that that issue, more than any other, led to the instigation of the Committee's inquiry. Although the courts have upheld the HFEA's power to make licensing decisions in that area, the topic remains controversial.
The analysis in the Committee's report is instructive. It raises several facets of the debate, including making sure that embryos are not created and destroyed frivolously, balanced against the avoidance of serious inherited disorders or the ability to treat a seriously ill sibling. It goes on to consider the appropriate setting for decision making and the respective roles of Parliament and the regulator. Responses to the consultation, where they agree that pre-implantation genetic diagnosis should be allowed, show that there is a view that there need to be some more explicit criteria in legislation to determine legitimate purposes for which embryo screening and selection may take place. Again, we need to think about how we deal with the pace of change in the science and the role of the authority in the future, as well as Parliament’s input into the decisions.
My hon. Friends the Members for Morecambe and Lunesdale (Geraldine Smith) and for Islington, South and Finsbury (Emily Thornberry) and the hon. Members for Congleton, for Harrogate and Knaresborough, for Oxford, West and Abingdon (Dr. Harris) and for Salisbury (Robert Key) debated time limits. The subject was also touched on by other hon. Members in various ways.
One of the differences between the last time Parliament discussed time limits and now is that then relevant professional bodies exerted considerable pressure in favour of a change. Some hon. Members may have participated in that debate, and I was certainly aware of it. It was clear that the professional bodies felt that the time limits needed to be changed. However, today, the Government have not been approached by any of the relevant professional bodies to state that they have changed their views since the limit was reduced from 28 to 24 weeks in 1990.
At low gestation age, even if the foetus is born alive, there are high risks of death due to immaturity. Indeed, while the possibility of survival of extremely pre-term babies has improved, data suggest that, even with modern intensive care, chances of survival at 22 weeks’ gestation are only approximately 1 per cent., whereas that increases to 26 per cent. at 24 weeks. However, it should be noted that 88 per cent. of abortions are carried out at less than 13 weeks’ gestation, 60 per cent. of which are at less than 10 weeks. Less than 1 per cent. are performed at 22 weeks and over. Only 124 have taken place at 24 weeks and over.
Parliament agreed in 1990 that the legal limit for most abortions should be reduced from 28 weeks to 24 weeks. The debate that informed the decision considered a wide range of issues, including both ethical and practical issues. It is still a matter for Parliament to decide, but I wanted to be clear about the pressures that were coming at the time from professional organisations. That is not happening today. Any proposed changes would need to be carefully thought through, and we have not had the pressure from the organisations for change. The BMA and the royal colleges, which advised the need for a change in 1990, have not given any such advice today.
That is an issue for the House to decide. I was trying to point out the differences between the debate in 1990 and today. In 1990, the professional medical organisations urged the Government to make changes, based on the scientific evidence, but they are not doing so today.
We are trying to ensure that women have access to abortion services as soon as possible. Primary care trusts have a performance indicator designed to encourage them to assist women to have access to early abortions. However, we know that some of those taking part in the debate disagree with any abortion. We have also carried out an audit of the gaps in access to contraception for women, and the point has been made this afternoon about access to better sex and relationships education and information for young people so that situations do not end in an unwanted pregnancy for which an abortion may be the only solution for the individual concerned.
Despite some of our best efforts, the provision of sex education is still patchy, although there is some very good practice, both in and outside schools. In fact, most young people do not want information only about sex. Most of those under 16, the hon. Lady will be pleased to know, are not having sex, but they do want information about the changes to their bodies as they grow up and how to cope with peer pressure during puberty. Much of the work that we do on teenage pregnancy also takes into account issues of low self-esteem. Young people need the confidence to not feel pressurised into having sex, but if they are going to have sex, to do so safely. I wish that the picture was as clear-cut as the hon. Lady might like to imagine, but relationships hardly ever are. We could certainly do more to improve sex and relationships education.
The Minister is correct to say that there is no call from the royal colleges or the BMA to reduce abortion time limits, and it is fair to recognise that. However, nor is there any opposition from those bodies to a review. The public want a review, and the Minister obviously thinks that public opinion is important, because she followed the public consultation on the changes to donor anonymity, despite the opposition of the BMA. The Minister has to recognise that in the end it will be a matter for Parliament, and many of us feel that it would be timely to address it in this Session, after 16 years, rather than wait for the next Session.
This afternoon has been an opportunity for all views to be aired on the issue, as was the hon. Gentleman’s Adjournment debate last year. I am sure that the discussion will continue. It is important that we understand how many women are having late abortions and why. For example, some women cannot be screened to see whether the baby they are carrying is likely to have severe disabilities until very late in the process, and they may also need some time to think about what to do—which might be not to have a termination. The timing can mean that women have to make very difficult decisions. I do not think that any of the 124 women who have been through that have taken it lightly, and my hon. Friend the Member for Islington, South and Finsbury made that point well.
We must also consider the science—what is and is not possible. I heard on the radio recently about the scans taken of foetuses that appear to be walking or sucking their thumbs, but some of those scans were taken at 12 weeks, so we need to think about what points people are making and whether the debate is about the wider issue of access to legal abortion, and not just time limits. I am sure that we will come back to the issue, perhaps next week in Committee and in future debates.
My hon. Friend the Member for Bolton, South-East asked about definitions of embryos and gametes, which he feels are inadequate. We have announced that we intend to ensure that the definitions used in the legislation are fit for purpose, taking account of the rise of new technology. That is a primary reason for reviewing the legislation. For example, we will ensure that all embryos outside the body are covered by regulation. However, we have made it clear that, in common with the Science and Technology Committee, we have no intention of altering the 14-day limit for embryo research.
My hon. Friend the Member for Bolton, South-East and the hon. Member for South Cambridgeshire (Mr. Lansley) raised the important issue of access to fertility services. There has been quite a debate about the Human Fertilisation and Embryology Authority publishing its own document on different clinics and what they provide. There were calls from across the Chamber—and, I think, from the hon. Member for Harrogate and Knaresborough—to look at success rates. The picture is not clear, because obviously the results very much depend on the profile of the people coming through. As with anything, we do not necessarily want a league table; we just need to be mindful of the issue. Having said that, it is fair that people seeking IVF and support should have some understanding of what they should be looking out for in a good clinic. That certainly should be part of the commissioning process.
I have been exploring further how we might improve the commissioning process for IVF services, both within a primary care trust and perhaps among a group of PCTs in an area, to see how they might commission such services and get better value for money, and perhaps better outcomes and understanding, too. I am pleased to have supported a new project by Infertility Network UK, which we provide with core funding, on ways in which it can work with PCTs to ensure that fertility patients’ voices are heard when decisions about services are made locally.
I am so pleased that the hon. Member for South Cambridgeshire mentioned the link between chlamydia and infertility. I have been trying to get the Department and non-governmental organisations to think much more closely about the connections between those two issues, and about why the screening programme for chlamydia is so important. We should do whatever we can to prevent the likelihood of future infertility, and one of the ways we can do that is through better screening for chlamydia; another is by people practising safer sex more regularly.
We believe that stem cell research offers enormous potential to deliver new treatments for currently incurable illnesses, such as chronic heart disease, diabetes and Parkinson’s disease. We want to encourage research exploring all sources of stem cells, including embryonic stem cells. In the March 2005 Budget, the Chancellor announced the establishment of the UK stem cell initiative, a taskforce charged with developing a vision and a costing strategy to make the UK a global leader in stem cell research. It is undoubtedly the case that frustrated scientists in the US who want to do the world some good through such research are coming to Britain to share their expertise and to be part of such an important scientific development, which brings hope to so many thousands of people, and so many future thousands of people, too.
The hon. Member for Windsor made a point about the decision to remove donor anonymity. We took account of the views provided in response to a public consultation and a further targeted questionnaire sent to clinics and, through them, donors. The fundamental matter was whether it was right to perpetuate the situation whereby donor-conceived people were denied information held on a national database about their donor. Following consultation, we decided that it was not. Again, that is an issue about the rights of donor-conceived children to have some information about their own life and background. We asked some other questions about that in relation to the consultation and we have also been looking into wider issues around information, which we are hoping to share in the near future.
We have had a wide-ranging debate. Clearly, there is an interest in the subject in the House, of which I have taken note. I have also taken note of the many different points that hon. Members on both sides of the House have raised. As I said before, we should be proud that we have a law that has done a huge service to the development of policy on the subject, both on science and social grounds. However, we have to reflect social as well as scientific changes, and we have to reflect on the best way to get a regulatory authority that has some flexibility, while considering fully Parliament’s oversight role for the future.
I thank everyone for taking part in the debate, and I very much welcome having had the chance to respond to it.
Question deferred, pursuant to Standing Order No. 54 (4) and (5) (Consideration of estimates).