Mark Simmonds (Shadow Minister, Health; Boston & Skegness, Conservative)

I beg to move amendment No. 38, in clause 25, page 26, line 4, at end insert—

‘(za) the disclosure is made—

(i) on clinical grounds, as part of the patient’s medical care, to a practitioner who is bound by the ordinary duty of patient confidentiality, or

(ii) in order to ensure the safety of medical treatment which the patient is to receive outside of licensed premises.’.

Jimmy Hood (Lanark & Hamilton East, Labour)

With this it will be convenient to discuss the following: Government amendments Nos. 45 and 46.

Amendment No. 150, in clause 25, page 27, line 27, at end insert—

‘(v) the disclosure is made in order to ensure the safety of medical treatment which the patient is to receive outside of licensed premises.’.

Amendment No. 151, in clause 25, page 27, line 27, at end insert—

‘(v) the disclosure is made, on clinical grounds, as part of the patient’s medical care, to a practitioner who is bound by the ordinary duty of patient confidentiality.’.

Government amendments Nos. 47 to 54.

Amendment No. 37, in clause 25, page 28, leave out line 46 to line 8 on page 29.

Mark Simmonds (Shadow Minister, Health; Boston & Skegness, Conservative)

Clause 25 relates to the sharing of information—between and with whom—the restrictions on disclosure, and the exceptions to those restrictions. I shall speak specifically to amendment No. 38.

In proposed new section 33C to the 1990 Act, the Bill provides for consultation and regulations to be made to allow the disclosure of identifying information without consent for the purposes of medical or other research that is

“necessary or expedient in the public interest or in the interests of improving patient care”.

However, as the Minister and many members of the Committee will be aware, this was debated at some length in the House of Lords. Members of the Lords believed that the confidentiality provisions of the Bill were too tight, thus preventing sufficient research on children born by IVF. In situations in which women conceive through IVF, there is no procedure for the woman’s obstetrician to be told about the method of conception. Clearly, this must be looked at in the context of patient confidentiality. Obviously, if a woman does not want that information to be passed on, her privacy should be protected.

However, there are cases in which sharing such information would be beneficial, and there seems to be a presumption against that information flow, although perhaps the presumption should be in favour of it, even though I do not think that it is relevant that obstetricians need to know who the donor was, or whether it was the partner’s sperm or a donor sperm that fertilised the egg. Clearly, with IVF, women undergo treatment and complex procedures that change the body. Such a thing would, in some circumstances, enhance patient care in the context of strict confidentiality, which does not apply to other sensitive or personal conditions, such as considerations of mental health. The amendment would allow for the sharing of information between medical practitioners, which could improve patient care, in the context of confidentiality. The woman’s privacy would be respected, and consent for that information to be passed on could be withdrawn, if she wished.

Amendment No. 37 would remove the regulation-making power in proposed new section 33B of the 1990 Act. My understanding is that the power enables future additional exceptions to be made on who can request information,  who must be informed, and with whom it can be shared. However, if consent is the cornerstone of the Bill, such issues should be debated and put on the face of primary legislation. Members of the Committee will see a very comprehensive list of exemptions on the main thrust of the clause in paragraphs (a) to (u) of proposed new section 33A(2). The matter has obviously been thought through very carefully, but will Minister put on record why she feels that it might be necessary to amend the list, given that it has clearly been thought through in great detail? Can she give the Committee an example of an amendment that might occur in future, although I understand that it might be difficult to find an additional category that is not covered in paragraphs (a) to (u)?

My final point about the clause concerns proposed new section 33A(3)(a), which details the interrelationship between the Bill and the Congenital Disabilities (Civil Liability) Act 1976? Will the Minister explain how the measures work together?

It would be helpful if the Minister could clarify whether the Government amendments are all tidying-up provisions, or whether they would actually change the meaning of the clause. They seem to remove certain provisions, but that could just be tidying-up drafting.

Evan Harris (Shadow Minister, Innovation, Universities and Skills; Oxford West & Abingdon, Liberal Democrat)

I tabled a couple of the amendments in the group, but it might be best to hear the Minister’s description of the effects of the Government amendments. They are better drafted than those in my name and, if I may say so, those tabled by the hon. Member for Boston and Skegness. The right hon. Lady’s amendments are comprehensive and complex, and if she is willing to accept questions after she has explained them, that might speed things along.

Amendment No. 151 states that an exception would be made for disclosure on clinical grounds

“as part of the patient’s medical care, to a practitioner who is bound by the ordinary duty of patient confidentiality.”

Those of us who want the rules on confidentiality to be loosened are not talking about a free-for-all. We just want to bring the provisions more, albeit not totally, in line with standard medical care rules under which medical notes are confidential. There are significant professional and, indeed, possibly criminal consequences from a breach of medical confidentiality, which is something that I feel strongly about. I have argued that the same procedure should apply to politicians and their children in respect of vaccinations, given that many in the media think that that should be a free-for-all, although I disagree.

Nevertheless, several clinicians have raised a problem with me. I shall not repeat what Lord Patel and Lord Winston said in the other place because that can be read, but scientists from Newcastle have explained that when a treatment is provided in a separate tertiary clinic, there is a clear distinction between the initial investigation of the problem and the subsequent provision of treatment. In a tertiary NHS referral centre, it is likely that the initial investigations and counselling will be carried out in a general infertility clinic. That might also occur a long time from the possible treatment. For instance, an unmarried 18-year-old with a severe pelvic infection will be counselled about the potential impact on fertility and the need to consider IVF. Such records—I  guess because this is a carried out in a licensed centre by a licensed person—are currently included in law under strict confidentiality regulations because they refer to IVF, and that is inappropriate.

There are two ways in which to tackle the problem. We could argue that only limited information should be included in the provisions and that they should be loosened to enable communication between doctors in the best interests of the patients in good faith. Doctors should always be answerable in respect of complaints to medical regulators and the professional regulator, the General Medical Council.

The Government have heard such concerns in the House of Lords on several occasions and I note that their amendments represent a response to that. I look forward to hearing the right hon. Lady explain their effect in detail. I hope that the clinicians who have contacted me will be satisfied by what she says, as well as the potential of the regulation-making power. I share the view of any Opposition parliamentarian that wide-ranging, regulation-making powers are questionable, but I feel more comfortable with the inclusion of the provision, given that I do not think that this debate has ended.

IVF still has a cachet, which makes it sensitive, but as its special status becomes less special, and as it becomes more routine, for many patients—it will always be their decision—it might well become appropriate to change the provisions to ensure that we keep up to date with what is practical and appropriate, rather than stick to what was felt to be appropriate in 1990.

Ian Gibson (Norwich North, Labour)

I wonder, Mr. Hood, whether I could have your view on an issue about the running of this Committee that is beginning to bother me. Several documents are being floated by people who have tabled amendments. During my time in Parliament, I have sat on several such Committees, and when documents are received from experts, it is important that every Committee member sees them so that we can come to a balanced judgment. Could you rule, Mr. Hood, that if people read from documents from eminent professionals, they be made available to the whole Committee? I say that because, advisably, I challenged a document before, and within an hour, I was being challenged by those who put the document in. My answer to them was, “Why didn’t you send it to all of us? How do I know whether what you are saying is true? Give us the evidence so that we can see.” I think that we are getting restrictive readings from different documents and that the Committee is hearing only half the story. We all feel passionately about this issue and want to get seriously involved.

Jimmy Hood (Lanark & Hamilton East, Labour)

I thank the hon. Gentleman for his point, but that is not a matter for the Chair. If Members receive information from other sources, it is for them to deal with that as they see fit. If evidence was given to the Committee per se, all members of the Committee would have that information, so that would not be a matter for the Chair.

Ian Gibson (Norwich North, Labour)

Perhaps the organisations or individuals that send in such information are not aware of Committee procedure. By floating it to one Committee member,  they restrict other’s involvement in the debate. When something is put forward, perhaps it should be presented by the individual to the Clerks so that they can judge whether it should be distributed.

Jimmy Hood (Lanark & Hamilton East, Labour)

Again, the hon. Gentleman makes his point, but I reiterate that that a matter for not the Chair, but those supplying the information to Members and, indeed, the Members themselves.

Dawn Primarolo (Minister of State (Public Health), Department of Health; Bristol South, Labour)

The HFEA is required to collect details of licensed treatments for its register of information, which contains identifying information about everyone who has received treatment, including IVF or donor insemination. The 1990 Act prohibits the disclosure of such information by either the HFEA or a licensed practitioner, and that is subject to a criminal offence, as the hon. Member for Oxford, West and Abingdon reminded the Committee. The Bill provides for exceptions to be made to that provision, so we have moved from the requirements of the 1990 Act to the exceptions, some of which we have dealt with this morning. Such exceptions are when a person identified in the information to be released has consented to its release, with the exception, of course, of donor information—we covered this in the previous clause—which is protected to a particular age; when the information would not identify any individual; or in an emergency, when a woman who has received treatment or services is in imminent danger that makes it necessary for information to be released. The list of exceptions consolidates those already permitted under the 1990 Act, as well as introducing some new ones. Furthermore, as the hon. Member for Boston and Skegness mentioned, the Bill contains a regulatory power that enables additional exceptions to be made.

When the hon. Member for Boston and Skegness referred to amendment No. 37, he asked me specifically why we need the regulatory measure. He referred to paragraphs (a) to (u) of proposed new section 33A(2). To be frank, the answer is that every exception that we can think of is already there, although we cannot think into the future in terms of future-proofing. The regulation-making power was in the 1990 Act. Measures would be subject to the affirmative procedure and the power would be a method of future-proofing the Bill, just in case. The hon. Gentleman is right to say that we made every attempt to put everything in the Bill, but we still believe that this measure is necessary in case—as has happened in the past—we need further exemptions. The regulations would not change the principles within which the exemptions work. He asked whether I could name any; I am afraid that I cannot because we think that we have been quite thorough.

I shall deal with amendments Nos. 38, 150 and 151 and respond to the questions asked by both hon. Gentlemen before moving on to the Government amendments. The amendments would provide additional exceptions for the disclosure of information. Specifically, they relate to the situation if the disclosure is made on clinical grounds as part of the patient’s medical care to a practitioner who is bound by the ordinary duty of patient confidentiality, or if it is necessary to ensure the safety of medical treatment that the patient is to receive outside licensed premises. Again, the hon. Member for Oxford, West and Abingdon drew comparisons with what happens elsewhere in medicine with regard to the exchange of information.

The Government’s view is that consent on disclosure should always be obtained when possible, and that doing so need not necessarily be burdensome. We appreciate that there are occasions when, during the course of treatment, it would be necessary for clinicians to share information with other health professionals. However, because of the consent arrangements in the Bill—I will go on to make further points—we feel that it is more appropriate to provide for the obtaining of general consent from the patient for that purpose at the beginning of treatment. That would enable clinicians to be confident that they were not acting outside the patient’s wishes, while also allowing them to share appropriate information regarding the treatment of the patient.

There are circumstances in which patients would perhaps want to limit the people who could be told about their treatment—perhaps they would not want such information to go to a GP who is a relative or a friend. By consenting at the beginning of treatment, the extent of information sharing could be limited accordingly. Again, that echoes back to a theme that we have discussed in previous clauses about the importance of clear explanation to the patient and clear adherence to consent.

Even after amendment, the provision would not provide scope for clinicians to disclose confidential patient information without the patient’s consent. I am not referring to drafting; I will reference other requirements. I should say something to the hon. Member for Oxford, West and Abingdon as a caveat because I have been a Member of the House for 21 years—quite a long time in opposition, although not recently, thank goodness. It is hard to draft amendments because parliamentary counsel are highly skilled. His amendments are about making progress on the principle, and I understand entirely what he wants to do.

The amendments would not provide for that because before information was disclosed to the health care professionals involved in a person’s treatment, the doctor would still need to consider whether disclosure was compatible with the Data Protection Act 1998, common law and any other relevant law where consent is generally required. Therefore, requiring the consent right at the beginning, and allowing that general disclosure, is in our view much more secure for the clinicians as well. They would have to satisfy themselves in all those other areas that they were disclosing information in the correct way. It is the Government’s view that the Bill strikes the right balance in respect of requiring consent to be obtained before identifying information is disclosed, even when that is to other health care professionals, with the exception of emergency situations. Consent to such disclosure in the course of treatment can be obtained, as I said, prior to the initiation of treatment, when the patient is consenting to that treatment.

The amendments that would introduce an exception to the disclosure are, in the Government’s view, inappropriate. The disclosure of identifying information without consent should be permitted only where there is good justification. There was a lot of discussion about that between the Government and stakeholders. The British Medical Association supported the Bill’s position. Obtaining consent for disclosure to health care professionals is possible. Therefore, the exception proposed by the amendments is not justified.

The hon. Member for Oxford, West and Abingdon made a point about the problems of disparity between different medical professions and that we are setting a higher level. I hope that I have dealt with that point, because a general consent at the beginning gives greater certainty and clarity to clinicians than having to satisfy themselves subsequently about data protection, common law and other law relating to confidential information, which is what the amendments would require.

The hon. Member for Boston and Skegness asked about the Congenital Disabilities (Civil Liability) Act 1976. That did not trip off my tongue—I was prompted on the exact date, I hasten to add. The 1990 Act extended the reach of that legislation to cover infertility treatments. Basically, the Bill does not alter that position. The 1976 legislation was carried over to the 1990 Act, which made the cross-reference and put infertility in, but the Bill, as it amends the 1990 Act, is silent on that, because it does not alter the positions. I hope that that deals with his point.

On the Government amendments, I suppose the quick response, although I might have to give a little more detail, is yes, they mostly tidy up the consent exceptions, following discussion in another place. The changes are tidying-up measures. However, there is one instance in which we need to be absolutely clear with regard to the interaction of the exceptions. We have to ensure that we do not inadvertently open up the consent to disclosure of non-identifying information or cause some difficulties in that regard. We are managing two types of information—the identifying and non-identifying—and under what basis it can be disclosed.

We recognise that it is very important that the 1990 Act and the Bill strike the right balance between safeguarding the confidential information of patients, their partner, donors and children held by the HFEA and clinics while, at the same time, allowing information to be disclosed by the HFEA and clinics in circumstances that warrant it. However, the 1990 Act is not always as conducive as it could be in that regard. For example, it prohibits the HFEA from disclosing identifying information about patients, even in cases in which the patient consents to such disclosure. That is one issue that needs to be addressed.

I will go through the Government amendments very quickly and return to them if Members have further questions. Amendment No. 45 amends and simplifies the wording in new section 33A(2)(g) to (j) and clarifies it to strike the important balance on consent, including identifying information as long as individuals have given their consent.

Amendment No. 46 is consequential to the new wording in proposed new section 33A about the disclosure of information, and replaces wording removed by amendment No. 50. It clarifies that the HFEA can disclose identifying information from its register to avoid imminent danger to a person’s health.

Amendment No. 47 removes wording from proposed new section 33A about consent to disclosure when treatment services are provided to two people together and both are identifiable. It recognises the provisions in proposed new section 33AB whereby the consent of each individual identified must be obtained.

Amendment No. 48 removes wording that is consequential and replaces it with wording that will be introduced by amendment No. 54. Amendment No. 49  clarifies that the disclosure of information for the purpose of investigating an offence or suspected offence, or in connection with legal proceedings, does not apply to identifying donor information.

Amendment No. 50 removes wording from new section 33A consequential to the replacement wording that is introduced by amendment No. 46. Amendment No. 51 reflects the fact that the Bill introduces provisions for fatherhood agreements for unmarried couples in which donor sperm is used. Amendment No. 52 is consequential on amendment No. 45. Amendment No. 53 defines what the term “identifying donor information” means with regard to new section 33A(2), which is a consequence of amendment No. 45. Amendment No. 54 applies in conjunction with amendment No. 45.

Therefore, without going into any detail, I am trying to indicate to the hon. Member for Boston and Skegness that we are cross-referencing and making it absolutely clear that the exemptions fit together and do not breach any of the principles. Overall, the Government amendments provide clarification rather than a change of policy by continuing to strike the balance between disclosure of identifying information, particularly that which might be helpful for follow-up research into the health of patients and their children, and ensuring that consent is properly and rightly obtained.

If I have not covered any of the points, Mr. Hood, I would be happy to catch your eye and return to them.

Evan Harris (Shadow Minister, Innovation, Universities and Skills; Oxford West & Abingdon, Liberal Democrat)

I am grateful to the Minister for her exposition on the amendments, which I followed on a track changes document—I think that that is the only way to do it. First, in response to a point made by the hon. Member for Norwich, North, I am a little confused. I had a meeting with Alison Murdoch last night, who is a clinician in Newcastle. I am sure that he would have been entitled to attend had I known that he was around and interested.

Ian Gibson (Norwich North, Labour)

Sorry.

Evan Harris (Shadow Minister, Innovation, Universities and Skills; Oxford West & Abingdon, Liberal Democrat)

I did not think that it was illegitimate to meet a clinician—

Ian Gibson (Norwich North, Labour)

What a cheek!

Evan Harris (Shadow Minister, Innovation, Universities and Skills; Oxford West & Abingdon, Liberal Democrat)

And to ask her to e-mail me—[Interruption.]

Jimmy Hood (Lanark & Hamilton East, Labour)

Order.

Evan Harris (Shadow Minister, Innovation, Universities and Skills; Oxford West & Abingdon, Liberal Democrat)

I did not think that it was unreasonable to meet someone and ask them to e-mail me a couple of points because the meeting was coming to an end, and then to raise them in Committee. That is entirely appropriate. In respect of the hon. Gentleman’s point earlier, I checked with Newcastle about the mitochondrial DNA and I checked my e-mail. I understand that that was sent to all members of the Committee. I merely quoted from a document sent to all members of the Committee about the research on mitochondria and IV-derived gametes.

Ian Gibson (Norwich North, Labour)

That may be so, but in my conversation with them I made it clear that I had not seen that document. They may have sent it, and these things happen now and again. The hon. Gentleman is in a difficult position if it is seen that he may be a lobbyist, rather than a full member of the Committee. I will be  watching carefully throughout our proceedings to see whether the individual views of scientists or others are available to all hon. Member, in terms of the whole context of what they have given to him.

Evan Harris (Shadow Minister, Innovation, Universities and Skills; Oxford West & Abingdon, Liberal Democrat)

I object to that. If the hon. Gentleman used the term lobbyist as a smear, I object to it, and I object to the assertion that when I and, for that matter, Lord Patel and Lord Turnberg meet any scientist to express concerns about the Bill, we are somehow not doing our job. It is reasonable to do that and we have been diverted in a peculiar way, Mr. Hood. I am happy to hand the hon. Gentleman a copy of the e-mail that was sent to me by Alison Murdoch last night.

Jimmy Hood (Lanark & Hamilton East, Labour)

Order. I am sure that the hon. Gentleman will get back to the debate.

Evan Harris (Shadow Minister, Innovation, Universities and Skills; Oxford West & Abingdon, Liberal Democrat)

I am keen to do so, but I thought it was right to defend the normal activities of Opposition Members. For 10 years I have been meeting people who are concerned about legislation, and I will continue to do so despite the hon. Gentleman’s admonitions.

I want to make two points on the Government’s provisions. Am I correct in understanding that amendment No. 45 does two things, which are brought together in one amendment because proposed new (h) follows on from proposed new paragraph (g)? New paragraph (g) is an important amendment because it makes it clear that the disclosure that would not be permitted is where any individual can be identified from the information, rather than a disclosure whereby no individual to whom the information relates could be identified. That is a separate and helpful amendment, and proposed new paragraph (h) is much more in keeping with the rest of the amendments. They are simply brought together by a good fortune of drafting, that (h) follows (g).

I understand the Minister’s specific point about getting general consent at the beginning. I think that the problem is merely one of interpretation by the HFEA, and what she said will be helpful. In normal clinical practice, information is not divulged without consent; it is divulged with implied consent. When people see a GP they do not have to sign anything to say, “You have my permission to send the information on to a consultant”, because when someone seeks a referral from a GP, it is implied that that information will be transmitted. When the medical or surgical team want to write to GPs to explain that someone is in hospital and has received treatment, that is not done without consent, because it is implied.

Dawn Primarolo (Minister of State (Public Health), Department of Health; Bristol South, Labour)

I hope that the hon. Gentleman forgives me, but I forgot to cover that point. I absolutely accept what he says about data protection and general confidentiality, but I remind him that the EU tissues and cell directive sets standards of safety and quality for human tissue intended for human application, which includes areas that we are discussing, and goes further than the Data Protection Act. When I alluded to other legislation that would impinge on confidentiality, I had not meant to be more specific than that. It explains why there is a higher hurdle.

Evan Harris (Shadow Minister, Innovation, Universities and Skills; Oxford West & Abingdon, Liberal Democrat)

The Minister has no need to apologise, because I assumed that that was what she meant, and I was going to raise that in my points at the beginning. I thought, given what she had said previously, that I would not raise it in advance. I have a question about it, so it is useful that she has raised it.

Coming back to what I was saying, there is implied consent; treatment is not done without consent. Because of the nature of this treatment, and because of the complication of identifying donor information, there needs to be a process. Otherwise relying on implied consent can lead people to fall into traps of not knowing where the division goes. I understand the reason why there is a need for an explicit or written consent. Consent is a process, and written consent is a sign that there has been a process and it is useful. However, there is a problem with interpretation by the HFEA, because clinicians tell me—I believe that this is on the record in the House of Lords debates as well—that they are required, or feel that they are required, by the HFEA, whether in their code of practice, in their inspection system or by some other means, to get a consent form filled in for every visit, every procedure and every test, even when the general consent form has been filled in at the beginning.

There may be scope here not for legislation, but for it to be made clear to the authority, which may feel that it is doing its job and playing safe, that the requirements of the tissues and cells directive, 2004/23 EC, particularly article 14, can be met by a written general consent at the beginning, and that specific consent is unnecessary as long as patients are made aware that they can at any point change the terms of that consent. That should be straightforward to do, and specific requests can be made for certain information not to be provided. I think that requiring a form each time is unnecessary.

I am hoping that the Minister can assure me that the extra requirements created by the directive would not prevent a general consent at the beginning as long as the patient knows that.

Dawn Primarolo (Minister of State (Public Health), Department of Health; Bristol South, Labour)

I am happy to confirm that to the hon. Gentleman. When we were discussing consent at the beginning of our proceedings, we noted that discussions are taking place between the Department and the HFEA, and the HFEA is considering the whole question of consent, the exceptions, and how it is provided. That point might have been raised by the hon. Gentleman. Some of the things that he is saying now would need to be clarified within that discussion. The HFEA would need to take forward those discussions and the support and advice given to clinics.

Evan Harris (Shadow Minister, Innovation, Universities and Skills; Oxford West & Abingdon, Liberal Democrat)

That is good news indeed. The Government amendments are an improvement on the existing situation. Using the Minister’s words today—I hope that I have got this right—a general, specific consent at the beginning does not have to be augmented, although it can be resiled from at any point by a patient; they must have the right to change their mind in respect of future disclosures or for new treatments.

Dawn Primarolo (Minister of State (Public Health), Department of Health; Bristol South, Labour)

Just to put a qualification in there: of course, that should be within the limitations of the 1990 Act. It is about identifying and non-identifying information about the donor. For example, the identifying  information cannot be made available until the child reaches 18; that cannot be the case, and nobody can vary that.

Evan Harris (Shadow Minister, Innovation, Universities and Skills; Oxford West & Abingdon, Liberal Democrat)

I completely accept that, and I have had no representations from clinicians questioning the need for such clear separation. They understood that part of being licensed was to understand the sensitivity of that. I welcome the fact that there are ongoing discussions and note that the Government amendments are an improvement. It should be possible to reduce the pressure. The criminal offence worries clinicians, and perhaps they are also playing safe. If the HFEA could make it clear that if they fulfil certain requirements—particularly for patients who give the general consent at the beginning that is not retracted at some point—it should be reasonable.

The only other point to bear in mind is that there is a continuing concern about the differentiation between licensed and non-licensed individuals, licensed and non-licensed treatments, licensed clinics and non-licensed premises. Some of that is inevitable. We cannot have a licence and say that there should not be a difference. The fact that one has to have a licence is because there is a difference, and that creates a difference. The Minister should have a discussion with the HFEA—I emphasise that for the columns of Hansard—about making sure that there is not what seems to be an unfair burden on someone doing normal work who happens to be licensed, or on someone doing work that could take place in an unlicensed place, but who happens to have a licence because they do other work. If it can be shown that they are not unfairly at risk, or facing unfair or unreasonable burdens, people will welcome the progress made, both in the legislation and in our debates.

Mark Simmonds (Shadow Minister, Health; Boston & Skegness, Conservative)

I thank the Minister for her response to my amendments and for her explanation of the Government amendments.

I accept what the Minister says about amendment No. 37. The list is clearly comprehensive and well thought through. It is correct that if there are to be regulations, or there is a necessity for them, they are subject to the affirmative procedure so that they have to be discussed in Parliament. Everyone on the Committee wants to see the Bill, when it becomes an Act, to last effectively at least as long as its predecessor, the 1990 Act. That is the whole purpose, so regulations can keep up to date with scientific advances as the years go by.

On amendment No. 38, again I thank the Minister. I understand what she says. It is right that there is general consent at the beginning of treatment, within the limitations of the Act, but she seemed to suggest that there was an ability for conditional consent—for information to be passed on. Her example was if the GP might be a family member. Is the Minister saying that exclusions can be specified on the consent form about whom is not able to receive that information, or, as I suspected originally, will there be generic consent?

On the implied consent argument and the exchange that has just taken place between the Minister and the hon. Member for Oxford, West and Abingdon, it is quite right that there is a higher hurdle when we are talking about such issues, as well as about human tissues. I am pleased that there are ongoing discussions with the HFEA and licensed premises, because I am  concerned, like the hon. Member for Oxford, West and Abingdon, about the potential to put unreasonable bureaucratic burdens on licensed premises. I hope that those ongoing discussions will facilitate such a situation not occurring.

With regard to the Government amendments, I have one question for the Minister relating to amendment No. 54, which I am not clear about. Proposed new subsection (3) of that amendment reads:

“Consent in respect of a person who has not attained the age of 18 years”—

referred to in the amendment as “C”—

“may be given...by C, in a case where C is competent to deal with the issue of consent”.

If I read that correctly, that implies that someone below the age of 18 could give consent. How young could that person be to give consent? Would they have to be above the age of 16 but below 18? Could they be 12? Could they be eight? There does not seem to be any clarification elsewhere in the Bill or anywhere in the group of amendments.

Dawn Primarolo (Minister of State (Public Health), Department of Health; Bristol South, Labour)

The hon. Member for Boston and Skegness asked about consent. What I described as general consent is the position that all the consent works from for disclosure of information. The patient is able to put exceptions into that. If the hon. Gentleman recalls the exchange between myself and my right hon. Friend the Member for Coatbridge, Chryston and Bellshill in last Thursday’s sitting, my right hon. Friend said that he might be prepared to give consent for certain types of research, but that he would want to make exceptions in other areas. We were talking about cases in which the donor was deceased. However, that starts from a general consent in which patients have the option to put in exceptions.

Although we are talking about general consent, patients should have the ability to make explicit exceptions to their consent for the disclosure of that information if those exceptions are not overridden by any of the other exceptions. It would be much too complex to have the two consents working in different ways against different principles. I understand that matters would proceed in very much the same way, but it is crucial that the HFEA examines the issue very carefully when it takes on new considerations of consent. There will clearly be active discussion of those particular considerations with stakeholders and the individuals and organisations that have made representations on this part of the Bill. I hope that I have made clear how the process will operate.

The other question that the hon. Member for Boston and Skegness asked was how old a person needed to be for the purposes of consent. The system does not work on the basis of age, but on whether an individual has sufficient understanding of the implications of the decision. That is obviously a fine judgment that needs to be made. I do not think that we can take that away from clinicians because individuals vary in their understanding. That is why there is not a specific age. I do not think that that is at odds with how we test competency elsewhere. Everybody has to be satisfied that an individual understands the implications.

The hon. Member for Oxford, West and Abingdon asked me a question about Government amendment No. 45, and I think that I answered it. The amendment specifically ensures that the provisions cannot be used to require the HFEA to disclose identifying information about donors for which specific provision is made elsewhere in the 1990 Act and the Bill. The amendment is constraining in that it reflects the wish to keep the measure very tight to the specific purpose. It was a result of clarification and tidying up following the very extensive debate on these measures that was held in another place.

I think that I have answered all of the questions that I was asked. If I have not, the hon. Gentleman needs to say now. I hope that the Committee will support the Government amendments, which I shall move formally at the appropriate time.

Mark Simmonds (Shadow Minister, Health; Boston & Skegness, Conservative)

I am grateful to the Minister for that clarification. On the basis of her response both to my questions and to the amendments that I have tabled, I beg to ask leave to withdraw the amendment.