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

I beg to move, That the clause be read a Second time.

The new clause relates to the complex issue of birth certificates, which we touched on earlier. In the context of the debate surrounding part 2, new clause 1 relates to some of the issues raised when we discussed schedule 6. The new clause would ensure that the Secretary of State made regulations either to annotate a birth certificate or to provide two versions—as the hon. Member for Bolton, South-East suggested earlier in today’s proceedings. The Minister explained the Government’s view that there should be a four-year period of reflection, although if possible they should report earlier. I think that that is too long, and that we should get clarity as fast as possible.

There are significant issues surrounding birth certificates, and I would like to make a point about the new clause on the record. The welfare of the child should be paramount in the consideration of these issues, and it is important that the Secretary of State holds detailed consultations about this, particularly as regards the changes in the Bill. There are some anomalies. For example, if an unmarried couple, who may have known each other for only a short period, are treated with donated sperm, they are both recorded on the birth certificate as parents. However, a same-sex couple in a civil partnership are not both listed as parents and the woman who did not give birth to the child would have to adopt it in order to have any legal claim. Under the proposals, at least theoretically, although I suspect that in a small number of circumstances it could be the reality, neither of the people named on the birth certificate—mother and father or mother and other parent—will have a genetic link to the child.

The fulcrum of the debate is whether the birth certificate should be primarily a biological or a social record. That throws up all sorts of issues and the interesting thing is that the bodies that represent the donor-conceived community—if I can call it that—have differing opinions that are almost inversely opposed, and that makes these arguments even more complicated. I would like to suggest why the fulcrum should be moved towards the biological end of the spectrum, rather than the social end. Earlier, we discussed genetic diseases. That subject will become more and more prevalent and important as medical and scientific advancements take place and there is a greater understanding of inherited diseases, such as cancer and  others that we have mentioned, which we hope will be circumvented by mitochondrial and other technologies.

Another issue is the deception of the state, and someone knowingly conniving—I use that word in its softest sense—in trying to remove the child’s genetic parentage from the birth certificate. There is the issue of sperm donors and donor anonymity, and the point raised earlier by the hon. Member for Oxford, West and Abingdon about donors having the choice to remain anonymous was pertinent. Inappropriate marriages may occur if people do not know, or at least have an indication, about their genetic history, and that goes back to some of the debates that we had about the age for obtaining the information from the HFEA.

Discrimination is another issue. Refusing to mark the birth certificates of those who are donor conceived, yet allowing two women to be shown as the parents of a child, inevitably makes a clear distinction between the two types of donor-conceived people. There are those who are donor conceived and for whom the information is made public—two women clearly cannot be the biological parents—and those for whom the information is not shown on their birth certificate. That seems to be an anomaly. The new clause, which I accept is not perfect, attempts to put on the record the great concern and strength of feeling about this issue.

Personally, I favour the suggestion made by the hon. Member for Bolton, South-East of a dual birth certificate, although I accept that that could be bureaucratic. I see the sensitivities of people who might not want to have it marked on their birth certificate that they were donor conceived. They may think that an infringement of privacy—why should someone have to produce that information when applying for a passport, or whatever birth certificates are used for? However, it is important that a child has an understanding, wherever possible, of their genetic make-up. A child should not necessarily have to wait until the age of 18 to understand that they are donor-conceived, although most parents do make an attempt to inform the child about such matters.

There is conflicting legal opinion on this matter. There are questions about how the human rights of the child and the right to health safeguards in the United Nations convention on the rights of the child will be met if a child is brought up without the requisite knowledge to avoid particular health consequences. It is important for healthy family life that genetic defects and intermarriage of relatives are avoided if at all possible. There is a real danger that, unless some solution is found to this complex problem, we will exacerbate an already difficult issue.

Robert Key (Salisbury, Conservative)

I endorse entirely what my hon. Friend the Member for Boston and Skegness has said. I would like to press him a little and to concentrate on the second paragraph (b) in the new clause, on the provision of a detailed birth certificate.

I am grateful to a number of organisations and individuals who have been in touch with me—the partnership focus group, the British Association of Social Workers Project Group on Assisted Reproduction, and the Donor Conception Network, to name but three. I am particularly grateful to Professor Eric Blyth, professor of social work at the university of Huddersfield, with whom I have had some correspondence on this  matter. It seems to me that, in view of the discussion in the other place and what my hon. Friend has said, there is a problem that we must crack with the short birth certificate and the so-called long birth certificate. In the other place no proposal has been made that does not involve extra bureaucracy, which would risk compromising the privacy of parents or donor-conceived people, or other members of their family. The principle risk to privacy is the fact that birth certificates are public documents. Not only is the long birth certificate, which provides details of the individual’s parents, increasingly required for a range of legal and other purposes, but anyone who is armed with minimal information and prepared to pay a modest fee can obtain a copy of the long birth certificate of any other person in the country. I shall not repeat what I said earlier about the discussion in the other place, but I wonder if my hon. Friend would agree that all certificates of birth—in other words, the short birth certificate—could include this text:

“Further information relating to the individual whose birth is recorded on the certificate may be held on the Human Fertilisation and Embryology Authority register of information, the parental order register or the adopted children register.”

All certified copies of an entry pursuant to the Births and Deaths Registration Act 1953—in other words, the long birth certificate—could have this text:

“Further information relating to the individual whose birth is recorded on this certificate may be held on the Human Fertilisation and Embryology Authority register of information.”

Adopted people and people subject to a parental order as a result of a surrogacy arrangement already have an adoption certificate or a parental order certificate, respectively, in lieu of a long birth certificate, clearly indicating their status. The proposal I am making would mean that all individuals had access to a birth certificate that alerted them to the existence of other registers. It would not single out any one individual or, by implication, their parents or family members; everybody would have this. Thus, the information could act as a trigger for the individual to make their own inquiries of the registers, subject to the legally mandated age limits for accessing such information. Both in advance of undergoing a donor procedure and as part of the new provisions for parent education, adults who are contemplating building their family through donor conception would in the future receive a clear message about the merits of early disclosure and would be advised about the new text on birth certificates. That would provide parents with an added incentive for early disclosure, rather than risking later and possibly traumatic disclosure. That seems to be something that both Houses have thought is the best way forward.

Brian Iddon (Bolton South East, Labour)

I have given this a lot of thought, but it seems to me that the hon. Gentleman’s proposal would increase the bureaucracy that he was trying to avoid by the previous suggestion. Most of us would want to know whether other information was available. We would want access to all those registers to find out whether we were donor conceived and to see whether they contained other information about us. That would result in a huge bureaucracy.

Robert Key (Salisbury, Conservative)

If that information was available online, it would not. I do not see a problem. However, that is the sort of detail that will have to be looked into. I do not have the answer.

Brian Iddon (Bolton South East, Labour)

Most of us are concerned about the privacy of the individuals and their parents. Making the information available online would not get around the objections that most of us have to putting marks on the short birth certificate.

Robert Key (Salisbury, Conservative)

I accept that argument. The hon. Gentleman is absolutely right; we should not go there. However, it does not destroy the argument that it would be a way of indicating on everybody’s birth certificate where they might seek further information if there was any doubt. Its other great virtue is that it would undoubtedly put some pressure on parents to come clean about their children’s origins.

John Pugh (Shadow Minister, Treasury; Southport, Liberal Democrat)

Having had the chance to reflect on our earlier debate, I accept some of the concerns of donor networks that knowing about someone’s genetic origins is not in the public interest, except in rare circumstances. I can imagine that those conducting a research project into the effect of the environment versus inheritance would justifiably feel miffed if some of those who were the subject of research for public health purposes turned out not to be the persons who they thought had been genetically identified. Except in extreme cases, there is no genuine public interest in the public, the employer or anyone else having access to information about a person’s origins. In a sense, the birth certificate is giving away the fact that there has been a donor conception.

However, many people accept that individuals have a right to know about their genetic inheritance. To put it another way, it is wrong in all but the most exceptional cases to withhold that information or to mislead people about it. Although there is a sort of abstract right—one can make inquiries if one thinks there is reason to do so—we have a real right to know our genetic inheritance, and we have the capacity to exercise it.

It also involves someone else having the duty to disclose that information, but who is that someone else? The onus could be put on the parents or the state, but none the less someone ought to have a duty of disclosure. We are struggling with how to balance that duty with other legitimate rights—to privacy, to an undisrupted family life and so on—but neither we nor the Government have a solution that adequately addresses that problem.

The Minister said that the Government were going to think about the matter, with a review lasting more than four years. It may take four years to come up with an adequate solution, but we should not pretend that there is not a problem—and the Bill does not solve it.

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

The hon. Member for Southport summed up the problem very well. The Committee is struggling—three suggestions have been made on how it might be solved during this short debate—to understand how we can balance obligations to the donor, the parents and the donor-conceived child. The hon. Member for Salisbury said that the point of this—if I am wrong, I am sure he will correct me—was to ensure that we kept up the pressure and encouraged parents to be truthful to the children from the beginning. I concur with that view; it represents everything that the Government are trying to do. We can all quote influential groups that take a different view about why the birth certificate should be annotated and why the new clause should be accepted, although some might go further, taking the view that it is counterproductive and would work against the objective pointed out by the hon. Member for Salisbury.

I pray in aid the Royal College of Nursing, which commented specifically on the new clause rather than speculating about what it might mean. The RCN made it clear that it supported the Government’s position as stated in another place, because we needed to be clear about what we required clinics to do, who must be notified, how any annotations on birth certificates must be provided, and where the obligations lie. The RCN ended up in the same place as the hon. Member for Salisbury. It decided that it was best for the parents themselves to tell the children.

Looking at some of the other stakeholders, it is not just the Royal College of Nursing, a considerable and influential organisation that supports the Government’s position. The Donor Conception Network, which represents donor-conceived children and their parents, also does, and has said so in submissions to Committee members with regard to birth certificates. The Donor Conception Network goes further. It starts by agreeing absolutely—again, who would not?—with the proposition made by the hon. Member for Salisbury, which is that if children are donor-conceived, their parents should communicate that important information when they think it appropriate and by a definite time, after which children have a right to know provided for in legislation.

However, the Donor Conception Network goes on to say that it is concerned that a move to annotate birth certificates, in whatever fashion, may be counter-productive. Parents who planned to tell their children about the details of their conception may decide when registering the birth not to give those details to the registrar because they do not want that sensitive information made public. They may find it much harder to tell the child if they have not been as open as they should be.

My hon. Friend the Member for Bolton, South-East suggested that two birth certificates might be the way forward, but the Donor Conception Network takes the view, and I agree strongly, that it is necessary for the Government to evaluate certain pieces of work alongside the review in order to come to an understanding and proceed. That involves the Donor Conception Network’s planned programme of work, which is supported by the Department of Health, to promote telling children at an early age that they are donor-conceived. The network is working directly with parents to understand the concerns and barriers, and what is necessary to move forward. The network’s programme is concerned with non-identifying information—just the straightforward fact that children are donor-conceived. We can all understand the importance of the rights of donors and of guaranteed anonymity.

Going further, the Department is funding a second project that will work with prospective parents hoping to conceive using donated gametes. Again, we seek to understand clearly what the barriers are and what can be done to help. It is entirely reasonable to say, in what we have all said is a difficult and sensitive matter, that we should pilot and evaluate such work to ensure that we have the best way to communicate with parents and prospective parents. We should get the feedback of information from it, include it within the review on birth certificates and what should be on them and come to the right conclusion. A decision made in haste might not be the right one. We might end up cutting across the important principle, identified by the hon. Member for Salisbury, of parents informing, explaining and discussing issues with their donor-conceived children.

That is why the Government continue to resist putting any compulsion in the Bill to move now. We think that it is sensible to collect the information, speak directly to those concerned, and make a judgement on that basis and no other. I hope that the hon. Member for Boston and Skegness will not press his new clause to a vote, but if he does, with regret and for the best of reasons, I will ask my hon. Friends to oppose it.

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

I am grateful to all those who contributed to the debate on new clause 1. My hon. Friend the Member for Salisbury made some very pertinent points and some of the issues that he mentioned about the Minister’s review deserve much more detail and consideration. Today’s exchange demonstrates the difficulties in coming to a conclusion. I understand and accept that, but none the less I do not regret having tabled the new clause for debate and discussion; it is important for us to put such concerns, however complex and challenging, on the record.

I am not convinced that the Minister should be prepared to accept a four-year time period in which this should be reviewed. Pressure should be put on whoever is responsible for that review to come to a conclusion, in consultation with the necessary people, in a much shorter time scale. I was also intrigued by the Minister’s defence and praying in aid outside organisations to defend the Government’s position, as there does not seem to be one. The Government’s position seems to be that this is complex and that there should be a review that reports in four years’ time.

I understand why many organisations—those who represent donors and others such as the Royal College of Nursing—do not support the second (a) in new clause 1 about placing

“a symbol to denote the fact of donor conception”

on the original birth certificate. I understand and agree with that, but I felt that without that in the new clause, we would not be able to debate the specific issue.

Of course, the priority must be for parents to inform their children about their origins, in consultation with counselling and other facilities that are available. However, I also think that very detailed consideration must be given to the necessity, where possible, of allowing a child to understand their genetic make up and where they come from as early as possible. A sensible and easy way of doing that is through some mechanism such as an extended birth certificate or via access to other information. I will withdraw new clause 1, but I would like to reserve the right to return to the issue on Report. I beg to ask leave to withdraw the motion.