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Human Fertilisation and Embryology Bill [HL]

Part of the debate – in the House of Lords at 7:00 pm on 19th November 2007.

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Photo of Lord Turnberg Lord Turnberg Labour 7:00 pm, 19th November 2007

My Lords, it has been a great privilege to have heard such a group of distinguished and expert speakers in the debate so far. I am particularly grateful, if a little humbled, to follow the noble Baroness, Lady Warnock, whose words I listened to with rapt attention. I declare interests as a fellow of the Royal College of Physicians, as a past chairman of its ethics committee, a fellow of the Academy of Medical Sciences and a scientific adviser of the Association of Medical Research Charities.

If ever there was a listening Government then this is it; at least as far as this Bill is concerned. It is a pleasure to see that they have taken on board the large majority of the recommendations of the Joint Committee, on which I have the privilege to sit for at least part of the time. There is much greater clarity and reason to the Bill, so that it is now much more fit for purpose. It strikes in general a good balance of protecting the safety and confidentiality of patients, including the children, and at the same time opening up the possibility of much valuable research which otherwise would not be possible. The increased flexibility that it envisages by allowing the Secretary of State to modify the regulations in light of new advances is, pace the noble and learned Lord, Lord Mackay of Clashfern, extremely important. I am not going to expand on the positive steps taken in the Bill, but the proposal to keep separate the HFEA and the HTA is a great relief. Although I am disappointed, as is the noble Lord, Lord Jenkin, that the Government do not wish to re-examine the Human Tissue Authority, I understand their reasons, and I hope that we will be able to return to it at some not-too-distant time. There are certainly some issues that need to be examined.

The inclusion in the Bill of greater clarity about the definition of what constitutes an embryo, a gamete and so on, about the regulations under which mitochondrial diseases, for example, might be researched, and under which hybrids and cybrids may be used for research are all major steps forward and are supported strongly not only by the scientific and medical community but by the patient groups that I have dealings with.

Having applauded the Government so loudly, it may seem niggardly to point out some aspects where we need to look again to see whether we have it quite right; nevertheless, I have to do so. Most of the problems that I want to focus on arise from the distinctions that are made between IVF and other forms of fertility treatment. I shall talk about the routine treatment of infertility by IVF, not the other possible uses of human embryos for research, the development of stem cells and so on. I am talking about infertility and the use of IVF. Patients who are infertile usually go through a range of treatments—drug treatments, occasionally surgery, often intrauterine sperm injections—and if they do not work they may go on to a trial of IVF. The point is that IVF is part of a continuum of a range of treatments and it is now well used and documented as a routine therapy in many places. And yet, it is treated quite differently from the other forms of therapy.

While some distinctions may be necessary, a number of gross anomalies arise. The first arises out of the need to take account of the interests of the child, which is very laudable in principle; but in practice a requirement is placed on the obstetrician to assess the suitability of potential parents for parenthood, which is difficult to fulfil. I go along very much with what the noble Baroness, Lady Warnock, said about the practical outcome of having that in the Bill. Leaving aside the practical difficulty of making such an assessment in advance, it is quite illogical to single out this form of fertility treatment from the other forms that I have mentioned. Indeed, it is almost bound to be the same patients who, having gone through a range of efforts to render them fertile, suddenly find themselves having to be formally assessed for their suitability for parenthood. What would happen if they were turned down at that last step, which is highly unlikely? If you go along that route, you might in logic need to assess every couple wanting to have a child. It does not seem that we have got this quite right.

There is the issue of data collection, which some noble Lords have mentioned, which is required by the HFEA. It does not, of course, collect data on other forms of fertility treatment, but it requires that not only all successful IVF treatments are reported to it but all unsuccessful cycles of treatment. All the units that practise IVF have to be licensed and collect their own data, but the HFEA collects them as well and then squirrels them away—that is the important point—so that this important body of information is unavailable to anyone. Even fully anonymised data held by the HFEA are inaccessible to legitimate researchers; what a waste. Data collected in the future, as I understand it and if I read the Bill correctly, may now be used for research under strict conditions, but what about the data that are already held over many years? These are rich sources of information, which could provide invaluable help for future patients. I hope that we might consider a mechanism that allows research access, such as through the Patient Information Advisory GroupPIAG—which has been so helpful for research in, for example, the cancer registry field, but which has been denied the HFEA field.

Finally, there is a discrepancy between the treatment of medical practitioners who are in breach of confidentiality in relation to patients' infertility treatments. A doctor who misbehaves in this way in relation to any other form of infertility treatment is liable to be up before the GMC disciplinary committee and is likely to be struck off and prevented from practising again. You might think that is a pretty severe sentence. However, a doctor involved in a similar misdemeanour in relation to IVF is liable to criminal proceedings against him or her and a jail sentence or a fine, or both. That anomaly seems quite unjustified.

I can understand that the Government may find it necessary to draw a line between the various uses to which IVF technology can be put and other forms of fertility treatments, but it throws up some stark illogicalities. I hope that we might be able to sort some of them out. Perhaps we should be considering ways in which we can separate out straightforward, routine IVF from the other provisions in the Bill governing research applications, which are clearly more contentious. I look forward to debates at the later stages of the Bill when we might be able to return to some of those points.