Previous SectionIndexHome Page


4.41 pm

Dr. Richard Taylor (Wyre Forest) (Ind): It is with some diffidence that I start by declaring an interest, because it is relatively unimportant compared with the major aspects of the Bill: I must own up to still possessing the skeleton that I bought as a student along with Gray's "Anatomy" and dissecting instruments—it cost the princely sum of £16. The language of the Bill is fairly incomprehensible, as I shall go on to illustrate in relation to more important matters, so I am not sure whether I have possession of the specimen only for the purpose for which I was so authorised to have possession of it. I am not sure whether I am legally allowed to lend it to my children for display in their schools during lessons in human biology. I am not sure whether I am allowed to sell it at what would be its value today of something like 240 quid. That is just one example of how difficult it is to understand provisions in the Bill.

At yesterday's briefing by Cancer Research UK, we heard that it thinks that the Bill's drafting is incomprehensible. It said:


I cannot resist reading to you, Mr. Deputy Speaker, a sentence from the Bill that Stephen McGinness of the Library staff drew to my attention. Clause 30(4) is a classic of incomprehensibility that says:


That is rather abstruse. I do not share the Minister's belief that schedule 1 is clear because several items in part 2 of the schedule—purposes not normally requiring consent—require the use of human tissue, so the situation needs clarifying.

15 Jan 2004 : Column 1026

As many hon. Members have said, by far the most important aspect of the Bill is consent. Consent is crucial to patients, families, clinicians and, especially, pathologists. The word "appropriate" has already been discussed. Why are we in a position in which we require legislation on the use of human tissue, which is a basic necessity? It is because requests for operations and post-mortems in many hospitals have been delegated to the most junior member of the team for generations. The houseman who has only just arrived on the scene has no knowledge of what the pathologist is going to do. I myself have been guilty of obscuring the difference between the removal of tissue and the removal of a whole organ. I am probably one of the few hon. Members with experience of asking for post-mortems and transplantation. A basic and practical point is when is the best time to make such a request? Should doctors do it at the same time that they tell the family about the death, or should they bring them back the next day, ostensibly to collect their relative's belongings, so that they can ask them at an easier time? Is it an easier time for the doctors, or is it easier for the family? There are therefore practical issues that need to be addressed.

From the doctor's point of view, a post-mortem to confirm diagnosis and the effects of treatment is vital. Attendance at the post-mortem provides an educational opportunity for the clinical team, which is often split by shift working, to come together. An article in the British Medical Journal in October by the vice-president of the New Zealand Medical Association examined the effect of the declining number of autopsies on medical student training. It said of post-mortems:


That experience is not easily gained elsewhere, so post-mortems are still of great importance. Consent is crucial, and equally crucial is the method of obtaining it. I have a copy of the agreement form for post-mortems that is used in my own trust and which, I am sure, is representative of forms used throughout the country. It is daunting for a hard pressed doctor to find the time to supervise the answering of 14 questions with ticks and filling in two boxes. The Minister of State kindly said that she was determined that it would not be onerous to request consent. However, it will be onerous if we do not get it right, and I hope that the Standing Committee will address that in detail. My trust's consent form ends with a killer request:


Much work therefore needs to be done on the way in which consent is requested. For example, should the pathologist be involved in obtaining consent?

I shall deal briefly with the Human Tissue Authority, because I am sure that it will be addressed at greater length in Committee. Codes of practice and licensing requirements are an essential part of its role. Provisions on its membership are loose in the Bill, but the Royal College of Pathologists would like representation, as

15 Jan 2004 : Column 1027

would the General Medical Council. I shall not spend more than a moment talking about consent for the transplantation of organs, because it has been fully covered by the hon. Member for Spelthorne (Mr. Wilshire), who spoke from very personal experience. The right hon. and learned Member for Rushcliffe (Mr. Clarke) mentioned a serious drawback for practising clinicians. In the intensive care unit of the hospital where I used to work, we almost groaned when someone was able to donate organs for transplantation because of the time that that took to organise. People do not realise that not only kidneys, hearts and livers, but skin may be used, which is incredibly disfiguring and one of the things to which relatives can really object.

Research has been fully covered by the right hon. Member for Holborn and St. Pancras (Mr. Dobson) and the hon. Member for Norwich, North (Dr. Gibson). The crucial importance of human tissue to research has already been mentioned.

I will conclude with some warnings from practical pathologists that illustrate some of the points made by the hon. Member for South Cambridgeshire (Mr. Lansley). First, a practising pathologist in Manchester said:


or the relatives. That is a huge burden. Another pathologist also emphasises the tortuousness, the lack of clarity and how hard the language is to follow. He even goes to say that he believes that there is a risk of defensive practices by pathologists, who may withdraw from activities that might put them at risk of criminal prosecution.

It is crucial to separate the retention and use of tissues from the deceased, which is emotive, from the use of surplus tissue excised for the good of the patients, which is obviously far easier to understand. So I welcome the intentions of the Bill, but I feel that there is a tremendous lot of work to do in Committee, and I am rather doubtful whether enough time will be allowed for that.

Several hon. Members rose—

Mr. Deputy Speaker: Order. May I try to help the House? Four hon. Members are seeking to catch my eye. We must wind up the debate at 5.30 pm, or thereabouts. If the time can be shared, everyone should be satisfied, I hope.

4.51 pm

Harry Cohen (Leyton and Wanstead) (Lab): The hon. Member for Wyre Forest (Dr. Taylor) made a valid point about improving the clarity of the language used in the Bill, and I hope that the Government will take that on board and that that will come about in the later stages, as the Bill passes through Parliament. However, I welcome the Bill as a whole.

The Bristol royal infirmary and the Royal Liverpool Children's NHS trust, Alder Hey, cases were scandals, and it is right that the Government have come up with

15 Jan 2004 : Column 1028

the Bill to address such issues. Body parts were kept without the consent or knowledge of parents and relatives, and the doctors failed to communicate with the families. Those families were denied their right to bury their loved ones wholly, and suffered subsequent anxieties. We have heard about some of those anxieties today, such as having to carry out multiple burials and dealing with the fact that some of the parts could have been experimented on without the family's consent.

The Bill rightly makes consent the principle for the retention and use of human tissues and organs. The post-mortem laws will remain unchanged. The removal and storage of human material at the direction of the coroner to determine the cause of death remains. Also, the police can still use human tissue for DNA testing to investigate suspected crimes—again, without consent. I want to return to those issues a little later in my remarks.

I welcome the principle of consent and the setting up of the Human Tissue Authority. It will have regulatory powers and responsibilities, including licensing for the specific purposes where it will be legitimate to store and use body parts. It will also have a general role in informing the public about the issues involved. When considering the creation of such quangos, what went through my mind was the Food Standards Agency, which is a good organisation—I am not critical of it—but it has a bit of a balance to address, and I sometimes think that it leans more towards the industry than consumers. I would not want that to be the case with the Human Tissue Authority. It is important that it recognises the public interest as opposed to those of the industry or, in this case, the pressure groups concerned with anatomy issues.

The authority will have the power to determine legally binding standards without oversight from Parliament. Again, I am not very happy about that. That means that the authority will not be as properly accountable as I would like it to be. The authority should report to Parliament annually to make it more accountable. Overall, however, I welcome the fact that it is to be set up.

The Bill rightly creates a new offence of trafficking in human bodies or body parts. That problem is very much linked to poverty and desperation, so it is absolutely right that such trafficking should be made illegal and subject to penalties. Harsher penalties should be imposed on those trading in organs than on the desperate people who sell them. However, the provisions on that should not stop proper organ transplants that would save lives.

We shall have to consider the modern ethical issues relating to reproductive and genetic tissue. Cell lines from stem cells can be used in the production of commercial products. There can be variations in the way in which the human material is used irrespective of how the original consent was obtained. That and the issues of whether the body part can be tracked back to the donor or whether the donor's or his family's privacy has been affected also create ethical questions.

Perhaps banks of tissues could be set up in the private sector—it is likely that they would be in the private sector—for subsequent profitable production. Therefore, the Human Tissue Authority should have the power to intervene if the use and storage of parts and

15 Jan 2004 : Column 1029

tissues is deemed to be contrary to the public interest. The profits of a corporation do not provide sufficient reason for there to be a loophole that could lead to the retention and use of many body parts. I re-emphasise my point that the authority should not be in the pocket of industry when it considers such important ethical issues.

The Minister referred to the "Bodyworlds" exhibition. I think that it was an excellent exhibition. It was extremely educative. It had an art element as well as changing and informing perspectives on the human body and how it works, and on death itself. It would have been wrong to ban the exhibition, although it was banned in Germany, for example. It was seen by more than 100,000 people and they probably learned a lot. The Human Tissue Authority should have to consider all the issues involved with such an event and it should do so openly.

My main reason for wanting to take part in the debate is that I asked a parliamentary question about the rules for the removals of brains, and was told in reply that organs and tissues may be removed if a person


The removal can also be authorised by their relatives or by a coroner who can remove or retain organs on his own authority. However, if they are used for a subsequent purpose, he must obtain a separate authorisation. The organs may also be removed


That was updated by the 1984 coroners rules, which state that the brain can be removed if that material, in the coroner's opinion, bears upon the cause of death and that it can be kept for such period as the coroner thinks fit. The coroner's opinion may not be openly stated and be in the public domain and the period might not be specified, so the organ could be kept for much longer—and those are only coroners rules, not reality.

I suspect that there may be loopholes, particularly in respect of major criminals—who sometimes hold a fascination that is out of proportion. I was amazed to read a report that Ronnie Kray was buried without his brain. Clearly, prior consent from Ronnie Kray or his relatives was neither sought nor obtained—which I found offensive. Although I asked a number of parliamentary questions, I could not get to the bottom of how that procedure was allowed and how widespread it is in relation to criminals. I have tabled another question asking whether Harold Shipman's body will be disposed of intact, and look forward to receiving the answer. Treating criminals in that way is a form of mediaeval punishment, showing contempt and disrespect post-death. It seems uncalled for and verges on barbarity.

Such practices also give rise to the possibility of Frankenstein-type experimentation. Together with the possible future reproduction of stem cells, the retention of the brains of criminals such as Ronnie Kray could make possible the recreation of criminals by a mad Dr. Frankenstein-type scientist or even by an officer of a state institution, perhaps accidentally. I am still not confident that such risks are ruled out by the Bill. There could be a loophole via the police, a coroner or the Human Tissue Authority that allowed such procedures, even if they were not explicitly or directly authorised.

15 Jan 2004 : Column 1030

Such a loophole would be an abuse of the role of the state. Are criminals treated differently from other members of society? They are not mentioned specifically in the Bill, yet in the past they have been treated differently. Does Crown immunity come into this? I do not think that it should apply.

My hon. Friend the Member for Liverpool, West Derby (Mr. Wareing) made the point that mentally ill persons may be alone and unable to make reasoned, proper judgments. The Bill should be reviewed in Committee to give such persons greater protection and to clarify their position.

I very much welcome the Bill. The Government have been brave to tackle this issue and have done a good job in bringing the measure before us—but I hope that the aspects that I have mentioned will be reviewed before the Bill completes its passage through the House.


Next Section

IndexHome Page