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5.31 pm
Dr. Andrew Murrison (Westbury) (Con): The Opposition welcome the Bill. It is a good Bill, and we have had a good debate. Twelve Back Benchers have spoken and, more importantly, we have heard speeches of real quality. That is just as well, because the pre-legislative input that we called for did not happen. As a consequence, the Bill has been robbed of the expert and informed contribution of people in the know in a complex and sensitive field. However, we are where we are, and we have to move on; and today's debate has been characterised by good humour and general consent. Indeed, the Bill is all about consent, drawing as it does on the Kennedy and Redfern inquiries into the unsatisfactory state of affairs at the Bristol royal infirmary and at Alder Hey in Liverpool.
In our general enthusiasm for the Bill, however, we should also be aware of the possible hurdles that it could put in the way of medical research, education and all the things that we hope will deliver us a better tomorrow. The hon. Member for Norwich, North (Dr. Gibson), with his long experience in these matters, reminded us firmly of that.
Between 1979 and 1985, I was in the foothills of my medical career at Bristol. Looking back, I can well recognise the patrician mind-set that led to the distressing circumstances revealed by Kennedy. To be fair to health professionals, they have gone a long way
to put their own house in order, and I am pleased that they have largely welcomed this attempt to put good practice on a statutory footing.I should like to deal with presumed consent. Although it is not expressly in the Bill, it has been raised by several right hon. and hon. Members. My right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke)—I see that he is not in his place—supported it so well, and the hon. Members for Sutton and Cheam (Mr. Burstow), for Oxford, West and Abingdon (Dr. Harris) and for Bristol, North-West (Dr. Naysmith) also supported it. In two notable Back-Bench contributions, the hon. Member for North Devon (Nick Harvey) and my hon. Friend the Member for Spelthorne (Mr. Wilshire) took a contrary line. All hon. Members who were present would acknowledge that my hon. Friend's speech will remain with them for some time. All hon. Members bring valuable experiences to the House, and my hon. Friend demonstrated the value of them in his contribution. The Bill, as I understand it, is about making consent explicit and fully informed—or it is nothing. Presumed consent, I submit, is no consent at all.
We certainly need more organs to be donated, as the hon. Member for West Bromwich, East (Mr. Watson) said in his contribution. Although the majority of people are in favour of organ donation, many of us would be uncomfortable with the appropriation of body parts by the state in the manner that appears to be favoured by the British Medical Association. I hope that the Bill will help to restore confidence in the gifting of body parts, not make the public more suspicious of what for many, particularly in the light of recent events, is a shady, even slightly sinister, domain. For those people, the doctrine of presumed consent would not help.
For our part, we suggest a stronger role for the Human Tissue Authority in the popularisation of voluntary organ donation, and we are disappointed that that is poorly reflected in the Bill's wording. My right hon. and learned Friend the Member for Rushcliffe mentioned the organ donor card and its status in his contribution—an issue that, I must confess, had not occurred to me. I am sure that we will examine that issue very closely in Committee, and table amendments that will improve the card's status, thereby increasing, we hope, the number of organs available for donation.
In response to the Adjournment debate led by my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) on 29 April last year, the hon. Member for Salford (Ms Blears) said that the Human Tissue Act 1961 was "unclear" and "ambiguous". I was given a copy of it earlier today. It extends to two and a half sides of A4—how different from the measure before us today! Nevertheless, it was apparently unclear and ambiguous. In contrast, the hon. Lady promised us that, before the summer break, draft proposals would be available for parliamentary scrutiny that were "unambiguous and transparent". I regret that in both timing and intention, the Government have fallen well short of their laudable intentions.
The Bill is remarkably difficult to navigate, given that it is meant to lend clarity to the obscurities relating to the removal, storage and use of body parts. A number of organisations have voiced concerns, several of which we
have heard today. There is a real risk that the vagueness of the Bill's wording and its lack of clarity in places will act as a disincentive to engaging in legitimate research and teaching based on human material. We will urge improvements on Ministers, to ensure that those working for our benefit—researchers and clinical teachers—do not feel that the heavy hand of the law will for ever be resting on their shoulder. The right hon. Member for Holborn and St. Pancras (Mr. Dobson) said in his excellent contribution that lawyers should be kept out of hospitals unless they are patients. He might have added that we should do what we can to keep doctors out of the law courts.Cancer Research UK is worried that those making career choices in research are already inclining towards basic science, in preference to the clinical research that would embroil them in regulation and bureaucracy and the possibility of legal dispute. It has noted the implications for cancer registries of the Data Protection Act 1998 and the forthcoming implementation of the EU clinical trials directive, and fears that this latest initiative will add to the wheelbarrow of material that is preventing it from doing what it wants to do—improve the lot of people with cancer. That is the very last thing that those involved with Alder Hey would want.
It is important to point out that much of the distress caused by Alder Hey had less to do with the removal of organs than with the fact that they were stored and not turned to any great purpose. The hon. Member for Liverpool, West Derby (Mr. Wareing) will relate to that point, given his obvious constituency interest. Indeed, we are told that many parents would have been far less troubled had organs been used, and at least some good had come from their removal.
In examining the Bill, we must constantly remind ourselves that the general public apply different significance and weight to various types of human material, and to the various ways in which it may be handled and used. For most people, blocks and slides of tumour removed during surgery are a world apart from a cadaver in an anatomy suite, or a child's heart in a pot in a medical school. For most people, surgically removed tissue is uncontested waste. Few owners will agonise, for example, over the fate of a necrotising section of malignant colon, but the removal of an organ—diseased or otherwise—from a loved one after death has a completely different psychological and emotional context. It is important that the Bill in its final form reflects that reality.
The Bill does not take the opportunity to deal in any depth with the human anatomical displays that can pass as art in UK galleries. The hon. Member for Leyton and Wanstead (Harry Cohen)—he is not in his place—enthused about the activities of Professor Gunther von Hagens and his "Bodyworlds". But it is probably true to say that what one might describe as the Damien Hirst school of anatomy sails fairly close to the wind legally, and it is certainly regarded by many as not being in particularly good taste. With that in mind, I am not sure that so-called "qualifying" museums should be accorded the special status and freedom from licensing given by the Bill, as to do so would deny easy access by the Human Tissue Authority and its inspectors. We must bear it in mind that Professor Gunther von Hagens
may hold exhibitions in the future and that an obvious place for them to be held would be in a qualifying museum.We should remember that post-mortem suites, medical school dissecting rooms, research laboratories and their staff are already multiply regulated, scrutinised and licensed for all manner of things. Why then, when constructing the Bill, was so little attention paid to areas that are, arguably, far more opaque?
I am concerned about the lack of scrutiny of imported material and am worried that that could lead to exploitation. I recall with affection the skeleton that accompanied me throughout my medical school career. The hon. Member for Wyre Forest (Dr. Taylor) has a similar recollection, but unlike him I have no idea where my skeleton is now. At the time, however, I was informed that, like hundreds of others, it came from the Indian subcontinent to circumvent the difficulties that arise in this country from the process of skelatinisation. The Minister will probably say that that loophole—if loophole it is—is a matter for a code of practice, but I fear that the Bill leaves so many aspects to be covered by codes of practice in future that the House can have but little idea of what the actual landscape that will eventually result will look like.
The failure to make words crystal clear in the Bill risks repeating the mistakes of the Human Tissue Act 1961. I shall set out a few examples, starting with the notion of appropriate consent. Organisations that we have consulted are concerned that future research needs, of a sort that we may not be able to anticipate at present, may be precluded because of the difficulties inherent in the notion of appropriate consent. There is, for example, confusion in the Bill about the use of existing specimens for DNA work. It is necessary to be more explicit about the nature of consent so that researchers, institutions and charities have the confidence to proceed with their work, which will, in any case, be subject to the rigours of local ethics committees.
The Bill does not really get to grips with licensing. We can all understand both the need for proper premises and that they should be licensed and inspected, but does the Minister have in mind an institution, a building or just a suite of rooms? Under extant legislation, there are licensed teachers, who are hands-on—I remember them well from my time at medical school; they were doctors who carried out dissections and taught students and were very much in control of the situation. The Bill does not indicate who our future licensees will be: will they be chief executives of hospital trusts or pathologists on the shop floor? We do not know. What responsibility will the licensees have for end users—for research workers from Cancer Research UK, for example? Representatives from that organisation and from the Wellcome Trust kindly met several of us last night.
The Bill refers to "relevant material", but we are left with no great understanding of its authors' intentions. Human cells seem to be a common thread, but does that include acellular serum and plasma, which, for their owners, are just as much blood as whole blood is? Why should cell lines be excluded? They may be created outside the human body but they are still very much related to the donor of the index tissue. Too much in the Bill defaults to codes of practice, and too much latitude is given to Secretaries of State to amend it by order at some future date.
In conclusion, I commend the Minister of State for introducing the Bill, with which my party is in general agreement. There are certainly some rough edges that might have been smoothed out during the pre-legislative scrutiny that we did not get, but we look forward to contributing in Committee so that the next time the measure comes before the House it will hold the confidence of the public, the research community and health professionals.
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