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5.44 pm

The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): If the House will forgive me, I shall begin by quoting something that the hon. Member for Westbury (Dr. Murrison) has just said:


I repeated that because I never expected to hear those words in the Chamber and I never expect to hear them again.

The hon. Gentleman's words sum up the tone of the debate. Members on both sides of the House have contributed their knowledge, experience and wisdom. The mood of the debate was constructive and it is clear that it will be followed by an interesting Committee stage, to which I greatly look forward.

Before I get into my speech proper, I want to pick up on one thing that the hon. Member for Westbury said. He said that Cancer Research UK claimed that there was evidence already that people who were deciding about their careers were choosing to steer away from clinical science in favour of basic science. The reason for that was that they feared getting involved in the difficulties that this Bill might impose.

I am a scientist. I know scientists—I have worked with them all my life, until I became a Member of Parliament in 1997—and I do not buy that for a second. I do not believe that such considerations feature on people's radar screens when they are making their choice of career.

If we are to have a constructive debate, in Committee and with scientists outside the House, we must all avoid hyperbole. It is important that we try to ensure that everyone understands what the Bill is about, and what its impact will be.

Dr. Murrison: The Minister needs to speak to Cancer Research UK, as I am sure he has in the past. I spoke to the organisation as recently as this morning. I understand that its survey of the vast number of students whom it is sponsoring for PhDs and other higher degrees has shown that about 70 per cent. are seriously considering doing basic science rather than clinical science, for the reasons that I outlined. I can do no better than quote Cancer Research UK.

Dr. Ladyman: I have no doubt that the organisation reported those figures. I simply do not believe them, or the survey. My extensive experience of talking to people making career choices in science makes it hard for me to believe that such considerations make it on to their radar screens. However, we must not get bogged down in that.

The background to this Bill is scandal. The organs of children and adults were routinely kept after post-mortem examinations, without the knowledge of

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families. That was unacceptable, and the distress that it caused was immense. A practice that resulted in such tragedy for so many families may once have had its place, but it certainly has no place in today's health service.

The hon. Member for Westbury referred to the patrician mindset that dictated how many people involved in clinical practice at the time made their judgments. That mindset is not acceptable now.

The expectations of individuals and families are, quite rightly, that they should know what is happening. They should be consulted, and they should consent. Practice had to change, and it has changed, but the damage has been done. Families have discovered—sometimes many years later—that they did not bury their loved ones in the way that they had believed and expected.

Many hon. Members have spoken about their constituency experiences, and the hon. Member for North Devon (Nick Harvey) recounted the distressing experiences of some of his constituents. The Bristol and Alder Hey inquiries, and the Isaacs report, exposed not a bungle or a mix-up, but a scandal. We would be failing in our duty if we did not take steps to address it.

Of course, as the hon. Member for Oxford, West and Abingdon (Dr. Harris) said, pathology is an honourable profession. I would go further, and say that it is a vital profession. However, we do it no justice by ignoring the mistakes that have been made. I am delighted that the mood of the House is that we should not ignore those mistakes and that we should move forward with this Bill.

In January 2001, the chief medical officer published his recommendations, and the Government accepted them in their entirety. That has led to a range of linked initiatives, including the establishment, in April 2001, of the Retained Organs Commission to oversee the return of organs, to give guidance to trusts, and to give support and advocacy to families.

The Government published new post-mortem consent forms, and a code of practice on communication with families. We have allocated £2.7 million per year in the current spending round for trusts to use in the development of bereavement services. We are also supporting an ongoing programme of professional education and training and public education.

There have been changes and improvements in practice, and more are taking place right now, but the Bill is needed to secure them firmly for the future. That is why we looked at the whole picture and prepared a Bill that is comprehensive and forward looking. But we have not done it alone. Through extensive consultation, we have found much consensus among family groups, professionals and other bodies, and we are pleased to have had a strong contribution from family support groups throughout the country. We also received good support from many groups, including those from Liverpool, Birmingham, Cambridge, Plymouth and Oxford, all of which helped in putting together a well prepared and welcome Bill.

I was happy to hear the hon. Member for South Cambridgeshire (Mr. Lansley) commit the Opposition to working co-operatively to get the Bill right. Certainly,

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the Government intend to do that. My hon. Friend the Member for Bristol, North-West (Dr. Naysmith) asked whether we were open minded. As he knows, my hon. Friend the Minister of State and I have well deserved reputations for always being prepared to compromise, to see the other guy's point of view, and to go the extra mile to achieve consensus; and I doubt that our approach to the remaining stages of this Bill will be any different.

The hon. Member for South Cambridgeshire said that people often act in a way that they believe to be benign. He is absolutely right—the road to hell can be paved with good intentions. That is why we have to balance the rights of individuals against the needs of researchers.

The hon. Gentleman also asked, rightly, why we did not have pre-legislative scrutiny. We had hoped to do so, and to publish a Bill earlier, but it was simply impossible because drafting resources were unavailable. We therefore had to make a judgment call—do we balance the need for scrutiny against the needs of the families who are demanding that we make progress? We decided that making progress was more important than publishing the Bill in draft. However, given that we undertook two rounds of thorough consultation to reach this stage, we are not lacking the necessary level of scrutiny; and the Committee will provide a further opportunity to consider the Bill and to get it absolutely right.

Several hon. Members, including the hon. Members for South Cambridgeshire and for Wyre Forest (Dr. Taylor) and my hon. Friend the Member for Bristol, North-West, accused us of making the Bill too complicated or convoluted. It replaces several pieces of legislation, including the Anatomy Act 1984, the Human Tissue Act 1961 and the Human Organ Transplants Act 1989, and provides a single legislative framework in an area where there is confusion and uncertainty. If that was not the case—if the current legislation had the degree of clarity that we are trying to achieve—would we face this problem or have had these scandals? Of course not.

Although the Bill has its complexities, as does all legislation, it is important that we make the effort to try to get it right. I believe that it is simple and understandable, and that we will be able to explain it to the scientific community and to give them the reassurances that they seek. We have tried to make it as flexible as possible in order that it should, I hope, last as long as the Acts that it replaces, and several right hon. and hon. Members alluded to that. Instead of trying to include all the possibilities and to predict everything that science may throw at us in the coming decades, we have created codes of practice that can be changed as good practice changes. That is the right way forward.

The hon. Member for South Cambridgeshire pointed out that the status of grandparents in the consent hierarchy is missing. I give him a commitment that we will consider that in Committee.

My right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) discussed whether consent would be wide and long lasting. He talked about the future uses of material and pointed out, as did the hon.

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Member for Sutton and Cheam (Mr. Burstow), that some discoveries relied on the fact that people were able to go back to old material. My hon. Friend the Member for Norwich, North (Dr. Gibson) gave some specific examples of that. The question was put whether medical staff must constantly return to relatives to obtain consent if new uses for material arise. The Bill sets out the fact that consent is needed for the use of tissue in research, but it does not limit the duration and breadth of the consent, so we would not expect patients to have to be revisited for further consents. I hope that that reassures them.

The hon. Member for Sutton and Cheam correctly raised the issue of bereavement services. The Government demand that NHS staff be sensitive to the needs of bereaved people when they gather consents, whether for organ donations or any other reason. He asked me a specific question about a follow-up survey, and we are supporting a survey, which I am pleased to tell him will begin in the spring.

My hon. Friend the Member for West Bromwich, East (Mr. Watson), the right hon. and learned Member for Rushcliffe (Mr. Clarke) and the hon. Member for Oxford, West and Abingdon all raised the issue of presumed consent. I suspect that we will return to that many times over the coming weeks, so I will not go into it in great detail. My hon. Friend raised the need to close the gap between demand for and availability of organs. I assure him that we are taking positive steps to increase the availability of organs. We have already made significant progress in reducing the gap between supply and demand without the need for presumed consent.

The hon. Member for Spelthorne (Mr. Wilshire) made a moving and very brave contribution to the presumed consent debate—I doubt whether I could have made that speech if I were in his position. I congratulate him on giving us the other side of the presumed consent issue. I say to those who support presumed consent that, if we own nothing else in this world, we own our bodies. There is no question but that we have the right to determine how our bodies are used in life and how they end up in death. If we move to a system that challenges that ethical principle, we will make a significant mistake.

The hon. Member for Oxford, West and Abingdon challenged the Government on whether in certain circumstances we might drop our objections to presumed consent. In return, I have a challenge for him: will he drop his campaign for presumed consent if we can show him in Committee that progress can be made without presumed consent, because it would not add significantly to the availability of organs, as he believes and hopes?


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