Examination of Witnesses (Questions 960
- 969)
WEDNESDAY 10 NOVEMBER 2004
MS MARILYN
CRAWSHAW, MS
DEBORAH CULLEN,
PROFESSOR ERIC
BLYTH, DR
JIM MONACH
AND MS
SHEILA PIKE
Q960 Dr Harris: If parents want anonymous
donation, do you think the state should disregard parental wishes
in those circumstances, on the basis of what is, at best, shaky
evidence.
Professor Blyth: Yes, I do. I
do not think—as indeed the Government have accepted—that
continuing the availability of anonymous donation should be permitted,
because, for all the reasons we know about, that is not conducive
to children's welfare.
Ms Crawshaw: I would want to come
in to say, on contacting children at the age of 16 or 18, that
I would be more concerned about it from the point of view of that
individual: if they suddenly get a letter out of the blue—or
however you are suggesting it—when you do not know whether
or not they do know, because obviously one of the concerns we
have is about unplanned or accidental disclosure of information
at a later age anyway. I think it would add into something we
are concerned about, that we know from the adoption field—which
is not the same, but which is the closest professional experience
that we have—of the need for intermediary services at the
point at which people may be receiving information from the register
or elsewhere about their donor. I think that is very difficult
for people to manage by themselves. We know from adoption that
it is very helpful to have intermediary services.[4]
One of our concerns would be if that remains as an offer at that
stage as well, rather than that the services are there and provided
and people should have them.
Q961 Dr Harris: My last question
is about the consultation that is forthcoming on payment for gamete
donation. What would you want to result from that? Do you think
the issue of the ending of anonymity should have a bearing on
the question of the level of expenses that are paid?
Professor Blyth: In terms of expenses,
our view would be that all legitimate expenses should be reimbursed.
We certainly would not want to move to a situation that then moved
into what might be seen as the commodification of gametes or embryos.
We would want to ensure that that distinction continues. That
has been a hallmark of the provision in this country. Reimbursement
of legitimate expenses.
Q962 Dr Harris: If the ending of
anonymity causes a real drop in the supply of donated eggs—and
that has been postulated, and, indeed, some people are telling
me that has already happened—do we just say, "Well,
people will not get treated" or do we say, "Let's raise
the level of expenses"—or be honest and call it "payment"—in
order that, again, it is a win-win: someone gets the money/someone
gets treated.
Professor Blyth: I can understand
why you are commenting in that sort of way. Our point is that
we would see the reimbursement of legitimate and reasonable expenses.
I take your point entirely, and one could move into the American
system where you pay "the market rate", but, albeit
that it may impact on supply, we are certainly not into recommending
paying the highest bidder.
Ms Pike: I would certainly agree
with Eric and see payment as a commodification and, as such, a
very unethical approach. I do not see how you can remove anonymity
and say that we are doing this for ethical reasons and then try
to solve the consequences in such an unethical way.
Dr Harris: You pay the doctors, you pay
the counsellors, you pay the cleaners—everyone gets paid
except the donor.
Q963 Mr Key: On the question of parents
telling children how they were conceived, we know that the majority
of parents who are seeking to access treatment with donor gametes
say they will tell their children because they perceive that is
what the counsellor wants to hear; whereas we know that the overall
majority—round about 85%—do not in fact tell.
Ms Crawshaw: I do not think we
do know. I think that is one of the great difficulties in the
whole of this area where you are trying to influence policy and
practice on the basis of quite a lot of unknowns. Certainly, anecdotally,
if you talk with people in clinics, even over the last five years
I think there has been a very significant change in the numbers
of people coming forward for treatment who are saying, "We
intend to tell," and I do not think that is just because
they think that is what they should say. I think there really
has been quite a change and it is more them thinking about "How
do we go about telling?" because that is a complex area.
Q964 Mr Key: Finally, interestingly
PROGAR have challenged the legitimacy of this Select Committee,
saying that because we do not have MPs from all four countries
of the United Kingdom therefore it is a democratic deficit. May
I gently point out that PROGAR's representatives do not either
come from all parts of the country. What is the point you are
trying to make here?
Ms Cullen: I do not think it is
a real point.
Q965 Mr Key: Why make it then?
Ms Cullen: We are in some embarrassment
about that in terms of the three of us here not having ourselves
written the evidence.
Q966 Mr Key: There must have been
a deep reason why you thought it was a point worth making, even
though it was perhaps made in jest.
Ms Cullen: No, it was not made
in jest, but there is a point about the complication of some areas
being half-devolved, like the regulations which dictate at what
age a person born as a result of surrogacy or through donor-assisted
conception will access the information, because the Scottish one
is paralleled on the Scottish adoption law and the English one
is posited on the English adoption law. I do not think it is actually
a huge issue, as long as there is an awareness within the HFEA
(or whatever body might replace it) of the distinctions and the
guidance that gets issued to clinics and to users, that there
is not uniformity between the four countries, and the differences
will get greater because things will get more different probably
in Wales as well.[5]
Mr Key: Thank you. I think that is a
very sensible point.
Q967 Dr Iddon: Finally, if people
get frustrated with the struggles against quite tight regulation
in this country—and after all we are ahead of the field—they
will just pack their bags and go abroad. What do we do about that?
Do you think that is important, reproductive tourism?
Ms Crawshaw: It is a very real
issue and I do not think we would pretend to have any answers
around it. We are hearing of clinics that are setting up links
with clinics in Europe and then saying to people, "You can
go and get your treatment there and get round the anonymity, if
that is what you want to do." It is extremely difficult.
I do not know what the solution would be. In adoption we had a
similar problem of overseas adoption and learned some very hard
lessons from it[6]
with some children and families who really got into some quite
deep difficulties. I am not suggesting that would necessarily
happen, because we do not know, but I think it is a concern.
Q968 Dr Iddon: Should we legislate?
Dr Monach: We already do in terms
of importing and exporting gametes themselves. But, in terms of
the people going abroad for treatment, I think that would be very
difficult. That would be our view. It would take us into a really
major set of obstacles really.
Q969 Dr Iddon: You have no answer
to the parliamentarians?
Professor Blyth: It is difficult,
even as parliamentarians. Well, I say "even"—I
mean, from where I am sitting you are far more powerful people
than I am in certainly trying to change things, but, even so,
we do have to recognise the limits of these. You talk about reproductive
tourism in the sense of thinking of people from the UK going elsewhere,
but we also need to think that we currently have a very liberal
system compared even to many western European countries and the
UK is also the destination of a lot of people. I do not know if
anybody does know the figures, but people do come into the UK
for treatment because it is not permitted in their own countries.
I am thinking of countries that do not allow egg donation, for
example, that do not allow embryo donation, countries where they
are far more restrictive on sexual orientation and marital status
in terms of accessing particular assisted conception procedures.
I should not go so far as saying the UK is a magnet to people
in those sorts of situations but we know there are a lot of people
who come to the UK for that as well. I do think it is a difficult
issue and probably there are elements of that that no individual
country can successfully legislate for. We just have to accept
that.
Dr Iddon: It sounds like a debate for
another day.
Dr Turner: On that note of controversy
we will stop this session. Thank you very much for your contributions.
4 Note by the witness: See, for example, Section
98 Adoption and Children Act 2002. Back
5
Note by the witness: PROGAR would like formally to withdraw
its challenge to the legitimacy of the Select Committee. The point
that it wishes to make in relation to the four countries of the
UK is that which was made by Ms Cullen. Back
6
Note by the witness: In the field of adoption much has
been done to try and achieve safeguards at an international level,
in particular the 1993 Hague Convention on Protection of Children
and co-operation in Respect of Intercountry Adoption, ratified
by the UK in 2003. Back
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