Examination of Witnesses (Questions 1320
- 1339)
WEDNESDAY 19 JANUARY 2005
MISS MELANIE
JOHNSON MP
Q1320 Dr Harris: How do you think
that makes people like Diane Blood feel, and single parents, lesbian
parents? Do you think they are welcome to hear they are second
class in that way?
Miss Johnson: I am sure Diane
Blood would have wished she could have had her children born into
a family with a mother and father.
Q1321 Dr Harris: But how about these
other people? How do these other families feel when they do not
meet your ideal? Do you think they are pleased to hear the government
pass judgment on them?
Miss Johnson: The government is
not passing judgment.
Q1322 Dr Harris: You are saying it
is best if there is a mother and father.
Miss Johnson: I said it is better
for children.
Q1323 Dr Harris: So it is worse if
it is not the case. Do you think it is right for government to
pass a judgment on what is better or worse?
Miss Johnson: That is a conclusion
you are drawing from that statement. I do not know what you are
going to recommend, and I will be very interested to see, but
at this stage in the proceedings we are hoping for discussion
and debate. We are not advocating any particular changes on some
of these issues: we are looking to see you set the baseline for
the discussion and the debate in this process and for the public
to have a period of engagement on it.
Q1324 Dr Harris: I am trying to work
out what is your message to non mother/father families. "You
are worse for your child", is that what you are saying?
Miss Johnson: No, absolutely not.
Q1325 Dr Harris: "You are just
not better"?
Miss Johnson: This is about—
Chairman: It is all right, Minister.
Thank you.
Q1326 Bob Spink: Minister, I congratulate
you on your very pragmatic, caring and listening approach to this.
Hard cases do make bad law, and I would say that to my colleague
here. Where society intervenes to create a life then it must accept
a special responsibility to look at the moral and ethical issues
surrounding that, and I welcome your view that the welfare of
the child is best served if it does have a mother and father.
I think on balance, although there are many exceptions, that is
a right statement and the right position for society to take.
I want to look at comparison with other regulatory models. Professor
Alan Templeton, the President of the Royal College of Obstetricians
and Gynaecologists, told us he thought a hands-off professional
inspectorate with a much more focused approach and informed by
a more professional input would be appropriate for regulation
of assisted reproduction and, in fact, abortion clinics are inspected
and registered by the Healthcare Commission on that basis. Have
you considered scrapping the HFEA altogether and going to a different
system of regulation which actually simply applies the views of
Parliament on behalf of society rather than seeks to interpret
what is best for society and protect Parliament from these difficult
decisions, as the HFEA said itself at our last inquiry?
Miss Johnson: I think this comes
down to the nub of one of the difficult issues facing parliamentarians,
and I speak as a parliamentarian as well as a minister. Parliament
is ideal for setting broad frameworks for doing things; it is
ideal for setting some of the detail in place where it is known,
but it is particularly difficult for Parliament, given our processes
with which we are all very familiar, to move quickly to future
prove things necessarily in areas where there may be unforeseen
and unforeseeable developments and to get the future dealt with
effectively as it arises. Now in a timely fashion one of the best
ways of doing that is to set the right frameworks to put as much
detail as we can sensibly put into it but to understand that,
as Parliamentarians, we cannot ourselves dot every "i"
and cross every "t" and we may well need organisations
and I think we do need a continuing organisation of the ilk of
the HFEA in the arrangements that we have in this area. I personally
think that is one of the things we would be quite surprised to
find we were not going to be recommending at the end of this,
can I put it that way. Of course we will be excited to see what
you are recommending but I think our view at the moment is that
we would expect a body to still be there to perform many of these
functions. Things will still occur even if we take an update,
as I hope we will in due course, of the legislation and reflect
some of the changes and issues that have arisen; there will be
new issues; the individual is always best dealt with on a different
level, as you said yourself, otherwise Parliament is making raw,
hard cases and the hard cases do not make good law. But it is
also it is not appropriate, and we cannot respond as quickly as
we should.
Q1327 Bob Spink: Professor Brazier
and others have told us that they feel it might make more sense
to merge the HFEA with the HGC rather than create the new Human
Tissues Authority. Do you think that has any merit? Would you
like us to explore that?
Miss Johnson: I am very happy
for you to explore all sorts of things. We looked at what we would
do with the Human Tissue Authority just because there was a lot
of coming together, in particular with the Tissues Directive as
well, of common issues that they could both be addressing, both
deal with tissues and gametes, as it were, and those come together
in the Directive. We need a competent authority; there seem to
be a lot of issues and some possible grey areas between the two
that might arise in time, and we thought it was most appropriate
to put those together in the new regulatory authority for fertility
and tissues, RAFT, which is our current proposal as you know.
Q1328 Dr Iddon: But what is going
to come first? The review of the HFEA, which we are beginning
to conclude is pretty urgent, or the regulatory reform which would
bring the two organisations together? Surely it would be more
important to get the HFEA looked at first and then the regulatory
reform after?
Miss Johnson: Yes, indeed. The
timetable we have proposed at the moment would see the new organisation
coming into being in about 2008 which is the timetable that fits
in with the Directive as well for April 2008,[2]
so it would probably physically as it were come into being in
some sort of shadow form at the end of 2007/April 2008 to be operational,
but this is an area where obviously if the Committee makes recommendations
which we feel ought to alter the course of things then we would
want to look at that, but one of the things I do not think we
are going to be looking at seriously unless someone produces something
very stunning is the idea we do not need a body to do this kind
of regulation because we think much public confidence has been
gained from having this arrangement; we are regarded very highly
internationally as a result of the arrangements we have here,
and we think finding a modernised version of those that takes
on board changes that have taken place and new issues is the right
way of moving forward. That is the sort of context in which we
are framing our own thinking at the moment in so far as it is
possible for us at this early stage to have any thoughts on these
matters.
Q1329 Dr Turner: Abortion, minister,
is as controversial a subject as assisted reproduction. We do
not have a separate regulator for abortion; we leave it to the
Healthcare Commission. Do you think there is a danger that by
having either the HFEA or even RAFT we are singling out the area
as being so special and dangerous that it itself slightly undermines
public confidence and runs the risk of stigmatising people who
use the services? Do you think there is a downside there?
Miss Johnson: I do not think there
is and I think because, sadly, about one in seven couples have
difficulties conceiving these days as well the problems of fertility
are becoming more widespread, more known and understood; any stigma
that did attach to infertility is rapidly evaporating because
people are well aware of how common it is and of all the issues
around it. I think that the authority has ensured a huge degree
of confidence in the arrangements, and I do not think the general
public would wish to see, but that is something we can test out,
that there was no body there overseeing this kind of arrangement.
Q1330 Dr Turner: And do you still
feel that it has to be a specific body rather than the Healthcare
Commission?
Miss Johnson: I believe that there
will be tricky policy and other issues. The membership of the
HFEA picks up lay members, it picks up the ethical and religious
dimension, it picks up people with a variety of backgrounds and
the experience of fertility, including patients themselves, and
I think it is very important that we have a body that pulls those
things together. With all due respect to the Healthcare Commission,
their primary responsibility is around inspection arrangements
and seeing standards are met, and that is not the only function
that the HFEA has by any means.
Q1331 Geraldine Smith: Surely the
problem with the HFEA is that it does not have a wide range of
views? That if someone disagrees with the Act they cannot sit
on that body. We have had a lot of evidence to suggest that there
should be a statutory, national bioethics committee to look at
some of these really difficult decisions that have to be made.
Can I ask, Minister, what your view is on this? Would you support
such a body that could have a wide range of views and could have
some sort of debate and inform and advise government on some of
these very difficult issues?
Miss Johnson: I think it is one
thing for, say, the House to take a view about having some body
which informs the House on these matters; it would be another
matter if you were seeing any such commission as providing some
sort of Court of Appeal over and above the working of the HFEA,
in this particular instance, or any other bodies who are performing
similar functions, because I think what you would get there is
a lack of clarity about where decisions were being made and a
constant batting backwards and forwards. I have to disagree with
you on the subject of those who completely disagree with the role
of the HFEA being represented on their board: I think it would
put those individuals in an impossible position and the organisation,
were they to be members, and I am sure that nobody would want
to find themselves in that position because they would not be
able to contribute to the organisation which they had been appointed
to contribute to, and I think that is a fundamental objection.
But we have got people currently with regulatory, philosophical,
media, patient, healthcare and law from a lay point of view, patient
again, backgrounds and a bishop on the HFEA and that does bring
together a wide range of different backgrounds amongst those 17
members.
Q1332 Dr Turner: Different backgrounds
but not necessarily different views, and I think that is the problem.
Miss Johnson: I am sure you have
discussed this with Suzi Leather and the HFEA but I expect they
would say they have some vigorous debates on some subjects. I
very much doubt that they all sit around a table and somebody
says something and everybody agrees. (A) the issues are so difficult
and (B) they clearly give a lot of thought to these issues and
they are individuals with different viewpoints. The fundamental
position is that they support the work of the authority and you
have to have people who are supporting that work at the bottom
line in order for the authority to be effective.
Q1333 Dr Turner: Can I ask, though,
why should someone opposed to embryo research not be engaged in
other areas? Why should they not be allowed to be on the body
just because they are opposed to one aspect?
Miss Johnson: I do not think anybody
is not allowed to be on the body. The question is how we arrived
at the present membership and I would argue that it has a very
diverse set of backgrounds representing all the ethical, scientific,
patient, lay, as well as professional issues that you might want
to see represented, and that people do have different perspectives
and there will be much discussion on the very difficult issues
from day to day that they sometimes deal with.
Q1334 Dr Turner: But surely there
are some people who are not allowed to be on, because if they
disagree with any aspects of the Act then they do not get the
opportunity to sit on the HFEA?
Miss Johnson: If you mean positive
people who are fundamentally opposed basically to the work the
HFEA is doing, all I have said is I do not think those people
could contribute. It would put them in a very difficult position,
and the organisation.
Q1335 Dr Turner: Has the department
never asked potential members for their views on embryo research?
Miss Johnson: I am afraid we do
not go through the appointments procedure. We formally appoint
the chair of the HFEA and the members but the detailed handling
arrangements ministers do not get involved in. Interviews and
so forth I cannot comment on, I am afraid.
Q1336 Mr Key: Minister, I think the
reason we were exploring this is because it is fairly obvious
that out there the public feels a lack of confidence in the HFEA's
ability to take ethical judgments which reflect the views of society
at large. Are we not coming back to saying the only place we can
ever do that properly is Parliament, and therefore a lot of these
ethical decisions, particularly when it comes to new medical technology,
are going to have to be taken by somebody, and it might be a national
bioethics commission but I hope it is not in view of what we saw
in Italy, to be honest—just another talking shop, probably
full of political appointees and the best place to talk politics
is Parliament—but would your government, a government, ever
allow Parliament to set up a mechanism for taking such decisions,
or would the government of the day say "No, Parliament would
be too controversial, we, the government, are going to have to
decide"?
Miss Johnson: I think we have
always seen it as a parliamentary role to make decisions about
these difficult issues because they are the difficult issues,
they are the moral and ethical issues about the frameworks, about
the things Parliament can properly do, and I go back to my earlier
point in relation to Mr Spink's comments really, that what we
have is a situation where we can set certain parameters, we can
even deal with some of the detail, but in terms of the future
proofing, the issues that will arise over time, and the question
of where some of the very difficult individual decisions are made,
I do not think Parliament is equipped or able to deal with those
decisions and I do not think we are the best place to do it.
Q1337 Mr Key: Did the government
whip the vote on embryonic stem cell research for the Labour Party?
Miss Johnson: I think it was a
free vote but I do not know.
Q1338 Mr Key: So with no inference
at all, but it is important, assuming we can get beyond the problem,
or the reality, if you like, of whipping and everything was free
votes, given the pressure on time in Parliament—you know
all about it—should there not be a separate Parliamentary
system, possibly even including the other Place, which reviews
the decisions that are currently taken by the HFEA? Should there
not be a new mechanism, a new Parliamentary Committee, which took
specifically those sort of issues and then made a recommendation
to Parliament?
Chairman: You are not calling it a think
tank, are you?
Q1339 Mr Key: No.
Miss Johnson: I personally do
not think so but I will be interested to see what you have to
say on these issues. I think there are certain things we can do
well in this place and we must do them to our best, and beyond
that there are detailed every day issues and things which can
arise, we can set the frameworks for others deciding, we can make
sure the safeguards are there, the accountability to this place
is there and we can deal with them best in that framework and
leave others to make the detailed decisions on the detailed points
within the framework Parliament has set, and our opportunity is
as much as anything to get the framework right. The framework
has not been updated for some 15 years, and now is our chance
to look at it again and to get it as right as we possibly can.
I do not think it is necessary to put, if I may say so, some more
bureaucracy into the system in dealing with those issues.
2 Note by the witness: Directive 2004/23/EC
of 31 March 2004 on setting standards of quality and safety for
the donation, procurement, testing, processing, preservation,
storage and distribution of human tissue and cells. Article 31
requires transportation not later than 7 April 2006, however member
states may decide not to apply member states may decide not to
apply the requirements of the Directive to tissue establishments
already bound by national provisions for a further year. The Government
has announced that, subject to primary legislation, the Regulatory
Authority for Fertility and Tissue will be established by 1 April
2008, consolidating the role of competent authority under the
directive. Back
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