Select Committee on Science and Technology Minutes of Evidence


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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