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Ann Winterton: Of course that is true, but people who do not believe in what I am saying usually go on to say that if those conditions are not in place, it is better for children to be aborted: that they are better off dead. I would say that not all those conditions can be in place in every single case. We know of children—in our own family circles and in wider circles—who have had unhappy childhoods, but have grown up to be excellent adults and have played their part in society. We cannot guarantee those elements in anyone’s life, because life is not perfect, but if they are there, that is a tremendous bonus.
As I was saying, the original Act enshrined many concerns about the welfare of children. Many of the recommendations of the Science and Technology Committee attempt to lessen the impact of those concerns. I believe that we should resist those recommendations, and insist that the provisions in the Act are reinforced.
5.6 pm
Dr. Brian Iddon (Bolton, South-East) (Lab): It is important that we are having this debate on an Estimates day. The subject is complex. The report from the Science and Technology Committee contains many chapters and much material that needs to be debated, and in the short time available today we shall not be able to do it justice. Let me say to the Minister that I hope this will be the first of many debates on the subject before we change the legislation, as we must.
When we embarked on the debate, I hoped that it would not be hijacked by the abortion issue. That is not because I do not consider the issue important. The Committee deliberately avoided debating it, however, because it had been debated so often in Government time on the Floor of the House and elsewhere in the Palace of Westminster. I rather hoped that today we would concentrate on other issues, which are not aired as frequently as they should be.
I regard my membership of the Select Committee as one of the most important duties that I perform in this place on behalf of my constituents. The Committee’s members believe that they have influenced Government thinking in a number of policy areas, and have also influenced organisations outside the House. A number of debates are taking place at present, of which this is only one.
During my time in the Committee disagreement has been rare, but the fifth report of the 2004-05 Session was an exception. It resulted in the eighth special report of that Session, which makes it clear that five of the 11 Committee members disagreed with the publication of the fifth report. That probably reflects the divided views of Members across the House, which is why we are given free votes on most of these difficult issues.
After a lengthy inquiry and prolonged discussions, the Committee met again on 14 March last year, faced with 130 further amendments to an already amended report. It was clear to me then that the report would not see the light of day, especially as we knew that Parliament was shortly to be dissolved. A great deal of effort had gone into compiling the report. It had also cost a lot of money, particularly because of visits to Stockholm and Rome—including a visit to the health
ministry and the Vatican—and to clinics in various parts of this country. We collected a large amount of evidence, and the inquiry lasted for an entire year. If the report had dropped out of sight, it would have been costly for Parliament, and it would have been a shame in the context of today’s debate. Therefore, I did an unusual thing in a Select Committee: I moved a guillotine. That caused quite a rumpus. On that day, the meeting began at 3.30 in the afternoon and the guillotine was for 8.30 in the evening. Even though it upset some of my colleagues on the Committee, I do not regret taking that action, because if we had not taken it, we would not be having the debate on this important report this afternoon.
“the evidence suggests that the scale of intrusion into the private choices of individuals seeking to have a family can no longer be justified. We do, however, accept that the research uses of the embryo of the human species remain a legitimate interest of the State.”
Other members of the Committee felt that that was too liberal a statement and they moved an amendment against the libertarian approach of certain members of the Committee, but the majority prevailed and the report was published.
I accept that these issues are difficult to grasp and even more difficult to legislate for, but it is now generally accepted that the Human Fertilisation and Embryology Act 1990 is in need of review and I believe that our report forms an excellent platform for that review to take place. As in many other areas, advances in technology in this field are racing ahead of our ability to consider reform of existing legislation.
As I have said, the Committee deliberately excluded abortion from its inquiry and it excluded surrogacy, too. I want to touch on one or two aspects in the report. On the status of the embryo, we agreed with the Warnock view that embryos should have special status. As the present Chairman of the Committee has pointed out, we took the “gradualist approach” that a human being is not created at the point of natural fertilisation but emerges gradually towards birth. However, we respect the 14-day rule that allows research to be carried out on an embryo during the period before the primitive streak emerges, which is the first sign that the nervous system, the spinal cord and the brain are beginning to develop. It is my personal view that no change to the law should be made in that respect, although there are arguments being advanced both to reduce that 14-day limit and to increase it to 20 days, or even beyond that. Baroness Warnock has admitted that that time scale of 14 days is “arbitrary” and it is based on the reasoning that I have already given.
The 1990 Act defines an embryo in section 1(1) as:
“a live human embryo where fertilisation is complete”
“an egg in the process of fertilisation”.
The term “gamete” covers live human eggs or sperm, but not eggs in the process of fertilisation.
Today, that definition is inadequate because artificially created gametes can be produced and embryos can be created through the process of cell nuclear replacement, or cloning, the process used to give birth to Dolly the sheep at the Roslin institute
nearly 10 years ago. Our Committee believes that attempts to define an embryo in any new Act would be counter-productive because it would lead to legal challenges, as the definition of the embryo in the present Act has led to legal challenges.
On sex selection, I agree with the majority of our report’s recommendations, but not all. I spoke against sex selection for non-medical reasons—Members have used the phrase “for social reasons”—either by sperm sorting or by pre-implantation genetic diagnosis. However, for the avoidance of sex-related disorders, I do support sex selection.
Some communities value boys more than girls; India and China are examples. I believe sex selection to be discriminatory and that it should not be sanctioned in this country. The policy of the two countries that I mentioned has serious demographic consequences. However, I recognise that there are arguments for family balancing, especially when a mother has given birth to a significant number of children of the same sex. Alan and Louise Masterton, who have four sons, lost their three-year-old daughter Nicole in 1999 in a domestic accident and campaigned for the right to rebuild their family with a daughter. If families cannot achieve what they want in this country, they will probably go abroad to achieve their ends. That applies to other areas of this debate as well as sex selection, but I have no ready answers to “reproductive tourism”. We have to face the fact that if people cannot get what they want in this country and it is legally available in other countries, they will go there to have that treatment, possibly under less safe conditions than would apply in this country.
Mr. Newmark: Just because another country may have lower ethical or moral standards, does the hon. Gentleman think that we should introduce them here?
Dr. Iddon: No, I did not say that. We want high moral standards in this country. We do not want to force people to go to other countries with lower moral and ethical standards. For example, the Mastertons had to go to Italy for treatment. Tragically, that resulted in only one male embryo, which was donated to an infertile couple.
Sex selection by PGD or sperm sorting is far preferable to sex selection by selective termination of pregnancy or by infanticide. Sex selection by sperm sorting is not covered by the human fertilisation and embryology legislation and, in my view, it should be.
Mr. Walker: Is the hon. Gentleman seriously suggesting that if we do not allow people to select the sex of their children, we will have parents committing infanticide?
Dr. Iddon: No, I am saying that in some other countries infanticide is used to achieve what people want. I have mentioned two countries in which it might happen.
“no adequate justification for prohibiting the use of sex selection for family balancing”.
Sex selection in the UK would probably work both ways and the demographic impact would, therefore, probably be imperceptible.
The concept of selection is one on which we need a full debate—fuller than we can have this afternoon—especially if we want to allow selection as a means of achieving greater intelligence or beauty, a certain hair or eye colour, increased memory capacity, or other factors. Science will make all those choices available. I do not say that I am in favour of them, but I am saying that we will have to debate the issue in this House at some point.
The birth of Louise Brown in 1976 at Oldham and district hospital as a result of in vitro fertilisation was a milestone in medical history. Unfortunately, today, only 1.5 per cent. of all live births in the UK are a result of IVF treatment and, considering that the UK gave birth to IVF treatment, it is not pleasing that we were ranked 12th out of 15 countries in Europe that offer IVF treatment in a report published a few days ago by the European Society of Human Reproduction and Embryology. Denmark offers 2,031 cycles per million population, but the UK figure is only 633. In Israel, where there is an active policy to encourage childbirth, the figure is 3,000 and 7 per cent. of treatments lead to a live birth. In comparison, the figure in Denmark is 3.9 per cent.
The Committee formed the view that IVF treatment has become such a routine medical procedure that its regulation can become part of mainstream clinical regulation. That is not to say, however, that there should not be continued inspection of clinics offering the treatment, both in the public and private sectors.
I represent a constituency with some of the poorest estates in Britain and it concerns me that my constituents have such poor access to IVF treatment. Indeed, only a few years ago, our local NHS would not fund IVF treatment. Nationally, only 25 per cent. of IVF treatments are obtained in the NHS. The rich get the most treatment, because they can afford to go to the private clinics. Unless we make IVF treatment more readily available on the NHS, my constituents—poor as many of them are—will continue to be discriminated against because they live in the wrong place.
However, the question is not just the availability of IVF, but the quality of the services on offer. I believe that the success rates of public and private-sector clinics offering that treatment should be published, although clinicians are sceptical about doing so, because their success rates depend on a number of factors; the main one, incidentally, is the age of the woman presenting herself for IVF treatment. However, it is important that people can judge the success rates of clinics, and in taking evidence our Committee found that those rates differed spectacularly.
In February 2004, the National Institute for Health and Clinical Excellence published guidelines on IVF treatment. It recommended the implantation of only two embryos per cycle to avoid the risks that we know are associated with multiple pregnancies. It also recommended that three cycles be offered to infertile women, which would have a considerable cost implication for the NHS. The Government, of course, have asked primary care trusts to offer only one cycle. Again, the House needs to have a proper debate on the NICE proposals. In Italy, the position is different; the
Italian Government have insisted that three embryos be implanted per cycle. There was considerable opposition to that proposal, as the Committee found when we visited Rome.
There is a rising trend of infertility in the richer nations. One in seven couples now experience problems with infertility; we need to invest far more in research to find out why. Some blame pollution of our environment by certain chemicals—so-called endocrine disruptors—but that is by no means proven. We should all remember that that trend comes at a time when the demographic make-up of our population is skewed towards the older end. We need more live births to make our demographic spectrum as it was in previous years. It costs an estimated £13,000 for every baby born by NHS IVF treatment, but we should remember that that baby will contribute an estimated £147,138 to the Exchequer throughout its lifetime, so it makes economic sense to support IVF treatment.
Spare embryos can be destroyed, donated, stored for future use by the woman or others, or donated for research. Many people believe that, once created, embryos should never be destroyed, despite the fact that 70 per cent. of embryos fail to implant and are merely washed down the loo. Is it not preferable to use spare embryos for important medical research? I was pleased when Parliament decided to debate stem cell research a few years ago, and to allow it to proceed in this country, admittedly under tight regulation. There is now a reverse brain drain in this country; people are actually coming from the United States of America to conduct much-needed stem cell research in Britain.
There are widespread concerns—shared by me, incidentally—about the principles and practicality of the welfare-of-the-child provision in the 1990 Act. Section 13(5) requires that
“A woman shall not be provided with treatment services unless account has been taken of the welfare of any child who may be born as a result of the treatment (including the need of that child for a father), and of any other child who may be affected by the birth.”
Although most of us have freedom of sexual reproduction, less fortunate individuals who need assisted reproduction actually have to be judged by others, mainly from the middle classes—general practitioners and people on various ethics committees. That is not right. Those people are not in touch, in my opinion, with some of the people on poorer estates in my constituency who are desperate to have children but who are infertile. I do not believe that they should be judged in the pursuit of having a child, and that is one of the reasons why I am against that welfare-of-the-child provision. It is highly discriminatory, especially to people who are leading non-conventional lives.
Our committee heard lots of evidence from professionals, such as GPs and clinicians, who are expected to implement that procedure, but they find it almost impossible to do so. How well does a GP know all the women who are on his or her books? Can they judge? The evidence that we took was that they cannot judge in the majority of cases. The medical profession wants the welfare-of-the-child provision in the 1990 Act to be abandoned. Our Committee also felt that adequate mechanisms are already in place to ensure
that any child born in an assisted manner will be protected. Of course we must remember that, since that legislation was passed, we have passed the Children and Adoption Act 2006, which also gives the born child a great deal of protection.
I wish to mention just one more thing: the insemination of single women. It seems ironic that, when we produced the report, the people in the media who wanted to do radio and television interviews with me—I think that it was the same for other members of the Committee—focused on one thing: sex selection, not on IVF, PGD or many of the other things in the report, not all bad and mostly good. Today, with me, they have been focusing on the insemination of single women. Why do not the media get real, look at the whole report and judge it across the spectrum?
During our inquiry we visited the Harley street office of a business called Man Not Included, which offers an internet service to collect and deliver fresh sperm to single women, including lesbians. As it deals in fresh sperm, its services are not covered by the 1990 Act. In my opinion, those internet services need regulating. I have two concerns, one of which is on grounds of safety? How can we be sure that sexually transmitted diseases are not being transmitted from the donor of the sperm to the recipient woman? That needs regulating.
I am also concerned that, whereas the Human Fertilisation and Embryology Authority has a register that lists all the donors of gametes and all the recipients of gametes, those internet services do not have to register donors or recipients on the central register. We are very keen for that to happen now that children, some time in their future, can find out exactly where their parentage is based, but those services will not allow any of the children born as a result of using their services to trace their parentage.
I am in favour of PGD because it will eliminate some of the most difficult diseases that we are facing. I am also in favour of the creation of a parliamentary bioethical committee, on which lay members and professionals from the industry could serve—it need not be made up only of parliamentarians—but what really gets to me is the fact that a quango, the HFEA, is making important decisions without reference to elected Members of Parliament, and it is about time that those important decisions were brought into the Chamber and our Committees, so that we can debate them properly.
It would be a brave person who could predict where these areas of research will take us next, but one thing is sure, they will always be controversial and we will always need to debate them in parliamentary time. I have many other comments to make, but in fairness to other hon. Members, I will sit down soon. Let me finish by saying that our report contains 104 recommendations and, alas, it impossible to touch on most of them this afternoon.
Mr. Deputy Speaker (Sir Alan Haselhurst):
Order. I offer guidance to the House and seek the co-operation of hon. Members. There are two subjects for debate today. I must try to protect the interests of those who wish to speak on the subject that is before us and also
of those who hope to have an opportunity to speak on the second subject. I hope that a measure of rationing will come into the remarks that are made if I am to call everyone who is seeking to catch my eye in this debate.
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