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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 nonmedical 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.
Several hon. Members rose—
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.
5.30 pm
Robert Key (Salisbury) (Con): I shall endeavour to speak as briefly as I can, as I am the only Member on the Opposition Benches, apart from the hon. Member for Oxford, West and Abingdon (Dr. Harris), who served on the Committee. I have a few things to say, but what I say will be much shorter because I can simply say that I agree with all 104 recommendations produced by the Committee.
I support the motion, which aims to supply funds and grant-in-aid for the Human Fertilisation and Embryology Authority. I congratulate Dame Suzi Leather on the work that she and her colleagues do on a remarkable committee. I think that there will probably be a need for more resources in future, not fewer.
I speak also as one of only two Members in the Chamber today who served on the Committee that considered what became the Human Fertilisation and Embryology Act 1990. I think it is true to say that my hon. Friend the Member for Congleton (Ann Winterton) and I agree on almost everything, and have done for almost 23 years, except on this issue. We have disagreed with each other for 23 years about some of the important issues that are now before us. I strongly respect her views although I disagree with them.
We are dealing with a report that was produced in the previous Parliament. It was undoubtedly the most interesting and significant Select Committee that I served on for 23 years, despite my having served on five Select Committees. I thank the hon. Member for Harrogate and Knaresborough (Mr. Willis), who is the current Chairman of the Committee, for his thoughtful contribution to the debate. I thank particularly the hon. Member for Norwich, North (Dr. Gibson), who throughout all the trials and tribulations of a remarkable Committee managed to lead us to a conclusion and to get a report published when it was the wish of some that that should not happen. It would have done a great disservice to the House if a report had not been published.
We are dealing with some of the last great taboos. That is why it is important to tackle them head on. To know what we should do about human reproductive technology, we should start by understanding and appreciating the widely differing views that people hold about the nature of the human embryo.
A young man living in a Jewish community about 2,000 years ago would probably have acceptedthe traditional Jewish position on the status of the embryo—it is not a person but must be treated with the respect due to a form of human life. That is surely something with which most of us could agree.
In the fourth century, teaching in Roman north Africa, St. Augustine of Hippo believed that the human embryo did not have a soul because it was not sentient. Writing in 13th century Naples, St. Thomas Aquinas rekindled Aristotlean philosophy and decided that humanity began with ensoulment at 40 days for a male foetus and 90 days for a female foetus. Was not that progress?
The Bishop of Rochester advised our Committee last year that the gradual emergence of a person was the usual approach in the Christian tradition until 1869, when Pope Pius XI abolished the distinction between early and late abortions. By 1984 the Warnock committee had concluded, rather in the Christian tradition, that a human embryo develops over time. It said that a human embryo cannot be thought of as a person or even as a potential person; it is simply a collection of cells which, unless it implants in a human uterine environment, has no potential for development.
I do not think that a human being is created at the moment of conception. That is the moment that takes the egg and the sperm a step nearer to implantation, with humanity commencing at 14 days with the appearance of the primitive streak, the precursor to the spinal chord, signifying cell differentiation and the beginning of sentience. I believe that life is a continuum with a genetic line moving ever onwards, unless it dies out through lack of procreation. That, surely, is why we humans are so interested in our ancestors and, indeed, the fortunes of our children.
There is a huge problem now. Only 30 per cent. of fertilised eggs of embryos implant. What about the rest: the spare embryos? The Church of England Mission and Public Affairs Council said in its report on embryo research:
“The superabundance of embryos, seventy per cent of which do not implant in the womb, is echoed throughout nature... Seed or eggs which do not reproduce are frequently sources of food for other creatures.”
The former Bishops of Oxford and Salisbury, in the other place, have in the past both talked of the problems that arise if all human embryos are regarded as having full human status from the moment of conception. If 70 per cent. of embryos are destroyed, do we believe that they are ensouled human beings and does that mean that heaven is largely populated by embryos? I do not know. I look forward to someone helping with that problem.
Research on human embryos can be undertaken without compromising their special status, but the research must have proper legal and ethical oversight. I also believe that it is right to create embryos for research purposes, always insisting on the 14-day rule. The hon. Member for Harrogate and Knaresborough said that Parliament sometimes had to tell scientists to stop that process. We cannot stop science or prevent progress. Science is moving onwards at a fast pace all the time. The report suggests that both Houses of Parliament should have a role in listening to all the arguments, in representing the different views in the legislative process and in deciding what should be legal for the time being—because what is legal now was not legal 20 years ago.
Mr. Willis: That is exactly the point that I was making and I am sorry if I misled the hon. Gentleman. It is important that Parliament be given an opportunity. The bioethics committee is the right vehicle for that.
Robert
Key: I am grateful to the hon. Gentleman for his
clarification. The problem is that reproductive technology is moving
way ahead of us as legislators. That was always going to happen. I
remember saying in
the Chamber during the Third Reading debate on the 1990 Act,
“They will be back.” I am quite surprised that it has
taken the scientific community and the Government so long to come back
to the House. I support the Select Committee’s call for
parliamentary oversight and a new parliamentary Standing Committee on
bioethics. Only then will all sides have the chance to be heard and
will there be an opportunity for the evidence to be weighed.
I wonder how many Members and how many of our constituents are familiar with the complexities of reproductive cloning, hybrids and chimeras, pre-implantation genetic diagnosis, embryo splitting, parthenogenesis, cell nuclear transplants, sperm sorting and haploidisation. Those things are happening around us, for our constituents, in our constituencies, every day of the year. They are real. They are happening today. We cannot ignore them. We cannot say that we wish that they did not happen, because they are happening.
For that reason, I was surprised by the announcement from the Vatican last week, as reported in The Daily Telegraph. The headline was:
“Vatican vows to expel stem cell scientists from Church”.
When the Committee visited the Vatican, it was a huge privilege to be invited to visit the archbishops and bishops and their medical advisers and experts, who did us great courtesy and showed us great respect, as we did them. They will be reading this debate—if not watching it in the Vatican. I would like, therefore, to put on record my thanks to them for putting up with us when we challenged them with some very difficult ideas—perhaps of a nature with which they were not familiar. Perhaps they were not used to being confronted by parliamentarians, because the politics of Italy are different and the role of the Church in Italy is different.
I am sorry that the Vatican made that announcement last week and that Cardinal Alfonso Lopez Trujillo said, in an interview with Famiglia Christiana, an official Vatican magazine:
“Excommunication will be applied to the women, doctors and researchers who eliminate embryos”
“politicians that approve the law.”
I therefore commend the courage of the Italian senator, Paola Binetti, a member of Opus Dei and a prominent campaigner for Catholic rights, who said:
“I am upset and stunned,”
“It is a mistake to give out the idea that God is angry with Man because he is not in agreement with him.”
I agree with that. The Vatican’s reaction looks a bit like panic.
I want to make a few comments
about the question of so-called eugenics and designer babies. The whole
argument is tainted by our memory of the appalling atrocity of Nazism
and all that happened then. The word “eugenics” is Greek
and simply means well bred and well-being—a good baby. Of
course, that is not how it is usually applied. Surely there is a great
difference between seeking to create a child with particular
characteristics such as blue eyes—or a child
who is sporty or musical—to make a master race, and trying to
filter out the damaging parts of this fragile human life where that is
humanly possible. I have wrestled with that problem for
years.
I recall that when the Human Fertilisation and Embryology Bill was going through the House in 1989 and 1990, I asked my bishop, John Baker, whether he would help. On 20 February 1990, he wrote this to me:
“Where nature itself spontaneously aborts a good many embryos in these very early stages of life, it is hard to feel that to do so deliberately for good reason is contrary to God’s own mind, so far as that is revealed in his created order. Moreover, if we are to be realistic, we human beings are not spiritually, psychologically and socially all so marvellous that we can promise the spina bifida or cystic fibrosis sufferer a quality and fulfilment of life that will make the burden of their sufferings worthwhile. On the whole if you can choose to launch either a life without these such handicaps or one with them, it seems morally better to choose the former. Many parents must pray for a disease-free child; when we are given the power to bring that about ourselves, what does it say about our prayer if we refuse to use that power?”
That puts that argument rather powerfully, and it is as true now as it was.
It is very important, therefore, to be careful when we are talking about designer babies to be clear that we are not talking about designing something to our own wish or to our own vision of a perfect child, but using science, which in my view is God-given, to enable us to use our brains to stop suffering as far as we may. I also feel—the hon. Member for Bolton, South-East(Dr. Iddon) said this eloquently, and I agree with everything that he said—that within the law, families should make decisions on their reproduction and not the state. The state does have a role, but we need to rebalance the arguments.
Finally, I want to say a quick word about abortion, because we cannot ignore it; it is part of the issue, and our report said what we thought we should be doing about it. If we want less abortion, we must look very carefully at the figures. Of the 185,000 abortions a year, just 124 occur after 24 weeks. If we are seeking to reduce the quantity of abortions in this country, does it make sense to vilify the tiny number of extremely vulnerable women in the most difficult and terrible circumstances who are in that category, and to say that they are somehow doing something unspeakable? I think not.
Let us look at the other end of the scale, too. Frequently we are told how awful it is that there are so many teenage pregnancies. I asked the Office for National Statistics for the figures, and in my constituency in the past 10 years the number of abortions among girls under 16 was 14. The ONS refused to set the figures out by year because it said that that would break confidentiality. We are talking very small numbers. The highest proportion of abortions in this country are performed on single women and those who have had abortions before. Perhaps that is where we should be considering education; something is wrong there. The hon. Member for Morecambe and Lunesdale (Geraldine Smith), who, sadly, is no longer present, used the word “Frankensteins”, but the proportion of abortions on the grounds of chromosomal abnormality is one third of 1 per cent.—that is all. If we want fewer abortions in our country—and, God knows, I am sure we all do—we will need more human reproductive technology and much more education.
5.43 pm
Dr. Ian Gibson (Norwich, North) (Lab): I quake a little when somebody says that we should have these debates in Parliament, because we will need about six weeks to go through the many issues that reflect our consciences and beliefs. It was not easy chairing the Committee—delightful bunch of people as they are; men and women united, just for a minute. I assure the House that I would much rather take penalties in the last minute than have to chair a Committee that was so severely divided. My attitude was, “Let’s just stay here all night”, and without my hon. Friend the Member for Bolton, South-East (Dr. Iddon) moving a guillotine motion—nasty man—we could have debated the issues for hours and hours. That reflects the problems.
We have come a long way in science from the days when we believed that only one parent was responsible for the creation of an individual. One was either an ovist or a spermist—there are pictures of sperm with young people within them—and that was how it all happened. It is not so long ago that we believed that. It is not so long ago, too, that we did not believe in genes and DNA—in fact, science in the Soviet Union was based on that for many years. In this area, knowledge moves on and beliefs change, and they do so pretty fast.
We as a Parliament need to regulate and legislate in respect of many of the processes that we have been discussing. However, we have to do more than that: we have to think about why we are regulating or legislating. In industry, there is continuous debate about whether legislation inhibits productivity, industrial growth, and so on. Sometimes we do nothing and sometimes we overreact, but I think that we in this country do nothing rather well. We do not get caught up in regulation, yet the world does not crumble about us. The same is true in the field that we are debating now, and that was the spirit in our Committee: we wanted to examine what was happening and make sure that we got legislation where it is needed. We were told at the beginning of our inquiry that nothing needed to happen—that we should leave the subject alone. Well, 104 recommendations suggest that something needs to change.
One has to ask whether the purpose of regulation should be to provide legal protection for the embryo, or to provide some regulation of assisted reproduction, or both. In fact, a regulator is not needed to protect the embryo. If the law says that a person cannot clone an embryo and someone does, one just calls 999 and gets the police in. Regulating IVF treatment is different, of course. IVF treatment is increasing and will continue to do so. Endocrine disruptors, which we have heard about, and many other factors are lowering sperm counts and otherwise making people infertile, but the desire to have a baby is an innate human characteristic, so there will be more pressure on IVF provision. The hon. Member for Congleton (Ann Winterton) will remember that when IVF was first introduced, people said that it was a pariah that would destroy the world and that it must not happen, but now it is a standard technique, even though there is not enough of it in the health service, and it is improving all the time. Should the regulator regulate only for technical standards, or do we want it to enforce directions on how treatment is administered, or so on? The spirit of our recommendations was not dogmatic: we were trying to help the new science to develop.
The HFEA was an extremely important addition under the 1990 Act. Regulation was extremely important to building public confidence in that legislation. However, events have moved on. We are not all old Labour—despite what some believe, we know that changes have to happen. We have to move on and the HFEA and its functions need to be examined seriously. For example, does it have the right people on it? It would not worry me at all if pro-life people had places on the authority, which they have been denied. We should get them in, have those arguments and not restrict them, because that diminishes the authority and makes people suspicious.
Is the HFEA rigorous enough about licensing and inspection? The HFEA has a triple role—regulator, policy maker and Government adviser—but it is not possible to fulfil all three functions. That is why the Committee said that we should try to separate them and why we said that Parliament’s role was extremely important. There is a plethora of knowledgeable, concerned people present in the Chamber and many more outside. I believe that the public would welcome involvement in the debate.
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