Mark
Simmonds: I thank the Minister for that answer and for the
offer to keep me in touch as the HFEA develops its thinking and makes
progress in that area. I would certainly like to take her up on that
offer. I am pleased that the HFEA recognises that there is an issue
that needs to be addressed, and I was comforted by the fact that the
Minister felt progress was being
made. Of course, I
understand that the community is small and that no particular clinic
likes to be criticised, whether that criticism is justified or not.
There are clearly sensitivities. Certainly, one of the things I felt
when meeting people involved in the clinics was that they tended to
divide into two camps: those who were satisfied with the reports and
inspections they were getting from the HFEA, and those who definitely
were not. This is not the only reason why they were not satisfied, but
clearly progress needs to be made. I also understand that we cannot
possibly have a situation where we are over-restrictive on the
recruiting pool. We need to have appropriate number of inspectors to
make inspections, and particularly to produce the interim reports at
the end of a licence. On that basis, I beg to ask leave to withdraw the
amendment. Amendment,
by leave, withdrawn.
Schedule 1
agreed
to.
Clause
6Additional
general functions of
Authority
Mark
Simmonds: I beg to move amendment No. 4, in
clause 6, page 5, line 35, leave
out subsection
(3). The amendment
relates particularly to the charging of fees specifically to give
advice. There is no question that there is a necessity for the HFEA to
be allowed to charge for licensing, even though some of the licensing
fees, based on the number of people benefiting from and using the
clinic, are very substantial indeed, in some cases running into the
hundreds of thousands of pounds.
The amendment would remove the
right of the authority to charge a fee for advice. Will the Minister
explain what that advice might be? What, in fact, might the HFEA want
to charge for? Surely advice should be freely available to allow those
who are considering applying for a licence to have the best opportunity
to submit all the relevant documents in the first place. That should be
part of a consultation process free at the point of access with the
HFEA. From my reading
of the clause, it would also enable the authority to charge a person
considering treatment for providing gametes or embryos. In my view,
this should be free, as the current process is costly, traumatic and
time-consuming enough. There has to be an assumption that the HFEA will
give free advice to clinics to enable them to meet the criteria, to get
the licence and to ensure that they are safe. There is concern from
within the clinic community that HFEA charges could amount to not
insubstantial sums for
carrying out roles that the authority should be fulfilling in the first
place. I am referring to the additional information that is required
for obtaining a licence, for renewing a licence, or for future
discussions and advice on interim inspection
reports. 4.45
pm Will the
Minister clarify what sort of categories of advice the HFEA will be
able to charge for? Is it advice about confidentiality, consent or
licensing? Might it also be advice to those donating embryos and
gametes, because the last thing that we want to do is to deter people
from wanting to be
donors? Robert
Key (Salisbury) (Con): I support the amendment very
strongly because it addresses the fundamental issue of whether it is
right for some of the services in the national health service to be
paid for by the patient. Any licence charge is inevitably passed on to
patientsand in different ways. Quite a lot of it comes down in
the end to postcoding. I object very strongly to the discrimination
against fertility centres in the national health service. They find
themselves faced with very high charges, as my hon. Friend the Member
for Boston and Skegness said. As far as I can see, this measure is an
extension of that, although perhaps the Minister will convince me that
it is nothing to do with that, that patients will not suffer or lose a
penny, and that the primary care trust will not be able to pass on any
of the charges to
patients. My
basic point is that there should be no discrimination against fertility
treatment. Fertility treatment is not a luxury; it relates to a medical
condition. The rich will continue to look after themselves. If we are
not careful, we will see the national health service clobbering the
poorit is as stark as that. This is an issue of principle. My
hon. Friend is seeking, in a far kinder way than me, to press the
Minister to explain the measure, and I support him. I shall take some
convincing that the amendment should be withdrawn, and I hope that it
is not.
Dawn
Primarolo: The intention behind the provision is not to
implement the charging to which the hon. Members for Salisbury and for
Boston and Skegness have referred. The clause provides for a
discretion, not a duty. It is discretionary to charge a fee for advice
provided under the clause when the advice requested from people to whom
licences apply is greaterlet me
explain. The provision
is intended to allow the HFEA to recover costs that it has incurred in
providing specialist advice. It was considered appropriate to make the
power discretionary, which enables the HFEA to consider whether a
charge is necessary. It is not about income generation. It is a
discretionary levy that will be used only when appropriate, such as if
a clinic wants to consider what systems it needs to put in place to
comply with a European directive. It will be provided for within the
national health service if we are required to move the entire service
to comply with a particular European directive, or if a restructuring
of the service is necessary. The amount of work generated for the HFEA
by such a request could go way beyond the usual requests suggested by
the hon. Members for Boston and Skegness and for Salisbury.
If the information provided by
the HFEA goes beyond that by helping the structure of the business, it
has the option to charge a fee. That power will be used sparingly
because such a thing will occur only in rare circumstances, but none
the less it will happen. The public purse would otherwise be under
pressure and strain because of having to provide advice to private
organisations on how to comply with requirements. That does not seem to
be the correct way to proceed.
I absolutely understand the
point made by the hon. Member for Salisbury. I imagine that he was
thinking of clinics asking for information. We are talking specifically
about them going beyond that and asking for much more detailed advice
about compliance or
structure. Jeremy
Wright (Rugby and Kenilworth) (Con): Of course we accept
the Ministers reassurances once again, albeit with the caveat
that she will not always be the Minister. Will she answer this specific
question? If I understand her correctly, she seems to be arguing that
in the majority of cases in which information or advice is sought by
organisations or individuals, the HFEA would not contemplate charging a
fee, but that in exceptional cases, it might. Why does the clause not
say that a fee is not to be charged save in exceptional
circumstances?
Dawn
Primarolo: The power would be a duty if it was required in
all circumstances. It is a discretionary power regarding not
information, but specific advice. If we intended the HFEA to charge for
everythinginformation and advicewe would put a duty on
it to do so. We are requiring it to charge, with discretion, if the
demand goes beyond information. The authority will have to decide
whether to make a charge.
Robert
Key: The Minister has the enormous advantage of having
been a Treasury Minister for many successful years. She will know that
in the arguments that we had with the HFEA over the charging of primary
care trusts or, more usually and more directly, fertility clinics, the
authority said that it was bound by the instructions of the Treasury.
That is about as discretionary as a local council charging council tax
to its residents. I
am totally unconvinced by the Ministers argument. She has been
unable to give a guarantee that the charges will be discretionary. We
all know of discretionary charges in almost every area of life, and I
am not convinced that the charges will not be passed straight on to
primary care trusts and fertility clinicsand ultimately to
those seeking help.
Dawn
Primarolo: I want to resolve this. I
understand the hon. Gentlemans fears, but this is discretion
under specific circumstances. If he has a way forward, I would be happy
to take a further intervention. When there is a request for substantial
advice from the HFEA that would cause substantial cost and go beyond
the information that it normally gives or the work that it would
normally do, it has the discretion to decide whether or not it charges
a fee. It need not definitely charge a fee, but it
may do so, to ensure that the public purse is not unduly called upon.
Has the hon. Gentleman a way of having that caveat but not removing the
provision completely, which is what the amendment would do? The
amendment would completely remove the HFEAs ability to have the
discretion to decide whether it wants to recoup its costs in
exceptional circumstances when the cost is
great.
Robert
Key: Of course, the answer is to include the phrase
exceptional circumstances somewhere and then to define
them. Will the Minister also point to anywhere in the Bill that
describes what the normal function of the regulatory authority
is?
Dawn
Primarolo: Given the advice and the information collected,
the work that the HFEA has done predicated on the 1990 Act, and the
hon. Gentlemans expertise in this area, he knows full well that
the HFEA will be regularly asked for information. The caveat that I am
drawing here is about advice. I am loth to leave the HFEA exposed when
there might be substantial claims on its resources through providing
advice, but I absolutely agree with the hon. Gentleman that we are not
sending a signal in the Bill or from the Committee that we would expect
everything to be charged. This is a caveat that is additional to the
provisions in place. Given that the Bill amends the 1990 Act, when it
is silent, it means that the measure is in the 1990
Act. I want to be open
with the Committee, but I do not want to accept a complete removal of
the proposition. I would ask the hon. Member for Boston and Skegness to
reconsider his amendment and give us time to think about it.
Regrettably, if he feels that he must press the amendment to a
Division, I fear that I must ask my colleagues to resist it. It would
be better to try and sort this out
properly.
Mark
Simmonds: I listened with great interest to the
Ministers response. She initiated her comments by using the
word discretion. My hon. Friend the Member for
Salisbury ably made the point that Governments have the discretion to
raise taxes all the time. I am not suggesting that fees for advice from
the HFEA are the equivalent of tax, but they could definitely have an
impact on costs for someone wishing to receive treatment from one of
the clinics, if an element of those fees was passed
on. If all this is
about implementing EU directives, my hon. Friend the Member for Rugby
and Kenilworth came up with exactly the right wording:
exceptional circumstances. I would argue that
implementing EU directives is probably an appropriate call on the
taxpayer, rather than the individuals using clinics. The HFEA, since
its inception, has survived perfectly adequately without having to
charge for advice under existing structures. Also, there could be a
major deterrent for those who are using the clinics in what is already
sometimes an extremely costly
exercise. I am sorry
to disappoint the Minister. I am grateful for her offer of looking at
the point again, but I am not prepared to withdraw the amendment and I
shall press it to a
Division. Question
put, That the amendment be made:
The
Committee divided: Ayes 7, Noes
8.
Division
No.
1] Question
accordingly negatived.
Clause 6 ordered to stand
part of the
Bill.
Clause
7Duties
in relation to carrying out its
functions Question
proposed, That the clause stand part of the
Bill.
5
pm
Mark
Simmonds: Clause 7 strikes me as a curious measure. It
states that the authority, meaning the HFEA, should carry out its
duties effectively,
efficiently and
economically, but one
would have thought that that is implicit for any Government authority.
Does it mean that the HFEA has so far been ineffective, inefficient and
uneconomic? What would be the impact on the HFEA if the clause was not
included? The HFEAs behaviour and performance should not be
altered because it should operate that way whether or not the clause is
included.
Dr.
John Pugh (Southport) (LD): My question is on proposed new
section 8ZA(2), which
states: In
carrying out its functions, the Authority must, so far as is
relevant I am
not clear when it would not be
relevant have
regard to the principles of best regulatory practice...including
the principles under which regulatory activities should be transparent,
accountable and so on.
It is accepted that the HFEA and its delegated committees will make
some big decisions, but it is not guaranteed to be without conflicts of
interest, whether financial, as have been mentioned, or based on
researchpeople may wish to encourage research in which they are
involved or actively discourage research in which they are involved. In
fact, such conflicts of interest, far from being hypothetical, are
regarded as extremely likely by most members of the Committee who have
spoken. There are also public funding
issues. I recognise
that the HFEA has a strong lay element, but in any environment in which
there are lay and professional people, the latter have a big impact on
what the former decide and think. The HFEA has a strong ethics
committee, but that is largely concerned with the treatment of its
clients. It
is perfectly likelyI am assured that this happensthat
when making decisions that have financial or research implications,
members declare and state their interests.
However, I pondered some time ago whether there was
a standing register of interests. My hon. Friend the Member for Oxford,
West and Abingdon declared an interest at the beginning of the previous
sitting, but I assume that if we check carefully, we will find a
further declaration in the Register of Members
Interests [Interruption.] One would indeed
hope so. I have scoured HFEAs website to find out what are
peoples relevant standing interests, whether financial or
research. I could not find that information, so I contacted the HFEA
and asked whether it had a standing register of interests. I thought
that that was a good idea if only because there will be huge sums of
money riding on some of its decisionsone has only to see the
investment by the Wellcome Trust and others to realise how big those
sums might be. Does the Minister know whether there is a standing
register of interests for HFEA members? If not, suggesting that it
produce one might be a laudable way of future-proofing
legislation.
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