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Baroness Jay of Paddington: My Lords, I wish to support the amendment for the reasons that have been given so eloquently by the noble Lord, Lord Swinfen, and my noble friend Lord Ashley of Stoke.

I have one additional concern relating to the impact of discrimination in this field; namely, the area of parental genetic counselling in order to achieve the prospect of a healthy child for parents who have a genetic predisposition. It may sound rather far-fetched, but it is already the case that identifying the gene for cystic fibrosis and replacing it through in vitro fertilisation techniques has meant that healthy babies have been born to parents who might previously have been at risk of producing a child with that particular condition. We should resolutely turn our faces against anything which leads the parents of children who might be healthy to refrain from the kind of genetic counselling and testing which might lead them to produce another generation of more advantaged children.

The paradox which is possible in the present situation is that where genetic counselling, genetic testing and identifying genetic markers is potentially one of the most exciting and liberating developments in medical science at the end of the 20th century, if it becomes the case that people feel that identifying those markers in their own personal situation will lead to discrimination, they will be less likely to take advantage of those extraordinary scientific advances which may help their own condition and in which medical science may be able to help future generations of children.

It is sometimes argued that, theoretically, the whole population has the potential for some kind of genetic problem. The issue now is that we are in a situation where science has developed so far that we can talk about specific developments in genetic markers which means that it is not sensible to talk about the whole population being at risk. It is possible to identify people who are at risk. We are beginning to see the results of work now on Alzheimer's disease as well as on other diseases such as Huntington's chorea and cystic fibrosis. It seems to me that it would be very foolish if at this stage we exacerbated the potential paradox of allowing people who may be helped in this way to feel that they will be discriminated against. I support the amendment.

7.45 p.m.

Earl Russell: I am grateful to the noble Lord, Lord Swinfen, for introducing an amendment which is not only important but also likely to be a great deal more important in 20 years' time than it is now.

In supporting the amendment, I must declare an interest. In doing so I should say that the issue of genetic counselling is perhaps slightly more complicated than the noble Baroness, Lady Jay of Paddington, suggested. When my father was in his twenties, which is now about 100 years ago, he was earnestly advised by several doctors that because there was a history of mental illness in the family he should never allow himself to have children. I declare an interest in the view that it is a good thing that he did not take that advice.

I say to the noble Lord, Lord Vinson, that my grandfather was an epileptic. It never occurred to me for a moment that that was a reason why I should not have a

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driving licence. I believe that the correct reaction to the noble Lord's point is that if there is any risk of accident sufficient to appear to the authorities a good ground for denying a licence, then the person should not drive. However, if the person is medically fit for a licence, then we should accept that the basic principle of insurance is spreading the risk.

Lord Inglewood: We have had an extremely interesting and very wide debate. At the risk of being slightly narrow minded, I draw the attention of the Committee to the fact that we are debating Part 2 of the Bill which relates to employment matters.

The debate echoed a number of points which were raised earlier. I should like to echo a point raised on a number of occasions by my noble friend Lord Mackay; namely, that this is a disability discrimination Bill. It is designed to cover people who would commonly be understood to be disabled. That is someone who has an impairment which has a long-term and substantial adverse effect on normal day-to-day activities. We think that these are the people everyone generally takes to be disabled. We have already included in the Bill the people who would be commonly understood to be disabled: people with severe disfigurements; people with a progressive condition which is in its early stages; and people with recurring substantial effects. However, we have to draw the line somewhere, and we must draw it where there is not and never has been a disability as it is commonly understood.

The noble Lord argued that people with genetic predispositions suffer discrimination. However, a person with a genetic predisposition is not disabled and therefore that argument is not relevant to the Bill, although it may be relevant to other matters.

I should like to touch on a point made by my noble friend Lord Swinfen in relation to house insurance premiums. I can tell him that the Government have powers in the Bill to prevent insurance companies discriminating unjustifiably against disabled people. Refusing to insure a disabled person or charging a higher premium than normal where there is no actuarial or other good reason for doing so will be prohibited. However, I have to tell my noble friend that the Government will not require insurance companies to charge lower premiums than the risk insured requires simply because the risk is based on the customer's disability. I am aware of no legislation in the world which would require insurance companies to do that.

As the debate has shown, there are serious ethical questions surrounding the whole topic of genetic testing. The rapid advance in scientific understanding of our genetic structure opens up a number of possibilities. It seems likely that in the relatively near future it will be possible to identify genetic predispositions in all of us. Does that mean that all of us will be disabled and covered by the Bill? Of course not. It means that scientists will be able to see in advance what conditions we are most prone to should we have the good fortune to live to old age.

I do not deny that the whole field of genetics needs to be looked at in its entirety. The Select Committee in another place is due to publish a report on the subject shortly. It would be a mistake to pre-empt that debate by accepting

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these amendments now. We believe that the effect would be counter-productive for people with genetic predispositions and it would serve to undermine the effectiveness of a Bill intended to protect people who have or have had a disability. It is for that reason—I hope that noble Lords understand it—that I must ask the noble Lord to consider withdrawing the amendment in line with what I said.

Lord Eatwell: Before the noble Lord sits down, perhaps I may ask him to reconsider the proposition that he made about insurance. It is not true that no insurance companies in the world would consider the generality of insurance to be separate from the risk of individuals. For example, in Germany, motor insurance does not consider the specific characteristics of individual drivers. The standard fee is related to the size of vehicle; and that is all. The structure is quite different from that of insurance in the UK. As a result, insurance is more widely held. There is less evasion. The settlement of insurance claims is more rapid; and the cost per driver on average is less because the risk is more widely spread.

It is an example by which insurance, by not discriminating between individuals, proves to be more efficient. The statement that the noble Lord made about the nature of insurance companies is not true.

Lord Inglewood: Perhaps I may answer the point made by the noble Lord. We are at cross-purposes. The proposition that I made, and I stick by it, is that I am aware of no legislation in the world that requires insurance companies to make such provision. The noble Lord described a situation in Germany. I have no reason to suppose that what he says is not 100 per cent. accurate. We are talking about legislation, not the commercial practice of insurance companies.

Baroness Jay of Paddington: At the risk of prolonging this interesting debate, perhaps I may say this. I believe the noble Lord has the point slightly wrong about the whole population being at genetic risk. Specific conditions have been identified in the Bill as being required to be on the face of the Bill as special cases. We debated whether HIV should be added to cancer and the other conditions which are described.

We can all hope for the day when a genetic marker will tell us whether or not we shall be more intelligent, or will live to 104 years. However, we have already identified genetic markers about specific genetic disabilities which could be included in the Bill.

Lord Inglewood: I am grateful to the noble Baroness. Undoubtedly in her own right she is a great deal more knowledgeable on these matters than I am. However, the point to which I return is that in the Bill we are talking about when the disability manifests itself. That is the focus on which we have debated the matter.

Baroness Hollis of Heigham: We have been talking about when the disability manifests itself, or gives rise to discrimination. The Minister repeats a problem that we encountered at the beginning of the debate this afternoon. By focusing exclusively on disability, discrimination will be generated against which other people in similar circumstances will have no protection.

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