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1.14 pm

Baroness Warnock: My Lords, like other noble Lords, I am extremely grateful to my noble friend for initiating this debate, which is extremely timely. I speak essentially as a lay contributor because, although I agree that there are moral considerations to take into account in finding the right framework of law within which stem cell research may go ahead, moral judgments cannot be properly made without a grasp of what is scientifically involved. Speaking for myself, I would not like to have to take an examination on the science that is involved.

Speaking as a lay member of society, I confess to a sense of urgency in the matter of settling how stem cell research and the implementation of the results of this research can best be carried forward. I do not detect much of that urgency in the Government’s White Paper. As a society we have been slower than might have been hoped in putting the theory of stem cell research into anything like useful practice, or even potentially useful practice. There are two reasons to regret this—indeed, to urge that we as a society should advance as rapidly as possible to the next stage, which means advancing the fundamental research that is necessary.

The first reason, roughly speaking, is that competition is strong and likely to get stronger. On economic grounds, therefore, it is important that we should not hang around. I want to be assured that funding is not lacking for the next crucial stage in moving towards the clinical outcomes that we all hope for, and which, I believe, lie ahead. I doubt, for example, whether a new president, when America gets one, will be so dogmatically hostile to stem cell research as President Bush has been; so competition from the USA may be even greater than it is now, and it is already, as we have heard, extremely strong. It is essential that the Government should be wholeheartedly—and show themselves to be so—behind the next stages of the work. It is all very well to pride ourselves, as we often do, that our regulation on all kinds of scientific research is better than in any other country, but I need to be reassured that such regulation

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is efficiently and speedily applied, and that there are not unnecessary and often absurd delays in issuing licences and carrying out the resolution that the Government may say that they have that the research should go ahead. I hear numerous stories of endless delays and illformed judgments by ethics committees, and so on, which hold things up. I want these reassurances, partly on economic grounds. We must not allow our wonderful research capabilities to go to waste.

I very much hope for these reasons, among others, that the Minister will promise to think again about paragraph 2.85 of the White Paper, where the proposition is made that the general use of hybrid embryos should be prohibited. I hope that the Minister has taken very good account of my noble friend’s speech, which preceded mine, on the need to rethink the status of the human embryo and to take into account the possibilities of the use of hybrid embryos.

My second reason for feeling a sense of urgency is even stronger. We have a moral duty to press ahead with providing the cures that we hear of for hitherto incurable conditions. When I say that “we” have a moral duty, I mean society. I take very much to heart the speech of my noble friend, Lord Crisp, who well understands the difference between private and public morality and between policy decisions and personal moral decisions. That is an extremely important point that the Government must be well aware of.

Nevertheless, we as a society have that moral duty. We cannot be content just to know that in future we may be able to restore damaged cells, but we need to decide to act on that knowledge now. I feel a certain despair at the length of time that it will take to carry out the consultations, as the now somewhat lame-duck HFEA and the Government propose to do. No good can come of consulting the public without first educating it—an important point which has been made again and again—but educating the public takes time. Without a better understanding no private or public moral judgments can be made. But there is no time to lose.

1.20 pm

Lord Harries of Pentregarth: My Lords, I, too, am grateful to the noble Lord, Lord Patel, for initiating this debate on a subject of such scientific interest and importance. My entrée into the subject came as a result of having the privilege of chairing your Lordships’ Select Committee on the subject for the 2001 regulations.

One key issue in the debates in the House at that time, and still an issue for a number of your Lordships, is whether the research could not be done just as well using adult stem cells rather than embryonic cells. Adult stem cells obviously do not involve either the manipulation or destruction of the early embryo and therefore do not pose the same ethical problems as embryonic stem cells. Our committee discovered then that, from a scientific point of view—and this is still the case—research on both adult and embryonic stem cells is necessary. We simply do not know which route is going to be most beneficial for future therapies, and at this stage there

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is some essential research that can only be carried out on embryonic stem cells. There is, for example, still a great deal to find out about the process of differentiation and dedifferentiation, whereby the pluripotent cells which we obtain from embryos become one of the 200 or so specialist cells in the human body, or about how that process is reversed, as the noble Baroness, Lady O’Neill, has just so strongly stressed.

I respect the position of those who argue for work on adult stem cells, and research in this area must be fully supported. Leaving aside ethical considerations for a moment, however, there is no doubt that, from a scientific point of view, work on embryonic stem cells is essential both for basic research and because it holds out great promise for at least some future therapies. As the noble Lord, Lord Patel, said right at the beginning, the two forms of research on adult stem cells and embryonic cells are complementary, not rivals.

All research on early embryos must be done under licence from the Human Fertilisation and Embryology Authority; I declare an interest as a member of it and chair of its ethics and law committee. I stress two points. First, on the careful procedures that must be followed for any research licence to be granted, we have just heard from the noble Lord, Lord Winston, of his own unfortunate experience with the HFEA. It may be that that was some time ago. I will certainly write to the noble Lord, giving him an accurate and up-to-date picture of the amount of time a research licence application takes at the HFEA. I shall also write to the noble Baroness, Lady Warnock. I am obviously not in a position to know how long it might take to go through local ethics committees, but I do not believe that the time spent with the HFEA is undue delay. It clearly needs to be as speedy as possible.

The research licence committee must obviously consider whether the research can be permitted under the 1990 Act as modified by the 2001 regulations. In particular, it has to decide whether the research is both necessary and desirable. In short, if the research could be done in some way other than by using early embryos, then a licence cannot be granted. The procedure is a careful and testing one, although, as I say, I do not believe that it takes an undue length of time.

The fact that we have this firm regulatory framework, respected the world over, has enabled public confidence in this research to be kept and valuable research to go ahead. Researchers know that there is a clear and firm but permissive framework within which to operate so that they know where they are, which is not always the case in some other countries. Parliament will shortly be revisiting the 1990 Act, which I welcome. It is remarkable, however, how robust that Act has been. Despite major scientific advances not envisaged in 1990, it has enabled research to proceed in an orderly, controlled way. It is essential that, if and when the new regulatory body—RATE—comes into being, with its much wider remit including human tissue and blood as well as embryos, public confidence is still retained.

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The Royal Society has recently raised important questions about whether the expertise built up in the HFEA in such an ethically sensitive area over the years will be able to be focused and utilised in such a necessarily specialist way in a body with such a wide remit as is proposed for RATE.

Finally, from a religious perspective, the whole scientific endeavour should been seen not as a rival to religion but as a way of exploring the wonder and miracle of nature. Walt Whitman began a poem with the words:

As to me, I know of nothing else but miracles”.

Many scientists, including atheistic scientists like Richard Dawkins, feel that sense of wonder. For those of us with religious beliefs, this is exploring the wonder of the divine source of the wisdom in all that.

Good research takes time. As a non-scientist, I am full of admiration for the painstaking, detailed and meticulous work which scientists do in their laboratories over many years, research which sometimes does not produce any very worthwhile results. This huge field is obviously very promising and a real gift. I think that we in this House would all wish researchers in the field well, because it will undoubtedly produce results which will ultimately enhance human health and well-being.

1.26 pm

Lord Rees of Ludlow: My Lords, we should all be grateful to the noble Lord, Lord Patel, for introducing this important and timely debate. As he emphasised, stem cells are crucial to understanding how living things develop. They offer immense long-term medical promise, but pose issues of special sensitivity in which the entire public have legitimate concerns.

I am a scientist but, unlike other noble Lords speaking in the debate, a lay man in respect of these technicalities. The Royal Society, of which I have the honour to be president, is actively engaged with the world's leading researchers in stem cells. Many of them are among our fellows. We have strong engagement with the policy and ethical issues and in advising on research priorities and protocols.

The regulatory framework in the UK, stemming from the Human Fertilisation and Embryology Act 1990, is widely admired internationally. It evolved from a broad consensus, brought about by effective dialogue and engagement between scientists, parliamentarians, ethicists and the wider public, led by some distinguished Members of this House. It was a model for how to regulate any research field involving safety and ethical concerns, but the science has moved on. There are consequently ever more ambiguities on how the existing guidelines should be applied.

The challenge to the regulators was exemplified by the HFEA’s stalling response on the issue of cybrid embryos earlier this year. We must cope with the idea that the everyday concept of species is blurred and unhelpful at the level of a gene, even of a single cell. It is not obvious what embryos should be classed as human and what should not, nor what groups of cells

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should be classed as embryos. In clarifying such conundrums, we will benefit from the kind of public engagement that has served so well in forging the present framework. I endorse everything that was said so eloquently about public consultation by the noble Baroness, Lady Kennedy. As a contribution to this end, the Royal Society has just produced a short document, in simple Q&A format, which should help the media and general public to understand the issues underlying cybrid research.

The cybrid issue exemplifies how the demands made on the HFEA are becoming ever more arduous as the science advances. In that context, we in the Royal Society have anxieties about some aspects of the Government’s White Paper. In particular, we are uneasy about the proposal to set up a single Regulatory Authority for Tissue and Embryos, with the acronym RATE, combining the role of the HFEA with that of the Human Tissue Authority. This new authority would regulate human reproductive technologies, including the use of human gametes and embryos for treatment and research, but it would also deal with the HTA’s current agenda—human bodies, body parts and tissues—and oversee transplantation and blood transfusion issues. The Royal Society’s concerns are shared by the Academy of Medical Sciences and the Wellcome Trust. We feel that a single body, as envisaged in the White Paper, cannot feasibly cover its huge remit without either diluting its expertise or delegating most key judgments to an infrastructure of expert panels.

However, I would like to end on an upbeat note. When the history of science is written, stem cells will surely rank as a highlight. This decade’s discoveries are just the beginning. It is a research field where the UK has pioneering achievements and retains world standing. We have escaped the strident politicisation and polarisation that bedevils the field in the US, and we have avoided the down sides—inadequate regulation or dubious ethical standards—that may taint research in some other parts of the world. We should sustain our research groups so that they remain a magnet for mobile talent in the face of growing international competition for that talent. To do so is surely good for UK science. More than that, it would be good for a field that, sensitively handled, promises great hope for human welfare. For all those reasons, we should welcome this debate and thank the noble Lord, Lord Patel, for obtaining it.

1.31 pm

Lord Alton of Liverpool: My Lords, although I disagree with my noble friend Lord Patel about the use of human embryos for these research purposes, I congratulate him on initiating today’s debate and on the way in which he introduced it.

Two seminars recently held in the Moses Room explored stem cell policy, the policy that led to our refusal to sign the 1997 European Convention on Human Rights and Biomedicine and aligned us in the General Assembly of the United Nations with countries such as China and Korea. In our overenthusiastic desire to become a sort of biotech El Dorado, we have become far too unquestioning

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about the ethical implications of what we have permitted. In other jurisdictions, such as Canada, France or Germany, scientists face prison sentences of up to seven years for what we have made legal. We cannot reduce these issues to opinion polls. Since the 1990 Act, with little regard for the special status of the human embryo, more than 1 million human embryos have been routinely manufactured, frozen, destroyed or experimented upon with only 4 per cent seeing the light of day.

Only last week, in a leader on 26 April, the Times reminded us that:

That should surely be unconscionable when alternatives are available. It is probable that we all have experience in our families of degenerative diseases and want to see medical advances. But, as Thomas Okarma, the CEO of Geron, has revealingly admitted, embryonic stem cells have value for the biotech industry for research, not for cures.

During this debate, mention has been made of the lucrative research grants. According to a Written Answer that the Minister gave me on Monday, they amount to about £100 million from the Government between now and 2008. Those grants and the money involved often skew judgments and, through conflict of interest, can compromise debate. The Minister needs to tell us clearly the division of the £100 million between adult stem cells and embryonic stem cells. Why have they not been treated in the even-handed way that we were told that they would be during our debates in 2002? In his Written Answer on Monday, the Minister admitted that no statistics are kept centrally on the allocation of private funds. Why? What assessment has been made of the analysis in Forbes investments journal which says that only “dumb public money” is going into embryonic stem cells? By contrast, I hope that the Minister will list some of the more than 1,200 trials and 70 diseases and conditions that have been successfully treated with adult stem cells, and tell us what therapies exist using embryonic stem cells.

At the Moses Room seminar, Dr Peter Hollands, a leading scientist involved in cord blood stem cell research, pointed to the Cinderella status of and lack of funding for treatments using adult stem cells. Cord blood is used to treat leukaemia, lymphoma, sickle cell anaemia, thalassaemia and immune system disorders. He said that it is scandalous that 98 to 99 per cent of all UK cord blood is currently incinerated or discarded and less than 1 per cent goes into the NHS public bank at Edgware. The mother of Eva Winston Hart, a seriously ill three year-old suffering from leukaemia, was at the seminar. She said that, after months of uncertainty, she has found a suitable donor in the US and is taking Eva there for treatment. Why can she not be treated here? Why are there only four NHS hospitals in the whole of the UK that are collecting cord blood, and what we are doing to create public cord banks?

Dr Carlos Lima told the same seminar how his team in Portugal has used olfactory cells taken from the nose to repair spinal damage. We saw clips of

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people who had previously been unable to move learning to walk again. They included British patients who had to travel to Portugal because the same treatments are not available here. Dr Lima succinctly reminded us that, “Embryonic stem cells were made to proliferate and adult stem cells were made to repair. We shouldn’t use one to do the job of the other”.

Professor Neil Scolding, Burden Professor and director of the Institute of Clinical Neurosciences at Frenchay Hospital, Bristol, specialises in the treatment of multiple sclerosis. He contrasted adult stem cells with embryonic stem cells and quoted the Lancet, which said that it is “ethically unacceptable” to create human embryos with no purpose other than to use them for stem cells. He said, “We know adult bone marrow stem cells are safe, it’s not a guess”.

Throughout our debates, advocates of using embryonic stem cells have constantly cited pluripotency as those cells’ greatest asset, but what use is it if a cell is dazzlingly pluripotent if it is going to be rejected by a patient’s body or, worse, if its very pluripotency creates stem cell-derived tumours? Dr Lima said that he believed that the UK had entered a blind alley, become obsessed with embryonic stem cells and had been diverted away from the much greater untapped potential of adult stem cells, which could deliver so much more for patients and which carry no moral hazards.

As we now consider whether to create cloned animal-human embryos and animal hybrids, we are entitled to have an intelligent debate in which views contrary to those driving the research are properly heard. I would like to register the strongest possible opposition to the proposals to create cloned animal-human embryos and animal hybrids, and to the hotchpotch of other proposals—to remove reference to fathers, new arrangements for surrogacy, to make human embryos available for training purposes, and to alter the genetic structure of embryos. When he comes to reply, I hope that the Minister will specifically tell us whether these new animal-human entities are to be treated as embryos under the 1990 Act, as animals under the Animals (Scientific Procedures) Act 1986 or as something in between. Will they have no moral status or special moral status? Is a so-called cytoplasmic hybrid human or not, or does he agree with the Chief Medical Officer, Professor Sir Liam Donaldson, who in February told the House of Commons Select Committee on Science and Technology that,

In the debate in your Lordships House’ in 2001, the Minister said that,

Many people would argue that that time has now come.

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1.39 pm

Lord St John of Bletso: My Lords, I join others in thanking my noble friend Lord Patel for introducing this topical and controversial debate. Unlike my noble friend Lord Alton of Liverpool, I am a great supporter of stem cell research, but I do not claim to be an expert and it is awesome to be speaking in such a long line of distinguished experts on this subject. For me, the key point in the wording of the Motion we are debating is,

which relate to their regenerative ability to treat future generations. I entirely agree with my noble friend Lady Finlay of Llandaff, who said that fantasy has fuelled scaremongering about stem cell research. Having said that, I entirely agree with the reasonable call of the noble Baroness, Lady Kennedy, that there should be greater public understanding of stem cell research.

My interest stems from seeing my 91 year-old mother suffer from a degenerative and degrading disease, and my desire that similar patients should have the chance through stem cell therapy to have a better quality of life. I have neither desire nor intention to debate the moral and controversial issues of embryonic stem cell research. My noble friend Lord Patel in his outstanding introduction mentioned that clear distinctions need to be made between different types of stem cells. I am interested in adult stem cell research and umbilical cord stem cells, which have been extensively researched around the world for several decades with no apparent ethical issues regarding obtaining them.

It is well known that the United Kingdom has permissive rules for embryonic stem cell research, but it is less clear about the policy on adult and umbilical cord blood stem cells, which are closer to application in patients. Given the extensive data on these cells, what is Her Majesty’s Government’s policy for doctors using this technology in the UK? I gather that we are a few years away from definitive stem cell therapy using adult and umbilical cord blood stem cells. As we all know, many patients are now in desperate need with dementia, Parkinson’s, Alzheimer’s and motor neurone disease, among many other ailments. My noble friends Lady Greenfield and Lord Sutherland spoke of the enormous costs of caring for these patients, and the enormous pain that not just their families but their carers go through. I commend the work of the AMRC, which supports the campaign about the need for and the potential therapeutic benefits of stem cell research.

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