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There are already extensive clinical trials with a variety of stem cells, most notably in heart repair, including phase 1 FDA safety tests from the Johns Hopkins University in the United States in 2003, as well as similar trials in Germany, which show a clear clinical benefit for heart regeneration. As these tests have been successfully completed, why do we need to repeat them with neurological patients? While I agree that it is important to regulate therapy, are we not protecting these patients to death? They have a parlous quality of life with limited treatments

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available. Should we not now be exploring first-generation stem cell therapy, perhaps on a named patient basis?

If time permitted I would have liked to explore the potential benefits of stem cell research and therapy to the underdeveloped world, particularly in Africa, where my passion lies. I have no doubt that we shall have more opportunities to debate this topical subject.

Clearly stem cell research is moving in the right direction. However, we need to support and streamline research. Research needs to be promoted and not restricted. I share the views of my noble friend Lady Warnock, who urges that we should move to the next stage of clinical outcomes.

Finally, in the words of my noble friend Lord Crisp, I hope that the Government will not sit on the fence.

1.43 pm

Baroness Neuberger: My Lords, I, too, pay tribute to the noble Lord, Lord Patel, for securing this important and timely debate. We have heard from considerable experts in the field—scientific, medical, legal and ethical. I am a little nervous at winding up at this stage. We have heard the experts speak with great authority. I want to add only a few points to what has been said. I need to declare a couple of interests. I am a former member of the Medical Research Council, the General Medical Council and the Human Fertilisation and Embryology Authority and its predecessor organisations.

First, I want to emphasise the extraordinary hope that stem cell work in its variety of settings offers to people with all sorts of deeply distressing conditions. The noble Baroness, Lady Greenfield, made that point very strongly, as have other noble Lords. We have heard from the scientists, the doctors and the ethicists, and from the noble Lord, Lord Turnberg, about the medical charities and how they have put on pressure to increase funding for this kind of research.

I want to speak from a pastoral point of view. I used to be a pastoral rabbi; these days I only do a little of that. I come from a tradition which is extremely life-affirming and where we believe that we should do everything possible to preserve life. I also come from a tradition which does not accord to the human embryo quite the status that Christian traditions have; and I think it is important to say that. However, like the noble and right reverend Lord, Lord Harries of Pentregarth, I believe that these scientific questions are also basically religious questions, giving us cause to wonder about it all.

Nobody suggests that we should prolong life unnecessarily, but these new advances give people huge hope that we will be able to stop the degenerative disorders and cause an end to some of these deeply distressing conditions for those who suffer from them and their families. Let me give a couple of examples: Duchenne muscular dystrophy—I am grateful to my noble friend Lady Thomas of Winchester for pointing this out to me—is a distressing, disabling and ultimately life-shortening illness. Stem

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cell research is well under way to look at ways to prevent muscle loss after the mechanism of the stem cells has stopped working, and to see whether there is a way to repair and replace the damaged muscle cells. That research is trying to prevent the muscle loss or to replace lost fibres and to understand the biology of the satellite cells and their potential to repair and replace muscle cells.

Thus far the researchers have shown that some satellite cells are capable of making large amounts of regenerative fibres. Not all satellite cells can do that, so they need to understand which can and which cannot. That might lead to satellite cell transplantation which could treat the various dystrophies; but there is a long way to go yet. There are no instant successes or cures here. There is no hype. We have been rightly warned by several noble Lords that sometimes some of this is overhyped. There is no false hope given here, and it is right that the noble Baroness, Lady Kennedy of The Shaws, reminded us that false hope should not be given. But work is taking place and it is giving people real hope, if not in the very short term. Researchers are working on developing a way to replace the dopamine-producing nerve cells that have died in Parkinson’s disease with healthy cells and on transplantation of healthy heart muscle cells for people with chronic heart disease—something that is immensely prevalent in my family from a relatively early age; so I shall be very grateful if they get on with that. They are working on slowing down the progression of type 1 diabetes by transplanting islets of Langerhans, which are the cells that specialise in the synthesis of pancreatic insulin. And so on. Previous speakers have cited examples: the noble Lord, Lord Soulsby of Swaffham Prior, on motor neurone disease; the noble Baroness, Lady Finlay, on heart disease; and the noble Lord, Lord St John of Bletso, on degenerative neurological disease.

For many people these techniques, which are in their very early stages of development, give hope to the individuals and their families. Many people are strongly opposed to this research, mostly for religious reasons, and we have heard from some of them today. The noble Baroness, Lady O’Cathain, raised many of the questions that disturb many people. The noble Lord, Lord Alton, made his opposition very clear to many of these advances. They believe it is wrong to use human embryos, even at the earlier stage for any purpose.

I think that the noble Baroness, Lady O’Neill of Bengarve, is right to ask us to think differently and to say that these scientific advances should make us reconsider what it means to have these clusters of cells, what is truly human and what is in fact animal. Do those terms still apply as we thought they did? However, many of us probably would agree with the BMA’s position that,

But, it continues,

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The noble and right reverend Lord, Lord Harries of Pentregarth, made the case clearly that we need to continue work on both adult and embryonic stem cells. But if it is right that we do not think at the moment that adult stem cells will take us to where we want and need to be to give hope to so many people, if we do not allow the use of embryonic stem cells, particularly those that go to waste, as the noble Baroness, Lady D’Souza, said, we would not only hamper scientific and medical research but destroy hope for many people.

It is very hard to justify a position that would destroy hope for hundreds of thousands of people. Like the right reverend Prelate the Bishop of Newcastle, who spoke earlier, I do not believe that using human embryos sensitively and with careful regulation means that we are destroying human life. One can have scientific advance and respect for human embryos at the same time. We have a strict and careful regulatory system in this country, and other noble Lords have made it clear how very much that is respected around the world. This is what leads me to make my second point. Government have flagged up their intention in their review of the Human Fertilisation and Embryology Act to ban the creation of hybrid and chimeric embryos.

We all know of the panic surrounding the publication of the story of two groups of scientists applying to the HFEA for licences to conduct research involving the transfer of human genetic material into animal eggs from which the nucleus had been removed. “Monsters”, said the headlines; “Chimera”, said the commentators. Yet this is desired only because human eggs from IVF patients are in short supply. Nor should we desire to so over-stimulate women’s ovaries that they produce masses more eggs, because it is dangerous for them. It is unclear why the Government are taking this view, particularly with 200 or more charities making great representation to the Prime Minister on this issue. It would be very good to hear from the Minister the exact reason for their view, particularly given the reassurance received thus far that there could be regulations later to allow such research using animal/human embryos in specific circumstances. Is it really necessary to have such a ban in the Bill?

There is general agreement around the world that the HFEA has done an excellent job analysing complex ethical and scientific issues, and it has developed a trusted and moderate approach to its regulatory functions. It is to be hoped that its proposed successor will be able to do the same, although its remit, as the noble Lord, Lord Rees of Ludlow, has said, and other noble Lords have agreed, seems to be extraordinarily wide. There is some doubt, as the noble Lord, Lord Patel, said in his introductory speech, that it will be given sufficient resources, both in funds and expertise, to do the job. Given our success in regulating and the approach that this country has taken since the very beginning of in vitro fertilisation, with its voluntary licensing authority, which eventually became the HFEA, should we not think differently about a total ban and instead allow the regulators to regulate? The HFEA

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has rightly launched a public consultation, and it will be very good to hear what it comes up with.

Stem cell research is already signalling that it will bring great benefits, and we are indeed among the world’s leaders in that area. In congratulating once again the noble Lord, Lord Patel, on securing the debate, I ask the Minister to reflect on whether it is really necessary to curtail scientific advance by imposing an outright ban on animal/human embryos. I also ask him what the Government will do to encourage this research, not only in terms of funding but by creating a climate of acceptance of scientific advance, even where some members of our society have real and understandable ethical concerns. Like the noble Lord, Lord Crisp, I believe that we need to think differently about how we will use all these technologies in our service design. Like the noble Baroness, Lady Carnegy of Lour, I believe that most of the public are ready for all this, but I think that we need to check. Like the noble Baroness, Lady Kennedy of The Shaws, I believe that this debate needs to be held in public, and that we need to create a climate of scientific education, scientific literacy, and an acceptance that scientific advance brings great benefits. I very much hope that the Minister can tell the House what the Government will do to ensure that this research is conducted in a climate of public debate, public education and scientific literacy.

1.54 pm

Earl Howe: My Lords, in listening to the successive contributions to this debate, I have come to the view that we have today witnessed the House of Lords at its very best. It is wholly characteristic of this House that it should have elicited from Peers on all sides that special combination of scientific expertise and balanced exposition that is so essential for a subject of this kind. I congratulate the noble Lord, Lord Patel, on tabling his Motion and on the quality of his opening speech, which set the scene most admirably for the speakers who have followed.

As we have heard, the subject of the noble Lord’s Motion has a number of layers to it. In the first place, we need to understand the value of stem cell research in purely scientific terms; what claims are being made of it, and why it is considered important. We also need to understand what the barriers are to achieving from it what our researchers want to achieve. We also need to place stem cell research in its broader context: global competition; public opinion in this country; and the ethical considerations that bear upon it, not least the ethical questions posed by those forms of research that have yet to receive parliamentary approval. All those aspects have been richly dealt with by those who have spoken.

I mentioned public opinion, as have others. When, earlier this year, the HFEA declined to give a ruling one way or the other on the applications of two academic institutions to produce cytoplasmic hybrid embryos, it came in for a fair degree of criticism. For my part, I congratulate the HFEA on realising that this was not an issue that fitted into the normal run of decision-making. If there is one thing that we have learnt in this country over the past 20 years—and

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learnt the hard way—it is that wherever science has a tendency to gallop ahead at speed, there is always a serious risk of its leaving public opinion behind it. As and when that happens, the situation becomes dangerous, because it is no longer the scientists who are in the driving seat but the tabloid press. We have only to think of the debacles over irradiated food, GM foods and the MMR vaccine to realise how ill-founded beliefs among the public can endanger or indeed scupper worthwhile scientific advances.

Those who bemoan what they see as an over-regulated environment for reproductive and stem cell research in this country need to reflect on something that is very easy to take for granted: the fact that this country has a regulator that reaches its decisions independently of government but within a framework of rules set by Parliament, which gives the public confidence that clearly delineated ethical boundaries are not being crossed and that agreed principles are being adhered to. That may sound obvious, but it is exactly the point at which, in the eyes of many, progress in the United States has been severely hampered. In that country, opposition to stem cell research among certain segments of the public has led to hard-line opposition on the part of government, to the extent that, ironically, the entire field of research remains unregulated and hence lacking in practical boundaries—a fact that in turn foments opposition all the more. The result is that, despite all that the noble Lord, Lord Winston, said, stem cell research in the United States receives nothing like the financial support that it would otherwise do in that entrepreneurial country, and that some of the best brains in the field migrate to this side of the Atlantic to pursue their work.

In the United Kingdom, public opinion on stem cell research has been generally positive, largely because the scientific community has been successful in keeping control of the debate and explaining why such research is important and necessary. One difficulty ensuing from that is the tricky business of managing public expectations. Embryonic stem cell research is a long-term enterprise. No one should imagine that it is going to produce treatment or cures for anyone or anything inside a decade. Indeed the scaled-up results of such research may not be evident for a good deal longer than that. There will almost certainly be failure and disappointment along the way. The noble Lord, Lord Patel, and the noble Baroness, Lady Finlay, sounded a warning about the risk of undue hype fuelling unrealistic expectations, and they are right. In the battle for public acceptance, hype is almost as dangerous as an information vacuum.

The HFEA was therefore right to defer a decision on cytoplasmic hybrid embryos, and a public consultation on the issue is now under way. We need theologians and philosophers to contribute to that. Once again, though, it is for the scientific community to make its case to the public. It needs to show convincingly that transferring human genetic material into an animal egg for research purposes can be fully justified by the scientific benefits that may ensue and is necessary to secure those benefits.

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Many people instinctively recoil at the thought of mixing human and animal genetic material. Others believe sincerely that it is morally unacceptable. We cannot get away from that fact, nor should we seek to. Nor should we duck the concern expressed by, for example, the Scottish Council on Bioethics, that work of this nature carries with it the risk of disease transmission across the species barrier. During the course of this debate, we have heard the research case made very powerfully, and it was a case which convinced the Science and Technology Committee in another place to say that in its view the Government's current stance on the matter was prohibitive.

It is equally for those who object to such research to say precisely why they do so. The Select Committee did not find arguments centring on the notion of human dignity convincing, mainly because the notion of human dignity is simply too vague. Reverence for human life can co-exist in its fullest sense alongside scientific inquiry. Humanity as a whole is not self-evidently debased by a process that intermingles with human DNA tiny quantities of animal material at microscopic levels.

In any case, it is not always clear whether the opponents of such research object only to the mixing of human and animal genetic material or to embryonic stem cell research in general. If it is simply the former, we need to understand from them why the notion of cytoplasmic hybrid embryos is inherently more objectionable than other techniques, which are already legal, for inserting human chromosomes into animal embryos or implanting human neural cells into the brain of a mouse. As I read the White Paper, the creation of animal chimera embryos, which the Home Office may currently license, would be made illegal under the proposals. We have not heard an explanation of why that should be. I, for one, find that concerning.

Having said that the HFEA was sensible to defer a decision on hybrid embryos, it would be very unfortunate if the delay was unduly prolonged. I do not know what the outcome of the current consultation will be, but let us suppose that at the end of it the Government say that they are receptive in principle to legalising that process. If we are to await the arrival of primary legislation, the coming into force of that legislation 18 months or two years later, and then, perhaps, the laying of regulations under that legislation even later, we are looking at an interval of many months before effective and meaningful research of the kind proposed can proceed. Such delay would surely serve no one's interests. I hope that the Government will bear in mind the need for reasonable expedition.

I also hope that they will take on board some of the other concerns expressed in this debate. The absence of any official means to accredit facilities for generating and maintaining embryonic stem cell lines presents a serious situation. The Government must resolve it. They must examine the concerns of the noble Lord, Lord Winston, about damaging delays in the ethical approval process. They need to reiterate their support for the recommendations of Sir John Pattison. They need to clarify what funding has been

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committed to basic stem cell research from public sources; and what their response is to the concern that there is a gap to be bridged if the UK-based programmes envisaged by Pattison are not to be short-changed.

Ministers also need to clarify to Parliament whether in the draft legislation that emerges from the White Paper, we will be dealing with government policy or a set of proposals to be presented to Parliament and determined on the basis of a free vote. I very much hope that, in line with the view of these Benches, they will follow precedent on issues of this nature and declare this to be free-vote territory. Indeed, I speak today on my own behalf, not that of my party. Above all, I hope that Ministers will bear constantly in mind the words of exhortation that we have heard repeated today from so many noble Lords for a sense of national effort and public commitment. I do not accuse the Government of being half-hearted on stem cell research, but if backing from the public is there, as I trust that it will be, the price that we would pay as a nation for any inaction or lack of urgency in this vital field would be lasting and heavy.

2.06 pm

The Minister of State, Department of Health (Lord Hunt of Kings Heath): My Lords, I am extremely grateful to the noble Lord, Lord Patel, for raising this important matter today. I pay tribute to him as chair of the UK Stem Cell Bank Oversight Committee and of the newly launched UK National Stem Cell Network. In his excellent opening speech, he referred both to achievements and to some of his concerns about the direction of the approach to stem cell research. I will of course respond to him as well as I can.

I start by saying that I very much agree with the noble Earl, Lord Howe, about the outstanding quality of this debate in your Lordships' House. As the right reverend Prelate the Bishop of Newcastle explored some of the ethical considerations, I, and many noble Lords, I am sure, recalled the extraordinary seven-hour debate that we had in 2001 on the regulations. I pay tribute to the noble and right reverend Lord, Lord Harries, for his subsequent work on the Select Committee established as a result of the amendment moved by the noble Lord, Lord Walton, to those regulations.

The noble Baroness, Lady Carnegy, took us back further than that to the original Act and to the outstanding work of the noble Baroness, Lady Warnock. She modestly described herself as a lay person today, but it was surely her clear understanding nearly two decades ago of the wide-ranging ramifications of potential advances in science which paved the way for legislation that anticipated some future developments and has stood this country in such good stead. I echo the remarks of the noble and right reverend Lord, Lord Harries, about the robustness of that legislation.

Although I disagree with the noble Lord, Lord Alton, I have always respected his views. As ever, he made a powerful contribution to our debate.

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Like the noble Lords, Lord Patel and Lord Soulsby, and the noble Baroness, Lady Neuberger, I am convinced that stem cell research offers us an unrivalled prospect for the treatment of a whole host of illnesses, such as degenerative diseases that have been mentioned today—Parkinson’s, certain forms of diabetes and strokes. Looking at the debates that we have had on health issues during the past few months, whether about funding, research or specialty nursing, it is remarkable that so much of that debate has focused on the degenerative diseases on which we are so keen to enhance our knowledge, the devastating consequences of which are lived and experienced by so many people in our country today. The noble Baroness, Lady Greenfield, eloquently described the potential of the research on stem cells. I was struck by her reasonable confidence, as she described it, and that of the noble Baroness, Lady Finlay, who outlined some of the potential extensions of research to, for instance, heart disease.

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