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I think knowing who you are is as important as knowing where you are and where you come from. It is a basic human right to know who you are—to know what your identity is—and it is an affront to a child, as many noble Lords have said, to deny that. It is abhorrent for the state, in its might, to conspire against children in their inherent weakness. That is an extremely important point. It is a matter of ensuring that the truth is told and freedom is protected in a way that only totalitarians—which I know this Government are not—would wish to deny.
We heard a little earlier about the importance of daughters from the noble Lord, Lord Carlile, who is not currently in his place. I took a reality check with my own dear daughter, Mary-Claire, who is up at Cambridge reading theology, and explained the issues in front of the House tonight. She said, “Surely, Daddy, the most important thing is not the wishes of adults, but the human rights of the children”. I thought your Lordships would be grateful to have her advice.
Lord Winston: My Lords, I must profess to a good deal of uneasiness about these amendments, and I am not pretending that I can offer a solution, but I hope that your Lordships’ House will bear in mind some of the practical consequences of what we are talking about.
As a practitioner running, at the time, a busy fertility clinic in Hammersmith, I think we invested in counselling more heavily than any other unit in the United Kingdom. Since then, one of our senior counsellors has been an adviser to the HFEA and is now a member of that authority. Therefore, our credentials for counselling are pretty impeccable. Certainly, as director, I took it very seriously and made certain that we invested in the salaries to ensure that every patient coming through for in vitro fertilisation could have extensive counselling if required, in particular when donor gametes were to be offered to a patient, something that we were very conscious about.
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Everyone has said tonight that it is important to be open with children, to be as honest as we can about their origins and explain to them as early as possible that they come from a donor parent of one or the other sort. The question here is how many parents decide to keep this matter a secret. My impression from following up on patients in the clinic—I admit that this is anecdotal and that I do not know of any solid research—is that, rather than seeing a decrease in the number of people who keep quiet, we have seen an increase in the number of men and women who want to keep the origin of their children secret. That cannot in any way be enforced in the clinic; it would be impossible.
The consequence is that children may find out at the wrong time. I have seen that in several children, including one young man I am particularly concerned about, who is now a student at university. The children find out at the time of their parents’ break-up, usually when they are young teenagers. That is probably the most damaging time. In the case of the young man—it has happened with other children as well—the father has said, “You’re not my responsibility, and I am not your father anyway”. That had a devastating effect on the young man, but I have seen the same in girls as well. That is a problem with sperm donation.
Another problem that we have not considered is, I think, even more serious: egg donation. I do not know if there is an easy answer. As has been explained ad nauseam, when women run out of eggs, one of the most successful treatments in infertility practice today is that of offering donor eggs. In fact, donor eggs given to an early menopausal woman in her late 30s or early 40s carry an almost 50 per cent chance of resulting in a pregnancy. But what happens in reality, particularly in the private sector, is that, because it is difficult to get hold of donor eggs, women who are not wealthy and are perhaps somewhat dispossessed and have to pay for their in vitro fertilisation treatment opt to donate some eggs from the clutch of eggs taken during an in vitro fertilisation cycle, in return for which they get free treatment. The recipient of those eggs remains anonymous. There is no way back because the eggs have to be exposed immediately. As a consequence, some women end up donating eggs, their own in vitro fertilisation cycle fails, and the woman they have given their genetic material to has an embryo implanted and has a baby.
Rightly or wrongly—I have views about it that are not relevant here—the HFEA has consistently sanctioned egg sharing of that sort. I am not sure that it is a wise decision, but that is what happens. However, the position is now made even more poignant with the loss of anonymity. Many women go through in vitro fertilisation treatment as poor patients. I have seen this, and indeed I wrote to a former Minister of health—not one of the current Front-Benchers in either House—to explain that I had just met a women who had had five treatments as a donor. The statistical probability was that she had at least two or three children of whom she was not aware. Imagine the problems for that woman, who was left infertile and has remained so, when 18 years later she is visited by a child of whom she had no knowledge. It is a very serious issue.
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The noble Lord, Lord Alton, was interesting about consanguinity and the risks of sperm donation. If it is bad technology, let us abandon it. However, this legislation increases the risk in some ways because the fact is that fewer men will be prepared to provide donor sperm because of the possible consequences of being traced later on. There is then a greater risk of consanguinity because there will be fewer sperm donors in the United Kingdom. A number of issues need to be teased out as we consider the legislation. I do not know the answers, but they have to be borne in mind during the passage of these amendments.
10 pm
Baroness Barker: My Lords, at this late hour I simply wish to make a few important points, not least in order to restore some balance to the debate. I start, as I have in all my contributions on the Bill, by highlighting again the need for us to rely on solid evidence. Over the past few months, I have been concerned when individual cases have been cited, some in the press, which your Lordships have no way of verifying independently, emotive though those cases may be. It behoves your Lordships’ House to look not only at the evidence base but at current practice before we legislate.
I had not intended to talk about birth certificates—the issue is not before us in the amendments, and the noble Baroness, Lady Deech, will take us into further discussions about birth certificates next week—but, as the person who raised the matter of birth certificates in Committee, I, too, have received a great deal of communication about them. There is an equally emotive case to be made on behalf of people who do not wish there ever to be any mark on any birth certificate that identifies a person as being donor-conceived. We will have a fuller debate in time, but noble Lords should be aware of that.
I wish to flag up two matters, one of which is the work of the Donor Conception Network. I have been involved in it, I have seen some of its work, and I invite noble Lords to take the easy action of clicking on to its website. There they will find not only guidance to prospective parents but guidance from existing donor fathers, donor mothers and same-sex couples about the importance of telling children at an early stage about their status and about all other aspects of the experience that they are likely to have and the things that they should consider as parents. So, even without the legislation, much work is already being done.
Many of the debates so far on this matter have been based on some very old data. I looked at data from a research study that was published last year. Prospective parents, who had been approached via infertility counsellors in licensed clinics, were specifically asked whether, in view of the changes in the rules on anonymity, they would be more or less likely to tell children at an early stage and what were the issues around that. Two-thirds of the prospective parents said that they were more likely to tell children of their donor-conceived status. Interestingly, though, a tenth said that they would be less likely. That flags up the fact that, whatever law we may pass, in practice this is an extremely
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We should do two things: we should encourage the Government to continue to support all voluntary efforts such as the talking and telling courses that are being implemented by the Donor Conception Network for parents; and we should be mindful that counselling is a resource, and it costs. I can think of many examples across the whole spectrum of social policy where one would like counselling to be available. I urge one note of caution: people who have made the conscious decision to go to a licensed clinic for this treatment may not be the people most in need of counselling; they may be well aware of what they are letting themselves in for and what the issues are for any future children. So be aware that adding a cost to a treatment may well put off some people who, in all other respects, would be extremely good parents of whom we would otherwise approve.
Earl Howe: My Lords, it will not have escaped the Minister’s notice that, with regard to the issue of principle that we are discussing—namely, the need to be open with the donor-conceived child—there is unanimity around the Chamber. I should like very briefly to add to the weight of that opinion. I begin by saying how very much I support the amendment in the name of my noble friend Lord Jenkin. As he and others have said, a number of us initially thought that it might be possible to devise a way of satisfying the child’s right to know by ensuring that the child’s birth certificate made clear in some way the fact of his birth status. It became apparent from the Government’s response and from private discussions that however it is dressed up, this is not an idea that Ministers are willing to accept, mainly on human rights grounds. It would be helpful to hear from the Minister exactly why that is; there are a lot of people out there who are unclear and unsure about the precise arguments. I understand, of course, that a couple who have become parents through receipt of donor sperm believe strongly that they have a right to privacy and that it is no part of the state’s function to interfere in their family life. However, it is at least highly questionable whether the rights of parents on that matter are of a comparable magnitude to those of donor-conceived children. I would maintain that they are not, which is why many of us have been trying so hard to find a way through the problem.
In Committee I also argued that whenever a woman requests IVF treatment involving donor sperm or ova, she should receive mandatory counselling. At present the Bill merely specifies that the woman and her partner should be given an opportunity to receive such counselling. Disappointingly, that idea was kicked into touch by the Minister. It is, however, very welcome to see the government amendment to Clause 23, which appears to go part of the way at least towards that objective. I hope that I understand the amendment correctly and that it is the Government’s intention to make it mandatory for anyone seeking treatment at a clinic to receive certain relevant information as part of the process of giving their informed consent. In other words, the woman and her partner would not only have to read and digest the information; they would
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However, I am going to sound a little like Oliver Twist because I do not think the amendment goes quite far enough, which is why I have tabled Amendment No. 129 as an amendment to it. This amendment specifies that included in the information received by people who request IVF treatment by donor, there needs to be a section making clear the critical importance of being open with the child about the circumstances of his conception and another section pointing the couple towards sources of advice designed to make it easier for them to approach the very sensitive process of actually breaking the news to the child. We have heard powerful contributions from the noble Baroness, Lady Finlay, and the noble and learned Baroness, Lady Butler-Sloss, on that point. The key elements here are the absolute necessity of explaining why it matters so desperately to a donor-conceived child to be told the truth, what happens to the child if he is not told the truth but discovers it for himself by accident, and what is at stake in terms of the trust placed in the parents by the child—trust that will vanish for ever if the child finds out that he has been deceived. The parents have to be taken through all of this—that is the point. While I have to recognise the reality that counselling will not be made compulsory, I hope that the process of obtaining informed consent will encourage couples to ask for counselling. Parents need to understand that bringing up a donor-conceived child carries with it some particularly onerous responsibilities that should not be ducked. I hope the Minister will consider my amendment in a positive way.
Baroness Royall of Blaisdon: My Lords, I will address both the amendments tabled by the noble Lord, Lord Jenkin, and the noble Earl, Lord Howe, and government Amendment No. 128.
Much of the discussion we have had about the Bill has been about the importance of donor-conceived people being made aware of that fact. Several reasons have been discussed today, a critical one being to avoid the distress caused when a donor-conceived person finds out in an uncontrolled way at a later stage in life that the person they thought was their biological father is not. We want to avoid situations such as the one cited by the right reverend Prelate.
The Government recognise the importance of ensuring that prospective parents understand how important it is that a child is told that they were donor-conceived. As the noble Baroness, Lady Finlay, said, honesty is fundamental, and a child who is told at an early age will grow up with that knowledge and will be better informed, and there will be better family relationships. That is done by the parents telling them in the most effective and least distressing way. It is the Government’s view that that is best achieved by education rather than enforcement.
To that end, the Department of Health is working closely with the Donor Conception Network to support projects to encourage telling. Like the noble Baroness, Lady Barker, I certainly recommend that your Lordships have a look at its website, which is rather good. We are
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The 1990 Act requires counselling to be available and relevant information, as is proper, to be provided by all licensed treatment clinics. It is a condition of all licences that a woman shall not be provided with treatment unless she and any person who is to be treated together with her have been given suitable opportunity to receive proper counselling and relevant information. Following discussions in Committee we have tabled Amendment No. 128, which strengthens provision in the Bill in respect of counselling and information, in addition to requiring that all patients be given the offer of counselling and provided with information. It also requires quite specifically that the HFEA produces in its code of practice guidance for the clinics about doing so. The noble Earl is quite right in his reading of our amendment. For example, where the treatment involves donated gametes, the code could specify that information relating to the importance of discussing this issue with the child from an early age was provided to prospective parents. In addition, we would also expect the guidance in the code of practice to relate to who provides the counselling and how it is offered.
Amendment No. 129, tabled by the noble Earl, Lord Howe, and the noble Baroness, Lady Finlay, takes that further. It adds to the government amendment by specifying that the information provided should make clear the importance of disclosing to any child born from treatment services the circumstances of their conception and to provide guidance designed to assist a person in making such a disclosure.
Amendments Nos. 111 and 130, tabled by the noble Lord, Lord Jenkin, would try to ensure that people born as a result of donor conception were informed by amending the licence conditions that apply to clinics about the welfare of the child. Those amendments also seek to ensure that there is guidance on informing a child in the HFEA code of practice. We wholeheartedly agree that the code of practice should address this area, and it was with that in mind that the government amendment was tabled. The purpose of our amendment is to ensure that the HFEA can specify what information should be provided to patients.
Let me answer a couple of questions that have been put during this short debate. The noble Lord, Lord Patten, asked if the Statistics Board had been consulted on birth certificates. The Human Fertilisation and Embryology Act 1990 ensures that donors are not regarded as the legal parents of children born as a result of assisted conception treatment. It provides
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The noble Lord, Lord Alton, asked for clarification on whether we meant 10 cycles or 10 children using donor sperm. The HFEA guidance states that donor sperm cannot be used by more than 10 families. A donor may state a lower number if he so wishes.
The noble Earl, Lord Howe, asked about birth certificates and compatibility with the European Convention on Human Rights. Any proposal to amend birth certificates in the way suggested would have to be considered on the individual facts. However, broadly speaking, the Government’s view is that the human rights of donor-conceived children and their parents are likely to be engaged. Therefore, any interference by the state into this private realm would have to be proportionate and fully justified. It is our view that the interests of donor-conceived children in finding out about their genetic origins are best protected by a programme of information and education to support their parents in discussing this information with them.
We accept in principle the intention of the amendments in this group. Indeed, we accept far more than that, and I would like to take away the three opposition amendments in the group. I can give noble Lords an assurance that I will come back on Third Reading with an amendment that takes into consideration the spirit of those three amendments. With that, I ask the noble Lord to withdraw the amendment.
Lord Jenkin of Roding: My Lords, before I withdraw the amendment, I should like to say how grateful I am for the widespread support that my amendments have attracted from all sides of the House. I think that we are all broadly agreed in principle. On the question of certificates—a number of Members raised this, including my noble friend on the Front Bench—I have tabled an amendment which provides what I hope will be an acceptable procedure whereby the HFEA will be able to maintain a continuing review of certificates. Like my noble friend, I accept that the Government are not going to provide for compulsory notification on birth certificates. That is quite right in my view. One of the organisations involved—the Donor Conception Network—is opposed to that at the present time. I do not want to anticipate the arguments on my later amendment, because it is even more complicated than the ones discussed in this short debate. This amendment is not about that.
I am greatly encouraged by what the Minister said about the intention behind the Government’s amendment. I am grateful for her assurances that she will consider, between now and Third Reading, whether some specific mention of donor conception should go into the code. Although many of us, such as the noble Lord, Lord Neill, and others, would like to see it in the Bill, if it is in the code and is sufficiently specific, one can feel that one has made a good deal of progress. With those words, I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
- House adjourned at 10.19 pm
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