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Department of Health

No, I am saying that in some other countries infanticide is used to achieve what people want. I have mentioned two countries in which it might happen. The Committee found"““no adequate justification for prohibiting the use of sex selection for family balancing””." Sex selection in the UK would probably work both ways and the demographic impact would, therefore, probably be imperceptible. The concept of selection is one on which we need a full debate—fuller than we can have this afternoon—especially if we want to allow selection as a means of achieving greater intelligence or beauty, a certain hair or eye colour, increased memory capacity, or other factors. Science will make all those choices available. I do not say that I am in favour of them, but I am saying that we will have to debate the issue in this House at some point. The birth of Louise Brown in 1976 at Oldham and district hospital as a result of in vitro fertilisation was a milestone in medical history. Unfortunately, today, only 1.5 per cent. of all live births in the UK are a result of IVF treatment and, considering that the UK gave birth to IVF treatment, it is not pleasing that we were ranked 12th out of 15 countries in Europe that offer IVF treatment in a report published a few days ago by the European Society of Human Reproduction and Embryology. Denmark offers 2,031 cycles per million population, but the UK figure is only 633. In Israel, where there is an active policy to encourage childbirth, the figure is 3,000 and 7 per cent. of treatments lead to a live birth. In comparison, the figure in Denmark is 3.9 per cent. The Committee formed the view that IVF treatment has become such a routine medical procedure that its regulation can become part of mainstream clinical regulation. That is not to say, however, that there should not be continued inspection of clinics offering the treatment, both in the public and private sectors. I represent a constituency with some of the poorest estates in Britain and it concerns me that my constituents have such poor access to IVF treatment. Indeed, only a few years ago, our local NHS would not fund IVF treatment. Nationally, only 25 per cent. of IVF treatments are obtained in the NHS. The rich get the most treatment, because they can afford to go to the private clinics. Unless we make IVF treatment more readily available on the NHS, my constituents—poor as many of them are—will continue to be discriminated against because they live in the wrong place. However, the question is not just the availability of IVF, but the quality of the services on offer. I believe that the success rates of public and private-sector clinics offering that treatment should be published, although clinicians are sceptical about doing so, because their success rates depend on a number of factors; the main one, incidentally, is the age of the woman presenting herself for IVF treatment. However, it is important that people can judge the success rates of clinics, and in taking evidence our Committee found that those rates differed spectacularly. In February 2004, the National Institute for Health and Clinical Excellence published guidelines on IVF treatment. It recommended the implantation of only two embryos per cycle to avoid the risks that we know are associated with multiple pregnancies. It also recommended that three cycles be offered to infertile women, which would have a considerable cost implication for the NHS. The Government, of course, have asked primary care trusts to offer only one cycle. Again, the House needs to have a proper debate on the NICE proposals. In Italy, the position is different; the Italian Government have insisted that three embryos be implanted per cycle. There was considerable opposition to that proposal, as the Committee found when we visited Rome. There is a rising trend of infertility in the richer nations. One in seven couples now experience problems with infertility; we need to invest far more in research to find out why. Some blame pollution of our environment by certain chemicals—so-called endocrine disruptors—but that is by no means proven. We should all remember that that trend comes at a time when the demographic make-up of our population is skewed towards the older end. We need more live births to make our demographic spectrum as it was in previous years. It costs an estimated £13,000 for every baby born by NHS IVF treatment, but we should remember that that baby will contribute an estimated £147,138 to the Exchequer throughout its lifetime, so it makes economic sense to support IVF treatment. Spare embryos can be destroyed, donated, stored for future use by the woman or others, or donated for research. Many people believe that, once created, embryos should never be destroyed, despite the fact that 70 per cent. of embryos fail to implant and are merely washed down the loo. Is it not preferable to use spare embryos for important medical research? I was pleased when Parliament decided to debate stem cell research a few years ago, and to allow it to proceed in this country, admittedly under tight regulation. There is now a reverse brain drain in this country; people are actually coming from the United States of America to conduct much-needed stem cell research in Britain. There are widespread concerns—shared by me, incidentally—about the principles and practicality of the welfare-of-the-child provision in the 1990 Act. Section 13(5) requires that"““A woman shall not be provided with treatment services unless account has been taken of the welfare of any child who may be born as a result of the treatment (including the need of that child for a father), and of any other child who may be affected by the birth.””" Although most of us have freedom of sexual reproduction, less fortunate individuals who need assisted reproduction actually have to be judged by others, mainly from the middle classes—general practitioners and people on various ethics committees. That is not right. Those people are not in touch, in my opinion, with some of the people on poorer estates in my constituency who are desperate to have children but who are infertile. I do not believe that they should be judged in the pursuit of having a child, and that is one of the reasons why I am against that welfare-of-the-child provision. It is highly discriminatory, especially to people who are leading non-conventional lives. Our committee heard lots of evidence from professionals, such as GPs and clinicians, who are expected to implement that procedure, but they find it almost impossible to do so. How well does a GP know all the women who are on his or her books? Can they judge? The evidence that we took was that they cannot judge in the majority of cases. The medical profession wants the welfare-of-the-child provision in the 1990 Act to be abandoned. Our Committee also felt that adequate mechanisms are already in place to ensure that any child born in an assisted manner will be protected. Of course we must remember that, since that legislation was passed, we have passed the Children and Adoption Act 2006, which also gives the born child a great deal of protection. I wish to mention just one more thing: the insemination of single women. It seems ironic that, when we produced the report, the people in the media who wanted to do radio and television interviews with me—I think that it was the same for other members of the Committee—focused on one thing: sex selection, not on IVF, PGD or many of the other things in the report, not all bad and mostly good. Today, with me, they have been focusing on the insemination of single women. Why do not the media get real, look at the whole report and judge it across the spectrum? During our inquiry we visited the Harley street office of a business called Man Not Included, which offers an internet service to collect and deliver fresh sperm to single women, including lesbians. As it deals in fresh sperm, its services are not covered by the 1990 Act. In my opinion, those internet services need regulating. I have two concerns, one of which is on grounds of safety? How can we be sure that sexually transmitted diseases are not being transmitted from the donor of the sperm to the recipient woman? That needs regulating. I am also concerned that, whereas the Human Fertilisation and Embryology Authority has a register that lists all the donors of gametes and all the recipients of gametes, those internet services do not have to register donors or recipients on the central register. We are very keen for that to happen now that children, some time in their future, can find out exactly where their parentage is based, but those services will not allow any of the children born as a result of using their services to trace their parentage. I am in favour of PGD because it will eliminate some of the most difficult diseases that we are facing. I am also in favour of the creation of a parliamentary bioethical committee, on which lay members and professionals from the industry could serve—it need not be made up only of parliamentarians—but what really gets to me is the fact that a quango, the HFEA, is making important decisions without reference to elected Members of Parliament, and it is about time that those important decisions were brought into the Chamber and our Committees, so that we can debate them properly. It would be a brave person who could predict where these areas of research will take us next, but one thing is sure, they will always be controversial and we will always need to debate them in parliamentary time. I have many other comments to make, but in fairness to other hon. Members, I will sit down soon. Let me finish by saying that our report contains 104 recommendations and, alas, it impossible to touch on most of them this afternoon.