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Debate on the Address

My Lords, I join others in welcoming the opportunity that we have this afternoon to discuss health matters of such importance and to receive the assistance of the noble Lord, Lord Darzi, whose success your Lordships hope for. It has been commented that there is little new in the legislative proposals made in the gracious Speech. In a non-pejorative sense, this is true of the Human Fertilisation and Embryology Bill, as the ethical and legal principles that it embodies have been of exceptional interest to this House and to the public for nearly 30 years, since the birth of the first IVF baby, Louise Brown—a miracle achieved by British doctors. I declare my interest as the longest-serving chair of the Human Fertilisation and Embryology Authority—from 1994 to 2002. Noble Lords will understand if I go on to say that Britain is an acknowledged world leader in IVF, embryology and stem cell research. It is as advanced as the USA but more regulated, avoiding the excesses of freedom and restriction in the USA and in Europe. Progress in this country has been largely in tandem with public acceptability. Other countries have run into trouble: the US bans federally funded stem cell research while leaving basic IVF unregulated; Germany and Italy prohibit diagnoses and treatments that are taken for granted in the UK; and South Korea, an advanced nation, has suffered from fraud in its practices. It stands to reason that the benefits of the existing law should be continued. It has the virtues of great flexibility of definition, discretion lodged in the regulator and a cascade of detailed decision-making down to the clinics, patients and scientists, all within an acceptable legal framework. This has been achieved since 1991 by the Human Fertilisation and Embryology Act. When I was chair of the authority under that Act, I was often accused of playing God, to which I would answer that it was not the chair or the members of the authority who were playing God. The Act represented, and still represents, a democratic compromise between strongly held views in society. The authority works to reconcile, to explain and to point to a way forward, and it is accountable to the public. Our structure at the HFEA has been studied and emulated to a greater or lesser degree worldwide. It rests on the famous report authored by the noble Baroness, Lady Warnock, in 1984. The Warnock report remains the most constructive, pragmatic, ethical, deep and influential report of its kind in the world. It just goes to show how much you can achieve by putting a university philosopher in charge of building an element of government regulation—how much better than putting businesspeople in charge of university philosophy departments. The Bill that will come before your Lordships transfers into primary legislation certain issues that so far have been left to the regulator: rules about pre-implantation genetic diagnosis, sex selection and animal-human hybrid embryos. The pre-legislative scrutiny committee on the Bill was able to come to conclusions on those issues, but it also tended to agree that the more that could be left to the regulator, the less likely the new law is to be short-lived and subject to legal challenge. Having heard evidence from ethicists, the committee rejected the notion of a national ethical body alongside the regulator. The law already incorporates ethical principles that determine most matters and it is open to this House to consider the setting up of a parliamentary bioethical Select Committee. That would be difficult to achieve. How can one, in one committee, reconcile the opinions of those who would stop all embryo research and those who go along with the regulatory framework? There would certainly be fewer ethical concerns if IVF was generally available on the NHS and if there was no postcode lottery for the limited service that is available. I must return to ethical questions. There are risks in the proposed new law that worry me. The risk is of dehumanisation. I am concerned to see that the Government still want to remove from the law that clause that states that the doctor proposing to give IVF treatment should consider the welfare of the future baby, including the need for a father. I find it extraordinary that it should at this moment be seriously considered that this House make a statement that, in welfare, there is no need for a father. This is a moment when we know from research in this country and abroad that a special contribution is made by fathers to the raising of their children, which is not replicated by the contribution made by mothers. We know that it is said that children lack male role models and that some of the violence and disorder in society is created by the lack of fathers. There is a further risk. In reproduction in general, the role of men has been downplayed. In recent years, women have fought very hard to have their femininity and their wishes recognised in the field of reproduction. Every woman is a worthwhile person, whether or not she has children. She is regarded as in control of her body and has fought to be respected. But what about men? They are in danger in this field of being reduced to a sort of genetic contributor and nothing more. It would be deeply regrettable if the express reference to their role as parents were undermined or removed. Women have won the battle to be respected as parents and it is now, for once, time to worry about men as well. There is another risk. I find it strange—I think that in 100 years it will be regarded as even more odd—that the law might provide that a birth certificate will show two women as the parents of the child. One understands that that comes from a desire not to discriminate, but at the same time we all respect the truth, and to have a birth certificate listing two women as parents is an odd way of pursuing the truth. The pre-legislative scrutiny committee was very anxious to ensure that donor-conceived children should be given every opportunity to discover the truth about their origins, but it believed that children need two parents, preferably including a father. The Bill will promote the truth about origins, so why should it also provide for birth certificates naming two parents of the same sex? The Bill will ensure non-discrimination between family units and persons, at the expense, it could be argued, of the welfare of the child. After all, British law still rightly discriminates against underage, polygamous and incestuous unions, so why should the family welfare of a child not be considered before the mother undergoes IVF? Current government and judicial policy is that fathers have a vital role to play. We should not be afraid of being labelled politically incorrect in standing up for the welfare of the child, as we best understand it in current conditions, even though this House should be assured that the existing requirement to consider the welfare of the child, including the presence of a father, has not been, and will continue not to be, a barrier to treatment. A sensible Bill would retain the HFEA, make reforms to the Human Tissue Authority and give broader discretion to the HFEA in future research involving hybrid embryos and genetic diagnosis. It would remove the excessive confidentiality provisions that block follow-up research on IVF children and would give the regulator greater powers over the charges and menu of treatments currently presented by private IVF work as well as greater enforcement powers. It should be minimalist, because what we already have is pretty good. Unfortunately, those who want to change abortion law and unsettle the consensus that has prevailed over the status of the embryo will look for opportunities to hijack the proposals. This House should remember that ethical principles regarding human fertilisation have already been worked out. One such principle is the assurance of human dignity, worth and autonomy. Everyone is dignified, and everyone should have the right to consent to the use of their bodies and not to be treated as a bank of spare parts. The welfare of the potential child must be considered and safety must be given great weight in new treatments. All of us who remember the Thalidomide situation so many years ago will understand the tremor of considering new and untested treatments, even in the light of the best possible scientific advice. Another ethical principle is respect for the status of the embryo. A new principle is that the saving of life is an acceptable use to which new advances in embryology may be put. However, let us not think that reaching ethical consensus is an easy matter. We are polarised. I close on a more light-hearted note. Your Lordships will know that every religion has different views about the viability of foetuses and embryos and how deserving they are of protection. I am often asked what the Jewish view is of the viability of the foetus, to which I say, ““It is not viable until it has graduated from medical school””. I look forward to further discussion of this important Bill and to improvements to the nation's health.