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Human Fertilisation and Embryology Bill [HL]

My Lords, I first apologise to the noble Lord, Lord Walton, for being so rapidly out of the stocks. Secondly, I declare an interest as a fellow of the Royal College of Obstetricians and Gynaecologists, a fellow of the Royal College of Physicians, a fellow of the College of Surgeons of Edinburgh and as someone who has held and still holds a licence to do stem cell work under British legislation and regulation. My noble friend is introducing an extremely good Bill. It is a very courageous Bill in many ways. But it is wrong to suggest for a moment, as a number of noble Lords have done, including the right reverend Prelate the Bishop of St Albans, and the noble Lord, Lord Hastings, who is not in his place, that this has been a rapid discussion. That is far from true. We have discussed this issue over many years, really since 1989. Indeed, I doubt whether there is a single scientific paradigm that has been more discussed in the general press, on television, radio and in the media. It is important to see that in context. The public has a pretty good idea about what is going on and in general it is fairly clear where people stand on most of these issues. I do and have always had problems with regulation. I find it difficult to justify why a single medical practice should be singled out in this way for regulation. Although embryos become babies, we do not single out obstetric practice for regulation. We do not single out paediatric care for neonates, which raise much greater ethical problems than in vitro fertilisation in a practical way. We do not regulate intensive care, where people are dying in this kind of way. Therefore, for a regulatory authority to regulate clinical practice is questionable given that other aspects of infertility such as tubal surgery, the admission of drugs and other treatments that are routinely given are not subject in any way to this kind of regulation. Having said that, I add that the same applies to research practice. What is the purpose of having research committees at the Human Fertilisation and Embryology Authority if we, as researchers, must first apply to local and national ethics committees to get ethical approval for the work? Is it suggested that the Government’s own ethics committees are not adequate for the purpose? That does not seem right. Indeed, they have often been much more skilful in looking at these issues than the HFEA, which has sometimes arrived at conclusions that seem to many people to be somewhat odd. I accept, as a practitioner, that it is reasonable to have regulation, but I plead with the Government that, during the Committee stage of this Bill, we ensure that the regulation is done with a light touch. The real things that need to be regulated are not regulated, and I will come to that later. We have heard a great deal from many speakers about how Britain leads the world in this research and how we lead in regulation. However, given that, it is surprising that so few countries have adopted our model in their regulatory framework. It is simply not true: they have not done so. Britain does not lead in this research any longer. It may have done originally, but at the moment, the United States, where there is a complete ban on embryo research involving human stem cells, publishes far more papers than we do—something like four or five times the number of papers in the highest impact journals. Israel, a country with a population two-thirds the size of London, publishes more papers than we do. Scandinavia publishes an equal number—I mean Scandinavian countries individually not collectively—so do Belgium, Singapore and Australia. Indeed, science in this country is suffering in some ways because it has been very difficult to get through a prolonged and protracted regulatory framework, which I hope the Government will take note of during the course of the Bill. The key things that affect patients are not being regulated and cannot be regulated. The first is the transfer of multiple embryos leading to multiple births, which affects small babies very adversely. A premature baby in an incubator costs the National Health Service a large sum of money and runs the risk of being seriously damaged—one in 23 twins is born dead and something like one in 13 is abnormal. Triplets carry a very high risk indeed. One has to accept that if the regulation becomes too tight, fertility tourism results. People go to Russia, Spain and other Mediterranean countries where they can get this treatment cheaper, but they face greater risk when they come back and have their babies under the National Health Service. There is also the exploitation of patients. This is burgeoning, largely because, as my noble friend Lady Jay said, we did not have in vitro fertilisation under the health service from the start. Had we done that, I doubt whether this regulation would have been necessary. As it is, grotesquely inflated prices are being charged in some clinics. We have heard about the child’s need for a father; how about the desperation of a father’s need for a child? In the Book of Genesis, Abraham asks: "““God, what will you give me seeing I go childless?””." He uses a Hebrew word meaning abandoned, desolated, because he does not have a genetic son. There is a notion here that he has lost his immortality, and that is something that infertile patients feel. This desperation leads patients to try all sorts of treatments which are not justified. That is one of the problems with the current regulation. The West End of London, for example, abounds with treatments which have no scientific justification, no proven success rate and simply exploit the desperate desire of these people to have children. That seems to me a crucial problem. The HFEA has failed very critically in another area. The failure to collect adequate data is a real problem. Frankly, the data that have been collected under regulation are almost entirely useless. We need much better follow-up data on children born by in vitro fertilisation. The problem of confidentiality with regard to the Bill is very worrying and we shall need to consider that in Committee. If you have very strict confidentiality, doing research follow-up on children becomes well nigh impossible, but it is very important. We now know that it is not just a simple question of genetics but of epigenetic effects on embryos. We now know that the condition of children in utero before birth affects their subsequent health when they are 50 or 60. For example, small-for-date babies are more likely to have heart disease, hypertension and osteoporosis and are more likely to die of stroke. The environments in which embryos are placed may have epigenetic effects which subsequently affect their health. It is critical that we are able to follow up these effects and do the research. If the confidentiality clauses are too rigid, that will be impossible. This is a good Bill, but adjustments need to be made. I hope that we can ensure above all that the Government accept the need for much more research in this country. This country has a unique research base, but the Minister will be aware of something that has happened in my own department at Hammersmith hospital, of which he has been director. I retired from my clinical chair in the health service two and a half years ago. As the Minister knows, that chair, which is a research position, is still vacant because this field of medicine is not attracting good enough applicants for one of the best universities in the country—Imperial College.