Norman Lamb on the Human Fertilisation and Embryology Bill

11.27.00am BST (GMT +0100) Tue 13th May 2008

'I want to say at the outset that . . the Liberal Democrats will have free votes on all matters in the Bill . . '

[May 12] Norman Lamb (Shadow Secretary of State for Health, Health; North Norfolk, Liberal Democrat): I am sorry that the right hon. Member for Rother Valley (Mr. Barron), the Chairman of the Health Committee, was cut off in his prime. It is a pleasure to follow him. I welcome the opportunity to debate the Bill. It has been a long time coming, and rightly so. There has been a process of deliberation: a draft Bill has been considered by a Joint Committee. I pay tribute to my hon. Friend the Member for Harrogate and Knaresborough (Mr. Willis) for his chairmanship of that Committee, and to its other members, who produced an impressive piece of work during an exhaustive process. What was particularly impressive was that the Government were prepared to listen. That is the way in which legislation ought to be developed before being presented to the House.

Why is the Bill necessary? The history in this area has been of legislation trying to keep pace with scientific endeavour and developments. The 1990 legislation followed the first great breakthrough: the first IVF birth back in 1978. It was six years after that that Baroness Warnock produced her report, which set out the ethical and moral principles that have guided us ever since, and which have stood the test of time. They included according a special moral status to the human embryo. Although those principles might not have secured universal acceptance, they have clearly provided a rational framework for the development of legislation. However, it took another six years before legislation finally arrived, in the form of the 1990 Act. I pay tribute to the right hon. and learned Member for Rushcliffe (Mr. Clarke) for marshalling that legislation through Parliament, because, remarkably, it has also stood the test of time.

We have led the way internationally, but science has moved on and those advances raise new ethical, legal and social issues. Although the 1990 Act has clearly given public confidence because it introduced a robust regulatory system, in order to maintain public confidence legislation must be able to meet new challenges; hence the need for updating. Ultimately, it has to be Parliament that sets the framework-the boundaries within which scientists and the medical profession can lawfully operate. In setting the framework here and now, we have to look forward and anticipate new breakthroughs, in order to make sure that the legislation is as durable as possible.

I want to say at the outset that, like the Conservatives, the Liberal Democrats will have free votes on all matters in the Bill. We have party policy on a number of issues-how could we not, when among our number we have my indefatigable and immensely impressive colleague, my hon. Friend the Member for Oxford, West and Abingdon (Dr. Harris)? Regardless of whether people agree or disagree with him, he clearly brings remarkable intellectual force to the debate. My party's policy position is to be pro-science and in favour of research, but within proper limits and with proper safeguards.

William Cash (Stone, Conservative): Does the hon. Gentleman agree with Einstein, who said: "Science without religion is lame, religion without science is blind"?

Norman Lamb: I would not necessarily agree with that comment-and let me move on.

I have an important point to make. There is a heavy burden of responsibility on us all in how we conduct this debate. When dealing with issues that engender strong feelings and anxieties and on which Members and others have deeply held convictions, it is incumbent on those on all sides of the argument to remain measured, avoid exaggeration or sensationalism and respect the other point of view. Some of the comments made outside this place so far in the debate have not met that test. Church leaders and others to whom people look for guidance have a particular responsibility for the comments they make.

My party's nominations to the Bill Committee will be two Members who come from very different standpoints on some of the issues involved: my hon. Friend the Member for Southport (Dr. Pugh), who is a Catholic, and my hon. Friend the Member for Oxford, West and Abingdon, who is a former junior doctors' leader. That reflects the fact that although we have party policy on a number of issues, within our party-as within others-there is a wide range of views, and they should be represented properly and fully on the Committee.

I wish to deal with some of the key issues in the Bill, the first of which is the case for embryo research. As a layman who has witnessed the horror of degenerative and genetic conditions, I believe that there is a powerful case for research, which increases understanding and could ultimately lead to cures. My father had Parkinson's, before he died, and I also knew well a local radio newsman in Norfolk who had motor neurone disease. I witnessed the deterioration that that cruel and horrible condition caused. If there is a chance of our finding cures or treatments, that is surely a worthy objective. Any such research would, of course, be subject, under this Bill, to tight control.

I wish to discuss human admixed embryos, which are inevitably one of the Bill's more emotive issues. Surely, for the purposes of research, it must be right to consider their use. We are talking about keeping them only for up to 14 days and, again, only in a laboratory. As I have said, some of the claims have been exaggerated. There is a genuine problem of a shortage of human eggs hampering research. It is difficult to recruit egg donors-the process is a physically demanding one for a woman to go through-and there are long waiting lists of people seeking donor eggs for IVF treatment, so scientists struggle to obtain enough eggs for research. Surely it makes sense to save human eggs for IVF treatment, so if we really want research that has the potential to deliver cures of treatments for some of these awful conditions to be done, there must be a compelling logic to making use of admixed embryos.

I read a moving account in today's edition of The Guardian by Geraldine Peacock, the vice-president of the Parkinson's Disease Society. She has had the early onset of Parkinson's for the past 18 years, which is nearly a third of her life. She says:

"I take 39 pills a day to keep me mobile. I freeze like a statue without warning and cannot move unless someone else touches me. It is relentless. This illness invades you. It feels like being locked inside your own body. I can cope with all of this as long as I know that there is hope."

The proposed legislation, and the capacity it offers for more research, give her and many others that hope, which is why I, personally, support that part of the Bill.

Robert Key (Salisbury, Conservative): Is not the most important point about human admixed embryos the fact that they behave like embryos but they are not embryos-they are not the product of a sperm and an egg, and they are not creating human life?

Norman Lamb: The most important issue is that such embryos facilitate research into horrible conditions. Anyone who witnesses such conditions is inevitably left with the sense that it is worth trying to defeat them. That is why I support the measure, which was also supported by the Joint Committee and by the Select Committee on Science and Technology. I understand the concerns, because we are dealing with a challenging concept and there is a sense that it blurs the distinction between animals and humans, creating unnatural entities. None the less, I am clear as to where I stand.

I wish to make one final point on this issue. The HFEA consultation in April last year found general public acceptance that such research for medical purposes may have some value. The HFEA has said:

"But there is a clear demand from people to know more about what researchers are doing and their plans for future work, highlighting a need for better communication about science and research from both the scientific community and ourselves as regulator."

The Bill has helped to generate a public debate, but the science community has an ongoing duty to continue that communication.

I want to raise an issue that was debated in the House of Lords, which I hope will be considered further in this House. The suggestion has been made that a regulation-making power could be included in the Bill to allow sperm and egg derived respectively from a male and female stem cell-not from testes or ovaries-to be permitted sperm or permitted egg for the purpose of implanting a permitted embryo in order to treat the infertility of those individuals, such as cancer sufferers, who cannot produce their own gametes in the normal way. The science is not there yet, but there is the potential to allow thousands of cancer survivors and their partners to have a child of their own genetic material. That is remarkable science, which was undreamed of not long ago. I would welcome an indication from the Government that they have not closed their mind on that issue.

I want to deal now with the genetic testing of embryos and, first, with the question of negative selection, which involves testing IVF embryos for serious inherited diseases and selecting those that are free from disease. Some disability rights campaigners argue that it is wrong to screen out and that it is tantamount to regarding an individual with a disability as less valuable in some way. I do not share that view. It must surely be preferable to avoid babies being born with very serious disabling conditions. That seems quite different from doing everything possible to avoid any discrimination against an individual who has a disability. There is also the potential to reduce the prospect of a termination at a later stage in pregnancy. For that reason, that negative selection seems entirely appropriate.

Secondly, I want to deal with the question of positive selection and the saviour sibling issue. By tissue-typing IVF embryos, we can identify an embryo that is a tissue match for a sick older sibling suffering from a serious disease so that the transplant of umbilical cord or bone marrow would be a more effective treatment. The original draft Bill limited screening for that purpose to circumstances in which an older sibling had a "life-threatening" disease. The Joint Committee thought that that was too narrow, and the Bill now refers to "serious" disease. That seems entirely rational. It would be hard to argue that we should help only those with a life-threatening condition, leaving those with serious conditions without hope.

I can understand the ethical concerns about saviour siblings. How does a saviour sibling cope with the knowledge that they were created for such a purpose? I do not dismiss that anxiety, but my judgment is that the benefits outweigh the concerns. Inevitably, each hon. Member must reach their own conclusion. The reference that the hon. Member for Bolton, South-East (Dr. Iddon) made to the Whitaker family was a powerful testimony to how the procedure can be enormously valuable for a family. In that case, it has led to a family being able to live happily.

Brian Iddon (Bolton South East, Labour): Does the hon. Gentleman accept that it is a treatment of last resort, first because it is costly and secondly because the family would look for a match transplant from elsewhere first? Indeed, as far as I am aware there have been only six cases of saviour sibling treatment in this country.

Norman Lamb: I entirely accept that point and agree with the hon. Gentleman.

Ian Gibson (Norwich North, Labour): But does the hon. Gentleman agree that in many conditions it is not just a question of simple genetic screening? Many of the conditions that afflict humanity are caused by many genetic factors interacting with the environment. As we would not be able to provide that evidence, we would be able to facilitate and help only a low number of people.

Norman Lamb: I accept that point, too, and I am grateful to the hon. Gentleman for his intervention.

Patrick Hall (Bedford, Labour): I think that the hon. Gentleman used the words "a child created for that purpose", but the context would also and overwhelmingly have to be that the child were wanted anyway.

Norman Lamb: I completely agree. I was putting the anxieties of those who are concerned, but the hon. Gentleman is absolutely right about the test that should apply in such cases.

Doctors, scientists and patient groups have pursued two campaigns, co-ordinated inevitably by my hon. Friend the Member for Oxford, West and Abingdon. The first relates to giving the HFEA the power to license the use of cells from existing holdings, which are anonymous, where the donor is either dead or untraceable. The second relates to the use of cells from children, with parental consent, where a child is suffering from a terminal or progressive illness.

Those important issues secured cross-party support in the Lords and I hope that the Government will facilitate discussion of them and will take a favourable view of both. As I said, they are supported by scientists, the medical profession and patient groups.

I shall now deal with licences for therapy. The 1990 Act provided for the use of embryos specifically for research, not for therapy. The 2001 regulations permitted therapeutic cloning to provide the prospect of generating stem cell therapy for diseases such as Parkinson's and diabetes. All those who support such research do so because of its potential to provide therapy. However, it is unclear whether research licences could lawfully permit the use of embryos for therapy if the research proved ultimately successful. It would be odd if we did not address now the potential for such research to succeed. Do we really want to return to the matter with more primary legislation? We should address it now to set up a framework to deal with the eventuality that the research will succeed in due course.

The need for a father is for many people the most emotive issue of all. It challenges many of our assumptions about families and society. I was struck by the number of single women and lesbian women who are already having IVF treatment. In 2006, 1.4 per cent. of the 40,484 IVF treatments were for single women and 0.5 per cent. were for registered lesbians-560 single women and 200 lesbian women in one year. Conservative Members argue that if that treatment is happening already, what is the point of changing the situation? However, there appears to be evidence that the need-for-a-father test is an additional hurdle that excludes some women. My hon. Friend the Member for Oxford, West and Abingdon refers to the criteria set by the NHS in its clinics. I understand that there is evidence of unequal access; if women are able to obtain treatment only in private clinics, some will inevitably be excluded.

Geraldine Smith (Morecambe & Lunesdale, Labour): What evidence is the hon. Gentleman referring to?

Norman Lamb: My hon. Friend the Member for Oxford, West and Abingdon tells me that the criteria that the NHS set refer to- [Interruption.] Let me develop my argument. The Human Fertilisation and Embryology Authority code of practice rightly says that if a single or lesbian woman seeks treatment, the treatment centre should assess the prospective mother's ability to meet the child's needs. Given that IVF treatment is already being given to single and lesbian women, the changes proposed-the deletion of the requirement to take into account the need for a father-is not actually that dramatic

Andrew Lansley (Shadow Secretary of State for Health, Health; South Cambridgeshire, Conservative): Will the hon. Gentleman give way?

Norman Lamb: In a moment; let me just develop my argument. As for the focus on what is surely the most important issue of all-the welfare of the child who will be born-the British Medical Association put the matter rather well in its briefing:

"We have consistently rejected the idea of applying inflexible rules on access to fertility treatment, believing instead that each application should be considered on its merits. Assessments should be made on the individual factors in each case rather than on blanket restrictions applied to certain categories of people or family arrangements."

I could develop that further: it is perhaps not entirely accurate to say that there are "blanket restrictions", but there are hurdles for some groups of people with particular family arrangements. Surely that is not right. Surely the test should be to consider in each case the welfare of the child that would be born.

Andrew Lansley (Shadow Secretary of State for Health, Health; South Cambridgeshire, Conservative): I have to tell the hon. Gentleman that there is no direct relationship between the text of the Bill and the criteria applied in the NHS for access to infertility treatment. We have complained many times to the Minister of State, Department of Health, the right hon. Member for Bristol, South (Dawn Primarolo) and her predecessors about the fact that arbitrary social criteria are applied. The changes in the Bill will not prevent that from happening. For example, the Bill will not stop primary care trusts from saying that a woman cannot have access to fertility treatment if her partner has children from a previous marriage, or from restricting access to such treatment for same-sex couples or single parents. It is a red herring to base arguments about the Bill on the NHS criteria.

Norman Lamb: I hear the hon. Gentleman's point, but I disagree with him. [Interruption.] May I just develop my point? The BMA addresses the question of whether there is evidence that children born to single women or lesbian couples are disadvantaged in any way. Its submission says that there is evidence that children raised by single women are more likely to be disadvantaged, but that is not true of children born to single women or lesbian couples who choose to start a family on their own through assisted conception. The early research indicates that such children fare just as well as those born to two heterosexual parents through assisted conception.

We are always told that we should make policy on the basis of evidence. If the evidence suggests that there is no disadvantage, there should not be in-built discrimination in legislation placing an additional hurdle before some people because of what they are. We should instead look at individual circumstances. The argument is not about anybody claiming to have a right to a child; it is about individuals having the right to be considered objectively for IVF treatment. The Bill would require treatment clinics to consider the welfare of the child, including the need for supportive parenting. That seems to be the right test, and I will support it.

Let me turn to the issue of whether the birth certificate of a donor-conceived child should have that fact recorded on it. There is considerable force behind the argument that the individual has the right to know. The issue was debated at length in the other place, and one of the possibilities that was considered was the use of a symbol to indicate that a child was donor-conceived. The Government are committed to carrying out a review of the law and practice, and I would be grateful if the Minister said, in her closing speech, where we are with that process and when the review is likely to reach a conclusion.

Finally, the issue of abortion is not part of the Bill, but we shall deal with it through amendments. Inevitably, it has always been a matter of individual conscience, and rightly so. We have heard in the past few days of a research study that shows that there appears to be no real advance in the survival rates of babies born before 24 weeks. That appears to be the scientific consensus. The Conservative spokesman, the hon. Member for South Cambridgeshire (Mr. Lansley), addressed the issue. If we are making legislation on the basis of evidence, we should not be persuaded that there is a case for changing the current 24-week limit.

In conclusion, I share the policy aim of reducing demand for abortions. We must all be concerned about the number of abortions taking place. The need to reduce the number of unwanted pregnancies highlights the importance of sex and relationship education in schools, which should be part of the minimum curriculum entitlement. That is what my party believes. It is dreadful that the United Kingdom continues to be top of the league table for teenage pregnancies, and the number of unwanted pregnancies suggests that we are failing as a society. If we can address that, we can deal with the number of abortions that take place. It must also be right that we ensure that the abortions that take place are carried out as early as possible by improving access where necessary. I agree with the comments of the Conservative spokesman in that regard.

It is not often that a Bill comes before the House that is so full of challenging moral and ethical questions. We welcome the fact that the Bill is being debated, and I repeat my hope that the debate is conducted on the basis of evidence and in a measured tone.