The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)

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My Lords, I thank all noble Lords who have taken part in this very important and wide-ranging debate. I am sure noble Lords will join me in congratulating the noble Lord, Lord Hunt, in once again being successful in the ballot with this Bill—I believe for the third time. I believe that my noble friend Lord Lilley, in the previous debate, had to wait 37 years to get one successful ballot.

My Lords, the unethical harvesting and sale of organs is a terrible crime which disproportionately affects some of the world’s poorest and most vulnerable people. The noble Baroness, Lady Finlay, gave a macabre history of this crime, and the noble Baroness, Lady Northover, rehearsed some of the powerful statistics, while my noble friend Lord Moynihan gave some of the clinical context. All that is to say that I want to make it clear that the Government stand adamantly opposed to any commercial trade in organs and any non-consensual harvesting of organs anywhere in the world. We have signalled our position on this on the world stage and towards having safeguards in place, to which I shall come, to prevent it from happening.

We absolutely support the Declaration of Istanbul on Organ Trafficking and Transplant Tourism, which encourages all countries to criminalise organ trafficking and to draw up legal and professional frameworks to promote ethical organ transplantation. We are also a signatory to the Council of Europe Convention against Trafficking in Human Organs, which likewise calls on countries to establish organ trafficking as a criminal offence.

I reassure the right reverend Prelate the Bishop of St Albans that our commitment to tackling organ trafficking is absolutely and clearly established in UK law. Under the Human Tissue Act, it is a criminal offence to give a reward in exchange for an organ, or to seek somebody who would be willing to sell organs. The Act also makes it an offence to receive a reward for supplying or offering to supply an organ. It is an offence to initiate, negotiate or even advertise any of these arrangements, and those guilty of these crimes may receive a prison sentence, a fine or both. Crucially, these provisions also serve to curtail transplant tourism. If any part of an overseas illicit transaction takes place in England, Wales or Northern Ireland, it will constitute an offence.

These arrangements and the Act are supported by regulations on importation. Any organs, tissues or cells being imported must have proof of traceability from donor to the recipient. The Quality and Safety of Organs Intended for Transplantation Regulations 2012 provide that it should be a licence condition for procurement or retrieval of an organ to ensure that consent requirements have been met. The Modern Slavery Act 2015 further supports these provisions by making it an offence to arrange for someone to travel with a view to their being exploited, with “exploitation” including their being encouraged, required or expected to do things prohibited by the Human Tissue Act, which includes the supply of organs for reward. The Act specifically covers the activities of UK nationals regardless of where they travel or the arrangements that take place. 

I completely agree with the noble Lord, Lord Alton, that the evidence, scale and severity of the human rights violations perpetrated in Xinjiang against the Uighur Muslims is far-reaching and paints a truly harrowing picture. The UK Government have led international efforts to hold China to account for its human rights violations in Xinjiang. We led the first two statements on Xinjiang at the UN and have utilised our diplomatic networks to raise the issue on the international agenda. We have backed up international action by domestic measures. On 22 March, under the UK’s global human rights sanctions regime, the UK imposed asset freezes and travel bans on four senior Chinese government officials and an asset freeze on one entity. On 12 January, the Foreign Secretary announced measures to help ensure that British businesses are not complicit in human rights violations or abuses in Xinjiang. We will continue to work with partners across the world to build the international caucus of those willing to speak out against China’s human rights violations.

I shall now focus on some specific areas of concern with the measures in the Bill. First, the Bill’s provision prohibiting travel outside the UK to receive a transplant without free, specific or informed donor consent raises some questions about the status of deemed consent provisions abroad. If this is intended to include deceased donors, the wording of the Bill suggests that a UK resident may be prohibited from receiving a donation in another country that has deemed consent provisions, as deemed consent may not amount to the specific consent of the donor or their next of kin. Secondly, we are concerned that the inclusion of a new explicitly extra-territorial provision may be counterproductive. Thirdly, we are concerned about how the Bill is to be applied in practice, which is always a test for legislation. For example, these proposals would apply in respect of acts and omissions which take place outside the UK and are done by persons with a close connection to the UK.

I emphasise that it is becoming ever more uncommon for UK residents to seek a transplant overseas. Since the days my noble friend Lord McColl talked about of operating theatre friendliness with French kidneys, we have taken massive steps to increase the supply of ethically retrieved organs in the last few years.

We are aware of a total of 566 cases of UK residents travelling abroad for organ transplants in the last 20 years. Only 179 of these cases date from 2009 onwards, after the introduction of the UK living kidney sharing scheme. We expect the introduction of deemed consent in England—which the noble Lord, Lord Hunt, sponsored and which has already led to 296 people donating 714 additional organs for transplant—to greatly support this downward trend. Although we believe that most of these cases represent legitimate donations, I think we can do more to make sure that any desperate UK patients who may be contemplating purchasing an organ overseas are fully aware of the law, the serious medical risks involved and the terrible consequences that organ trafficking has on the lives of others.

I want to be helpful. Therefore, I commit to this House today to step up efforts with the Human Tissue Authority and NHS Blood and Transplant to promote more awareness of this issue through their websites, social media and their connections with professional societies, transplant centres and clinical communities so that everyone plays their part. I also plan to convene a round-table event with the Human Tissue Authority, NHS Blood and Transplant and members of the stakeholder forum to discuss what further action is needed and how the Government can help.

We will also consider what further steps we can take to increase interagency working between NHSBT, the FCDO and the Home Office to improve understanding of, and facilitate legitimate travel into the UK by a donor from outside the UK donating to a UK resident. I pay tribute to my noble friend Lord Ahmad’s engagements on this issue with the WHO. I am also very keen that we use excellent initiatives such as the Tribute to Life project, which will launch in Birmingham next year, to share knowledge and expertise and increase ethical organ donation for the benefit of all Commonwealth citizens, regardless of transplant infrastructure. I pay tribute to the noble Baroness, Lady Finlay, for her involvement in this important initiative, which the Government wholeheartedly support.

Following the points of the noble Baroness, Lady Thornton, I turn to Clause 2, which seeks to prevent the public display of imported bodies and body parts without proof of the donor’s consent. As my noble friend Lord Ribeiro stated, six months ago, during the passage of the Medicines and Medical Devices Act, my noble friend Lady Penn committed in this House to take forward and ensure that robust assurances on consent were fully received, considered, assessed and recorded before any display licences could be issued.

To meet this commitment, we asked the Human Tissue Authority to strengthen and revise its code of practice. I am pleased to say that the new code, which was laid before Parliament on 10 June, is absolutely clear: the same consent expectations should apply for imported bodies and body parts as apply for such material sourced domestically. To respond to the noble Baroness, Lady Thornton, who summed up very clearly on this, I say that because of this change, for an exhibition such as “Real Bodies” to receive a licence, it would need proof of the donor’s specific consent to be displayed publicly after death. If it failed to provide such proof, it would be denied a licence by the Human Tissue Authority for not meeting its standards.

I again thank noble Lords who have spoken today for their impassioned concern towards the ethical donation of bodies and organs. The Government agree wholeheartedly that this is an important issue, but it is one that our laws already address, although we can do a lot more to increase awareness of the dangers involved. Therefore, I advise that the Government have expressed their reservations and oppose the Bill.

The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)

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My Lords, I thank the noble Lord, Lord Hunt, for bringing this Bill to the House and for enabling further debate on the best approach to tackling transplant tourism and how to ensure that consent is always provided for the public display of bodies of the deceased.

While all noble Lords will agree with the sentiment behind this Bill and have been horrified by the way in which the Uighurs are treated by the Chinese Government, we feel that that the new provisions it would introduce could create unnecessary burdens while doing little more than the existing legislation to address their concerns about human rights abuses. Looking at the data, the Government have not seen evidence of any large-scale travel of British citizens to other regions seeking a transplant for payment or without consent. Indeed, despite our having a growing and ageing population with increasing healthcare needs, the figures from NHS Blood and Transplant demonstrate a steady and consistent decline in patients receiving follow-up treatment on organs received overseas: from 72 patients in 2006 to just seven in 2019.

In addition, existing provisions in the Modern Slavery Act and the Human Tissue Act already make transplant tourism an offence in many circumstances. Because of this, we believe that the most effective action we can now take is to work towards removing any incentive for UK residents to seek to purchase an organ by continuing our efforts in improving the rates and outcomes of legitimate organ donations, while maintaining the highest standards of care for those in need of an organ.

I turn now to the issue of the public display of bodies, on which there has been some debate, especially in terms of people who have given consent before their death for their bodies to be displayed. We believe that existing rules make it clear that any establishment which seeks to display bodies must provide proof of consent. If it cannot, it will not receive a public display licence from the Human Tissue Authority, and any exhibition of bodies without a licence, when one is required, will be breaking the law. I am informed that the Human Tissue Authority does receive requests from people in Britain who seek permission for their bodies to be displayed after their death.

That said, I thank all noble Lords for their contributions, which allowed for an important and wide-ranging debate on this topic. It also served as an opportunity to highlight the broader human rights concerns which I know all noble Lords share. I particularly acknowledge the persistence of the noble Lords, Lord Hunt and Lord Alton, in bringing these issues forward for debate. I congratulate the noble Lord, Lord Hunt, on being successful in the ballot with this Bill.