Organ Tourism and Cadavers on Display Bill [HL]
Friday 16th July 2021
(3 years, 5 months ago)
Lords ChamberOrgan Tourism and Cadavers on Display Bill [HL] 2021-22 View all Organ Tourism and Cadavers on Display Bill [HL] 2021-22 Debates Read Hansard Text Read Debate Ministerial Extracts
Lord Hunt of Kings Heath (Lab) [V]
My Lords, it is a great pleasure to speak to my Bill and I thank all noble Lords who are taking part. My interest in tackling the issue of forced organ harvesting in China came about after I was a sponsor of the opt-out organ donation Act, which is now in UK legislation. I took the view that, if we are to ask the UK public to have full confidence in our opt-out system, it was essential that its ethical basis was assured and overseen with rigorous inspection and regulation.
When I first heard about forced organ harvesting in China from the noble Lord, Lord Alton, I was horrified. Organ donation is a precious act of saving a life but forced organ harvesting is commercialised murder and, without doubt, among the worst of crimes. I have spoken against forced organ harvesting many times in the House and I am pleased to say that a great number of my fellow Peers have shown support on this issue.
In January this year, after significant pressure from across the House, my amendment to the Medicines and Medical Devices Bill ensured that the Act was the first piece of UK legislation to fight against forced organ harvesting by ensuring that no medicines in the UK could include human tissues from its victims. This small but significant step in legislative change is only the beginning of the work that we must do here in the UK to prevent complicity in this horrific crime; my hope is that it acts as a precedent for further action, both in the UK and around the world.
The Bill before us today serves to prevent UK citizens from complicity in forced organ harvesting by amending the Human Tissue Act to ensure that UK citizens cannot travel to countries such as China for organ transplantation and to put a stop to the dreadful travelling circus of body exhibitions, which sources deceased bodies from China. I come from Birmingham where, in 2018, an exhibition called “Real Bodies” by Imagine Exhibitions visited the National Exhibition Centre. It consisted of real corpses and body parts that had gone through a process of plastination whereby silicone plastic is injected into the body tissue to create real-life manikins, or plastinated bodies. The exhibit advertised that it
“uses real human specimens that have been respectfully preserved to explore the complex inner workings of the human form in a refreshing and thought-provoking style”.
Dig deeper, however, and it becomes clear that those deceased human bodies and body parts are “unclaimed bodies”, with no identity documents or consent, sourced from Dalian Hoffen Biotech in Dalian, China.
The commercial exploitation of body parts in all its forms is surely unethical and unsavoury. When it is combined with mass killing by an authoritarian state, we cannot stand by and do nothing. In 2019 the China Tribunal, led by Sir Geoffrey Nice, stated:
“The Tribunal’s members are certain—unanimously, and sure beyond reasonable doubt—that in China forced organ harvesting from prisoners of conscience has been practiced for a substantial period of time involving a very substantial number of victims … Falun Gong practitioners have been one—and probably the main—source of organ supply … In regard to the Uyghurs the Tribunal had evidence of medical testing on a scale that could allow them, amongst other uses, to become an ‘organ bank’.”
We are now hearing further testimonies during the course of the Uyghur Tribunal of the potential forced organ harvesting of Uighurs, including from Sayragul Sauytbay, who testified during the June hearings that she discovered medical files detailing Uighur detainees’ blood types and results of liver tests while she was working at a Uighur camp. Ethan Gutmann, senior research fellow at the Victims of Communism Memorial Foundation, spoke about his recent December 2020 report, including his witness interviews, the human organ “fast lanes” in the Urumqi and Kashgar airports and the construction of vast crematoriums throughout Xinjiang.
China has always denied the claims, brushing them off as rumours, and the World Health Organization has continuously backed this up. The UK Foreign, Commonwealth and Development Office has stated that the WHO shares its view that China was implementing an ethical, voluntary organ transplant system in accordance with international standards, although it has concerns about overall transparency. However, it was revealed by the UK Government in 2019 that the WHO’s assessment is based on China’s own self-assessment. The WHO has not carried out its own assessment of China’s organ transplant system—it does not have an independent expert compliance assessment mechanism in place to carry one out.
Over the years, evidence of forced organ harvesting has continued to build and whistleblowers have stepped forward. The body of evidence is becoming vast, including detailed statistical analysis of transplantations and donations, numerous recorded undercover telephone conversations, legal and policy statements and the practice of the Government and the party, advertisements, admissions of university and military personnel and a large number of very brave personal testimonies.
Last month, 12 United Nations special procedures experts raised the issue of forced organ harvesting with the Chinese Government in response to credible information that Falun Gong practitioners, Uighurs, Tibetans, Muslims and Christians are being killed for their organs in China. In the correspondence, UN human rights experts called on China to
“promptly respond to the allegations of ‘organ harvesting’ and to allow independent monitoring by international human rights mechanisms.”
Their full correspondence to China will be made public shortly.
I have always believed that the UK Government could be a powerful advocate for changing these practices, but also that we should put our own house in order and deal with current gaps in human tissue legislation. Currently, human tissue legislation covers organ transplantation within the UK but does not cover British citizens travelling abroad for transplants, and British taxpayers’ money will pay for antirejection medication regardless of where the organ was sourced or whether it was forcibly harvested from prisoners of conscience. According to NHS Blood and Transplant, between 2010 and July 2020 there were
“29 cases on the UK Transplant Registry of patients being followed up in the UK after receiving a transplant in … China.”
The Human Tissue Act 2004 has strict consent and documentation requirements for human tissue sourced within the UK, but it does not restrict imported human tissue in this way; it is merely advisory.
My Bill aims to amend the Human Tissue Act in five ways. First, it would prohibit a UK citizen from travelling outside the UK and receiving any controlled material for the purpose of organ transplantation when the organ donor or the organ donor’s next of kin had not provided free, informed and specific consent. Secondly, it would prohibit a UK citizen from travelling outside the UK and receiving any controlled material for the purpose of organ transplantation when a living donor or third party receives a financial gain or comparable advantage, or, if from a deceased donor, a third party receives financial gain or comparable advantage.
Thirdly, it would provide for the offences in Section 32 of the Human Tissue Act 2004 to be prohibited even if the offence did not take place in the UK, if the person had a close connection to our country. Fourthly, it would provide for regulations for patient-identifiable records and an annual report on instances of UK citizens receiving transplant procedures outside the UK by NHS Blood and Transplant. Lastly, it would provide for imported bodies on display to have the same consent requirements as those sourced from the UK.
We must take this action internationally and in the UK in order to do all we can to prevent this abhorrent practice. My Bill takes us a step forward. I hope the Minister, who has proved himself to be incredibly helpful in this area, will be sympathetic and say how the Government intend to help to take this forward. I beg to move.
Lord Ribeiro (Con) [V]
My Lords, I thank the noble Lord, Lord Hunt, for introducing this Bill. It is a pleasure to follow him. The Bill serves two purposes: first, to prevent a trade in organs, be it for transplantation or display in public exhibitions, and, secondly, to provide dignity and protection for prisoners in detention camps in China and elsewhere, where Uighurs and Falun Gong practitioners are exploited by the state.
The Human Tissue Act 2004, which was referred to earlier and which underpins this debate, followed the discovery of more than 2,000 pathological pots of body parts, removed between 1988 and 1995 from some 850 infants. This was the organ retention scandal at Alder Hey Hospital, which arose from a lack of consultation with the mothers affected by the disaster. Consent remains at the very heart of this Bill, and in the case of cadavers on display, evidence of consent is not always apparent, particularly if the body parts are the result of judicial execution by the Chinese state, as evidenced by Sir Geoffrey Nice in his report.
As president of the Royal College of Surgeons from 2005 to 2008, I continued a programme of repatriation of human remains held at the college’s Hunterian Museum, started by a former president, Sir Peter Morris, an Australian and a member of the working group on human remains commissioned by the Department for Culture, Media and Sport in 2001. He concluded that meaningful research on the remains could be done in Australia with the collaboration and permission of the original peoples. Remains of Tasmanian Aboriginal origin were repatriated in 2002, setting a trend for other museums and universities in the UK. In 2007, during my presidency, a smoking ceremony was performed for the spirits of the ancestors by representatives of the indigenous peoples. The Royal College of Surgeons has repatriated remains to Australia, New Zealand and Hawaii, and will continue to do so if legal evidence is produced by claimants.
The Human Tissue Act 2004 made it clear that written consent was required while the person was alive before donated bodies or body parts could be displayed. That principle needs to be applied to the authorities in China to demonstrate that consent has been obtained before body parts are removed. In the debate on the Medicines and Medical Devices Bill on 12 January, my noble friend Lady Penn said that the Government would undertake to strengthen the Human Tissue Authority’s code of practice on public displays of imported tissue, and that consent standards would be clear, firm and enforceable. Six months on, can she say what progress has been made in this respect?
Baroness Finlay of Llandaff (CB)
My Lords, it is a pleasure to follow the noble Lord, Lord Ribeiro, and I congratulate the noble Lord, Lord Hunt, on all the work he has done in this area and on the Bill. I declare that I chair the UK advisory panel of the Commonwealth “Tribute to Life” project, which is creating a memorandum of understanding to promote and support the highest standards of ethical transplantation across all Commonwealth nations.
The “Real Bodies” exhibition reminded me of the two mass murderers Burke and Hare, who killed between 1827 and 1828 in Edinburgh, supplying victims’ bodies to Edinburgh University for anatomy dissection. One night, they killed an old woman and her grandson. When Hare’s horse refused to pull the heavy load of two corpses uphill in a herring barrel, in anger he shot the horse dead. Burke was convicted and hanged; people paid good money to watch his execution, after which he was publicly dissected. Hare, though, escaped to England. Why the association? Both involved a supply of bodies for purported anatomical education, for profit and with no known consent.
The plastinated bodies exhibition had commercial gain, no evidence of consent to these people’s bodies being used and no evidence they died naturally. Indeed, emails reveal some were supplied for plastination in China after key organs had been removed, suggesting their bodies are the remains from a despicable trade in genocide, organ harvesting and commercial transplantation in China. These bodies on display included a woman in advanced pregnancy. Did she give fully informed consent when dying in pregnancy? The evidence of proper consent processes should be open to international scrutiny. It is not.
China appears to have been killing persecuted religious minorities, particularly Uighurs and Falun Gong practitioners, then harvesting and selling their organs on an industrial scale. At least 29 people have gone from the UK to China to avail themselves of organ transplants. They will have been told the organs came from people who died in accidents et cetera, not that someone was killed to order because there was a reasonable blood group match.
We cannot legislate directly against China’s despicable organ trade, but we can close the loophole in the Human Tissue Act 2004 that makes us complicit. We require careful consent for anatomical donation, through the Anatomy Act, and the use of tissues in this country, through the Human Tissue Act, for any practice. UK ethical standards around transplantation are exemplary. This Bill stops double standards, it supports ethical transplantation and it sends a message worldwide. I hope that the Government will support it.
Baroness Northover (LD)
My Lords, I too commend the noble Lord, Lord Hunt of Kings Heath, for his pursuit of these issues. He has introduced his Bill brilliantly, as ever, cogently and comprehensively. It is a real privilege to follow him and such leading medical practitioners as the noble Lord, Lord Ribeiro, and the noble Baroness, Lady Finlay.
I had long been appalled by the body exhibitions, which just seemed macabre, but as with many it never occurred to me that the bodies might not have been willingly donated for that purpose, as for medical science. It is appalling to think that these were likely to have been the bodies of Chinese prisoners, and absolutely sickening that money was made from them and that visitors to exhibitions unwittingly colluded. This Bill would put an end to that in the UK, as it has been ended elsewhere.
The Bill also addresses organ harvesting. In this case, often desperate people may travel abroad to undergo organ transplants without thinking or knowing of where these organs are sourced. I recall with shock one current Minister who, clearly out of lack of knowledge, praised China for the number and speed of its organ transplants. Given her strong personal faith, had she known then that praise would never have been expressed. We now know so much more: that beyond reasonable doubt, organs have been forcibly extracted from prisoners and others in China, killing the victim in the process. The harvested organs are sold for transplantation.
The China Tribunal, chaired by Sir Geoffrey Nice, released its full report in March 2020 and the judgment concluded that forced organ harvesting had been committed for years throughout China on a significant scale, and that Falun Gong practitioners were probably the main source of organ supply. It also concluded that, in relation to the Uighurs, there was evidence of medical testing on a scale that could allow them, among other uses, to become an “organ bank”. It concluded:
“Commission of Crimes Against Humanity against the Falun Gong and Uyghurs has been proved beyond reasonable doubt”.
As the noble Lord, Lord Hunt, mentioned, UN human rights experts have called on China to respond to the allegations of organ harvesting and to allow independent monitoring by international human rights mechanisms. That has not happened. Sir Geoffrey Nice is now chairing the Uighur tribunal and we await its conclusions with huge concern. In June this year, during the first set of hearings, further evidence of forced organ harvesting from Uighur victims has already been heard. This is a horrific crime and the treatment of the Uighurs has been classed by the US, for example, as genocide. The Bill takes actions to make sure that we are not complicit in these crimes.
I noted the very welcome support of the noble Baroness, Lady Penn, for action in this regard during the passage of the medical devices Bill. Things were moved forward, and I thank her and the Government for that. We are all therefore agreed, and I urge the Government to accept the Bill, work with the noble Lord, Lord Hunt, on any changes needed to make it as effective as possible and make sure it goes on to the statute book with immediate effect. We surely owe that to the victims of such appalling exploitation.
Lord Moynihan (Con)
My Lords, I congratulate the noble Lord, Lord Hunt, on the Bill, which is rightly commanding significant support in the House. The reason I take an interest in this issue, like the noble Lord, Lord Ribeiro, is the long-term support I have for the outstanding work undertaken by the Royal College of Surgeons. My grandfather, the first Lord Moynihan to sit on these Benches, was president of the Royal College of Surgeons, and I declare that I had the privilege to chair the fundraising committee for the Hunterian Museum, which houses the collection underpinned—as the noble Lord, Lord Ribeiro, said—by the repatriation policy that he admirably pursued.
The legislation before us achieves the right balance between authorisation of such collections and their use, closing some of the key loopholes. Yet the illegal or at least unethical use of cadavers without permission is still, as has been pointed out, a global problem. That said, major medical advances from which we all potentially benefit simply would not have been made, and could not be achieved, without the donation of cadavers.
The haptic feedback in medical training is essential, and however advanced holograms become for replacing cadavers it is important for the surgeon to understand and master the complex array of sensations that travel from the blade to the brain in advanced surgery. Yes, it is likely in coming decades that modern computer simulations will include haptic feedback, but it is only at that point that I can see immersive technologies replacing training on cadavers. A great deal of work is being undertaken in this pioneering field by the Royal College of Surgeons but, as one of the leading experts in the field, Shafi Ahmed, has said, we must not lose sight of the fact that:
“Two-thirds of the population, five billion people out of seven billion, do not have access to safe and affordable surgery.”
So, as set out in the Bill, strict standards must be in place, especially to cover the loopholes.
In 2004, as the House knows, we moved from second-person consent to the first-person consent which is necessary today. Yet Britain imports from America, for example, where rules are looser and second-person consent is permitted, in the use of unclaimed corpses from prisons and elsewhere, in many states. Supply is constrained and the demand for cadavers has increased in the UK, as the numbers training to be doctors increases. In 2005, medical schools in the UK asked for 600 cadavers; in 2017, it was 1,300. What is essential, as the noble Lord’s Bill confirms, is clear provenance in the UK—and ultimately worldwide—covering the procurement, handling and disposition of cadavers. This needs to be built into global regulatory frameworks.
It should no longer be the case that bodies which are willed to be used to educate medical students, to provide materials for patients or to promote research on human disease should subsequently be sold on to non-profit or, worse still, for-profit organisations without the knowledge and detailed informed consent of the donors. They were once living human beings and we should have legislative-backed respect extending at every stage from procurement to use, until final disposition takes place.
The Lord Bishop of St Albans
My Lords, I too support this Bill and welcome the very excellent speech by the noble Lord, Lord Hunt of Kings Heath, and this important priority to equalise the law so that, whether a body or an organ comes from someone in this country or some other part of this world, they will be given the same protections and treated with the same dignity.
Noble Lords have already spelled out with great and horrifying clarity some of the allegations of organ harvesting by the Chinese authorities targeting minorities. I have risen to speak today because I have been raising again and again in this House the issue of the Uighurs, and this absolutely touches on what is happening to this incredibly persecuted group of people. It is terrifying to see what is unfolding before our very eyes. In June 2021, a group of independent UN experts said that they had received information that detainees from ethnic and religious groups such as the Uighurs, Tibetans, Falun Gong and Chinese Christians were being subjected to examination without their consent, with the express intention to facilitate organ allocation.
We know that, back in 1984, harvesting organs from political prisoners was permitted in Chinese law. We know that the subsequent crackdown against the Falun Gong in 1999 meant that many of its members are likely to have been subject to forced organ harvesting. It is rumoured that, in the 1990s, prisoners of conscience of Uighur origin were the largest source of organs, before being surpassed by Falun Gong. Now, however, the Uighurs are again in the sightlines of the Chinese Communist Party, and the accounts of harvesting organs are rising. Expert estimations of the number of Uighurs killed in Xinjiang for their organs range from 20,000 to 25,000 per year. There are also stories of vast lanes to streamline the distribution of these organs, and of crematoria to dispose of the victims’ bodies and to deny the deceased a proper Islamic burial.
I had previously refrained from using the term “genocide” to describe the awful repression of the Uighur minority, but, following the House of Commons debate in April and its Motion, when it was labelled as such, it seems to me that we now have to name it and not mess around any more. A genocide is being perpetrated against Uighur minorities. I am not blind to the difficulties that our own Government have in trying to save these lives, but we must become far more robust in terms of the representations and, if necessary, the actions that we are willing to take against China. I have found Her Majesty’s Government’s response to the situation in Xinjiang disappointing over recent months. The current law allows British citizens to receive organs from unknown and possibly non-consenting sources without consequences. If that happens, British citizens are acting as accessories to genocide.
I will make one final, brief point. I am glad that this Bill extends to the treatment of the bodies of those who have been executed, but it is also for those who have died peacefully. It remains unacceptable that they should be displayed without appropriate consent. Christianity has always held that our bodies have been created by God and are temples of the Holy Spirit, and as such that we must reverence them and treat them with dignity, both in life and in death. For centuries, the Christian tradition has taught that burying the dead is one of the seven acts of corporal mercy. It is rooted in the belief that the body is sacred. This is so fundamental to us as we look to the future. I hope that Her Majesty’s Government will bring this Private Member’s Bill into law as soon as possible.
Lord Sheikh (Con) [V]
My Lords, we must change the United Kingdom’s connection with unethical and unacceptable organ transplantation and harvesting. Successful organ transplants are an outstanding achievement. Such medical procedures, carried out with proper safeguards, save lives. I wholeheartedly support the practice. I am the president of the Conservative Muslim Forum, which has over 1,500 members. We are holding a meeting in September to explain the organ donation system in the country and how organ transplantation harvesting through force and financial coercion and without proper consent being obtained is totally unacceptable. This Bill, from the noble Lord, Lord Hunt, intends to discourage Britain’s involvement in these practices. We must all give it our utmost support.
We appreciate that there are people who are in vulnerable situations and who are targeted or exploited for the value of their human tissue. In certain parts of the world, this practice is more common than in others. United Nations human rights experts are extremely alarmed by reports of organ harvesting in China. A tribunal chaired by Sir Geoffrey Nice QC found that in China, the practice of organ harvesting from prisoners of conscience has gone on for several years. The Uighurs and Falun Gong practitioners have been particularly subjected to these inhumane practices.
I have spoken on this issue in your Lordships’ House previously and I had hoped that it had stopped. The practice of purchasing human organs places a price on somebody’s body or on their value as a human being. This is a violating of humanity, and ethically and morally wrong. Furthermore, this Bill will provide accountability. Patient-identifiable records should be initiated so that we can identify UK citizens travelling for these procedures. The system is shrouded in secrecy. This Bill will introduce suitable and effective regulations to identify the culprits who engage in these practices. Although the United Kingdom’s involvement may be small, this extensive trade is worth millions of dollars. Gangs and traffickers operate all over the world, exploiting people in underdeveloped countries to obtain organs for profit and without any proper aftercare.
I agree with the proposal set out in the Bill that appropriate consent should be made mandatory for cadavers that are imported and displayed in the country. The physical and financial coercion involved in sustaining this practice is inhumane and should be stopped. Through this Bill we can prevent the practice growing and close existing gaps in our legislation.
Lord Mackenzie of Framwellgate (Non-Afl) [V]
My Lords, I also commend the noble Lord, Lord Hunt, for his work in bringing this before the House. For many years in this House we have debated, called to account, criticised, and been horrified by, the revelations based on substantial evidence that a so-called civilised country, a member of the United Nations Security Council, governed by the Chinese Communist Party, which was born 100 years ago this year, was committing genocide and discriminating against its own citizens because they were different in their beliefs or their religion. We have watched with mounting despair as minorities such as Falun Gong and Uighur Muslims were arrested, gang raped, sterilised, and used as organ banks on an industrial scale, with the world looking on. It is also clear that we are complicit in this denial of basic human rights in providing a ready market for the high demand for organs forcibly taken, in many cases from living prisoners.
At last, I am delighted that this House can put its money where its mouth is and is taking legislative action by means of this Bill to make it illegal to be complicit in such organ harvesting and transplant trafficking. The Chinese communist Government have continually denied involvement in such shocking atrocities, not seen since the Holocaust, and we have a moral duty—and also, hopefully, a legal duty—to do something about it. We are not alone in this humanitarian crusade and are following Spain, Italy, Taiwan, Israel, Belgium, Norway, and South Korea, who have already taken legislative action to prevent organ tourism by their citizens to China.
We cannot stand idly by while fellow human beings are dehumanised in such ways. The Bill enables us to metaphorically not cross over to the other side of the road but, like the good Samaritan, do what we do best in this country and apply our long-held values to help our fellow human beings enjoy the human rights we take for granted. The Bill provides us with the legislative means to achieve this. I support it and commend it to the House.
Lord Alton of Liverpool (CB) [V]
My Lords, I declare my role as vice-chair of the all-party parliamentary groups on Uighurs and Hong Kong and as a patron of the Coalition for Genocide Response. The noble Lord, Lord Hunt of Kings Heath, has fearlessly shone a light on a practice that, even for the Chinese Communist Party, which is responsible for the deaths of tens of millions of its own people, plumbs new depths of depravity. His admirable Bill deserves our wholehearted support, and I fully endorse and agree with all the preceding speeches in the debate today.
The China Tribunal said that it was
“certain—unanimously, and sure beyond reasonable doubt—that in China forced organ harvesting from prisoners of conscience has been practised for a substantial period of time involving a very substantial number of victims.”
Dr Enver Tohti, a Uighur doctor, described to me how he had been required to remove organs and ordered to
“cut deep and work fast”
on a victim who was still alive. The theft of organs has been described as an almost perfect crime, because no one survives.
However, the crime does not end there: there is a further twist to this infamy. Anonymous, plastinated corpses taken from Chinese prisons have been paraded in a carnival of horrors at money-making exhibitions—a final sneering insult to these victims. In 2018, after one such exhibition, I wrote to the Times, along with Professor Jo Martin, President of the Royal College of Pathologists, and 55 others, saying:
“We believe that the legislation requires reform”.
The Bill of the noble Lord, Lord Hunt, now seeks to do precisely that, and he is to be commended warmly for bringing it before your Lordships’ House.
However, we should go further still. The plastinated cadavers indicate that many are young people. The Minister should establish whether it is possible to extract DNA from these corpses to discover something of their origins and ethnic identity. The law did not require the coroner to determine how the corpses exhibited in Birmingham had died. It should.
What of the World Health Organization? Will the Minister tell us why the Government resisted my freedom of information request to publish their correspondence with the WHO on organ harvesting? They should press it hard to lead an international campaign for legislation like this to be enacted elsewhere, combating and ending these criminal practices.
On 22 July it will be 22 years since the start of the persecution of Falun Gong. Jiang Zemin established the 610 Office to eradicate—his word—Falun Gong, practised at the time by 70 million Chinese people. In undercover phone calls recorded during investigations, Chinese doctors said that Jiang Zemin gave direct instructions to harvest organs from Falun Gong. Last week, the Chinese Communist Party said that it wanted Falun Gong outlawed in Hong Kong.
The Bill of the noble Lord, Lord Hunt, would demonstrate to the persecuted and cruelly treated—to the 1 million incarcerated Uighurs, Tibetan Buddhists, imprisoned Christians, lawyers, journalists and political dissidents, who are subjected to abductions, disappearances, torture, ethnic cleansing, execution and, as the House of Commons determined in April, genocide in Xinjiang—that we have not forgotten them and will not be intimidated or silenced into submission. The Bill deserves a Second Reading and has my full support.
Lord McColl of Dulwich (Con) [V]
My Lords, I also thank the noble Lord, Lord Hunt, for presenting this valuable Bill. Of all the different operations that I used to do, kidney transplantation was the most exciting. When the vein and artery were connected to the donor kidney, it would spring to life. As a contribution to good Anglo-French relations, I pay tribute to France: the French kidneys were the best of all because they would start functioning immediately by peeing on the operating table. The reason for this was said to be French wine being a good diuretic. As there was always a shortage of kidneys, there was a European system for sharing in order to have the best match for each patient. Unfortunately, this shortage led to abuses of all kinds. On many occasions, live donors were paid to give their kidneys, for a relative or a stranger. It later transpired that genuine consent was often not obtained.
Later, the horror of the Chinese practice of forcibly taking kidneys from prisoners came to light. The numbers involved have shocked the world, but is the world going to repeat its failure to take action against the Nazi atrocities, which also included horrific medical experiments on prisoners? Instead of an effective response to China, the West continues to allow it to buy up our industries, enabling the Chinese Government’s plan to dominate and control the world. When will the world wake up and take effective action?
On medical devices, it is worth saying that the medical profession has a history of reluctance to put foreign materials into bodies. The surgeon who pioneered the use of metal plates and screws to fix fractures was threatened with removal from the medical register. Another example was an eye surgeon, Harold Ridley, who was carrying out a standard operation for cataracts in 1949, simply removing the cataract and sewing up the eye. A medical student who was watching the operation suggested that perhaps the cataract should be replaced with an artificial lens. What the surgeon said at the time was not recorded, but he kept the suggestion in his mind and, the following week, he noticed a piece of plastic from a smashed windscreen in a pilot’s eye—but there had been no reaction to it. So began artificial lens implantation. In spite of great opposition, it was finally accepted 25 years later. New inventions are often opposed. Careful evaluation is essential to allow and promote good new developments as well as to stop harmful ones.
Baroness Brinton (LD) [V]
My Lords, I join in congratulating the noble Lord, Lord Hunt of Kings Heath, on presenting this excellent Bill, which will give the United Kingdom confidence that no one having a transplant with an organ from abroad will have received an organ donated without consent, and which will prevent the display of cadavers where that consent has also not been obtained. The noble Lord’s role in taking the opt-out organ donation Bill through Parliament was much welcomed at the time, and the change in legislation has worked, with public opinion very much supporting opt-out. Transplants are a wonderful medical advance, when the organs have been donated with the consent of the individual. They are a real gift of life to those who knew that they had run out of treatments.
This Bill tackles a very specific problem that has emerged in recent years and is a very helpful clarification of the law in two areas. First, I suspect that members of the public who visited the Imagine Exhibitions tour would have been horrified to discover that the plastinated cadavers on display came from China and were the bodies of those executed by Chinese authorities—and, possibly worse, that some of their organs had been harvested. The noble Lord, Lord Hunt, along with other noble Lords, is right to say that the treatment of the Uighur Muslims by the Chinese authorities, as reported to the United Nations by the expert China Tribunal, chaired by Sir Geoffrey Nice, is extremely worrying.
The Chinese may, as with their treatment of the Falun Gong, deny their involvement in the use of people’s organs or bodies without their explicit consent. They say that forced organ transplanting stopped in 2015. We may choose, as we do, to listen to the evidence to the contrary presented to the United Nations. The noble Baroness, Lady Northover, made an important point about the lack of Chinese explanation about evidence presented to the United Nations; their silence on this does not confirm their innocence.
We on these Benches note that the NHS Blood and Transplant organisation has reported that between 2010 and July 2020
“there are 29 cases on the UK Transplant Registry of patients being followed up in the UK after receiving a transplant in the People’s Republic of China”.
We know that UK citizens are going to China to receive transplants. I wonder how many of them know exactly where those organs came from.
It is vital that the UK, whether its citizens or its NHS in treating people after transplants, is protected from the possible lack of consent from individuals into the use of their bodies for organ transplant or bodies on display. We are now behind the curve compared to many other countries that have legislated already against these practices, and that needs to be remedied as a matter of urgency. The noble Lord, Lord Ribeiro, with his expertise through his role in the Royal College of Surgeons, and the chairing role of the noble Baroness, Lady Finlay, on ethics, both spoke with authority on the medical practice of transplants and true consent. The experience of the noble Lord, Lord McColl, as a kidney transplant surgeon, of various nefarious practices in gaining consents for transplant, was very helpful. His last comments at the end about the development of plastic lenses for cataracts just shows how slowly and carefully this country has taken the progression of transplantation.
Along with the noble Baroness, Lady Finlay, my thoughts turn to Burke and Hare, and their appalling supply of bodies for profit. Our own shameful history in this area means that we must ensure that standards of consent are of the highest calibre, which is why we need absolute clarity on consent for any practice involving organ transplants and cadaver display. The noble Baroness is right to say that this Bill prevents double standards. The right reverend Prelate the Bishop of St Albans confirms the view of all speakers in this debate so far that we in the UK must be robust in ensuring that we have those right standards in our country and that we continue to push for an examination of the treatment of persecuted minorities in China. I hope that the Government, who are now taking very seriously the issue of China’s treatment of Uighur Muslims, will smooth the rapid progress of this small but vital Bill through Parliament and into legislation as soon as possible.
Baroness Thornton (Lab)
The noble Baroness, Lady Brinton, made a very important point about our history in this country and how we have had to resolve these issues over many years. I very much welcome the comments of the noble Lords, Lord Ribeiro and Lord Moynihan, on that matter.
I start by congratulating my noble friend Lord Hunt on bringing this Private Member’s Bill before the House today and on all the work that he and other noble Lords have done. This issue has truly been a good example of the House of Lords working as one to solve what we think is a serious problem and a gap in the law. I am honoured to deal with this from the Front Bench on behalf of the Labour Party today.
I intend to speak mostly about the section of the Bill which addresses cadavers on display. My own personal view, which the people involved in this issue will know, is that exhibitions such as “Real Bodies” should be banned completely, as they are in France. Over 10 years ago, a French judge ruled to shut down a Paris exhibition of real human bodies from China, saying that exhibiting dead bodies for profit is a
“violation of the respect owed to them”.
I hate to repeat what I said in the House in 2019, when my noble friend Lord Hunt, brought an Oral Question, in February. But I said then that there was a
“much more fundamental ethical issue at play here. Leaving aside the need for cadavers and human tissue for scientific and medical training purposes”
and research, which I completely and utterly understand but which we regulate in this country through the Human Tissue Authority,
“it seems likely that all the exhibitions which use plasticised cadavers and foetuses for supposedly educational purposes could use modern materials and production to create the same exhibits. That begs the question: why use cadavers and human body parts at all? If the answer is that people want to see such things and will pay to do so, I remind noble Lords that people used to flock in their thousands to see public executions until 1868.”
There is an echo of what the noble Baroness, Lady Finlay, said about this issue. I went on to say
“Does the HTA exist to regulate what, in this case, is akin to ghoulish curiosity and its manifestations? What is the ethical position and who should be examining it?”—[Official Report, 27/2/19; cols. 228-9.]
Those were the questions that I asked in 2019.
A series of “Body Worlds” anatomical exhibitions has toured many countries worldwide, sometimes raising controversies about the sourcing and display of actual human corpses and body parts. Gunther von Hagens, the inventor and initiator, maintains that all human specimens were obtained with the full knowledge and consent of the donors before they died, but this has never been independently verified. In 2004, von Hagens returned seven corpses to China because they showed evidence of being executed prisoners. In 2002, two Russian doctors from the University of Novosibirsk were charged with illegally supplying von Hagens with 56 bodies, including convicts, homeless people and mentally ill people, without any consent from their relatives. Gunther von Hagens said that none of the body parts were used in the “Body Worlds” exhibitions, but I have to say that that raises doubts and scepticism, unsurprisingly.
Consent is not regulated worldwide according to the same ethical standards, which indeed raises concerns. Paperwork is separated from the bodies, which can be used for displays or sold in pieces to medical schools. No one will know for sure, because each plastinated corpse is made anonymous to protect its privacy. Hans-Martin Sass, a philosophy professor with a speciality in ethics, was hired by the California Science Center to investigate “Body Worlds” before the show’s US debut in 2004. He matched 200 donation forms to death certificates, but he could not match the paperwork to specific bodies that von Hagens has on display.
There is a gap in the law in the world, but there is also a gap in the law for the Human Tissue Authority. Like many noble Lords, I welcome the fact that the noble Baroness, Lady Penn, said that the Government would look to strengthen the HTA, which does not have the powers to deal with imported human material. We have to address this—and from these Benches we support this Bill wholeheartedly and hope the Government will do the same and that we will see it rapidly on the statute book.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
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.
Lord Hunt of Kings Heath (Lab) [V]
I am very pleased to be able to respond to this debate. I thank all noble Lords for taking part and the Minister for his very careful response. We heard from the noble Lords, Lord Ribeiro and Lord Moynihan, how important the ethical basis of organ transplant and use of research in this country is. It sets the context for the debate. The noble Baronesses, Lady Finlay, Lady Brinton and Lady Northover, and the noble Lord, Lord Alton, spoke graphically about the appalling nature of the “Real Bodies” exhibition; the noble Lord, Lord Alton, who has been such a champion of human rights, expressed disappointment about the WHO’s record, which I very much share.
The noble Lord, Lord Sheikh, talked about the vulnerable people who have been targeted globally to provide organs, and I so agree with him. I echo the remarks of the right reverend Prelate the Bishop of St Albans about the appalling tragedy of the Uighurs, and I applaud the role of the Church. The noble Lord, Lord Mackenzie, supported the Bill. The noble Lord, Lord McColl, talked about the balance between the ethical basis of transplants and research in general and the need to encourage innovation, which I agree with.
The noble Baroness, Lady Brinton, brought us back to the point that we need more organ transplants in the UK. The presumed consent measures, as the Minister said, have led to increased donations already but we need to do more. But we must have a system where people are absolutely convinced that consent has been given and where there is integrity in its operations.
My noble friend Lady Thornton, in a powerful speech, spoke about the strength of the case and her scepticism about consent being given in the “Real Bodies” exhibition. I think she is absolutely right on this.
The Minister has always been sympathetic, and I very much applaud him for that. He has expressed some concerns about the details of my Bill, which I will of course reflect on. He argued that there are many provisions already in place, and certainly in relation to exhibitions, the new code published very recently by the HTA states that specific consent is needed when it comes to obtaining a licence. He has also said that he will step up efforts, through round tables and discussions with the relevant agencies, to ensure that the country is doing all it can to prevent these dreadful things happening. I thank him for all of that. I think, though, that there is a strong argument for saying that, at the end of the day, we need explicit legislation. I certainly wish to continue with this Bill and to explore some of the Minister’s detailed comments, perhaps in Committee.
For the moment, I thank all noble Lords who have taken part in what has been a fantastically interesting and important debate. I commend the Bill to the House.