Public Bodies Bill [HL]

Baroness Warwick of Undercliffe Excerpts

Monday 9th May 2011 Lords Chamber

[Baroness Bottomley of Nettlestone]

My Lords, I, too, support the amendments of the noble Baroness. My interest is that I appointed her as chairman of the Human Fertilisation and Embryology Authority all those years ago. One of the first Bills for which I had responsibility in Parliament when I was Minister for Health was the Human Fertilisation and Embryology Act, following the very distinguished report of the noble Baroness, Lady Warnock. I have also served on the Medical Research Council.

The noble and right reverend Lord, Lord Harries, said that umpteen days had been spent debating the Bill. I like that term, and it is absolutely accurate. I, too, when I was a Minister in another place said, “Thank God for the House of Lords”, because, whenever a particularly difficult and emotional issue arose, I knew that words of wisdom could be consulted in the House of Lords. They were a very good touchstone for me when I took on the task.

If ever there was emotion between scientists, clinicians, social scientists, theologians and patient groups, it was then. The fact that it has now become a relatively quiet issue does not mean that it does not have the potential to become once again extremely noisy. It speaks for the hugely effective way in which the HFEA has gone about its work, and the confidence that it has built not only in the United Kingdom among all parties but, as has rightly been said, around the world. If clinicians are irritated by the HFEA from time to time, that makes me even more convinced that there must be something good about it, because there is a distinction between the mind of the scientist and pioneering doctor, and the ethical balance of those calling for slightly more caution, control and constraint. When the area is that of the creation of life outside the body, it is a moral issue: we should never forget that.

The Minister, who is sympathetic, thoughtful and kind, and who listens endlessly to requests from Members of this House, has already been extremely accommodating. He has agreed to coherence and transparency; he has agreed that he will not rewrite the ethical standards; and he has agreed that most of the functions should be kept together. Nevertheless, the Care Quality Commission has a huge agenda of work, as was rightly said by the noble Lord, and most of its activities are of a different nature from those of the Human Fertilisation and Embryology Authority, so can the Minister give us further assurances and find a way to meet the objectives of the noble Baroness’s amendments?

Amendment 9, which is about the establishment of the health research regulatory agency, is even more important to me because it seems to be a prerequisite for the changes taking place. Of course we all believe in what we have now learnt to call a bonfire of the quangocracies. The easiest thing for any junior Minister to do is to make their name by setting up a quango; it is much harder to make your name by shutting down a few quangos, and we know it needs to happen. However, like other noble Lords, I urge the Minister to think very carefully before he puts the HFEA and the HTA at the top of his list.

[Baroness Warwick of Undercliffe]

My Lords, I shall speak to all three amendments in this group. I declare my interest as chair of the Human Tissue Authority, whose work is so much affected by this Bill. At the start of the passage of the Bill, there was much confusion over its purpose and the future direction of travel for many of those arm's-length bodies listed in it. Much progress has been made during the passage of the Bill. The Government have given due attention to concerns raised, thought through the potential outcomes and clarified many issues for all of us. I want to thank the Minister, the noble Earl, Lord Howe, for the attention he has paid to our specific areas of interest: the HFEA and the HTA. I particularly welcome his statement in the letter he sent to my noble friend Lady Thornton in which he recognised the need for our preferred option, which is to keep the functions of the HFEA and the HTA together, and gave a commitment to discuss directly with the HTA any potential movement of our research-related functions to another organisation.

I believe we are nearly there, but I feel that these amendments are necessary and will act as a safety framework for the Bill as it enters the other place and then goes onwards for external consultation. We are seeking a set of reassurances and safeguards from the Minister to ensure that the hard work everybody has done to shape this Bill will not be lost further down the road.

The noble Baroness, Lady Deech, and the noble Lord, Lord Walton of Detchant, have already set out the main arguments in favour of the amendments. I support them and shall not reiterate them. The amendments suggest measures by which the Government could assess the cost-effectiveness of the proposed moves, and I urge the Minister to consider utilising them. In his letter to my noble friend Lady Thornton, the Minister addresses the need for an impact assessment, but he proposes only a partial assessment. I believe that a full and thorough assessment is needed in order to give a true picture of cost-effectiveness. We are all looking for ways in which to reduce costs and bureaucracy and therefore see an increase in cost-effectiveness as the gold standard we should aim for in the public services we provide. If a saving is made in one area only to increase costs in another, that would be unacceptable. It is for this reason that I urge the Government to conduct a full impact assessment, not a partial one.

The HTA is already recognised as an efficient regulator with a clear focus on improving value for money. We are a lean organisation costing only £1 million in government grant in aid and we will reduce that by 14 per cent in cash terms this year. We have reduced our licence fees across all sectors this year, including a 30 per cent reduction in the research sector. I have already raised and evidenced my concerns that any proposals to transfer the HTA's research functions would not achieve either simplification or financial savings. Indeed, we estimate that it would impose additional regulatory and financial burdens on around 200 establishments across various sectors. So I suspect it will not surprise your Lordships to know that I am concerned to ensure that cost-effectiveness is real and not just perceived as an outcome of this assessment.

I now turn to the amendment that deals with setting up the new independent health research agency. As I mentioned, I seek reassurance from the Minister in a set of safeguards. The Government have set out a draft transfer timetable, and have made clear their intention to cause the least amount of disruption to all involved by enacting all transfers of the HTA and HFEA functions at the same time. None of this can happen until the health research agency has a legal basis in its own right and it has been decided whether any HTA functions should transfer to it. Will the Minister therefore outline a more specific timetable for its establishment, and reaffirm his commitment to hold off transfers until then?

In addition, the amendment would require that a separate ethics committee be established within the new agency to undertake the ethical considerations of any functions that are transferred. This would be paramount in ensuring that we do not lose public and professional confidence through this period of change and that we continue to ensure that tissues and organs are used safely and ethically and with proper consent. Finally, therefore, is the Minister minded to establish such a committee and so accept this amendment in full?

[The Lord Bishop of Guildford]

My Lords, I support both this amendment and the two related amendments that follow it. They would guarantee in one way or another that the enormously valuable work of precisely the present ethics committee of the two bodies is continued. I speak in general, so far as a Bishop can ever speak, for the Christian churches and for other faith communities for whom the human embryo and human tissue have moral significance. That is not to say that the present ethics committee is in the pocket, so to speak, of the Bishops or of any faith community leaders. It is not, and the range of views and commitments of its members is and should be wide. However, it would be a serious mistake not to have an ethics committee or expert body specifically to weigh the moral as well as the medico-scientific questions that are involved in this very proper research, not least into the tragedy of infertility.

Also of great significance for me is the serious support of the relevant professional bodies, so I urge the Government to consider these amendments very favourably.