Fertility Treatment Regulation
Debate between Lord Winston and Baroness Blake of Leeds
Baroness in Waiting/Government Whip (Baroness Blake of Leeds) (Lab)
My Lords, I am very pleased to respond to this debate, particularly regarding the adequacy of law on the regulation of fertility treatment. I thank the noble Baroness, Lady Deech, for raising this topical and important matter and for her thoughtful and wide-reaching comments which framed the debate that followed.
As always, I have to start with the caveat that I probably will not be able to answer everything that has been raised today in the time that I have, but I am always happy to write to noble Lords to expand on their very thoughtful points around this complex issue. Just to reframe it, I remind everyone that the UK’s Human Fertilisation and Embryology Act came in 1990, and we all need to reflect on just how long ago that is. The Act set out to regulate assisted reproduction and human embryo research. It established the Human Fertilisation and Embryology Authority, as we have heard from the noble Baroness, Lady Deech, and I shall refer to that as the HFEA. This was the first dedicated regulator of fertility treatment and embryo research anywhere in the world. It is quite extraordinary that it still has so many robust features that are applied to this day.
The HFEA ensures that fertility clinics operate to high standards and that sensitive and complex treatments are carried out safely and ethically. It remains an important and effective regulator, helping to ensure that treatment and research are conducted responsibly, with positive outcomes for patients. This is particularly important as fertility treatments continue to help people in the UK to have children—we must not forget this—with almost 21,000 babies born from IVF in 2023, accounting for one in 32 UK births. Having treatment in a UK-licensed fertility clinic continues to be very safe. In 2024-25, out of more than 100,000 cycles of fertility treatment, storage or donations, incidents occurred in less than 1% of cycles.
The issue of postcode lottery was raised by many noble Lords today, including the noble Baronesses, Lady Deech, Lady Pidgeon and Lady Gerada, and the noble Earl, Lord Effingham. The National Institute for Health and Care Excellence guidelines for fertility problems, assessment and treatment were published on 31 March 2026, and this guidance informs how ICBs should commission fertility services within their local populations. However, the Government recognise that access to NHS-funded fertility services is variable in England and are looking into achievable ambitions to improve access to fertility services. With regard to ICBs, the nature of commissioning that we have in England is a really important element of this.
However, the Government recognise that the success of the legislative framework does not mean that it is fully adequate for the modern day, which has framed so many comments today. The fertility sector has evolved significantly since 1990, when the first Act was introduced—the noble Baroness, Lady Deech, was quite right to highlight the challenging issues—and, although it was updated in 2008, that is still a significant amount of time away. Scientific advancements, changes in societal attitudes and the growth of a largely privately funded treatment sector have transformed both demand and delivery for such a service. The HFEA itself has concluded that while much of the original framework remains fit for purpose, targeted reform is now required.
In 2023, the HFEA published the detailed set of recommendations to update the original Act, identifying four key areas in which reform is required, including patient protection and safety, as we have heard so clearly today, consent, donor anonymity and scientific developments. Within this, the HFEA set out its views to strengthen regulatory powers to protect patients, simplify consent, and ensure that the system can accommodate scientific innovation, as so clearly raised by the noble Baroness, Lady Owen, and the noble Earl, Lord Effingham. These issues do not undermine the foundations of the existing system; rather, they highlight an opportunity to update and future-proof the framework.
The HFEA has highlighted the need for the regulatory framework to reflect changes in how patients access information and treatment decisions. Since 1990, the growth of online platforms and social media has fundamentally reshaped the fertility landscape, influencing how patients engage with clinics, access information, and make decisions about treatment.
In terms of the very thoughtful contributions around surrogacy, I should add that the Government recognise the significance and importance of this issue and welcome the Law Commission’s comprehensive report, published in 2023. However, given the limited parliamentary time available and competing legislative priorities, we are not currently able to bring forward the reform immediately, but we will publish a formal response as soon as capacity allows and keep this issue under review.
To the point made by the noble Lord, Lord Palmer, on setting financial penalties, I say this would also need to be considered as a part of the broader update in regulatory powers. The other absolutely critical area covered by so many noble Lords, including the noble Baronesses, Lady Gerada and Lady Deech, the right reverend Prelate the Bishop of Chelmsford, and the noble Lord, Lord Winston, is the whole issue of consent. The Government recognise concerns raised by noble Lords on the complexity of consent arrangements, including withdrawal of consent and ensuring patients fully understand the legal implications, and we will consider all these issues as part of any wider reform.
I am very grateful to my noble friend Lady Nargund for her informed contribution to this debate. She is right to highlight the success and the continuing importance of the regulatory framework. That framework, together with the work of the HFEA, has delivered tangible improvements in patient outcomes, including significant reductions in multiple birth rates and greater transparency through the publication of clinic performance data.
The Government are clear that patients must be at the centre of the system. Fertility treatment can be physically and emotionally demanding, and we expect providers to meet the highest standards of care, safety, and ethical practice. We recognise the argument that the legislation should more explicitly reflect the safety and protection of those undergoing treatment. This has been carefully considered as part of the wider discussions on potential reform.
We acknowledge concerns about the limits of the current enforcement regime to drive improvement and that better use of data has the potential to strengthen oversight and support joined-up care. I assure the House that all these issues are receiving careful and ongoing consideration. Any reforms must strike the right balance in maintaining public trust and patient safety while enabling responsible scientific progress.
I again emphasise the fact, which I know will be disappointing to noble Lords, that the legislative programme for this parliamentary Session is very full. Due to the limited time available to undertake legislative reform and the priorities the Government set out in the King’ Speech, we are not able to pursue immediate legislative reform of the Act in the current Session. However, the Government are considering potential legislative options and, if parliamentary time allows, will ensure that any future reforms support patient safety, reflect societal change and maintain the UK’s position as a global leader in fertility regulation. I can tell that the noble Baroness, Lady Owen, is perhaps not as impressed as she might be, but I am sure she was expecting my comments none the less.
On the possibility of setting up a Select Committee, which was raised by the noble Baroness, Lady Deech, we will of course consider all the different options. As she outlined, one of those options could indeed be setting up a relevant committee.
I recognise the need to update the Act. On the significant changes in fertility and scientific innovation we have witnessed and the comments by the right reverend Prelate the Bishop of Chelmsford, I am sure she will appreciate that any reform must be approached in a considered and balanced way, given the ethical sensitivity and complexity of this area.
On the issues raised about the lack of clarity on the fate of embryos for those families who very sadly could not continue treatments, any future reform would include a review of issues relating to digital clinics and how we might move forward to improve the regulatory regime in the digital area.
On the inequity and commercial exploitation in the fertility sector, raised by my noble friend Lord Winston, it is right to highlight the pace of change in the sector. While we acknowledge that the legal framework has provided strong safeguards and recognise the growing pressures from the expanding and increasingly complex private market, the Government are clear that patient safety and fairness must remain paramount and support the HFEA in maintaining the robust regulation of clinics. However, we also recognise concerns about affordability, access and the risk of inequity. While the UK continues to have a strong, established regulatory regime, we are not complacent and will continue to determine next steps to ensure that it reflects developments in both technology and the market.
Going back to the framework, the task before us is to build on the framework to retain the strengths of the existing legislation while reinforcing the capability of the HFEA and ensuring that the law keeps pace with science, society and patient expectations. We look to ensure that the UK continues to lead in the responsible regulation of fertility treatment.
My noble friend Lord Winston raised important issues about egg freezing. As we are aware, elective egg freezing is not a service provided by the National Health Service. The HFEA publishes advice about egg freezing on its website, including information about the process, risks, success and data on this. Those who freeze their eggs do so within a tightly regulated system with strict rules set out in law and in the HFEA code of practice. The HFEA expects clinics to follow consumer law and advertising guidance for UK fertility clinics produced by the CMA and the ASA. Although egg freezing is becoming a popular choice, it is not, as we have heard very clearly today, an insurance policy that can guarantee a baby in the future. Fertility clinics have a responsibility to ensure that anyone using fertility services understands the risks and the long-term impact of any treatment decisions that they make.
I am pleased to say that my noble friend Lady Merron listened very carefully to the issues raised by my noble friend Lord Winston during the King’s Speech. Although she was not winding up on that particular debate, she undertook to write to him, sparing the noble Lord, Lord Hendy, from attempting to answer his questions in the summing up. I am pleased to say that she has since written to him to address his concerns and will, Iusb have no doubt, engage with him on the further concerns that he has raised.
The noble Baroness, Lady Owen, raised particular concerns about Apricity. I think all of us will have heard about those cases with extreme concern and felt sensitivity for those people who went through such a distressing experience. Of course, we know that Apricity’s closure did not fall under the HFEA’s regulatory remit, as it was a digital service only. Of course, affected patients were advised to complain through trading standards about the service that was offered. Cases such as this will be very much at the forefront in considering the work we need to do going forward.
I have on several occasions listened with enormous interest to the noble Baroness, Lady Boycott, about the impact of chemicals in our system. I do not have the ability to respond to her fully on that point, but it is an issue—also raised by my noble friend Lord Winston—that is generating a huge amount of concern. I reassure her that I will write to Defra colleagues and ask them to pass on their comments. We will send a copy of the words she said today to move that on.
I do not think I have debated with the noble Baroness, Lady Shawcross-Wolfson, before. I was very interested to hear her comments, obviously based on a lot of experience at the policy end of the spectrum. I look forward to her further contributions on this point.
I again thank everyone for taking part in this important debate. The challenges are very well recognised, and we look forward to addressing them in a way that many couples, families and individuals can benefit from in the future.
Lord Winston (Lab)
Before the Minister sits down, I wonder whether she would be kind enough to answer one question for me. The figures that I presented on embryo freezing show that there were 909 births, some of which miscarried. However, it is clear that at least 42,000 treatments with embryos were given to different women in that period of time. That is a massive disappointment for women who are hoping to preserve their fertility. Even that figure is clearly an underestimate. I repeat my question to my noble friend Lady Merron and request that she be kind enough to write to me explaining why the HFEA no longer keeps these figures in the way it used to. It is really important to find out what is happening.
Baroness Blake of Leeds (Lab)
I am delighted to say that I will pass on my noble friend’s comments to the noble Baroness, Lady Merron. As I said, she will follow up on further comments that he has made today. I was struck by the statistics that I looked at and that my noble friend has raised in the debate today. In this day and age, we should make sure that we have up-to-date data to analyse. We have the tools to do it, and we should make sure that everyone involved makes full use of that opportunity.
Terminally Ill Adults (End of Life) Bill
Debate between Lord Winston and Baroness Blake of LeedsFriday 13th March 2026
(2 months, 4 weeks ago)
Lords ChamberRead Full debate Terminally Ill Adults (End of Life) Bill 2024-26 View all Terminally Ill Adults (End of Life) Bill 2024-26 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: HL Bill 112-XI Eleventh marshalled list for Committee - (11 Mar 2026)
Baroness Blake of Leeds (Lab)
I completely recognise the noble Lord’s strength of feeling, which he has expressed on many occasions. However, I just reaffirm that we would go through a process for determining the mechanism around the matters that he raises should the Bill progress, and that is a clear point from the Government in response to his—
Lord Winston (Lab)
I wonder whether my noble friend the Minister might be able to help me. I presume that the Government would look at the extensive literature that is available in medical and scientific journals on the action, tests and usage of these drugs in a number of sovereignties where they have been used successfully for assisted dying.
Baroness Blake of Leeds (Lab)
As always, my noble friend raises an important point. I will go on to talk about the whole issue of substances, so if I do not address the points he raised, I will be happy to speak or write to him afterwards to make sure that he has had the clarification he requires.
Sudden Cardiac Death: Screening for Young People
Debate between Lord Winston and Baroness Blake of Leeds
Baroness Blake of Leeds (Lab)
I am not convinced that the evidence is as categoric as the noble Lord asserts, but I am delighted to tell the House that the UK National Screening Committee will open a public consultation on sudden cardiac death screening in the spring. It is crucial that we let it do its work and bring all the evidence forward to make sure that we come forward with the right approach to a desperate situation.
Lord Winston (Lab)
My Lords, does the Minister agree that the UK National Screening Committee is an excellent body doing a fine job of work? It is interesting that this is the third Question on screening we have had in the past two months of parliamentary work. What we see is that screening that is not focused is not only not valuable but risky because it causes a great deal of harm to perfectly healthy people. Will she point out that focused screening is what we need and that that requires considerable scientific endeavour? I think we are endeavouring to do that at the moment.
Baroness Blake of Leeds (Lab)
My noble friend raises the crucial point about the NSC. I emphasise again that it has a well-earned international reputation for rigour and for making robust, evidence-based recommendations that stand up to scrutiny. My noble friend is right that we have to understand that introducing population-level screening for some aspects can cause harm, and we have to be mindful of that, let the experts do their work and come up with the best way forward for the majority of people.
Weight Loss Medication
Debate between Lord Winston and Baroness Blake of Leeds
Baroness Blake of Leeds (Lab)
Quite a few points were made there. I think the noble Lord is referring to reports about acute pancreatitis, for example. The MHRA has done a thorough review of the suspicions around these medicines. No new safety concerns were identified but, every time something comes up, it will be looked into. The noble Lord is absolutely right that we need to support the longitudinal studies that are happening, but going on beyond the initial licensing will also be critical. As I answered previously, work in other areas to encourage healthy lifestyles will be ongoing, and this will need to be taken seriously by patients from a very young age.
Lord Winston (Lab)
My Lords, the causes of obesity are many, not just one or two issues. Has my noble friend the Minister considered whether some sort of pilot programme looking at particular types of obesity might be sensible, just as the questioner has, in effect, already asked? I agree that the long-term effects are really important and must not be forgotten.
Baroness Blake of Leeds (Lab)
My noble friend raises an important point. I would not stand at the Front Bench and counter what he has said. I will be very happy to pick up his ideas after this session and look at all the innovative ways in which we can take future work forward.