Public Bodies Bill [HL]

Baroness Deech Excerpts

Monday 9th May 2011 Lords Chamber

Moved by

[Baroness Deech]

7: Schedule 5, page 22, line 11, at end insert—
“2 An order may not be made in respect of the Human Fertilisation and Embryology Authority or the Human Tissue Authority unless an independent assessment indicates that making such an order under section 5(1) would increase the cost-effectiveness of the functions exercised by that Authority.”

[Baroness Deech]

My Lords, in a nutshell what I and others are calling for is that the HFEA and the HTA should remain untouched until a new research regulatory body is in place with its own statute ready to receive those functions, and that in the mean time there should be a wholly independent external review of the HFEA.

The HFEA is like no other quango. Its work touches deeply on the intimate lives of the one in six couples who cannot conceive naturally, the health of babies, scientific research, cures for diseases now and in the future, the profits of scientific companies, and public morality. It is unique, has an international reputation and was a British first. I am seeking to preserve it from being shattered and to prevent lasting damage being caused to that area.

The HFEA and the Human Tissue Authority, to which similar considerations apply, are both listed in Schedule 5 as bodies that may have their functions transferred or modified under Clause 5. In Committee and at Report, amendments were tabled to remove the HFEA and the HCA from that schedule but, for various reasons, the proposal was not voted on but withdrawn to give the Government a further chance to reflect on the damage that it seems to us will be done, which we were convinced would persuade the Government to change their minds. This did not occur. Indeed, it seems that the Government are developing policy in this area as they go along. I sometimes suspect that behind closed doors there would be relief if the amendments being looked at by the House today were to succeed.

The first two amendments in the group are set down in my name and those of the noble Baroness, Lady Warwick, the noble Lord, Lord Walton, and the noble and right reverend Lord, Lord Harries, who cannot be in his place today because he has an unbreakable prior commitment but is giving his full support. The amendments seek to rectify an omission—the need for an independent review—and to prove a point that change in the organisations will be for the worse.

We have the support of the key organisations in this field—the Association of Clinical Embryologists, the British Fertility Society, the British Infertility Counselling Association, the BMA, the RCN, the RCOG and the Infertility Network UK. They do not consider that the HFEA should remain in the Bill because there has been no full and impartial public review of the risks and benefits of the new proposals, including the financial costs of all the options. However, as I have said, the removal of the two bodies from the schedule is not now a possibility. There is agreement that there are some elements of its remit that the HFEA could do better. Therefore, there should be an independent external review of the HFEA, with the aim of reducing bureaucracy, increasing accountability and saving money—albeit that the cost to the public purse is only £2 million and can be reduced. Even those who are most critical of the HFEA cannot oppose these two amendments, which call for just such a review.

The consultation proposed by the Government is not at all the same. No doubt the HFEA’s working practices could be streamlined with other regulators. Efficiencies could be found in the back offices and research regulation could be improved. However, there was no need to include the HTA and the HFEA in this Bill. No matter how irritating the HFEA may have been found to be by clinicians, they must surely welcome a review, for if they accept the Government’s way forward the irritations will no doubt increase and there will be no improvement of those functions.

I wish to say a few words about the third amendment, Amendment 9. Just shifting the HFEA into the Care Quality Commission will not achieve money savings or efficiency. The shift will not meet the objections of the professionals to some of the ways in which the HFEA works. I am saying: do not take it apart but make it better, with an impartial review by, for example, the King’s Fund, the Nuffield Foundation or the Wellcome Trust. Indeed, the proposed overarching regulatory body could work with the HFEA to achieve the aims desired by the Government. By splitting away the research functions of the HFEA as the Government propose, there is the risk of creating additional bureaucracy and increasing, rather than diminishing, the burden of regulation. The HFEA and HTA functions will be transferred to the Care Quality Commission, and research will go to a new body that has not yet been created. There is to be consultation about that reallocation of functions, even about the database—perhaps the most important feature to be concerned with in dismembering the HFEA—but in the mean time, the shadow of destruction hangs over the HFEA. That will affect staff morale and retention, and the confidence of scientists and clinicians, who rely on it for legitimacy and guidance, not to mention international respectability.

--- Later in debate ---

[Baroness Deech]

I thank the noble Lord the Minister and all noble Lords who have spoken. However, I particularly thank the noble Lord the Minister who has, as others have said, been very attentive throughout the passage of the Bill to the concerns of those involved in this field. I know that he has the best interests of the HFEA, the HTA, and all the people involved in them, at heart. When the noble Lord the Minister says that he gives a firm commitment, the whole House believes him and relies on his word.

The noble Lords, Lord Alderdice and Lord Winston, pointed to problems: in one case in the HTA; in the other in the HFEA. However, those points, and the points made by the noble Lord, Lord Patel, are irrelevant as, whatever problems there are with the HFEA and the HTA will not be solved by moving them lock, stock and barrel to another agency, because, as we all know, the human fertilisation and embryology Acts will remain. I say to the noble Lord, Lord Winston, that there is nothing that the agencies can do about costs. They are not able to fix costs. We all wish that the NHS would take on IVF; that would provide a solution to all our problems. However, no one can seriously imagine that if regulation were transferred to another government department, charges would somehow mysteriously come down, the patients would be charged less and nobody would make a profit. Indeed, the stories that the noble Lord, Lord Winston, shared with the House show precisely why regulation is necessary. If the doctors are all competing and jostling for pole position, this again confirms the need for regulation by a body other than a purely medical one.

It is also the case that the law is involved. I am sorry to say this about my fellow lawyers, but there are many things that the HFEA and the HTA cannot do, or cannot do more vigorously, because of the way in which the Human Rights Act came in on top of the existing human fertilisation law and shifted it much more towards the individual, the requirements of the Competition Commission and the requirements of the Data Protection Act, which make it very hard to carry out the research that we wish could be undertaken. If ever there was a case for calling for an external independent review, which is what at least one of these amendments calls for, the noble Lord, Lord Winston, has made the case because all those points can be looked at by an external impartial review, which is what we are calling for.

Although there is no time to go into this, other countries do have regulation such as is carried out here. Israel has a system for considering cases on a one-by-one basis. Canada is emulating us. Surely we do not want to be like the USA where recently a woman gave birth to octuplets. Noble Lords who have a spare moment can go online and look up Cryobank and see sperm for sale. Usually the students involved are called Randy and have a PhD from Berkeley or Stanford and sell their sperm online. We do not want to go down the unregulated route followed by the USA. I know from my involvement with the HFEA that we were bombarded all the time with concerns from the public. Many noble Lords will recall that when the HFE Act was revised in 2008, members of the public lined the streets across the road and waved banners that depicted their fear about hybrid embryos as they showed embryos that were half man and half horse because they did not understand the subject yet it meant an awful lot to them. Therefore, it is very important that regulation is put in place. I should not say that the issue was more important than abortion or neonatal care, but all these areas have their own special regulations and laws taking care of them, as this area should do. The points made by the noble Lords, Lord Alderdice, Lord Winston and Lord Patel, perfectly make the case for an independent review.

The noble Earl, Lord Howe, to whom I am extremely grateful, seems to have given a firm commitment that there will be only one transfer, if it ever happens, of the functions of the HTA and the HFEA—one jump straight into new bodies that will have been firmly established by legislation. That is very satisfactory and I am grateful to those who have listened to that case. I know it is difficult, but they have listened and we should be appreciative of that.

That leaves just one area of disagreement—the nature of the review. I do not wish to sound sceptical, but government reviews and consultations often start from a particular point of view and present rather limited options, and in the end the Government may well do what they wish anyway. I believe that given the range of problems that have been revealed, not just when I was addressing your Lordships’ House but by expert speakers on the Floor, there is a strong case for a wholesale review by an external learned body before the HFEA and the HTA take the irreversible move into the new bodies, when they are established.

Therefore, the points that lie behind certainly Amendments 7 and 8 have not been met and I wish to test the opinion of the House on Amendment 7.