Baroness Deech asks UK Government to review fertility and surrogacy laws

Peers have called for law reform during two debates in the UK House of Lords, discussing issues including fertility treatment, surrogacy, embryo research and declining birthrates.

The first debate was put forward by a crossbench Peer, Baroness Ruth Deech, who was previously chair of the UK's fertility regulator – the Human Fertilisation and Embryology Authority (HFEA). She discussed proposals from the HFEA for reform of the Human Fertilisation and Embryology Act (see BioNews 1216), and proposals from the Scottish Law Commission and the Law Commission of England and Wales for reform of the Surrogacy Arrangements Act (see BioNews 1185).

'Parliament should plan by setting up a Select Committee to examine the HFEA's proposals to expand regulatory powers, simplify consent rules, modernise donor information provisions and create a flexible framework for future scientific developments,' she said.

Contributors to the debate included former fertility professionals. Professor Lord Robert Winston (Labour, founder of the IVF service at the Hammersmith Hospital, London) argued that 'infertility is not a disease; it is actually a symptom of something wrong.' Professor Baroness Geeta Nargund (Labour, current member of the HFEA and former medical director of CREATE Fertility) disagreed with Lord Winston on this point, stating that 'infertility is a disease, as stated by the World Health Organisation' (see BioNews 536).

Baroness Caroline Pidgeon (Liberal Democrat) discussed the work of PET (the Progress Educational Trust), citing figures from the PET NHS Fertility Funding Tracker which show that only two out of 42 integrated care boards (ICBs) comply with the recently updated Fertility Guideline published by the National Institute for Health and Care Excellence (NICE) (see BioNews 1334 and 1335). She pointed out that many ICBs are offering only a partial IVF cycle, rather than a full cycle as defined by NICE (see BioNews 1342).

Professor Baroness Clare Gerada (crossbencher, former president of the Royal College of General Practitioners) noted that 'the proportion of NHS-funded IVF cycles has fallen to just under 30 percent, the lowest level since 2008' (see BioNews 1195 and 1295) and said that in relation to IVF 'the NHS system has collapsed'. Lord Monroe Palmer (Liberal Democrat) said it was 'very ironic that it is difficult for many patients to access publicly funded fertility treatment in the very country where IVF was originally pioneered'.

Edward Howard, Earl of Effingham (Conservative) picked up on the issue of the NICE Fertility Guideline. He observed that 'access remains highly variable across England, because ICBs are not required to implement that guidance' and pointed to 'a clear gap between guidance and enforceable entitlement'.

Baroness Deech called for 'automatic record sharing between clinics and the NHS central records system'. Baroness Nargund supported this, relating the ambition to the Single Patient Record that forms a key part of the UK Government's Ten-Year Health Plan for England (see BioNews 1297) and that is provided for in the Health Bill currently before Parliament.

However, Baroness Pidgeon observed that such ambitions are at odds with the exceptional degree of medical secrecy that currently applies to IVF (see BioNews 1026). She also pointed to 'a clear desire for the HFEA to be able to permit patients to give generic consent for the use of their embryos in research', which is not an option at present (see BioNews 1219, 1220 and 1268).

Responding on behalf of the Government, Baroness Judith Blake (Labour) said that 'immediate legislative reform' in this area is not possible, because 'the legislative programme for this Parliamentary session is very full'. Baroness Deech replied: 'It might well take some years, but the Government really needs to set up that Select Committee and do the legislative scrutiny right now.'

A second debate on related issues followed immediately afterwards. This began with Baroness Nargund asking the government 'what assessment they have made of the UK's declining birthrates in an ageing population' (see BioNews 1305 and 1340) and observing that 'we still have a postcode lottery for IVF provision, with nearly 70 percent of ICBs funding only one cycle of treatment' (see BioNews 1326).

Speaking for the Government, Lord Philip Wilson (Labour) responded: 'The Government are committed to improving fair and equitable access to fertility services, recognising the significant emotional and health impacts of infertility.'