The latest online event held by the Progress Educational Trust (PET), the charity that publishes BioNews, was 'The Special Status of Mary Warnock: From Fertility Treatment to Embryo Research'. This discussed the legacy of PET's late patron Baroness Mary Warnock, and her work in reproductive healthcare, research and regulation.
Sarah Norcross, director of PET, began by thanking the sponsors before giving an introduction into Baroness Warnock's life. Norcross spoke of Baroness Warnock's strong relationship with PET and her impact on public policy, describing her work as some of the most influential in assisted conception and embryo research. Baroness Warnock is known for leading a committee to discuss the ethics of assisted conception and related research following the birth of the first IVF baby, culminating in a publication in 1984 best known as the 'Warnock Report'. The report paved the way for the original Human Fertilisation and Embryology Act (HFE Act) in 1990, and recommended the foundation of a government authority that would regulate human fertilisation and embryology, leading to the creation of the Human Fertilisation and Embryology Authority (HFEA).
The first speaker was Professor Emily Jackson, professor of law at the London School of Economics. Professor Jackson's talk argued that the legacy of Baroness Warnock is the Report and legislation that has 'stood the test of time', with the Warnock proposals from 1984 still being used today to regulate 21st century science.
Professor Jackson discussed how one of the main challenges faced by the Warnock committee was coming up with realistic proposals when faced with morally challenging questions. The report identified the need for lay representation in regulation, the need for tough sanctions, and highlighted the benefits of using a code of practice within regulation that would allow flexibility and updates in regulation. Most challenging was the importance of drawing some lines and moral boundaries that could not and should not be crossed. The regulatory model created from the recommendations of the report has been very resilient and has worked for other non-departmental government bodies such as the Human Tissue Authority.
Professor Jackson noted that the Warnock Report was relatively progressive compared to the political background of the time where 'Victorian values' were being promoted. The Report does not suggest any statutory restrictions on treatments for single-sex households or homosexual couples, but instead suggests flexible and respectful legislation. The legacy of Baroness Warnock, concluded Professor Jackson, was in her placing value on expertise and demonstrating the benefits of a deliberative approach to law reform.
The next speaker was Professor Sarah Franklin, director of the University of Cambridge's Reproductive Sociology Research Group. Professor Franklin began by emphasising how the birth of Louise Brown was the 'birth of a "legal vacuum"' in which there was no legal precedent for the regulation of IVF, hence the importance of the Warnock Report.
Professor Franklin's talk focused on the 14-day rule suggested by the report, in which embryos can only be kept alive in laboratory conditions for up to 14 days. Professor Franklin argued that not only was this decision a scientific contract, but also a social one, drawing a clear line that would demonstrate that although 'controversial' research would be allowed to proceed, a strict limit would be enforced. The difficulty in drawing this line was that it would never be right for everyone, but even though the HFE Act has been amended the 14-day rule has – so far – endured. Moreover, it has been taken up as a 'default global standard' and has been used as a 'textbook case for developing successful regulatory policy', a testament to the Warnock Report.
The next speaker was Peter Thompson, chief executive of the HFEA, speaking of the impact of the Warnock Report on the HFEA. He explained that the HFEA's powers and work are a product of the Warnock Report, and of the consensus Baroness Warnock managed to forge. He praised the report's approach to scientific, regulatory, and social issues, while noting that its framework enables certain regulatory lines to be revisited, to take into account more recent developments.
Thompson spoke of how the regulatory regime initiated by the Warnock Report has stood the test of time remarkably well, and said that much of it continues to fulfil its purpose. Nonetheless, he added, it would be surprising if an exercise from the 1980s was not showing its age in 2021.
Finally, Professor Alison Murdoch, professor of reproductive medicine at Newcastle University, spoke from a clinical point of view of the impact of the Warnock Report. She said that Baroness Warnock and her colleagues took on a daunting task, and that their report was pragmatic and wise, having benefited patients, practitioners and researchers alike.
Professor Murdoch noted that at the moment, particularly in England, the provision of IVF is dominated by the private sector, and that many couples are childless because of their inability to access healthcare. To resolve this, she suggested that IVF should be considered more of a core service of the National Health Service (NHS).
Professor Murdoch argued that it was time for a thoroughgoing review of the HFE Act, because it needs more incremental adjustments, and there are problems that need 'putting right'. She acknowledged that challenging discussions would need to take place for any changes to be made, and acknowledged some apprehension about reopening the HFE Act in Parliament, but said there had been a shift in the public perception of assisted reproductive technologies and this needed to be taken into account.
Sarah Norcross then invited the audience to ask the panellists questions. Questions focused on changes in the fertility sector, and whether the HFEA's remit needs to be amended.
Professor Murdoch agreed with audience members that there needs to be a focus on improving access to NHS-funded IVF, and Professor Franklin added that the smaller private IVF market in Scotland is a testament to the prioritisation of public funds (see BioNews 1073). Professor Jackson explained that the HFEA has limited powers which relate to what is done with gametes and embryos outside of the body, rather than extending to areas such as advertising and pricing.
Norcross posted a virtual poll, asking whether attendees thought there should be a new inquiry into the regulation of assisted reproduction and embryo research in the UK, similar to the Warnock committee. 81 percent of attendees stated that they thought there should be a new enquiry, and Norcross asked the panellists whether they agreed.
Thompson pointed out that if people wanted speedy change, that an expert committee was not the way to do this. The Warnock Report took two years to complete, and several more years before its recommendations were translated into legislation.
Baroness Ruth Deech, a former chair of the HFEA and a member of the House of Lords, was in attendance and said 'Parliament would be very reluctant to find time for another HFE Act after a Commission'. She argued that it was 'far better to keep extending whatever discretion there is in the Act and use regulations'. There would be significant challenges in establishing a new inquiry.
PET's event gave numerous insights into Baroness Warnock's life and legacy, demonstrating the remarkable impact that her work had on assisted conception and embryo research – in the UK, and also elsewhere.
PET is grateful to the British Fertility Society, the London Egg Bank, Theramex and the journal Reproduction and Fertility for supporting this event.