Fertility Treatment: Selection of Patients (Hansard, 9 June 1993)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, guidance has been issued by the Human Fertilisation and Embryology Authority, by the Royal College of Obstetricians and Gynaecologists and by 929 the Department of Health. The Government have made it clear that health authorities should think carefully before providing fertility treatment to people without a stable family background.

§ Lord Astor of Hever
My Lords, I thank my noble friend for that very helpful reply. What guidelines are given to health authorities to prevent multiple births of the sort recently reported? Will she consider recommendations made in the Warnock Report regarding regional co-ordination of fertility treatment?

§ Baroness Cumberlege
My Lords, the report of the Royal College of Obstetricians and Gynaecologists, which was issued last year, contains advice on the need for careful monitoring to reduce the risk of multiple births. In respect of centres licensed by the Human Fertilisation and Embryology Authority, the authority makes it clear that not more than three eggs (or embryos) should be placed in a woman during any one cycle of treatment.
With regard to my noble friend's second question, we rely on health authorities locally to decide what services are needed. The department recognises that they may require guidance and last August issued an effectiveness bulletin on the management of sub-fertility.

§ Lord Boyd-Carpenter
My Lords, is my noble friend aware that in a recent case fertilisation produced six tiny children in a previously barren woman? Is it not necessary to be very cautious indeed about treatment of this kind with all the dangers that it involves?

§ Baroness Cumberlege
My Lords, I agree with my noble friend. The thought of six babies at once is anathema to me. But I should like to stress that the case in Grimsby was exceptional. That was only the third set of surviving sextuplets to be born in the UK since 1983 as a result of infertility treatment.

§ Lord Molloy
My Lords, in view of the increase in concern among the general public quite recently à propos this matter, would it be possible for the noble Baroness to consider having further discussions with the appropriate medical department, if she has not already done so, or will she seek to obtain their more recent views?

§ Baroness Cumberlege
My Lords, clearly, if the Government's advice is not followed, then there will be a need to re-examine that advice and also to have further discussions with the professions concerned.

§ Lord Orr-Ewing
My Lords, will my noble friend draw the attention of the authorities to the undesirable long-term social consequences of multiple births of this sort? Is she aware that these instances are particularly discouraging to those married couples who are waiting in the queue and who would look after their children within a happy marriage and give them the tender care which is so essential? Is that situation not preferable to getting two unmarried people of doubtful background to harbour six very small children for a long time?

§ Baroness Cumberlege
Yes, my Lords. I agree with my noble friend. At this moment, however, the Government have no plans for an outright ban on infertility treatment for unmarried couples or single women. But the judgment certainly has to be made whether the child will be part of a stable family background. That is the important point.

§ Lord Williams of Mostyn
My Lords, will the Minister bear in mind a slightly different perspective; namely, that there are many good and responsible prospective parents who are unable to have children and who regard that as quite a deep wound, indeed almost a source of bereavement? Does she agree that a rational, organised, not haphazard approach to the matter is needed, so that people all over the country would have equal, sensible, access to the facilities that are available?

§ Baroness Cumberlege
Yes, my Lords. I sympathise with the point that the noble Lord makes. I believe that not being able to have children is, in a sense, a great bereavement. But this particular treatment is still very new. Indeed, six out of seven courses fail. The average success rate of live births from IVF in the main age-group is about 15 per cent. I believe it is right that such a new treatment should be tried out in a few centres first before it is spread more widely.

§ Lord Renton
My Lords, does it not seem from my noble friend's original Answer that there is scope for saving public money on quite a considerable scale within the National Health Service on this matter? Is that a factor that will be borne in mind with regard to the development or otherwise of this service?

§ Baroness Cumberlege
My Lords, it is up to local health authorities to decide where they spend their resources. In this specific treatment a great deal of money comes not only from the National Health Service, but also from private, charitable and research funds.

§ The Duke of Norfolk
My Lords, is it not true that we need further ethical guidelines on this subject? We seem to be wandering around without quite knowing what we are going to do. Will the Minister say what progress the Government are making in seeking those ethical guidelines?

§ Baroness Cumberlege
My Lords, a document has been published by the Human Fertilisation and Embryology Authority for consultation on the question of ethics. The consultation period ended on 1st June. The Government consider that decisions on what, if any, further legislation or controls may be needed are best taken after the authority has advised on the outcome of its consultation exercise.