Human Fertilisation and Embryology Bill
Second Reading, House of Commons
With a membership of almost 400,000 registered nurses, midwives, health visitors, nursing students, health care assistants and nurse cadets, the Royal College of Nursing (RCN) is the voice of nursing across the UK and the largest professional union of nursing staff in the world. RCN members work in a variety of hospital and community settings in the NHS and the independent sector. The RCN promotes patient and nursing interests on a wide range of issues by working closely with the Government, the UK parliaments and other national and European political institutions, trade unions, professional bodies and voluntary organisations.
The Royal College of Nursing is broadly supportive of the Bill and welcomed the Government’s decision to retain the Human Fertilisation and Embryology Authority and the Human Tissue Authority as distinct agencies given the extensive and complex remit of these bodies. This briefing focuses on areas of particular concern to RCN members working in fertility services.
Embryo testing: sex selection
The RCN supports the view that regulations may not authorise testing embryos to establish their sex or other sex selection for social reasons except on grounds relating to the health of any resulting child.
Consent to use or storage of gametes, embryos
The RCN welcomes the changes in consent in relation to storage and use of embryos to bring greater flexibility and clarity for patients. From a nursing viewpoint, fertility nurses who support patients on a day to day basis and provide the continuity of care recognise patients are very diverse in terms of their needs, situation and capacity. These changes better represent the diversity of the patient experience. In addition it will allow patients who are physically incapacitated to charge a third party to sign consent.
The RCN considers that the storage period for gametes and embryos should be limited. We believe it would be a considerable burden and an enormous logistical task to manage and audit large numbers of gametes and embryos in storage. However, the RCN would support the amendment that alters the maximum statutory storage limit for embryos to bring it into line with the ten year maximum limit applicable to the storage of gametes.
Welfare of the child
The RCN recommends that the ‘welfare of the child requirement’ remains within the legislation. RCN guidance on safeguarding children recommends it is “every nurses’ business” to take into account the welfare of the child. The RCN believes that it is for the regulatory body and professional organisations to agree specific guidance that is based on general good practice, is consistent between clinics and is proportionate and in line with discrimination legislation.
The RCN supported the original drafting of the Bill that removed the provision for ‘the need of that child for a father’ from the existing conditions of licences for treatment. Article 12 of the European Convention on Human Rights gives each citizen a right to “marry and found a family”. The ECHR has been incorporated directly into UK law by the Human Rights Act 1998. The RCN notes that the wording of section 13(5) of the HFE Act 1990 may be considered discriminatory as it could deny access to fertility treatment to woman for the reasons set out in the section.
Following significant debate in the Lords the Government tabled a compromise amendment. This amendment inserted the requirement to consider ‘the child’s need for supportive parenting’ into the provision of the welfare of the child. The RCN broadly supports this compromise but is concerned about the differing interpretations of ‘supportive parenting’. It will be necessary to ensure ‘supportive parenting’ is clearly defined to make certain there are not variances in implementation.
Parenthood in cases involving assisted reproduction
In principle we support the proposed changes as it reflects our changing society and the increasing number of civil partnerships that are undertaken in the UK. From a nursing viewpoint this better reflects the patient experience and the diversity of patients attending fertility units. It also encompasses the holistic management of the client and their partner.
Informing donor conceived children about their origins
The RCN supports the Government’s amendment made in the Lords that will require clinics to provide prospective parents receiving treatment with donated gametes about the importance of telling their children from an early age that they were donor conceived.
Restrictions on disclosure of information
The RCN welcomes the new section 33C Disclosure for the purposes of medical or other research (1) regulations (a) and (b).
However, the RCN does question the need for the regulations to allow for the establishment of a separate body to assess the applications that may be submitted. The existing regulatory body should be able to fulfil this function.
Royal College of Nursing
7 May 2008