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Baroness Andrews: My Lords, it has been a very distinguished debate and I am particularly glad that the noble and learned Lord, Lord Mackay, was here to take us back to the origins of these regulations. As we expect in this House, the dilemmas which are represented by the professions and people outside are well represented here. Although it is unusual for me to find myself not in agreement with my noble friends Lord Turnberg and Lord Winston—the latter could not be in his place—we do of course listen very closely to their views, as we listen to those of all who have spoken in this debate. It has been extremely thoughtful indeed.
I do not want to reiterate any of the detail, but will try to address the issues that have been raised. They have ranged fairly far and wide, but it seems that one of the overriding questions has been the issue of the shortage of donors. While noble Lords have welcomed the idea of a campaign, some issues have been raised about it. As the noble and learned Lord, Lord Mackay, put it, why are we right to be optimistic? Indeed, the noble Earl, Lord Howe described this as "blind optimism". In so far as our policy has to be evidence-based, I think that we have used the evidence that is available. This suggests that there may well be a temporary drop and we must be prepared for that. This is why we have put aside
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£200,000 to be invested in the campaign in the first instance. Trying to draw in new donors and to make them—I address this point particularly to the noble Lord, Lord Alton—fully aware of their responsibilities is a very serious undertaking. Those responsibilities are greater now that they include the potential for being identified.
Apart from a campaign—and it is something which we have every intention of taking seriously—I should like to make some other points about the supply of donors. It is possible that fewer live births per donor will be permitted under the regulations. The noble Earl, Lord Howe, raised that issue. The number might be three or five, rather than 10, so we will need to increase the number of donors. Two hundred sounds like a small number of donors, but there is a high attrition rate, and there is a huge gap between the number of people who put themselves forward and the number of those eventually selected. It is a serious undertaking.
Lord Alton of Liverpool: My Lords, before the noble Baroness leaves the issue of the campaign that is to be waged next year, I want to know the answers to my two particular questions about the cost of the campaign and whether it would emphasise the risks to women involved in egg donation.
Baroness Andrews: My Lords, I answered the question on cost: £200,000 has been set aside. As for the risks to women, every donor who comes forward for egg donation or sperm donation is told whether there are risks to their health. We will continue to do that.
Another reason why we can be fairly optimistic about our stocks of gametes is that, although it is hard to get the information, some clinics tell us that their stocks are high and that they have enough for a year and some tell us that they have stocks for more than a year. So, we have a temporary respite. We will, of course, liaise with the National Gamete Donation Trust to make sure that clinics are as fully prepared as possible. We also know that the technology is changing. I understand, for example, that, in Sweden, there are new technologies that enable sperm to be kept for longer. We are not going into an identical situation, and we can bring in gametes from other countries, provided that we can source them and identify them. So, there are other sources. I hope that that helps noble Lords to understand the background.
Several noble Lords raised the important issue of research. The research that I quoted is unpublished, which is why noble Lords will not have come across it. It is about to be published. The researchers are well prepared to do further work, and we will look at it with great interest. I take what the noble Earl, Lord Howe, my noble friend Lord Turnberg and the noble Lord, Lord Patel, said on that point. We recognise that, as the noble Lord, Lord Alton of Liverpool, said, there is
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a need for more research on infertility, and we are putting increasing amounts into medical research as a whole.
We would consider whether there was a need to widen the scope of the 1990 Act to cover fresh sperm, if we needed to take such a step. The noble Lord, Lord Alton of Liverpool, spoke about how women should not be put under pressure to donate eggs. It is a fundamental part of the whole arrangement that people are not put under pressure. They are voluntary donations. When it comes to egg sharing and altruistic egg donation, a great deal of counselling goes on. I was not making a direct allusion between blood donation and gamete donation; I was simply commenting that the notion of a gift relationship goes back a long way.
The noble Lord also asked why the measures were not retrospective. Historically, donations have been made under conditions of the strictest anonymity, and we would break faith with those donors if we made the legislation retrospective. That is an ethical position that I think the noble Lord will accept.
I was also asked about the future of the HFEA. The noble Lord is right: there is a review of arm's-length bodies, including the HFEA. We will have to wait for the outcome, as the matter is still under consideration.
In relation to the details of the advertising campaign, we are developing that campaign by liaising with the National Gamete Donation Trust, the Infertility Network, the Donor Conception Networks and the clinics themselves, so it will be put on a sophisticated footing.
I was asked why we do not allow information to be made available to those under 18. The age of 18 is in the primary legislation and these regulations cannot address that. That is why the information will become available at that point.
The noble Lord, Lord Alton, asked whether embryos can be donated for uses other than fertility Treatment; for example, stem cell research. Embryos are donated with informed consent, and this must include informing the donor. It does include research, including stem cell research. I cannot give the noble Lord the figures he seeks, but I will certainly do so if I can.
I hope noble Lords will forgive me if I have left any other questions unanswered. I shall not reiterate what I have said. I am grateful for the support the regulations have received. We are acting in good faith. While I would not say that we are dealing with futurology, it is certainly difficult to know what the world will look like in 18 years' time. We have done our very best to keep faith with all the people involved in these provisions, but we cannot be expected to have all the answers. I believe that the changes achieve a balance of rights and interests and I am happy that they seem to command the majority of opinion in the House.
On Question, Motion agreed to.
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Health Professions (Operating Department Practitioners and Miscellaneous Amendments) Order 2004
Baroness Andrews rose to move, That the draft order laid before the House on 28 April be approved [18th Report from the Joint Committee].
The noble Baroness said: My Lords, I am going to cut short my speech, in view of the hour. I propose to write to noble Lords if they want further information about training opportunities, and so on. I shall whizz through as fast as I can.
The order will introduce statutory regulation for operating department practitioners—ODPs. It will strengthen public protection for patients undergoing operations by setting and maintaining in law standards of practice, training and conduct for this group of healthcare staff who are closely involved in the delivery of patient care. It will bring ODPs in line with their medical and nursing colleagues who work in the same area.
I do not know how much noble Lords know about ODPs. I knew very little, and I am very impressed with what I have learnt about the role they play. They are important healthcare professionals who have to ensure that every operation is as safe and effective as possible. Their work takes in the whole range of peri-operative care, from preparing anaesthetics right through to taking care of the patient when they are coming round.
The history of the profession goes back to the 1970s. I shall not rehearse it, but I will say that the qualifications over the years have changed as the role itself has developed. We have moved from an NVQ to a Higher Education Diploma in Operating Department Practice, which will come into operation this October.
ODPs are skilled members of the medical team, and they are important to ensuring the patient's recovery. Not only are they employed within operating departments, but they are also now being employed in accident and emergency and cardiac arrest teams. If we are to deliver a modern and responsive health service, we have to ensure that they meet national standards set by an independent regulator.
The order has the warm support of the Association of Operating Department Practitioners and the entire profession. But if they are to benefit from Agenda for Change, they have to be able to register by October 2004. Failure to do so could damage recruitment and retention of ODPs.
The protected title is proposed, as it is currently in use by practitioners and recognised by members of the public. We are not going to protect alternative
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titles, such as "anaesthetic practitioner" or "surgical practitioner", since these titles are already in use and they reflect different roles. We propose to protect the single title of ODP.
The legislation also proposes opening a new part of the HPC register for ODPs. This means that there will need to be new members of the council—registrant, alternate and lay. This will increase the HPC from 12 practitioner members and 11 lay members to 13 practitioner members and 12 lay members. I am sure noble Lords will know that once ODPs are regulated they will have to pay fees of £60.
The order has been the subject of extensive consultation over three months and has attracted, I am pleased to say, broad agreement. The provisions of the order are compatible with the European Convention on Human Rights.
This programme has grown out of the order that set up the Health Professions Council in April 2002, which was designated with the power to regulate new professions that were currently unregulated. This is the first new profession to be covered in this way. It will be followed by applied psychologists in 2004; healthcare scientists in 2005; and psychotherapists and counsellors in 2007–08.
The effect of the order will be to bring ODPs within the remit of the Health Professions Council, the role of which is to set standards of proficiency, conduct, performance and ethics under Article 21 of the HP order; to set standards of education and training under Article 15 of the HP order; to maintain a register of those who meet the standards and are fit to practise under Article 5 of the HP order; to have a mechanism for investigating complaints; and to deal with registrants who cease to meet the standards by taking any necessary action. That, of course, will be the responsibility of the HPC's "fitness to practise" system.
I shall conclude my contribution at this point. I have available a great deal of detail about how we shall incorporate the Association of Operating Department Practitioners, which has brought the profession to this point. I pay tribute to it. There are 6,000 members already on the voluntary register. There are a further 10,000 outside it, many of whom share the same training and qualifications. We wish to make sure that such people are also registered because they have the right qualifications. To ensure that people who came into the profession early are able to register, grandparenting arrangements have been introduced to enable them to prove that they also have the right training and qualifications. I shall happily write to noble Lords about how we intend to achieve that.
With that very short explanation, I commend the order to the House.
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Moved, That the draft order laid before the House on 28 April be approved [18th Report from the Joint Committee].—(Baroness Andrews.)
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