The Bishop of Chelmsford spoke in a debate on the regulation of fertility treatments, emphasising the importance of the issue and the need for consideration in forming policy:
The Lord Bishop of Chelmsford: My Lords, I recognise the depth of expertise in this Chamber and that my background is not a scientific one. However, it is incumbent on us all to engage in these crucial issues, which hold wide significance and implication. I approach this debate in the knowledge of what it is to long deeply for children. I am profoundly grateful for the gift of my own three children following the experience of difficult and intrusive treatment over many years, including miscarriages and several cycles of IVF. Indeed, if I may be personal, I was for a number of years a patient under the care of the noble Lord, Lord Winston, for whom I have both affection and great admiration and to whose speech I listened very carefully indeed.
I want to recognise the highly complex and agonising experiences of infertility that many go through, and what it is like to have an unfulfilled longing for a child. This debate takes place in a profoundly challenging scientific, moral, legal and emotional context. I recognise that the lives of my children are the result of extraordinary scientific and medical advances, but, ultimately, like any child, they are a remarkable gift from God. Throughout the treatment, I was always aware that they were never a right of mine to be claimed. Good legislation, thoughtful limits and sober weighing of the implications of those limits are vital if we are to continue responsibly in this work with clarity for all. Indeed, I know personally the importance of those limits for tempering what can be a very human dimension, which, if unchecked, can lead to desperation and a willingness to do anything to have a child.
I turn to the HFEA’s proposed changes to the law in its 2023 report. The Church of England’s policy team responded to the consultation about the recommendations put forward at the time, which I am also drawing on. They and I recognise the important issues highlighted and the need for a regulatory update, especially around patient safety, licensing and the HFEA’s ability to incentivise compliance within fertility clinics. With the development of the online world, the landscape for people accessing information and selecting their options is changing significantly. There is much misleading advertising on social media, including claims about the guaranteed success of IVF treatment. On such a highly emotional and charged issue, this is deeply troubling and there is a clear case to be made for ensuring stricter regulation of services. The moves towards patient safety and the HFEA having sufficient powers to take action where patient safety is at risk also seem clear to me.
However, some of the proposals in the HFEA report must be considered with more caution. First, it highlights the 14-day limit on embryo experimentation as something that could be changed in the light of scientific developments. In 2003, the General Synod of the Church of England affirmed
“the sanctity of the human embryo and therefore the need to treat it with profound respect”.
Though I recognise the possibility for research into the development of embryos between 14 and 28 days, and, from that, the possibility of therapeutic benefit, it remains the case that individuation and identity are significant to moral status, so I believe that the 14-day limit should not be overstepped.
Secondly, the report proposes changes to the way consent is obtained. In order to prioritise patient safety and access to the best possible care, it seems vital that information can be shared with other healthcare providers. My caution is around the proposals related to changing the consent approach to one which is package-based. Anyone undergoing or considering fertility treatment and having a conversation with a specialist is likely to be experiencing intense stress and possible feelings of overwhelm. That is precisely why it is essential they understand absolutely what they are proceeding with. Each part of the process is weighty and should be considered carefully, according to the conscience of the individual or couple concerned. It is right, proper and honouring of them to ensure that this weighing-up is enabled and facilitated.
Similarly, with the proposed change to the consent regime for research on embryos, if a decision has been made to donate embryos to scientific research, there is likely to be a variety of preferences and approaches. Though some may be content for their embryos to be used for any available research, this will not be the case for everyone. Maintaining the requirement for consent to each named project will be important for some and so should not be overlooked.
I have touched on just a handful of issues for consideration in this complex and important debate. What is clear is that, if legislation is to be brought, it must be preceded by full consultation which facilitates public understanding and engagement. These are matters not only of personal importance, though I understand that dimension all too well, but of societal importance, and any proposals to change the law must be treated with both compassion and great care.
Extracts from the speeches that followed:
Baroness Shawcross-Wolfson (Con): My fourth and final question is: what do children need? Even if a surrogate mother is consenting freely and the commissioning parents will provide a loving home, how do we centre the child in the practice? In all other circumstances we would consider it traumatic for a newborn to be removed from its birth mother. Does that trauma exist for babies born to surrogate mothers? The adoption framework has evolved over decades as we have come to understand, often painfully, that questions of identity and origin matter deeply to children as they grow.
Many children born to surrogates will never see their birth mothers again. Does that matter, and if it does, how can we best support them? What those children need from us is expertise in child development—expertise that has generally been missing in this debate so far.
These are sensitive and emotive questions, but they are hugely important for the women and children involved. So, if this Government, or a future one, conclude that reform of surrogacy is the right path, I very much hope that they will commit to significantly more work and a full, open and, as the right reverend Prelate the Bishop of Chelmsford described, compassionate debate on these issues before the legislation comes to this House.
Baroness Pidgeon (LD): My Lords, I thank the noble Baroness, Lady Deech, for bringing forward this important short debate and for her work in this area. I am also grateful for the richness of the debate from noble Lords across the House, and with such expertise, and for the personal contribution from right reverend Prelate the Bishop of Chelmsford.
One in seven couples may have difficulty conceiving, and as the noble Baroness, Lady Nargund, stated, there is now roughly one IVF child in every classroom, with IVF births making up around one in 32 of UK births. The number of patients having fertility treatment has increased over the last 30 years—over 52,000 in 2023.
The noble Lord, Lord Winston, stated that there are more than 100 reasons for infertility, which are not always investigated, but the noble Baroness, Lady Boycott, highlighted for us the issue of plastics and chemicals and their impact on fertility.
As we have heard today, there is a postcode lottery of access to IVF and fertility services across the country, which is undermining the hopes and family life of many couples. Patients in England are struggling to access publicly funded IVF, despite the NICE recommendation that has been in place since 2004 that the NHS should offer an initial three full cycles of IVF treatment to any woman under the age of 40. A briefing from the Progress Educational Trust highlighted that only two out of the 42 integrated care boards in England comply with the NICE fertility guidelines, and 19 offer only a partial IVF cycle, not even a full cycle. This means stopping treatment before all the viable embryos already created have been transferred.
The Earl of Effingham (Con): The right reverend Prelate the Bishop of Chelmsford talked about social media disinformation. My noble kinswoman Lady Boycott referenced the “Wild West”. The noble Baroness, Lady Gerada, pointed to hope that has been sold. The regulatory gaps become particularly visible in relation to online fertility services, where patients are increasingly looking for advice from charity websites, social media, online forums and clinic websites. Patients are increasingly encountering providers marketing themselves as offering “fertility services”. However, key clinical interventions take place elsewhere, sometimes under separate regulatory arrangements and sometimes outside clear regulatory oversight altogether. Patients may reasonably assume that a service presenting itself as a clinic-equivalent is fully regulated. However, as the noble Baroness, Lady Nargund, agreed, it can be a mistake to make assumptions. The fertility sector has evolved rapidly, with new online models and commercial networks that do not fit neatly within the assumptions of the 1990 Act. This is precisely the kind of gap that undermines transparency and public confidence, notwithstanding the related issue concerning surrogacy reform.
Baroness Blake of Leeds (Lab, Government Whip): To the point made by the noble Lord, Lord Palmer, on setting financial penalties, I say this would also need to be considered as a part of the broader update in regulatory powers. The other absolutely critical area covered by so many noble Lords, including the noble Baronesses, Lady Gerada and Lady Deech, the right reverend Prelate the Bishop of Chelmsford, and the noble Lord, Lord Winston, is the whole issue of consent. The Government recognise concerns raised by noble Lords on the complexity of consent arrangements, including withdrawal of consent and ensuring patients fully understand the legal implications, and we will consider all these issues as part of any wider reform.
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I recognise the need to update the Act. On the significant changes in fertility and scientific innovation we have witnessed and the comments by the right reverend Prelate the Bishop of Chelmsford, I am sure she will appreciate that any reform must be approached in a considered and balanced way, given the ethical sensitivity and complexity of this area.
On the issues raised about the lack of clarity on the fate of embryos for those families who very sadly could not continue treatments, any future reform would include a review of issues relating to digital clinics and how we might move forward to improve the regulatory regime in the digital area.
The Church of England in Parliament 
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