Stem Cell Research

My Lords, I am extremely grateful to the noble Lord, Lord Patel, for raising this important matter today. I pay tribute to him as chair of the UK Stem Cell Bank Oversight Committee and of the newly launched UK National Stem Cell Network. In his excellent opening speech, he referred both to achievements and to some of his concerns about the direction of the approach to stem cell research. I will of course respond to him as well as I can. I start by saying that I very much agree with the noble Earl, Lord Howe, about the outstanding quality of this debate in your Lordships' House. As the right reverend Prelate the Bishop of Newcastle explored some of the ethical considerations, I, and many noble Lords, I am sure, recalled the extraordinary seven-hour debate that we had in 2001 on the regulations. I pay tribute to the noble Lord, Lord Harries, for his subsequent work on the Select Committee established as a result of the amendment moved by the noble Lord, Lord Walton, to those regulations. The noble Baroness, Lady Carnegy, took usback further than that to the original Act and tothe outstanding work of the noble Baroness,Lady Warnock. She modestly described herself as alay person today, but it was surely her clear understanding nearly two decades ago of the wide-ranging ramifications of potential advances in science which paved the way for legislation that anticipated some future developments and has stood this country in such good stead. I echo the remarks of the noble Lord, Lord Harries, about the robustness of that legislation. Although I disagree with the noble Lord, Lord Alton, I have always respected his views. As ever, he made a powerful contribution to our debate. Like the noble Lords, Lord Patel and Lord Soulsby, and the noble Baroness, Lady Neuberger, I am convinced that stem cell research offers us an unrivalled prospect for the treatment of a whole host of illnesses, such as degenerative diseases that have been mentioned today—Parkinson’s, certain forms of diabetes and strokes. Looking at the debates that we have had on health issues during the past few months, whether about funding, research or specialty nursing, it is remarkable that so much of that debate has focused on the degenerative diseases on which we are so keen to enhance our knowledge, the devastating consequences of which are lived and experienced by so many people in our country today. The noble Baroness, Lady Greenfield, eloquently described the potential of the research on stem cells. I was struck by her reasonable confidence, as she described it, and that of the noble Baroness, Lady Finlay, who outlined some of the potential extensions of research to, for instance, heart disease. The noble Lord, Lord, Crisp, emphasised the importance of the impact of the research on services and, more particularly, on the National Health Service. That is an important consideration not only for the services to be provided but for the architecture of services which need to be planned and developed over the next 10 to 20 years; indeed, there could be an enormous impact on workforce considerations. In visioning out where healthcare needs to be over the next 20 years, we need to take into account this and other kinds of research. In the past, we have not been able to do that as effectively as we might have. We must also ensure that the intelligence that we can get from the pharmaceutical industry is made available to the NHS as quickly as possible. It is important that we see how the current pipeline, which I am glad to report looks encouraging in an enormous number of areas, might impact on the way in which we run services in the future. Like the noble Lord, Lord Rees, I am proud of our achievements in this country, for which quite a few noble Lords who have spoken today can take a great deal of credit. I say to my noble friend Lord Winston that I am not at all complacent. I take note of what he has to say about our research effort and the efforts of other countries to invest properly in research. The Government are not at all complacent about where we stand. I agree with the noble Baronesses, Lady Finlay and Lady O’Cathain, and with the noble Lord, Lord Harries, that we wish to support all types of stem cell activity and research. I have not moved one jot from the position that I expressed in 2001. We see these approaches as being complementary, and it is important that we say that again and again. If research in adult stem cells shows promise, I rejoice as much as the noble Lord, Lord Alton. I agree with the noble Lord, Lord Sutherland, that we have to get the balance right with regulation. We have heard criticisms today of the way in which the regulator performs its functions but, as the noble Baroness, Lady D’Souza, said so well, the principles underpinning the UK legislation have stood us in good stead; indeed, they have been replicated in one form or another by many other countries. We are, of course, proposing to overhaul the legislation on the Human Fertilisation and Embryology Authority. I will come back to that in a minute, but I should first respond to my noble friend Lord Winston on the performance of the HFEA. The target performance indicator for dealingwith research licence applications is three months, excluding the time taken for peer review of applications. I understand that the HFEA hits the target rate for 75 per cent of applications and is seeking to improve that performance further. I will come on to deal with the Regulatory Authority for Tissue and Embryos, but my hope is that the arrangements that we will introduce to create that body may enable decisions to be arrived at more quickly, albeit as rigorously as the noble Earl, Lord Howe, suggested. I say to the noble Baroness, Lady Warnock, that I understand the tensions that sometimes arise with local research ethics committees. However, they have expertise in dealing with wider research ethical issues and I believe that many of them have raised their game considerably in the past few years. I accept the challenge of the need to streamline the process so as to remove or reduce any duplication between the HFEA and the local committees. I understand that discussions are under way between my department, the HFEA and the Central Office for ResearchEthics Committees to see how we can do that. My department is also planning to consult on the future role of LRECs generally. The noble Lord, Lord Harries, as a member of the HFEA, made a reassuring point on this. I echo what the noble Earl, Lord Howe, and the noble Baroness, Lady Neuberger, said about ensuring that the regulatory framework provides reassurance to the public. The regulatory framework and the way in which the HFEA conducted its role were highly important in persuading noble Lords in 2001 to support the amendment of the noble Lord, Lord Alton, which allowed the regulation to go through but also established a Select Committee further to advise the House; those factors were a telling point in those debates. I know that there are concerns about the nature of the proposals in the new human tissue and embryo Bill that we will bring before Parliament. First, let me deal with the Regulatory Authority for Tissue and Embryos. I say to those noble Lords who have expressed concerns that we want the best of the HTA and the HFEA to be brought together in the new regulatory body. That will provide a more cost-effective system of regulation. It will ensure that common principles and standards can be applied wherever appropriate. It will also ensure that the risk of overlap between sectors is minimised and that there is continuity at the interface between related areas, such as embryo research and cell therapies. I fully take into account the issues that have been raised today about the importance of regulation, which we will ensure are carefully considered. We will publish a draft Bill, which will allow pre-legislative scrutiny. That will surely enable a lot of these issues to be teased out in a reasonable space of time further to inform the Government in bringing forward the Bill. I understand what the noble Earl, Lord Howe, said. In fact, he said two things. He said that we should be cautious, as we should, and that the science should not march way ahead of public opinion, but he also worried about delays and blight in relation to legislation. He expresses the dilemma in getting the balance right. I cannot give him a legislative timetable, but I assure him that, as far as my department is concerned, we want to get on with this and we understand the need for certainty and stability. Equally, the pre-legislative scrutiny will be enormously important in helping us to understand so many of the issues that have been explored today and to find the best way forward. Your Lordships always rightly enjoy the contributions of the noble Baroness, Lady O’Neill. She made some profound remarks about the status of human cells. She suggested reasons why such research should be sanctioned and spoke of the ethics around egg donation. I know that a number of noble Lords agree with what she said. That brings us to the question of public engagement. My noble friend Lady Kennedy, as chair of the Human Genetics Commission, made a telling point about the need to engage the public. She was right to say that the public have differing views; it is important that they are able to express those views, and that they are taken into account. They should not just be dismissed as oppositionist. We have to take those views into account and give them the respect they deserve. That is why I noted with interest the remarks of the noble Baroness, Lady Carnegy, and indeed the noble Baroness, Lady O’Cathain, about public opinionand confidence. We heard from the noble Lord,Lord Sutherland, who reported on the Alzheimer’s Scotland survey that put forward such a positive view of the impact of research. He made the point, as did the noble Lord, Lord Crisp, that in order for the public to have trust, it is vital that we engage with them and that they fully understand the issue, and I am delighted that the noble Lord, Lord Rees, has said that the Royal Society has produced a document to help them do so. In echoing the remarks about the need for public engagement, we have to have sympathy for the way the HFEA handled the two applications that noble Lords have mentioned. The noble Earl, LordHowe, importantly congratulated the HFEA on the judgment it exercised. It would be all too easy simply to dismiss the authority as putting off a decision, but it has had to exercise a very difficult judgment. Even if we disagree with it, it would be right to acknowledge the difficult role the HFEA has to play, and I hope the noble Lord, Lord Harries, will take that back to the board, alongside what I am sure are legitimate criticisms of some aspects of its performance. The noble Lord, Lord Alton, questioned whether the Government and the bodies responsible for allocating research were being unfair to adult stem cell researchers. He is right—we do not list the different types of stem cell research. My understanding is that the research councils do not do that; they base their funding on the quality of science. I assure the noble Lord that that is right; whenever I have had debates here and noble Lords have argued for funding in a particular area, I have gone back to those funding organisations and suggested they jolly well ought to fund that area, and that is the response I have always received. I understand the issues the noble Lord raises, and I will pursue with the funding bodies the question of whether there is some more knowledge about this that I can send to him and other noble Lords. I say again that I do not see these various avenues of research as being in conflict. Surely they are complementary; surely we all, unless one is ethically opposed to embryonic stem cell research, wish to see the best possible research that can have the most positive impact on patients in dealing with these appalling degenerative diseases. The noble Lord, Lord St John of Bletso, made an interesting point, asking where adult stem cell research has gone and what the delays are in translating that research into treatment. It would be fair to say that stem cells have in effect been used in bone marrow treatments and skin grafts for many years, but perhaps we are only now understanding which stem cells in these sources are important. I understand his frustration about the number of trials and the time it takes for trials to take place, but they are necessary to give us a better understanding of what is happening inside the patient’s body, the best way to treat and, of course, the safety and efficacy issues. I ought to come to funding before my time is up. I understand the issues noble Lords have raised about resources. The Pattison report was very important here. It costed the total amount required over a 10-year period. My understanding is that the projected investment this year is around £45 million, which takes total funding since 2003 to approximately £109 million. Noble Lords have asked me to go on and state what the Government will do in the future, but they know I cannot do that; it depends on the CSR. I fully understand that noble Lords want to make sure that we invest as much as possible in this area, but it has to be seen in the context of overall funding. Recalling past six or eight health debates in your Lordships’ House in which I have taken part, I remind noble Lords that if I were to total up the amount of money that noble Lords collectively wish to spend, it would be a huge figure indeed—and I would add our debates on the Mental Health Bill to the total bill. This is not easy. We understand the priority and the need. The Government have produced a lot of additional resources, but there are other issues that require investment. I pay enormous tribute to the charities under the umbrella of the Association of Medical Research Charities, mentioned by my noble friend Lord Turnberg. The work they have done has been very important in maintaining and encouraging public confidence in this kind of research. I hope the intention is that we work strongly together with those organisations to ensure that collectively the research amount is as high as possible. On funding, I must remind noble Lords that the Chancellor, in his Budget, reinforced his commitment to science by announcing an annual average rate of 2.5 per cent in real terms over the CSR period. I would also say that, on a visit to the US to encourage more investment by its pharmaceutical industry in this country, I found that the quality of our science base is strongly recognised, and we need to do everything we can to enhance that in the future. This has been a remarkable debate that has been extremely helpful to the Government in making the important decisions that must be made on the way forward. I am most grateful to the noble Lord, Lord Patel, for his initiative and for the fine quality of his opening speech.