Public Bodies Bill [HL]

My Lords, I declare an interest because my wife is a pathologist who works in the National Health Service. She does no forensic work. Nevertheless, I declare that interest appropriately. A number of noble Lords have mentioned the importance of the role of the House of Lords in considering such difficult and complex matters. We had plenty of evidence of that even before the Bill came to your Lordships' House, at least in debate on these two issues. Indeed, we had a very fruitful debate on 1 February this year in the Moses Room on the questions. There is a great deal to commend the amendments, although I have some difficulty with the fact that they link the two bodies. They are quite different in many ways and have a somewhat different track record and set of relationships. I listened very carefully to what the noble Baroness, Lady Deech, said, and I do not disagree with any of it. She put forward her case clearly, but she focused in particular on the HFEA. A whole set of very important issues are involved there, and I hope that my noble friend the Minister may be able to give some kind of comfort to her and her colleagues, because I have a lot of sympathy for her case, as I do for much of what the noble Lord, Lord Walton, said. However, one of the difficulties has been that although there is clearly a need for legislation and for a body that undertakes these matters—the operation of the HTA in Scotland has been rather better than it has in England—it is important to draw to the attention of your Lordships' House that the impact of the way in which the legislation has been interpreted and conducted by the HTA has not inspired confidence, particularly among pathologists. I heard what my noble friend said about that proving what a good thing it is, but that does not show a very nuanced understanding of what is going on. One of the problems, which the noble Lord, Lord Walton, and other medical noble Lords will know very well, concerns the final diagnostic tool, the post-mortem. We all have our thoughts about diagnosis from a clinical point of view but in the end you will get a definitive answer from the pathologist after a full post-mortem and all the investigations. When I was training, the Government’s ambition was that 10 per cent of all non-forensic cases would have post-mortems conducted. Why? It was in order that there would be a proper audit of clinical diagnosis. Is that the case? On the contrary, it has gone completely in the opposite direction. There are whole departments now where month after month scarcely a post-mortem takes place. We are now coming to the point where many members of the Royal College of Pathologists feel completely deskilled in the process of conducting post-mortems because there has been a feeling of a hostile environment in the conduct of post-mortems. We have to recognise this. I shall quote from a letter written in February by the president of the Royal College of Pathologists to the right honourable Andy Burnham, the Minister. It is an eight-page letter from which noble Lords will be relieved to know I will quote only a short amount. The letter states: "““The Royal College of Pathologists does not contest the need for legislation on the uses of human tissues that led to the Human Tissue Act 2004—though we do continue to protest, with others, that aspects of that legislation are not working as intended and that the parallel Scottish legislation is much more sensible. Nor do we deny the need for a regulatory body such as the Human Tissue Authority. But it seems obvious that the HTA and the profession need to work together with mutual respect, and that at present neither group is displaying that respect. The recent actions of the HTA have considerably exacerbated an existing problem. Since the events””—" he refers to earlier events to which he has referred in the letter— "““pathologists will inevitably perceive the Human Tissue Authority as an aggressive regulator, all too ready to wield the force of the criminal law even when, it transpires, a crime has not been committed””—" thus wielding the law against medical practitioners. The letter continues: "““Changes in the attitudes of pathologists cannot be expected to occur without very visible and major changes in the Human Tissue Authority””." The letter goes on to list a page of suggested changes. That is not to say that there should not be some kind of authority or legislation. But it is important to put on record in your Lordships’ House that everything had not been going smoothly and suddenly the Government have come in to knock over something that was working perfectly well. As I say, I exclude the HFEA from that discussion. That is not the issue for me. Having said all that, and giving that as a backdrop to my sense that it would be easier if the HTA and HFEA were not in the same amendments because they involve different issues, I have considerable sympathy with the intentions behind these amendments. They are thoughtful and are an attempt not to knock the whole applecart over. They try to ensure that the transitional arrangements, and where we come to at the end of the journey, are building and capitalising on all the very good things that have happened and that none of that is lost. In that regard, I hope my noble friend may have some comfort for those who have put their names to these amendments and that they will find some satisfaction.