Improved welfare checks system will be better, fairer and clearer for fertility patients, GPs and clinics

New HFEA guidance provides greater focus on risk and clinical responsibility

2 November 2005

A better system for protecting the welfare of children born as a result of fertility treatment has been announced today by the Human Fertilisation and Embryology Authority (HFEA).

Under the 1990 Human Fertilisation and Embryology Act, clinics have a responsibility to make an assessment of the welfare of any child or existing children before they can provide treatment to a woman (see Notes). The HFEA provides guidance to clinics on how this assessment should be carried out.

The new guidance provides extra support for clinicians when they are carrying out a 'welfare of the child' assessment by providing clear guidance on the areas of risk that they should be using their professional skills to assess. These include:

• mental and physical conditions in the parents which could threaten a child's care
• drug and alcohol abuse
• previous convictions related to harming children
• medical history which means the child could be born with a serious medical condition

The revised guidance follows detailed consultation with patients, doctors and other professionals and builds on experience of how the system works in practice.

The key changes are:

• A clear focus on areas of serious harm, with vague and subjective social questions removed from the assessment
• That clinics should assume they will provide treatment unless there is evidence that the child is likely to be at risk of serious harm. This will enable treatment for the majority of patients to go ahead with the minimum of disruption
• Clinicians should use their professional judgement to decide which cases warrant further investigation rather than being obliged to contact a patient's GP in each and every case
• Clinics should provide extra encouragement and preparation for donor conception patients because of the risks to children if information about their genetic origin is not shared at an early age

Speaking at the launch of the new guidelines, Suzi Leather, Chair of the HFEA, said:

"By focussing more clearly on the risk factors that could lead to serious harm, we will have a system that is fairer for patients and more proportionate for doctors whilst still protecting children's interests.

"Our revised guidance will support clinicians in using their professional judgement to assess patients. Where they have concerns, clinicians will still contact GPs, social services or other relevant bodies.

"These new guidelines will enable medical teams to get on with the job and will give patients reassurance that the process will not be unjustifiably burdensome or intrusive."

The 'Tomorrow's Children' consultation gathered views from a significant number of patients and a wide range of experts in assisted conception, in addition to those with a background in law, social work, ethics and counselling. Public meetings also took place during the consultation in Glasgow, London, Manchester and in Parliament.

Angela McNab, Chief Executive of the HFEA, explained how the new guidelines will be implemented and monitored:

"We are going to be working closely with clinics to ensure that the new guidance is clearly understood and new processes are put in place to implement them. We will monitor how well the revised system is working in the coming months."

The new guidelines are fully implemented by January 2006.

Ends

Notes to editors

1. Section 13(5) of the Human Fertilisation and Embryology Act 1990 says:
A woman shall not be provided with treatment services unless account has been taken of the welfare of any child who may be born as a result of treatment (including the need of that child for a father), and of any other child who may be affected by the birth.

2. Our revised guidance gives clinicians the underlying principle that these conditions should be judged on whether they would either give rise to a risk of serious harm to the child or that would prevent a person from being able to care for a child throughout its childhood.

In such circumstances clinicians will need to use their judgement - and the advice of other professionals, where appropriate - to evaluate how likely a medical or psychiatric condition is to risk serious harm or threaten a child's ongoing care.

For example, a woman who had suffered a short period of post natal depression after her first IVF child should not be ruled out from trying for a second while a history of poorly managed schizophrenia would raise a serious question on a person's ability to care.

3. The HFEA is the independent regulator for IVF treatment and embryo research. Our role is to protect patients and the public interest, to drive improvement in the treatment and research sectors and to provide information to the public and policymakers about treatment and research.

The HFEA was set up in August 1991 as part of the Human Fertilisation and Embryology Act 1990. The HFEA's principal tasks are to license and monitor clinics that carry out in vitro fertilisation (IVF), donor insemination (DI) and human embryo research. The HFEA also regulates the storage of gametes (eggs and sperm) and embryos.

For more information see the Tomorrows children page under HFEA policy.