NHS fertility treatment is to be strictly the privilege of the traditional two-parent, heterosexual family, the government made clear yesterday, at the launch of a major consultation document, which also raised the possibility that parents could choose the sex of their child.
The public is being asked its views to help in the rewriting of the Human Fertility Act, which has served for 15 years but is being undermined by the frantic pace of advancing science. Modernisation of the act, however, does not mean modernisation of the concept of the family, the public health minister, Caroline Flint, made clear yesterday.
"We don't expect single women and lesbian women to be provided with treatment on the NHS," she said at a press conference. Some receive treatment at private clinics. "The current act talks of taking into account the welfare of the child and the need for a father. It doesn't say there has to be," she said. "That's why private clinics are providing some services to single women and lesbian couples.
"We're not proposing to remove the need for a father, but we're asking questions about how this section of the act works."
Priority would be given to heterosexual couples. The consultation document states: "As a general rule the government believes it is better for a child to have both a father and a mother."
The government's view flies in the face of the science and technology committee, which produced a radical and controversial report on reproductive technology this year. It said the requirement for doctors to consider that a child needed a father was "too open to interpretation and unjustifiably offensive to many. It is wrong for legislation to imply that unjustified discrimination against 'unconventional families' is acceptable." Even Suzi Leather, the chair of the regulatory body, the Human Fertilisation and Embryology Authority, said last year that the requirement was "a bit of nonsense".
Yesterday the Labour chair of the science and technology committee, Ian Gibson, said Ms Flint was "wrong - absolutely wrong. She is out of tune with the times. We have got to realise that a loving family can involve people of the same sex. There is no blueprint for a happy family."
He pointed out that the government was at the same time giving legal rights to lesbian families. A change was taking place in the concept of the family, he said, but the government was out of line in its thinking on infertility.
The consultation paper suggests as an option replacing the "need of the child for a father" with "the need of the child for a father and a mother". The Liberal Democrat MP Evan Harris, a member of the committee, said this was stigmatising. "Are they really wanting to label all single and same sex parents as second class and why?" he asked.
The consultation document roves the length and breadth of the ethically fraught terrain of modern reproductive technology. Many of the issues on which it canvasses opinion are hotly disputed. It asks whether the public think couples should be allowed to choose whether their baby should be a boy or a girl. There is strong public opposition in opinion polls to sex selection, but the document goes a tentative step further, by offering people the chance to agree to sex selection specifically for "family balancing" - where they already have a number of children of one gender.
The science and technology committee suggested family balancing should be allowed. If it were, asks the consultation paper, "how many children of one gender should a couple already have before being allowed to use sex selection techniques to try for a child of the other gender?"
John Harris, professor of bioethics at Manchester University, is in favour of choice. "If it's not wrong to wish for a bonny, bouncing baby girl, how can it be wrong to use technology to play fairy godmother to ourselves?" he said. "Sex selection should be a matter of individual choice and the principle should be that unless palpable harm can be demonstrated, people should be free to make their own choices."
Peter Braude, professor of obstetrics and gynaecology at King's College London, suggested a limited experiment of perhaps 2000 IVF attempts, to see whether people chose one gender more than another.
Also likely to provoke impassioned discussion is the obligation on doctors to consider "the welfare of the child" before they agree to treat a couple, which the government appears inclined to retain. Patients feel angered and insulted, because those who conceive naturally are not screened ... and doctors dislike being required to judge a couple's potential parenting skills.
"Patients have for some time felt that the current system discriminates against them and that their ability to parent a child is being judged," said Sheena Young of the patient support organisation Infertility Network UK.
Dr Harris said: "Child protection and social services care should be used to prevent damaging parenting, not sterilisation by statute, based on a subjective judgment that a child would be better off never being born to prospective parents."
The government proposes to regulate the burgeoning internet services that offer to provide anonymous donor sperm by courier service to women who then inseminate themselves at home - a process that escapes regulation at the moment because it is not "treatment" under the present act.
The consultation paper canvasses opinion on the creation of so-called "saviour siblings" - babies chosen from embryo because they are a tissue match for a child with an inherited disease and can donate cells of their umbilical cord blood.
