New NHS services for surrogate motherhood smack of state baby- farming. But, asks Polly Toynbee, can we condemn women for profiting from... surrogacy

It is an unsavoury business, surrogacy. However decorously it is presented, the basic fact is that a rich infertile couple pays a poor woman to bear their child. Almost always it is her own genetic child, conceived with a test tube of the buyer's sperm, so the word "surrogate" is a serious misnomer - the child is as much hers as any other. Now occasionally an embryo created from the egg and sperm of the couple may be implanted instead.

The law cannot prevent surrogacy. How do you ban women being impregnated by men they barely know? (It happens all the time). How do you stop a man adopting his own genetic offspring, if the mother hands it over? The law is left on the sidelines, banning middle-men from profiteering, and somewhat arbitrarily fixing the maximum price paid to the mother at pounds 10,000, describing the money euphemistically as "costs" and "compensation for loss of earnings". For a mother on social security, that is a lot of money. Without mincing words, these babies are being bought and sold.

Usually it happens behind closed doors, but the British Medical Association reckons about 100 surrogate babies are born each year. Until it comes to the adoption hearing, the state has no involvement and even then often no one reveals what has passed. Some of these arrangements end in the bitter tears of women who regret giving away their babies, or the angry tears of would-be parents who have no legal redress if the surrogate changes her mind and keeps both baby and fee.

Now the National Health Service is to venture into these treacherous waters. The NHS will rent a womb and purchase a baby for you. It is cheaper, they say, than test-tubes. At this point what was a private, if unseemly deal between individuals becomes the direct responsibility of all us tax- paying citizens. This is state baby-farming and the moral ground feels as if it shifts uneasily beneath our feet. But why should we be queasy at the state buying poor women's babies in our name? Why shouldn't the NHS let poor couples also exploit other poor women?

There is a dubious moral squeamishness at work here. We live in a society where many of the poor, by accident, bad luck, stupidity or incompetence, have no chance of participating in the ordinary quality of life of the great majority. There is, however, absolutely no sign that tax-payers are so morally shocked that they yearn to pay more in order to fund expensive new projects to rescue the poor from their benighted lives. On social security the only thing many have left to sell is their bodies. Some women turn to prostitution, a few to womb-renting. And why not, since we have nothing else to offer them?

By the same token, I see no valid moral argument why the poor should not sell their kidneys if they choose. Most healthy people can function perfectly well with one. The chance to earn a windfall of, say, pounds 50,000, could make a real difference to their lives, and would seem a pefectly rational choice to make.

In fact kidney sale is a far better proposition than surrogacy, since the donors are unlikely to mourn their loss the way a mother may mourn her missing child. A hard-headed examination of the issues raised by surrogacy on the NHS may well lead down the path to NHS-purchased spare organs. It would save the lives of many kidney patients dying while they wait, and the livelihoods of the desperately poor.