It is a huge pleasure to serve under your chairship, Mr Robertson, and I sincerely thank the hon. Member for Jarrow (Kate Osborne) for bringing forward this debate. She spoke beautifully and eloquently about her experiences; it enhances debate when Members, like the hon. Member for Pontypridd (Alex Davies-Jones), bring their own personal experiences.
It is very clear that there is unanimity, which does not happen often. I trumpet and champion the positive equality and the better standards that we have in Scotland, but I would love to see those standards rolled out, so that they were the same throughout the UK. It is not about political point scoring; it is about genuinely working together and sharing best practice. However, although it is significantly better in Scotland, we still have arbitrary limits across the board on the age when women are offered IVF. That is global—not just in the UK.
A recently-published report showed that, for the first time since the second world war, more women in their 40s than women in their 20s are having children. That is just a reality. There are all sorts of reasons for that—the cost of living crisis, the cost of accommodation, women’s career paths and the lack of childcare. All Governments in the UK are trying to do more around childcare and I recognise those challenges, but the reasons are varied and complex.
A Conservative Member recently said that more people need to have babies. I will not mention the Member, as I have not given due notice. It was an offhand comment and it rightly came in for a lot of criticism because of the intent. However, there is an irony there in that some on the Government Benches are saying that, yet we need more action from the Conservative Government. They need to reflect on that. They should look at the reasons why we have a stagnant birth rate and fewer people having children, and at what more can be done.
We have heard, particularly from the hon. Member for Jarrow, about the issues with the women’s health strategy: it is ambitious and the guidance is good, but it is not mandatory. We need it to be. We need to move away from the pot-luck nature of treatment, particularly in England and Wales. I was struck by the briefing, which led through the different levels of care, all the different boards across England and Wales and how challenging that must be for people—not just LGBT people but anyone seeking fertility treatment.
The hon. Member for Jarrow also spoke about the outdated BMI criteria and how those can vary. That is particularly challenging as well. Women’s bodies come in all shapes and sizes and for all different reasons. We must recognise that. The hon. Member for Strangford (Jim Shannon) also spoke about that issue in relation to Northern Ireland: that arbitrary line is discriminatory. We need to remove the discrimination and those barriers.
The hon. Member for Jarrow also spoke about those with HIV and how they are being discriminated against, and both she and the hon. Member for Pontypridd talked about black-market sperm. Members may remember the 2017 BBC Three documentary. I watched it and was horrified. It showed LGBT couples and female same-sex couples searching the internet for donors and often facing quite dangerous situations. In 2023, people who so desperately want to have a family and to have children should not be forced into those situations. It is unthinkable.
Someone very close to me has been through several rounds of IVF. It cost her tens of thousands of pounds. She talked to me about going to a fertility fair in London, and all the different stalls and what an amazing experience that was in her journey; but a man came up to her and, in the middle of the fair, handed her a note with his phone number and a really inappropriate message, basically trying to push himself on to her to offer his
sperm. She reported it and that person was removed, but that is a truly shocking story, showing just how predatory some men can be in such situations.
We also have to recognise that there are a lot of incredible men out there who donate their sperm and make it possible for others to use it, and there are also incredible women who donate their eggs. Such people make it possible particularly for those in the LGBT community but also heterosexual couples to have children.
It is a particular privilege to be able to represent Scotland’s approach to IVF, which, as I said, I am extremely proud of. Not only are we providing a higher proportion of NHS-funded cycles of treatment, but that means that the ability to have a baby is less affected by income.
There are particular challenges for LGBT couples, but I think we are pioneering some work in relation to those challenges. In addition, one of the things that happens if there is more standardised NHS treatment is that the clinics across Scotland—in Edinburgh, Glasgow, Dundee and Aberdeen; I think that is correct—collaborate, whereas when people are moving around, particularly in the private sector, they find that those private clinics keep their pioneering work—I am afraid to say—to themselves. I am sure that there is some collaboration, but that seems to be the case.
So, under the SNP-led Scottish Government, we have become a “gold standard” for IVF treatment. Those are not my words but those of Sarah Norcross, the director of Progress Educational Trust, which is an independent, London-based charity that advocates for people affected by fertility issues.
I must say that this is an area where the priorities of the Scottish Government and those of the UK Government are different. I hope that the UK Government will follow our lead; if they did, I am sure that my colleagues in the Scottish Government would be happy to share their experiences and best practice. Ms Norcross said that in Scotland IVF services were
“as good as it gets”.
The UK Government obviously have a different standard. So, as I say, I hope that this is something that we can share best practice on.
I also recognise that, as has already been mentioned by other hon. Members, the briefing yesterday by Megan and Whitney, LGBT Mummies and TwoDads UK was particularly powerful. It was really stark about the challenges that our community—I say this as a member of the LGBT community—has to face.
However, I also have heterosexual friends who have been through IVF. I have one friend who was fortunate enough to have her first baby through natural means. However, for various reasons she then went on to have secondary infertility. She cannot get fertility treatment on the NHS in Scotland. We will offer it to blended families. So, in the situation of the hon. Member for Pontypridd, I can tell her that if she had lived in Scotland, she would have been entitled to treatment. However, if someone has one child and wants to have more children with the same partner, unfortunately they would not be entitled to treatment. That is something that we need to look at in Scotland. Blended families are very much the norm now. If it is the case that someone has a child, or they and their partner both
have children from previous relationships, and they are unfortunate enough to experience secondary infertility, they should have access to fertility treatment.
NHS-funded cycles in England decreased in number from 19,634 in 2019 to 16,335 in 2021, which is a 17% reduction. Covid will undoubtedly have played a part in that. In Wales, the number of NHS-funded cycles decreased from 1,094 to 704 over the same period. In Scotland there was a slight decrease, of just 1%, in that period.
In England, treatment is much more likely to be outsourced to private clinics, even when the costs are covered by the NHS, which has a serious negative impact on overall services. Fertility experts have pointed out that the major reason that fertility care in Scotland is so consistently excellent is that there is the collaboration that I mentioned.
I have also heard from a number of people I have spoken to that people are going abroad for fertility treatment. It would appear that they are going to clinics in Europe because the service there is better. That IVF tourism, as some people call it, is cheaper and seems to be better than the treatment here in the UK, but we do not want people to have to go abroad for that reason; we want people to be able to have their babies here.
The hon. Member for Cities of London and Westminster (Nickie Aiken) spoke very powerfully about her work in workplace fertility support. That is interesting, because a lot of people will not want to disclose information about their fertility, or they will not feel comfortable about doing so unless their employer is being open. I have perhaps a slightly different opinion from that of the hon. Member. Of course businesses should just provide such support, but businesses have a lot of pressure on them, and sometimes legislation can be the precursor or the catalyst for changes in behaviour and lead to the provision of real, solid support for people who are going through things such as IVF treatment.
Obviously, National Fertility Awareness Week is coming up; however, it was Baby Loss Awareness Week just the other week. I know somebody who, having gone through expensive fertility treatment, only managed the one embryo transfer, which unfortunately did not work. It can be very upsetting when an embryo transfer does not work, no matter the person’s sexuality.
I thank LGBT Mummies for the excellent job it has done on briefings. I will briefly go through its asks for the LGBT community, which include equal and equitable access, national mandated funding policy and provisions for all LGBTQI people. As the hon. Member for Jarrow powerfully highlighted in her speech, the LGBT community is facing discrimination and attacks like never before, including the removal of health services, which is something we all have to reflect on and look to improve. Its asks also include personalised fertility care and education for staff—something I have experienced myself, in the language health practitioners use and in their understanding of the different healthcare requirements of the LGBT community. They also include access to funded medication and tests for home insemination, co-produced funding provision with the community, and the ability to create our families safely by our chosen routes—not being forced down a route.
The difference in Scotland is that we do not have to go through those IUI cycles, but a challenge we have across the board is the arbitrary two-year timeline,
where people have to have been in a relationship for two years. I do not know of anywhere where we say to heterosexual couples, “Don’t be having a baby until you’ve been together for two years.” We don’t do that, do we? So why are we doing that to LGBT people? That really does not make any sense.
Briefly, I want to reflect on my personal experience. I had a partial failed attempt at IVF with a former partner—I will not go into the details—but I did not start my journey until after I turned 40. I now regret that, because I am 40 and I will get only one shot, rather than three. I am only at the very beginning. I want to highlight to the Minister that piece about those of us who came out later in life. When I came out at 32, most of my friends were getting married and having kids, or already had kids, and I was just working out who I was. One reason that I did not come out earlier was that I so strongly wanted to have a family, and I did not think that would be open to me if I was gay. Equal marriage came much later in life for many people. Like many of us who did not start life as their authentic self, as some people say, until much later, I have felt like I am perennially playing catch-up, and I have now decided to just do it on my own. I do not know where my journey will take me, but I know there is a lot of support out there, and a lot of incredible people.
I am in a very fortunate position, but not many are that fortunate. As we have heard, people are going to the black market and putting themselves in massive debt; we should not be putting anybody in that situation. I hope the Minister will hear the calls from across the House, and I look forward to working with colleagues on this very important issue.
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