It is a pleasure, as always, to serve under your chairship this morning, Mr Robertson. I congratulate my hon. Friend the Member for Jarrow (Kate Osborne) on securing this important debate, and thank her for championing such an important issue so eloquently today. She talked about the barriers that LGBTQI+ couples face to having children, particularly being priced out, and the fact that while the guidance is good, more work needs to be done.
I thank Megan and Whitney for sharing their hard-hitting story, along with many others who have done so much work to ensure that we are informed about these challenges. I know that there was an urgent briefing yesterday on IVF provision. I am sure everyone will agree with me that this has been a good debate, and that it is clear that a number of changes need to be made for the sake of equality and fairness.
I also thank the hon. Member for Cities of London and Westminster (Nickie Aiken), who has clearly done a lot of work in this area, for talking about the barriers that individuals may face in the workplace when undergoing IVF treatment. She mentioned businesses signing up to the fertility workplace pledge. The hon. Member for Strangford (Jim Shannon) spoke about how the IVF process was impacting his constituents and, as always, gave a helpful picture of the situation in Northern Ireland. I also thank my hon. Friend the Member for
Pontypridd (Alex Davies-Jones) for sharing her personal story and for her work on the private Member’s Bill, the Fertility Treatment (Transparency) Bill.
As we all know, becoming a parent can be a special and rewarding time for many people. It is the start of an exciting journey into parenthood and a time to celebrate new life. However, as we have heard, there are many challenges that women and families face when conceiving and many challenges in the way of those who seek NHS fertility treatments. As my hon. Friend the Member for Jarrow powerfully said, the challenges—both financial and emotional—for LGBTQ+ couples are so much higher. IVF is one of several techniques available to help people become pregnant. This medical procedure has transformed countless lives, providing hope and the possibility of parenthood to those who might otherwise never experience it.
While IVF is a celebrated medical advancement, the lack of accessibility and the inequality of provision in England and across the UK are issues that cannot and should not be ignored. The National Institute for Health and Care Excellence is responsible for making recommendations about who should have access to IVF treatment on the NHS in England. The current guidelines for England recommend that IVF should be offered to women under the age of 43 who have been trying to get pregnant for two years, as has been mentioned. The exact NICE recommendation is three full cycles for women under 40 and one full cycle for women aged 40 to 42. While in some areas women under 40 can access three cycles of IVF, in other areas they are offered one or even none.
For example, in 2020, the British Pregnancy Advisory Service used freedom of information requests to find out that 86 clinical commissioning groups—now ICBs—funded only one cycle of treatment. More concerningly, it found that three CCGs in England did not provide any funding for IVF services at all. In fact, only 23 CCGs funded three cycles as recommended by NICE.
Unsurprisingly, the provision of IVF services across England, as pointed out by my hon. Friend the Member for Jarrow, has been described as a postcode lottery. I am sure we all agree that this is not right, that the policies are unfair and out of date, and that they must be updated as soon as possible.
I want to tackle the important issue raised by my hon. Friend about the need to break down barriers for all couples. As Stonewall has highlighted in its campaign on this issue, LGBTQI+ couples face incredible financial costs to achieve the same outcomes as everyone else. While the women’s health strategy pledged to remove financial barriers for female same-sex couples in England, the statistics prove that little progress has been made. According to Stonewall’s research, only four of the 42 ICBs in England officially provide NHS funding for artificial insemination, and nine in 10 ICBs in England still require same-sex couples to self-fund at least six cycles of intrauterine insemination before they are eligible for IVF treatment on the NHS. As the Minister will know, that means that LGBTQI+ couples are forced to go privately and end up paying large sums of money—thousands or even tens of thousands of pounds— before they can access NHS fertility services.
I agree with the crucial point that the Government must commit to tackling inequality in access to NHS-funded fertility services. ICBs should ensure fair access to treatment
for all, and ensure that individuals within the LGBTQI+ community, including lesbians, bi women and trans individuals, are not left behind but have the same access to NHS-funded care. However, sadly, going private is now not the last resort but the norm for all individuals in England. In recent years, fewer and fewer women can access IVF treatments on the NHS, with everyone else having to go private. In fact, the use of privately funded IVF cycles by patients across the UK aged 18 to 34 increased to 63% in 2021 from 52% in 2019. That coincides with a fall across the board in numbers of NHS-funded IVF cycles. It is a damning result, highlighting the lack of support available on the NHS for women in the UK. Women are being forced to go private, and parents and families up and down the country face the added financial burden.
The Government must acknowledge that one of the main reasons for the falling levels of provision has been the extraordinary waiting times that women face prior to starting treatment. As the Royal College of Obstetricians and Gynaecologists has shown, although waiting lists were growing too quickly before the pandemic, the impact of the pandemic has made the situation significantly worse. There is an urgent need to reverse the growth of NHS waiting lists in gynaecology, and to ensure that women can access high-quality, timely care and treatment. I know that the Minister and this Government have committed to tackling those extraordinary waiting times, and I hope that she can update us regarding their progress on this critical issue. We all know that the quicker women are seen, the better the outcome will be.
Another critical factor is non-clinical access criteria, where mothers and parents can be denied access to treatment because of their relationship status—as pointed out by my hon. Friend the Member for Jarrow—their body mass index, or the fact that one partner has a child from a former relationship. The women’s health strategy seeks to remove non-clinical access criteria to fertility treatment, and to address geographical variation in access to NHS-funded fertility services. We on the Labour Benches welcome that ambition, but we know, as do the Government, that it cannot be realised without providing the NHS with the staff and resources it needs. As part of the work, the Minister has said that her Department will work with NHS England to assess fertility provision across ICBs, with a view to removing non-clinical access criteria. Can she confirm the extent of her conversations with NHS England and update Members on the timeline for making the changes?
For far too long, women and their partners have faced unnecessary obstacles to accessing IVF treatment. The Government have had 13 years to address those problems. Instead, I am concerned that they have weakened standards for patients, who are paying more tax but getting worse care. On the important issue of provision of IVF treatment, I welcome the ambitions outlined in the women’s health strategy. I hope that, along with Megan and Whitney’s powerful story, the Minister has been listening to hon. Members, especially my hon. Friend the Member for Jarrow, who has made it clear that the reforms need to happen sooner rather than later.
I urge the Minister to assure us today that there will be full implementation of these aims, and to give us a timeline for when they will occur. I urge her to give us hope that there will be an end to the postcode
lottery, and to the inequality in provision faced by so many individuals and partners across England and the UK.
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