Following Prime Minister’s Questions this week, I plan to introduce a Ten Minute Rule Bill with the intention of equalising access to NHS fertility services across England.
I first became aware of this problem in 2016 when I was contacted by constituents who were being refused IVF treatment because of new criteria drawn up by their Clinical Commissioning Group (CCG). This criteria judged that if one partner had had a child from a previous relationship, no matter how long ago and what the level of contact, it was grounds for denying treatment.
As I investigated further, I found that the provision of fertility services in England is indeed a post code lottery with substantial variations across different CCGs. I have to confess I don’t understand how it can be right that within a single NHS, people who live in Thurrock or Luton can have access to a full NHS fertility service while my constituents don’t.
The National Institute for Health and Care Excellence (NICE) issued guidelines in 2004 stating that women under 40 who’ve failed to get pregnant after two years of trying should be offered three full cycles of IVF. However, these recommendations are not binding and according to the charity Fertility Fairness only 12% of CCGs in England offer three full cycles. If you live in Herts Valleys, Cambridgeshire & Peterborough, Croydon, South Norfolk, Mid Essex, North East Essex or Basildon & Brentwood, there is no access to IVF at all.
The World Health Organisation describes infertility as ‘a disease of the reproductive system’ but it’s clear that we are not treating this condition as we would other illnesses. NHS England shouldn’t be rationing fertility treatment in this way which is why I’m calling for action to rectify the situation.
Since 2016 I’ve discussed these problems with four different health ministers; I’ve lead a backbench debate on the issue; and, I spoken with senior officials from NHS England. There have been many promises of improvements but virtually no progress. Indeed, every other week a new CCG announces plans to further reduce fertility services. Without action, I am certain more cuts will follow and eventually fertility treatment will be squeezed out of the NHS becoming available only to those who can afford to pay.
My Bill would aim to eliminate regional variations in access to IVF. It calls for an end to arbitrary access criteria and says all CCGs should make fertility treatment available in line with NICE guidelines. The Bill would also call for the development of national benchmark pricing in England to end the disparity in commissioning costs. It seems ridiculous that the cost of exactly the same NHS treatment can range from £1,343 to £5,788 in different parts of the country. The Bill would guarantee eligible patients fair and equal access to NHS fertility services, reduce costs and eliminate moralistic judgments, with no clinical value, being used as grounds for exclusion.
The NHS was founded on the principle that treatment should be universal, comprehensive and free at the point of delivery. Access to fertility services should be dependent on a person’s medical need not subject to their post code or bank balance. Infertility is a medical condition, it’s time we started treating it like one.
Steve McCabe is the Labour MP for Birmingham Selly Oak