That this House has considered fertility treatment and employment rights.
It is a pleasure to serve under your chairmanship, Sir Edward. This week we mark National Fertility Awareness Week, so I am incredibly grateful to have secured this important debate. I would like to put on the record my heartfelt thanks to the incredible Fertility Matters at Work, Fertility Network UK, Burgess Mee Family Law and Dr Michelle Weldon-Johns. These organisations and individuals have been instrumental in driving forward positive change in this area, and I would not feel equipped to speak on this issue without their help.
Issues to do with fertility treatment affect hundreds of thousands of people of all ethnicities and socioeconomic backgrounds. Infertility does not discriminate. Fertility treatment is emotionally draining, costly, risky and often long. People can go through multiple cycles before conceiving. According to the latest figures from the Human Fertilisation and Embryology Authority, the UK fertility regulator, it takes an average of three cycles of in vitro fertilisation to achieve success. Cycles can be unpredictable, and women have to deal with the symptoms, the risk of complications, and day-to-day practicalities, such as self-injecting with hormones.
Undergoing fertility treatment is difficult at the best of times, but it is particularly difficult to juggle it with a job. Whereas there is employment legislation to do with pregnancy, maternity and paternity leave, there is no enshrined legislation that compels employers to give employees time off work for fertility treatment or an initial consultation. The Equality Act 2010 was well-intentioned and removed some forms of discrimination in the workplace, but unfortunately it does not prevent discrimination against those pursuing fertility treatment as it does not class infertility as a disability.
Despite the World Health Organisation describing infertility as
“a disease of the… reproductive system”,
in practice, there is little recourse to legal, medical, practical and emotional support for both men and women undergoing fertility treatment. For example, most workplace protection policies exclude elective medical procedures, which puts fertility treatment on a par with cosmetic surgery. I am sure you will forgive me, Sir Edward, for saying that we should not equate fertility treatment with cosmetic treatment such as a nose job or, dare I say, a boob job.
I am pleased that my hon. Friend got this debate. I want to back up what she is saying: we should treat fertility as a medical issue, but we do not. The National Institute for Health and Care Excellence guidance says that women should be able to access three full cycles. That in itself—saying “three strikes and you’re out”—would be cruel enough, but the reality is that many people would love to get to three cycles; as a result of local decision making, they often do not even get two. Do we not need to level up fertility treatment across our constituencies?
I absolutely agree with my hon. Friend. There is so much pressure on the NHS, and on the provision of proper fertility treatment, that many people have to spend their savings or remortgage their home to pay for private facility treatment. I hope this debate will lift the lid on the lottery that still exists.
Women are, of course, protected from pregnancy-related unfair treatment and discrimination throughout the protected period. However, for those undergoing fertility treatment, this protected period would begin only at implantation, not before. That means employers are unlikely to be liable for pregnancy discrimination in relation to any unfair treatment prior to implantation. That leaves people vulnerable to unfavourable treatment or dismissal during the earlier stages of treatment, and without any legal recourse.
Data from Fertility Matters at Work shows that one third of people going through IVF treatment have considered leaving their job rather than facing workplace discrimination. The organisation’s findings also indicate that many people feel uncomfortable discussing IVF treatment openly with their employer, and struggle through the journey largely unsupported and in silence. Some said that they feared that the fact that they were having fertility treatment would be held against them, and that they would not be considered for the next promotion, or might even face redundancy.
I thank the hon. Lady for making a passionate speech on such an important issue. Given that 3.5 million people in the UK face fertility issues, should not employers look at how they can come up to date and make sure that there is space for their staff to discuss the issue in the workplace?
I completely agree. One in six couples experiences fertility issues. That is a huge number of people, as she says. If we are to retain brilliant people in their jobs, we must do more to support them at such a difficult and emotional time.
The Fertility Matters at Work research found that when people spoke to their employers, many felt that what they said was used against them when it came to future opportunities and progressing in the company. The reality of the issue was brought to light by a constituent of mine. I commend her for her bravery in sharing her story; it led to my campaign. She had been working in finance for 19 years. Everything was going well. She was a senior person in her organisation. Sadly, she found she could not conceive naturally, and realised that she had to go for IVF. She did everything under the radar because she did not feel that her employer would be supportive. Sadly, complications in the treatment led to her being in hospital for two weeks; there was then a further four weeks of recovery. The hospital wrote a sick note for her employer that said, “complications due to IVF.” The cat was out of the bag.
When my constituent went back to work, her employer immediately called her into a meeting and told her that she was being moved abroad; she had no choice. She stuck to her guns and went through the IVF. She was told that if she went for the implantation, she could be sacked. She went for the implantation and then decided that she would have to go off work because of stress.
As the hon. Member said, more than one third of employees undergoing fertility treatment consider leaving their job because of the problems she has described. Does she agree that that is not good for the economy, let alone the personal and financial circumstances of the person concerned? That is why this debate is so important, and I thank her for initiating it.
The hon. Member is absolutely right. We have to ensure that we retain these brilliant people in their jobs. We have 1 million job vacancies, and we know how difficult it is to recruit people to jobs, so why do we make it as hard as possible to keep people in their jobs when they are going through fertility treatment?
My constituent nearly ended up in an employment tribunal, but because she was in early pregnancy and did not want the stress any more, and because she was finding it difficult to pay the lawyers’ fees, she came to an agreement with her employer and signed a non-disclosure agreement. Since then, she has been unable to speak about her case in public. She came to me in confidence, which is why I took up this cause, so I thank her. She is not the only one. Since I started the campaign, I have been contacted by scores of people, but I know that thousands of women are affected every year. Many women have told me that admitting they are undertaking IVF or any form of fertility treatment can be considered career suicide. We should not allow women to feel that they have to put having a baby up against progressing their career. In the 21st century, why can they not do both? It is important that we listen to such stories, act on them, and provide women and their partners—men or same-sex partners—with the respect and the protections that they need. After all, it is 2022, not 1922. That is why I started this campaign.
The first part of my campaign is my private Member’s Bill, the Fertility Treatment (Employment Rights) Bill, which is due to have its Second Reading on 25 November. The Bill would give individuals the right to take time off for fertility treatment, just as they would if they had antenatal appointments. It is supported by leading charities and non-governmental organisations, as well as the Chartered Institute of Personnel and Development. The Bill goes hand in hand with the incredible work that this Government are already doing to support women in work, through policies on the menopause, couples requiring neonatal leave, and those who have experienced baby loss. I hope that the Government will fully support the Bill on Second Reading.
It is always a pleasure to speak in any debate in Westminster Hall under your chairmanship, Sir Edward. I commend the hon. Member for Cities of London and Westminster (Nickie Aiken) on leading the debate today. Some of my constituents back home told me about the hon. Lady’s debate, and I am very pleased to participate. I thank her for her ongoing interventions and for introducing her private Member’s Bill on fertility treatment and employment rights. I look forward to hearing further contributions from other Members from all parts of the House. It is always a pleasure to see my good friend, the right hon. Member for Romsey and Southampton North (Caroline Nokes). We seem to be on the same side in these debates, and it is good to see her in her place.
It is an unfortunate and sad reality for many women and couples wanting to have children that natural conception is not always an option. Seeking fertility treatment is the most viable option. Across the UK, some 1.3 million IVF cycles have resulted in the birth of 390,000 babies—that is one in three, which unfortunately means that two in three are not successful. That is the reality. IVF and other fertility treatments are incredibly common nowadays, yet the provision of employment rights for women undertaking this treatment is feeble. I could use stronger words, but it would be inappropriate. We look to the Minister to strengthen what the hon. Lady wants to bring forward. I believe everyone in this Chamber wants that to happen.
In some cases, men require time off for sampling and consultancy appointments. There is a need for clarity on employment rights for that. There are two in this equation: the lady who wants to conceive and the man who wants to be part of that. Employer discretion has played a pivotal role in deciding time off for fertility treatment. There are no specific UK rights, but there should be. Perhaps the Bill of the hon. Member for Cities of London and Westminster will change things.
It is a pleasure to serve under your chairmanship, Sir Edward. I congratulate my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) on securing this important debate and on her introduction. I am equally delighted to see the Minister in her place and, if I am allowed to say, slightly relieved that we have a Department for Business, Energy and Industrial Strategy Minister to talk about fertility and work, because too often in this place I come to talk about the menopause and work and am confronted with a Health Minister.
It would be expected of me to start instantly with a pitch for an employment Bill, because I make that pitch every time I come here. I say, “We need to have an employment Bill; we were promised it in the Queen’s Speech some years ago, but it is still not forthcoming.” I am going to put it in the hands of the Minister for Science and Investment Security, my hon. Friend the Member for Wealden (Ms Ghani) to produce the aforementioned Bill.
I pay tribute to my hon. Friend the Member for Cities of London and Westminster for securing the PMB slot and making progress in that regard. We need to see some legislation around this. Make no mistake, this is a “women in work” issue. I know that is very gendered, and I am going to move away from that in a moment. But it is about securing women’s place in the workplace and ensuring that they keep opportunities. As the hon. Member for Bootle (Peter Dowd) said, this is a fiscal issue, about the individual fiscal wellbeing of families and the economy as a whole.
There are very few points I want to make and I will be brief. We have heard it explained by other Members that IVF ends in failure for two thirds of parents going through it. It is a gruelling and stressful process, which is why flexibility in employment and adequate time off is so important. It is why we need employers to be understanding. We often talk about mental health in the workplace. I have spent the past 18 months talking about menopause in the workplace, and the importance of having policies in place in the workplace that support individual employees and a culture of openness, so that we do not have the secrecy, shame and fear of coming forward with these issues. People should be supported to take off the time that they need, and that should not be part of their holiday entitlement. We have heard that it can be long and gruelling. Most people’s holiday entitlement would simply not be enough.
I thank the hon. Member for Cities of London and Westminster (Nickie Aiken) for securing this debate. It is an important issue and one, as a female MP, I get lobbied on regularly. I am sure we all know couples who have gone through the IVF journey. No couple would choose to have to go down that pathway to start a family.
When speaking with many couples, they have told me of the physical, mental and emotional rollercoaster of hope, disappointment, joy and despair. For some, it brings that little bundle of enjoyment, and for others it brings heartache. In the midst of such a journey, to be fully focused on work, in the right frame of mind and physically capable, is undoubtedly too much for some. It is wrong that there is currently no legal entitlement to time off in such circumstances.
Members will know that as the law currently stands, employees undergoing IVF have limited IVF-specific protections prior to embryo transfer. Most of their legal protections stem from standard employment protections to prevent discrimination. In such unique circumstances, a unique legal provision for additional employment rights is needed.
I am conscious that the hon. Member for Cities of London and Westminster has tabled a private Member’s Bill to address the lack of legal provision to give women time off. As a party, we will support that Bill on the basis that IVF treatment should be categorised as antenatal treatment, and thus patients should be given the same work rights. To me, that is a sensible provision and I will fully support the Bill as it progresses though the House.
I will briefly mention one other fact. For many, IVF is a multi-cycle experience. Unfortunately, in Northern Ireland couples are entitled to only one cycle of IVF. That is very distressing for couples and puts more pressure on them. Within the “New Decade, New Approach” document, which restored the devolved Administration, there was a commitment to provide three cycles of IVF. Unfortunately, that has not been fulfilled. Last week, the Government moved to fulfil part of the NDNA agreement with the Identity and Language (Northern Ireland) Bill, but that commitment, which brings about new life, has not been fulfilled. I encourage the Minister to take up that issue and run with it, and allow the Government to deliver on that promise within the NDNA agreement.
It is a pleasure to serve under your chairmanship, Sir Edward. I congratulate my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) on her wonderful campaign. If I can support it, I will do so.
By coincidence, this morning we were discussing general cultural issues related to getting pregnant. The conclusion was that if a man had a child—if it is clear what I mean—that would be an excuse for the employer to give him a pay rise and to change his job. If a woman gets pregnant, she is just put to one side. We have heard how the whole fertility treatment process is very stressful. In fact, we have only heard about a portion of it. If we read about the number of tests that they need and the details of how they go through it, we can see how very frightening it can be. I think we have to remember the effects of that stress on people’s work.
It is not just women who are involved in this; males can have infertility problems as well. They can be due to lifestyle habits, for example smoking, or hormonal changes, for example low testosterone. That leads me to mention some figures produced by AXA. One of the most important was that 85% of employees undergoing fertility treatment said that it had had a negative impact on their work. A phenomenal number of people involved in this process experience a profoundly negative impact on their work.
We have already heard that a third of those undergoing IVF treatment—in fact the figure that I saw was 38%, so it is a little higher than a third—have either considered or have actually quit their jobs as a result of the impact on particularly their mental health. Although we have tried to separate mental health from other reasons for approaching this subject, we cannot separate them. They are intimately linked, and the mental health applications that take place have to be looked at very carefully and with a great deal of consideration.
I cannot understand why a business would not want to allocate time specifically for fertility treatment. I cannot understand why it is not part of their natural, compassionate approach to dealing with employees. They are compassionate in many other ways, which is to be applauded, but given that this issue directly affects the work that people undertake and the way in which they operate, I cannot understand why businesses do not allocate time for fertility treatment.
20 of 35 shown
I know how long it can take to get a private Member’s Bill through the House, but there are also other steps that we can take. We must encourage employers now—today—to take proactive steps to support people undergoing fertility treatment. That is why during this week, National Fertility Awareness Week, I am launching my fertility workplace pledge. The pledge calls for employers of all shapes and sizes to lead the way by voluntarily signing up to a clear set of commitments relating to accessible information, awareness in the workplace, staff training and, crucially, flexible working. Tomorrow morning, I will hold an event here in Parliament, to which all hon. Members are invited. It brings experts and academics together with leading businesses that, I am delighted to say, have already signed up to a pre-launch of the fertility workplace pledge, including NatWest, Metro Bank, Zurich, Channel 4, Co-op, Cadent Gas, UKHospitality and a huge array of UK law firms. I am particularly proud that the House of Commons has also agreed to take part.
By signing the fertility workplace pledge, all those organisations will improve their workplace culture and the wellbeing of their staff, which in turn reduces stress and sick leave, and safeguards against employee tension. Importantly, it will put no unnecessary burden on their businesses. That shows that businesses are supportive of the key principles of my Bill. We must remember that the pledge is voluntary. No matter how hard we try, without the necessary legislation and protections, thousands will be left vulnerable to discrimination.
There are so many misconceptions about fertility treatment, especially in the workplace. Many think that it is a lifestyle choice for older career women who have waited too long before trying to start a family. That could not be further from the truth. More than 40% of women who resort to treatment are under 35, and many turn to IVF for medical reasons, such as having gone through early menopause or cancer treatment. It is also a route to having a family for LGBT couples, as well as for those who do not have a partner or are clinically infertile. People should never be penalised because they cannot conceive naturally.
It is time to recognise fertility treatment as a very important part of reproduction. We have a falling birth rate in this country. We cannot put unnecessary hurdles in the way of people who want to start families. After all, our children are our country’s future. We must support everyone who is going through fertility treatment in order to conceive, and give them the employment rights that they need and deserve.
This is not an issue that applies solely to small businesses—often, large chain stores across the UK have no specific guidelines whatsoever on employment rights for fertility treatment, and really have no desire to even try to address those issues. One constituent of mine who is only 24 made the interesting point that if she were trying to conceive naturally, there would be no expectation to tell her employer that she is trying for a baby. However, given she had to go down the IVF route, she had an obligation to tell her employer because of the additional time off that she would need for appointments. Something does not add up there. In my book it is quite clear, and others will reiterate that.
Another woman contacted me at the tail end of the third lockdown to tell me that her employer stated that if her IVF appointment took over three hours, including travel time, she would be forced to take holiday. If human resources considered that she was attending too many appointments, she would have to make up the time. There is a big lack of compassion and understanding there.
Couples should not be penalised for fertility issues that lie completely out of their control. There is a huge mental strain on both men and women who are seeking fertility treatment. The ladies who have come to see me over the years as an elected representative—as a Member of the Legislative Assembly in my previous job and as an MP—sit there and their faces betray their stress and anxiety. We need to do better. There are 3.5 million people in UK and 5% of people in Northern Ireland who struggle to get pregnant naturally. We must do more to normalise the fact that there is a right to those appointments, as there is a right to a GP or a dental appointment. A woman’s ovulation cannot be pinned to a certain day off or a lunchtime break. There must be flexibility as a norm.
Consideration must be given to the overall cost of the process, too. For employees who are not paid for the time they take for appointments or are made to take statutory sick pay, there are often already extreme financial pressures going on through the cost of IVF treatment. Additional pressure from employers is unnecessary and unfair. NI Direct has stated that employees will be entitled to paid time off for antenatal care only after the fertilised embryo has been implanted. There is not even an understanding in the Department. In many cases, the most important check-ups are before implantation. These are the issues that we must focus our time on.
I have high hopes for the hon. Lady’s private Member’s Bill. As my party’s spokesperson for health, I support it and its intentions fully. I hope for a future for couples where they can get the support from their employers as needed, both before implantation and after. We all want the best for our constituents, so it is crucial that we stand here today and represent those facing difficulties with fertility and managing employment.
I said I had made it a gendered issue, and it is not. The reality is that partners need to be there to support the woman who is going through IVF. We must recognise the need for same-sex couples to have that support, and the need for support to be available when surrogates are used. We may like to think about traditional family units, but families come in all shapes and sizes nowadays. It is crucial that we recognise there is a role for LGBT couples to get this support.
There are some great examples out there. I look at companies such as NatWest and Centrica, which have led the way in fertility policies in the workplace. I was pleased to hear from the Co-op, which employs in the region of 60,000 people in this country. Even in the past few weeks, it has published its policy on paid leave for fertility treatments, making the point that the time off provided is flexible and unrestricted. It makes the point that it cannot assume what individuals going through fertility treatment need. The measures extend to partners accompanying those going for fertility treatments, with paid leave for up to 10 appointments per cycle. That gives a measure of how significant a commitment that is, both from the individual and the employer.
We have a great deal of work to do in this area. It is too little understood and too little spoken about. I pay tribute to my hon. Friend the Member for Cities of London and Westminster for the great work she is doing in National Fertility Awareness Week to raise this issue.
We want a society that values life; we want a culture where women feel valued. Women go through much in the workplace, including miscarriage, pregnancy, IVF and the menopause. Employers need to support women in the workplace, and therefore this debate is very welcome.
I am pleased by the number of companies that my hon. Friend the Member for Cities of London and Westminster has already signed up to her campaign, and I look forward to their involvement and to being able to take it forward. As we have heard, this issue is a major problem not just for this country, but for the western world. Unless we take it seriously, we will end up in even greater trouble than we would otherwise be, and I thank my hon. Friend for the work that she has done to make sure that we are all aware of it.