That this House has considered the matter of IVF provision.
It is a pleasure to serve under your chairmanship this morning, Mr Robertson. I start by thanking everyone who came along to the briefing on this matter yesterday, and in particular, Megan and Whitney, Laura-Rose Thorogood from LGBT Mummies, and Michael Johnson-Ellis from TwoDads UK for sharing their deeply personal stories and for the time they spent talking to MPs about this important issue.
As a mum of two wonderful boys, one of whom was conceived through IVF—in vitro fertilisation—this subject is close to my heart. Everyone deserves a chance to start a family, no matter their sexuality or gender identity. It was around 14 or 15 years ago that I started the IVF process as part of a same-sex couple. At the time, we went through unnecessary procedures, a long waiting list and significant costs, but despite the hurdles, it was achievable and my wonderful youngest son is now 13.
In the 13 years that my son has been alive, life for LGBTQ+ people in the UK has got progressively worse, and not just in terms of IVF. In many ways, life for LGBTQ+ people has gone backwards over the past decade. Homophobic and transphobic bullying is on the rise, trans hate crime has risen, waiting lists for LGBTQ+ physical and mental healthcare are through the roof, and virtually every day we see an attack on our community from this Government. From attacks on LGBTQ+ refugees to attacks on inclusive education in schools, to language outright denying trans rights, the Government have ramped up their war on woke using divisive and inflammatory rhetoric that is designed to stoke hate and distract from the mess they have made of this country, ahead of the next general election.
Ministers have failed to keep their promise to ban so-called conversion therapy in full, allowing the barbaric practice to continue. As for IVF for same-sex couples, we are still waiting for the Government to keep their promise to remove the discriminatory practical and financial barriers that LQBTQ+ couples face.
Since the IVF journey that I was part of, NHS waiting lists have become longer and the hurdles that LQBTQ+ couples have to jump through have increased. A fragmented NHS means that there is a postcode lottery for provision, and the financial cost is significantly higher. If I were starting my journey to become a parent now, even on an MP’s salary, I doubt I would be able to afford to complete the process. It is a disgrace that 14 or 15 years later, couples like Megan and Whitney still have to go through the same unnecessary fertility tests that we had to go through.
When speaking to people ahead of this debate, it has been depressing to repeatedly hear from women who have given up on their dream to become a parent because they have run out of money. LGBTQ+ people are being priced out of having a family. Lesbian, bisexual, non-binary and trans women couples are expected to demonstrate their infertility before the NHS will fund IVF. To do so, they must pay privately for up to 12 rounds of artificial insemination.
Yesterday, MPs heard at first hand from people this is having a huge impact on, including Megan and Whitney, who are here again today to listen to this debate. Megan and Whitney spoke about their integrated care board requiring them to pay for 12 rounds of artificial insemination before they would be eligible for any treatment on the NHS, which led to their decision to take their ICB to a judicial review. I have spoken to many couples who have spent £30,000, £50,000, or £60,000 on treatment, and many more have given up because they cannot afford to start the process. They have been priced out of having children. Last week, the BBC referred to the situation as a
“‘gay tax’ facing same-sex couples starting a family”.
Megan and Whitney’s legal case more than a year ago helped to prove that NHS England’s IVF policy discriminated against same-sex couples. The National Institute for Health and Care Excellence recommends that couples who have been unsuccessful in conceiving after two years should be offered three full cycles of in vitro fertilisation for women under 40 and one cycle for women aged between 40 and 42. The current requirement is that same-sex couples are expected to self-fund up to 12 intrauterine insemination cycles before they are eligible for NHS IVF treatment.
One thing that is becoming more dangerous as a result of same-sex couples having to pay for artificial insemination is the rise in people on Facebook offering their services at a low-cost price. This means that unofficial sperm donors are selling their sperm on social media sites, and that is not covered by the Online Safety Bill. It is really dangerous and exploits same-sex couples, and there are all the health ramifications to which this could lead.
My hon. Friend is absolutely right, and I will touch on that later. The guidelines are due to be updated next year. The Government have accepted that the situation is unfair and discriminatory. Last year’s women’s health strategy promised to remove the additional financial barriers to IVF for female same-sex couples in England, including removing the requirement to privately fund artificial insemination to prove fertility status before accessing NHS IVF services.
I am pleased that the Minister with responsibility for mental health and women’s health strategy is responding to this debate. In May she said:
“We expect the removal of the additional financial burden faced by female same-sex couples when accessing IVF treatment to take effect during 2023.”
On 11 September 2023, in response to a parliamentary question, she told the House:
“We remain committed to remove the requirement for female same-sex couples to self-fund six rounds of artificial insemination before being able to access National Health Service-funded treatment. NHS England are intending to issue commissioning guidance to integrated care boards to support implementation, which is expected shortly.”
We are still waiting for that guidance. The response also failed to acknowledge that, even now, some ICBs are still requiring self-funding for up to 12 rounds. With just 10 weeks left of 2023, the promise to remove the additional financial burden in 2023 will obviously not be met.
Of the 42 integrated care boards in England, only four offer fertility treatment to same-sex couples without the requirement to pay privately for artificial insemination. Ten more have said that they are reviewing their policies, but without the guidance from the Government or NHS England, there is not even a timeline for ICBs to make the changes needed. The Minister must ensure the full implementation of the recommendation from the women’s health strategy and work with NHS England to set out a clear timeline to bring an end to the inequalities experienced by LGBTQ+ couples when accessing fertility services.
Hannah Bardell (Livingston) (SNP)
I congratulate the hon. Lady on securing this debate. As well as the point about the strategy’s length of time, there is the age of some of us in the LGBT community. The fact that same-sex marriage did not come until some of us were older, and that many of us came out later in life, means that there is a very short window for older LGBT people to take the opportunity to get pregnant or be parents.
The hon. Lady is absolutely right. Generally, couples are starting their families later, and all these barriers make it almost impossible for so many to start a family.
Many organisations have been in touch with concerns about IVF provision, such as the Royal College of Obstetricians and Gynaecologists, the British Pregnancy Advisory Service, the Progress Educational Trust, the National AIDS Trust and many more. The National AIDS Trust has been challenging discriminatory legislation that prevents many people living with HIV from starting a family.
Under UK law, people living with HIV do not have the same rights as everyone else in accessing fertility treatment. Scientific evidence has demonstrated that there is no risk of HIV transmission through gamete donation, due to advances in HIV treatment. That has been accepted for people in a heterosexual relationship. Heterosexual couples are classified as being “in an intimate relationship” by the Government’s microbiological safety guidelines, and people living with HIV are allowed to donate gametes to their partner. However, that intimate relationship designation is not available to LGBTQ+ couples, creating yet another layer of discrimination on access to fertility treatment for LGBTQ+ people living with HIV.
Yesterday, LGBT Mummies told MPs that, in some cases, when people are denied fertility funding access, they look to alternative routes, such as home insemination. Going down that route comes with physical, psychological and legal implications, which, in turn, cost the Government and the NHS more than if the treatment and chance of family creation were offered in the first place. Laura-Rose told us that although home insemination has really worked for some people, and they have a great relationship with their donor, it can be dangerous for others. It has led to inappropriate proposals to donate only if people have intercourse with the donor. As well as the health risks, if people do not use registered banks or clinics to obtain sperm, there is the possibility that a donor could later try to claim parental rights over a child.
It is a pleasure to serve under your chairmanship, Mr Robertson. I thank the hon. Member for Jarrow (Kate Osborne) for securing this important debate about IVF provision for the LGBT community, but I think we need to talk about the whole of IVF provision across the country. This is so important, particularly in the week before National Fertility Awareness Week. We are not here next week, unfortunately, so we have to speak about it this week.
IVF has become a focal point for much of the work that I am doing in Parliament, ever since I received disturbing correspondence from a constituent. She told me her story and when I looked into it, I found that it resonated with women across the country. She was working in the financial sector and had had a very successful career for 20 years. She decided to use IVF to get pregnant because of her fertility issues. After complications, her employers discovered that she was undergoing IVF treatment, and from that day onwards, they put pressure on her to move from the UK to Switzerland for her job, which meant she would not be able to continue with her IVF treatment.
My constituent made the really difficult decision to leave her job. She went to an employment tribunal and ended up getting a non-disclosure agreement. She has not been able to speak publicly about her experience and the unfairness that so many people face when it comes to IVF provision, whatever their sexuality or gender, and that is why I have taken up her case.
Unfortunately, stories like that are repeated too often across the country. To make matters worse, the issues relating to the availability of treatment—the inability of people to access it due to work commitments—are countrywide. Work commitments are not the only constraint on accessing IVF treatment. For example, the availability of treatment has, for years, been based on where an individual lives. However, 2023 has provided us with reasons to be hopeful for the future: for the first time in over a decade, all areas of England now have access to NHS-funded facility treatment. But as we heard from the hon. Member for Jarrow, that does not always mean that people can get instant access to it. It is vital that we end the postcode lottery that has been established in this country when it comes to accessing IVF treatment.
Hannah Bardell
There are, of course, many in the LGBT community who will suffer from infertility, but the reality is that, as a starting point, it is not necessarily the infertility that is the issue; it is that we are same-sex. Does she recognise that the guidelines are based on infertility rather than recognising the unique nature and differences of various LGBT families?
Absolutely, and I will come on to that point. It is always about infertility, is it not? It should be about fertility and fertility treatment.
According to the UK fertility regulator—the Human Fertilisation and Embryology Authority—it takes, on average, three cycles of IVF to achieve success. I would like to praise the regulator for its recent announcement— I think from last week—regarding its grading of supplementary fertility treatment to help individuals and couples to determine what is a proven treatment and what is safe and cost-effective. That is most welcome, and I have had so many people come to me over the past year or so saying that the cost of IVF can be added on to all the time. In particular, people in clinics say, “Oh, you should have this scan” or “You might need to have this blood test—it might prove more successful.” When a person is in that situation, they will do anything they can to get pregnant. The costs do add up, so I am really pleased that the HFEA has released that guidance. I hope clinics across this country will take note.
Nevertheless, fertility treatment is still an emotionally draining, costly, risky and very long process. Undergoing treatment while juggling a job is particularly tough, regardless of gender or sexual orientation. Unlike employment legislation on pregnancy, maternity and paternity, there is no enshrined legislation that compels employers to give time off work for fertility treatment or any initial consultation. The Equality Act 2010 was well intentioned and removed some forms of discrimination in the workplace, but unfortunately it does not help to prevent discrimination against those who are pursuing fertility treatment, as it does not class infertility as a disability. For example, most workplace protection policies exclude elective medical procedures, putting fertility treatment on a par with cosmetic surgery.
Last year, I introduced the fertility workplace pledge. While my private Member’s Bill, the Fertility Treatment (Employment Rights) Bill, has faced its difficulties progressing through the House, the fertility workplace pledge that I launched asks businesses to sign up voluntarily to provide employees undergoing IVF treatment with the support and the time off they need. We have consistently seen new businesses signing up over the past year, including the likes of Channel 4, Aldi and NatWest—even the Houses of Parliament have signed up to become a fertility workplace ambassador. More and more businesses are signing up, and there are now several a week. I ask hon. Members to encourage employers in their constituency to look at the fertility workplace pledge and consider signing up. If we can do this voluntarily rather than through employment law, all the better, because it changes the debate, the discussions and the attitude towards fertility treatment.
The hon. Member is making a brilliant speech; I thank her for all her work in this area. One of the problems is that the societal stigma around fertility treatments persists and is quite vicious and vocal. Infertility is not seen as a disease, and it is not seen as something with equal weight to other conditions. We need to change this in schools. There has been a lot of talk today about the Government’s sex education programme. In school we are taught how not to get pregnant, but we are never told that we might not be able to get pregnant. There are serious conversations to be had about how to change the cultural stigma around fertility treatment. That starts with education in schools.
The hon. Member makes a very good point. On sex education in schools, it is imperative that we teach our children about all types of relationships, including same-sex and heterosexual couples, at an age-appropriate time. In my opinion, four and five-year-olds need to be taught about same-sex couples as much as about heterosexual couples. I really hope that that goes ahead—but I digress.
I want to pay tribute to all the organisations that have been helping me on my fertility workplace journey: Fertility Matters at Work, Fertility Network UK, TwoDads UK and many more whose help has unquestionably been vital to push towards the fertility workplace pledge and improve access to IVF for everyone.
As we have heard, there is one particular group who can benefit greatly from IVF and deserve equal access. The LGBTQ+ community are reliant on IVF to have their own biological children. I was pleased to hear the Government promise to make access to fertility treatment fairer last year. For too long, many in the LGBTQ+ community have faced what has been labelled the gay tax. This is because LGBTQ couples have to pay privately for their first six to 12 rounds of artificial insemination to prove their infertility, which would then grant them access to NHS IVF treatment or, as the hon. Member for Livingston (Hannah Bardell) said earlier—
Hannah Bardell
I remind the hon. Lady—not to boast too much, but to share positive experiences—that that is only in England in Wales. People in Scotland do not have to go through that process.
I thank the hon. Lady for pointing that out. It is not often that Scotland is ahead of England on the NHS. I am delighted to hear that.
I acknowledge that the change in policy will take time to implement. However, I ask the Minister to look into speeding up support to our LGBTQ communities. Such support is needed desperately in this area. They should not have to wait longer even than heterosexual couples.
Ultimately, I believe that we are on the cusp of real progress in access and attitudes. As the hon. Member for Pontypridd (Alex Davies-Jones) made clear about attitudes towards IVF, it is important that we break down the barriers from as early an age as possible. I know that the Minister is as passionate as I am about supporting individuals as they decide to go through fertility treatment. I therefore see it as vital that we all work together to bring down the remaining few barriers to make IVF treatment a viable option for everyone and anyone who wishes to start their own family, and to make it as stress-free as possible.
It is a pleasure to speak in this debate. I thank the hon. Member for Jarrow (Kate Osborne) for raising the issue of IVF provision and setting the scene so well. I will raise some examples from my constituency, where IVF treatment issues have had a detrimental effect on ladies who wish to have a family, with costs and financial implications for their lives, which have been changed in dramatic ways. A number of my constituents have contacted me about the issue over the years.
I am ever mindful that the Minister present does not have responsibility for the figures or the subject matter in Northern Ireland, but there is a real anomaly that I have to put on the record. I always bring a Northern Ireland perspective to these debates, as everyone knows. I do so because I hope to add to the conversations that we are having and perhaps show where the shortfalls are.
This important issue has an impact on many parents daily—it is indeed daily—and it is a pleasure to speak about it as my party’s spokesperson on health issues. Nothing is more precious than the gift of life. It is awful that for so many it is a struggle, so it is great to have the opportunity to debate, discuss and request further provision of IVF across the United Kingdom.
I will first highlight some differences between the mainland and Northern Ireland to add perspective to the debate. It was recently brought to my attention by a young constituent going through the process of IVF that on the mainland a person whose BMI is 35 can access medicated ovulation support, but in Northern Ireland it is 30. Sometimes that request is difficult for people in Northern Ireland to achieve. On the mainland, too, a person whose BMI is 30 can qualify for IVF, but in Northern Ireland it must be 25. Again, the criterion set in Northern Ireland is more stringent and difficult to achieve than that on the mainland. That is not the Minister’s fault, but it provides perspective for the debate.
It is a privilege to serve under your chairship this morning, Mr Robertson. I thank all colleagues for their contributions, which really have been excellent. This is the best of Parliament. I particularly congratulate my hon. Friend the Member for Jarrow (Kate Osborne) on her fantastic speech and on securing this vital debate.
It is fair to say that we are living in difficult times, with a huge range of issues facing us as parliamentarians, from healthcare to education and from energy prices to job insecurity. They all have an impact on our constituents up and down the country, but there is absolutely no reason why fertility and IVF provision—issues that clearly impact so many people—should not take centre stage.
It has been genuinely fascinating to meet and hear from so many families impacted by infertility and access to fertility treatment, including some who are here today. The brilliant Megan and Whitney Bacon-Evans, Michael Johnson-Ellis from TwoDads UK and Laura-Rose of LGBT Mummies are some of the many who have campaigned hard on this issue for many years.
As we have heard, one in six couples suffer issues related to fertility. My IVF journey began in 2018, and I have been open that I knew right from the start that my road to pregnancy would not be easy. I am certainly one of the lucky ones—I was able to take out a loan and borrow from family to pay for my treatment, and after only one round of IVF I was blessed with my beautiful son Sullivan—but I still had many eye-opening experiences during my fertility journey that have led me to this point today. Ask anyone who has experienced IVF, whether personally or from watching loved ones go through the process, and they will say that IVF is one of the most emotionally, mentally and physically challenging and financially demanding processes that anyone can ever undertake.
We must be clear that the current state of the IVF and fertility treatment offering across the UK is far below what would-be parents deserve. It is vital that we right those wrongs that I am many others have experienced at first hand as IVF patients. The main issue, as has been discussed today, is the sheer lack of consistency across the UK in IVF services and provision. I was incredibly fortunate because I was in a position to pay privately for my IVF and because my partner already had two children from a previous relationship, although that meant that we suffered from what we call the step-parent tax. It should not have to be that way.
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In England, the NHS will fund in vitro fertilisation for heterosexual couples who have been trying for a baby unsuccessfully for at least two years and who also meet certain other criteria such as age and weight, yet even here, there is a postcode lottery for IVF. Some ICBs use the outdated tool of body mass index as a way of measuring health and refuse women IVF on the basis of their or their partner’s BMI. Some ICBs set their own criteria—that happened to one of my constituents—and refuse to offer IVF if either person in the couple already has a child with a previous partner. I hope that the Minister’s guidance deals with all those inequalities in provision.
Stonewall and DIVA’s 2021 LGBTQI+ Insight survey found that 36% of LGBTQI+ women and non-binary respondents who had children experienced barriers or challenges when starting their family. One in five of those stated that the greatest barrier or challenge was the high cost of private fertility treatment.
Stonewall’s latest research shows that 93% of ICBs are still falling short of the women’s health strategy’s target. The Government and NHS England have said that they have a 10-year strategy to tackle that. Most women cannot wait 10 years for the rules to change. For the majority of people, raising tens of thousands of pounds is impossible. The policy is making them financially infertile.
Laura-Rose spoke about how lucky she is to be a parent, but she is still paying off the debt after incurring costs of more than £60,000. So many families she is working with are simply priced out of having a family. TwoDads UK also raised similar concerns in their briefings and contact with MPs, with Michael setting out that the inequality is pushing a community of people to take risks. The Royal College of Obstetricians and Gynaecologists told me that there is significant and unacceptable variation in the availability of NHS-funded fertility treatments in the UK, and that it strongly believes there should be equal access to fertility treatment for same-sex couples. It called on the Government and NHS England to support integrated care boards to ensure that that commitment is realised as soon as possible.
I hope that the Minister has listened to all the concerns and evidence from the many organisations I have mentioned, and others will no doubt be referenced in the debate. Ministers and NHS England can put an immediate end to the discrimination in IVF provision facing LGBTQ+ couples. It is unacceptable that the fertility treatment available for women through the NHS varies depending on where they live. The financial burden on same-sex couples is unacceptable, and we cannot wait any longer. The Government’s guidance and timetable for this to end should be published now. The Minister has recognised that the discrimination is unacceptable, and I hope to hear in her response that immediate action will be taken to remove these unnecessary additional practical and financial burdens from LGBTQ+ couples.
The NHS estimates that one in seven couples may be struggling to conceive, and obviously, for the LGBT community that is higher because of same-sex marriages. I have always said that infertility does not discriminate. It does not matter what a person’s background is. I have heard some really emotional testimony from people from ethnic minorities who have struggled even further in this country because of egg donation, and who have to go to Nigeria, in particular, to get their eggs. We have to widen the understanding of how people from ethnic minorities in the LGBT community struggle even more than same-sex white couples in this country. That is why it is so important to have this debate.
Many women in Northern Ireland have stated that the BMI issue is by far the biggest, and it leaves them with a feeling of sheer inequality. We have a clear issue of inequality in the system. Some of my constituents have come to the mainland to get IVF treatment. It can have a significant cost for them, which cannot be ignored. Why do they have to have a lower body mass index and be smaller to achieve the same fertility treatment as their English counterparts?
There is definitely an equality issue to be addressed. The hon. Member for Jarrow set out inequality in the system, and I support what she said. I reiterate the clear inequalities that my constituents face in comparison with those here. It is also worth mentioning that a woman suffering from polycystic ovary syndrome will struggle to lose weight at the same pace as someone who does not have PCOS.
There is already a prolonged process in place before people even achieve the criteria set back home. In England, according to NICE, women under 40 should be offered three rounds of NHS-funded IVF treatment if they have been trying unsuccessfully to start a family for two or more years. In Northern Ireland, it is only one round, and if the person or their partner has prior children, the entitlement is zero. As the hon. Member for Jarrow set out, the inequality is very apparent. Additionally, given that the chances of success vary depending on age, one round can be completely worthless in some cases. Unfortunately, some of the ladies who have come to me over the years have put themselves into debt in excess of a five-figure sum just to have a child, and the treatment may not be successful. Some of them are still paying the money back, and they have not had the child they sought to have in their life. It really is frustrating.
The Stormont Executive committed in 2020 to increase the number of funded cycles for a woman to have a baby. However, this is purely dependent on the money that Northern Ireland receives under the Barnett consequentials. Financial capacity restraints are the reason why the change has not been implemented. In this afternoon’s Westminster Hall debate on the future of NHS funding, I will highlight the issue of IVF funding and how it affects my constituents. We cannot expect to have a sustainable NHS if we do not make the effort to fund it properly.
I understand that capacity is different in Wales, where women are able to have only two rounds of IVF treatment. The fact that women in Scotland and England get three is completely unjust, as those in Northern Ireland get only one. It is a clear example of how we continue to be left behind, and it demonstrates the inequalities in the system for us in Northern Ireland.
NHS funding for IVF cycles varies considerably across the United Kingdom. In 2021, Scotland had the highest rate of NHS-funded IVF cycles, at 58%, compared with 30% in Wales and 24% in England. I know that the hon. Member for Livingston (Hannah Bardell) will give the figures for Scotland; I commend the country for achieving that percentage. Let us give it credit for doing so, because we should all be trying to achieve that.
The figures for Northern Ireland are not available, although I have sought hard to get them. I have written to the Department of Health back home to see whether they can be accessed, so hopefully I will have them in the next week or two. Self-funding is not always an option for couples due to the sheer cost of the process, but it is important to note the comparison.
Every time a lady undergoes an IVF cycle and is not successful, anxiety, depression and disappointment creep into the process. Then she might do it again and again. I know of one lady who has had IVF treatment at least five times, but it has never been successful. I feel for ladies who are keen to have a child and who go through the cycles of IVF treatment but are not successful. I believe that children make a marriage or a relationship. They might sometimes stress parents out but, at the end of the day, children are a bonus and a pleasure to have. I am pleased that at least some of us have had that opportunity.
I urge the Minister to take my comments into consideration and to discuss these matters with the Department of Health in Northern Ireland. I seek the Minister’s input; she always responds with compassion and understanding, which we appreciate. In relation to where we are in Northern Ireland, will she accept my request to have discussions with the Department of Health back home and see whether there is some way we can work together better to help my constituents and those across Northern Ireland who do not have funding for IVF? We must allow people in Northern Ireland the same right as those in the rest of the United Kingdom, and implement NICE’s recommendation to have three cycles of IVF for women struggling to conceive.
I wanted to make this small contribution to the debate, because it is important that we share our experiences. For those in Northern Ireland whose IVF treatment has been successful, the experience has been wonderful, but for many people it has not. The inequalities are clear.
As we all know, the NICE fertility guidelines are crystal clear; we have heard them this morning. The NHS should offer women under 40 three full cycles of IVF if they have been trying for a child for more than two years. When policies and cycles offered are so different between integrated care boards, and do not take same-sex provision into account, that means that women and would-be parents across the UK are not being offered IVF services in a fair and transparent manner. That is an incredibly important point, made even more complicated by the huge discrepancies between fertility treatment providers in the data they publish.
Colleagues may be aware of my private Member’s Bill, the Fertility Treatment (Transparency) Bill, which is due to have its Second Reading on 24 November. The Bill will
“require providers of in vitro fertilisation to publish information annually about the number of NHS-funded IVF cycles they carry out and about their provision of certain additional treatments in connection with in vitro fertilisation”.
Those add-on treatments, as we have heard from the hon. Member for Cities of London and Westminster (Nickie Aiken), have been offered to patients who are at their wits’ end and will do absolutely anything to improve their chances of having a child. I know their pain, because I was one of them. That is why I work closely with the HFEA, the Progress Educational Trust, Fertility Network UK and many others in the fertility sector who are concerned that many patients are frequently being offered and charged for optional extras to their treatment that claim to improve their chances of having a healthy baby, but are really exploiting people at their most vulnerable.
I was particularly pleased to see last week that the HFEA launched a new rating system to support patients undergoing fertility treatment. Patients are offered add-ons that claim to increase the success of treatment, but for most fertility patients the evidence to support that is missing or not very reliable. The HFEA add-ons rating will help patients to make better informed decisions about their treatment, although it is still only guidance and clinics have the right to ignore it. There is no right to enforce it: as we have heard, the HFEA as a regulator has very few teeth for enforcement. I urge the Minister to look at the issue more carefully and ensure that the regulations are being adhered to and that clinics are adopting the guidance. The new rating system, developed with patients and professionals in the fertility sector, has five categories giving detailed information for patients on whether add-ons increase the chances of success, along with other outcomes that also have an impact on miscarriage rates.
Although I welcome the progress, the wider issues on accessing IVF persist and we clearly have a long way to go in improving the situation. The Government’s women’s health strategy was a good starting point, but sadly we have still not seen any commitment on concrete action to improve access to IVF and fertility treatment. The strategy was published more than a year ago and was an opportunity for the Government to finally take some direct action, but instead it is once again clear that IVF is not an immediate priority.
I know that the Minister is listening. She has made her position very clear in previous debates on this subject, and I thank her for that engagement, but I sincerely hope that her colleagues in the Department and across Government are also listening and are taking the issue seriously. We have heard the strength of feeling this morning. I know that the Government are listening and that the Minister is listening; I just urge some direct action.