Steve McCabe MP has led a parliamentary debate on the variable provision of fertility treatments across the UK, calling for a revision to how fertility services are funded and provided.
The National Institute for Health and Care Excellence (NICE) recommends that women under 40 who have been unsuccessful in conceiving after two years should be offered three full cycles of IVF, and that one cycle should be offered to women between 40 and 42.
However, as these are guidelines, CCGs are not legally obliged to follow them. Further still, reports have shown that the cost to CCGs of commissioning one cycle of IVF varies from £1300 to £6000, leading many to limit fertility treatment provision in an effort to reduce financial pressures (see BioNews 826, 870 and 860). This has led to significant variation between CCGs in terms of the extent to which fertility treatments are available on the NHS.
A recent survey by campaign group Fertility Fairness (see BioNews 881) found that only four out of 209 CCGs offer access to all three cycles, while others have completely decommissioned assisted conception services.
McCabe secured the Backbench Business Debate after he was contacted by constituents concerned with this 'postcode lottery' system of IVF provision across England. The debate was also informed by a preceding 'digital debate' run by the House of Commons on Facebook, where hundreds of contributions from patients, clinicians and charities shared experiences of infertility and treatment.
Drawing on these experiences, McCabe noted that infertility is not a lifestyle issue, but a valid medical condition that can have a number of impacts, including mental health issues. He added that poor access to treatment on the NHS and the high expense of private treatment has led to many people travelling abroad, where treatment is cheaper but where standards are often lower. In turn this may increase the risk of multiple births and complications, which are costs that ultimately fall back on the NHS.
He therefore called on the Health Secretary to investigate the cost disparities and the variations of IVF provision across England to find out why the NICE guidance isn't being followed universally. McCabe also called for a national tariff of IVF services, explaining that this could help everyone have equal access to infertility treatment.
Nicola Blackwood MP, the Parliamentary Under-Secretary of State for Health, responded to McCabe by stating that she will write to NHS England to ask that it communicates clearly to CCGs the expectation that the NICE fertility guidance should be followed by all. She also added that various stakeholders will increase their efforts to develop a benchmark pricing for fertility services, which would act as a precursor to NHS England introducing a national tariff.