Steve McCabe MP (Birmingham Selly Oak) has welcomed an intervention by the Health Minister who has written to Clinical Commissioning Groups across England telling them to end the postcode lottery of fertility treatment following the publication of new commissioning guidance but the campaigning MP wants to see deeds not words.
He will be contacting every CCG in England to ask them if they are prepared to re-examine their commissioning of fertility treatment and eligibility criteria in light of the new guidance and advice from the Health Minister.
Health Minister, Jackie Doyle-Price MP has written to CCGs in England advising them to implement the latest commissioning advice from the Human Fertility and Embryology Authority on commissioning fertility services. The letter says CCGs should move towards implementing the NICE fertility guidelines in full and end the lottery once and for all.
Unfortunately the guidance is only advisory not instructive and this means there is a real danger that CCGs, looking to save money, will ignore them in exactly the same way they routinely ignore existing NICE (National Institute for Health & Care Excellence) guidelines on access and treatment cycles.
The Commissioning Advice from the Human Fertility and Embryology Authority states that access restrictions to fertility treatment should only be in place for clinical reasons which are support by evidence but the reality for lots of couples is that they are having non-medical criteria applied to stop them accessing IVF on the NHS. For example, in Birmingham if your partner has a child from a previous relationship you are not entitled to treatment on the NHS.
Ending the post code lottery which allows different access criteria and different prices to be applied to fertility treatment depending on where a person lives, has been one of the key aims of campaigners who want to end the vast disparities in the cost of commissioning IVF treatment and eligibility criteria for IVF. Some Clinical Commissioning Groups, including Steve McCabe’s own CCG Birmingham and Solihull, apply non-medical criteria such as the body mass index of the male partner or whether the male partner has ever had a child by a previous relationship to exclude couples seeking IVF treatment.
Steve McCabe MP said:
“This looks like an important step forward and covers part of what I was hoping to achieve with my Private Member’s Bill. I am very pleased that the Minister has listened and wants to make a difference.
“However this guidance really needs to be instructive and not advisory if we are going to make a breakthrough on behalf of the three and a half million people who need help with fertility issues and I am writing to CCGs to ask how they will be updating their commissioning of fertility treatment in response to the new guidance.
“It’s a scandal that a medical condition, recognised by the World Health Organisation, is routinely ignored by accountants seeking to trim CCG budgets. That’s why I wanted to legislate for these changes because it is obvious that some of these people don’t respond to advisory guidelines. They need to be told that what they are doing is unfair and in conflict with the basic principles of the NHS in terms of providing treatment at the point of need.
“We are meant to have a National Health Service but at the moment that’s not the case if you suffer with an infertility problem. I will keep pushing until we end the postcode lottery and the moralistic judgements of commissioners about who is entitled to IVF. Medical need not easy budget savings should be the priority and that probably means instructions to CCGs not advice.”
Steve McCabe MP has been campaigning to end the postcode lottery of IVF treatment for some time and this year introduced his The Access to Fertility Services Bill. The Bill sets out the campaign’s key demands:
- ENDING the postcode lottery of access to IVF by ensuring that clinical guidelines and quality standards produced by NICE are followed when assessing eligibility
- It explicitly prohibits the use of eligibility criteria based on non-clinical factors relating to either partner
- Bringing the pricing of NHS fertility services under the NHS National Tariff Payment system which would address the vast difference in pricing for a cycle of IVF for different CCGs.
Steve first began his campaign for fair access to IVF treatment after being contacted by constituents who were denied IVF based on arbitrary moral criteria which had nothing to do with medical eligibility and did not follow guidelines set by NICE. Steve found that there are huge variations across different areas, for example only 34 clinical commissioning groups (CCGs) provide 3 cycles of IVF in line with NICE guidance whereas 175 CCGs provide 0-2 cycles.
Data obtained by Campaign Group Fertility Fairness shows that 7 CCGs have stopped offering IVF on the NHS entirely. 12 deny treatment to women over 34 and 85 CCGs have cut IVF for women over 29 – despite NICE guidelines outlining women should be eligible for IVF up to 42 years old.
Fertility Fairness previously reported that the number of clinical commissioning groups (CCGs) in England offering the recommended 3 IVF cycles to eligible women under 40 has halved in the last 5 years: just 12 per cent now follow national guidance, down from 24 per cent in 2013. The number of CCGS which have removed IVF treatment from the NHS completely has almost doubled in the last year
Charities have come together to launch their #Scream4IVF petition which has got over 100,000 signatures showing just how much support there is to end this injustice.