Fertility Treatment and Employment Rights

Tuesday 1st November 2022 Westminster Hall

16:30

[Nickie Aiken (Cities of London and Westminster) (Con)]

I beg to move,

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.

[Steve Brine (Winchester) (Con)]

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?

[Nickie Aiken]

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.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

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?

[Nickie Aiken]

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.

[Peter Dowd (Bootle) (Lab)]

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.

[Nickie Aiken]

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.

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.

[Several hon. Members rose—]

[Sir Edward Leigh (in the Chair)]

Order. If everyone is going to get in, speeches must be kept to no more than five minutes.

16:44

[Jim Shannon (Strangford) (DUP)]

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.

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.

16:49

[Caroline Nokes (Romsey and Southampton North) (Con)]

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 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.

16:53

[Carla Lockhart (Upper Bann) (DUP)]

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.

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.

16:57

[John Howell (Henley) (Con)]

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.

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.

17:01

[Angela Crawley (Lanark and Hamilton East) (SNP)]

It is a pleasure to serve under your chairmanship, Sir Edward. I congratulate the hon. Member for Cities of London and Westminster (Nickie Aiken) on securing this incredibly important debate, and on all her work in Parliament on the Fertility Treatment (Employment Rights) Bill. I wish her every success with its Second Reading. I welcome the Minister to her place, and I hope that we will continue to have fruitful discussions on many issues, including my Bill on miscarriage leave, which I will undoubtedly continue to lobby her on.

We have heard from many Members that this is being National Fertility Awareness Week, so I am grateful that we are having the debate. As always, the hon. Member for Strangford (Jim Shannon) passionately conveyed his constituents’ experiences. My right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) spoke of the importance of making changes to workplace cultures to reflect modern families and the different routes to parenthood.

As we have heard, there are currently around 3.5 million people in the UK who experience fertility treatment. They do so for several reasons, but the most common is infertility. However, an increasing number of same-sex couples are undergoing treatment to start their own families, and a growing number of individuals are opting to preserve their fertility. Sadly, although advances in assisted fertility have allowed many more families who are unable to conceive without assistance through donor sperm or egg donation to opt for treatment, such as IVF, intrauterine insemination or surrogacy, this issue continues to be shrouded in secrecy and carries an element of stigma. As we have heard, those who have that lived experience do not appear to have a voice in the process, meaning that millions of UK citizens face the prospect of fertility treatment alone and in silence, and there are no specific rights within UK law to protect those who need time off from work.

No doubt the Minister will give the same response—I hope she will not—to what I have raised on several occasions regarding my Bill, which would introduce paid miscarriage leave for couples experiencing pregnancy loss before 24 weeks, but I will take this opportunity to remind her that the introduction of an employment Bill would have addressed many of the issues relating to guaranteed rights for workers. It is unfair that any employee should have to take annual leave for medical-related appointments, or even to take time off for what is already an arduous process.

Fertility treatment is undoubtedly one of the most challenging experiences that a couple can undertake. It is precarious, unpredictable and uncertain. Trying to plan for hormone cycles, treatment and blood appointments —nothing can prepare someone for what they will go through and the time that they will need from their employer. It can change and be fairly unpredictable, which is why it is essential that we understand the emotional impact that infertility can have. It cannot be underestimated.

Fertility treatment can be both traumatic and emotionally draining. It can be arduous and long, and it can take months or years. For couples who continue to go through that process, it can result in many unsuccessful attempts. Until a person has gone through it themselves, they will never fully appreciate how challenging it is.

I want to end with the testimony from a couple who wrote to me:

“Our plan was to grow our family, we saved and planned for fertility treatment. We didn’t plan for a global pandemic, cancelled treatment cycles, we didn’t anticipate how long our treatment would take, but we knew there was a possibility it may not work.

Thankfully, after several failed embryo transfers, we are now beginning to feel the excitement of being 16 weeks pregnant. While the journey steam rolls ahead it’s hard to stop and reflect on the pains and heartaches along the way…It’s the surrendering control to that little soul when it decides to join us was nothing short of a lesson in patience and gratitude.”

The reality is that nothing can prepare people for fertility treatment. Will the Minister signal to those undergoing fertility treatment that she will commit to introducing statutory rights for workers going through fertility treatment? Will she commit to introducing an employment law Bill, which we have long awaited over successive Parliaments? It is high time that the Government took action to bring employment law up to date in this country, whether by introducing fertility and miscarriage leave or by enacting the Taylor review. I urge the Minister to act now and introduce leave for the many couples who need it.

17:06

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to see you in the Chair, Sir Edward. I congratulate the hon. Member for Cities of London and Westminster (Nickie Aiken) on securing this debate and on her excellent speech. She said that there is little legal, medical, practical and emotional support for those seeking fertility treatment. That encapsulates the broad issues facing people in that situation; obviously, we are looking at a very specific issue today. I agree that IVF should not be considered on a par with cosmetic surgery—it is a very different thing altogether.

The hon. Lady really brought it home to me how far we need to go. She gave the example of her constituent who was told that she would be sacked if she undertook IVF treatment. That is the sort of thing that we would expect to have been said in the ’70s to someone who said they were pregnant. Rightly, society and the law have said that that kind of response is unacceptable. The hon. Lady summed it up well when she said that people should not be penalised for being unable to conceive naturally.

There were a lot of good speeches from Back Benchers. As always, the hon. Member for Strangford (Jim Shannon) gave a good contribution. I think everyone was pretty much in agreement about the importance of this issue.

The right hon. Member for Romsey and Southampton North (Caroline Nokes), who does an excellent job in all sorts of areas on equality in the workplace, said that we need to create a culture of openness and support for employees, and I hope this debate engenders that. She also asked about an employment Bill. The Minister is standing in today, but she may know that I have asked many previous Ministers when we can expect such a Bill. I am not expecting an answer, so to the right hon. Lady I say that I suspect it will take a Labour Government to introduce the plethora of employment legislation that this country desperately needs.

I am grateful to the hon. Member for Cities of London and Westminster for securing this debate. This issue has not traditionally received the attention it deserves because people understandably find it difficult to talk about, but we need to foster a culture of openness.

As we have heard, infertility and fertility treatment are the second most common reason for a woman to visit her GP—the most common is pregnancy. About one in seven couples are affected by infertility, which is about 3.5 million people in the UK. Since 1991, 1.3 million IVF cycles have been undertaken, resulting in 390,000 babies being born. IVF has become commonplace over those three decades: 6,700 IVF cycles took place in 1991, and 69,000 took place in 2019. I doubt that a tenfold increase in employers’ awareness has accompanied the increase in IVF treatment, which is why this debate is so important.

[Steve Brine]

It is interesting to hear those figures. There is a group who are not included in those figures, for whom all these issues around fertility challenge do not exist because they are banned from fertility treatment. Current legislation means that people living with HIV are banned from using such treatment. HIV medication is so effective these days that someone with HIV who is on it cannot pass HIV on, so their babies can be born without HIV. There is therefore no medical reason for this law to still exist. Are the Opposition aware of that situation? Do they think that law is a really brutal bit of discrimination that belongs to another age?

[Justin Madders]

I thank the hon. Gentleman for his intervention. I was not aware of that; obviously it is a matter that comes within the Department of Health’s bailiwick, so I would have to defer to my shadow colleagues in that sector. However, perhaps in a few days he will have a new role that will enable him to put a focus on this issue in a way that we have not seen so far.

We have heard a number of statistics that show why fertility treatment is such an important issue in the workplace. Fertility Network UK says that 56% of those seeking such treatment reported decreased job satisfaction; 63% admitted to reduced engagement; 36% had increased sickness absences; and 38% had seriously considered leaving their job or actually quit their job because they were trying to conceive—a statistic that should shame us all. Similarly, recent research published by Zurich found that 58% of women undergoing IVF treatment withheld that information from their employer and 12% of women left their job completely because their employer was unsupportive. These are statistics that we absolutely have to challenge and change.

It is easy to see why those undergoing fertility treatment report such experiences. Both from what we have heard today and from issues reported in the media, it is easy to see why so many people—particularly women—report feeling vulnerable and distressed about discussing these issues with their employer. I think that almost all in society are sensitive to how emotionally challenging and stigmatising seeking fertility support can be. However, having to physically administer treatment while in the workplace, and possibly while alone in a toilet stall, must be extremely difficult for those who have to do it, and fearing that a line manager might be questioning where they are while they do that can only add to the anxiety that people feel. Then there is the issue of whether someone’s treatment will negatively impact on their career, because they have an unsympathetic line manager. The experience can be very isolating. We have to change the culture to make sure that women feel supported and do not feel alone during these times.

In conclusion, the statistics that I have cited and the testimony today should give us all food for thought about whether we have got the balance right and make us consider whether there is sufficient support for those with fertility issues. The picture that has been presented today overwhelmingly suggests that we have not got that balance right at all.

17:12

[The Minister for Science and Investment Security (Ms Nusrat Ghani)]

It is a pleasure to serve under your chairmanship, Sir Edward.

I am standing in today for the Under-Secretary of State for Business, Energy and Industrial Strategy, my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake), but I want to put it on the record that we work as a team within BEIS—it is absolutely spot-on that BEIS is responding to this debate today.

I congratulate my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) on securing this important debate about fertility treatment and employment rights. We have heard so many shocking stories about the impact that this invasive treatment has on women, couples and families. However, I will take a moment to say that we have probably all been a little bit complicit in this situation, have we not? So many of us will know girlfriends, family members or colleagues who wanted to keep this treatment a secret; we have kept it a secret for them, because they were anxious about the behaviour they may experience at work. It is so important to get this issue out into the open. I pay tribute to my hon. Friend: putting together the fertility workplace pledge will be a fantastic contribution during her career in Parliament, which has only just begun. I thank her so much for bringing this matter to the fore.

There have been a lot of discussions about the challenges of infertility treatment and the impact that it has on women and couples, and potentially on their employment as well. We know from the statistics that so many people are going through the treatment, so it is shocking that it is still a secret. In 2019, about 53,000 patients had 69,000 IVF cycles and 5,700 donor insemination cycles at licensed fertility clinics in the UK. Those are huge statistics. The fact that women and couples feel that they cannot talk about their treatment in case they are treated in an inappropriate fashion is shocking.

National Fertility Awareness Week, which is actually this week, is a superb event; it starts off with awareness of fertility fairness, awareness of fertility in the workplace and evolves into awareness of infertility. It is great to have heard some male contributions today. There is also fertility education and taught fertility, as well.

I pay tribute to everyone who has contributed today, including the hon. Members for Strangford (Jim Shannon) and for Upper Bann (Carla Lockhart), and my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes)—who would dare to challenge my right hon. Friend, the Chair of the Women and Equalities Committee? Additionally, I pay tribute to my hon. Friend the Member for Winchester (Steve Brine), who has a tremendous record on health issues; I am also a little bit anxious about responding to his point. Of course I also pay tribute to my hon. Friend the Member for Henley (John Howell), who always speaks so sensibly as well.

I will quickly go through some of the work that the Government are doing and hopefully respond to some of the questions that were put, too. There is no denying that IVF is one of the most invasive fertility treatments. I do not understand why anybody would compare it to a cosmetic procedure; that is just absurd. It is invasive, gruelling and stressful, and it can last for years. We all have girlfriends who have started the process; it takes many years and has a financial impact as well, so there is no denying that it is an incredibly difficult thing to do. Also, injecting is a private matter and many women want that private space to inject themselves as well.

What we are talking about today is the fact that women and couples just cannot come forward and explain that they are going through this treatment, because they are anxious about how they are going to be treated in the workplace. As has been mentioned, that is an absurd anomaly because we are struggling to fill jobs and we want skilled people, who are loyal and who understand the workplace, to remain in work.

Something is not quite right and we know that the situation has to change. The issue is cultural, because we want people to be able to come forward, present what they are going through and have the support that they need within the workplace. We obviously need a cultural change, which is why the pledge is so important. Sometimes it is quicker to get businesses to move than Government, so, once again, congratulations to my hon. Friend the Member for Cities of London and Westminster for putting that pledge in place.

I want to reflect on some of the work being done by the Government. We have the women’s health strategy, which looks at the system as a whole: educating society at large and looking at the role that the health sector, employers and individuals can play. This summer, the first Government led “Women’s Health Strategy for England” was published, and a woman’s health ambassador was appointed to drive system-level changes to close the gender health gap. The theme of the health and wellbeing fund 2022 to 2025 is women’s reproductive wellbeing in the workplace. The fund supports organisations to expand and develop projects that support women experiencing reproductive health issues to remain in, or return to, the workplace.

The Government also have an active agenda on work and health more widely. We want employers and employees to have better interactions about work and health. That is particularly important in tackling some of the perception issues around women’s health generally, and IVF specifically. The Government’s response to the “Health is Everyone’s Business” consultation was published in July 2021. It sets out some of the measures we will take to reduce health-related job losses; that was spoken about today and is obviously a major issue that needs to be addressed. “Health is Everyone’s Business” did not consult on infertility or any other specific conditions. It looked at system-level measures to support employers and employees to manage any health condition in the workplace.

There has been some conversation around the employment rights Bill, and why it was not in the Queen’s Speech. That was raised by the hon. Member for Lanark and Hamilton East (Angela Crawley) and my right hon. Friend the Member for Romsey and Southampton North. We are obviously disappointed that the Queen’s Speech did not include an employment Bill for the third Session of this Parliament, but some good things have come out recently that are cross party; I know that my colleague, the hon. Member for Ellesmere Port and Neston (Justin Madders), wanted to have a little pop at the Conservative party, but we work with Members across the House.

Numerous private Members’ Bills have been introduced on employment rights as a result of the PMB ballot. In particular, there has been the Neonatal Care (Leave and Pay) Bill, the Employment (Allocation of Tips) Bill, the Protection from Redundancy (Pregnancy and Family Leave) Bill, the Carer’s Leave Bill and the Employment Relations (Flexible Working) Bill.

Good work is being done through private Members’ Bills, even though we may not have the employment Bill that everybody is asking for in this debate. The private Member’s Bill of my hon. Friend the Member for Cities of London and Westminster will require employers to allow employees to take time off for appointments for fertility treatment, as she said. I know that the Minister responsible will engage with her intensely before the appropriate time is made available for the Bill to return to the House.

I am anxious that we do not put across too much of a negative story on existing rights and entitlements, because there is already some good stuff out there. Even though there is no overarching right to time off for medical appointments, there are a number of ways employees may be able to take time off to attend medical appointments, including for IVF. I do not want anyone listening to feel any more stressed than they already do, if they are considering or going through IVF.

Many employers are willing to agree informal flexible working arrangements on a short-term basis. An individual may be able to take annual leave, or agree general unpaid leave with their employer. Fundamentally, the pledge campaign that my hon. Friend has put in place will really challenge some employers who have an old-fashioned view. It would be a badge of honour for these firms to say, “We have this in place”, because it will not only attract new staff but retain the staff they currently have.

If an individual is unwell, they can take a period of sickness absence and may be entitled to statutory or occupational sick pay. We cannot legislate to make employers act with compassion, but if employers want to employ committed employees one of the things they can do is adopt the fertility workplace pledge. It is a really positive step in taking this agenda forward and, as we have heard, a number of employers have already signed up, so I have no doubt that over a period of time it will grow and grow.

I will reference some of the comments made by colleagues. My hon. Friend the Member for Winchester spoke about NICE guidance on three opportunities at IVF. I am speaking outside of my brief, as these issues fall to the Department for Health, but we recognise that NHS-funded access to fertility services has been varied for a long time, and our ambition is to see an end to the postcode lottery. The Government published the health strategy in July this year, which made a commitment to address the geographic variations over the 10-year lifetime of the strategy. I have no doubt that my hon. Friend will carry on campaigning for that. The hon. Member for Lanark and Hamilton East talked about miscarriage leave. Once again, that is outside of BEIS—it falls to the Department for Health.

[Angela Crawley]

I want to comment on that specific point. This is about the right to paid leave, so it does sit specifically within the BEIS portfolio.

[Ms Ghani]

I will give a response to that as well, which will hopefully provide some satisfaction.

Miscarriage is obviously a personal experience; there are opportunities to try and request time away from work, and we need to ensure employers understand that. The pledge, for example, is one way of getting employers to understand how important it is to treat their employees with due care if they want to retain people in work. I think I covered the points made by my right hon. Friend the Member for Romsey and Southampton North; if I have not, I am sure she will pop up and intervene. She has not, so I believe that she is satisfied, which is a wonderful place to be when it comes to that particular Member.

I am not directly responsible for this brief, but I want to confirm with colleagues that I am incredibly passionate about it. So many people have gone through these issues, and here in Parliament we can promote it in particular and stop women being discreet about something that is so difficult and evasive.

I have already set out some of the Government’s activity in supporting health issues, in particular when it comes to those undergoing IVF. We have talked about how difficult it is to employ and retain loyal staff, and what we have been discussing is one way of dealing with that issue. Why would employers not sign up to the fertility workplace pledge? It does not make sense. I encourage my hon. Friend the Member for Cities of London and Westminster to do as much work as she can to promote the companies that sign up and out the companies that do not. I am determined to work with all my colleagues in BEIS to ensure that we are playing a full role in driving this agenda forward.

I thank everyone once again for this helpful and informative debate; it is important that we talk about these issues openly, and I wish my hon. Friend luck with the progress of her private Member’s Bill.

17:23

[Nickie Aiken]

I thank everyone for taking part in such an important debate. When I was first contacted by the constituent I mentioned in my speech, to be honest I was not aware that people undergoing fertility treatment did not receive employment rights and could not take time off on paid leave for treatment. That is wrong.

By raising this issue in Parliament, I hope to give people going through fertility treatment, and those who may go through it in future, the sense that they are supported by Parliament and businesses across the country. We must lift the taboo and ensure that people who want to speak about it—some will want to keep it quiet, and we respect that—and want such support deserve to have that support from their employer. I hope we can get the private Member’s Bill through, or that the Government adopt it eventually, when we have an employment Bill.

I repeat that business leaders who are serious about inclusion and retention must be willing to discuss fertility openly and to create policies to support employees in that phase of their life. I hope the legislation gets through, but in the meantime the fertility workplace pledge will provide accessible information, awareness in the workplace, staff training and flexible working. I hope that more and more businesses, big and small, will take part in the pledge, signing up to it and giving their employees the support that they deserve. I ask all hon. Members available tomorrow to pop into Room R in Portcullis House to support the fertility workplace pledge by having a photograph taken and speaking to the experts who will be there.

This is just the start. I want to ensure that people going through fertility treatment feel heard and supported, and that they get the rights they all deserve. We need more babies in this country, whether naturally or through fertility treatment. The plain fact is that if we are to continue to grow our economy, we need more babies, so let us ensure that people undergoing fertility treatment have the support.

Question put and agreed to.

Resolved,

That this House has considered fertility treatment and employment rights.

17:26

Sitting adjourned.