IVF Provision

Hannah Bardell Excerpts

Tuesday 24th October 2023 Westminster Hall

[Kate Osborne]

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.

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 Some ICBs use the outdated tool of body mass index as a way of measuring health and refuse women IVF on the basis of their or their partner’s BMI.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.

[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.

[Kate Osborne]

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.

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.

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

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.

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.

[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?

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[Nickie Aiken]

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.

[Nickie Aiken]

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.

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[Hannah Bardell (Livingston) (SNP)]

It is a huge pleasure to serve under your chairship, Mr Robertson, and I sincerely thank the hon. Member for Jarrow (Kate Osborne) for bringing forward this debate. She spoke beautifully and eloquently about her experiences; it enhances debate when Members, like the hon. Member for Pontypridd (Alex Davies-Jones), bring their own personal experiences.

It is very clear that there is unanimity, which does not happen often. I trumpet and champion the positive equality and the better standards that we have in Scotland, but I would love to see those standards rolled out, so that they were the same throughout the UK. It is not about political point scoring; it is about genuinely working together and sharing best practice. However, although it is significantly better in Scotland, we still have arbitrary limits across the board on the age when women are offered IVF. That is global—not just in the UK.

A recently-published report showed that, for the first time since the second world war, more women in their 40s than women in their 20s are having children. That is just a reality. There are all sorts of reasons for that—the cost of living crisis, the cost of accommodation, women’s career paths and the lack of childcare. All Governments in the UK are trying to do more around childcare and I recognise those challenges, but the reasons are varied and complex.

A Conservative Member recently said that more people need to have babies. I will not mention the Member, as I have not given due notice. It was an offhand comment and it rightly came in for a lot of criticism because of the intent. However, there is an irony there in that some on the Government Benches are saying that, yet we need more action from the Conservative Government. They need to reflect on that. They should look at the reasons why we have a stagnant birth rate and fewer people having children, and at what more can be done.

We have heard, particularly from the hon. Member for Jarrow, about the issues with the women’s health strategy: it is ambitious and the guidance is good, but it is not mandatory. We need it to be. We need to move away from the pot-luck nature of treatment, particularly in England and Wales. I was struck by the briefing, which led through the different levels of care, all the different boards across England and Wales and how challenging that must be for people—not just LGBT people but anyone seeking fertility treatment.

The hon. Member for Jarrow also spoke about the outdated BMI criteria and how those can vary. That is particularly challenging as well. Women’s bodies come in all shapes and sizes and for all different reasons. We must recognise that. The hon. Member for Strangford (Jim Shannon) also spoke about that issue in relation to Northern Ireland: that arbitrary line is discriminatory. We need to remove the discrimination and those barriers.

The hon. Member for Jarrow also spoke about those with HIV and how they are being discriminated against, and both she and the hon. Member for Pontypridd talked about black-market sperm. Members may remember the 2017 BBC Three documentary. I watched it and was horrified. It showed LGBT couples and female same-sex couples searching the internet for donors and often facing quite dangerous situations. In 2023, people who so desperately want to have a family and to have children should not be forced into those situations. It is unthinkable.

Someone very close to me has been through several rounds of IVF. It cost her tens of thousands of pounds. She talked to me about going to a fertility fair in London, and all the different stalls and what an amazing experience that was in her journey; but a man came up to her and, in the middle of the fair, handed her a note with his phone number and a really inappropriate message, basically trying to push himself on to her to offer his sperm. She reported it and that person was removed, but that is a truly shocking story, showing just how predatory some men can be in such situations.

We also have to recognise that there are a lot of incredible men out there who donate their sperm and make it possible for others to use it, and there are also incredible women who donate their eggs. Such people make it possible particularly for those in the LGBT community but also heterosexual couples to have children.

It is a particular privilege to be able to represent Scotland’s approach to IVF, which, as I said, I am extremely proud of. Not only are we providing a higher proportion of NHS-funded cycles of treatment, but that means that the ability to have a baby is less affected by income.

There are particular challenges for LGBT couples, but I think we are pioneering some work in relation to those challenges. In addition, one of the things that happens if there is more standardised NHS treatment is that the clinics across Scotland—in Edinburgh, Glasgow, Dundee and Aberdeen; I think that is correct—collaborate, whereas when people are moving around, particularly in the private sector, they find that those private clinics keep their pioneering work—I am afraid to say—to themselves. I am sure that there is some collaboration, but that seems to be the case.

So, under the SNP-led Scottish Government, we have become a “gold standard” for IVF treatment. Those are not my words but those of Sarah Norcross, the director of Progress Educational Trust, which is an independent, London-based charity that advocates for people affected by fertility issues.

I must say that this is an area where the priorities of the Scottish Government and those of the UK Government are different. I hope that the UK Government will follow our lead; if they did, I am sure that my colleagues in the Scottish Government would be happy to share their experiences and best practice. Ms Norcross said that in Scotland IVF services were

“as good as it gets”.

The UK Government obviously have a different standard. So, as I say, I hope that this is something that we can share best practice on.

I also recognise that, as has already been mentioned by other hon. Members, the briefing yesterday by Megan and Whitney, LGBT Mummies and TwoDads UK was particularly powerful. It was really stark about the challenges that our community—I say this as a member of the LGBT community—has to face.

However, I also have heterosexual friends who have been through IVF. I have one friend who was fortunate enough to have her first baby through natural means. However, for various reasons she then went on to have secondary infertility. She cannot get fertility treatment on the NHS in Scotland. We will offer it to blended families. So, in the situation of the hon. Member for Pontypridd, I can tell her that if she had lived in Scotland, she would have been entitled to treatment. However, if someone has one child and wants to have more children with the same partner, unfortunately they would not be entitled to treatment. That is something that we need to look at in Scotland. Blended families are very much the norm now. If it is the case that someone has a child, or they and their partner both have children from previous relationships, and they are unfortunate enough to experience secondary infertility, they should have access to fertility treatment.

NHS-funded cycles in England decreased in number from 19,634 in 2019 to 16,335 in 2021, which is a 17% reduction. Covid will undoubtedly have played a part in that. In Wales, the number of NHS-funded cycles decreased from 1,094 to 704 over the same period. In Scotland there was a slight decrease, of just 1%, in that period.

In England, treatment is much more likely to be outsourced to private clinics, even when the costs are covered by the NHS, which has a serious negative impact on overall services. Fertility experts have pointed out that the major reason that fertility care in Scotland is so consistently excellent is that there is the collaboration that I mentioned.

I have also heard from a number of people I have spoken to that people are going abroad for fertility treatment. It would appear that they are going to clinics in Europe because the service there is better. That IVF tourism, as some people call it, is cheaper and seems to be better than the treatment here in the UK, but we do not want people to have to go abroad for that reason; we want people to be able to have their babies here.

The hon. Member for Cities of London and Westminster (Nickie Aiken) spoke very powerfully about her work in workplace fertility support. That is interesting, because a lot of people will not want to disclose information about their fertility, or they will not feel comfortable about doing so unless their employer is being open. I have perhaps a slightly different opinion from that of the hon. Member. Of course businesses should just provide such support, but businesses have a lot of pressure on them, and sometimes legislation can be the precursor or the catalyst for changes in behaviour and lead to the provision of real, solid support for people who are going through things such as IVF treatment.

Obviously, National Fertility Awareness Week is coming up; however, it was Baby Loss Awareness Week just the other week. I know somebody who, having gone through expensive fertility treatment, only managed the one embryo transfer, which unfortunately did not work. It can be very upsetting when an embryo transfer does not work, no matter the person’s sexuality.

I thank LGBT Mummies for the excellent job it has done on briefings. I will briefly go through its asks for the LGBT community, which include equal and equitable access, national mandated funding policy and provisions for all LGBTQI people. As the hon. Member for Jarrow powerfully highlighted in her speech, the LGBT community is facing discrimination and attacks like never before, including the removal of health services, which is something we all have to reflect on and look to improve. Its asks also include personalised fertility care and education for staff—something I have experienced myself, in the language health practitioners use and in their understanding of the different healthcare requirements of the LGBT community. They also include access to funded medication and tests for home insemination, co-produced funding provision with the community, and the ability to create our families safely by our chosen routes—not being forced down a route.

The difference in Scotland is that we do not have to go through those IUI cycles, but a challenge we have across the board is the arbitrary two-year timeline, where people have to have been in a relationship for two years. I do not know of anywhere where we say to heterosexual couples, “Don’t be having a baby until you’ve been together for two years.” We don’t do that, do we? So why are we doing that to LGBT people? That really does not make any sense.

Briefly, I want to reflect on my personal experience. I had a partial failed attempt at IVF with a former partner—I will not go into the details—but I did not start my journey until after I turned 40. I now regret that, because I am 40 and I will get only one shot, rather than three. I am only at the very beginning. I want to highlight to the Minister that piece about those of us who came out later in life. When I came out at 32, most of my friends were getting married and having kids, or already had kids, and I was just working out who I was. One reason that I did not come out earlier was that I so strongly wanted to have a family, and I did not think that would be open to me if I was gay. Equal marriage came much later in life for many people. Like many of us who did not start life as their authentic self, as some people say, until much later, I have felt like I am perennially playing catch-up, and I have now decided to just do it on my own. I do not know where my journey will take me, but I know there is a lot of support out there, and a lot of incredible people.

I am in a very fortunate position, but not many are that fortunate. As we have heard, people are going to the black market and putting themselves in massive debt; we should not be putting anybody in that situation. I hope the Minister will hear the calls from across the House, and I look forward to working with colleagues on this very important issue.

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[Maria Caulfield]

As the hon. Lady will know, it was only last year that we published the women’s health strategy. IVF was front and centre of that—the first year priority. Getting that information is the first step, and then we are able to look at the ICBs that are not offering the required level of service, have those conversations about why and have a step change to improve the offer. That is just one tool in our box to fulfil our ambition to end the postcode lottery for fertility treatment across England.

Colleagues have also raised the issue of lack of information about IVF, both for the public and healthcare professionals. We are working closely with NHS England to update the NHS website to make IVF more prominent, and also with the royal colleges to improve the awareness of IVF across healthcare professions. One area we are dealing with is that of add-ons, which the hon. Member for Pontypridd (Alex Davies-Jones) and my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) addressed. As part of our discussions with the HFEA, it now has the add-on rating system, so that people can see what percentage difference an add-on would make and make an informed choice about whether they want to do that as part of their IVF treatment.

I have also just received the HFEA’s report about modernising the legislation, with particular regard to its regulatory powers. That will cover the provision of add-ons, and I hope to be able to respond to the report as quickly as possible. We are making really big changes to some of the issues that have been holding back IVF for a long time. I know that for many people this is not quick enough, but I reassure hon. Members that progress is being made.

For female same-sex couples and same-sex couples across the board, I know that this is a really important matter. I took the position that it was unacceptable for female same-sex couples to shoulder an additional financial burden to access NHS-funded fertility treatment. On the transparency toolkit now on the gov.uk website, we can easily see which parts of the country are asking for six cycles of self-funded insemination, for instance. In Cambridgeshire and Peterborough it is 12 cycles, in Bristol and north Somerset it is 10. As the hon. Member for Erith and Thamesmead (Abena Oppong-Asare) said, that is exactly the information we need so that we can tackle the issue head-on and directly with the ICBs. Indeed, one of our key commitments in the women’s health strategy was to remove this injustice once and for all. We were hoping to do that completely in the first year; it will in fact take us a little longer, but it will not take us 10 years.

[Hannah Bardell]

It is certainly comforting to hear that, but I urge the Minister to supercharge that work, so that female same-sex couples and, indeed, the trans community can make sure they can access that. Will the Minister say something about surrogacy, because I know that across the UK—though, again, we have somewhat better standards and access in Scotland—there are still major challenges, legal and otherwise, for male same-sex couples accessing surrogacy?

[Maria Caulfield]

The Law Commission has recently produced a report on changes to surrogacy, which we are in the process of responding to. It will address some of the issues raised today. The Government’s position is to abolish the requirement for female same-sex couples to undergo six cycles of self-funded treatment before they can access NHS-funded treatment. We have been clear that the NHS-funded pathway should now offer six cycles of artificial insemination followed by IVF to female same-sex couples, giving everyone access to NHS-funded fertility services. Some ICBs are doing that already, but others have delayed implementation, and that is what we want to focus on now. We are clear that that needs to be urgently addressed, because same-sex couples’ expectations have rightly been raised and the service has not met them swiftly enough. I take that on board from the debate today and reassure colleagues that that is a priority.

To accelerate action, NHS England is developing advice to assist ICBs. I hope they will be able to share that soon. I will share that with the House as soon as it is available. When it is published, we expect ICBs to update their local policies. There should be no further delay and no waiting for NICE guidelines when they are published next year. ICBs must urgently address all local inequalities in access to fertility treatment. There is a reason that IVF was made a priority in the women’s health strategy and a reason it was a priority in the first year.

Our health service pioneered the use of IVF in the 1970s. It is a great British invention that should be available to every couple who want to start a family, because the Government back women and families and the accessibility of IVF to those who need it. I look forward to the hon. Member for Jarrow continuing to hold my feet to the fire until we have delivered the change—deliver it we must.

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[Kate Osborne]

I thank the hon. Member for her intervention. In my contribution I touched on the unsafe and inappropriate online advances facing same-sex couples, which the hon. Member has just raised, as did my hon. Friend the Member for Pontypridd (Alex Davies-Jones). Megan and Whitney told us yesterday of horrific, very detailed, explicit and inappropriate proposals that they have received online, and many other couples have reported the same. In 2023, we should not be forcing desperate women to turn to black market sperm and be pushed into tens of thousands of pounds of debt.

I thank the hon. Member for Strangford (Jim Shannon) for describing the situation in Northern Ireland and adding to the concerns that I raised around the inappropriate use of BMI as a factor in deciding IVF provision, particularly how BMI is different for people with PCOS. I would add other conditions such as lipoedema. BMI is not an adequate measure to deny people IVF. Indeed, I believe that BMI is not an adequate measure in pretty much anything.

I thank my hon. Friend the Member for Pontypridd for sharing her story, for highlighting financial risks taken and the concerns about regulatory practices in fertility clinics, and for her incredibly important private Member’s Bill.

[Hannah Bardell]

One other condition or disease that has not been spoken about is endometriosis. Endometriosis sufferers often have a terrible time conceiving and face significant challenges. I hope the hon. Lady will recognise that we must include them in all our conversations.

[Kate Osborne]

I absolutely agree that we should include those sufferers. The hon. Lady’s own contribution to the debate was incredibly powerful. She shared her personal story and pointed out how much better the situation is in Scotland, although improvements can always be made. She rightly pointed out that people are going abroad for treatment. TwoDads UK made that point eloquently in our briefing yesterday.

My hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) spoke about the need to end the postcode lottery, with that additional emotional and financial toll. I am pleased the Minister confirmed that she will remove discrimination against HIV as soon as possible through secondary legislation. I hope that “as soon as possible” means imminently and that we are not still talking about this in a year’s time.

The Minister mentioned the HFEA and changes to regulation. The 2021 guidelines for fertility clinics highlight the need for improved understanding of consumer law and how it applies to clinics and patients. The guidance significantly improves the availability of knowledge of the topic, but it still misses out conditions and vulnerabilities faced by same-sex couples and transgender people, so I look forward to receiving her update.

I am glad that the Minister welcomes me holding her feet to the fire on discrimination in provision for IVF. I will continue to do so. She said that it has taken a bit longer than she would like—but not 10 years. I want to see an urgent timeline from her. The inconsistency in IVF provision across the UK is unacceptable. We must end the postcode lottery for fertility treatment and the unacceptable financial burden on same-sex couples. As has been pointed out today, many women cannot wait any longer.

Question put and agreed to.

Resolved,

That this House has considered the matter of IVF provision.