In May 2003, the National Infertility Awareness Campaign (NIAC) approached myself and other parliamentarians for assistance in setting up an All Party Parliamentary Group on Infertility (APPGI), both to raise awareness in parliament of infertility issues and to put pressure on the Government to implement the National Institute of Clinical Excellence (NICE) guidelines - which had recently been leaked whilst in draft stage. In June 2003, the Group was formed and I agreed to act as Chair.
Our first major project, with the help of a specialist advisory group of professionals, was to compile a report, entitled 'Infertility Treatment in the UK: Taking NICE Forward'. This was published in February 2004, to coincide with the publication of the NICE guidelines. The report challenged the cost estimates provided in the draft guideline and also examined the potential cost savings to be made by improving infertility services. Since then, the group has sought, in a constructive way, to urge the Government to fully implement the guideline.
On 26 January of this year, I instigated a debate on this subject in parliament; the Health Minister, Melanie Johnson, replied on behalf of the Government. We debated issues such as costs, eligibility criteria, timescales and waiting lists. It was noted during the debate that the APPGI and NIAC were conducting a survey of PCTs on implementation of the NICE fertility guidance. The Minister said that the Department would be interested in seeing the results of the survey. If barriers to implementation were then identified, they would bring them to the attention of the relevant Strategic Health Authorities. The survey achieved a 70 per cent response rate from PCTs and showed that progress is being made towards the Government's initial response to the NICE guideline: that PCTs should make available at least one full cycle of IVF by April 2005.
The results of the survey, published on 1 April, provided quite a comprehensive snapshot as to the progress being made. However, there are some worrying aspects thrown up by the survey which need to be addressed by Ministers. Waiting times, for example, are of concern: less than one third of the PCTs reported waiting times of one year or less, whilst 36 per cent have waiting times of over one year, including 10 per cent over two years.
Disinvestment is another issue: the report shows that 20 PCTs which are currently funding more than one cycle of IVF are intending to reduce their provision to one cycle as from April of this year. This contravenes the direction given by the Health Minister in the debate in January: 'Where existing provision is greater than one cycle...we expect provision to continue at that level'.
Other issues, such as non-implementation by PCTs, or the use of eligibility criteria also need to be tackled. On the day that the NICE guideline was published I asked the Prime Minister for his support, to which he replied: '...over the next couple of years we shall see at least very substantial progress towards implementation of the full NICE guideline...'. Unless the Government is prepared to take more decisive action, this is not going to happen.
Copies of the survey conducted by the All Party Parliamentary Group on Infertility and NIAC are available from Susan Seenan at the National Infertility Awareness Campaign, by email.
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