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Human Fertilisation and Embryology Bill [HL]

That was another extraordinary debate. I am proud to be able to participate in it. As the noble Lord, Lord Winston, and the noble Baroness, Lady Finlay, passionately pointed out, infertility affects thousands of people across the country. Approximately 27,000 people receive infertility treatment every year, both privately and in the NHS. The Government recognise the pain, distress and stress caused by fertility problems. As a mother of three, I recognise that the pain for those who are infertile must sometimes be intolerable. I listened with care to the speech on sexual health by the noble Baroness, Lady Tonge. It is important issue, but it is for another time. The Government are committed to improving the provision of IVF services. We began that process when we commissioned the NICE fertility guidance some seven years ago. The guidance was published in 2004, and recommended among other things up to three cycles of IVF for eligible couples. At that time, we recognised, as did NICE, that the guideline could not be implemented in full overnight, and we asked the NHS to begin by offering at least one cycle of IVF to eligible couples. Most PCTs now provide this, but we recognise that there remain considerable variations in access criteria from locality to locality. I should explain that NICE technical appraisals are mandatory, but that NICE guidelines are not. The fertility guide provided by NICE in 2004 was a guideline. The noble Baroness, Lady Finlay, was right to point out both the problems and the examples of good practice in certain parts of the country—although I recognise that they are too few. She was right also to mention multiple births. The noble and right reverend Lord, Lord Harries, told us of the deliberations in the HFEA. I understand that the HFEA has today called for a professionally led, co-ordinated national strategy to reduce the number of multiple births following fertility treatment. The Government will consider the part that they can play in that strategy, including through the expert working group on primary care trusts that we are in the process of setting up. I shall speak about that again shortly. To help address the regional variations, we are funding a project run by the leading fertility patient support organisation, Infertility Network UK, to work with the NHS to identify and disseminate good practice in the provision of fertility services, and to develop standardised criteria for access to IVF, such as whether to treat people who have children from previous relationships. We are also in the process of setting up an expert working group whose remit will be to identify the barriers, which have been graphically described, to the full implementation by the NHS of the NICE fertility guidelines and to provide advice, support and information to help overcome them. We of course need better commissioning. The group will be comprised of NHS commissioners and the leading fertility patient support organisation. This is the best way to improve access to NHS IVF services, as it aims to improve services while retaining local decision-making to meet the needs of local populations. The crux of our discussion today and of many debates in this Chamber about the health service is the discrepancy between our national policies and the way in which they are implemented on the ground. The best way forward is to listen to the expert group. We will ask it to consider the spirit of the amendment of the noble Baroness, and to consider recommending that PCTs should identify local IVF needs, explain their local decision-making and report to SHAs annually on the process and outcome, with the SHA making the report public. Naturally, I would facilitate meetings between the noble Baroness, the noble Baroness, Lady Jay, and the expert working group to ensure that their clear, passionate views were taken into account. I hope that, on that basis, the noble Baroness will feel able to withdraw her amendment.