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Human Fertilisation and Embryology Bill [HL]

moved Amendment No. 164: "164: Clause 59, insert the following new Clause—""““Infertility services""(1) Infertility services shall include services for diagnosis, treatment and appropriate information.""(2) Strategic Health Authorities shall report annually on their local commissioning arrangements for infertility services.””" The noble Baroness said: My Lords, in the absence of the noble Baronesses, Lady Finlay and Lady Jay, I have been asked, if the House permits, to move this amendment in their names and I promise no vote. As the noble and learned Lord, Lord Mackay, said in Committee, this issue concerned the pre-legislative scrutiny committee: that is, the postcode lottery of IVF treatment and that the NICE guidelines—they are not targets or requirements—did not appear to be followed as we believe they should. That there is such a lottery can be in no doubt. The noble Baroness, Lady Finlay, furnished me with statistics to that effect. I understand the figures are for 2006-07 and they are the latest figures that she has. For example, East Sussex has a population only slightly less than that of Dorset’s PCT—326,000 to 395,000—yet East Sussex gave IVF treatment to only 32 women and Dorset treated 110 women. Mid-Essex, with a population of 359,000 in its PCT, treated 43 women; and south-west Essex, with 420,000 people in its PCT, treated 76 women, nearly double. Similarly within London, Camden, with 210,000 people in its PCT, treated 51 women; and Croydon, with a population of 343,000, treated 52 women. There is a variation of 50 per cent or more between adjacent authorities, which suggests that it is not just a matter of demographic profile, local needs or local wishes as expressed through PCTs. Why does this matter? Your Lordships know the arguments, which were much more fully rehearsed in Committee. There are basically two. First, human misery, so eloquently described by the noble Lord, Lord Winston, led to the desperation of many women and their partners. If they could not get treatment from the NHS, that misery sent them into the private sector at high cost. Given that the private sector worked at profit, it sometimes offered treatment that was profitable but not efficacious—bordering, in some cases, on the exploitative. If it was improper, as I believe it is, to buy babies, there must be a question mark over the ability to buy embryos as opposed to having them as part of the gift solution within the NHS, which I suspect most of us would much prefer. The first reason is therefore that finance becomes a barrier and, once it is in the private sector, there is the risk of unnecessary and exploitative treatment in a competitive financial environment. The second reason why the pre-scrutiny committee was concerned about the failure of so many PCTs to follow NICE guidelines was that it also means that, in desperation—and as a result of tight finance—many would-be mothers will seek the implantation of multiple embryos. Again, as many of your Lordships said in Committee, this presents both a high risk to the mother and foetus and, if there is a multiple birth, often a high cost to the authority in terms of the support—cots and beds—needed for small, premature, low-weight babies struggling with respiratory and feeding problems. The amendment is modest. It simply requires the strategic health authorities to report annually on local commissioning arrangements. That is a gentle way of highlighting the problem in exactly the same way as reports from the Audit Commission highlight problems for local authorities by use of comparators of appropriate adjacent authorities with which it is proper to compare the cost, quality and delivery of services. Such reports work. They still respect the need for local choice, and the fact that different areas may have different demographic profiles and needs. They do make sure that, if there is a judgment not to spend as much on IVF treatment in one area than another, that is based on information, and not ignorance, as now too often applies. I have read again the Committee speech of my noble friend Lady Royall, in which she said that this was the subject of an expert working group—that is splendid. I hope that that will be pursued, as I am sure it will be. Such an annual report would help the expert working group come to more firmly based and routed solutions. Therefore, I see this amendment as complementary to what the Minister is already proposing to suggest to the House—if her Committee speech is a guideline. It is in this context that we want to see as much IVF treatment in the NHS as is affordable, that there should not be a postcode lottery and that money should not be a hurdle to parents seeking to have a child. We should not expose parents to the profit motive of the private sector and also to the risk of multiple implantations. In that context, I hope my noble friend will agree that anything that encourages PCTs to provide equity of access to IVF treatment—and, as NICE has suggested, to a required and appropriate number of cycles—should be supported. I hope that my noble friend will welcome this amendment. I beg to move.