Rebecca Smith

It is a pleasure to serve under your chairmanship, Dr Huq. I thank the hon. Member for Torbay (Steve Darling) for securing this debate. I am here to focus specifically on fertility treatment in Devon, which is one of the costs we have because of the atrocious funding situation to which the hon. Member referred. The Devon integrated care board is not currently funding fertility care for local patients in line with Department of Health and Social Care expectations, and is not following National Institute for Health and Care Excellence guidelines in their entirety. Its policy is not based entirely on the clinical factors recommended by NICE, but is based instead on previous clinical commissioning group policy, economic factors and additional non-clinical factors, which are all understandable, but that is not good enough for local patients. NICE states: “Commissioners…should commission sufficient capacity within specialist fertility services to provide 3 full cycles…for women aged under 40 years who meet the criteria for IVF…A full cycle should include 1 episode of ovarian stimulation and the transfer of any resultant fresh and frozen embryo(s)”, and that any previous cycle counts towards that total. NICE guidelines also state that women under 40 who meet the criteria for IVF treatment “should be offered 3 full cycles of IVF” with a cycle defined as including one episode, as I have said. A full cycle ends either when every available but viable embryo has been transferred, or when one results in a pregnancy. Devon ICB incompletely funds only a portion of one cycle. It has made up a different definition of a cycle, and, in the commissioning policy, defines a cycle as “one…fresh and one…frozen implantation of embryos. A frozen embryo transfer episode will only be available if there are embryos generated from the fresh cycle suitable for freezing.” That does not include any remaining embryos from the first cycle of stimulation, nor the remaining two cycles recommended by NICE. Devon should be funding three full cycles, and it is not. That means that we are living in a legitimate postcode lottery: people with a PL, TQ or EX postcode are being completely sold short. I believe we need to treat this, and we need to see what the Government can do to mitigate the problem and to encourage ICBs such as Devon to ensure that just living within their health authority should not mean that people cannot access the treatment that others in other parts of the country can access, particularly those under 40 years old.