Will the next general election put an end to the IVF postcode lottery? By Bethan Phillips, Senior Consultant
06/02/2023
For those working in the health and women’s sector, and indeed for couples and individuals struggling to conceive, the phrase ‘The IVF postcode lottery’ is well known. For those outside of these groups, let me explain.
In England fertility services, including IVF, are provided by a mixture of NHS and private services. Responsibility for commissioning fertility services in England is taken by Intergrated Care Systems (ICS) formerly CCGs. Guidance for how fertility services should be commissioned and provided is issued by NICE. However, the extent to which ICS’s follow this guidance is varied. Differences between individual ICS’ policies in England has led to the emergence of significant regional variations in fertility funding, dubbed the “IVF postcode lottery”, which has been criticised by campaigners, professional bodies, the media and even the former Health and Social Care Secretary, Matt Hancock MP.
Put simply, the lottery means a couple in Camden could access up to three cycles of IVF on the NHS, but a couple 10 miles down the round in Croydon can’t access any IVF on the NHS. The variation does not only relate to the number of IVF cycles, other regional policy differences span, age, sexual orientation, previous children, relationship status to name a few.
The launch of the women’s health strategy last summer brought some good news with the announcement of the removal of requirements for same-sex female couples to self-fund fertility treatment before becoming eligible for NHS-funded care. However, the government also announced measures to improve "transparency" around local policies to help to "tackle the IVF postcode lottery." Campaigners criticised this announcement, stating "the IVF postcode lottery is not the result of a lack of transparency but a consequence of a systemic problem with the way fertility services are funded in England."
The only way to truly end this postcode lottery is to introduce a national standardisation. Former Labour Shadow Health Sec Jon Ashworth made a commitment to increase tax to reduce the lottery in 2019, and last year former Shadow Equalities Minster Charlotte Nichols called for an end to the postcode lottery. Sadly, none of the current Labour front bench have officially called for an end to the lottery.
With the cost-of-living crisis look set to continue, arguably access to fertility treatment might not be top of everyone's agenda when it comes to voting. But with 1 in 6 couples, 3.5 million people, struggling to conceive, removing this lottery-like system seems a no brainer when political parties, specifically Labour are producing election manifestos this year.
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