- In August 2019, it emerged that NHS South East London Commissioning Alliance’s IVF policy explicitly denied funded IVF services to single women because of the “burden on society” caused by one-parent families.
- A coalition of charities and parliamentarians wrote to the Commissioners stating that the policy was in contravention of NICE guidance and added “to the stigma already experienced by many single parent families.”
- Following a review, NHS SE London have now announced that they will amend their policy to allow single women access to IVF in line with NICE guidance.
- Charities welcome this decision while also warning that thousands of women across the country continue to be denied funded IVF according to other “arbitrary, non-clinical criteria” such as their male partner’s BMI.
Charities have today welcomed the decision by NHS South East London to amend their IVF policy after it emerged in August 2019 that single women were being denied NHS-funded infertility treatments “because of the known disadvantage that providing assisted conception to a single woman would cause both the child and the mother”.
The policy caused outcry from charities and politicians when it was published. It is not known how many women have been affected by the policy which was based on a document which stated that “single mothers are generally poorer; they are likely to have greater support needs compared to two-parent couples, thereby placing a greater burden on society in general” and that “a sole woman is unable to bring out the best outcomes for the child”.
The National Institute for Health and Care Excellence (NICE) evidence-based clinical guidelines state that women under-40 should be offered 3 full cycles of IVF if they have not conceived after 2 years of regular unprotected sex or 12 cycles of artificial insemination (including 6 or more by intrauterine insemination.) NICE guidance does not include any stipulations as to the relationship status of the person planning to have treatment.
In their review, NHS SE London compared their policies with those of the 20 other London CCGs and found that “none of the policies reviewed mention either the ethics of restricting funding for NHS funded fertility treatments or issues pertaining to the welfare of the child”. The CCG has now announced that they will “amend the SE London Treatment Access Policy for IVF for single women, to enable them to have access to IVF” if they have confirmed infertility by “unsuccessful cycles of artificial insemination (AI) within the 12 past months.” The letter concludes that “amended policies should be on CCG websites in January 2020”.
However, charities have warned that a “postcode lottery” is “hindering fair access to treatment for infertility” across the country. Research by the charity Fertility Fairness has found that the majority of women in the UK live in areas which do not offer funded IVF in line with NICE guidance, and that a number of CCGs continue to use non-clinical reasons to justify restrictions to treatment, including the length of a couple’s relationship and the BMI of the male partner.
Between 2013 and 2017, the number of CCGs in England offering the recommended 3 IVF cycles to eligible women under 40 halved: just 12 per cent of CCGs stated they were following national guidance in 2017, down from 24 per cent in 2013. Since then, a number of other CCGs have announced further restrictions and currently at least 4 CCGs do not offer any funded IVF treatment.
Commenting on the decision:
Dr Emily Scott, IVF Fairness:
“It is only right that this policy has been amended to allow single women to access IVF treatment on the NHS, and we are very glad of the swift review and decision-making undertaken by South-East London CCGs to address the limitations of this.
“We implore other CCGs to follow suit and to take urgent steps to address other shortcomings and inequalities which are hindering fair access to treatment for infertility for people across the country, particularly the allocation of treatment according to postcode, relationship status, and other arbitrary, non-clinical criteria.”
Katherine O’Brien, spokesperson for the British Pregnancy Advisory Service, bpas, said:
“NHS South East London’s previous policy has forced women to spend tens of thousands of pounds on IVF treatment and made others feel that they might not be a good parent because they did not have a partner. Infertility is recognised as a disease by the World Health Organisation. Ill-found social judgements and discriminatory rationing should play no part in the allocation of IVF treatment on the NHS.
“While we welcome this decision, it is heart-breaking that for many women and their partners their ability to have a child will be dependent on their postcode or their bank balance. It is time for a national review of IVF provision to ensure that all CCGs have the funding and guidance they need to provide evidence-based, comprehensive care to those experiencing infertility.”
Maria Booker, Programmes Director, Birthrights
"We warmly welcome the revision of South East London's policy to ensure that single women can access IVF treatment. Human rights law prohibits discrimination by the State in policies affecting family life and there is no justification for the claim that providing IVF treatment to single women has a negative impact on the welfare of her baby.
“We urge all commissioners to review their access to fertility treatment policies to ensure they are fair, and based on evidence not prejudice."
For more information, please email firstname.lastname@example.org or call 020 7061 3377
The announcement of NHS SE London’s IVF Treatment Policy Review is online here
bpas is a charity which sees nearly 100,000 women a year for reproductive healthcare services including pregnancy counselling, abortion care, miscarriage management and contraception, at clinics across the UK. It supports and advocates for reproductive choice.
Birthrights is the UK’s only organisation dedicated to improving women’s experience of pregnancy and childbirth by promoting respect for human rights. We believe that all women are entitled to respectful maternity care that protects their fundamental rights to dignity, autonomy, privacy and equality. We provide advice and legal information to women, train healthcare professionals to deliver rights respecting care and campaign to change maternity policy and systems.
About IVF Fairness
IVF Fairness was established by Dr Emily Scott to campaign for fair access to infertility treatment on the NHS. In 2019, IVF Fairness launched a parliamentary petition calling for government action to end the IVF postcode lottery. The petition received over the 10,000 signatures required for a Government response, however the petition was closed early as a result of the General Election. There has been no response from the current Government.