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8 Mar 2007 : Column 1717

Coming from the mother of Parliaments, I was pleased to see affirmative action work in Pakistan and the reality of 33 per cent. representation for women providing a clear image of power and value to other women. I hope that we will see that as valuable and that my party will quickly adopt 33 per cent. as the minimum threshold for affirmative action for women in this House, on councils and in other elected bodies.

I have an equal commitment to the issue of infertility and I have the pleasure of chairing the all-party group on infertility. If any hon. Member has not had the experience of speaking to couples—often in their 20s, sometimes in their 30s and 40s—struggling with this issue, I urge them to do so, although I cannot believe that there is anybody who has not done so. It is an issue in which we all, in different ways, get very involved. Today, one in six couples in Great Britain have problems conceiving. People are often embarrassed by that, and think that their womanhood or manhood is reduced. That is nonsensical, but that is the impact that infertility has. The statistic of one in six is probably wrong, and it is likely to be at least one in five.

The all-party group has had a positive and supportive relationship with the Minister of State, Department of Health, my hon. Friend the Member for Don Valley (Caroline Flint), who has helped to deliver for the group, but the issue needs more than one Minister in one Department. We need the whole House to be very involved in the issue. The Government have put reasonable amounts into that area of health policy and made it clear that each couple should receive three IVF treatments if they are suitable, but that does not happen. The fact that primary care trusts are not obliged to implement National Institute for Health and Clinical Excellence guidance means that they can decide that IVF treatment is not a priority. Perhaps there is a postcode lottery, because we know that many young couples suffer from the fact that some PCTs do not offer IVF treatment.

Mrs. Maria Miller: I have written to the Department of Health on numerous occasions on behalf of constituents of mine who have had problems accessing IVF treatment in the way that the hon. Lady has described. A postcode lottery does exist: women in Hampshire cannot get IVF treatment until they are over 35, and even then they get only one cycle. Does she share the concern of our colleague my hon. Friend the hon. Member for Welwyn Hatfield (Grant Shapps), who undertook a nationwide survey on this matter? His findings show that women throughout the country suffer from the problems that she has set out. The Government should long ago have begun to address that inequity, in what is a sensitive and important matter.

Ms Taylor: I agree with an awful lot of what the hon. Lady has said. The hon. Gentleman’s survey is excellent, and I shall refer to it again later, but the all-party group has also conducted a survey of PCTs. The shameful fact is that a third of them did not bother to respond. Moreover, two thirds of those that did respond displayed a much less determined approach than we would have wanted. Their casual approach to the problem was totally unacceptable.

We need more than a statement of expectation. Therefore, my first request to the Ministers attending
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the debate is that they undertake to secure from the Department of Health a directive requiring all health authorities and PCTs to implement NICE guidance in respect of the provision of IVF treatment. Without such a directive, and in the absence of women knocking on their doors and telling them of the difficulties that they face, those bodies will simply assume that no problem exists. I assure the House that the problem does exist, but the sad thing is that it is often invisible.

Researchers and medics involved in infertility tell us that IVF treatment gives women under 35 a one in four chance of becoming pregnant, and that that success rate is even higher for women under 30. The evidence shows that when women of the right age—that is, under 27—are given the right medical treatment, there is a 70 per cent. chance that they will get pregnant. I am sincere when I say that, if cancer treatments could achieve the same success rate, we would all be demanding that they be made available. However, although the figures for all cancer treatments are very blurry, a 5 per cent. cure rate is the usual one cited. Cancer treatments are funded by the NHS, and no one in the House would ever say that they should not be—indeed, we would all call for more funding to be made available. If IVF were to be funded in the same way as cancer treatments, very many more people who need it would be able to benefit.

Angela Watkinson: There is a very generous IVF treatment service in my own hospital trust area, and it has found that it is most effective to offer women two cycles of treatment. In areas with restricted funds, women can receive only one cycle of treatment. Does the hon. Lady agree that that might be a waste, and that it is better to treat 50 women with two cycles of IVF than 100 with one?

Ms Taylor: The hon. Lady makes a very important point, for which there is statistical proof. I do not think that any of us are fooled by the information that the research has supplied. We are keen to get that research disseminated more widely and, in particular, accepted at PCT level.

If there is a funding problem, we need to know about it. From my experience, I know that there is no such problem, so I want to know why three cycles of IVF treatments are not being made available. Why must a woman wait until she is 35 before she is put on the list? Why must she then wait two years to be seen by a consultant gynaecologist? A woman can reach the age of 40 after 15 years desperately wanting treatment for a disease. Part of her body does not function, so why must she wait 15 years for treatment? We would not dream of such delay in treating any other medical problem, so my second request is clear, although controversial: whenever we talk about infertility in this place, we should accept that it is a disease, not a lifestyle issue. It is a disease—parts of a functioning system do not work—and there are ways to improve the condition and possibly achieve conception. Many women desperately want a family.

Barbara Keeley (Worsley) (Lab): One of my constituents who needs IVF treatment is in the unfortunate position of having her hospital in one local authority but living in another, which has a three-year waiting list. She is 32 and has had ectopic pregnancies, so IVF is her only
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chance. Members have made some useful points, but does my hon. Friend agree that women such as my constituent who have suffered several ectopic pregnancies and for whom IVF is their only chance should be given priority over others in the queue?

Ms Taylor: I can only agree. People living in the same road can be in different PCTs, so policy differences are completely unacceptable. We need a central Government directive on the issue, otherwise the present situation, in which PCTs make different policy decisions, will never change. Invariably, PCTs are trying to interpret what the Secretary of State said about full treatment, but for many PCTs a full treatment is only one cycle of IVF, not three; yet three treatments were anticipated and that is what we believe was said at the time.

Mrs. Maria Miller: The hon. Lady is generous in taking interventions. I want to pick up on her point about funding. She said that in her PCT area there was no problem with funding for IVF treatment. Unfortunately, I live in an area that suffers severe funding problems for all sorts of health care, because we receive only 80 per cent. of the average. I have been told by my PCT that my constituents cannot have access to IVF treatment because the trust does not receive average funding, which means that tough choices have to be made and unfortunately those women suffer as a result.

Ms Taylor: It would be appropriate if the hon. Lady wrote to me. I am not making a political statement, because that is not how the all-party group operates, but if she is saying, as I think she is, that there is a money issue, we need to look at it. Information from other PCTs shows that value judgments are made about priorities, so it would be valuable to hear from the hon. Lady. In fact, I definitely invite her to join the all-party group. That would be tremendous.

At present, a review of the Human Fertilisation and Embryology Act 1990 is under way, which is appropriate. I have observed the work of the Human Fertilisation and Embryology Authority throughout Great Britain and find its regulatory procedure overwhelmingly controlling and strict. In actual fact, I think they reach a point where they begin to stigmatise infertile couples and stigmatise children who are born through fertility treatments. Let me explain.

If we look at the Government’s detailed central register of all couples who have received infertility treatment, we find that—regardless of whether they have achieved pregnancy or not—all children born through that procedure are included and maintained on it. I view that as intrusive and totally unnecessary. It is my third request this afternoon that they are taken off that register, as they should not have been placed on it by he HFEA in the first place.

My fourth request is to look further into private clinics. We are very aware of how they work. They have a job to do and I am certainly not knocking them, but it would be very valuable if they were brought into line with NHS procedures. Indeed, I would think it appropriate if they became part of the NHS so that they did not exist outside it and could not promise women and young and older couples things that cannot be done. We need to see clearly what their competences are in order to deliver.

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Will the Minister reflect on a further request? I have been greatly involved with the Newcastle fertility centre. As well as supporting IVF as a treatment, it is an excellent research establishment. Every year, this excellent research centre, which does work that any infertile person would acknowledge as invaluable, has to pay out £70,000 in licences. For every patient it incurs a cost of £100 and every patient pays £100. It is a tax that the infertile have to pay. It is totally nonsensical and I would hope that Ministers looked further into that problem.

Before finishing, I want to refer to a piece of research that was carried out very thoughtfully by the hon. Member for Welwyn Hatfield (Grant Shapps). His study has proved very valuable. Although his research probably tells us what we already know, sadly, despite the fact that we all know it, it remains an absolutely controlling influence in the delivery of infertility services. The hon. Gentleman points out that in some authorities, one has to be aged 30 or 36 to receive any IVF treatment; in others, the age is 35 and still others 36 to 39. There is not an hon. Member in the House who doubts the research showing that IVF’s capacity to achieve a conception becomes significantly less for women over the age of 35 and that it will work for a singularly very small minority of women over 40.

Let us think about a young couple, perhaps around the age of 22. If the medics have said clearly that the prognosis is that they are not going to conceive naturally, why are we asking couples to wait from the age of 22 until they are 30 to 36, 35 or 39 before treatment kicks in? Clearly, the hon. Gentleman’s research is valuable. He believes that infertility and fertility services are being marginalised and that there could well be a problem with funding. What he is saying, in total, is that the delivery of such services is messy and has no uniformity. I have always believed that any medical intervention should be provided at the point of need. The point of need seems to vary according to where people happen to be living. I suggest to my Front-Bench colleagues that it would be valuable to have a look at the hon. Gentleman’s thoughtful piece of research.

My real request is for the House to accept that we are seeing the development of new procedures and technology in infertility. We are seeing some staggeringly good developments in clinical standards. Slowly, we are seeing a change in public attitudes to infertility and we should encourage that to continue. I accept that there is a need for effective regulation, but I want infertile couples to be treated in the fair and just way that other patients in the national health service are treated, and from which they benefit.

2.50 pm

Lorely Burt (Solihull) (LD): It is a great honour to speak for the Liberal Democrats on this important day. Members will be relieved to learn that I shall not use the occasion to make cheap political points about Baroness Thatcher or anyone else—except to say that she acted as such a role model to her party that it has the lowest percentage of women in Parliament, at 9 per cent. of Members elected. At the rate that the Conservatives are going, it will take 400 years to achieve parity of gender. However, I acknowledge that Baroness Thatcher stimulated women—Labour and Liberal Democrat Members—to go into politics to try to remedy the damage that she did.

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I thank hon. Members on both sides of the House for signing the early-day motion that I tabled yesterday to mark international women’s day. The word “mark” is more appropriate than “celebrate” because, although we have made some advances, many of which were heralded by the equal opportunities legislation 30 years ago, women in Britain and all over the world are still not treated equally and they are still abused physically, mentally and sexually. On the Order Paper, the title of today’s debate is “Women, justice and gender equality in the UK”, so I will confine most of my remarks to what is happening here at home. Goodness knows, there is enough material for 10 debates, let alone one. However, on international women’s day, it is right to spare a moment to think about our sisters overseas who suffer regular physical abuse, rape and torture. We are debating equality and justice in the UK, but compared with some of our sisters overseas—in Rwanda, Sudan, and many other parts of the world—we do not know that we are born.

The theme for international women’s day this year is ending impunity for violence. According to the UN, violence against women is the most common and least punished crime in the world. One in three women has had violence perpetrated against them. Domestic violence affects women all over the world, irrespective of location, culture, ethnicity, education, class or religion. Violence against women is the bully’s way of demonstrating their power in the most humiliating and—literally—hurtful way. In the UK, behind closed doors, women put up with sexual and physical abuse every day of their lives and say nothing.

Angela Watkinson: Will the hon. Lady include in that list emotional violence from a controlling partner?

Lorely Burt: The hon. Lady makes an extremely important point. Violence is not only physical. It can also encompass the controlling behaviour of partners. It has to be said that men are also subject to that type of violence. We must not forget about the men, but it is most often perpetrated against women.

The women who flee to one of the few refuges in this country are not even the tip of the iceberg—they are the tip of the tip of the iceberg. How do we go about protecting women in Britain? It is a shameful fact that things do not seem to be getting better. As far as rape is concerned, they are certainly getting worse. Ten years ago, 24 per cent. of reported rapes resulted in conviction. Today, the figure is less than a quarter of that, at under 6 per cent. I hope that the Minister for Women and Equality will comment on that in her speech, and will suggest why that is the case.

There are twice as many women in prison as there were 10 years ago, yet 80 per cent.—the same proportion as 10 years ago—are there for minor offences such as shoplifting. Again, I would be grateful if, in her speech, the Minister enlightened me on why that is. We lock those women up, but we close local women’s prisons and make sure that they are sent so far from home that it is almost impossible for their families to get to see them. Every year, 16,000 of their children are left motherless. Of those 16,000, only 5 per cent. are
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able to remain at home. Families are broken up, and children are the innocent victims of a policy that could not be better designed to destroy lives.

What of the women entering prison? As I said when I intervened on the Under-Secretary of State for Constitutional Affairs, the hon. and learned Member for Redcar (Vera Baird), two thirds of women who go to prison have a mental illness, and 55 per cent. test positive for class A drugs. Are we really saying that prison is the best place for many of those people? It makes one want to weep.

I will not even go into the subject of prostitution, except to say that 90 per cent. of prostitutes are addicted to class A drugs. Those women are stigmatised and rarely helped, but there is no social criticism of the men who use and abuse them. Instead, I will move on to the apparently fairer world of work. Economic independence and equality are among the most powerful tools at our disposal for creating a fairer and more just society. Money talks. About 30 years ago, we passed landmark equal opportunities legislation and although the pay gap is not as bad as it was 30 years ago, on average, women still earn 17 per cent. less than men for full-time work and 26 per cent. less for part-time work. The situation for graduates is even worse. Women graduates begin their careers earning an average 15 per cent. less than men, but by the time that they are between 35 and 40 years old, that gap has widened to 40 per cent. The glass ceiling is strong and thick and shows no sign of cracking.

Meg Munn: I do not know whether the hon. Lady is aware that the most recent statistics on the gender pay gap show a closing of the gap for women in their twenties, which may herald some progress.

Lorely Burt: Women in their twenties generally have not had children, and it is when children come on the scene that women start to fall behind. However, I welcome the Minister’s optimism; I wish I could share it, but I have reservations.

Moving on to women in top jobs, only 7 per cent. of top judges and 4 per cent. of directors of the UK’s top 100 companies are women. Fewer than 20 per cent. of Members of this House are women. Of course, ethnic minority women face two glass ceilings, so that wonderful pool of talent is going to waste. Whether one looks through the glass from above or from below, it should be recognised that the talent that we are wasting could be used to create a much more prosperous and equal society.

Talking of a waste of talent, what about women entrepreneurs? Only 14 per cent. of companies in this country are wholly owned by women. Women are also less likely to be offered bank loans. Furthermore, female entrepreneurs are forced to pay on average 14 per cent. more interest than men when banks deign to give them loans.

What should we do? Is it enough to carry on making the right noises and making incremental changes? At the current rate that we in Parliament are going, it will be another 200 years before we get equality, as the Minister said in her opening remarks.

Mrs. Laing: People often quote interesting statistics to do with the different generations—the Minister did so. However, we are not currently making progress at
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the same rate that progress was made over the past century; we are making far greater progress. That is one of the reasons why the Members who are present are able to have the debate that we are having this afternoon. Do not many of us work on this matter 100 per cent. of the time? Therefore, progress will be far greater. That is not empty optimism; that is determination.

Lorely Burt: I am glad to hear that the hon. Lady is determined to make progress. However, I think that I am right in saying that the rate of progress is what is happening at the moment; it does not rely on any huge historical background.

Meg Munn: May I provide some clarification on that? On current policies—this has been reviewed by the Fawcett society following each general election—Labour Members will achieve parity much more quickly. That will take between 30 and 35 years, which is still far too long, but we are making much more progress than the Conservatives or the Liberal Democrats.

Lorely Burt: The Minister is right that the Labour group is making much more progress, and I shall address that shortly. However, at our current rate of progress it will take too long whichever way we look at it; I am a bit too impatient to accept that it will take potentially eight more generations before we achieve parity.

Mrs. Maria Miller: I should like to ask the hon. Lady a question which perhaps I should have asked of the Minister during her speech earlier. Many women Members who are present in the Chamber have family commitments, myself included. I am not sure whether the following question is about a particular party political issue or just one that the entire House must deal with; how do we make this job more attractive to women who have family responsibilities? It is a difficult job for anyone to do, let alone those with young children. It might be unfair to have asked that question of the hon. Lady but I would be interested to hear her answer.

Lorely Burt: I am grateful to the hon. Lady for making that excellent point. The Committee stage of the Companies Bill lasted seven weeks last summer—it was arguably the longest and most boring Bill in history. A Labour Member discovered when her child care arrangements broke down that there are no crèche facilities at the House of Commons for Members. Her little daughter learned to walk on the corridor outside the Committee Room, which was one of the few pleasurable and enlightening moments that I experienced during the passage of the Bill. I do not tell that story to belittle what the hon. Lady says, which is hugely important. I have asked the Minister about crèche facilities and she has been generous and kind enough to say that she will look into that.

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