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Fertility Treatment: Costs

Lord Alton of Liverpool asked Her Majesty's Government:

Baroness Jay of Paddington: It is not possible to calculate an average cost of fertility treatment for an infertile couple, since the needs of couples vary greatly. Treatment for infertility ranges from counselling in primary care settings to drug treatments and complex procedures such as in-vitro fertilisation (IVF). Costs per couple will vary accordingly. We have however estimated the National Health Service costs of some of the procedures. These are set out as follows:

Tests/initial investigations£250-£800 per couple
Drug treatments£250-£600 per cycle
In-vitro fertilisation/intra cytoplasmic sperm injection£2,000-£3,000 per cycle
Donor insemination£600-£1,000 per cycle
Surgery for ovulation factors or tubal damage£1,000-£1,500 per person


Estimates derived from information supplied by the Royal College of Obstetricians and Gynaecologists and the National Infertility Awareness Campaign.

Human Fertilisation and Embryology Legislation

Lord Alton of Liverpool asked Her Majesty's Government:

    Which members of the Human Fertilisation and Embryology Authority uphold the sanctity of human life.[HL1789]

Baroness Jay of Paddington: Members of the Human Fertilisation and Embryology Authority are selected on the basis of their experience and personal qualities, in accordance with guidance issued by the Commission for Public Appointments following the first Report of the Committee of Standards in Public Life (Nolan Committee, Cm 2850-1, May 1995).

The Human Fertilisation and Embryology Act 1990 governs membership of the authority, including the proportions of lay and professional members and that both men and women must be appointed. The chairman and members of the authority are responsible collectively for discharging the functions of the authority as set out in the 1990 Act. As such, when being considered for appointment, members are asked to state whether they subscribe to the aims of the authority.

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Lord Alton of Liverpool asked Her Majesty's Government:

    How many human embryos:

    (a) have been created;

    (b) have been experimented upon or destroyed;

    (c) have been used successfully in fertility treatments;

    in accordance with the Human Fertilisation and Embryology Act 1990.[HL1786]

Baroness of Jay of Paddington: The most recent figures verified by the Human Fertilisation and Embryology Authority are for 1 August 1991 to 31 March 1996.

Four hundred and sixty-two thousand, two hundred and thirty-five embryos were created through in-vitro fertilisation (IVF) treatments.

Thirty-six thousand, nine hundred and thirty embryos were donated to research and 138,450 embryos were discarded during the course of IVF treatment cycles. This latter figure includes embryos considered non-viable for implantation. Figures are not collected routinely of the number of embryos allowed to perish because the statutory storage period has ended or a patient has requested it.

The number of IVF treatment cycles which resulted in one or more babies was 15,563: 40,589 embryos were used in these cycles.

Lord Alton of Liverpool asked Her Majesty's Government:

    What steps are taken to obtain the consent of donors for their fertilised eggs to be destroyed or used in human fertilisation and embryology experiments; and what breakthroughs in fertility treatment have arisen from such experiments.[HL1788]

Baroness Jay of Paddington: Effective consent under the terms of the Human Fertilisation and Embryology Act 1990 is required for the storage and use of human embryos. Embryos must be removed from storage if either of the donors withdraw their consent to storage or when the embryos reach the end of the storage period allowed under the Act.

The 1990 Act also sets out the criteria for research involving human embryos. The Human Fertilisation and Embryology Authority will only license research which meets these criteria and is important for the development of further understanding of issues relating to infertility. Such research has included biopsy work which has enhanced understanding of severe genetic diseases such as cystic fibrosis, chromosome disorders and mitochondrial studies. A full list of current projects is included in the authority's annual report, copies of which are available in the Library.

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Lord Alton of Liverpool asked Her Majesty's Government:

    How many:

    (a) babies were adopted in the last 12 months for which figures are available;

    (b) parents are currently known to be trying to adopt a baby in the United Kingdom.[HL1791]

Baroness Jay of Paddington: Three hundred and seventy-five babies under one year of age were adopted in the United Kingdom during the 12 months period 1 January-31 December 1995.

Information on the number of people who wish to adopt babies in the United Kingdom is not held centrally.

Gulf War Veterans: Pensions Assessment

Baroness Park of Monmouth asked Her Majesty's Government:

    Whether the War Pensions Agency has referred some Gulf War veterans for whom medical reports are required to doctors who are also acting as expert witnesses for the Treasury Solicitor; and, if so, whether this breaches the principle of independent assessment; and [HL1746]

    Whether the War Pensions Agency has refused to accept the diagnosis of such experts as Group Captain Coker and Colonel Bhatt when they have declared Gulf War Syndrome to be present in an applicant for a war pension; and what measures they are taking to increase the number of independent experts. [HL1747]

The Parliamentary Under-Secretary of State, Department of Social Security (Baroness Hollis of Heigham): One of the key aims is that delivery of service should be simpler and more efficient. Queries on operational matters concerning the War Pensions Agency are for its Acting Chief Executive, Mr. Steve Johnson. I have asked him to write to the noble Baroness.

Letter to Baroness Park of Monmouth from the Acting Chief Executive of the War Pensions Agency, Mr. Steve Johnson, dated 13 May 1998.

The Parliamentary Under-Secretary of State for Social Security has asked me to reply to your recent parliamentary Questions about ex-servicemen who served in the Gulf conflict.

You have asked about the referral of some Gulf War veterans for medical reports to doctors who are also acting as expert witnesses for the Treasury Solicitor.

Some 10,000 medical reports from consultants are requested yearly to provide evidence for war pension determination. Where the case is particularly complex or there is a conflict of medical opinion, reports are

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commissioned from regional consultants who have particular experience and expertise in their field. When a case is referred to a consultant or regional consultant a report based on impartial medical opinion, taking into account the documented evidence, is clearly requested. A fee is paid for each consultant or regional consultant report but there is no retainer or appointment fee.

Other government departments, including Her Majesty's Treasury, may also on occasion obtain consultant opinion. No information is recorded by the War Pensions Agency, the Treasury or Ministry of Defence as to whether an individual consultant also provides opinions for other government departments, nor is such information shared between departments. Any connection a consultant may have with other departments is therefore coincidental.

It is possible that the same consultant may be asked to give an opinion on the same case by more than one department. It is then for the doctor to consider, as a matter of professional judgement, whether there is a conflict of interest. The consultant is free at any time to decline a request from the agency or indeed from anyone else to prepare a report. I hope this will reassure you that there is no breach of independent assessment.

You have also asked whether the War Pensions Agency has refused to accept the diagnosis of experts when Gulf War veterans apply for a war pension. I can assure you that neither Group Captain Coker nor Colonel Bhatt has ever made a diagnosis "Gulf War Syndrome" in a war pension case. This is because so far extensive international research has failed to identify a specific "Gulf War Syndrome".

It is however acknowledged that illness has occurred in relation to Gulf service. War pension is paid not for specific diagnoses but for any disablement which is causally related to service within the legislation relevant to the claim. Where a claim is accepted, all service related disablement is assessed and certified, forming the basis for the award. The success rate for Gulf-related claims is high, although, since certification in war pensions must reflect current medical understanding, the description "Gulf War Syndrome" is not used for the accepted condition.

As I have said, the War Pensions Agency currently obtains some 10,000 consultant reports per year for claims determination. For particularly complex cases, regional consultants who are appointed by the Chief Medical Adviser, Department of Social Security, on the basis of experience and expertise in their field, provide reports.

At present there are 412 regional consultants, representing the spectrum of medical specialities. The regional consultant list is routinely reviewed to take account of retiral or resignation. When this happens, replacement consultants are appointed as soon as possible. Beyond this, the present number and specialty range of regional consultants are such that there are no plans for increase in their number.

I hope you find my reply helpful.

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