HC Deb 17 September 2004 vol 424 cc1975-7W
Mr. Barron

To ask the Secretary of State for Health (1) what support his Department is providing to primary care trusts to ensure that a national minimum level of one full cycle of in-vitro fertilisation is in place for those eligible by April 2005; [188275]

(2) how his Department will monitor the implementation of his decision to ensure that a national minimum level of one full cycle of it-vitro fertilisation is in place for all those eligible by April 2005; [188278]

(3) what assessment his Department has made of potential blocks in the current commissioning and delivery of infertility services in the UK that could affect the ability of primary care trusts to provide a national minimum level of one full cycle of in vitro fertilisation for all those eligible by April 2005; [188284]

(4) if he will provide a timeframe for full implementation by primary care trusts of the National Institute for Clinical Excellence's clinical guideline on the assessment and treatment of people with fertility problems; [188285]

(5) what direction and assistance his Department will offer primary care trusts to ensure that the planned increase in national health service funding between 2003–04 and 2007–08 goes towards implementing in full the National Institute for Clinical Excellence's clinical guideline on the assessment and treatment of people with fertility problems; [188279]

(6) what role strategic health authorities will play in ensuring the implementation of his decision to ensure that a national minimum level of one full cycle of in-vitro fertilisation is in place for all those eligible by April 2005; [188276]

(7) whether the National Institute for Clinical Excellence (a) has and (b) will have a role, as part of its new implementation programme, in examining capacity to ascertain whether it is sufficient to implement in full the National Institute for Clinical Excellence's clinical guideline on the assessment and treatment of people with fertility problems; [188280]

(8) what the repercussions will be for those primary care trusts that fail to meet the target of ensuring that a national minimum level of one full cycle of in-vitro fertilisation is in place for all those eligible by April 2005; [188277]

(9) whether his Department will undertake an assessment of existing national health service capacity to ascertain whether it is sufficient to implement in full the National Institute for Clinical Excellence's clinical guideline on the assessment and treatment of people with fertility problems; [188281]

(10) what steps he is taking to assist primary care trusts to identify and overcome potential service blocks in order for them to implement in full the National Institute for Clinical Excellence's clinical guideline on the assessment and treatment of people with fertility problems;[188282]

(11) what assessment his Department has made of potential blocks in the commissioning and delivery of infertility services in the United Kingdom to the implementation in full of the National Institute for Clinical Excellence's clinical guideline on the assessment and treatment of people with fertility problems; [188283]

(12) what support his Department is providing to primary care trusts to assist them to (a) plan for and (b) implement in full the recommendations made in the National Institute for Clinical Excellence's clinical guideline on the assessment and treatment of people with fertility problems. [188286]

Miss Melanie Johnson

The Government welcomed the publication in February 2004 by the National Institute for Clinical Excellence (NICE) of the clinical guideline on the assessment and treatment for people with fertility problems. The guideline is aimed at the national health service and it is for the NHS locally to take it into account when determining how best to meet the needs of the local population, in discussion with patients and the public and within the resources allocated to the health service overall. Those resources are to rise at record levels, from £69 billion in 2004–05 to £92 billion in 2007–08.

We expect the NHS to make progress towards full implementation of the guideline. As with other NICE guidelines, we have not set a timetable for this. However, we and NICE recognise that the NHS cannot reasonably be expected to implement the full guideline immediately and we have therefore advised all primary care trusts (PCTs) to begin implementation by offering a minimum of one cycle of in vitro fertilisation by April 2005 to those who meet the clinical criteria set out in the guideline and to give priority to couples who have no children living with them.

We have agreed a broad programme of action to support the NHS in implementing NICE guidance, disseminated to the NHS on 14 June, which makes it clear that local health economies need to work together on implementation. We look to strategic health authorities (SHAs) to work with PCTs to ensure that they have effective arrangements in place for the provision of services, to investigate the barriers to implementation of NICE guidelines and to help ensure that the barriers can be overcome. The programme of action also includes, for example, the provision of advice from NICE on the development of resource templates to enable local health economies to estimate the resources needed. NICE provided the first such template for the fertility guideline, taking account of total PCT population, proportion of women aged 23 to 39 and the different local costs of providing services.

SHAs are responsible for overseeing PCTs' performance. They will expect PCTs to be able to demonstrate that they are working to implement NICE clinical guidelines. Where a PCT is failing to implement a guideline, the SHA will explore with the trust the reasons for this, with the aim of overcoming barriers to implementation.

The national standards for the NHS, published as "Standards for Better Health" on 12 July 2004, include a standard (Standard D2) for patients to receive effective treatment and care that conforms to nationally agreed best practice, particularly as defined in NICE guidance. This encompasses NICE's clinical guidelines, such as the one on infertility. The independent Healthcare Commission, which we established in April 2004 and which reports directly to Parliament on the state of healthcare in England and Wales, is developing criteria to review the provision of health care and in doing so is taking into account the requirements of "Standards for Better Health". There are no plans for NICE to have a role in examining NHS capacity to implement NICE guidance as part of its new implementation programme.