Debate contribution: In Vitro Fertilisation Equality

Debate contribution by Mr Mike Nesbitt on 22 June 2026.

MLA: Mr Mike Nesbitt
Party at the time: Ulster Unionist Party
Date: 22 June 2026
Type: Debate contribution (made as a minister)
Business: Opposition Business
Heading: In Vitro Fertilisation Equality
Assembly identifier: Official Report component 5638557

Text

Thank you very much, Deputy Speaker, and thanks to the Opposition for bringing a debate on this issue. All healthcare is personal, and I thank Órlaithí Flynn, Kellie Armstrong, Linda Dillon and Nuala McAllister for making the debate personal, because that is the only way that we will really understand. I welcome the opportunity to update Members on the work to increase the provision of IVF. As Members have said, that is a commitment from New Decade, New Approach, and it is also recommended in guidance from the National Institute for Health and Care Excellence. There are many people who long for a child to start or extend their family and are desperate to hear when the current fertility service will be expanded. Members will be aware that it was actually my party that requested and secured that commitment in NDNA. The commitment was, on the one hand, a welcome recognition by the Executive that, for far too long, women and hopeful couples in Northern Ireland had to experience the imbalance of IVF provision, which is below what NICE recommends and below that which is available across some other parts of the United Kingdom. On the other hand, I ask Members to recognise that no additional funding has ever been provided by the Executive to implement that NDNA commitment. That means, of course, that the service can only grow by doing more with the same resources, as we have done — I will come to that in a moment — or by stopping something else. In 2020, women who met the access criteria were able to access one fresh cycle of IVF and one frozen embryo transfer — that is to say, a partial first cycle. We then established a project board to work with the regional fertility service to explore ways of expanding provision. Like many, that service was severely impacted on by the COVID response but recovered quickly, and I record my thanks to those staff for clearing the resultant backlogs. Investment to increase staff numbers and physical space have also been key constraints. By February 2024, my predecessor, Robin Swann, was able to announce an increase in provision to one full cycle from within existing resources. That enabled all eligible women who were added to the waiting list for treatment from 1 October 2022 to use all their frozen embryos until a live birth was achieved. At that time, however, it was made clear that any further expansion of the service would depend on securing additional funding and additional capacity at the regional fertility centre, both physical space and additional staff to deliver that increased capacity. Although those are significant constraints, I remain keen to find a way to increase provision for those who are struggling with fertility. It should be noted that any increase would be on an incremental basis, and, accordingly, efforts are being made to scope requirements to offer a second cycle. While additional funding has still not been secured, I assure Members that my officials and the staff at the regional fertility centre are working to continue to explore ways to increase provision within the current funding envelope. That includes considering the additional staff required to deliver any increase and seeking to secure additional accommodation as required. I mentioned waiting times. Part of the challenge of expanding a service within its current funding envelope is to do so sustainably and to ensure that any increase in provision is not to the detriment of the current service. In May, the waiting times were 12 weeks for a first appointment, one month for IVF after being put on the waiting list for treatment — it was 16 months during COVID — and three months for frozen embryo treatment after being put on the waiting list. Again, that was much longer — 12 months — during COVID. While I am not yet in a position to confirm a further increase in provision, I am assured that all avenues are being explored to identify the additional financial and physical resources to allow that to happen. With regard to the equity of services across the rest of the United Kingdom, I ask Members to note that, in England, provision varies across the country, depending on the location of the patient. Many authorities provide one IVF cycle, while others provide up to two or maybe even three. While I note that Scotland currently offers up to three cycles to eligible women and Wales offers up to two cycles, access criteria in both those jurisdictions are more restrictive for some of the criteria, meaning that publicly funded treatment is available to a wider cohort of women here in Northern Ireland. For example, there is no barrier to women accessing fertility treatment here if they or their partner already has a living child. That is not the case in Scotland or Wales, where treatment is available only if either the woman or her partner does not have a living child. In addition, couples accessing treatment in Wales and Scotland must have been in a relationship for a minimum of two years. That is not the case here. In Scotland, those who use artificial insemination to demonstrate infertility must undergo six to eight treatment cycles, and it is six in Wales. In Northern Ireland, that has been reduced to four, thereby offering earlier access to other treatments than in Scotland and Wales. I accept that that makes it somewhat difficult to compare across regions. While some areas may provide more cycles of IVF, the criteria in Northern Ireland are less restrictive and mean that treatment is available to a wider number of women. Nevertheless, the guiding principle, as we seek to expand provision in what is an extremely constrained climate, is to use the resources that we have to maximise access to these important services on a fair and equitable basis. Diane Dodds pointed out that, on 31 March 2026, NICE published a revised guideline, NG257, fertility problems: assessment and treatment. In response to her question, that is being assessed by my Department. However, 31 March was effectively three months ago, so I will ask questions and look for a decisive timeline for reaching a decision on that. Kellie Armstrong asked about a time-bound commitment to investment and expansion. I have to go back to the motion and the call on me:
"to urgently bring forward proposals and secure the necessary funding to expand publicly funded IVF provision".
I would love to do that. However, I live in a world where conditions and treatments compete for funding and resources, and nobody has given me a proposal for where I should find the money. Should I give up the plan to do 24/7 thrombectomy? Should I abandon plans to lower the age for bowel cancer screening? Should I close an intensive care unit bed to find the funds? That is the world that I live in. I regret that, because I would like to move to three cycles immediately. In the real world, however, we can do it only as quickly as we can. That, I am afraid, is my limited commitment to Members today.

1,192 words. Text as published by the Northern Ireland Assembly.

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