Women refused sterilisation because they ‘might regret it’

The Parliamentary and Health Service Ombudsman (PHSO) has criticised an integrated care board (ICB) for denying women, but not men, NHS funding for sterilisation.

Leah Spasova complained to the Ombudsman after her request for sterilisation was rejected by Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (ICB).

At the time, the ICB did not routinely fund female sterilisation and cited the risk of regret as a reason for refusing women the procedure. Its policy was to routinely fund vasectomy for sterilisation for eligible men.

The Ombudsman concluded that the ICB’s approach was unfair, inconsistent, and based on subjective reasoning.

The Ombudsman found that women were not given the same opportunity as men to make an informed decision about sterilisation, despite clinical guidance that states sterilisation should be available for women and that counselling – not blanket exclusion – should address the risk of regret.

The investigation also identified inconsistent use of cost-effectiveness arguments. Male sterilisation was recommended for funding without updated cost data, while female sterilisation was rejected due to a lack of recent evidence, despite older studies showing it can be more cost effective over time.

Paula Sussex CBE, Parliamentary and Health Service Ombudsman, said,

‘The issue highlighted in [this] case about the commissioning and managing of services by ICBs is not an isolated one. We are concerned that there may be similar wider problems affecting multiple areas of healthcare. There are often unclear explanations of treatment or diagnosis in the NHS, confusing pathways, a lack of updates while patients wait for care, and poorly communicated changes to provision.