One of the experts behind new clinical guidelines on fertility treatment has accused the Department of Health of back-pedalling on a ministerial promise to end the postcode lottery in infertility services.

William Ledger, professor of obstetrics and gynaecology at Sheffield University and a member of the expert group that produced the guidelines on managing infertility in tertiary care, told HSJ he was 'very unconfident that they would be put into practice.'

The guidelines were funded with DoH money, and there were DoH economic advisers on the development group. But since publication there has been quite a bit of back-pedalling and lack of commitment from the DoH.

Professor Ledger said things might have been different if the guidelines, published last week by the Royal College of Obstetricians and Gynaecologists, had come out while Frank Dobson was health secretary .

Mr Dobson was personally really interested in infertility , but the new team have made it clear that cancer and heart disease are their buzzwords. I think these guidelines will fall on deaf ears.

The expert group found evidence of inadequacy and inequity in service provision, and concluded that a national service framework was the only long-term solution.

Last week's guidelines will inevitably increase pressure on health authorities to allocate more funds to infertility services, particularly invitrofertilisation.

Expert group member Susan Rice, chief executive of Issue, the national fertility association, said 'immediate national guidance was essential.'

There are quite ridiculous decisions being made by HAs. It's a national scandal.

Pressure on the DoH could also come from HAs, which feel ill-equipped to proceed.

Dr Henrietta Ewart, consultant in public health medicine at Northamptonshire HA, said: 'We all feel very strongly that there should be national guidance. I would very much welcome a national service frame - work. I don't feel comfortable that these really big ethical and social issues are being left to HA's or fertility experts to decide.'

Just 25 per cent of IVF cycles in the UK are NHS-funded.

The DoH has congratulated the RCOG on its research and a spokesperson said: We obviously want to end the postcode lottery . But he said it was up to the National Institute for Clinical Excellence to decide whether national guidelines or a framework should be developed.

A NICE spokesperson said it could not look at the infertility guidelines unless requested to do so by the DoH