The Questions About the February 2026 Female Sterilisation Policy that Dr Priya Singh Wouldn’t Answer
Alongside my questions about whether Dr Nick Broughton, Chief Executive of NHS Thames Valley ICB, had faced any leadership accountability following the Ombudsman’s findings, I repeatedly asked Dr Priya Singh, Chair of NHS Thames Valley ICB, another straightforward question:
Did the ICB consider its February 2026 Female Sterilisation Policy fully compliant with equality law, the NHS Constitution, informed consent, bodily autonomy, relevant clinical guidance, Montgomery v Lanarkshire and the Parliamentary and Health Service Ombudsman’s findings?
I asked for a clear answer. Instead, over a series of emails in June 2026, I received acknowledgements, promises of future answers, explanations about another policy review, general statements about patient-centred care and eventually a declaration that the correspondence was closed.
During that same period, the NHS South East Region Priorities Committee recommended removing one of the policy’s central restrictions: the requirement that women trial Long-Acting Reversible Contraception before accessing sterilisation.
To me, that made the question even more obvious: if the February 2026 policy was compliant and defensible, why did one of its central requirements have to be removed only months after it was introduced?
Dr Singh promised that I would be updated when the replacement policy was approved.
Updated 12 September 2026: I have received no such update from Dr Singh. Her 27 June 2026 email remains the last communication I received from her.
The full correspondence and supporting evidence can be read in my Evidence Folder.
A note about my conclusions: throughout this website I distinguish between established documentary facts and my interpretation of them. My opinion is that I have repeatedly been misled, stonewalled and faced institutional attempts to close down scrutiny rather than answer it. In places, I believe I have been lied to and that failures have been covered up. That is my opinion.
Please feel empowered to review the evidence yourself and reach your own.
Why should women have to prove temporary contraception is unsuitable before permanent contraception is respected?
By spring 2026, the history was already extraordinary.
I had originally challenged an Oxfordshire policy that effectively prevented women from routinely accessing NHS-funded sterilisation.
The Parliamentary and Health Service Ombudsman later found serious failures in the evidence, decision-making, equality considerations, consultation and complaint handling surrounding that policy.
The ICB then introduced another Female Sterilisation Policy in February 2026.
On paper, this new policy appeared more permissive because female sterilisation was no longer simply described as “not normally funded”.
But it introduced another form of gatekeeping.
Women seeking permanent contraception were expected to undergo, or demonstrate the unsuitability of, a “therapeutic trial” of Long-Acting Reversible Contraception (LARC) before accessing sterilisation.
That immediately raised the same underlying question I had been asking for years:
Especially when men seeking permanent contraception through vasectomy were not being subjected to an equivalent requirement.
Did NHS Thames Valley ICB actually consider the February 2026 policy compliant?
On 28 April 2026, my correspondence with Dr Priya Singh was primarily about leadership accountability following the Ombudsman investigation.
But I also raised the new February 2026 Female Sterilisation Policy.
I told Dr Singh that I did not believe the underlying problem had actually been resolved.
I specifically challenged the requirement for a “therapeutic trial” of LARC before sterilisation.
My position was straightforward: if a woman is seeking permanent contraception, forcing her through a temporary contraceptive pathway before respecting that choice does not look like patient-centred informed consent to me.
It looks like gatekeeping.
I also pointed to the growing contrast with male sterilisation. NHS-funded vasectomy services were being made more accessible, including routes involving private providers and direct referral arrangements, while women continued to face additional hurdles before accessing permanent contraception.
Why couldn’t the Chair answer a question the Board should already have resolved?
On 1 June 2026, after Dr Singh had answered my separate questions about Dr Nick Broughton and the Fit and Proper Person Test, I turned squarely to the current policy.
I asked her to tell me whether NHS Thames Valley ICB considered the February 2026 Female Sterilisation Policy fully compliant with:
- the Equality Act 2010;
- the Public Sector Equality Duty;
- the NHS Constitution;
- Montgomery v Lanarkshire Health Board [2015];
- relevant NICE guidance;
- relevant WHO guidance;
- the Ombudsman’s findings in case C-2121396;
- and the principles of informed consent, bodily autonomy and patient-centred decision-making.
I deliberately made the question difficult to evade.
I asked her to answer:
YES — the ICB considers the policy compliant.
or
NO — it does not.
If the answer was yes, I asked her to explain how forcing women through a LARC pathway was compatible with bodily autonomy and informed consent.
If the answer was no, I asked the equally obvious question:
Why had the policy been approved and imposed on women in the first place?
On 3 June 2026, I received only an acknowledgement from the Office of the Chair confirming receipt of my email.
There was no answer to the compliance question.
On 6 June 2026, I chased again.
Still no substantive answer.
Why was another committee review needed only months after the policy was introduced?
On 8 June 2026, I wrote again.
I reminded Dr Singh that the February 2026 policy had already been approved, adopted and applied to women for months.
If the Board had approved that policy, surely somebody must already have established the basis on which it was considered lawful, ethical, clinically defensible and compliant.
This should not have required weeks of research after I asked the question.
The reasoning should already have existed.
I asked again for a detailed response.
On 9 June 2026, Dr Singh finally responded — but still did not answer the question.
Instead, she told me that, following further feedback about the application of the policy, female sterilisation was going to be discussed again at the NHS South East Regional Priorities Committee.
She wrote that:
That commitment matters.
I had asked whether the existing February 2026 policy was compliant.
The response was effectively: another committee is looking at it and we will come back to you.
By itself, that told me something important.
The policy I was challenging had only been operating for a few months and was already back under review.
If the February 2026 policy was sound, why was its LARC requirement removed?
On 16 June 2026, Dr Singh wrote to me again.
She explained that the South East Region Priorities Committee had considered sterilisation on 14 April 2026 and again on 9 June 2026.
And this time there was a substantial development.
The Committee had recommended that women should be able to choose sterilisation after being fully informed about alternatives, without first having to undergo a trial of LARC.
In other words, one of the central requirements I had been challenging was now being removed.
Dr Singh told me:
- the recommendation would go to NHS Thames Valley ICB for adoption;
- the process would include Board-level scrutiny;
- it would include Quality Committee approval;
- the process was expected to be prompt;
- a new policy was expected to be implemented in early autumn 2026;
- and I would be informed as soon as the new policy became available.
Those are concrete commitments.
But changing the policy did not answer whether the February 2026 policy should ever have been approved.
The fact that the NHS was now fixing the LARC requirement did not answer whether it had been appropriate to impose that requirement on women in February 2026.
Quite the opposite.
Its removal made the question sharper.
And if the requirement was not defensible, how had it passed the governance process in the first place — especially after the ICB had just been through an Ombudsman investigation into failures involving this exact area of healthcare policy?
Why did I keep having to ask the same compliance question?
On 19 June 2026, I wrote back because Dr Singh still had not answered what I had actually asked.
I told her directly that my patience was running out.
I pointed out the chronology:
- the original female sterilisation policy had been challenged;
- the Ombudsman had found serious failures in how it was developed;
- there had been no leadership accountability consideration;
- a replacement policy had then been introduced in February 2026;
- and only months later that policy was already being rewritten.
I again asked Dr Singh to answer:
Did the ICB consider the February 2026 policy fully compliant — yes or no?
If yes, why was one of its core requirements being removed?
If no, why had it ever been approved and why was it still being applied to women?
Why did acknowledgements keep replacing answers?
On 23 June 2026, Dr Singh acknowledged my email and said:
I wrote again on 23 June 2026 because, once again, I wanted an answer to the question — not another acknowledgement that the question existed.
By 26 June 2026, the promised week was ending.
I emailed again:
Did she intend to answer the question?
Or was another self-imposed deadline going to pass?
This pattern had already become painfully familiar to me.
Why did Dr Priya Singh refuse to give a yes-or-no answer?
On 27 June 2026, Dr Singh finally sent a substantive response.
But she still would not answer yes or no.
She told me it was “not appropriate or accurate” to reduce complex healthcare policy to a binary question.
She then listed principles she said underpinned the February 2026 policy:
- patient-centred care;
- informed consent;
- clinical judgement;
- a least-invasive approach;
- recognition of biological differences;
- and alignment with legislation, national guidance and the Ombudsman findings.
Those statements may sound reassuring.
But once again, they did not answer my question.
I had not asked whether reassuring principles could be written around the policy.
I had asked whether the actual policy — including its LARC requirement — complied with the standards I had identified.
And by this point the regional committee had already recommended removing that requirement.
What did Dr Priya Singh promise would happen next?
Across the correspondence in June 2026, Dr Singh made several specific statements about what would happen next.
I was told that:
- the female sterilisation policy would be reconsidered following the South East Region Priorities Committee recommendation;
- the new recommendation would go before NHS Thames Valley ICB;
- there would be Board-level scrutiny;
- there would be Quality Committee approval;
- the process would be undertaken promptly;
- a revised policy was expected in early autumn 2026;
- I would be told “as soon as the new policy is available”;
- and, even after correspondence was closed, Dr Singh specifically preserved one exception: sending me a link when the policy was approved.
Why was correspondence closed while the central question remained unanswered?
The final part of Dr Singh’s 27 June 2026 response is particularly important.
She told me:
“We do not consider there to be any further substantive issues to address through this correspondence.”
She said this would be the ICB’s final response, apart from one exception:
She then said further correspondence on the same issues would not receive substantive replies unless I raised something materially new.
So the correspondence was formally closed while I still maintained that the central question had never been answered.
I have received no further email from Dr Priya Singh.
I have not been sent the promised link.
I have not received an update from her confirming that Board-level scrutiny occurred.
I have not received an update confirming Quality Committee approval.
I have not received an explanation of what happened to the timetable she described.
Her 27 June 2026 email closing correspondence remains the last communication I have received from her.
Why did I resort to Freedom of Information legislation?
By this point, I had learned not to rely only on promises that somebody would eventually explain the process.
I wanted the records.
So on 8 June 2026, while this correspondence with Dr Singh was still unfolding, I submitted a Freedom of Information request seeking the documentary evidence behind the February 2026 Female Sterilisation Policy.
I asked for material showing its approval, equality assessment, evidence base, legal and ethical rationale, comparison with vasectomy, treatment of autonomy and informed choice, and evidence that the Ombudsman’s recommendations had actually been incorporated into subsequent decision-making.
The statutory deadline was 6 July 2026.
That deadline passed.
And passed.
And passed.
I chased.
I chased.
I chased and filed an Internal Review Request - as per ICO guidelines.
By the time substantive disclosure arrived in September 2026, I had been waiting for roughly three months.
The response arrived more than two months beyond the statutory deadline. NO LEGAL justification was provided - this was an invented deadline by the ICB themselves. So, now they are - in my opinion - cool with breaking the law too. And the kicker - CEO Dr Nick Broughton is the one in charge of FOI requests - as per his title of Accountable Officer. But more on that in the posts tagged with FOI - you can find those in the Chronicles page.
By 11 September 2026 — 95 calendar days after my original request — the ICB was around 48 working days beyond its statutory deadline.
That delay became a separate transparency battle in its own right.
What did the delayed FOI disclosure still fail to show?
When the documents finally arrived in September 2026, they still did not provide everything I had asked for.
The disclosure did give me useful evidence.
But it also exposed major gaps.
The material supplied showed that much of the documentation underlying the February 2026 policy pre-dated the Ombudsman’s final findings.
The ICB’s own response referred to further post-Ombudsman work carried out in February, April and June 2026.
It referred to:
- documented feedback on the Ombudsman findings;
- further regional committee consideration;
- a refreshed policy report;
- a 14-item action tracker;
- updated decision-making processes;
- and subsequent comments raising what the ICB itself described as “significant concerns”.
Yet key parts of that post-Ombudsman audit trail were not included in the disclosure.
The documents I received also did not show me the complete decision record I had expected to see for adoption of the February 2026 policy.
The Equality Impact Assessment supplied was an older document and the disclosed records indicated further equality work was supposed to occur.
And the ICB expressly confirmed that the detailed comparison I had sought between female sterilisation and vasectomy access had not been conducted in the earlier supporting work.
Why does this look like a wider transparency problem rather than one unanswered email?
Because this is now a pattern running through the entire case.
First I asked the ICB questions directly.
Then I asked its Chief Executive.
Then I asked the Ombudsman.
Then I asked the Chair.
Then I asked through Freedom of Information legislation.
Again and again, obtaining the answer has required another mechanism, another deadline, another chase, another escalation and another documentary search.
And I have now made multiple Freedom of Information requests relating to this case.
One examined leadership accountability and Dr Nick Broughton’s FPPT status.
Another sought the evidence behind the February 2026 Female Sterilisation Policy and its supposed post-Ombudsman governance.
A further strand has examined male vasectomy commissioning and access, including providers, self-referral, criteria, equality assessments and whether the NHS ever properly compared those pathways with the hurdles imposed on women.
Those FOI battles deserve their own articles.
What am I still waiting for as of 12 September 2026?
As I update this article on 12 September 2026, I am still waiting for clarity on several things that should not require detective work by a patient.
- Where is the final revised Female Sterilisation Policy Dr Singh said I would be sent?
- Did the promised Board-level scrutiny occur?
- Did the promised Quality Committee approval occur?
- What happened to the “early autumn 2026” implementation timetable?
- Where is the complete post-Ombudsman documentary trail showing how the earlier governance failures were corrected?
- Where is the complete equality analysis comparing the female sterilisation pathway with male vasectomy?
- Why did I have to use Freedom of Information legislation to try to establish things the Chair told me would form part of a transparent governance process?
What does this pattern say about transparency at NHS Thames Valley ICB?
I do not think NHS Thames Valley ICB has been transparent with me.
I think I have repeatedly been given partial answers, reassuring language and future promises instead of the documentary accountability I was asking for.
I think some statements made to me during this case have been untrue.
I think serious failures have repeatedly been absorbed into process rather than confronted openly.
And where records capable of proving what happened have been delayed, omitted or extraordinarily difficult to obtain, I believe it is reasonable to ask whether institutional self-protection has crossed into cover-up.
That is my opinion.
Please do not take it on faith.
Read the evidence.
Read the Ombudsman findings.
Read Dr Singh’s emails.
Read the FOI responses.
And form your own view.
Was the February 2026 Female Sterilisation Policy compliant with the legal, clinical, ethical and equality standards the NHS said it respected?
I asked the Chair repeatedly.
I still do not have a straight answer.
Where can I read the evidence?
You can read the correspondence with Dr Priya Singh, Chair of NHS Thames Valley ICB, the relevant Freedom of Information material, the Ombudsman evidence and the wider documentary history in my Evidence Folder.
