Thursday, August 06, 2009

IVF Postcode Lottery Continues Despite Brown Promise

It's not often I write posts about lady bits, or man bits come to that matter, but here goes. Tory MP Grant Shapps is today issuing a report which clearly shows that the postcode lottery for IVF provision on the NHS has got worse over the past two years. The research, titled ALL YOUR EGGS IN ONE BASKET shows:

* Over 8 out of 10 PCTs are failing to follow National Institute for Health and Clinical Excellence (NICE) guidelines which say that 3 full cycles of IVF treatment should be provided to infertile couples. 2 PCTs have even admitted to not providing any IVF treatment at all in the last two years.

* 1 in 8 PCTs fails to comply with NICE guidelines with regards to the age of the female partner. This means that there is still a bizarre postcode lottery which sees the same woman being too old for treatment in one area and too young in another.

* Over half of all PCTs refuses to give treatment to couples with existing children, even if the partner in question was widowed.

The report is based on FOI responses from more than 80% of PCTs and is the most comprehensive picture of IVF provision in Britain since a similar piece of work Shapps carried out two years ago. He told me last night...

"When couples go through IVF they face enough emotional and worries without discovering that Prime Ministerial promises of three cycles of IVF on the NHS just aren't true. The Health Service has many priorities and some people will argue that it should primarily be about saving, rather than creating, life. However what is cruel about the current situation is that government has raised expectations only to let people down. What we desperately need is greater honesty from politicians about what can be delivered rather than headline grabbing promises which are casually broken."

Shapps speaks with some authority on this subject since he and his wife have three chldren via IVF before the NHS provided any assistance at all.


Mr Eugenides said...

Are the Tories not in favour of more localism? I know I am.

If you believe in local people making local decisions about resource allocation, then there will inevitably be postcode lotteries. The alternative is centralisation and a national one-size-fits-all policy.

I'm entirely relaxed about "postcode lotteries" if it means local people setting their own priorities.

Anonymous said...

@Mr Eugenides

If local areas are freed to make their own decisions then, your comment may have merit.

However, as you well know, the ruling was made centrally and so should be applied in the same manner across England/Wales/NI (Scotland has its own rules).


Anonymous said...

This report is an irrelevance. The NHS has to be reserved for illness and sad as it is, infertility does not qualify.

We cannot afford this sort of luxury anymore - the NHS along with other spending has to be looked at radically if we are to get sorted out.

Will Team Dave be able to do it? - I have my doubts.

Voyager said...

I'm entirely relaxed about "postcode lotteries" if it means local people setting their own priorities.

I provision of Law, Health ? Then let us decide our own tax rates and primary legislation. Why shouldn't Bradford have different laws from London ? It is after all an island.

But when we have a NATIONAL Health Service we should have consistent standards or the huge rotation of Junior Doctors taking place this month becomes pointless

Clive said...

At the risk of being contentious, why should IVF be available on the NHS? Having children isn't a right.

Anonymous said...

Grant 1234 Shapps is misquoting Tony Blair. He claims that Blair said that infertile couples would be GUARANTEED three cycles of IVF treatment.

What Blair actually said in Parliament was "We HOPE very much over the next couple of years we will be able to see at least very SUBSTANTIAL PROGRESS towards the implementation of the full NICE guidelines ... "

A bit different from guaranteeing it.

Priorities for NHS treatments depend very much on local needs. In some areas - e.g. Worthing - there is a very high proportion of elderly people and a correspondingly low proportion of childless young couples. It is understandable that infertility treatment is low on the list of priorities in such areas.

Incidentally, your last paragraph is odd - "Shapps speaks with some authority on this subject since he and his wife have three chldren via IVF before the NHS provided any assistance at all."

Are you saying that he and his wife already had three children when they sought and obtained NHS fertility treatment? I would have thought that the NHS funds would have been better spent on CHILDLESS couples.

talwin said...

Mr Eugenides.
Providing it is local people determining priorities and not just local PCTs screwing up (or ducking the issue because they're broke).

Flemingcrag said...

IVF shpuld not be funded by the NHS whilst there is one child still in care for want of adoptive parents.

GHS said...

IVF shouldn't be offered on the NHS. The money should go on life saving or enhancing treatments. If people want kids then start young and don't leave it till your too old biologically.

Roger Thornhill said...

Best to end free NHS IVF.

Ignoring the fact that the Stalinist NHS apparatus should go, the NHS should charge at full cost for IVF and each PCT therefore should not be limited to its geographic monopoly*.

If someone cannot afford to save up 5k or so it neeeds before kids they almost certainly cannot afford to have kids nor make personal sacrifices that it entails.**

* one major disgusting facet of the NHS - their monopolistic control over our healthcare. this is why localism does NOT work as you would quite literally have to move house to escape a ropey PCT.

** unless you are someone who relies on the taxpayer to not only fully fund your entire existence but your procreation and ongoing support of your issue.

Brian E. said...

As far as I am concerned, the NHS appears to be only interested in abortions, not producing life.
My daughter had a series of early miscarriages and the NHS was totally off-hand. On consultant went so far as to say that my daughter should face the fact that she would never have children.
However she went on holiday to Sardinia when she realised again that she was pregnant and beginning to have the same signs of a possible miscarriage as before. She was rushed into the local hospital, given preliminary treatment, taken by ambulance to a hospital the other side of the island for scans and further treatment. At our local hospital, it the same time period, she'd probably have still been waiting in A&E.
They kept her in for two weeks but really wanted to keep her in longer, and sent her home with some drugs that are not used for that purpose in this country, and last January I had a healthy grandson.
And there is a tendency for people to look upon Italy as being almost a third world country for medical services; judging by her experience they are totally mistaken.

Ed P said...

Is IVF available free on the NHS? It's hardly life-saving and it must drain scarce resources from those very sick people waiting for operations. Perhaps Cameron will cut off state funding for this and direct the NHS to concentrate on the sick first.

Anonymous said...

Mr Eugenides is right. It's no good praising localism in one breath, and decrying the variety it brings in another.

Quite apart from that, no one should receive IVF on the NHS when people are still waiting for weeks for cancer treatment. No wonder the budgets are so out-of-control.

Man in a Shed said...

The problem with infertility has two root causes:

1) People having children too late.
2) The wide spread of chlamydia ( which is getting far far worse with the governments push for sexual promiscuity campaigns - they call them something else but this is the underlying effect ).

Its always better to fix the underlying problem than pay for an expensive rectification of the problem.

On 2) at the IVF clinic that one of my family works at every woman gets screened for chlamydia as a matter of course.

If we did something about 1) & 2) then we could afford IVF to help everyone else !

Bryony Gordon has an article on 1) today that poignant. Though frankly I would have thought she has to fight of male interest off with a stick (with nails based through it).

PS It is also the case that success rates between IVF clinics vary a lot - the cost we should look at is the cost per achieved pregnancy - not IVF treatment.

Newmania said...

There is a rather facetious post up at next left saying you cannot have localism without local variation but Sunder Katwala ( a usually good egg ) utterly misses the point and underestimates the fury this issue is arousing ( As does Mr. Eugenides ! )

I commented as follows

IVF is an issue without any obvious parallels. My wife and I went through cycles of IVF one intermediate procedure paid for by the NHS and then we were on our own. This was a cost of £10,000 or so which we did not have and was an ordeal to come up with. Of course we could have chosen not to have a family , ta , but then heres your problem. Why should working people who get very little form the State be denied just about the only major thing they ever ask for from the NHS when between us we would be paying for about £1000,000 of healthcare insurance over our lives.
This obvious injustice is felt deeply especially by women whose working patterns ,sought or not ,often make early children difficult and the withdrawal from the deal already underway carries on. Is this what you want ( Sunder)?

IVF , women’s lifestyles and the fairness or otherwise of the middleclass welfare state ( small thought it is ) are a large and serious problem you ( Sunder) are not interested in because it chiefly effects women with careers . Do you have any idea what the proportion of childless graduate women is , about 35% .IVF and its cost is part of a deep and growing problem of a broken society at all levels especially the working family .Your post ( Sunder ) trivialises the issues throws silly partisan pies and fails entirely to address the scale of misery .A few focus groups and Polls and you may just get it , better be quick.

Is it possible we can have localism in some areas and not others ...why yes I think it just might be !

Norfolk Blogger said...

Presumably Grant Shapps Postcode Lottery numbers are 1234 ?

Newmania said...

Man in a shed said Bryony Gordon has an article on 1) today that poignant. Though frankly I would have thought she has to fight of male interest off with a stick (with nails based through it).

Come on she was joking and I agree ,she is funny pretty sexy and ..yummy. Her Oppo at the Guardian for ditzy girly smiley stuff is Hadley Freeman , also funny and cute ( if a bit ‘right on’ as you would expect). I have a nice idea for a sandwich

Bryony Gordon
Hadley Freeman


Anonymous said...

IVF should be banned. The planet is full up, dammit.

andrewha said...

Why are we paying for IVF on the NHS at all?

If we have to make tough choices on public funding then I think that this may be one of them.

Donut Hinge Party said...

Why should working people who get very little form the State be denied just about the only major thing they ever ask for from the NHS when between us we would be paying for about £1000,000 of healthcare insurance over our lives.
The ignorance of this statement is mind-boggling.

Healthy Taxpayers - tired of paying for a service you're not directly using?

Why not break both your legs and inflict yourself with a virulent cancer? Then you can REALLY get your money's worth from the NHS.

Cash back!

Even if you are wealthy enough to pay for private health cover (and I'm forced to through my work) society tends to benefit by having a healthy, non-crippled workforce.

Not a sheep said...

Why are we paying for anyone to have IVF? Having children is a lifestyle choice not a medical issue.

Uncle Bob said...

I don't agree with the NHS paying for IVF treatment at all. As other people have said it is a lifestyle choice. If couples wish to have children and find they are unable to conceive but cannot afford the IVF treatment then they have a simple option, adopt. There are plenty of children who need to be adopted. Having children is not a right, it is a privilege.

Wrinkled Weasel said...

IVF is a lifestyle choice, not a medical necessity or a right. I is absurd that this treatment is available on the NHS and just another symptom of a bonkers country that still thinks it is a superpower and not the tin-pot banana republic it has become.

Anonymous said...

While there are kids in homes desperately needing adoption, providing IVF at the taxpayers expense is totally immoral.

Mrs H, Tunbridge Wells said...

PLEASE!!! Give me a break!!! As someone who was only entitled to one cycle of IVF on the NHS (unsuccessful), I find some of the comments on here narrow-minded and thoughtless.

After two further cycles funded from our own savings (and also an operation to redo the botched NHS treatment) we now have a beautiful son who is nearly two.

Our particular form of infertility is nothing to do with either age or chlamydia. As fit and healthy adults we make few demands on the NHS, so I don't see why we shouldn't have access to treatment for something that is not our fault. After all, there are thousands of people treated on the NHS every year for obesity, smoking- and alcohol-related illnesses, all of which could be deemed "self-inflicted".

A large part of this problem is undoubtedly political, but the contradictions in funding rules as highlighted by Grant Shapps deserve serious action.

nick said...

I cannot see why IVF should be provided free of charge by the NHS when, unless tight means-testing criteria are met, dental treatment and eyecare are not. The economy is a mess, and savings have to be made to avoid massive tax rises. As others have said, having children is a lifestyle choice, not a medical necessity. Save up your own money or adopt. Maybe the insurance industry could sell "fertility insurance" if there's a market for it.
Oh, and the NHS should not be funding bogus pseudo-scientific rubbish like homeopathy either.

beenthereandi'mangry said...

The whole IVF thing is misguided. The population of this country - let alone the planet - is not in decline. The species is in no risk of dying out. There is often a very good reason why some couples can't breed naturally and even more often a very good reason why they shouldn't. People do not "have" to have a child. Having a child is not just be another tick in the boxes of life. Get over it.

Anonymous said...

I'm not sure about IVF on the NHS - it's not essential, but nor is a lot of the stuff the NHS does. I'd support IVF over gender reassignment surgery or gastric bands for the obese.

As it happens, my wife and I were looking at IVF - we had tried to conceive for 2.5 years with no success. We weren't old, and didn't have STDs.

Then my wife quit her job. Two weeks later, she was pregnant. Our explanation (anecdotal, natch) is stress - her job was sufficiently stressful that her body was effectively saying "now is a bad time to have a baby about the place".

We have since met several couples who have had IVF children where the wife has had a fairly stressful job before her pregnancy, and wondered...

Anonymous said...

"Do you have any idea what the proportion of childless graduate women is , about 35%"

This is a meaningless statement. You may as well ask how many males born under Gemini are childless.

Female graduates can be any age from around 20 to 100+, some will be childless, some won't be. I would gues that most women graduating this year will be childless right now - doesn't mean they will be in ten years' time

Roger Thornhill said...

Mrs H " so I don't see why we shouldn't have access to treatment for something that is not our fault. "

That is the problem here - YOU DON'T SEE WHY.

Look beyond your own self interest and sense of entitlement.

Anonymous said...

I am afraid that harping on about this plays into the hands of those who say Tories are opportunists.

I don't care about postcode lotteries on something as unimportant as giving IVF to childless couples.

A would-be government in waiting who talks about localism and bangs the drum on this 'postcode lottery' is asking for trouble, which will be richly deserved when it arrives.

My sadness is that I want a bunch of principled brave people in government who leave matters such as this to local priorities.

This is a shame.

Newmark said...

Anonymous 9.50 a.m. said...
"Do you have any idea what the proportion of childless graduate women is , about 35%"
This is a meaningless statement. You may as well ask how many males born under Gemini are childless.

Not meaningless. Newmania was simply leaving out some of the detail.

His figure was from a study carried out by the Centre for Longitudinal Studies which found that 40% of the graduate women born in 1970 were childless at age 35 - a much higher percentage than for non-graduates and for graduates born in earlier years.

Only 33% of graduate women born in 1958 were childless at 35.

Obviously the difference is partly due to the fact that many women are now leaving it later to start a family but the Centre concludes that it is almost certain that a higher proportion of the 1970 cohort will remain childless.

chatterbox said...

I can honestly NOT beleive how utterly IGNORANT the majority of the responders to this article have been.

God forbid any of you or your children or close family members experience the SEVERE EMOTIONAL TRAUMA infertility causes.

Let me explain, at age 30 and 31, my husband and i started trying for a family, cutting an extremely long story short, we found out my husband has poor quality sperm through ABSOLUTELY NO FAULT OF HIS OWN! NO to the totally misinformed ignorant idiot who quoted infertility is caused by STI's! In the majority of cases IT IS NOT! NO to the people who say it is always due to increasing AGE! No the majority of causes are nothing to do with AGE! YES, INfertility IS an illness in many cases, such as endometriosis, polysystic ovaries, and illnesses which affect sperm production! They are ALL illnesses so should be treated on the NNNNNNHS especially as the person did nothing to cause the problems!

I agree the NHS should treat illness and cancer treatments should be at the top of the list, however, the argument is what illnesses should take precedent over a young, fit, otherwise healthy couple who have NEVER had ANY cause for NHS treatment other than needed help to have a child?

Should the grossley obese person who ate themselves stupid but gets £30k worth of free surgery on the NHS, or the person who has a complex about a mis-shapen breasts who gets free plastic surgery be more entitlied to funds than someone who needs a helping hand to have a child?

What about the person who KNOWINGLY smokes 20 cigarettes a day then contracts cancer and drains our NHS resourses.... all these things could have been prevented, but my husband could do NOTHING to prevent his sperm problems!!

Do you really think those situations are fair, if you do you need NHS help too for BRAIN surgery!

My husband and i have good jobs, we have paid our fair share of taxes over the years, we have NEVER, ever needed help on the NHS all our lives, all we want is a little help to try have a family.

For those of you who say no to help for IVF on the NHS, well just imagine if you couldnt have had your children, but that the was a way to get them with a little help by the NHS!! Just imagine how you would feel if someone said well you cant have them cos that smoker over there needs an operation to remove self inflicted cancer!!

It's easy to say you would adopt, that is not an easy process either. Besides i am perfectly fertile, i just happened to fall in love with a man who isnt. Put yourselves in my shoes, you are perfectly fertile and could have children, all you want is your partners child cos you love them. You dont want to leave them cos you love them, but if you stay with them you stand a chance of not getting your own biological child! Seriously think about how you would feel putting your predudices and misconceptions aside for just one moment! Shouldnt you be allowed free help if neither of you have done anything to cause your infertility? Why should some OBESES person who smokes get their treatment for free above you??

We are currently having to pay £5k a cycle privately for IVF with ICSI. Luckily we can afford it, but only due to using life savings to try get our child. MANY other people in the same situation cannot afford it!!!

You all need to think outside your narrow minds, lets hope one of your children does not have fertility problems in the future OR marry someone who does. Remember 1 in 5 couples have infertility issues, it could happen!!! IN fact of all the ignorants who responded saying NO to IVF on the NHS, i guarantee that you will have a close family memebr be in the same situation at some point in YOUR LIFE! I know you will all change you narrow minds then!