The postcode lottery – it could be you!

Britain was the first nation to deliver an IVF baby. Now, due to NHS budget cuts fertility treatments are an increasingly restricted privilege for those that can afford it

The NHS is on a mission to reduce expenditure on “ineffective” services.

So why is IVF being cut back?

Having looked at various CCG reports, this seems to be due to the relatively low success rates per IVF round and the low overall number of “infertile” patients. This is totally at odds with the fact that one in six couples across the UK experience fertility problems.

NICE guidelines recommend three rounds of IVF for effective treatment. This recommendation is based on extensive research and yet CCG’s commonly ignore it.  60% of CCGs now offer just one NHS IVF cycle. And almost 10% of CCG’s are known to be consulting to reduce or cut NHS fertility treatment altogether. Seven CCG’s have completely removed it aside from offering it to patients in extenuating circumstances, such as undergoing HIV or cancer treatment.

In June this year, seventeen “ineffective”, “unnecessary” and “little value for money” treatments were also “in consultation” with a view to being removed from the roster of treatments offered by the NHS. These include treatments for varicose veins, arthritic knees, breast reduction, tonsil removal and snore surgery.  These cuts will supposedly save the NHS £200 million per year.

Determining which procedures should be provided on the NHS is an ethical, moral, social and political minefield. For anyone going through IVF, the current restrictions must seem unjust when set against the range of self-inflicted, contentious and arguably unnecessary treatments that are covered.

One controversial example is this – if the government can deny eager, committed, childless couples the chance to have a baby, how can it justify helping children change their gender?

The NHS has spent £9million on sex swap operations in the last five years and demand is growing, with gender reassignment amongst children an increasingly common occurrence. Children as young as three are being referred to gender reassignment clinics! This irreversible process is a physically, biologically and emotionally extreme course of action – some patients are at an age where they’re barely able to communicate comprehensively, let alone determine the need to change gender. And the taxpayer is funding it.

Infertility is also recognised as a medical condition with devastating emotional and mental consequences, including anxiety, depression and relationship breakdown

NICE, in their Clinical Guidelines, recommends that couples ‘should be offered counselling because fertility problems themselves, and the investigation and treatment of fertility problems, can cause psychological stress’.

Additionally, Anya Sizer from the Fertility Network UK said “We’ve carried out a comprehensive survey …. it found 90% of those with fertility issues had experienced depression, 70% said it had an effect on their relationship. And 42% said they had had suicidal thoughts. So, it really does create one of the biggest life crises for someone to go through.”

So, while the provision of free IVF treatment is being scaled back, the NHS has started to offer counselling to combat the mental health ramifications for childless couples. How enduring will this treatment be, relative to the lifetime of heartache couples will suffer?

In some CCG’s, IVF is only allowed for patients who may be left infertile as a consequence of HIV or cancer treatment.  Not to diminish their rights, but why is it that these patients have priority to fertility treatment above others?

Could there also be a hidden and unpredictable cost for the NHS?

Cutbacks are encouraging more couples to head overseas for cheaper IVF treatment.  Some of these clinics encourage multiple embryo transfers, leading to an increase in multiple births. This is counter to the UK policy of single embryo transfer, which while protecting the health prospects of mother and baby, is also aimed at reducing ongoing healthcare costs for the NHS.

Across the UK, the cost to the NHS of an IVF cycle varies massively, from £3k to over £11k. Whilst some regional price variation is expected (availability of expertise, living costs etc), the budgetary impact of higher treatment costs is likely to have a direct consequence on the number of IVF rounds being funded in that area and is a significant contributor to the NHS postcode lottery.

In contrast, patients in Scotland, Wales and Northern Ireland have a nationally standardised IVF cost.  And in other European countries, such as Belgium and France, the cost of IVF is capped.

The NHS already sets a national price for a wide range of treatments, from hip replacements to radiotherapy, but doesn’t follow this policy with IVF. Why not?

There are organisations fighting for the right for funded NHS IVF treatment. These include the Infertility Network UK and the National Infertility Awareness Campaign NIAC.  The latter has campaigned for more than 20 years for “people to have comprehensive and equal access to a full range of appropriate NHS investigations and treatments for infertility; this includes the right to access up to three cycles of IVF treatment free on the NHS”. It seems they are losing the battle and it needs more public support.

You may feel that the government is right to cut back on IVF. It is a perfectly legitimate view that everyone does not have a right to medical services designed to counter infertility.

However, if you feel that the government needs to rethink its spending strategy and health priorities, please sign the petition encouraging greater funding of IVF treatment and forward on to others for discussion and open and frank debate.

Good luck my fellow fertility struggling friends,

Thora Negg x

 

DISCLAIMER

IVF is a gamble and everyone’s fertility journey is unique.

I am not a medical professional, fertility coach or psychologist.

I have no idea what my story will be, but I will share it openly and frankly.

Hopefully it will provide you with hope and reassurance.

And don’t forget, underneath all the totally justified, mixed-up emotions, there is still a strong woman at the core – follow your instincts and forgive yourself, this isn’t your fault X

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