Comment Postcode lottery faced by desperate couples
LOCAL health authorities are depriving desperate couples of fertility treatment in a bid to save money.
Methods include arbitrarily reducing the age limit at which treatment stops being available, refusing treatment if one partner has a child from a previous relationship, or refusing to provide a full course of treatment.
Four Clinical Commissioning Groups (CCGs), the NHS bodies which commission services in local areas, have ended assisted conception services, while one in ten are consulting on reducing or entirely decommissioning NHS fertility treatment.
Birmingham Labour MP Steve McCabe and Ed Vaizey, a Conservative MP who was a government minister until July 2016, have raised concerns.
And Nicola Blackwood, the health minister responsible for fertility services, said she would demand that CCGs provide the same level of service across the country.
Guidelines produced by the National Institute for Health and Care Excellence (NICE), which advises the NHS, state that women under 40 should receive three cycles of treatment – placing embryos in the womb on up to three occasions – while those aged between 40 and 42 should in many cases by offered one cycle of treatment.
Ms Blackwood said: “I will be writing to NHS England to ask that it communicates clearly to CCGs the expectation that NICE fertility guidelines should be followed by all.”
Her pledge came after MPs told a Commons debate that NICE guidelines were being ignored across the country.
Infertility affects one in six couples, but they face a postcode lottery in services, with different rules imposed across the country.
Mr McCabe highlighted the case of one resident of his Selly Oak constituency, Louise Jackson, who had been trying for a baby with her partner for six years. But when tests confirmed they would need IVF treatment, they were told it wasn’t available – because her partner had had a child from a previous relationship in 1975.
He said: “Without being required to offer any kind of explanation, some CCGs have lowered the maximum age for IVF to 35; others have introduced non-medical criteria, such as refusing couples treatment if one of them has a child from a previous relationship, as happened in the case of my constituent, Louise Jackson; and apparently even more criteria are applied for same-sex couples, including a requirement to demonstrate that they have already paid privately for six cycles of treatment before they can be considered by the NHS.
“Those requirements do not look like medical criteria to me, they look like crude, discriminatory rationing, based on pseudo-moralistic prejudices.”
Furthermore, CCGs that do offer IVF service are often providing a limited service.
A survey of CCGs by pressure group Fertility Fairness found that only 16 per cent of them offer three cycles of IVF as recommended by NICE, down from 24 per cent in 2013.
The number of CCGs offering just one cycle of NHS-funded IVF treatment has risen to 60 per cent.
Senior Tory Ed Vaizey echoed Mr McCabes concerns. He said: “In 2016, North East Lincolnshire, Somerset, Wiltshire, Herts Valley, Cambridgeshire and Peterborough, and Bedfordshire CCGs all cut their fertility services and now offer the bare minimum – one funded IVF cycle. Approximately 10 per cent of CCGs are currently considering disinvestment.”
He added: “We have also heard how more and more clinical commissioning groups are now disinvesting in NHS fertility services.
“The signals from NICE, the Government and the CCGs themselves clearly show that fertility services are seen as second-class NHS services that do not rank alongside other, more important services.
“We in this House know from the many debates we have had, and not least from the huge increase in the profile of and focus on mental health services, that treating something as a second-order issue stores up significant problems. We can reverse that attitude through sustained campaigning.”
Coventry MP Colleen Fletcher (Lab, Coventry North East) said one Coventry couple had been denied fertility treatment because they had previously suffered a miscarriage. But she said: “Were the couple to live in a different part of the country – my own area of Coventry, for example – they would be eligible for at least one fully funded cycle of IVF on the NHS.
“In other areas, they would be eligible for three fully funded cycles. That inequitable postcode lottery adds insult to injury for a couple who, like many others, are already trying to cope with the distressing effects of infertility.”
Those requirements do not look like medical criteria to me; they look like crude, discriminatory rationing