Why shouldn’t single women be able to have IVF?
Since it is funded by the taxpayer, there will always be a degree of rationing in the services the NHS offers patients free at the point of use. The debate over which services it provides, based on which criteria, is therefore a constant in our public discourse. There are few areas more sensitive than the provision of IVF.
The NHS limits access to IVF in all sorts of ways in different parts of the country, but the reports that NHS South East London is to bar all single women from receiving funding for such treatment were startling. In justifying its decision, which is now under review, the authority controversially cited a document which declared: “A sole woman is unable to bring out the best outcomes for the child.”
In a country where nearly a quarter of families with dependent children have a single parent at their helm and – according to the charity Gingerbread
– 90 per cent of those are women, this is an extraordinary statement. A stable, loving, two-parent family is undoubtedly an ideal environment in which to raise a child. But there are around 1.6 million single mothers in the UK who are bringing up their children alone for myriad reasons. In fact, Gingerbread reports that the “proportion of families with children headed by single parents has remained at around 25 per cent for over a decade”, over which period the proportion of single fathers has also remained around 10 per cent.
To glibly declare that these mothers have failed to bring out the best outcomes for their children simply isn’t credible without the knowledge of the circumstances of every individual case. But looking beyond the insensitive language, how on earth is the relevant NHS authority planning to
establish the relationship status of a woman seeking IVF treatment? Has it really thought through what implications its insistence on a partner might have for the lives of women desperately wishing to have a baby?
No woman relishes the prospect of the daily hormone injections and the invasive medical procedures of an IVF cycle. For most, it will be a desperate, last resort attempt to have a baby. What would prevent a woman in such a situation from producing a pretend partner at medical appointments to satisfy the condition of being in a relationship? Or, more worryingly, will this stop a woman in an abusive relationship from walking away in order to clear the hurdle set before her, endangering both herself and the baby? How would NHS South East London verify the authenticity or the quality of these relationships?
This decision also highlights a wider problem with the system: the so-called postcode lottery approach to treatments offered on the NHS. Devolving decisions to local bodies to set priorities according to local needs is to be encouraged. But it is rarely ever made clear to residents what the authorities are basing their decisions on. What say do residents have in deciding whether the limited resources of a local NHS trust are spent on IVF treatment, costing around £3,500 per cycle, as opposed to, for example, a gastric bypass costing taxpayers £6,000?
If NHS decentralisation is to work, these questions need to be answered.