Anyone who has any personal experience of IVF will know that our funding situation in the UK is patchy at best, but the report released from ESHRE this week showing quite how badly we're trailing behind our European neighbours was still something of a shock. We came third from the bottom in a European table for funding fertility treatment, with only Russia and Ireland behind us. Belgium and Denmark both fund around three times as much treatment per million inhabitants as we do. Even Slovenia funds twice as much.
I've just been on Radio Humberside discussing the situation, and the presenter seemed not to have considered that infertility might be a medical condition. It always strikes me as odd that if it's your fallopian tubes or your ovaries that don't work, a medical problem becomes a "lifestyle choice". Where do we draw the line with "lifestyle choices" and medical treatment? Infertility is not going to kill anyone, people often say. No, it probably isn't, but surely the NHS wasn't set up only to treat people who would drop dead if they weren't helped right away? Even funding three full cycles of IVF for all those who needed it would be a tiny drop in NHS budgets - and cutting all IVF funding entirely wouldn't begin to solve our financial problems (indeed it could make them far worse, if more and more fertility patients started going overseas and coming back pregnant with triplets).
I think this debate is about something much more than infertility - although our attitudes to families and children in the UK probably provide an interesting tangential discussion. It seems to me that deciding that some medical conditions are unworthy of treatment is the tip of a very large iceberg which rests on our decisions about what the NHS is for. What other treatments might constitute "lifestyle choices"? Hip and knee replacements perhaps? Might people decide that they aren't entirely essential? Perhaps being able to walk long distances without any pain is a "lifestyle choice" - you don't have to walk far, you can take painkillers.
Cutting IVF funding is easy - some people even think it's a good thing. People with fertility problems are often so distressed that they haven't told their closest friends and family about what's happening to them. They aren't going to be outside the local PCT waving banners and shouting. Just because something is easy, that doesn't make it right - and being oblivious to the longer term consequences of short-term financial decisions seems to be all too common at the moment.
Showing posts with label ivf funding. Show all posts
Showing posts with label ivf funding. Show all posts
Tuesday, 3 July 2012
Tuesday, 1 March 2011
The blog is back...
Apologies for the lack of posts for the last few months. I've been finishing my new book, due out later this year, which is now finally written and in the editing stages, so the blog is back!
It has been a dreadful few months for anyone needing fertility treatment, as one PCT after another has slashed funding despite the Department of Health and the government making it quite clear that PCTs are expected to be working towards implementing the NICE guideline and providing up to three cycles of IVF. It's particularly sad to see that many of the PCTs are now using the fact that others have already cut funding as an excuse - as if following someone else's bad decision makes it acceptable.
Don't worry - the blog won't all be doom and gloom. There will be the latest updates in fertility tests and treatment, and lots of interesting news and comment so I hope you will enjoy following Fertility Matters again!
It has been a dreadful few months for anyone needing fertility treatment, as one PCT after another has slashed funding despite the Department of Health and the government making it quite clear that PCTs are expected to be working towards implementing the NICE guideline and providing up to three cycles of IVF. It's particularly sad to see that many of the PCTs are now using the fact that others have already cut funding as an excuse - as if following someone else's bad decision makes it acceptable.
Don't worry - the blog won't all be doom and gloom. There will be the latest updates in fertility tests and treatment, and lots of interesting news and comment so I hope you will enjoy following Fertility Matters again!
Friday, 12 November 2010
Surrey funding cuts
So Surrey is the latest to jump on the bandwagon - hping to make up a deficit of £125 million pounds by axing spending on tattoo removal, treatments for baldness and guess what... yes IVF. However they managed to end up with a deficit of £125 million pounds, one can safely say that it wasn't by spending money on fertility treatment, which is estimated to be less than half a percent of total NHS spending. And it's interesting that they have managed to cut £7 million from their spending on "management" (which is still going to cost around £10 million a year).
It's easy to cut IVF spending. No one gets terribly upset, apart from the people waiting for treatment who are often so devastated by their experience of not being able to conceive that they find it hard to talk to their friends about it, let alone to start waving placards outside their local PCT offices. The long-term impact for these couples is usually neglected in talk about "priorities". We know that more than 90% of couples with fertility problems suffer depression, and this can often lead to other health problems. In the future, the opportunity to try to have a child if you can't do it easily will only be available for those who have the cash to pay.
What's really worrying about all this is the precedent that is being set. Surrey have cheerfully announced that "If you don't need it, the NHS won't pay for it." Who decides what constitutes "need"? Do you really "need" a hip replacement? Or a cataract operation? Do children "need" free prescriptions? Do pregnant women "need" scans? If the NHS is only there to deal with life-threatening conditions, then we don't "need" an awful lot of what it does, but is that really a future that anyone wants?
It's easy to cut IVF spending. No one gets terribly upset, apart from the people waiting for treatment who are often so devastated by their experience of not being able to conceive that they find it hard to talk to their friends about it, let alone to start waving placards outside their local PCT offices. The long-term impact for these couples is usually neglected in talk about "priorities". We know that more than 90% of couples with fertility problems suffer depression, and this can often lead to other health problems. In the future, the opportunity to try to have a child if you can't do it easily will only be available for those who have the cash to pay.
What's really worrying about all this is the precedent that is being set. Surrey have cheerfully announced that "If you don't need it, the NHS won't pay for it." Who decides what constitutes "need"? Do you really "need" a hip replacement? Or a cataract operation? Do children "need" free prescriptions? Do pregnant women "need" scans? If the NHS is only there to deal with life-threatening conditions, then we don't "need" an awful lot of what it does, but is that really a future that anyone wants?
Monday, 4 October 2010
an interview later...
I've just done an interview for LBC radio about IVF funding, which they'd linked to Robert Edwards getting the Nobel prize. It's such a shame that on the day one of our country's greatest scientists gets awarded for his ground-breaking work, we end up discussing how to cut all funding for an amazing treatment that was invented here. We carry out less fertility treatment in the UK, and considerably less funded treatment, than most of the rest of Europe - and yet this was a field in which we once led the world.
It always fascinates me when I do these interviews that there is a general assumption that the NHS is funding huge amounts of treatment at the moment, when in fact that isn't the case at all. It's a tiny percentage of the NHS budget and cutting it would cause such distress. Today the person interviewing me equated IVF with breast-enlargement operations for teenagers - it seems to get worse by the day...
It always fascinates me when I do these interviews that there is a general assumption that the NHS is funding huge amounts of treatment at the moment, when in fact that isn't the case at all. It's a tiny percentage of the NHS budget and cutting it would cause such distress. Today the person interviewing me equated IVF with breast-enlargement operations for teenagers - it seems to get worse by the day...
Tuesday, 7 September 2010
IVF cuts - make your feelings known...
It was depressing to get back from my holiday and discover that one Primary Care Trust had decided to stop funding fertility treatment due to the recession.
It's an easy way to look as if you are being thrifty - but the ridiculous thing is that it actually saves a very small amount of money whilst causing a huge amount of heartache. I heard an estimate the other day that in total fertility funding was less than 0.1% of the NHS budget. I suspect far more could be saved by a more careful monitoring of exactly what can be covered by executive expenses - and that wouldn't cause any heartache to anyone.
Clare Lewis-Jones MBE, chair of the National Infertility Awareness Campaign and Chief Executive of Infertility Network UK has made her feelings clear, urging Warrington PCT to rethink the decision; “We are very angry indeed at the decision taken by Warrington PCT to suspend funding for IVF treatment. The PCT has suggested that infertility does not affect general physical health but we deal with patients every day who contact us and whose health has been adversely affected by this illness. NICE Guidance issued in 2004 recommended eligible couples should receive up to three full cycles of treatment. It is high time that PCTs realised the impact infertility has on patients."
I think sometimes Primary Care Trusts are too quick to listen to the small but vociferous minority who oppose fertility treatment and to take their views as being representative. People who are living without the children they'd love are often so adversely affected by their situation that they feel unable to make a fuss when PCTs make decisions like this. Maybe you could help them. Tell Warrington PCT Chair, Mr John Gartside, what you think about the decision.
Mr John Gartside
Warrington Primary Care Trust
Headquarters
930-932 Birchwood Boulevard
Millennium Park
Birchwood
Warrington WA3 7QN
It's an easy way to look as if you are being thrifty - but the ridiculous thing is that it actually saves a very small amount of money whilst causing a huge amount of heartache. I heard an estimate the other day that in total fertility funding was less than 0.1% of the NHS budget. I suspect far more could be saved by a more careful monitoring of exactly what can be covered by executive expenses - and that wouldn't cause any heartache to anyone.
Clare Lewis-Jones MBE, chair of the National Infertility Awareness Campaign and Chief Executive of Infertility Network UK has made her feelings clear, urging Warrington PCT to rethink the decision; “We are very angry indeed at the decision taken by Warrington PCT to suspend funding for IVF treatment. The PCT has suggested that infertility does not affect general physical health but we deal with patients every day who contact us and whose health has been adversely affected by this illness. NICE Guidance issued in 2004 recommended eligible couples should receive up to three full cycles of treatment. It is high time that PCTs realised the impact infertility has on patients."
I think sometimes Primary Care Trusts are too quick to listen to the small but vociferous minority who oppose fertility treatment and to take their views as being representative. People who are living without the children they'd love are often so adversely affected by their situation that they feel unable to make a fuss when PCTs make decisions like this. Maybe you could help them. Tell Warrington PCT Chair, Mr John Gartside, what you think about the decision.
Mr John Gartside
Warrington Primary Care Trust
Headquarters
930-932 Birchwood Boulevard
Millennium Park
Birchwood
Warrington WA3 7QN
Saturday, 13 March 2010
An existing child...
Whether you qualify for NHS-funded IVF doesn't just depend on where you live in the UK, it can also depend on your personal circumstances. Women who are overweight, who are over a certain age or under another, couples or single women who need donor eggs or sperm may all find that their situation makes them ineligible. In many areas, having an existing child from a previous relationship means that you won't qualify for NHS help.
If both you and your partner have been in previous relationships and you have one or more young children from either of those relationships living with you in your home, discovering that you don't qualify for fertility treatment may be upsetting as you'd like a child together, but you do have "an existing child". However, what about a woman whose partner has an adult "child" from a previous relationship? She may have absolutely no contact with that young person and it's a very different scenario - yet she will also be deemed ineligible for treatment by many PCTs.
Fertility patients understand that these are difficult financial times and the NHS doesn't have unlimited funds, but is it really right to make up rules which treat people unfairly in order to disguise the fact that fertility treatment is rationed?
If both you and your partner have been in previous relationships and you have one or more young children from either of those relationships living with you in your home, discovering that you don't qualify for fertility treatment may be upsetting as you'd like a child together, but you do have "an existing child". However, what about a woman whose partner has an adult "child" from a previous relationship? She may have absolutely no contact with that young person and it's a very different scenario - yet she will also be deemed ineligible for treatment by many PCTs.
Fertility patients understand that these are difficult financial times and the NHS doesn't have unlimited funds, but is it really right to make up rules which treat people unfairly in order to disguise the fact that fertility treatment is rationed?
Thursday, 6 August 2009
Survey on funding
I've been on Channel Four News this morning, talking about the latest survey on funding for fertility which suggests that 80% of primary care trusts are not offering the treatment they should.
The website www.fundingforfertility.com has all the latest details on NHS funding for fertility treatment, and shows that your chances of getting treatment depend entirely on where you live. The system is blatantly unfair, with individual primary care trusts making up their own criteria. In some parts of the country, you only get treatment if you are over the age of 36, in others if you are under the age of 35.
Many are refusing to pay for spare embryos to be frozen and transferred, which means patients end up having more than one embryo transferred and the multiple birth rate rises. The cost to the NHS of more multiple births would far exceed the cost of freezing and transferring spare embryos, but there seems to be little in the way of joined up thinking on this issue.
There is little point in going to the expense of having a National Institute for Health and Clinical Excellence to look carefully at all aspects of a problem and make recommendations if primary care trusts are then free to ignore them entirely and make up their own rules.
You can see more of the Channel Four News coverage at www.channel4.com/news
The website www.fundingforfertility.com has all the latest details on NHS funding for fertility treatment, and shows that your chances of getting treatment depend entirely on where you live. The system is blatantly unfair, with individual primary care trusts making up their own criteria. In some parts of the country, you only get treatment if you are over the age of 36, in others if you are under the age of 35.
Many are refusing to pay for spare embryos to be frozen and transferred, which means patients end up having more than one embryo transferred and the multiple birth rate rises. The cost to the NHS of more multiple births would far exceed the cost of freezing and transferring spare embryos, but there seems to be little in the way of joined up thinking on this issue.
There is little point in going to the expense of having a National Institute for Health and Clinical Excellence to look carefully at all aspects of a problem and make recommendations if primary care trusts are then free to ignore them entirely and make up their own rules.
You can see more of the Channel Four News coverage at www.channel4.com/news
Saturday, 27 June 2009
Latest statistics on IVF funding
If you want to check whether you'll qualify for funded IVF treatment, the Department of Health has just published the latest detailed statistics on what the NHS provides and where.
It makes fascinating - if somewhat depressing - reading. Overall, the situation is getting a little better, and we are gradually working out way towards the three funded cycles suggested by the government's own advisory body. However, it's a slow process and in some areas access to treatment is restricted by some very strange rules.
The government's advisory body had suggested that treatment should be available for couples when the female partner was 39 or under, but in North Yorkshire and York, they've decided to fund treatment for women who are older instead. There, you only qualify for treatment in the six months between being 39.5 and 40 - despite that, they did manage to treat a total of 19 women who fell into that category in 2008! We know that treatment is less likely to be successful by the time a woman reaches 40, and it seems an odd decision not to offer help to younger women who have a greater chance of getting pregnant.
Some areas are still only funding fresh cycles, and not making any allowances for freezing spare embryos and transferring them later. This is going to make it very difficult for clinics who are being encouraged to promote single embryo transfer in younger women - if the NHS will pay for you to create the embryos but then refuses to pay for you to store them, you're more likely to ignore the risks that a multiple pregnancy could bring.
Overall, there's still a long way to go - but things are moving, albeit gradually. You can see the detailed breakdown of what is being offered where by checking out www.dh.gov.uk
It makes fascinating - if somewhat depressing - reading. Overall, the situation is getting a little better, and we are gradually working out way towards the three funded cycles suggested by the government's own advisory body. However, it's a slow process and in some areas access to treatment is restricted by some very strange rules.
The government's advisory body had suggested that treatment should be available for couples when the female partner was 39 or under, but in North Yorkshire and York, they've decided to fund treatment for women who are older instead. There, you only qualify for treatment in the six months between being 39.5 and 40 - despite that, they did manage to treat a total of 19 women who fell into that category in 2008! We know that treatment is less likely to be successful by the time a woman reaches 40, and it seems an odd decision not to offer help to younger women who have a greater chance of getting pregnant.
Some areas are still only funding fresh cycles, and not making any allowances for freezing spare embryos and transferring them later. This is going to make it very difficult for clinics who are being encouraged to promote single embryo transfer in younger women - if the NHS will pay for you to create the embryos but then refuses to pay for you to store them, you're more likely to ignore the risks that a multiple pregnancy could bring.
Overall, there's still a long way to go - but things are moving, albeit gradually. You can see the detailed breakdown of what is being offered where by checking out www.dh.gov.uk
Friday, 22 August 2008
Time to celebrate in the East of England
Anyone who needs fertility treatment and lives in the East of England should be celebrating today with the announcement that the area is to be the first to fully implement the guidelines on fertility treatment and offer three full cycles of IVF.
This fantastic news will offer new hope to many couples living in Norfolk, Suffolk, Essex, Cambridgeshire, Hertfordshire and Bedfordshire. There are some criteria, but unlike those used by many other primary care trusts, these are perfectly reasonable - the female partner must be between the ages of 23 and 39, they should not smoke and there should be no existing children from the current relationship.
The funding will start next April - just five years after the initial guideline from the National Institute of Clinical Health and Excellence which recommended that all primary care trusts should be funding three full cycles of treatment. It may have taken time, but maybe now more trusts will realise that these guidelines are meant to be followed rather than ignored, and perhaps couples in other parts of the country will eventually be able to access the treatment they need.
You can read the full details of the proposals for the East of England at www.eoe.nhs.uk/news
This fantastic news will offer new hope to many couples living in Norfolk, Suffolk, Essex, Cambridgeshire, Hertfordshire and Bedfordshire. There are some criteria, but unlike those used by many other primary care trusts, these are perfectly reasonable - the female partner must be between the ages of 23 and 39, they should not smoke and there should be no existing children from the current relationship.
The funding will start next April - just five years after the initial guideline from the National Institute of Clinical Health and Excellence which recommended that all primary care trusts should be funding three full cycles of treatment. It may have taken time, but maybe now more trusts will realise that these guidelines are meant to be followed rather than ignored, and perhaps couples in other parts of the country will eventually be able to access the treatment they need.
You can read the full details of the proposals for the East of England at www.eoe.nhs.uk/news
Friday, 27 June 2008
Apologies
I'm afraid I haven't been updating much this week, but I've just been finishing my new book, the companion to The Complete Guide to Female Fertility, which is due out next year. The first draft is completed, and I'll be back on track again now!
There has been some interesting coverage of the postcode lottery for IVF funding this week, after the Department of Health published their survey of local primary care trusts. All the trusts were questioned about what arrangements they had for funding IVF, and the majority are finally offering one cycle of treatment. The problem is that some invent such stringent criteria that it's virtually impossible to qualify, and others refuse to pay for freezing and transferring any frozen embryos, which doesn't really count as paying for an IVF cycle. It's great that people are finally taking notice of this, four years after the government's own advisory body, The National Institute for Clinical Excellence, said that anyone who needed it should get three funded cycles. There doesn't seem much point in having an advisory body if you ignore the advice it gives, but at least people are finally starting to take some notice of the problems fertility patients face. You can see details of the survey at here
There has been some interesting coverage of the postcode lottery for IVF funding this week, after the Department of Health published their survey of local primary care trusts. All the trusts were questioned about what arrangements they had for funding IVF, and the majority are finally offering one cycle of treatment. The problem is that some invent such stringent criteria that it's virtually impossible to qualify, and others refuse to pay for freezing and transferring any frozen embryos, which doesn't really count as paying for an IVF cycle. It's great that people are finally taking notice of this, four years after the government's own advisory body, The National Institute for Clinical Excellence, said that anyone who needed it should get three funded cycles. There doesn't seem much point in having an advisory body if you ignore the advice it gives, but at least people are finally starting to take some notice of the problems fertility patients face. You can see details of the survey at here
Monday, 14 April 2008
Nurses to debate fertility funding
Members of the Royal College of Nursing (RCN) will discuss funding for infertility treatment in a debate at their annual conference in Bournemouth at the end of the month.
The RCN's Congress will consider a motion calling on the union to lobby for proper funding for fertility treatment, recognising the inadequacies of the current system. Most people still pay for their IVF in the UK, despite the recommendation by the National Institute for Clinical Excellence (NICE) that women under 40 who needed IVF should get three cycles of NHS treatment. That guideline was issued in 2004 and at the time the government responded by saying that, as a first step, all those under 40 who needed IVF should get one NHS cycle by 2005.
In fact, this still hasn't happened. Instead, there are a wide variety of different criteria applied in many areas to make sure fewer women will qualify for their single cycle of treatment. In other parts of the country, there is simply no funded treatment available at all. Whatever you think about funding for fertility treatment, the current system is unfair and causes heartache for thousands of couples who find they can't get the help they need.
You can read more about the RCN motion on the issue at the union's website www.rcn.org.uk
The RCN's Congress will consider a motion calling on the union to lobby for proper funding for fertility treatment, recognising the inadequacies of the current system. Most people still pay for their IVF in the UK, despite the recommendation by the National Institute for Clinical Excellence (NICE) that women under 40 who needed IVF should get three cycles of NHS treatment. That guideline was issued in 2004 and at the time the government responded by saying that, as a first step, all those under 40 who needed IVF should get one NHS cycle by 2005.
In fact, this still hasn't happened. Instead, there are a wide variety of different criteria applied in many areas to make sure fewer women will qualify for their single cycle of treatment. In other parts of the country, there is simply no funded treatment available at all. Whatever you think about funding for fertility treatment, the current system is unfair and causes heartache for thousands of couples who find they can't get the help they need.
You can read more about the RCN motion on the issue at the union's website www.rcn.org.uk
Monday, 19 November 2007
IVF funding
When the government promised one full cycle of IVF on the NHS for all eligible couples by April 2005, it looked as if things might be about to change for all of those who were having difficulty conceiving. At last, the problem was being taken seriously. Perhaps the chances of getting at least some funded help would no longer depend on where you lived.
Two years on, that government promise remains unfulfilled. In some areas, there's no funding at all for patients who need IVF. In others, trusts have come up with stringent criteria to ensure that the majority of those who need treatment won't qualify. Is it really logical to refuse to fund treatment for women who are under 36, when we know that IVF is far more likely to be successful for younger women? And is it fair to refuse to fund anyone who has ever paid for treatment in the past? Or anyone whose partner may have adult children from a previous relationship?
The postcode lottery is more complicated than ever, and your chances of getting treatment depend on your age and your situation now, as well as where you live. Fortunately, there is an ongoing survey by the charity Infertility Network UK with the backing of the Department of Health to look at the way funding is working, or rather not working, which aims to help lay the foundations for better provision of treatment across the board. Maybe this is the first step towards keeping that government promise.
Two years on, that government promise remains unfulfilled. In some areas, there's no funding at all for patients who need IVF. In others, trusts have come up with stringent criteria to ensure that the majority of those who need treatment won't qualify. Is it really logical to refuse to fund treatment for women who are under 36, when we know that IVF is far more likely to be successful for younger women? And is it fair to refuse to fund anyone who has ever paid for treatment in the past? Or anyone whose partner may have adult children from a previous relationship?
The postcode lottery is more complicated than ever, and your chances of getting treatment depend on your age and your situation now, as well as where you live. Fortunately, there is an ongoing survey by the charity Infertility Network UK with the backing of the Department of Health to look at the way funding is working, or rather not working, which aims to help lay the foundations for better provision of treatment across the board. Maybe this is the first step towards keeping that government promise.
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