3/4/07
IVF treatment in England a lottery, MP says
Couples in England struggling to conceive face a postcode lottery over whether they qualify for fertility treatment on the NHS, an MP said today.
The eligibility criteria for free IVF vary widely across England, with some local health trusts refusing to provide any fertility treatment, according to survey by Grant Shapps, a Conservative.
Many of the primary care trusts that run local health services are not following guidelines on the provision of IVF set by the National Institute for Clinical Excellence (Nice). Nice decides the treatments that are available on the NHS.
But Mr Schapps said the Department of Health's "muddled" approach to the guidelines, along with record NHS deficits, were leading couples to seek IVF in areas of the country other than where they lived.
The Nice guidelines on IVF, issued in 2004, recommend that women aged between 23 and 39 should be offered up to three cycles of treatment.
The department said it would ask care trusts to offer women of that age group who met the medical criteria a minimum of one full cycle of IVF from April 2005, with priority given to couples who do not already have a child.
However, the survey found that Stoke-on-Trent care trust classed IVF as a "low-priority treatment" and was not offering it at all over 2006-07, while North Staffordshire had decided to stop all fertility treatment in December 2006.
Lincolnshire and Luton trusts will provide IVF only to women younger than 35, while Hampshire and the Isle of Wight specify women must be between 36 and 39.
There are also widespread differences over whether one partner having a child from a previous relationship should make a couple ineligible. According to the report, 51 trusts exclude couples where one of the parents has a child, 54 do not and four do not mention it in their policies.
The number of cycles of IVF treatment trusts offer varies between one and three. Trusts also vary in their criteria on the length of a couple's relationship before approving fertility treatment, and on smoking.
For example, Gloucestershire asks that couples have been together for three years; Hartlepool demands a "stable" relationship; and Plymouth wants the female partner to have been free from nicotine for six months.
The report said: "A muddled approach by the Department of Health and a failure to follow the Nice guidelines, combined with growing PCT deficits in many parts of the country, have created entirely arbitrary borders that decide which couples can start a family and which couples cannot."
The report, called The Messy Business of Conception, was compiled from requests under the Freedom of Information Act to trusts throughout England.
Mr Shapps, MP for Welwyn and Hatfield, and his wife have three children as a result of IVF treatment. He said his survey showed that fertility treatment was "sometimes just downright unfair".
The MP said: "When, in 2004, Nice and the then secretary of state for health announced plans to provide at least one cycle of NHS-funded IVF for childless couples, I was relieved for couples who would follow in our footsteps.
"Sadly, we now know through this comprehensive study that the reality for thousands of couples is anything but a stress-free IVF experience. In fact, a woman's chances of ever conceiving a baby are largely dependent on her postcode and the level of debt within her primary care trust.
"The rules are complex, unequal and sometimes just downright unfair. Even if you qualify on all fronts, the evidence is that a woman may still be denied treatment because of budgetary deficits. Three years after the secretary of state's announcement, the situation is cryptic, confused and inconsistent. In 2007 the business of conception is nothing short of a mess."
Clare Brown, chairwoman of the National Infertility Awareness Campaign (Nice) said: "The eligibility criteria being imposed by the PCTs are unfair and are causing couples additional heartache at a time when they are struggling to cope with their infertility.
"We urge the government to consult with all those involved, including patient representatives and clinicians, with a view to implementing the full Nice guideline and to setting centrally agreed criteria to overcome these inequalities once and for all."
The public health minister, Caroline Flint, said: "We recognise that infertility causes pain and distress . One in seven couples experience problems. So it is important that infertile couples have access to IVF regardless of where they live."
But she added: "The guidelines are just one of many factors trusts have to take into account when deciding which local services to provide."
Guardian Unlimited © Guardian News and Media Limited 2007
¶ 8:51 PM
Couples in England struggling to conceive face a postcode lottery over whether they qualify for fertility treatment on the NHS, an MP said today.
The eligibility criteria for free IVF vary widely across England, with some local health trusts refusing to provide any fertility treatment, according to survey by Grant Shapps, a Conservative.
Many of the primary care trusts that run local health services are not following guidelines on the provision of IVF set by the National Institute for Clinical Excellence (Nice). Nice decides the treatments that are available on the NHS.
But Mr Schapps said the Department of Health's "muddled" approach to the guidelines, along with record NHS deficits, were leading couples to seek IVF in areas of the country other than where they lived.
The Nice guidelines on IVF, issued in 2004, recommend that women aged between 23 and 39 should be offered up to three cycles of treatment.
The department said it would ask care trusts to offer women of that age group who met the medical criteria a minimum of one full cycle of IVF from April 2005, with priority given to couples who do not already have a child.
However, the survey found that Stoke-on-Trent care trust classed IVF as a "low-priority treatment" and was not offering it at all over 2006-07, while North Staffordshire had decided to stop all fertility treatment in December 2006.
Lincolnshire and Luton trusts will provide IVF only to women younger than 35, while Hampshire and the Isle of Wight specify women must be between 36 and 39.
There are also widespread differences over whether one partner having a child from a previous relationship should make a couple ineligible. According to the report, 51 trusts exclude couples where one of the parents has a child, 54 do not and four do not mention it in their policies.
The number of cycles of IVF treatment trusts offer varies between one and three. Trusts also vary in their criteria on the length of a couple's relationship before approving fertility treatment, and on smoking.
For example, Gloucestershire asks that couples have been together for three years; Hartlepool demands a "stable" relationship; and Plymouth wants the female partner to have been free from nicotine for six months.
The report said: "A muddled approach by the Department of Health and a failure to follow the Nice guidelines, combined with growing PCT deficits in many parts of the country, have created entirely arbitrary borders that decide which couples can start a family and which couples cannot."
The report, called The Messy Business of Conception, was compiled from requests under the Freedom of Information Act to trusts throughout England.
Mr Shapps, MP for Welwyn and Hatfield, and his wife have three children as a result of IVF treatment. He said his survey showed that fertility treatment was "sometimes just downright unfair".
The MP said: "When, in 2004, Nice and the then secretary of state for health announced plans to provide at least one cycle of NHS-funded IVF for childless couples, I was relieved for couples who would follow in our footsteps.
"Sadly, we now know through this comprehensive study that the reality for thousands of couples is anything but a stress-free IVF experience. In fact, a woman's chances of ever conceiving a baby are largely dependent on her postcode and the level of debt within her primary care trust.
"The rules are complex, unequal and sometimes just downright unfair. Even if you qualify on all fronts, the evidence is that a woman may still be denied treatment because of budgetary deficits. Three years after the secretary of state's announcement, the situation is cryptic, confused and inconsistent. In 2007 the business of conception is nothing short of a mess."
Clare Brown, chairwoman of the National Infertility Awareness Campaign (Nice) said: "The eligibility criteria being imposed by the PCTs are unfair and are causing couples additional heartache at a time when they are struggling to cope with their infertility.
"We urge the government to consult with all those involved, including patient representatives and clinicians, with a view to implementing the full Nice guideline and to setting centrally agreed criteria to overcome these inequalities once and for all."
The public health minister, Caroline Flint, said: "We recognise that infertility causes pain and distress . One in seven couples experience problems. So it is important that infertile couples have access to IVF regardless of where they live."
But she added: "The guidelines are just one of many factors trusts have to take into account when deciding which local services to provide."
Guardian Unlimited © Guardian News and Media Limited 2007
Labels: IVF treatment in England
¶ 8:51 PM
