'Postcode lottery' continues for infertile English couples
Dr Jess Buxton
Progress Educational Trust30 June 2008
Only nine out of 151 primary care trusts (PCTs) in England are funding the recommended three cycles of IVF for infertile couples, according to the UK Department of Health. The latest figures reveal that despite guidance issued over four years ago, four trusts are still offering no IVF treatment at all, and 94 per cent are not providing the full three cycles recommended. The failure to fully fund IVF treatment could jeopardise a new drive to cut the number of multiple births after fertility treatment, say experts.
The survey, which does not include data from Scotland, Wales or Northern Ireland, was published on the Department of Health's website in response to a parliamentary question. It found that just seven PCTs currently offer three cycles of NHS-funded IVF treatment: Heywood, Middleton and Rochdale, Bury, East Lancashire, Stockport, Tameside and Glossop, Trafford, and Blackburn with Darwen. According to the Times newspaper, the four PCTs that have suspended free IVF treatment are North Lincolnshire, North Staffordshire, North Yorkshire and York, and Stoke on Trent, though the latter has since resumed provision.
The National Institute for Health and Clinical Excellence (NICE) recommended, in February 2004, that three cycles of IVF should be offered to all infertile couples, subject to certain clinical criteria, to end the 'postcode lottery' of provision. Shortly afterwards, the then health secretary, Sir John Reid, announced that all infertile couples where the woman was aged between 23 and 39, and fitting certain other additional criteria - including having no other children living with them - should be given just one free cycle of IVF on the NHS from April 2005, with a view to increasing provision further in time.
Dr Mark Hamilton, chairman of the British Fertility Society (BFS), called the current IVF funding 'very patchy' across England. He said that it was 'imperative that the funding issues around IVF' were addressed in collaboration with the launch of a new strategy urging clinics to cut the number of multiple pregnancies after IVF. 'The funding issue is very, very important', he stressed.
Even where IVF treatment is funded, there is wide variation in the eligibility criteria set by different PCTs. For example, across the whole of South Central - which includes Oxfordshire to Portsmouth, Milton Keynes and the Isle of Wight - only women aged between 36 and 39 are eligible and only if neither partner has any children from a previous relationship. Meanwhile, in East Riding, Yorkshire, men over the age of 46 will not be treated on the NHS. In many areas women under the age of 25 cannot have free IVF, while in Bath and North East Somerset women will not be treated until they reach the age of 35.
Susan Seenan, of the charity Infertility Network UK (I N UK) said: 'It's a disgrace, it is so unfair. It is ridiculous that some PCTs are forcing women to wait until they are over 35 when their natural fertility has declined and the chance of a successful outcome is much less'. She added 'What we need is a set of standard centrally agreed criteria which the PCTs have to work with and then we will have a level playing field and everyone treated equally'.
Reproduced with permission from BioNews, an email and online sources of news, information and comment on assisted reproduction and genetics.