Praesidium

Sunday, August 12, 2007

IVF 'Lottery'

The media seem to enjoy giving lotteries a bad name, and even the BBC are in on it. Interestingly, having just scanned through the article, I don't see anyone actually mention lotteries in the text, it's simply a gratuitous title.

The Facts: Guidelines say all eligible women aged 23-39 should get one free cycle of IVF. But some areas have introduced restrictions such as age limits, with some saying a woman over 35 is too old, with others saying that is too young. Other PCTs, like North Staffordshire, are so cash-strapped they have put a freeze on all forms of fertility treatment. Half of the 114 PCTs offered couples free IVF even if either partner already had a child. In other words, local decisions on health spending lead to local inequalities (though presumably areas spending less on IVF spend more on something else, like cancer drugs, so perhaps I should simply say differences)

Comments: Mr Shapps, whose own three children were conceived through IVF, said that PCTs were, to some extent, "playing God" - deciding who had the right to a child and who did not, based largely on the state of the PCTs' annual budgets and deficits. He explained: "Couples are effectively being told that they cannot have a baby while their friends on the other side of the street, who might have a similar set of circumstances, are able to obtain three cycles of IVF provided for them by the NHS."
Dr Mike Dixon, chairman of the NHS Alliance which represents PCTs, said: "For the individual, it might seem an unfair system. But looking at it nationally, I think it's better that there should be local determination of provision."
However Infertility Network UK said: "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."


I'm not really sure why these decisions are decentralized. Healthcare priorities aren't obviously local issues, and you might well think that if a life-saving cancer drug is a better use of NHS resources than IVF fertility treatment then that holds true everywhere. But (and I'm sure this won't be the last time I have to say this) regional variation isn't a lottery!

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