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King's College London - Health: More than a medical matter






IVF on the NHS?

11 August 2003

By Juliet Tizzard

Director, Progress Educational Trust

Appeared in BioNews 220
This weekend, the Daily Mail newspaper broke a story that a British government agency is considering a proposal to offer six IVF cycles to women under 40 years of age on the NHS. If NICE, the National Institute for Clinical Excellence, ends up publishing what are at present draft proposals, it could spell the end of the 'postcode lottery' in IVF provision, in which access to service depends upon where you live, rather than whether you need treatment. It could also mean an end to the dominance of the private sector which currently provides treatment to 80 percent of couples undergoing IVF.

Not everyone thinks this proposal is a good one. Stephen Pollard, writing in the Independent, suggests that if the NHS were to start funding IVF in this way, it would undermine its policy of funding only essential services. This, according to Pollard, is 'redefining the purpose of the NHS to include the provision of all treatments, rather than just those that are clinically necessary.' However, the NHS already provides non-essential services which are not clinically necessary to patients. One such service is family planning. Pregnancy is not a disease (though, in fact, infertility often is a result of disease) and having a baby is not life threatening, yet contraceptive advice and services are provided free of charge - and so they should be.

That is not to say that NHS provision of family planning services is guided by an enlightened view of women controlling their fertility. Early adoption of such services was probably motivated at least in part by a desire to limit the number of babies born to single women or to families on low incomes. But regardless of the reason for the introduction of family planning services, they are now part of our health system and few would argue that they ought to be removed. The point remains that whilst preventing conception is seen as a legitimate service for the NHS to provide, assisting conception is regarded by some as unworthy of government funding.

Pollard argues that the crux of the issue is whether 'there is any "right" to children, the absence of which is something that the state, through the NHS, has a duty to rectify'. He goes on to say that IVF treatment is provided largely by the private sector 'because the existing consensus is that there is no such right, and thus no such NHS duty'. Does such a consensus exist and, if it does, how was it arrived at? Until now, there has been no real public or political debate about NHS provision of fertility services. In truth, the current poor provision of IVF on the NHS is based not upon rational decision-making, but upon ethical reactions to IVF which are 25 years out of date. IVF grew up as a private service because the state was unwilling to fund what was regarded at the time by many influential people as an ethically dubious treatment. Times have changed and public attitudes have changed with them. Perhaps it's time that the health service's view caught up with the times.


Juliet Tizzard is the Founder of BioNews and was formerly Director of the charity that publishes it, the Progress Educational Trust (PET). She is coauthor of Key Issues in Bioethics (buy this book from Amazon UK or Amazon USA) and Designer Babies: Where Should We Draw the Line? (buy this book from Amazon UK or Amazon USA).

 

SOURCES & REFERENCES

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

26 May 2005 - by BioNews 
The UK's Human Fertilisation and Embryology Authority (HFEA) has published a new edition of its 'Guide to Infertility'. The Guide contains details of all UK clinics that are licensed under the Human Fertilisation and Embryology Act 1990 to carry out in vitro fertilisation (IVF) and donor insemination (DI), although it... [Read More]
14 February 2005 - by Professor Brian Lieberman 
The failure of the UK government to provide, or to identify additional funds for NHS funded IVF treatment is of increasing concern to many thousands of infertile couples, led to believe that they would receive such treatment following the report by the National Institute of Clinical Excellence (NICE) in February... [Read More]
31 January 2005 - by BioNews 
Members of the UK parliament have called upon the government to make fertility treatment available on the National Health Service (NHS) to all couples in England and Wales with a proven need, regardless of where they live. Members of the All Party Parliamentary Group on Infertility (APPGI) made their case... [Read More]
25 February 2004 - by BioNews 
The UK's National Institute of Clinical Excellence (NICE) has recommended that, in line with earlier draft guidance published in August 2003, the National Health Service (NHS) should fund up to three attempts at in vitro fertilisation (IVF) for infertile couples meeting specific criteria. NICE is a cost-effectiveness watchdog established by... [Read More]
25 February 2004 - by Dr John Mills 
Today is not the greatest day for those hoping that they might receive NHS treatment to overcome their inability to have children, nor is it for those who try to provide them with help. Doctors have struggled for years to provide good treatment for deserving patients with realistic results and... [Read More]

11 August 2003 - by Dr Jess Buxton 
Draft guidelines aimed at standardising the government-funded provision of fertility treatment in the UK triggered media speculation last week. The first version of the recommendations being developed by the National Institute for Clinical Excellence (NICE) suggest offering up to six IVF attempts to women under forty, according to a report... [Read More]
10 July 2003 - by Julian Jenkins 
Although the media frequently present stories about infertility, how aware are the public about infertility and what are their views on NHS provision of infertility treatment? It is well recognised that there is a 'post code lottery' for NHS provision of infertility services, but how is this regarded by the... [Read More]

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