The British Fertility Society (BFS) has issued an independent report stating that access to fertility treatment in the UK is still unequal and governed by a 'postcode lottery'. The BFS conducted a survey of 64 fertility clinics in England and Wales, receiving responses from 37, which showed that one in 10 was not providing IVF treatment free on the NHS because they were not being given funding by the local PCTs. Across the country, the BFS found that many (PCTs) have insufficient plans to meet government targets set over two year ago, and no clear criteria regarding who should be eligible for NHS-funded treatment.
In February 2004, health ministers in the UK recommended that all health authorities should follow guidance issued by the National Institute of Health and Clinical Excellence (NICE), which had recommended 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.
In the light of its findings, the BFS has written to every PCT in England and local health board in Wales asking them to meet government fertility targets and setting out recommended criteria for NHS funding of fertility treatment. Its report makes 11 recommendations, aimed to help PCTs become more uniform in the services they provide, and provide value for money by providing treatments for those it would most likely benefit. The report says that single women and same-sex couples should be given equal access to treatment as heterosexual couples and that people with children from previous relationships should not be excluded from access to NHS treatment. However, it advises that women over the age of 40 should not receive NHS-funded treatment; women who are overweight initiate a weight-loss programme before treatment; and that those who are severely overweight should not receive treatment until their weight has reduced. It also says that underweight women should address their weight before treatment is given. These and other recommendations ought to 'provide a basis for consistent application of social as well as medical criteria for access to state-funded fertility treatment in England and Wales', said Dr Mark Hamilton, chair of the BFS.
Mr Richard Kennedy, lead author of the BFS study, which is published in the September issue of the journal Human Fertility, said that for there to be equality of access across the UK, 'there must be an explicit plan for the provision of three fresh cycles of IVF and consistency in the criteria used for NHS treatment'. He added that the proposed criteria would standardise access to treatment and said: 'We must use the findings of this survey to pursue the goal of full implementation of the NICE guideline'. The BFS recommendations have been given the support of the UK's main patient support group, Infertility Network UK. Clare Brown, the chief executive, said that 'from our own surveys and from the many, many calls we receive from patients, we know only too well that there are still unacceptable inequalities in the funding of treatment around the country and couples face huge difficulties in accessing services'.