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Nurses mobilise to put an end to 'postcode lottery' of IVF provision

6 May 2008
Appeared in BioNews 456

Last week, nurses in the UK decided to take action and lobby the British government to demand uniform eligibility criteria for infertility treatment and for the provision of up to three cycles of NHS-funded IVF be implemented by all UK fertility clinics, replacing the arbitrary 'postcode lottery' system presently in place. The nurses voted nine to one at a Royal College of Nursing (RCN) Conference in Bournemouth to petition the government to put an end to the insufficient provision of infertility treatments by most NHS trusts.

State-funded IVF has remained at the bottom of the resource allocation pile, viewed more as a luxury or lifestyle choice than a medical necessity. Yet, one in six UK couples experience infertility and it can be a profound 'personal tragedy' for women who find they cannot have children, according RCN board-member of the Lothian branch in Scotland Geoff Earl. 'If women are denied access, they will often suffer depression, anxiety and stress which feed back onto the NHS', he said.

In 2004, the National Institute of Health and Clinical Excellence (NICE), a government body that evaluates and decides resource allocation guidelines, recommended that three cycles of IVF should be provided to infertile women between 23 and 39 for the administration of effective treatment. Despite regulation requiring primary care trusts to phase-in NICE guidelines as far as possible, few have actually done so, according to a Department of Health survey last year. Former health secretary, John Reid, supported the guidelines and promised that all PCTs would offer at least one funded cycle of treatment by 2005, with a view to moving towards the full three cycles over time. The RCN thinks it is high-time that most PCTs stop ignoring the guidelines and causing unnecessary personal and financial anguish to infertile couples.

Jane Denton, from the RCN's fertility group, provided a statistical overview of the current situation at the conference which revealed that those seeking infertility treatment often face an 'enormous battle' to overcome the 'stigma of infertility'. A majority (98) of the 151 trusts surveyed provide one cycle of IVF but commonly have strict criteria restricting access: 73 trusts have a weight limit, 45 trusts consider lifestyle choices including smoking and alcohol, and 59 trusts deny state-funded treatment to those who already have children from previous or current relationships. There were 32 trusts that provided two cycles of treatment and seven said they would fund three cycles providing eligibility conditions are met. Fourteen either do not provide public-funded IVF or did not provide details of the number of cycles they would fund. The provision of alternative treatments had similar distribution figures. Claire Brown, chief executive of Infertility Network UK is 'delighted' by the RCN's decision: 'Four years on from the NICE Guideline it is totally unacceptable that patients are still facing inequalities in eligibility criteria and being denied treatment', she said.

Nurses brand UK IVF treatment 'a disgrace' and call for an end to 'postcode lottery'
The Daily Mail |  29 April 2008
30 June 2008 - by Dr Jess Buxton 
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...
23 June 2008 - by Dr Kirsty Horsey 
A British MP has raised more concerns about access to National Heath Service-funded IVF in the UK. It transpires that a number of IVF clinics in the UK are denying free treatment to women who smoke. Labour MP Sally Keeble identified the latest barrier to accessing...
5 March 2007 - by Katy Sinclair 
A report has revealed that couples receive varied IVF treatment across UK Primary Care Trusts (PCTs), despite guidelines issued by the National Institute of Health and Clinical Excellence in 2004 that all women between the age of 23 and 39 years old should receive three cycles of...
9 October 2006 - by Antony Starza-Allen 
A survey conducted by a UK newspaper, The Independent, has revealed that nine out of ten NHS Primary Care Trusts (PCTs) have failed to deliver their pledge of three free IVF treatments for infertile couples, as recommended by the National Institute for Health and Clinical Excellence (NICE...
31 August 2006 - by Dr Kirsty Horsey 
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...
10 April 2006 - by BioNews 
The UK's Independent on Sunday (IoS) says that 'a generation of women is being denied the chance to give birth', following an investigation that shows that provision of IVF services in the UK remains a 'postcode lottery'. The newspaper revealed that only 40 per cent of the nation's primary care...
21 November 2005 - by BioNews 
A study of Primary Care Trusts (PCTs) in the UK has found that at least 23 were not providing any National Health Service (NHS)-funded fertility treatment by an April deadline earlier this year. Eighteen other PCTS were only offering IVF under 'exceptional circumstances' and many others were denying treatment...
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