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'Postcode Prescribing' is still alive and well in NHS-funded infertility treatment

5 April 2005
By Clare Lewis-Jones MBE
Chief Executive of Infertility Network UK, and Chair of the European Infertility Alliance.
Appeared in BioNews 303
1 April 2005 has been a long time coming for thousands of couples in England. They read the same headlines we all did, back in February 2004 when John Reid MP, Secretary of State for Health announced that 'by April next year I want all PCTs including those who at present provide no IVF treatment, to offer at least one full cycle of treatment to all those eligible'.

Since that time, I have had hundreds of emails and calls from patients who were trying to decide whether to wait and see what their PCT provided. For some, given the importance of the age of the woman in the success of treatment, the decision was whether they should not wait and should start private treatment to try and give themselves the best chance of success. However, if they began doing so, when their local PCT started funding IVF, would they be refused treatment because they previously went privately? A huge dilemma, possibly affecting the rest of their lives. What would you do?

The recent survey conducted by the All Party Parliamentary Group on Infertility (APPGI) and the National Infertility Awareness Campaign (NIAC) has provided valuable information for the continuing campaign for a fully funded, comprehensive range of infertility treatments. It has also provided valuable information for the Department of Health so that they are aware of what is happening around the country. Finally, it has provided information for patients and their representatives such as Infertility Network UK in that we can now let patients know what is happening (or not) where they live. That is, of course, for those patients whose PCT was one of the 70% who responded. This is an excellent response rate, but the reality is that we did not hear from 91 PCTs so we still don't know what they are doing. However, we plan to find out! Their plans are of equal importance to the thousands of couples whose lives and futures are in their hands.

Although our survey showed that progress has been made in providing one cycle by many PCTs, this has been accompanied by an increase in the greater use of eligibility criteria to restrict access to treatment. For example, over half of the PCTs have a policy on maximum age for the woman, but those policies vary enormously. Only 35% of the PCTs use the maximum age of 39 as recommended in the NICE guidance.

The Secretary of State for Health stated that local priority should be given to couples who do not have any children living with them. 102 of the responding PCTs said that they had a policy on existing children, with 58% of them barring all couples that have children from either partner, adopted or otherwise. Patients are particularly concerned that it appears that some PCTs are reducing the funding they currently provide - that was certainly not meant to happen. There is also more IVF being funded than ICSI (intracytoplasmic sperm injection) - that also was not meant to happen. Waiting lists are far too long overall, and this needs addressing urgently.

Please do not misunderstand me, the APPGI and NIAC are generally encouraged by the progress being made, but we urge the government to take action to address the areas of concern I have mentioned, in particular waiting lists, disinvestments in IVF/ICSI cycles and in respect of those PCTs not yet implementing the NICE guideline. We also are calling on the government to give a clear indication to PCTs of exactly when it expects the remaining two cycles (as well as the other recommendations in the NICE guideline) to be implemented.

I urge the government to consult with the relevant organisations, including patient representatives, with a view to setting centrally agreed criteria to overcome the current inequalities that still exist. The medical profession want it, and I'm sure PCTs would be grateful for the guidance. Most importantly, we should make this happen for the one in seven couples affected by infertility who have had their lives put on hold for the last year or more. These couples have suffered enormously, not just because of the current inequitable situation, but simply because they live in the wrong place at the wrong time.

14 July 2008 - by Clare Lewis-Jones MBE 
Louise Brown, the world's first IVF baby, will be 30 years old on 25 July 2008. Here Clare Brown, who was among those to speak at a reception organised by the All Party Parliamentary Group on Infertility to mark next week's National Infertility Day 2008, reflects on three decades of...
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...
26 September 2005 - by BioNews 
Some UK couples seeking help to have children will have to wait until their thirties before they qualify for state-funded IVF treatment on the National Health Service (NHS), according to a report in the Independent on Sunday (IOS) newspaper. While many health authorities set an upper age limit for treatment...
8 September 2005 - by BioNews 
Research published by the UK's Audit Commission says that a 'postcode lottery' still exists in many aspects of the provision of medical services, despite guidance issued to ensure that patients across the nation have equal access to services and drug provision. Included in the Audit Commission's report is the provision...
22 August 2005 - by BioNews 
A Conservative MP, from Fareham in Hampshire, has written to the UK's Healthcare Commission, which looks into complaints against the National Health Service (NHS), to ask for an inquiry into the provision of fertility treatment in the county. Mark Hoban is MP for a constituency where no fertility treatment is...
4 April 2005 - by BioNews 
As the deadline for the partial implementation of guidelines recommending free fertility treatment for patients in England and Wales passed last week, a new survey reveals that many couples are still facing lengthy waits. Following guidance issued by the National Institute for Clinical Excellence (NICE) in February 2004, which recommended...
4 April 2005 - by Rt Hon Kevin Barron 
In May 2003, the National Infertility Awareness Campaign (NIAC) approached myself and other parliamentarians for assistance in setting up an All Party Parliamentary Group on Infertility (APPGI), both to raise awareness in parliament of infertility issues and to put pressure on the Government to implement the National Institute of Clinical...
23 February 2005 - by BioNews 
Proposed guidelines from the Welsh Assembly Government, put forward for consultation until 14 March, would rule out IVF treatment on the National Health Service (NHS) for couples if one partner already has a child. This would include adopted children and would apply even if the child does not live with...
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...
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...
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