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Time for fertility clinics to improve on compliance and procedures

30 April 2012
By Annabel Christie
Solicitor specialising in fertility and embryo storage law and compliance
Appeared in BioNews 654
Following the investigation of abortion clinics, fertility clinics should now improve their compliance and procedures so that there are no unwanted surprises if they are similarly inspected.

Earlier this month, the Care Quality Commission (CQC) found that one in five abortion clinics may be in breach of regulations and law. Of particular concern were issues with compliance such as doctors not filling out forms correctly or not taking the time to provide appropriate counselling and advice. Focus was also on findings that doctors are not taking time to follow procedures.

There are a number of areas in which fertility clinics can also sail close to the regulatory and legal wind in terms of compliance and procedure. For example, a recently reported alleged failure of procedure in IVF led to a mix-up leaving a couple with two children of different ethnic origins (1).

A more common failure of proper procedure and compliance is the denial by many fertility clinics of treatment to women who belong to population groups deemed to have little chance of motherhood. This practice is appealing to clinics as it allows them to keep their conception success rates high. So smokers, those over the age of 35 and overweight people often find that fertility clinics are refusing to treat them. But would this practice withstand legal scrutiny?

Even the women who are not sent away can be discouraged in other ways. The services provided by many fertility clinics are far from user-friendly and women can find themselves waiting for months to receive treatment. This is potentially in breach of a number of regulations, but to date there has been little investigation into or inspection of such procedures. As the number of women who are seeking fertility treatment is increasing, it is likely that that waiting times will also lengthen. This may then lead to complaints which in turn may spark review of practices adopted by fertility clinics.

Furthermore the attitude of the CQC to compliance and standards may change as a result of the criticism it has received for its previously lax inspections. This could mean that the regulator will be tougher in the future and the policies of fertility clinics may attract censure. Or worse: the abortion clinics that have not followed the law are now at risk of being shut down and the doctors who erred may face criminal investigation.

Clearly women seeking the help of abortion clinics were not getting the help and level of service that they are legally entitled to. As for fertility clinics, whether a woman has access to high quality services depends, more often than not, on the postcode in which she happens to live. And in many cases women are not provided with fertility treatment to which they are legally entitled because of what can be described as little more than excuses.

Even though increased age, obesity and smoking clearly do not improve the chances of pregnancy there are many women who conceive naturally who meet any or all of those criteria. Therefore refusing treatment to someone who is a bit older, a smoker or overweight may be questionable practice.

The women affected by such policies may yet claim that fertility clinics have failed them in their duty of care. Most worrying for fertility clinics is that classifying some women as old and refusing treatment on the grounds of age could be in breach of anti-discrimination legislation.

Were fertility clinics subjected to the same level of scrutiny that abortion clinics have recently endured then many practices currently accepted by practitioners as routine, but which are of questionable legality, may come to light. This possibility should ring alarm bells in clinics. They would be best advised to use the time available to them to improve their procedures and administration, and ensure they are in full compliance with all relevant regulations.

1) Gay couple had two children from 'different racial backgrounds in mix-up at IVF clinic'
Mail Online |  29 April 2012
14 April 2014 - by Ruth Wilde and Sophia Parsons 
The British Infertility Counselling Association recently collaborated with Infertility Network UK on a short survey to get a snapshot of the patient experience of counselling in licensed centres. The results reveal some worrying findings about both the offer and provision of counselling from clinics...
10 December 2012 - by Dr Lucy Freem 
Couples seeking IVF treatment who do not eventually conceive or adopt are more likely to die early, claim scientists...
17 September 2012 - by Jennie Bristow 
In the 80 hours of Parliamentary debate given to the Human Fertilisation and Embryology Bill in 2008, a full ten percent were devoted to a heated discussion of the clause on the 'welfare of the child' that might be born as a result of treatment...
28 August 2012 - by Jessica Ware 
A Northern Irish fertility clinic has protested against a regulatory notice which could mean it may have to stop accepting new patients....
12 March 2012 - by Dr Rosie Morley 
Nine NHS primary care trusts (PCTs) have introduced restrictions to IVF treatment for patients who smoke or are overweight...
12 March 2012 - by Cathy Holding 
IVF is only miraculous and life-changing if it works, but in some areas of the country you're less likely to be able to try on the NHS. BBC One's 'Postcode Lottery' follows a couple who could attempt treatment if they lived elsewhere...
12 December 2011 - by Oliver Timmis 
The Care Quality Commission (CQC) will take over policing of IVF clinics, despite worries it cannot cope with the additional workload...
8 August 2011 - by Dr Anna Smajdor 
In 2007, the world's media reported - with various degrees of shock and disapproval - on a Big Brother-style TV programme being created in Holland. This was Big Brother with a bizarre twist: instead of a cash prize and a moment of minor celebrity, the winner would get ... a kidney. Fast forward to 2011. A similar media outcry has been provoked by the announcement by fertility charity To Hatch of a lottery where the prize is - not cash; not a kidney, but... fertility treatment...
13 June 2011 - by Gareth Johnson MP 
IVF is one of Britain's greatest inventions. Professor Robert Edwards received the Nobel Prize for Medicine for his pioneering work developing this fertility treatment and - in the last week - it has been announced that he will be knighted in the Queen's Birthday Honours list. The result of Professor Edward's work was Louise Brown, the world's first so-called 'test tube' baby. Britain, more than any other country, should be championing the use of IVF treatment...
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