The Jesus and Mary Chain CD: Psychocandy at WHSmith today
Which is a shame, because the muddle of treatment on the NHS is a far greater scandal than the continued operation by Mr Taranissi of a private clinic whose licence was under review. And under review not because he had done anything wrong, but because the Human Fertilisation and Embryology Authority (HFEA), the regulatory body for IVF clinics, had suddenly reduced the number of embryos Mr Taranissi was allowed to transplant, and he had objected.
Women over 40 are allowed to have three embryos transplanted during IVF; the HFEA wanted Mr Taranissi to transfer no more than two. Because twins and triplets are far more likely to have health problems than lone babies, the HFEA wants to encourage people away from multiple embryo transfers. About one in four IVF pregnancies produces twins, more than ten times the rate for natural conceptions. Half are born prematurely, with low birth weight, and subsequently run a much higher risk of cerebral palsy (18 times as high in the case of triplets). Neonatal and first-year care for twins and triplets is expensive for the NHS.
There is a public policy issue worth debating here, but the HFEA has not had that debate publicly, and it isn’t official policy yet, so what right it had abruptly to curtail Mr Taranissi’s freedom to operate is unclear. Those who know a lot more about the sector than I do say that the HFEA is suspicious of Mr Taranissi’s success rates and have long suspected him of fiddling his figures or some such. The surgeon’s friends insist his success rate is due to his absolute dedication and in particular his willingness to implant embryos at precisely the correct moment, whether that be 3am or Christmas Day.
The other allegation against Mr Taranissi’s clinic is that IVF was inappropriately offered to a 26-year-old who had tried for only a year to conceive. The clinic says the doctor’s comments were taken out of context by the BBC, which has refused to show them unedited tapes. It cannot be pure coincidence that the HFEA raided Mr Taranissi’s clinics on the day that Panorama was due to broadcast its allegations. The HFEA was pandering to the cameras; sick behaviour from an unelected regulatory authority that appears to be out of its depth.
I could argue at length about the costs of private IVF treatment, success rates (23.6 per cent for women of 35-37, just 10.6 per cent at 40-42), proper regulation and the social engineering it represents — babies on a plate for people wealthy enough to afford them — but that would be missing the point here. The real scandal is in NHS units up and down the country. Three years ago the Government said that all infertile couples where the woman is under 40 would be offered one cycle of IVF within a year, as a first step towards implementing official guidelines that stated that three cycles of treatment should be offered. Research by the National Institute for Health and Clinical Excellence (NICE), which drew up the guidelines, showed that the cost per live birth of IVF rises from £12,000 when the woman is 24 years old to £13,000 if she is 35, just over £20,000 at 39 but £38,000 at 42. Hence the age 40 cut-off.
But, surprise surprise, what the Government promised hasn’t happened. Local health managers have interpreted the guidelines in wildly different ways. A year ago a survey by NICE found that only 40 per cent of primary care trusts would confirm that they even offer IVF treatment. Those that do offer it have waits of up to five years and a bewildering array of conditions that the patient must meet.
Research carried out by Infertility Network UK two years ago, and now being updated by them for the Department of Health, found, for instance, that in Durham you must wait four or five years, have a body mass index not greater than 30 and have no surviving children in your current relationship, before you are allowed IVF treatment on the NHS. Thames Valley will not treat a woman unless she is 36 and has never paid for any IVF treatment privately. In Norwich you have to have a body mass index no more than 34, no children from a previous relationship and must be a couple who have lived in Norfolk for at least two years. In Southampton City there are no social eligibility criteria; in North Dorset you must have been in a stable relationship for at least three years. In Rowley Regis and Tipton there must be no children on the maternal side; in Mendip there must be no children living with the couple and “no access to children from previous relationship”. And in Cherwell Vale the couple must be non-smokers.
There is an astonishing degree of social manipulation going on in a complicated postcode lottery five years after the Prime Minister promised couples could expect “the same level of high-quality services” for IVF wherever they lived. Some services are being cut: Luton has stopped funding new fertility treatment for now, and York is considering doing the same.
And then, of course, if you do get your treatment paid for, there are all the pitfalls of sloppy NHS service to negotiate: lost X-rays, long queues, rude receptionists, dismissive doctors. It must be particularly painful to be treated to the NHS’s special brand of production-line treatment when you are in the sensitive process of trying to get your own little production line moving. So the popularity of Mr Taranissi’s and all the other private IVF clinics is easily explained. But what a pity Panorama couldn’t find the time to investigate that.
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Why is IVF treatment not subjcet to the same processes as adoption? If a couple, or an individual require the State's assistance to have a child does the State not then have the same responisbities - a duty of care?
K, London,
in southampton female has to be between ages of 36-39, both non smokers, no previous children, and no more than three previous attempts even if self funded policy to be reviewed no later than dec 2006, but new policy is not on website to date. (13/02/07)
sally chivers, southampton, england