Mark Henderson, Science Editor
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Thousands of infertile couples are being denied IVF that should be funded by the NHS because only 9 of 151 health trusts are offering the recommended level of therapy.
A total of 94 per cent of primary care trusts in England are still not providing the three free cycles of IVF that should be available under national guidelines issued in 2004, government figures have revealed.
The survey of IVF provision last year also showed that all but a few trusts have imposed tough criteria for free fertility treatment, rejecting patients who smoke or who already have children, including those from previous relationships.
Most of those that offered treatment paid for one cycle, and four trusts provided none at all.
The results – the first to incorporate figures from every trust in England – were published yesterday by the Department of Health. They show that a postcode lottery for IVF is flourishing despite guidance from the National Institute for Health and Clinical Excellence (NICE).
The NHS financial watchdog recommended in 2004 that three cycles should be available to infertile couples in which the woman is aged between 23 and 39. Women’s chances of conceiving are considerably better when more cycles are offered, to the extent that NICE identified three cycles as cost-effective. The advice is not binding, and the Government has provided no extra funds for it to be put into effect. The Department of Health has asked trusts to provide at least one cycle, and to move towards implementing it in full.
About one in six couples is affected by infertility. Almost 45,000 cycles of IVF are performed in the UK each year, but the level of NHS provision means that more than 30,000 of these are conducted privately, at an average cost of about £2,000 per cycle.
The new figures were published as doctors prepare to celebrate the 30th birthday of Louise Brown, the world’s first test tube baby, who was born in Oldham on July 25, 1978. Oldham is one of the nine trusts – all in the North West of England – that provide three cycles.
Susan Seenan, of the patient support charity Infertility Network UK, said: “Thirty years after the inception of IVF treatment, in the country that pioneered IVF, and four years after the NICE guideline, it is a complete disgrace that only nine PCTs are offering three free cycles.
“We are also disappointed that some PCTs are still offering no cycles at all, and that most are adding social criteria that make it difficult and unfair for patients to access the treatment they need.
“There is a real need for a standard set of eligibility criteria that operate nationwide.”
The survey was published on the Department of Health’s website in response to a parliamentary question from Sally Keeble, the Labour MP for Northampton North. It does not include data from Scotland, Wales or Northern Ireland.
It found that seven PCTs offer three cycles – Heywood, Middleton and Rochdale; Bury; East Lancashire; Stockport; Tameside & Glossop; Traf-ford; and Blackburn with Darwen. Central Lancashire offers two or three cycles, and Oldham “a maximum of three”. The four PCTs that have suspended free IVF treatment were North Lincolnshire, North Staffordshire, North Yorkshire and York, and Stoke on Trent, though the latter has since resumed provision.
About two-thirds of the trusts (100) offer one cycle, while 35 offer two, and three did not provide full information. More than half (86) specify that a couple must have no children, while another 46 impose other restrictions such as no children from the current relationship, or not more than one child. The survey found that 35 trusts specify no smoking, 30 say that patients must be in a stable relationship, and 33 impose age restrictions beyond those in the NICE guidelines.
A spokeswoman for the Department of Health said: “We recognise that there are local variations in the provision of IVF and that this does cause distress to many childless couples who feel that they are not getting the treatment they need.
“NICE published their guide recommendations that trusts provide up to three cycles of IVF in February 2004. But NICE and the Department of Health realised that this could not be immediately implanted and so trusts were encouraged to use this as a goal they move towards. The first step is for all PCTs to offer at least one cycle of IVF and the vast majority do so, with almost a third already offering more than one cycle.”
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You talk about necessary treatment I work in a hopsital we had a lady come in for gastric banding cause in her words I can't be doing with trying to lose weight when i can do it for free. IVF is my only choice and when we both work for the NHS treating people without bias why can't we be treated to!
kate, london, uk
If you have not been through infertility then you can not understand the pain & anguish that it brings. I have had 1 NHS IVF and paid for 2. I am happy to continue to pay as & when we can afford to but agree that help from the NHS is also needed. As for adoption people have no idea how hard it is!!
Claire, London, England
i have been waiting since i was 23 for ivf but the nhs didn't do it then i am now 34 and have been told i have to be 36. I found out last year i have ms my doctor went to the pct to get extra contractual funding and they said no because my only child isn't dead and i don't have cancer.
Tammy Paget, southampton, England
We're having IVF at the moment. Those who think it should not be treated on the NHS I'm sure either have children, or don't want them. We want a family, which we have the resources to love and support. Unless you have lived it, you have no right to say "life ain't fair".
Alison , Nottingham,
My husband and I know only too well about the postcode lottery for IVF. Having been diagnosed with endometriosis in 2001 it took our GP 6 years to refer us to a specialist. Age 40, We now have to self fund and the GP will not fund the medication. This is how tax paying citizens are treated.
clare , bexleyheath, uk
If the NHS can afford homeopathy, teenage pregnancies, tattoo removal etc. it should help loving couples have a child. The NHS funds many non-life-threatening conditions. Would you rather have hayfever, mild indigestion, or be unable to have children? Those crying "adopt" should adopt themselves.
Tina, South Wales, UK
The reason the NHS is in such a bad way is because there is too many immagrants coming to England and using our NHS/Social benifit. People who have paid into the systems and there parents had paid into the system should be entitle to free nhs for IVF or Cancer and anything.Nobody should be denied
Lisa, Northamptonshire, England
I have just read all 39 previous comments and am appalled by the degree of ignorance shown by some contributors. If you don't know about a subject, don't comment. Infertility IS a medical condition and adoption is NOT an easy option if you are British, middle class, educated, white and heterosexual
Derek, High Wycombe,
Cancer. Luck of the draw. Life aint fair. Don't treat it.
Childhood lukemia. Luck of the draw. Life aint fair. Don't treat it.
Broken bones. Luck of the draw. Life aint fair. Don't treat them. Should have been more careful.
Car crash. Luck of the draw. Life aint fair. Don't treat it.
CPS, Mossley,
I am disgusted with some people's attitudes to IVF. Wanting a child and not being able to have one is one of the most difficult things that a couple can go through. Only ignorant people would suggest otherwise!. Unfortunately it is only us who are in this position who will ever understand.
Toni, Northampton,
Norman Pitkin, London = Your comments are brilliant......which world do you live in?
Why should couples be penalised for being infertile?? Its not something you want to be when you grow up? Maybe i should quit my job and claim benefits because that seems the right thing to do!!!
Matt, Biggleswade, Beds
Martin, Newmarket and Terry, Newcastle - can i live in your great world?????
Matt, Biggleswade, Beds
The lack of humanity in some of the comments beggars belief. It is fair enough if you disagree, but it seems that those who use 'armchair politics' to validate their arguments just come across as being ignorant and rude. Cheap pot shots and crude biological rationalism is not the way the to go.
Luke, London, United Kingdom
If you have an illness you go to your doctor and get treatment regardless of what that illness may be. Infertility is an illness too and should also be treated!
We treat alcoholics and drug addicts and it is self inflicted with millions of government money!!
karen, prestwick,
If you have an illness you go to your doctor and get treatment regardless of what that illness may be. Infertility is an illness too and should also be treated!
We treat alcoholics and drug addicts and it is self inflicted with millions of government money!!
karen, prestwick,
Well said Martin, Newmarket.
Terry, Newcastle,
James - infertile couples pay taxes too - and Labour said they had the right to treatment. Don't promise it, if you're not going to deliver it.
Pete - and yet, Labour insist we need more you people to tax to pay for our retirement. I guess you would prefer British citizens than migrants?
W Smith, Manchester,
Infertility is not an illness and scarce NHS resources are better used treating the sick and injured. If couples are determined to try and override what nature has intended then they should pay the going rate or better still, adopt one of the thousands of children in the UK looking for a good home.
Oxford Don, Oxford, UK
Infertility is not an illness nor a medical condition and therefore should not be funded by the NHS. There are people with cancer who are being denied the best drugs to treat them on the NHS. If the NHS can not afford to fund the best cancer treatment then why on earth is it funding IVF at all?
B Naunton, Cambridge, UK
If you develop cancer as a result of your lifestyle, perhaps 'nature is trying to tell you something' , like it's time to kick the bucket? If you are impotent, listen to nature and stop having sex! Forget about modern medicine, it's not natural, nobody deserves it, let's go back to the middle ages!
Cam, Canterbury, UK
When NHS funding is limited, why are we wasting a single penny of tax payers' money on IVF? If a couple can't have children without IVF, surely nature is trying to tell them something . In addition, if a couple are so hell bent on IVF, they should stop moaning and pay for it themselves.
Peter, W-S-M, UK
This is precisely why the NHS is bankrupt and often cannot provide vital, life-saving treatments. It has grown into a financial black hole, funding whatever the most powerful pressure group wants. This sort of treatment was never envisaged in 1947 when "free at point of use" was planned
Bob Finbow, Haverhill, England
The human body is designed to reproduce - if it is failing to then it is as much a medical issue as any other physical impairment. What about people who get ill through smoking and drinking? They get treatment despite ignoring health warnings. IVF is a cure for infertility: it is absolutely valid.
Jeremy, Bristol, England
The whole point of this that those suffering from infertility are being treated by postcode which is totally unfiar.. Infertility has been diagnosed as an illness for which a treatment is available - couples suffering need to access treatment on a fair basis the same as any other medical condition
Susan, Irvine, UK
Unfortunately this tells only part of the story - the inadequate patchy service is ususally only available after a substantial wait - 2-3 years in our case. NHS incompetence meant it took more than a year to get a proper diagnosis and hence even join the waiting list.
Soz, london, uk
They say that it's OK to give an alcolholic a new liver because he's paid his national insurance. Well neither my husband or I smoke or drink, we have always worked and have a good diet /lifestyle. I have a chronic disease that makes it hard for me to conveive why shouldn't we have a bit of help?
Kay G, Wootton Bassett, UK
In answer to those who believe IVF patients are not deserving, given the amount of despair and depression that it causes, who IS deserving enough to receive "excellent basic health care"? Smokers? The overweight and obese? The lazy who don't exercise? The impotent? Any other suggestions?
Cam, Canterbury, UK
The NHS should not be paying for this "treatment". The "patients" are not ill in a way that say someone with chronic lung disease, heart problems, diabetes, cancer or requiring a joint replacement would begin to recognise.
Bill Langley, Northampton, UK
Firstly I must reply to the person who feels that IVF should be STOPPED as the world is over populated! In that case where do you stop? If you are unfortunate enough to have cancer shall we let you die? Or perhaps if he was in a road accident shall we just leave him to die? - its just bad luck!
ND, Reading, Berks
The NHS should be there for illness; for when you can not afford to pay for your own health treatment. It should be a safety net, not a given.
There are plenty of children in this world that need a loving home if you are desperate to have children.
Chantel , Wales,
We have had three failed IVF attempts before we decided to try adopting. We are a stable middle class family, with no criminal record and both CRB checked and we were obstructed at every turn in our attempts to adopt in the end we had to give up and continue with donor IVF which was successful.
ND, Reading, Berks
Yasmine Yes and apparently it is OK for people to have as many children as they want never mind that they are expensive for the rest of us ,. IVF for two kids is entirely fair This would be easily paid for by refusing to fund the selfish over breeding many choose to do
Andie, Shrewsbury, UK
The point of this article was to highlight the postcode lottery of funding, not to debate if IVF should be funded! Some PCT's will pay for multiple cycles, some won't pay for any treatment. It would b better if everybody who needed IVF got a contribution towards treatment from the funds available
ND, Reading, Berks
And yet we fund the overfecund by the barrel load. It costs 5 grand a year just for education per child. We need a stable or diminishing population. It would seem fair to fund for the birth of two kids with IVF and not fund services for those who have more than two.
Billie, Newham, UK
It's easy to be judgmental when you haven't suffered yourselves but I'm shocked at the prejudice here. So it's ok to treat people with smoking, alcohol or drug related diseases on the NHS but not people with fertility problems? The infertile pay taxes too and no-one choses to be infertile.
Yasmine, Leicester,
If people really want to bring children into this world, they should be means tested to ensure that they can afford to look after them properly. If they want IVF they should be able to pay for it. The health service is for health! there are too many children that people have as fashion accesories!
Norman Pitkin, London, uk
People do not choose to be infertile, but they do choose to be fat, smoke, drink,play dangerous sports, drive cars.
Money should be diverted from these reckless individuals to those suffering from the infertilty. IVF should be free for all.
Benny, Bristol,
I have just finished my 2nd IVF attempt and unfortunately it did not work. The first attempt did work but my baby died as he was born prematurely. It is very easy to say that IVF should not be offered on the NHS when you have not suffered the heartbreak of infertility or indeed baby loss as I have.
Kath, Cheshire, UK
IVF, Tattoo removal, Quitting smoking etc. all available on the NHS.
Yet there are many operations and treatments which are peoples only chance at a decent standard of life that aren't.
There are children to be adopted if you can't conceive your own . I'm afraid life is unfair.
Lucie, Macclesfield,
The NHS has to have it's priorities and IVF should not be one of them. I sympathaise with childless couples but it isn't life threatening is it. The NHS should first save lives then, if it has money to spare the quality of life. It offends me to hear of and see nose and boob jobs being done too.
Mr E O'Hara, Wakefield, West Yorkshire
As someone who has had to pay for IVF in the past, I strongly believe this is NOT what the NHS is for.
The NHS is for caring from the cradle to the grave, not tattoo removal, nor cosmetic surgery (except disfigurement repair) nor 'gender relocation' nor fertility treatment, not it's purpose AT ALL!
David, St Albans, UK
Fi Gilbert,
Have you ever tried adoption in this country, its practically impossible? The comments so far are obviously from people who do not want or have found it easy to have children. If infertility affected you or anyone in your family you may feel differently I guess
SM, Swindon,
I agree with Martin. Fertility treatments should not be provided on the NHS. Drug companies and clincs have a vested interest in creating an "infertility epidemic".
Kay, Haslemere,
IVF should be stopped immediately, FULL STOP! The world is over populated and if you are unfortunate enough to be infertile, well, them the breaks. Nobody said that life was fair. But we must start reducing the population, otherwise war & famine are on the agenda for your children!
Pete, St Albans, England
Why should the NHS be providing IVF treatment in the first place? Its first priority surely must be to provide excellent basic health care.
Martin, Newmarket, Suffolk
Since when was IVF medically necessary, to the extent it should be funded by the taxpayer?! NHS resources should be focused entirely on *necessary* treatment, without which people will actually die or be significantly harmed, from broken legs to bypass surgery - not lifestyle choices like this.
James, Perth, Scotland
Why do people feel the need to have biological children?? There are so many beautiful children looking for a family to love them.
Fi Gilbert, San Francisco, USA