07/06/2011

Wrong question on IVF

Radio 5 is asking the question: Is IVF a right? With the sub text can the NHS afford IVF?

This is based on the latest report from MPs that claims that:
More than 70% of NHS trusts and care providers are ignoring official guidance on offering infertile couples three chances at IVF
..
Others are placing tough restrictions on who can qualify.
The problem with this and any other debate on the NHS is that they rarely start from the premise that it is a rationed system. We might not like the idea but with modern treatments, especially treatments that extend the life of cancer patients by weeks or a few months huge expense, we will never be able to afford everything that everyone wants. These means that expectations are set way too high and the debate never addresses the real issue, how to apply rationing.

Furthermore, if IVF is a right it means someone else has an obligation to pay. This can be done in one of two ways: either we increase the health budget so that everyone gets all the treatments they want, irrespective of its impact on the economy, or someone else foregoes treatments that aren't a right.  In the former case we eventually end up with nobody getting treatment as the whole economy collapses under the dead weight of the increased taxes or we end up with a battle of "rights". For example, is the IVF treatment of one person more important than keeping alive a young mother so that she can spend, say, an extra six months with her young family by prescribing very expensive cancer drugs?

I don't know the answer to this one but what I do know is that MPs aren't helping with the debate by not being open and honest about the problem.

And then we move on to one of my favourite subjects, the postcode lottery. All 3 main parties keep talking about localism and the need for communities to take more control of their lives. This is something I loudly applaud but it does have a consequence. We here in Dorset may have different priorities to the people of, say, Newcastle. We may not like the rationing choices that are made but again its the local communities that make the choices and here are a few:

For example, Bury PCT only allows women to be treated between the ages of 39 and 40, with a similar picture in many Welsh Health Boards.

Others have restrictions on access for smokers, those who are overweight or if one of the couple already has a child - even if that child does not live with them.

At the time of the survey, five PCTs - Warrington, Stockport, North Yorkshire and York, North Staffordshire and West Sussex - offered no IVF at all.

As long as these restrictions are consistent within the community and published for all to see then what is the problem? And as West Sussex NHS spokeswoman says:

"Now we are in the new financial year, the decision we made last year on fertility treatment has been reviewed and funding has been reinstated for all eligible cases."

Exactly.

And do we really want MPs making the decisions from their ivory towers, especially when that decision is most likely to be based on the latest vote winning survey for their area?

"It's clear that many PCTs are not giving IVF the priority they should. There are instances where it is being lumped in with tattoo removals.”

Gareth Johnson MP

Do we really believe that  Mr Johnson's judgement that IVF is more deserving than tatoo removal? Me, I'll go with the local communities decisions rather than Mr Johnson's or any other MP for that matter.









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