IVF is increasingly seen as a bit of a soft touch on the funding front.
We’ve reported previously that some PCTs were restricting access as one way of saving cash, and this week we report that the number of cycles funded on the NHS has fallen by a pretty startling 14% over the course of this financial year.
Our story also contains the starkest defence I’ve seen of restrictions to funding, with GP Dr Andrew Davies, chair of the Warrington Health Consortium, putting it thus: ‘While we fully understand infertility is a condition that causes great distress to couples, it does not affect general physical health or life expectancy.’
That’s a valid viewpoint, but one I think needs to be tested in the crucible of public opinion – if GPs and NHS managers are serious about engaging the public in their commissioning decisions, then IVF looks as good a place to start as any.
But it’s pretty clear, as GPC deputy chair Dr Richard Vautrey makes clear in our story, that restrictions in IVF are here to stay, as demand outstrips the potential for supply.
And in places like Warrington, where IVF is only funded in ‘exceptional circumstances’ and only seven requests have been granted this financial year, some patients who feel they need the treatment will not be able to get it on the NHS.
Of course they could go private – as 60% of those accessing IVF currently do – but that’s only an option for couples who have the cash.
An essentially non-NHS approach to IVF like this looks to me inappropriate and inequitable, but equally, the NHS simply doesn’t have the cash to provide fertility treatment to everyone who wants it.
Is it time therefore to take a new approach – one that might not even be legal under the current NHS framework, but could become so as the health service responds to the financial restrictions it is under.
Could it be, I wonder, time to accept means-testing for fertility treatment?
It will feel like the upper reaches of a very slippery slope to many defenders of the NHS, and it’s certainly no-one’s ideal solution, but it’s arguably better than allowing an ad hoc system to develop that simply denies IVF to anyone who doesn’t have money.
There are a host of complexities to consider of course – what means-testing would be based upon, how it would be administered, and whether other treatments commonly being rationed on the NHS – such as cosmetic surgery – might also be included.
But we need to start having these debates, because as our IVF figures show, Andrew Lansley’s claims that funding restrictions will not harm front-line NHS care are being exposed for what they always seemed to be – a fantasy.
