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| IVF couples 'in postcode lottery' | |
| (about 1 hour later) | |
| More than 80% of NHS primary care trusts in England fail to offer the recommended three free cycles of IVF to infertile couples, an MP has claimed. | More than 80% of NHS primary care trusts in England fail to offer the recommended three free cycles of IVF to infertile couples, an MP has claimed. |
| The Department of Health says 30% of PCTs provide three cycles of the fertilisation treatment. | The Department of Health says 30% of PCTs provide three cycles of the fertilisation treatment. |
| But Tory MP Grant Shapps, who has contacted every PCT, says these figures are out of date. | But Tory MP Grant Shapps, who has contacted every PCT, says these figures are out of date. |
| A "postcode lottery" operates, with rules on age, relationships and other children varying widely, he insists. | |
| In some cases women who would be deemed too old for treatment by one PCT would be seen as too young by another. | In some cases women who would be deemed too old for treatment by one PCT would be seen as too young by another. |
| PCTs were recommended to provide three cycles of IVF in 2004. | PCTs were recommended to provide three cycles of IVF in 2004. |
| The guidance was published by the medical watchdog, the National Institute for Health and Clinical Excellence (NICE). | The guidance was published by the medical watchdog, the National Institute for Health and Clinical Excellence (NICE). |
| Figures issued by the Department of Health released earlier this year showed over a quarter of PCTs were offering the full three cycles in 2008, up from 5% the previous year. | Figures issued by the Department of Health released earlier this year showed over a quarter of PCTs were offering the full three cycles in 2008, up from 5% the previous year. |
| But Mr Shapps said his study, entitled Putting all your eggs in one basket, suggests that a string of PCTs have changed their policy. | But Mr Shapps said his study, entitled Putting all your eggs in one basket, suggests that a string of PCTs have changed their policy. |
| Our survey of every PCT in England shows the NHS is making good progress in implementing NICE guidelines and in providing fair and consistent access to IVF Department of Health | Our survey of every PCT in England shows the NHS is making good progress in implementing NICE guidelines and in providing fair and consistent access to IVF Department of Health |
| He concluded that just 18% of PCTs were offering three cycles with nearly half only offering one, while just under a third offered two. | He concluded that just 18% of PCTs were offering three cycles with nearly half only offering one, while just under a third offered two. |
| There were major differences between regions, with no trust in the South East offering three cycles, while the majority in the East region did so. | There were major differences between regions, with no trust in the South East offering three cycles, while the majority in the East region did so. |
| Within regions, there were also discrepancies: a third of London trusts, for instance, offered just one cycle, just over a quarter two and about the same proportion three. | Within regions, there were also discrepancies: a third of London trusts, for instance, offered just one cycle, just over a quarter two and about the same proportion three. |
| Some 80% of the PCTs contacted responded to Mr Shapps's survey. | Some 80% of the PCTs contacted responded to Mr Shapps's survey. |
| Too young, too old | Too young, too old |
| Mr Shapps also described "a confusing hotchpotch" of eligibility criteria which trusts are free to impose - ranging from how much the mother weighs to how long a couple have been together. | Mr Shapps also described "a confusing hotchpotch" of eligibility criteria which trusts are free to impose - ranging from how much the mother weighs to how long a couple have been together. |
| Couples in Gloucesteshire must have been in a stable relationship for more than three years, those in Kensington and Chelsea just 12 months. | Couples in Gloucesteshire must have been in a stable relationship for more than three years, those in Kensington and Chelsea just 12 months. |
| ELIGIBILITY CRITERIA MAY INCLUDE AgeBody Mass IndexLength of relationshipPrevious childrenPrevious private treatment | ELIGIBILITY CRITERIA MAY INCLUDE AgeBody Mass IndexLength of relationshipPrevious childrenPrevious private treatment |
| The survey found that the majority of PCTs now offer IVF to couples in which the woman is aged between 23 and 39, as recommended by NICE, but more than one in eight impose other age restrictions. | The survey found that the majority of PCTs now offer IVF to couples in which the woman is aged between 23 and 39, as recommended by NICE, but more than one in eight impose other age restrictions. |
| In Lincolnshire, Swindon and Luton, IVF would be funded if a woman were aged 35 or under. In Hampshire and the Isle of Wight, she would have to be at least 36 before she would be considered. | In Lincolnshire, Swindon and Luton, IVF would be funded if a woman were aged 35 or under. In Hampshire and the Isle of Wight, she would have to be at least 36 before she would be considered. |
| Average success rates of 25% per cycle are believed to fall sharply after the age of 35. | Average success rates of 25% per cycle are believed to fall sharply after the age of 35. |
| More than half of trusts impose criteria which exclude couples in which one of the partners has a child from a previous relationship. | More than half of trusts impose criteria which exclude couples in which one of the partners has a child from a previous relationship. |
| And a further one in six trusts would not consider fertility treatment for a couple who had previously paid for it. The Human Fertilisation and Embryology Authority, which regulates IVF clinics, estimates that around 80% of couples seek IVF privately. | And a further one in six trusts would not consider fertility treatment for a couple who had previously paid for it. The Human Fertilisation and Embryology Authority, which regulates IVF clinics, estimates that around 80% of couples seek IVF privately. |
| Mr Shapps said he was aware that "spending on the NHS is finite and funding is precious. | Mr Shapps said he was aware that "spending on the NHS is finite and funding is precious. |
| "This report acknowledges that priorities must be made but that those prioritisations must be made equitably and that unfounded pronouncements should not be made by politicians or others if the effect is to increase the hopes of emotional couples beyond what they can reasonably expect." | "This report acknowledges that priorities must be made but that those prioritisations must be made equitably and that unfounded pronouncements should not be made by politicians or others if the effect is to increase the hopes of emotional couples beyond what they can reasonably expect." |
| Clare Lewis-Jones, head of the Infertility Network UK, said there had been improvements in the provision of treatment. | Clare Lewis-Jones, head of the Infertility Network UK, said there had been improvements in the provision of treatment. |
| But, she added, there still remained totally unjustifiable and unfair variation in the criteria used to determine whether or not couples could access treatment. | But, she added, there still remained totally unjustifiable and unfair variation in the criteria used to determine whether or not couples could access treatment. |
| "This is yet another survey which proves that, five years on from the issue of the NICE guideline, patients are still facing a postcode lottery when it comes to accessing NHS fertility treatment. | "This is yet another survey which proves that, five years on from the issue of the NICE guideline, patients are still facing a postcode lottery when it comes to accessing NHS fertility treatment. |
| A Department of Health spokesperson said: "Our survey of every PCT in England shows the NHS is making good progress in implementing NICE guidelines and in providing fair and consistent access to IVF. | A Department of Health spokesperson said: "Our survey of every PCT in England shows the NHS is making good progress in implementing NICE guidelines and in providing fair and consistent access to IVF. |
| "Our figures show that 30% of PCTs are providing three cycles of IVF, 23% two cycles and 47% one cycle. This shows significant improvements, with only two trusts not routinely providing infertility treatment in England. | "Our figures show that 30% of PCTs are providing three cycles of IVF, 23% two cycles and 47% one cycle. This shows significant improvements, with only two trusts not routinely providing infertility treatment in England. |
| "The option to become a parent is something most of us expect to have. People who cannot conceive naturally should have access to NHS treatment, just as they would for any other clinical need." | "The option to become a parent is something most of us expect to have. People who cannot conceive naturally should have access to NHS treatment, just as they would for any other clinical need." |