Place a cap on IVF costs and the NHS could double the number of treatments – The Guardian

Posted: Published on August 14th, 2017

This post was added by Dr P. Richardson

One of the founding principles of our NHS is a commitment to providing fair and equal access to healthcare. It is this principle that ignites such passion in us all when it is threatened or belittled. Yet the recent revelation that 13 areas of England have restricted or completely halted IVF treatment, with a further eight consulting on similar steps, shows that we are failing in this commitment.

The World Health Organisation defines infertility as a disease. And guidelines from the National Institute for Health and Clinical Excellence (NICE) recommend that women under 40 with fertility problems should be offered three full cycles of IVF on the NHS. But more than 80% of patients do not currently receive this.

Those who have been through IVF treatment know that it is often a difficult and emotional process, and requires deep commitment to having a child. Critics claim infertility is not a life-threatening condition. Yet fertility treatment creates life, and in my mind that is just as vital to our society. By denying NHS funding for IVF treatment we are creating inequality, where only those with the resources are able to fight for that choice to become parents. As an NHS consultant, I am all too aware of the funding challenges facing our health service. Equally, as a fertility expert and a founder of private fertility clinics, I am also conscious of the rising rates of infertility in the UK one in six couples now face trouble conceiving.

I passionately believe that cutting or reducing IVF funding is an unnecessary and short-sighted move. We could make the existing budget go so much further simply by making some key changes to how we spend it. As it currently stands, each clinical commissioning group (CCG) individually procures IVF treatment from fertility providers, with significant variance in cost. The price paid for IVF by individual CCGs ranges from under 3,000 to over 11,000 a cycle.

This regional system was developed in the early 1980s, as IVF treatment became accessible, and the NHS pursued an internal market system in which it was thought that allowing the NHS to buy in treatment from competing providers would drive down price and increase efficiency. Yet this is widely considered to have been a failure, and it no longer works in a world where the standardisation of fertility treatment is possible. The massive range in pricing it produces has a fundamental bearing on the number of IVF cycles CCGs are able to provide within their allotted budget for fertility treatment.

There will always be some variance in the fees fertility clinics choose to charge patients, but it is simply unacceptable that in one part of the country the NHS should be charged double for the same treatment. It is essential that the NHS standardises a national price per IVF cycle that would function as a cap on the costs clinics can charge. This would reduce the price per IVF cycle and ensure patients across the country have equal access to IVF treatments, and end the postcode lottery in which people are losing out on the opportunity to become parents, simply by virtue of where they live. The NHS already sets a national price for a wide range of other treatments, from hip replacements to radiotherapy. Why not for IVF? A cost cap for IVF is also already successfully employed across other European countries such as Belgium and France.

At the moment, the private IVF industry is capitalising too much on the lack of a price cap, at the expense of the NHS, taxpayers, and people struggling to have children. A price cap for NHS-funded IVF could allow us to double the number of IVF treatments that can be offered within the existing budget in many regions.

Almost 40 years ago, Britain became the first-ever nation to conceive and deliver an IVF baby. I find it incredibly sad that instead of clamping down on the overcharging of the NHS by private fertility clinics, we are cutting back provision at a rate that could make us the first country in Europe to remove public funding for IVF altogether.

Geeta Nargund is the medical director of Create Fertility, which runs fertility clinics

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Place a cap on IVF costs and the NHS could double the number of treatments - The Guardian

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