IVF on the NHS: a debate (topic split)

I find this thread shocking.  I can think of plenty of ways that waste can be cut in the NHS - not least reducing the numbers of admin staff, managers, cutting Chief Executive salaries and pulling out of wasteful PFI deals - before anyone goes looking at cutting IVF!

Talking about preventative treatment, there is a very high number of women who have difficulty concieving who suffer from deep depression, and I certainly have no problem with paying for women to have this resource.

Vicky

This is exactly what I was going to say.  Arguing that it isn't an illness or life threatening is kind of missing the point to me.  Most cases of infertility are brought about by illness (cancer, child-hood illness and injury, cancer treatment, PCOS).  People aren't seeking IVF simply because they can't be arsed to have sex with their partners.  There is a medical reason behind it.  And I also feel a bit 'until you've walked a mile in someone else's shoes' about the whole thing.

Precisely why I posted above my friend's story and why she needs IVF. She's not rich ands not fair that just because she had bit cuts out that she shouldn't have a child.  Science allows her through IVF to possibly have one and in my mind, its worth every penny for someone to be able to have a child if they want one. 

I find this thread shocking.  I can think of plenty of ways that waste can be cut in the NHS - not least reducing the numbers of admin staff, managers, cutting Chief Executive salaries and pulling out of wasteful PFI deals - before anyone goes looking at cutting IVF!

For sure!!

I'd rather not debate that either ... but it does make me wonder why you brought it up in the first place if you have no interest in discussing it.

Only because I would expect the NHS spend on IVF to be a drop in the bucket by comparison, so it's not a matter of singling out IVF as being a major source of cost containment, it was only a mere example.

As Vicky said, there is far more administrative waste that could be cut to save lots of £££.

I never meant to start a lengthy debate on IVF being paid for by the NHS and am sorry for anyone who is upset by the discussion.  I do understand this is a very emotive topic, so I won't say anything further about it as it's already gotten a lot of air time and is not going to solve the world's (or the NHS's) problems.

To try and get this thread back on track, I will add to my previous comment about co-payments under the Australian NHS - that they also charge a nominal amount for doctor's appointments to discourage no-shows and to try to ensure people only use the service when they really need it (another poster mentioned people who try to get in for any old thing and ignore advice to let a few days pass and see if the body heals itself naturally).  This relates to the comment someone else said earlier about how frustrating it is to have to ring up at 8:30 am and if you don't get through, you can't book an appointment and have to try again the next day.  I know from having used 9 different NHS trusts in the greater London area that PCT policies do vary, but in instances where people are not allowed to book appointments in advance, I have been told it is because people tend to no-show the farther in advance they book, and the "solution" to this is to adjust the bookings policy.  However, as I said earlier, in Australia, they allow people to book in advance because they have a lower no-show policy due to the charge that people would incur if they failed to cancel with sufficient advanced notice.

The point of comparing Australia's NHS is to say that there are other ways that other countries with socialised medicine do things that the UK could look at adopting with a view to improving the service for everyone.

You think whether funding IVF on the NHS is a controversial topic? How about this: I don't think IVF should exist at all! The world is already overpopulated and plenty of unwanted kids are around who need good people to adopt them. Rather than going through difficult, sometimes painful, expensive (and ultimately we don't know how it affects women's long term health or that of children conceived by IVF!) treatment because of an ultimately selfish desire to pass on your genes, why not adopt instead?

OK, I'll just run away now while everyone tells me I'm a horrible insensitive cow until the mods delete my post.

I know that I'm perpetuating the offtopic nature of the thread, but this is an interesting point.

Adoption: I think many prospective parents (especially first time parents) may find the idea of adopting a baby easier to deal with, simply for not having to deal with the consequences of the child's earlier history (behavioural difficulties, emotional trauma etc. which might be part of the picture ). If you have no experience of bringing up children, then starting gently might be easier - you might also imagine that you're not starting at a disadvantage.

In another sense, people may be scared to approach adoption because of fear of rejection - what does it mean to be told you're not a suitable parent? (It may not be that rejection is common, but people very often fear rare and unpleasant events disproportionately).

IVF: I think there are grounds on which IVF should be offered, and cases where it isn't appropriate that the NHS pays (for example, someone who already has children would generally be a lower priority to me). I'm happy for my tax to go to providing IVF on a rational and fair basis, and would agree that trying to make the NHS more efficient on an organisational level is a better way to look for cost savings (there are also useful negotiations with drug companies via NICE that essentially say - "for the benefit your treatment gives it is too expensive so we won't approve it" - so the drug company looks for a way to make the product cheaper for the NHS...)

NHS care should be holistic, and geared to increasing good health and happiness! Of course there are financial limits, but the development of NICE has been part of a process of at least aspiring to rational rules for the provision of treatment, even though that is itself a controversial and emotive topic!

That isn't what I said. It isn't a matter of 'deserving' it. But it is a fact of life that the longer you wait, the more difficult it will be, and I don't want to be paying for women in their 50s who think it's as much their right to have children at any age as it is for that soldier to get life-extending drugs.

The NHS has an age limit on covering IVF and it is much younger than 50.

Again, in order to get IVF at all on the NHS you have to meet criterion.  The age limit is well below 50, you have to have been diagnosed as infertile, have gone through a series of tests, in some trusts, have also tried alternative means of conception.  Many who have had children already are not permitted to access IVF unless their child/children has died.

And in some trusts, the waiting list is so long the people will be over the age limit threshhold if they wait, so they go private anyway.

It's good to see a little more compassion for others on this thread, and I think jayvee made an excellent point that it's easy to form armchair opinions on issues if they don't affect you personally.

But that doesn't mean not trying to see things from another point of view.

I've never had a weight problem or struggled with my weight or been overweight, but wouldn't presume to think that obese people who do shouldn't get whatever treatment they need to help them if they want that just because I don't have a problem with my weight, or assume it's their fault and they should just deal.

People who need IVF and obese people and smokers and drinkers are taxpayers, too.

You are making connections with unrelated points. The only thing I don't agree with is IVF. Health treatment for people who are already conceived or alive is a totally different thing from artificial conception. It is well known that helping people stop smoking or lose weight saves the NHS money in the long-term because of the reduced susceptibility to other more expensive illnesses to treat.

Now, while getting IVF treatment on the NHS is limited to those under 40, presumably even those who go private will still have all of their antenatal care and delivery on the NHS, and the older the mother the more likely that care will need to be more intensive and expensive, so we are still paying for it somewhere.

People who need IVF

My very point is that nobody NEEDS IVF, because nobody NEEDS to have biological children. Unlike needing life-saving treatment, having biological children is a want, and unlike treating obesity or smoking-related illness, there are no benefits to the taxpayer or the NHS in the form of significant later savings and future good health for satisfying that want. If anything it may create future health problems because we are not yet fully aware of the long-term health implications of IVF.

Now, while getting IVF treatment on the NHS is limited to those under 40, presumably even those who go private will still have all of their antenatal care and delivery on the NHS, and the older the mother the more likely that care will need to be more intensive and expensive, so we are still paying for it somewhere.

Where are you statistics regarding the age of the average woman who receives NHS IVF treatment?

You seem to assume they're all 'older', so I'm concluding you mean 35+?

I'd be interested in seeing if the facts back that up.

Where's is the evidence that women who conceive using assisted conception experience more complications than women who fall pregnant naturally.

Maybe we should just stop all these 'older mothers' altogether so 'we' don't have to pay for their selfish desires?

My very point is that nobody NEEDS IVF, because nobody NEEDS to have biological children. Unlike needing life-saving treatment, having biological children is a want, and unlike treating obesity or smoking-related illness, there are no benefits to the taxpayer or the NHS in the form of significant later savings and future good health for satisfying that want. If anything it may create future health problems because we are not yet fully aware of the long-term health implications of IVF.

Using your reasoning, however, nobody NEEDS to smoke or overeat, either.  It's elective behaviour to pick up fags or not exercise or eat too much. 

Nobody NEEDS to drink alcohol and become violent.  It's a real burden on the taxpayer when they wind up in A&E with alcohol-related injuries, shall we just not treat them because their selfish need to get p*ssed is cost-prohibitive?

What about cancer drugs that are not going to cure the patient, but will extend their lives for a few months?

Is it selfish of them, to want to live that much longer and be such a burden on the taxpayer?  I mean, these drugs are not curative, they're just prolonging the inevitable.  So by your reckoning, since they don't really NEED to live longer, shall we not treat them, too?

I'm staying WAY out of this whole argument, but if I can provide any information from my job that will be of use I will.

Where are you statistics regarding the age of the average woman who receives NHS IVF treatment?

Thames Valley area has a long list of criteria. The age criteria is as follows.

The time of the cycle of IVF or ICSI or IUI (including DI) starting for the first time is recommended to be progressively lowered in order to achieve the greatest likelihood of success.
April 2007-March 2008: 36yrs to 39 yrs inclusive (same as previous years)
April 2008-March 2009: 35yrs to 38yrs inclusive
April 2009-March 2010: 34yrs to 37yrs inclusive
April 2010-March 2011: 33yrs to 36yrs inclusive
April 2011 onwards: 32yrs-35yrs inclusive

Where are you statistics regarding the age of the average woman who receives NHS IVF treatment?

You seem to assume they're all 'older', so I'm concluding you mean 35+?

I'd be interested in seeing if the facts back that up.

There's no evidence that women who conceive using assisted conception experience more complications than women who fall pregnant naturally.

My friend is definitely not an "older mother", but she has been on the waiting list for almost 5 years and if she can't get in and get pregnant now, they won't let her for much longer.  

And anyways, like you say expat,

Maybe we should just stop all these 'older mothers' altogether so 'we' don't have to pay for their selfish desires?

Whats being old got to do with the price of tea in china?  Fact remains we cannot pass judgement on other peoples circumstances.  What works for you may not work for someone else.  Someone may want to adopt and some may want their own kid and some choose not to. But just because you plan your future one way doesn't mean it should be that way for everyone.

I know the costs for NHS are out of control, but the US healthcare system is probably worse, where most people pay for their IVF.  NHS could use with some leaning (as in lean manufacturing only in a transactional enviornment) and cycle time and costs can be drastically reduced, while still providing some of the best healthcare in the world.  

Plenty of us geriatric mothers here on the board gave birth with little or no complications.   

What about younger mothers who are obese.  Now I'll need to dig it out, but there's plenty of evidence that they have more complications during pregnancy and delivery.  Maybe we should force them not to conceive until they're brought their weight into line.

How long is a ball of string?  Let's start unravelling!

The mind boggles.

How long is a ball of string?  Let's start unravelling!

The mind boggles.

Oooh I know, lets every woman and man of child bearing age take a "fit parent" test... and if she/he is deemed to be an unfit mother, has some kind of genetic disorder or risk factors, doesn't have enough money, etc  she gets sterlized. That way only the best people are parents, the world doesn't become overpopulated, we have no illness anymore, and only rich people can pass on their genes. 

Alright, in all seriousness, I know I'm going a bit far, but I could unravel the string all the way down there! 

At least we can argue whether or not IVF should be paid and not whether or not we can only have 1 child and it must be a boy, otherwise we give it up for adoption, ala China... 

Due to medical issues, I may have trouble conceiving myself and I want my own kids... I hope maybe someday IVF works for me.

I consider infertility is a medical problem and I understand that other people may not. But what I find it interesting that there seems to be an assumption that a person who is in need of IVF is first, a woman and second, a woman who has waited too long to have children. IVF is also used to treat male infertility.

The point I was trying to make is this: a diverse population with diverse health issues requires a  comprehensive medical system that encompasses treatment for all.

There’s a larger context to consider in that what is considered a medical need? If I realise hard choices have to be made and resources are finite but I find it disturbing how easily people argue for cutting treatment for certain people classified as ‘undeserving’.

I find it scary and reminds of the poem ‘First they came’ by Martin Niemöller and I wonder: First they came for the smokers, then the fatties, then the old people. Who’s next? You may find that when it’s your turn there will be no left to speak out.

What about younger mothers who are obese.  Now I'll need to dig it out, but there's plenty of evidence that they have more complications during pregnancy and delivery.  Maybe we should force them not to conceive until they're brought their weight into line.

Again, criteria only for the Thames Valley area. And again, provided only as information, not as any bolstering of any comments on any side.

Women must have a BMI of between 19.0 and 30.0 inclusive for a period of 6 months or more before receiving any treatment. They should be informed of this criterion at the earliest possible opportunity in their progress through infertility investigations in primary care and secondary care. GPs are encouraged to provide unambiguous and clear information about BMI criteria to infertile couples.