NHS IVF policy change

[Bambamrubblesmum]

Have you seen this?

www.independent.co.uk/life-style/health-and-families/health-news/rip-ivf-nhs-cuts-to-fertility-treatment-will-deny-thousands-parenthood-a6717326.html

I can see both sides of the argument but AIBU to feel very sad that it's come to this

there has to be natural selection in any species and to override this makes me nervous

So your preference is for financial selection, where only the rich can afford fertility treatment?

In addition, IVF is time-critical, the comments about it being non-urgent are misguided. Efficacy of IVF is much better the younger the patient, so keeping people waiting around for months or years is incredibly wasteful of funds.

This. I was nearly 39 by the time we finally got to the front of the queue, after being fobbed off at every turn. I had pretty much no hope that one cycle would work, and sure enough it didn't. Even two years before that would have given me much better odds.

If children are "a gift not a right", that should be applied equally to fertile couples too. It makes no sense as an anti-IVF statement, as of course children born through IVF are just as much of a gift.

If the answer to not yet being a parent is "why don't you just adopt?" this should be equally recommended to fertile couples, every time they mention their hopes of having a family.

If we "ought" to think about "all the children in care who need a loving home", then that applies equally to those with or without fertility problems.

If a couple can't afford IVF, it doesn't mean they can't afford to raise a child, because of course an amount phased over 18 years is very different to suddenly having to lay your hands on several thousand immediately.

If it's not OK to pass on genes which could affect fertility, the same should apply equally to all other genes which may cause problems (obviously a dreadful idea, and the real answer is to allow couples their own choice). Additionally, many causes of infertility aren't genetic or have a low risk of being passed on.

If IVF is solely responsible for the lack of funds available for cancer treatment, then so are the staggering percentage of A&E attendances which are related to alcohol, every missed GP appointment, the multi-layered beaurocracy, treatments for things which make far less of a difference to someone's life than IVF, and dozens of other factors.

If treating a woman for medical difficulties with her reproductive system is subject to NHS cuts, then the same should apply for treatments for the male reproductive system.

Why should anyone but the woman herself decide whether she wishes to go through what IVF entails? Particularly as she is clearly very willing to give birth several months down the line, and no Robert Winston is going to prevent her.

If "get a dog/cat" is the answer to fertility problems, then all the fertile people who blithely suggest it are presumably happy to have their own family supplanted with a dog/cat.

If "everything happens for a reason" why do some potentially fantastic parents never have the good fortune to have children, unless the "reason" is random chance?

If the world is overpopulated, that clearly isn't due to infertile people but the opposite, so it's illogical to deny people IVF on that basis.

Sukey

NICE are increasingly having to make decisions on a cost/clinical effectiveness basis though.

Most of the time, IVF does not work.

It's pointless attempting to draw comparisons between the morality of couples conceiving, because the simple fact of the matter is that if you conceive naturally, you are not asking a stretched NHS to fund your treatment.

Don't get me wrong I would like to see a lot more R&D into infertility, pregnancy loss and stillbirth. But IVF is an ineffective treatment for most people and it doesn't help treat what is behind the infertility, only attempts to circumnavigate it.

simple fact of the matter is that if you conceive naturally, you are not asking a stretched NHS to fund your treatment

Utter bollocks.

COnceive naturally and you're asking a stretched NHS to stump up a minimum of £4,385 to cover the cost of your antenatal care, labour and post birth care - and that's if you're textbook with no issues/additional requirements.

Speaking as someone who suffered secondary infertility I can see the argument that the NHS can't afford to fund treatments like this when they can't fund some say cancer treatments. Unfortunately the NHS model was set out when people didn't live as long and there were no where near as many treatment options. We need to go back the drawing board, look at how the slack is taken up by insurance, stop bed blocking. Reduce people's expectations as to the welfare state does

I know some IVF clinics abroad ( I think maybe in the states) offer a type of funding for IVF where you have 3 goes and if you are successful you pay more than if you are unsuccessful. So the ones who are succesful are essentially subsidising those for whom IVF doesn't work.

I do think this is a good idea if the NHS cannot afford to fund NHS treatment any more and that maybe some private clinics here should offer this model.

Whilst my heart goes out to anyone with infertility, if resources are limited I'd rather they were spent on preventing conditions that lead to death or disability. I nearly went blind and had to pay privately for an op to save my sight, and the NHS were unable to operate straight away due to waiting lists and I was in danger of a retinal detachment which I wasn't going to risk. I'd rather things like IVF were cut than people suffering permanent sight loss due to lack of funds. There simply isn't enough money for everything.

NICE are increasingly having to make decisions on a cost/clinical effectiveness basis though.

NICE recommend three cycles are funded

The cost benefit analysis has been done and NICE recommend that IVF treatment be funded

It's CCGs who are making the decisions at a local level due to under funding and budget pressures

The economists who weight up the cost benefit analysis believe IVF is worth funding

bananafish, what is the point of NICE making recommendations based on cost benefit analysis, if the local CCGs just decide that actually, they can't afford it?

It sounds like the economists who work for NICE aren't really on the same page as the people who actually decide where the money can go at a local level.

Surely they should be?

Icy - yes if you conceive naturally you may be costing the NHS that much (although I am pretty confident not all my births did thanks to having one private birth and on other occasions using an independent midwife and avoiding the NHS and hospitals) but if you are using IVF you are asking the NHS to fund that AND the cost of the birth.

Until we find 100% contraception then for as long as people are having sex then people will be getting pregnant and needing care.

I'm not an economist and don't work in the NHS so I couldn't tell you Maggie

Different areas have different pressures from ageing populations, social deprivation, high levels of obesity and type 2 diabetes. Social care funding and bed blocking.

My CCG funds 2 cycles, Camden next door funds 3 fresh and unlimited frozen cycles. Other trusts don't fund any. The pressures vary across local areas. As I say, I don't work in NHS administration to be able to offer an informed comment

Agree maggie and TBF some of NICE decisions have appeared questionable.

I do admit we need to be extremely careful when it comes to thinking about money. In some US states & Canada terminally patients have been refused life prolonging treatments by insurance companies who have however offered to fund euthanasia

Oopsdearyme if natural selection was an argument, surely someone as dense as you wouldnt be here, you keyboard masher.

"The health service now spends more on medication for type 1 and type 2 diabetes than for any other ailment. The number of diabetics across the UK as a whole has recently risen to more than four million and has increased by 65% over the last 10 years....

Diabetes is thought to cost the NHS about £10bn, once the cost of treatment, including amputation and hospitalisations for life-threatening hypoglycaemic attacks, is included."

www.google.co.uk/amp/s/amp.theguardian.com/society/2016/aug/03/diabetes-drugs-cost-nhs-1bn-a-year-presciption?client=safari

A goodly proportion of type 2 diabetes patients are obese and their illnesses lifestyle induced.

IVF funding is limited based on BMI because of the health issues associated with being obese. You can't reverse infertility with lifestyle changes.

Copy and paste went weird there! You get the gist in any case...

I do wonder about the fact that IVF has been around a while now yet success rates haven't risen in line with advancements in other treatments.
Maybe that needs looking at and then at least the NHS would be funding something more effective. Seems like IVF has got to a certain point and no further which I'm sure suits all the private clinics as they can charge ££££ for something numerous times

Not all cases of type 2 diabetes are induced by lifestyle-a big proportion is but not all. I know of 2 people who developed it, one had PCOS and a good diet and wasn't overweight and the other had chemo and developed it after that
Type 1 is completely different as is not caused by lifestyle in any cases-it's an autoimmune condition therefore spending on type 1 medication and treatment is not comparable

"Everything happens for a reason" is the most patronising insulting bollocks you could ever tell anyone.

If anyone here ever finds it marching in the direction of their mouth, please stop and vow never to say it. It never made anyone feel better ever.

I do think this is a good idea if the NHS cannot afford to fund NHS treatment any more and that maybe some private clinics here should offer this model

Plenty of clinics already offer this model
It's about £7k for a 3 round package. You can get up to 3 packages but as soon as you get to 20 weeks pregnant, you lose any remaining rounds

It's one of a number of horrible lottery decisions people have to make. Another is egg sharing, which is just another way of saying 'selling your eggs to another women to pay for your own ivf'

But of course if it was actually called that, everyone would be up in arms about the lengths women are forced to go because of the lack of NHS funding
Can you imagine someone having to sell their bone marrow to another patient in order to fund their lukemia treatment..?

The access fertility scheme doesn't remove any unused cycles unless you have a take home baby and if you're unsuccessful you get a refund

I don't think you can compare the two / that's the problem with fertility treatment as it's not a life saver per se - it will always get de prioritized

In some US states & Canada terminally patients have been refused life prolonging treatments by insurance companies who have however offered to fund euthanasia

That's every single kind of screwed - and better that being in a developing country . My friend saw her dad die of cancer with very limited palliative care and I he got barely any kind of cancer treatment . So yeah - better euthanasia than what he suffered . Despite all we are luckier than many here - and the NHS is not unlimited ?

There are many treatments that are not life saving yet IVF seems to have a stigma attached to it. Almost as if it's 'greedy' to want or need it. I'm not saying everyone has that view but it seems to often be the case when discussing cost issues and the NHS

You can eat, drink and smoke yourself into needing treatment which is provided without question.

You can have a medical condition which means you cannot conceive which cannot be provided.

Really?

(Speaking as a UK citizen, resident in Ireland where we had to go private - five IVFs and change of clinic to have our amazing 14 year old daughter.)