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

niceglass - what is the success rates for patients who will actually be getting funded, which usually has an age cut-off, right?

I had 1 funded IVF which didn't work but gave me frozen embryos. I have a DS and am pregnant with #2, both using those frozen embryos.
I spoken to the doctor when we started the whole journey and made a comment about it not necessarily being vital treatment. Loved his response though as he said that the NHS treats so many non vital things - injuries from skiing holidays being the one I remember most

niceglass - what is the success rates for patients who will actually be getting funded, which usually has an age cut-off, right?

An age cut off, a weight cut off and a FSH cut off
Funding criteria already eliminates a lot of the patients who have a low chance, but you won't find any clinics who only treat NHS patients
In fact, a lot of NHS clinics take private patients at a profit and use the money they make to cross-fund other bits of the hospital.

Is that moral? It is one thing for a private clinic to benefit from the desperation of people who want a baby, but a whole other thing when the NHS does it

Sparechange - some clinics don't have any cut offs for self-funded women who agree to use donor eggs. A lot of clinics prefer younger women (under 30s) and will heavily discount them as they are more likely to have a successful treatment.

Astoria

The cut off for egg sharing is age 35 and women with good ovarian reserve, who meets the BMI requirements, with a strong medical history

Private clinics won't let you egg share unless you meet these requirements so many many women aren't eligible for discounted private treatment in return for egg sharing

many people who have private treatment do so because they don't want to sit on a waiting list for 2 or 3 years. The clinic I used wouldn't treat women using their own eggs if they were older than 42 because of the very low success rates.

Sadly success rates for IVF are low and only become lower as women age. I think it's an awful decision for the CCGs to have to make but there is a finite amount of money.
I agree that IVF should be free on the NHS but in a realistic world there just isn't the funds available.
The NHS is the worst funded per patient of all the european health systems and we have less doctors per 1000 patients too. If we want things like IVF to be available we have to increase the money going into the NHS.

It's an easy choice to make between providing life saving cancer treatments and hip and knee replacements that give people there independence back over providing IVF.

It's an easy choice to make between providing life saving cancer treatments and hip and knee replacements that give people there independence back over providing IVF.

Agreed. But what about the billions of pounds that obesity is costing the NHS.

Before any jumps down my throat, I am NOT saying all causes of obesity are self inflicted

But a significant proportion of the cases that the NHS are having to treat are down to poor lifestyle choices

Alcohol induced injuries in A&E are also self induced and down to poor lifestyle choices

See also all the money wasted on DNA appointments, stockpiled medications

The latter are a drop in the ocean - but the former is not.

None of it is cut and dried. But it's not as simple as life saving cancer vs IVF

Astoria
That's my point...

Some posters have been say 'ah, but IVF has terrible success rates so the NHS shouldn't fund it. Look, here is a link to say only 1 inX cycles work'

My point is that data is for all cycles, including women who fall outside the NHS funding criteria, so of course the success rates are going to be lower than if you just take the funded cycles.

If older, fatter, low-egg-reserve women want to pay for their own cycles, knowing the chances of success are lower, then that is their absolute right.
But that shouldn't then be used as a stick to beat IVF as a technique and its efficacy for younger women who would qualify for NHS treatment

and ski injuries, lets charge those well of middle class fuckers who can affords to sky, pay for insurance - bitches!

Meh, like really where to start on this- sigh

I think the issue with saying ‘let’s not pay for ski injuries/obesity related sickness/smoking related sickness’ is that a lot of that type of thing is likely to either be life threatening or cost more in the long run if it does become life threatening than infertility is. And no one really wants to be the doctor saying to someone’s mother ‘as your son had £245 to pay for a skiing trip, either he, or you, now cough up £2000 for his broken leg, or he risks life long disability, or further infection and death.”

Obesity is normally treated because not treating it costs more in the long term, and refusing to treat potentially life threatening conditions like diabetes because someone weighs too much strikes me as totally inhuman. So what happens if someone is overweight and on low income? Do they just cut out that self-indulgent insulin? That’s awful.

I know I’ve said this before, but I genuinely don’t think there are ‘easy’ cuts for the NHS to make. My feeling is that our future is a far more stripped down ‘free’ service and some kind of insurance for everything else, and if we’re lucky, we’ll have a heavily regulated insurance set up along the lines of the French or German system. We just need to pay more.

But why should people be able to knowingly run up huge bills for the NHS others have to pick up the tab for whilst others don't and when they need the NHS can't access it.

Many women using IVF have worked hard at a career,payed a shed load of tax and NI and decided to have children after they've saved. Many lead very healthy lives and do everything to enhance fertility and help themselves.They don't choose infertility.

Kind of gets my goat others just do everything they know they shouldn't but just think stuff it the NHS will pick up the tab.And it does at great expense and cost to everybody else.

It isn't fair.

GreenGinger2 - No one chooses ill health. And the NHS shouldn’t be a reward for a virtuous life. It is meant to be a universal health service which is delivered on the basis of need.

If you want healthcare for good people, who work hard and save and pay into whatever system they use, the American healthcare system is over there.

You can't have any sort of health system that applies moral judgements as a criteria for selecting who is prioritised for treatment.

That said it is fair to ensure that obese patients take all possible steps to alleviate their obesity or lose weight before they are accepted for treatment. That's not a moral judgement but sensible clinical practice.

Equally you cannot allocate treatment in terms of who is the most deserving.

Both of the above are subjective and a dangerous path to go down.

But you can make an objective judgement in terms of the efficacy of IVF and whether or not it merits funding. I understand all the mental health considerations and speak from a privileged position of never having had to struggle with infertility but objectively infertility is not going to kill you.

It might be a contributing factor to mental health but objectively speaking (and I understand this is a really hard thing for anyone who has had IVF or suffered from infertility to hear) wouldn't it be better to treat the mental health issue?

When someone feels that they will commit suicide if they can have xyz happen to them, surely that's indicative that they need some kind of healing, which IVF may not solve?

Green and many women haven't paid a shed load of tax and NI. They're not less entitled. It's not a case of getting out what you pay in! I'm not sure many people go skiing and "knowingly" run up a bill either. Just like it's unfair to compare IVF to cancer treatment, it's also unfair to compare IVF to people who actively do something that causes harm. I am not against funding IVF, quite the opposite, but it sticks in my throat when I see people not looking at the wider picture. Then again, I did wait months for my CCG to approve a drug that stopped my joints eating themselves and I know they only did it because it's cheaper than replacing them all and revising them over the course of my lifetime.

You choose ill health if you eat too much sugar and crap,get zero exercise,smoke and drink too much.

You'd have to be on planet Mars to not know,most GPs would be issuing warnings at the frequent appointments ill health from the above would cause.

can't have xyz. Imagine if people had loans written off because they felt suicidal?

But then again people are allowed to have gender reassignment surgery on mental health grounds, so maybe I am wrong?

Though my instinct is that gender dysphoria is a mental, not physical issue...

The NHS is on it's knees because people abuse it.

They rack up bills with lifestyle choices,rock up to A&E/ their GP when they don't need to.

It no longer works as a system and yes I do think it needs to change. For some it simply isn't value for money.

Green It's government rhetoric that the NHS is on it's knees due to people abusing their bodies but you've fallen for it. It's on it's knees because we are a rapid ageing population, social care has been slashed to the bone and the most important factor - it is chronically underfunded.

genuinely don’t think there are ‘easy’ cuts for the NHS to make

Curious about the following:

translators, seriously I could not sit down in the maternity waiting room for translators (I know its controversial) but these should be last resort
Free prescriptions .should not people apply for a card for this, rather than just tick a form at the pharmacy?
Health tourism (another controversial one)
A nominal charge for MIU and A&E, say £15 pp
Equipment hire (ie crutches)
Controls on minor procedures such as lipoma removal, veins etc. - people can live with a Lipoma, they look shit but....
Encourage referrals from the NHS to the many people on private healthcare, most people stay with NHS as its hard to acess private.
Remove ELCS until for obvious reasons

Its a mere drop in the ocean isn't it? But there are ways, can see it myself frankly

The NHS is on it's knees because people abuse it

I don't believe that is the reason

Oh and nothing heals infertility other than a child.

Until you've felt the agony and gone through the counselling procedures you have no idea. You live with it but you don't get over it. It is a loss,agonising grief that doesn't stop just because you go for a daily walk or talk things through.

Mental health issues x2 for life I'm pretty sure would cost more than a few cycles of IVF.

Green Perhaps you should avoid making assumptions about people because they disagree. I don't even know why you'd say that, to be honest, especially as I said I agree IVF should be funded. You know nothing about me.

That said it is fair to ensure that obese patients take all possible steps to alleviate their obesity or lose weight before they are accepted for treatment. That's not a moral judgement but sensible clinical practice.

And it already happens. I lost two stone to get me back into the ideal BMI for an operation. And every diabetic I know is on a strict diet.

Green It's government rhetoric that the NHS is on it's knees due to people abusing their bodies but you've fallen for it. It's on it's knees because we are a rapid ageing population, social care has been slashed to the bone and the most important factor - it is chronically underfunded.

^This

Plus the sugar thing is a new one. Years ago it was saturated fats.

People contract chronic illnesses through no fault of their own. Illness (including infertility) is not a moral failure.

It's like we've gone back to Victorian times, except prudishness about sex has been replaced with a worse Puritanism about food.