to think NHS IVF rules are unfair?

[kathkim]

So I have adenomyosis and endometriosis. It's looking increasingly likely I will need IVF. Why can't I get it on the NHS just because my partner has a child with someone else? It's me who needs the help. How much would it cost privately?

I am a higher rate tax payer and I was lucky enough to have DD easily enough. I contribute far more than I take out, and everything medical - inc the GD consultants etc - bar actually having DD was private. In fact a big part of my choosing to pay (I didn't even take the free prescriptions during pregnancy) was because I know the NHS is struggling and money not spent on me could be spent elsewhere.

I mention all this because some of these posts seem to say that some people who didn't need IVF don't think it should be funded - and i think that is very cold. And not everyone who didn't need it and who is a net contributor thinks that way about it.

To me, IVF is definitely part of that "elsewhere" where money can and should be spent. I think everyone who needs it should get say 3 rounds of IVF. If it works first or second time, you get an optional shot at a second child too. Nobody asks to be infertile. Nobody deserves it. It's fucking unfair and unlucky and it can tear apart relationships and friendships and even lives. If we can do something to treat that, even if it's the symptom not the cause, then that's just as important as other medical issues IMO.

Applebite, the NHS is overdrawn. It's offering more services than it can pay for. Decisions need to be made at policy level about what the NHS is for. Is it to just treat, i.e "needs", or is it to satisfy "wants".

boopsy I see where you're coming from, but couples who want IVF and go private have months to save up. I know some people are limited by time because of their age, but by and large, they have the time to save. I don't know how much an abortion costs the NHS, but I can't imagine that everyone who isn't eligible for free prescriptions has the money lying around, and it's a rather more urgent need for an abortion than it is for IVF.

I think ivf should be funded.
However i do agree with not funding second dc for anyone (including the step parents, sorry OP)
I think this is because then the infertile partner could change partners several times and have ivf with each new one.
End postcode lottery so either 1 or 2 rounds across the UK.
I would also lower the age limit as at say 40 some clinics it's only 5% effective (or was). And i think if having dc was so important then ttc would have started by at least 35, as it's widely known how fertility declines.
I think re the saving the living. Imagine being an 80yo and seeing that treatment could allow them to live to 85 or their grandchild could have ivf to have their (only) great grandchild...
Maybe everyone should agree to have no more than 2dc and we can spend the savings on ensuring all can try to have at least 1. As one families' 18+ extra kids would fund lots of ivf.
We do need to turn the tide of people leaving it so late to ttc though. I dont think the ivf funding should be for just people leaving it late. As eventually with obesity and lack of exercise almost all may need ivf. I just dont think that is good for the resulting kids as we are not certain there are no risks to being born via ivf. After all the oldest are im guessing maybe 40.

I completely disagree with increasing the population to provide for the elderly. As where would that end..?

Applebite I'm so reassured to hear you say you feel that way, I was starting to wonder!

I also like that you choose to fund things you can easily afford; many years ago I wrote a paper at uni that voluntarily using private healthcare instead of the NHS could be akin to a charitable act. I realise now it's more complex than that - because of things like quality staff "following the money" for example, and the potential creation of a two-tier health service for rich and poor - but I do think the idea is essentially charitable.

How do you define needs and wants though portico when not talking about a life threatening condition? My MIL suffers from chronic pain which is treated by the NHS. She doesn't need treatment - if you think it's acceptable for her to live in pain, that is - but she certainly wants it! It's all a question of what you think it's acceptable for others to put up with. I don't think the avoidable pain and life-limitations of infertility is an acceptable price. I think people suffering from this need treatment.

EpoxyResin, i take your point. MIL needs treatment. I am talking about the elephant in the room. At some point, where we have finite resources, decisions, rules etc will need to be implemented/enforced as to what the purpose of the NHS is. I also want to see its budgets reined in.

Portico - agreed. But to my mind picking and choosing services isn't the way forward, ESPECIALLY not when it's different in every post code.

Instead, I would get rid of some of the middle management, scrap prescriptions for cheap things like paracetamol, maybe even charge nominal amounts like £10 for GP appointments for those who can afford it and don't have chronic conditions, etc. I would also be looking at things like developers having to build more medical centres when getting planning permission and I would be tough on "healthcare tourism".

Applebite, not sure health tourism accounts for a big chunk of the £150Bn a year NHS budget. I would like to see where the big chunks of waste and get rid. As a former pen-pusher in the NHS (for 18 months), I returned to the proivate sector because I felt I added no value to the NHS. I was just part of its bureaucracy - and it is this bureaucracy that needs to be expunged, too.

Portico - Whilst I don't agree with the need for reining in NHS spending, I do agree decisions have to be made about what is done on the NHS. But I've said before I think that line is a long way away from not funding fertility treatments. I'd understand if this were a thread about non-reconstructive cosmetic procedures for example; that would surely be far more debatable; but IVF for a childless woman unable to conceive without it? I think that's without the bounds in anybody's book. Except it isn't - and I'm surprised!

Oh, I do agree the NHS needs to be better run with regards to it's spending though! It needs some serious efficiencies auditing. But I think that ideas been knocking around for eons and no-one seems to be able to get anywhere with it.

Portico, I wanted children. The NHS paid for me to have them. I was in the very fortunate position of not having deep-seated medical problems which prevented conception, though the NHS did treat me for multiple miscarriages because I wanted to keep trying.

I know that Mrs DV has already posted about her own experiences with her daughter, and that Applebite had significant private maternity healthcare. Other than that, I would be genuinely astounded if I am the only person on the thread whose choice to have children /attempt pregnancy has cost the NHS. I'm especially curious about all the posters who have declared that the NHS can't afford to fund the choice to have children, including any parents among them who managed to have zero-cost babies.

EpoxyResin, I am not being mean. But we need to live within our means, the NHS too. Somethings have to give.

I'm sure all the people who are most vociferously against ivf/fertility funding had their own children with no issues. Arseholes

I had secondary fertility. I never had IVF as we couldn't afford it and the NHS - quite rightly - wouldn't treat me as I had a child already.

I don't believe any IVF should be on the NHS with the current money issues. In an ideal world it would be, but this is so far from an ideal world.

The irony is - that I am now prescribed free of charge contraception to treat period issues

I think charging non residents would help. Take the most extreme example of the Nigerian lady who had quintuplets and cost the NHS £145,000. That's 29 rounds of IVF, just in one case. It's not just Tesco where every little helps!

She did not have IVF on the NHS, she had IVF in Nigeria. She ended up stranded in the UK after giving birth prematurely waiting for a connecting flight back to Nigeria from the UK. That bill is the cost of caring for her sick babies. What are you suggesting, we put her back on the plane to Nigeria even though she was in premature labour?

There is a systems for reclaiming health tourism costs, it's just never been fully utilised.

i think if having dc was so important then ttc would have started by at least 35, as it's widely known how fertility declines.

What about cases where like mine Naty where the time from first starting TTC, through investigations to the recommendation of IVF takes of the order of 5 years? I have a chromosomal abnormality that causes profound disability/miscarriage and I eventually had my girls by IVF with PGD to pick out the one or two healthy eggs from all the affected ones. The NHS wouldn't investigate my miscarriages until I'd had three, which took three years. Getting referred to the recurrent miscarriage clinic took 6 months, and getting referred to the local clinical genetics unit from there took about another 6. Only then was I eligible to go on my PCT's waiting list. And what about people who get ill while they're TTC? Or who lose their job, or whose partner leaves, or dies? This is why I think you have to base the cutoff on the statistics on success with age - it's not easy to make judgements about how much someone wants a baby based on their age when they show up at the fertility clinic.

A line has to be drawn somewhere as there isn't enough money. This is all hypothetical. Yes, I would prioritise treating residents who've paid taxes over visitors to the country. You might choose to prioritise someone who is already pregnant - fine, that's your view.

If you're having 5 babies, you know there's a v real risk of premature labour when you choose to travel whilst pregnant. If you can't afford that risk, you can't afford to travel. What would have happened to her in the US, for example?

She went to the US for treatment. She couldn't afford to stay. Hence flying home to Nigeria, which was via a connection in the UK. She went into labour around 24 weeks.

I'll ask again. Should we have put her majorly premature babies and her herself, who needed extensive treatment following a traumatic birth, on that plane back to Nigeria knowing full well they would all die in flight without hospital care?

In fact, if you look at the timing, she came here on a visa early in her pregnancy, but then had the babies 7 weeks early. That's not exactly a short holiday. one could be rather cynical as to why she stayed here - where there is an NHS!

Now she's just one example, albeit a dramatic one. But if we were better at recovering costs from people who haven't paid anything into the system, it would help to plug some of the holes IMO.

www.telegraph.co.uk/news/health/news/11832487/Nigerian-mother-let-off-145000-NHS-bill-after-birth-of-quins.html

I'm going to hide this thread now because Applebite's lack of humanity is disturbing.

You're talking about a different case, Donad.

In fact, the lady you are referring to cost the NHS £500,000. So that's £645,000 for just 2 cases.

I hate seeing this. In our area couples with children qualify for one cycle and childless couples have 2 or possibly 3, I'm not sure.

Elsewhere people get nothing at all. It's hugely unfair and both primary and secondary infertility is incredibly hard to deal with.

Not sure what the answer is though - maybe it should be apply the same 1 or 3 cycles across the U.K. Or maybe it should be means tested.

"maybe it should be apply the same 1 or 3 cycles across the U.K. Or maybe it should be means tested."

Or maybe the top 10% should pay more tax?