A study of PCTs in the UK has found that at least 23 were not providing any NHS funded fertility treatment by an April deadline earlier this year. Eighteen other PCTS were only offering IVF under 'exceptional circumstances' and many others were denying treatment to women in their late thirties. This means that thousands of women who would otherwise be eligible under clinical guidelines set by the Government-commissioned National Institute for Health and Clinical Excellence (NICE) are routinely being denied treatment.
These findings come despite assurances from health ministers that all health authorities follow the NICE guidance. NICE had recommended, in February 2004, that three cycles of IVF should be offered to all infertile couples, subject to certain clinical criteria, ending the 'postcode lottery' of provision. Shortly afterwards, the then health secretary, Sir John Reid, announced that all infertile couples where the woman was aged between 23 and 39, and fitting certain other additional criteria - including having no other children living with them - should be given just one free cycle of IVF on the NHS from April 2005, with a view to increasing provision further in time.
In September, research published by the UK's Audit Commission said that a 'postcode lottery' still exists in many aspects of the provision of medical services, despite guidance issued to ensure that patients across the nation have equal access to services and drug provision. Included in the report was the provision of fertility treatment on the NHS. The report suggested that the problems continue to exist because of poor planning and financial management in the NHS. Another example of the continued 'postcode lottery' came to light in July 2005, when ten PCTs in the county of Hampshire were shown to be refusing to fund IVF treatments, despite the Government's promises. They said that, because of limited funding, IVF treatment in the county has to be a low priority.
In the latest survey, undertaken by the National Infertility Awareness Campaign (NIAC) in conjunction with the All Party Parliamentary Group on Infertility, 302 PCTs in England were sent questionnaires asking whether and how they were implementing the Government's recommendations. About 250 responses were received and as well as the restrictions imposed on the provision of IVF, it was found that the waiting times in 21 PCTs were longer than two years. Clare Brown, president of NIAC, said that PCTs restrict their provision of IVF 'so they can create shorter waiting lists'.
NIAC has now produced a guide for patients, setting out the results of the survey, so patients can find out what services are provided by the individual PCTs across England. In a press statement, Clare Brown said that the guide was designed 'to let patients find out what treatments are available in their own area, but if the PCTs were following Government guidance and providing treatment in line with NICE there would be no need for it'. She continued: 'The fact that the guide consists of over 180 pages highlights the range of criteria currently being imposed... some are still refusing to fund any treatment and others are asking women to wait... effectively reducing any chance they have of success'. She called on PCTs to reassess the way they provide fertility treatment and on the Government to set centrally agreed criteria.