'Postcode lottery' ongoing in UK healthcare and IVF

Research published by the UK's Audit Commission says 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 Audit Commission's report is the provision of fertility treatment on the NHS. The report suggests that the problems continue to exist because of poor planning and financial management in the NHS.

Many infertile couples are still denied equal access to NHS fertility treatment in many regions of the UK; while in other parts of the country patients are being offered no NHS treatment at all. This comes despite assurances from health ministers that all health authorities follow guidance from the National Institute for Health and Clinical Excellence (NICE). In February 2004, the then health secretary, Sir John Reid, announced that all infertile couples fitting certain criteria should be given one free cycle of IVF on the NHS from April 2005, with a view to increasing provision further. Prior to his announcement, the National Institute for Health and Clinical Excellence (NICE) had issued guidelines stating that three cycles of IVF should be offered to all infertile couples.

One 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.

The Audit Commission has now found that a third of all NHS Trusts in England were unable to introduce all treatments recommended by NICE in the years 2002-3. While the report acknowledged external factors, such as a rise in the price of drugs, poor financial planning was most to blame, it said. It found that the financial implications of the NICE guidance (in relation to all recommendations) had only been considered by 26 per cent of trusts. Next year, the Healthcare Commission - the NHS's own standards watchdog - publishes its own checks on healthcare trusts, so the full implications of these findings will then be known.

Andrew Lansley, the shadow health secretary, said last night that the report raised fundamental questions about the government's health policy. 'There is little point in introducing a code of best practice if the resources are not provided to deliver it', he said.