The right to try

“For those not blessed with the absolute privilege to conceive naturally, infertility triggers long-term feelings of grief, loss, isolation and severe depression. The emotional dependency we place on fertility treatment cannot be overstated; it is the critical opportunity on which we place all our hopes, fears and identities.” – Former IVF patient

Infertility is a medical illness defined by the World Health Organization as a disease. And yet, adequate support in the UK is being increasingly threatened by the creation of a ‘two-tier’ health service where our underfunded National Health Service functions alongside privatised services which offer patients the opportunity to purchase higher-standard care. It’s a system which focuses on finances over need.

If nothing is done to radically rethink our ability to offer medical intervention and provision for the one in six couples currently facing infertility, we will, bluntly, face a society that is only allowing the very wealthy to procreate.

Fertility Network research shows that currently, 98 per cent of Clinical Commissioning Groups (CCGs) in England provide inadequate fertility provision for its residents in line with NICE recommendations. These recommendations by NICE – the National Institute for Health and Care Excellence – have been produced to provide the best medical and financial opportunities from both a clinical and a patient perspective, and yet for the main part remain at best as guidance only.

Although Scotland leads the way with provision of three IVF cycles to all who meet eligibility criteria, Northern Ireland, Wales and England still fall far below clinical medical and arguably ethical guidance. Indeed, the situation in England is often described as a postcode lottery in terms of provision and availability, with huge variation being experienced by patients according to where they live.

The reality is that for a person dealing with the enormity of their own infertility and the myriad ways in which this diagnosis might affect them, the government is then subjecting them to fight for their right to try for a family. A fight that many people simply don’t have in them anymore.

Indeed, such is the impact of this diagnosis that approximately 90 per cent of people going through treatment admitted to feelings of depression, with a staggering 42 per cent of those surveyed also saying they had at times felt suicidal according to a Fertility Network survey from 2016.

Since the end of last year, 25 CCG’s have slashed fertility services and 18 are currently consulting on reducing the number of IVF cycles to residents.  This simply means that some people will be financially prohibited from pursuing treatment and the hope of a child.

And what then of the cost per cycle? In the private sector, for which approximately 60 per cent of couples end up being forced into, the average price per IVF cycle is around £6,000, with couples spending on average around £11,000.

For many people, such costs are simply not attainable – I have seen couples remortgage their houses or pile debt on to credit cards. For some people, such huge figures simply end any possibility, without hope of ever affording treatment.

The NHS however has also fallen into its own postcode lottery, with CCGs being charged hugely differing prices by service providers; the conclusion being that some CCGs are choosing to see treatment as an unaffordable luxury.

Thankfully there is a great deal of work behind the scenes to provide CCGs with a benchmark price for all IVF provision and this, we hope, will go some ways to equipping the groups on a local level to make IVF affordable for the NHS. The Human Fertilisation and Embryology Authority hopes to release this information and guidance by the end of the year. However, without the backing of government and cross-party support, such recommendations could prove ineffective and without any real strength.

Certainly, in recent times there have been major initiatives to tackle the unfairness surrounding fertility treatment. Last year, Steve McCabe MP organised a parliamentary debate and a Facebook discussion, and I hosted an event with Paula Sherriff MP which saw cross party support and delegates from the sector meeting to discuss the way forward.

This year Steve McCabe MP had a first reading of a private members bill in parliament which will be presented again in November, and the Fertility Network are gearing up to run its largest ever campaign around funding at the same time . In short these campaigns are simply asking for the NICE guidelines to be met and adhered to, that all who are eligible should be allowed the right to try for a family.

Indeed such a proposal if properly implemented may even have very limited cost implications. One example of this being the standardisation of an IVF cycle cost through the work around creating a bench mark price for all local CCGs. It is simply untrue to say IVF needs to be an expensive treatment option, even if this may well be contested within the private sector.

As the effects of austerity have worsened and local CCGs are being increasingly forced to make unbearable decisions, there needs to be consensus and an urgent review on how we should be championing this cause. The time for action, intervention and policy is now.

We on the left are passionate to increase NHS investment and provision must prioritise care for this area as critical. To quote the Labour manifesto, the right to try for a family needs to be for the many not the few.

If the government fail to act urgently and swiftly, we will see a generation denied its reproductive rights and the beginnings of a society where only a small number of people will be able to try for their own family.

If you’d like to get involved with the Fabian Health Group please email healthgroup@fabians.org.uk