Is the failure to meet IVF treatment guidelines a breach of duty?


Figures show couples being refused recommended three cycles of IVF

Increasing numbers of infertile women are being denied the three cycles of IVF treatment which Government health advisers say they should have, according to new figures.

The National Institute for Health and Care Excellence’s (NICE) guidelines for the NHS states that couples with a defined cause for infertility should be referred for three rounds of IVF. Three rounds should also be offered to all women under the age of 40 with ‘unexplained infertility’.

However, figures from England’s 211 Care Commissioning Groups (CCGs) suggest something of a postcode lottery has now developed in terms of the scale of IVF treatment available and there is a real question mark now over the fairness of the system.

Clearly, in some areas, women, and couples, are being let down.

The number of CCGs offering three cycles has fallen from 48 (23%) last year to 38 (18%), while the number offering women only one or two cycles has risen from 149 (71%) last year to 171 (81%).

NICE guidance does not come with any money attached to it and CCGs still have to manage funding accordingly

With the guidelines only being voluntary, hospitals are able to impose their own rules, and given the NHS is currently in something of a financial crisis, with the cost on average to fund a round of IVF standing at £3,435, it is perhaps not a surprising situation.

“If I moved 20 miles west to Leeds I’d get one cycle and if I moved 20 miles east to Hull I’d get three cycles,” said frustrated Karen Boardman, 34, who lives in York, a city which does not offer IFT treatment on the NHS at all.

Dr Laurence Buckman, a former chairman of the British Medical Association’s GPs committee, has described it as a ‘desperately sad and unfair situation’, but quite rightly says it is all down to tough financial choices being made.

“In the end it boils down to, are you going to budget for cataract operations or hip replacements, or forgo a third round of IVF treatment?” he said.

With the Department of Health saying it expects CCGs to consider NICE guidance and abide by it, perhaps there is a need to toughen up policies.

Unlike in cases of medical negligence and hospital neglect, where experienced solicitors can clearly identify liability and breaches of care, there is currently no legal position of strength for those desperate to become parents and feel badly let down by the NHS system.

As Dr Louise Irvine, a South London GP who will stand for the National Health Action (NHA) party against the Health Secretary, Jeremy Hunt, in next year’s election, has pointed out: “NICE guidance does not come with any money attached to it and CCGs still have to manage funding accordingly.

“The responsibility ultimately remains with central government.”