I wrote to Health Secretary Jeremy Hunt earlier this year to introduce a National Tariff for IVF. My call for national tariff received wider support from patient support organisations and the media. When you visit an NHS hospital for a hip replacement, the price, which the hospital is charged for this procedure, will be exactly the same - whether it happens In Bristol or Bradford. Yet when a woman or couple are referred to the NHS for IVF treatment, the amount a Clinical Commissioning Group (CCG) pays for exactly the same service of a single IVF cycle can vary from £2500 to over £6000. The reason for this is that, no National Tariff exists to nationally standardise the cost per IVF cycle across the UK, and the result is a 'postcode lottery' in which individual Clinical Commissioning Groups (CCGs) source their IVF treatment with huge variances in cost. Some CCGs have shown little interest in getting the best value for money and increasing access to more couples.
With NHS budgets already stretched this cost has a direct bearing on the number of women and couples who can access treatment within a CCG budget. This price differential is therefore not only unjustified, but is needlessly preventing thousands of couples every year from becoming parents. I propose a simple solution; to introduce a national IVF cap or tariff that sets an upper limit for the price any CCG pays for IVF treatment.
Fertility problems affect one in six couples in the UK. With a growing trend for women to have children later in life, coupled with an increase in male subfertility due to various lifestyle factors, this figure is only set to rise. At present, couples trying to conceive can access IVF treatment on the NHS - but most overcome a great many hurdles.
A range of caveats exist to qualify for the receipt of IVF treatment on the NHS, including a woman's age, whether either partner has a child from a previous relationship, or whether a woman's egg reserve is normal enough to merit treatment (as measured by follicle stimulating hormone levels in the blood). Further, although the National Institute for Health and Clinical Excellence (NICE) guidelines recommend that women with fertility problems should be offered three full cycles of IVF on the NHS, this varies dramatically from region to region and currently less than 80% of CCGs in England meet the recommended standard of three cycles.
The cost to the NHS of providing fertility treatment is significant, with figures of over £200 million per year cited for IVF alone, and this cost is likely to keep rising. Pressures on NHS budgets make equal and fair access to treatment around the country almost impossible within the current system. The result is that women and couples are losing out on the chance to become parents, often by virtue of where they live and how much their CCG is paying per cycle of IVF.
A national cap on the IVF tariff paid by CCGs would not only save the NHS money but would also give more couples around the country access to treatment within the existing budget. It is a method the NHS already employs with medical treatments and an upper limit per cost of IVF treatment cycle is already employed across other European countries such as Belgium, where it contributes to a broader level of access to fertility treatment for those who need IVF.
I believe that the national cap per IVF cycle should not exceed £3000-£3500 (all inclusive), which is significantly below the price many CCGs are currently paying. With a cap in place, CCGs will be able to choose the best provider to suit their needs, safe in the knowledge that cost parameters accurately reflect the treatment they are purchasing. They should use their collaborative purchasing power to make sure they receive the best value treatment. It helps them to achieve economies of scale and cost savings. This principle already enjoys broad support amongst many patient support organisations, charities and professional bodies in the sector. Following my letter to Jeremy Hunt earlier this year I have now been granted a meeting with Jane Ellison, Public Health Minister to discuss the benefits a National IVF Tariff would bring - a great first step to levelling the playing field and helping our NHS to help more people.
Equal and fair access to treatment is one of the founding principles of our National Health Service and it is our duty to make sure this extends to IVF - as currently both the public purse and childless women and couples are suffering. A small change will make a huge difference to people's lives by doubling the number of IVF cycles in some regions and thus increasing access to IVF. Every day I see the devastating impact infertility can have on many women, couples and their families, and the national tariff is a simple idea that could make a tangible and positive difference to so many lives.