NHS shouldn’t fund IVF just because you want a baby

Next week, it will be 40 years since scientists first created life in a test tube — and IVF was born.

The first baby born from this revolutionary breakthrough, Louise Brown, now 39, has been speaking about the ‘devastating’ impact of the NHS rationing of fertility treatment.

She’s right, of course. Fertility treatment on the NHS is an iniquitous situation, because different health authorities sanction different numbers of treatment cycles.

Figures this week showed that just 12 per cent of areas in England gave the full three cycles of IVF treatment that Nice recommends. (In 2013, it was 24 per cent.)

Campaigners such as Louise Brown want it to be readily available to everyone who wants it. And while I understand this sentiment, it’s not a view I share.

Yes, the IVF postcode lottery is unfair on couples who are desperate to conceive, and I don’t for a second deny the heartache this can cause, but there’s another kind of unfairness here, too.

I’m afraid, as unpopular as this opinion may be, that in the real world of scant resources in the NHS, the desire to have a child simply because you want one is not something I think our health service should be prioritising.

A generation ago, infertility was a life sentence. Medicine could offer no help, and couples had to choose between adopting or remaining childless.

But with the advent of IVF, a whole industry has developed around fertility. IVF clinics are now established in most large hospitals, not to mention the array of private fertility clinics. It has all served to promote the idea that having a child is a right, not a biological privilege.

Any challenge to this is controversial, so sensitive is the subject matter to so many people and so strong the sense of entitlement.

But while IVF doctors champion their specialty and the incredible advances that have been made in recent years, many other doctors are more reticent about its widespread use in the NHS.

Those who work in services where funding is often tight, such as dementia care, cancer services and geriatrics, and who face having to make decisions based on cost, rather than what would really be best for their patients, question funding such procedures on the NHS when so many medications or treatments which could have a dramatic effect on people’s lives are denied because the money is not available.

And those, such as myself, who have worked with children in care, question the sense of bringing more children into a world where there are already so many who are desperate for a loving and stable family life.

But while IVF doctors champion their specialty and the incredible advances that have been made in recent years, many other doctors are more reticent about its widespread use in the NHS

But there’s another angle to all this that people rarely talk about, and that’s the psychological toll of going through IVF. Couples embarking on IVF can struggle to appreciate quite how gruelling, exhausting, frustrating and — for many — ultimately futile it will be.

Even for those for whom it is a success, the toil of treatment — the unpleasant hormone injections, surgery to retrieve eggs and then implant embryos, the weeks of waiting anxiously to find out if it’s worked — can leave nerves frayed and relationships on the rocks. I have two friends who are both now separated from their partners because of the strain of IVF treatment.

But because the technology exists, there is an implicit assumption that those who struggle to conceive will go down the IVF path.

It is sold as a definitive answer to infertility, when the reality is less straightforward. The brave new world of reproductive technology that was ushered in with the birth of Louise Brown promised a cure to the alleged blight of infertility. Yet this has not proved to be the case.

IVF still fails more often than it works. According to the NHS, IVF is successful for about one-third of women under 35. This drops to 13 per cent in women aged 40-42 and to 5 per cent in women aged 43 to 44. That’s pretty poor odds for something that is so costly and so emotionally draining.

A study conducted nearly 20 years ago showed that after five years or more, couples still had significant psychological problems, and that this was most marked in those who did not conceive, thanks largely to the sense of failure that this brings.

For all the joy it has brought to some, IVF has also heralded an era where childlessness is seen as even more stigmatised. Sadly, I fear it often causes far more problems than it solves.

Death of the family dinner

Eating alone increases the risk of obesity, according to research published this week.

It is thought that this is because people who eat alone are more likely to be isolated, which can have an overall impact on someone’s health. It also means they’re more likely to make unhealthy food choices.

But it’s not just single people who should take note. As our lives become more frenetic, sit-down family meals have almost become a thing of the past. From a medical perspective, I lament its loss. In fact, it’s actually something I go so far as to prescribe for families struggling with a mental health issue.

It does far more than make sure everyone in the family gets at least one proper meal a day, it’s also key to psychological well-being.

Family mealtimes used to be an opportunity to spot when youngsters were struggling or didn’t quite seem themselves. Now, too many children’s experience of mealtimes is a take-away or microwave meal eaten on the sofa, with no interaction, because half the family are glued to their phones and the other half to the TV screen.

It astonishes me that so many families I advise to introduce an evening meal struggle to implement it. No TV, no mobile phones — they are the only rules.

Yet time and time again it’s the parents, not the children, who can’t seem to do without constant stimulation.

Is it really any wonder that childhood mental health problems are on the rise?

Fewer bosses, more doctors 

The NHS is desperate for more doctors, and there’s an urgent shortage of nurses. Yet what does it get more of? Managers.

Latest statistics show the number of managers in the NHS has soared, with senior management increasing by 13 per cent in less than three years. This is shameful.

Part of my prescription to save the NHS would be to axe at least one entire echelon of management, as so many contribute absolutely nothing to patients.

A few years ago, one of the senior managers I worked with went on long-term sick leave.

No one had told me, and it was nearly six months before I realised she wasn’t working.

I’m sorry, but to me that says it all about what managers contribute to the overall running of the NHS.

Our MPs need a reality check

With increasing frustration, I have been watching the Westminster sex scandal unfolding.

Yes, the accusation that a rape took place and was hushed up is utterly chilling — and, if proven, unforgivable.

But the majority of the scandal has, to date, been a list of various people being propositioned, touched or spoken to inappropriately.

Of course, this is humiliating and it shouldn’t happen. But what has annoyed me is how hours and hours of time and energy have been devoted to dissecting these indiscretions, while I have patients who have been seriously sexually assaulted — and yet the provision for them is beyond pitiful.

In the past month, two of my patients have told me they’ve been raped: horrific, violent attacks that are likely to stay with these poor women for the rest of their lives.

I know them both well and spent several hours talking to them, but I’m not an expert in this area.

What has annoyed me is how hours and hours of time and energy have been devoted to dissecting these indiscretions, while I have patients who have been seriously sexually assaulted — and yet the provision for them is beyond pitiful

One, in particular, had started self-harming as a result and clearly needed specialist help — but what provision is there for these women?

One of my patients was too distressed to call the local rape support centre, so I did it for her while she sat in the room with me.

I was told that after an initial assessment by a nurse, victims are eligible for psychotherapy — but there’s a six-month waiting list. That’s half a year before they can even begin to get the support they need.

My question is, where are the campaigns to improve their lot?

I find the discrepancy between how politicians act when sexual assault is found to affect their tiny privileged clique and what goes on outside the Westminster bubble nauseating.

It is hard not to see the current fuss as self-congratulatory navel gazing when you compare the allegations with what has happened to some of my patients.

To me, this is the real scandal. Not the fact that some dull man in a grey suit made some smutty innuendo a decade ago.