Patients are switching GP practices to try and ‘get around’ rationing of services such as IVF, a health minister has claimed.
Jackie Doyle-Price criticised the ‘unacceptable’ disparity in health treatments across the UK for creating postcode lotteries.
She claims women are signing up with surgeries further away from their own home because their own CCG does not offer enough rounds of IVF.
Ms Doyle-Price said her own CCG has recently cut the number of courses from three to two – going against official guidance.
Patients are switching GP practices to ‘get around’ rationing of services like IVF, health minister Jackie Doyle-Price has claimed
Speaking in the House of Commons last week, she said: ‘The postcode lottery is not acceptable, and patients manage to get around it.
‘My local CCG, having funded three courses of IVF, has had to reduce that to two because demand has doubled owing to the lack of provision in neighbouring CCGs.’
Ms Doyle-Price later confirmed she meant patients switch to a GP operating under a different CCG that offers more rounds of IVF.
Ms Doyle-Price was responding to a question in parliament from MP Rachel Maclean, who said: ‘Provision of IVF in Redditch has been reduced from two cycles to one.
‘I warmly welcome the work that the minister has done to increase equity across the country.
‘But what more can she do to address the postcode lottery in this and other areas, such as hip and knee surgery?’
CCGs, or clinical commissioning groups, are the local boards in charge of funding for GP surgeries and hospitals in the area.
They ration procedures, including hip replacements, cataract surgery and diabetic glucose monitors, in order to save money to redirect it elsewhere.
Patients can switch GP practice to one that is not in their area under the out-of-area patient choice scheme which came into effect in 2015.
GP practices can register new patients who live outside the catchment area, without any obligation to provide home visits.
BEST AND WORST AREAS FOR IVF
A report by Fertility Fairness released in October 2017 provided a ‘league table’ of NHS-funded IVF provision in England.
Top of the league (providing 3 cycles and least strict criteria):
- NHS Bury
- NHS Heywood, Middleton and Rochdale
- NHS Oldham
- NHS Tameside and Glossop
Bottom of the league (providing none):
- NHS Basildon and Brentwood
- NHS Cambridgeshire and Peterborough
- NHS Croydon
- NHS Herts Valleys
- NHS Mid Essex
- NHS North East Essex
- NHS South Norfolk
The full table can be seen here.
Approximately 99,000 people are registered with a GP this way, according to NHS data.
However, it is not clear how many women may be using the scheme to benefit from more IVF cycles.
Dr Richard Vautrey, of the British Medical Association, said: ‘The BMA has always been clear that patients should have access to all NHS services wherever they live.
He added that the BMA appreciate commissioners ‘are under pressure to meet rising demand despite increasingly stretched resources’.
However, Dr Vautrey said: ‘National access to services should be equitable, clear and non-discriminatory.
‘If, as a result of CCG financial pressure and cuts to services, patients feel they have to switch to another CCG to access treatments that are not available in their own area, it not only underlines the unfairness in these commissioning “postcode lotteries”, but also risks destabilising the way local services run.’
Guidelines from watchdog the National Institute for Heath and Care Excellence (NICE) recommend eligible women under 40 should be offered three full IVF cycles.
However, figures from 2018 reveal that only 13 per cent of areas in England offer three cycles. This is down from 24 per cent in 2013.
The campaign group Fertility Fairness highlighted how, in some parts of the country, couples have to pay thousands of pounds for private treatment, while other trusts provide a full service funded by the taxpayer.
NHS pension reform ‘ready by next week’
By Sophie Borland, Health Editor for the Daily Mail
Doctors’ pensions are set to be overhauled following warnings they are causing a staffing crisis in GP surgeries and hospitals, sources said last night.
The Government is finalising a new deal for their pension schemes which would allow the staff to side-step punitive tax bills.
Thousands of GPs and consultants have cut back on their hours or taken early retirement as a result of Treasury rules introduced in 2016.
The legislation has resulted in doctors being charged for paying more than £10,000 into their pensions each year and then billed again if the value of the pot exceeds £1million.
This week a survey by the British Medical Association found 42 per cent of GPs and 30 per cent of consultants had cut back on their shifts to avoid being penalised.
The Department of Health and the Treasury have been drawing up reforms which would give doctors greater flexibility with their pension contributions.
Doctors could decide to put very little money into their pots and take a much larger salary, thereby avoiding the tax bills.
One source told the Mail a deal was ‘very close’ and that if the proposals are agreed by both government departments, they could be announced as early as next week.
Seven CCGs out of 208 have reportedly stopped offering IVF on the NHS entirely.
Ms Doyle-Price said: ‘I have made it very clear that it is unacceptable for any CCG to offer no IVF cycles at all, I have given them that guidance.’
Ms Doyle-Price’s local health board, NHS Thurrock CCG, said it was ‘correct’ that there is variation in IVF treatment offered by CCGs.
Ms Maclean’s CCG NHS Redditch and Bromsgrove said it made the decision to cut the IVF cycles two years ago due to a ‘financial challenge’.
HOW DOES IVF WORK?
In-vitro fertilisation, known as IVF, is a medical procedure in which a woman has an already-fertilised egg inserted into her womb to become pregnant.
It is used when couples are unable to conceive naturally, and a sperm and egg are removed from their bodies and combined in a laboratory before the embryo is inserted into the woman.
Once the embryo is in the womb, the pregnancy should continue as normal.
The procedure can be done using eggs and sperm from a couple or those from donors.
Guidelines from the National Institute for Health and Care Excellence (NICE) recommends that IVF should be offered on the NHS to women under 43 who have been trying to conceive through regular unprotected sex for two years.
People can also pay for IVF privately, which costs an average of £3,348 for a single cycle, according to figures published in January 2018, and there is no guarantee of success.
The NHS says success rates for women under 35 are about 29 per cent, with the chance of a successful cycle reducing as they age.
Around eight million babies are thought to have been born due to IVF since the first ever case, British woman Louise Brown, was born in 1978.