16 Aug 2009 Want a Baby? Thanks to Government Health Care, In Britain Becoming a Parent May Depend on Where You Live
Everyone over a certain age knows what you have to do if you want to have a baby — that is, except in Britain, where for some couples, the route to parenthood lies in changing their home address.
That’s because Britain’s government-run health care system, the National Health Service, or NHS, decides whether to provide in vitro fertilization (IVF) procedures to couples based in part on their home address.
It’s a situation known as the “postcode lottery” to ordinary Britons, who have long known that their ability to get knee replacement operations, cancer-curing drugs and other medical services and procedures may be granted — or withheld — from them simply because of where they live.
Now, thanks to a survey by a Member of Parliament, it’s become clear that its not just quality-of-life and death that may be determined in the postcode lottery, but the opportunity to be born itself.
MP Grant Shapps found that the regional primary care trusts under which the NHS operates have widely divergent rules covering when couples are eligible to receive IVF services, despite the existence of uniform national recommendations set out by the British government’s National Institute for Health and Clinical Excellence, or NICE.
Under NICE recommendations, women under 40 should be eligible for up to three cycles of IVF on the NHS. Nonetheless, in some areas it was unavailable to women aged 23-39. In others it was available only to women aged 37-39.
In about half of Britain, the NHS declines IVF services to couples in which one partner already has a child. Likewise, in half the country couples are required to have been in a relationship with one another for at least three years before seeking treatment, while in other areas there is a shorter time requirement, or none.
In many parts of Britain couples who smoke are ineligible for IVF, although some regional trusts relent if only the man smokes.
Despite NICE guidelines calling for access to three cycles of IVF on the public NHS system for all women under 40, Britain’s Department of Health said only 30 percent of regional primary care trusts provided three cycles, 23 percent provided two cycles and 47 percent one cycle.
Watch for The National Center for Public Policy Research’s upcoming new book, Shattered Lives: 100 Stories of Government Health Care, for more on “postcode lotteries” and rationing in countries with government-run medicine.