Warning: long ranty blog post alert!
I’m curious to know, has anyone successfully appealed against the NHS for the qualifying age limit for a fully funded IVF cycle?
In Windsor, UK, where I live, women over 35 do not qualify for any free rounds of IVF on the NHS. Apparently this policy applies across 10 NHS Clinical Commissioning Groups (CCGs – the bodies that decide the criteria on behalf of the NHS) across Berkshire, Buckinghamshire and Oxfordshire.
The reason our CCG gives for imposing this age restriction is:
‘In general, women in this age group are more likely to have a successful pregnancy through IVF than women who are older than 35.’
When I discovered the CCG policy in our area, I literally couldn’t believe my ears. I was 35-years-old at the time, with three weeks until my 36th birthday. You’d have to be ‘under 35’ before treatment starts, i.e. before your 35th birthday, so there was no chance for me.
We’d just literally bought a house in Windsor the month before. We’d intended to settle here for the medium term – why continue to pay rent when we could have a little place of our own? Well, if I’d known then what I know now, I would have bought somewhere else – perhaps a few miles away in Surrey – where you get two rounds of free treatment if you’re under 40.
Where is the sense in this post code lottery?
What made it even more galling was a friend of mine, who lives in central London, was just starting on fully-funded round one on the IVF at the same time. The CCG in her area funds three full goes on the NHS*, up to the age of 40. She’s the same age as me bar a couple of months, and lives 20 miles away.
How is this fair?
How is it fair that two women who are in the same boat – childless due to male factor infertility – have completely different treatment on the NHS? One gets three free rounds (and gets pregnant on the first one) and one’s £4K down, staring down the barrel of another £5K, or who knows how much more besides?
I get it, I really do. I understand how under-funded the NHS is, and how it has to prioritise the way it allocates its budget. And I know being infertile isn’t as ‘important’ as treating other illnesses and ailments.
But it’s the inequality and unfairness of it all. The policy should be the same across every CCG. There should not be women in my position seriously considering upheaving their lives to move into another area, just to qualify for free treatment. Women who are chucking their life savings down the drain just to have the same opportunity as other woman in the same position as them, up and down the country.
The CCG says it has taken into account the age discrimination laws enshrined in the Equality Act 2010 when making its decision, i.e. saying it’s within the law to discriminate against women over 35. So why has this CCG in Bristol recently decided not to go ahead with the same policy? It says for fear of age discrimination legal challenges.
Now I’ve been looking into this. I found this 2012 article that says to appeal against an NHS decision, you’d need to argue that the upper age limit (35) is not objectively justified, and that you should be treated as an individual and not written off by an arbitrary age limit.
The article also highlights one woman who was taking her primary care trust to court for being refused IVF because she was ‘too old’. But no matter how much googling I do, I cannot find what the outcome of this case was. Anyone know?
I’ve got an appointment with my GP next week as I want to get a private referral from them to – what a joke this is – an NHS clinic in Sheffield for our next round of IVF. (Why? Cos it accepts private patients, has great results and is way cheaper than anywhere in Berkshire. And my mom lives in Sheffield, so I’m hoping to stay with her through the treatment.) So at this appointment, I’m going to ask them about my right to appeal.
I mean, let’s be honest, how many people try to appeal in this process? Faced with thousands of pounds of private NHS treatment, who’s got another few thousand to throw at court fees? The CCG know this, and certainly have more financial clout than the likes of you and me.
But I still can’t help but wonder if it’s worth a punt… I’d love to hear from anyone who’s been down this route and what the outcome was. Is it worth it? Might they make an exception for me? Please get in touch.
*According to NICE, the body that decides which drugs and treatments should be available to patients on the NHS, women aged under 40 should be offered three cycles of IVF treatment on the NHS.