Do people “deserve” fertility treatment?

So, let’s take two very cute children who need operations to help them walk, an obese man and a couple who can’t have children and ask who is most “deserving” of NHS treatment. Last night Channel 4 aired a programme on the NHS which started from the premise that we need to ration treatment and used some figures seemingly calculated on the back of an envelope to decide how much funding different treatments might cost the NHS and then put them against one another.

The couple featured who needed IVF had fertility problems due to the woman having an STI when she was younger, and they were being denied treatment because the male partner had a child from a previous relationship – so already value judgements were being set when it came to deciding who should and should not receive medical treatment. We were told that their treatment would cost the NHS £10,000 – in fact as this was a younger woman with blocked tubes, it was far from certain that she would need three cycles of IVF – but it didn’t stop the programme makers showing us what other vital tasks the NHS could use £10,000 for. The team were very well aware of the fact that we don’t actually know how much IVF costs the NHS as this varies hugely from area to area and we have no national tariff- but the real issues weren’t a story they were covering here.

Most of the ire on Twitter about the programme was directed at the obese man who needed weight-loss surgery, and there were some angry tweets suggesting that NHS spending should be reserved for ‘life-threatening” conditions – quite bizarre as the vast majority of us only use the NHS for non life-threatening conditions and I suspect these same people would object fiercely if they were told they were not allowed to visit their GP unless their life was at risk. And of the cases featured it was the obese man who probably had the most life-threatening condition, not the sweet children.

It’s hugely depressing that anyone should feel a need to put different patients up against one another to decide who is most “deserving” of medical treatment – and what we should be asking is not who we should allow to be treated, bur rather where this kind of debate takes us.

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