Why the NHS should fund infertility services.

Some trusts have adopted a system of a "ring-fenced" allocation per head of consultant and if any of this funding remains unused it can be carried over to the next financial year. The time is right for the Government adequately to fund the CME/CDP activities of career-grade hospital staff. (This should include part-time staff. A doctor who works half time must not be half trained). In view of the travel distance involved, the costs of courses, and the rising cost of hotel accommodation, I suggest that more realistic funding might be achieved by the provision of funding of £100 per CME point obtained for courses outside Northern Ireland and a lesser sum for local courses depending on the distance of the Trust from Belfast. make use of assisted reproductive technologies annually. Currently in Northern Ireland, no public funding is available for in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI), (College of Health Report, 1997/8). Treatment, therefore, depends solely on the couple's ability to contribute financially towards the costs incurred. Pressure to ration and prioritise treatments within the NHS is significant. The 1995 House of Commons Health Committee report on priority setting in the NHS stated that the NHS must remain responsive to shifting public concerns and debate. Bowling (1996) randomly sampled the views of the British population. Out of twelve possible health priorities interviewees ranked 'treatments for children with life threatening illnesses' first and 'treatment for infertility' eleventh, just above 'treatment for people aged 75 and over with life threatening illnesses'. However, when the public is asked, in isolation, if infertility treatments should be funded by the NHS their answer is different. For example, 84% of medical students at Queen's University felt that infertile couples should not fund their own infertility treatment. (Moore et al, 1998) Caldwell et al (1998) in another study reported similar findings. In dealing with the issue of infertility, there is, amongst the community at large, a lack of understanding of the associated stresses. Diana, Princess of Wales famously remarked when she was patron of 'Birthright', a research charity of the Royal College of Obstetricians and Gynaecologists, that "infertility was not a disease and people should get on with their lives". In Northern Ireland particularly, the situation is further confounded by an active fundamentalist religious lobby which sees assisted reproduction as immoral. In other areas of health service provision there are nationally set minimum numbers …