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Friday, 20 May 2011

In the News: The Telegraph "Infertility...a condition the NHS can ill-afford to treat"

I was alerted to something by a great infertility blog  - although I am in the UK I have never bought or read The Telegraph and was disgusted to read this particular article, arguing that the NHS, with all it's money woes, should not be funding IVF treatment.

Max Pemberton - apparently a "child psychiatrist" (so obviously very well placed to spout about fertility problems) - does not believe infertility is a disease. He is even reluctant to classify it as a medical problem at all. He blathers on that "While childlessness is distressing, it is not associated with long-term disability, morbidity or mortality...Rather, it is about people unable to have something that they want."

Good lord! My sincere apologies, Max. All this time while trying to figure out why my body doesn't work right and coming to terms with the fact that I may never be able to do the most natural thing in the world - have my own child - I thought I was dealing with a medical problem. A condition. An internationally recognised syndrome. After reading your thoughtful article I now see that really I am just a spoilt child in a toy shop, screaming and stamping my feet because my mum won't buy me a Sindy doll. 

I also now see that, far from wanting a child being about my own natural desires, a wish to create something out of the love me and my fiance share, about fulfilling not only a basic, normal human urge but something I want to devote the rest of my life to, actually, I'm just trying to keep up with the Joneses. An "expectation on individuals to reproduce and become parents...childlessness is a status that does not readily fit within society’s cultural norms". I just want a baby because it's what everyone else has got. 

And of course, why am I putting myself through all this when "It’s not as if such people are being denied the chance to be parents at all. Adoption offers them the possibility of parenthood". Why don't I just apply for a child this weekend? Two maybe? I'm sure no time at all I'll forget all my problems!

To cut my sarcasm short, this article is ill-conceived (pardon the pun), badly constructed and downright rude. He is aligning fertility with something like freckles. Some people are born with them, some aren't, and why should the NHS fund giving you an item of such vanity for the sake of fashion? Freckle-less people aren't ill, their lives aren't about to be cut short, and there is no underlying medical problem causing you to be freckle-less. Of course, this is total tosh when applied to infertility. The vast majority of people with fertility issues - even if they are currently under the banner "unexplained" - have an underlying medical reason for that infertility. And - worse than that - increasingly environmental factors are being found to harm the delicate hormonal balances in the human body - toxic chemicals in plastics, certain foods, pestacides.

Let's look at it logically: the human race's ability to reproduce is the reason for our continued existence. If infertility had been rife in our ancestors, we may not have survived as a species. Therefore fertility is the norm; infertility is where there is a problem. Infertility doesn't just "happen" to some people due to "a quirk of fate" as Max so eloquently puts it. It is an abnormality somewhere in our systems. Bodily functions not working as they should. Totally against what our bodies are meant to do. Is this not what constitutes a medical problem?

Max implies that as infertility is not life threatening, it is not as important as "real" medical problems. But what about people with serious burns scars or phobias, or amputees? Reconstructive surgery after a masectomy? People who can't walk or talk because of a stroke? They're definitely not life threatening conditions, so probably shouldn't receive any NHS funding either. In fact, Max, by your own logic, you should be out of a job, because I'm fairly sure child psychiatry isn't one of the leading areas associated with "long-term disability, morbidity or mortality" which apparently is the criteria for determining whether or not you deserve help from the service you pay for.

The fact is, so much of what the NHS funds now could be classified as helping to improve quality of life, instead of extending life. Slot infertility into this category if you will - I see it as something more than that - but even if you accept it as only a "nice to have" rather than "vital" treatment, you align it with a huge proportion of what the NHS offers unchallenged.

Max also seems to imply that those who can't conceive should just accept that it's a natural condition, a quirk of fate. Well, by that logic, people who develop cancer or heart disease should just accept it as a "natural" condition - their body telling them they shouldn't live any longer. Should they be denied treatment too?

Basically, if you rule out treatment for anything that is not life threatening, and anything that just happens to people as a natural "quirk of fate", the NHS would only provide treatment for serious accidents, and a small minority of conditions directly caused by external environmental factors, such as asbestosis or radiation poisoning etc. Everything else would have to be paid for privately. 

Yes, there is only a limited amount of money and resources available, and yes, we have to prioritise. Which is why most NHS Trusts offer a maximum of 1 or 2 IVF cycles per elligible couple. Personally, if funding has to be cut from anywhere, I would much rather see the NHS stop helping people who have actively and directly caused their disease or condition: chronic overeaters, smokers, drug takers, alcoholics etc. - why should my taxes pay for them to receive treatment?

Which brings me to another point. The NHS is funded through my taxes. I therefore have as much right as anyone else to use the NHS to deal with my medical problems. I don't take up resources with my chronic fatigue or IBS, and I've been suffering with anxiety for most of my life without medical intervention. Why should I potentially be denied NHS funding for the one service I would actually pursue and use?

I would love nothing more than for the NHS to put more money into finding a cure for the various ailments that cause infertility, which would save them a hell of a lot of money in the long run. Unfortunately, it is considered to be too expensive, and the money is better spent treating the symptoms of these various ailments - among them infertility - than finding out why it occurs in the first place. If I could do something to naturally correct my PCOS, I would. But I can't, and so I will take all the medical assistance I can get. 

Of course, our friend Max puts a cherry on top by trotting out the old adoption solution, fall back of anyone who is anti-fertility treatment, anti-procreation, anti-life. What these people fail to realise is that wanting to have a child - your own biological child - is an inherent, deep rooted, totally natural urge, not a lifestyle choice, especially for those who can't conceive naturally. Does he think people suffering with infertility would willingly put themselves through intensive treatments, invasive procedures and years of emotional turmoil just so they can be like their friends? NO - this is something that goes through to the very core of what being human is about. Adoption is a fantastic option for some couples, but it isn't the solution for all. And with the ridiculous constraints on adoption, the lengthy and expensive processes and no guarantee of a positive outcome, it is more than many, who have already been through the mill with infertility, have strength for.

Finally I consistently find it baffling that so many consider the prolonging of life more important than creating new life. That intervening to make someone live 1, 5, 10 years more when their bodies have had enough is seen as a societal norm, yet assisting conception - the continuation of the species - is attacked. And then when we get people to live longer they get shoved in a nursing home and treated appallingly. It's a messed up world.

ETA: Ironic that the Telegraph doesn't produce an opinion piece on other, much more ludicrous, means of "wasting" NHS money...see here and here for just two examples that I found in their recent news.

Final edit: And now it all becomes clear. Max is a homosexual male. Max obviously does not see himself having any children naturally, and his article is sour grapes perhaps at the fact that he will have to pay for his children no matter what. Case closed.

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