In vitro fertilisation for all?: Local decision making has led to inequality

doi:10.1136/bmj.327.7425.1226-d

BMJ 2003;327:1226 (22 November), doi:10.1136/bmj.327.7425.1226-d

Letter

In vitro fertilisation for all?

Local decision making has led to inequality

The first 150 words of the full text of this article appear below.

EDITOR—Ashcroft is right to point out that whether fertilitytreatment is funded by the NHS is essentially a political decision.¹He is also right to point out that the National Institute forClinical Excellence is not mandated and does not attempt tosettle questions on any basis other than clinical effectiveness.However, his prescription for leaving decisions about fundingfertility treatment to a mythically accountable local levelis a recipe for perpetuating discrimination and lack of accountability.

The issue of access to fertility treatment is now on the nationalpolitical agenda partly because of the lack of accountabilitylocally. How are equity and fairness better served by currentmethods of local accountability than by centrally peer reviewedand clinically effective advice? Either the NHS as a whole subscribesto these basic concepts or we might as well drop the "National."

Raj Mathur, locum consultant

Addenbrooke's Hospital, Cambridge CB2 2QQ rajmathur@repromed.co.uk

Competing interests: RM works in an NHS reproductive . . . [Full text of this article]

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