A tale of two health services
When I found out that falling pregnant would involve either a) the second immaculate conception or b) scientific intervention, it was a distant and abstract notion. At the time, single and living in the UK, I took comfort in the knowledge that we have a progressive, free national health service which takes pride in waving magic wands and bestowing little babies on poor unfortunate souls such as myself. A bit like Ursula the sea witch but less curvaceous. I assumed that, when I located the man lucky enough to spend his life by my side, we would pop down the local clinic and ‘Ta da!’ — a perfect ginger baby called Theophane-Monet Van Winkleburg. The Third. If one is going to be bullied as a child, one may as well give the little fuckers too much material to work with, and confuse them.
In the event, the lucky man seems perplexingly unaware of his luck, and prefers travelling alone to Vladivostok in the dead of winter rather than a life by my side, but never mind. He’s legally bound now and is too tight to pay for a divorce lawyer, so let’s assume he’ll stick around for a while. Or fake his own death.
When we moved back to London from New York, where a single cycle of IVF with donor eggs cost upward of $20k, or 40 cocktails at our favourite NYC bar, we (and by this I mean ‘I’) had a vague idea of wanting a family at some point in the coming years. Now you may or may not be aware of this, but it transpires that your ability to get the NHS to fund fertility treatment is almost entirely a matter of chance. What follows is a step-by-step account of our ultimately unsuccessful attempt…
Step 1 — pick your postcode
We (again, continue to assume this means ‘I’ unless I indicate otherwise, which I won’t) chose to move to Islington borough, which according to the official guidelines will fund 2 cycles of IVF if you’re under 40 / don’t smoke / don’t already have kids in the relationship / aren’t a member of UKIP / recycle.
Step 2 — register with GP
At this point I should state that I generally have nothing but respect for GPs. Some of my very good friends are GPs, and I fully recognize that they are central to strong communities, work well over their paid hours, and spend far too much of their working life filling in forms and listening to the idiotic British public (I include myself) complain about a sniffle / the weather / the price of fish / the size of their boobs, than actually helping people. Unfortunately, having said that, I do seem to have a tendancy to locate GPs who don’t actually like other humans, alongside all the above annoyances. This pattern continued in Islington, with a GP who basically rolled his eyes when I explained I had premature ovarian failure, scribbled a quick referral to a fertility consultant, and crossed himself as I stormed out.
Step 3 — go through the diagnosis ALL OVER AGAIN
In order to get into the system and on the waiting list for IVF treatment, you need a referral from the Borough Fertility Guru. Or The BFG as I imagine s/he is known. This was 4 years after my original diagnosis and involved another few visits to a hospital to have bloods taken, internal scans, prodding and poking etc, to be diagnosed with (drum roll…) Premature Ovarian Failure. What an excellent use of taxpayer money that was.
Step 4 — general confusion about funding guidelines
At this point, the fertility nurse (not sure where the actual consultant was during all this, possibly counting his money and playing Candy Crush) casually announced that Islington borough would almost certainly NOT fund our IVF treatment. The meaning of this sentence did not change when she repeated it. Upon further questioning, complete with two-way mirror and waterboarding, she elaborated upon this alarming new information:
Nurse (who for the record was lovely, but ‘lovely’ doesn’t make for a funny tale): ‘you see, your follicule-stimulating hormone levels are reeeeeeeally high. Like, over 35. A NORMAL woman of your age is under 20’.
Me: ‘I’m sorry, are you under the impression you are telling me something new?’
Nurse: ‘I see your sarcasm, and raise you a reality check. The NHS will take one look at them hormones, assume a zero chance of successfully retrieving any eggs from your ovaries, and won’t waste their precious IVF pennies’
Me: ‘wait, they’ll assume we’re going to try and do this with MY eggs? The eggs I no longer have? Do they think I’m a complete moron laboring under the illusion of overflowing fertility?’
Nurse: ‘is that a rhetorical question?’
Me: ‘oh, a joker are we? We’ll use a donor egg. We’ll even fund it if necessary. We just want funding for the procedure’
Nurse: ‘ok, well let’s pretend that the NHS isn’t stretched to breaking point, and has the capacity to individually review every funding request. Your GP will need to submit an appeal’
Me: ‘can’t you do it? Please? Don’t make us go back there’
Consultant (who had wandered in off the streets at some point during this exchange): ‘No. Here’s a letter for the GP explaining you have a severe form of female infertility, which is a medical condition and not a lifestyle choice. Now please leave’
Step 5: Submit the least appealing appeal since…some event in history when a half-arsed appeal was submitted
So we return to the GP, explain the situation, explain what needs to be done, explain that the consultant said the GP has to do it, explain that I don’t know why, explain that I don’t care who does it as long as it gets done, explain that this is actually quite important to us. Special funding request is submitted. I am not exaggerating (genuinely) when I say that, beside my name, address and NHS number, the answer to each and every question on that form was ‘see letter from consultant’. It was a masterpiece in not giving a shit.
Step 6: write to our MP demanding help and fair representation
This was my favourite bit of the whole fiasco (to, be fair, there wasn’t much competition). Partly because we got a reply on thick cream paper headed by the House of Commons portcullis logo that sort of looks like the gate I imagine prisoners at the Tower of London went through before being beheaded. But mainly because our MP is Jeremy Corbyn. For any non-Brits reading this (and, for that matter, any Brits who understandably think politics is a waste of time) Jeremy Corbyn is the new leader of the British Labour party and something of a personal hero. He is about 85, looks like he hasn’t washed since Glastonbury 1974, was divorced by his wife for refusing to send his son to a private school instead of the local state school, and refuses point-blank to acknowledge that being the possible future Prime Minister requires him in any way to behave differently to how he has behaved as a maverick, Socialist back-bencher for the last 50 years. I adore him. So imagine my delight when he (definitely not a junior member of his staff) wrote to the NHS on our behalf demanding that the funding request be given due consideration. His letter has replaced our marriage certificate on the mantelpiece.
Step 7: appeal rejected
Despite Jeremy’s (DEFINITELY NOT A JUNIOR MEMBER OF HIS STAFF) best efforts, the spectacularly ill-written appeal form and spectacularly inflexible funding guidelines resulted in a rejection of our funding request. Apparently there was not sufficient information on the medical reason behind the request. Shocking.
I’m obviously making light of all this, because time makes amusing all things, but it really was a kick in the teeth. As I’ve mentioned before, one of my core values is fairness, and being told that the medical system I’ve paid into since age 16 wouldn’t help me overcome the only real medical problem I’ve ever had, pissed me RIGHT off. I remember being with my sister and collecting the appeal decision from the GP receptionist — apparently it didn’t warrant someone actually telling me face to face — and just sitting in the park and crying. I felt deflated, angry, and let down. I am also acutely aware that we are fortunate enough to have the financial means to get private treatment, but there was no small amount of cruel irony in moving from a country with a hugely expensive private medical system to one with a national health service, and ending up in exactly the same damn place.
So we now had two options. 1) Continue to fight the good fight; campaign against the decision; write to the Daily Mail; risk Katie Hopkins saying people like us are responsible for child cancer, appear on GMTV with red-rimmed eyes etc. 2) Throw money at the situation and go private.
You can probably guess which route we went for.