Health InsurancePoorly Performing IVF Clinics Should Be Closed
BioNews publishes a controversial editorial by Dr Gedis Grudzinskas, Director of Fertility Focus Professional Services. If the same standards were applied to ivf centres as cardiac surgery, one in five ivf centres in the uk would be closed immediately.
With the HFEA about to publish its annual report, which includes not only how well IVF units have done in terms of babies born, comparing one centre to another but also an opportunity to see how they have performed year to year, Gedis Grudzinskas questions the viability of centres that under perform. Should they be permitted to continue and to do so unnoticed?
Having been Medical Director and Person Responsible of at least two of the largest UK IVF centres in both the public and private sectors, I am aware of the different quality of care in IVF centres. While one could argue that this does not affect patients" lives in the same way as cardiac surgery, it is nonetheless vitally important to those patients who are seeking IVF treatment and clearly hoping for a positive outcome.
When one studies this problem, it quickly becomes clear that there are centres which are performing at an international level as well as other centres whose outcome data is at least half, if not a third of that reported by the IVF centres in the top tenth centile of the 70+ IVF centres in the UK. It is disappointing to note that wide variations in outcome between the top and bottom performing units continue to be tolerated and perhaps ignored by the regulators and commissioners. Little attempt is made to share good practice and guide the underperforming units out of their unsatisfactory situation.
Anecdotally, centres that obtain advice from an external agent/re (be it scientific, clinical or a combination of both) invariably see an improvement in outcome data, even before all the recommendations made by the outside agent/re are implemented.
Why do underperforming centres not seek advice? If they do not, one could present a case for regulatory sanctions until such time as they do. Underperforming centres continue to receive public funding and are patronised by fee-paying patients. A few clinical leaders are proactive enough to seek independent advice as to how to fill any gaps in the safety and effectiveness of their IVF procedures. A change in attitude is necessary to improve IVF care in this country and reduce the wide variations in quality of care across the sector. As was once said, "I am not sure that standards will improve if we change but I am certain that we need to change if standards are to improve!".
Notes
Gedis Grudzinskas, is a Director of Fertility Focus Professional Services (FFPS is an expert unaffiliated, independent, multi-disciplinary, international network of infertility specialists). He works as a consultant in Gynaecology and Infertility, based at 92 Harley Street, London W1G 7HU
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