When it comes to NHS funding, why should a childless couple lose out to an ailing smoker?

Lighting a cigarette is a free choice, being infertile is not

"Most of the women I spent interminable hours sitting alongside at my IVF clinic had, like me, been trying for a baby for years"

Let me start with a simple, straightforward question. Who do you think has a greater right to scarce NHS resources: a smoker who wants to kick the habit, an obese person with diabetes, or a couple who desperately want a baby but cannot conceive without medical intervention?

If you had asked me that question a few years ago, I would not have hesitated to say that IVF should be a low priority for the NHS. There is no God-given right to have children and the needs of the healthy-but-infertile should never be given priority over those of the genuinely sick.

Tough decisions have to be made, so no surprise that earlier this week we learned that clinical commissioning groups (CCGs) in many areas of the country are now choosing to deny couples access to IVF to save the NHS money. Indeed, only a fifth still offer the three full cycles of NHS-funded IVF that the health watchdog Nice’s guidelines say most couples should get.

When people are dying of cancer, how can we possibly spend thousands upon thousands helping perfectly healthy people have babies? That’s a view that, not so long ago, I would have fully backed. But then something happened to change my mind.

It wasn’t when I started paying for IVF myself, shelling out thousands of pounds because, at the age of 42, I was too old to qualify for NHS funding. And it wasn’t even when the bills mounted up to £25,000 with no baby to show for it.

In fact, it was while I was standing at the pharmacy counter waiting for a prescription in Boots and the man ahead of me in the queue was angrily arguing with the pharmacist because his doctor’s regular three-week prescription for nicotine patches had mistakenly been made out for only two. It was, he said, his “right” to obtain nicotine patches for free.

Meanwhile, I was preparing to spend £250 to buy just one day’s drugs in a desperate bid to boost my chances of conceiving a baby. Yet he had freely chosen to spend his money on cigarettes; I had not chosen to face the struggle of infertility.

The NHS happily spends billions to help smokers kick the habit, or to treat smokers for lung cancer or heart disease. Even more cash is spent on diabetes medication for the obese. Though the arguments for such spending are valid, how is it right or fair that, in some areas, the infertile no longer receive a penny towards their treatment? Lighting a cigarette or preferring a poor diet over healthier foods are free choices, but it is wrong that being infertile is now considered a lifestyle choice when applying for support.

Couples seeking IVF are typically not selfish high-fliers who have put their careers ahead of their family only to discover too late that they can’t get pregnant. On the contrary, most of the women I spent interminable hours sitting alongside at my IVF clinic had, like me, been trying for a baby for years. Some, like me, had repeatedly miscarried; one had a husband who had suffered cancer, so could not conceive without help. Under the new NHS allocation system, these women are deemed to be less deserving of NHS funding than those who need support to stop smoking.

If we want scarce NHS resources to be targeted at those in genuine need, wouldn’t it be a good idea for us to work out who really does – and doesn’t – need it?