Health ministers must have thought it was their birthday and Christmas come
at once when mother-of-sextuplets Jean Gibbon was discovered to be a single
Two weeks earlier health ministers had been pilloried by every infertility
specialist within reach of a TV studio. Support groups and campaigning organisations
had used National Fertility Week to expose the diabolical provision of infertility
services in the UK. In France women are entitled to four state-funded cycles
of IVF (in vitro fertilisation) as a right, plus another two at the
discretion of their con-sultant. Here, women across much of the nation (including
London) have no access to NHS provision at all. The infertile have to shell
out around £1800 a go for IVF with only a slim chance of it working.
A national disgrace. Politicians said it. Doctors said it. Psychotherapists
said it. Articulate women were paraded to explain the agonies of childlessness.
One specialist got so carried away he declared that infertility provision
was more important than cancer treatment. It takes all sorts....
But within two weeks the birth of the Leeds sextuplets had changed everything.
The worm had turned, problems of getting infertility treatment were forgotten
and everybody was attacking doctors for rashly providing IVF with no thought
to the consequences.
Why the change of heart? The plight of nicely spoken, educated, middle class
but barren couples talking of their longing for a child tugs at the heart
strings. After all they have so much to give. On the other hand, the birth
of six infants to Jan Vince and Jean Gibbons, a working class, unmarried,
pair of divorcees who don't even live together raises different issues entirely.
When the media and political circus discussed the Leeds sextuplets the issue
was not one of how much did the parents have to give - but how much were
they trying to take. They were pilloried for having an agent with a brief
to sell their story to a national newspaper and they were castigated for
the amount that it would cost the state to raise their six children. The
health correspondent of the Daily Telegraph calculated that Jean
Gibbons would receive 'at least £45 000 in benefit over the next
There was not just the cost to the nation to be considered, but the emotional
cost to the children of being born to such inadequate and unconventional
Tom Sackville strutted on the stage to threaten new guidelines if there
was widespread evidence that people 'without a stable family background'
were receiving infertility treatment on the NHS. And the very consultants
who two weeks earlier had pleaded for more resources now lined up to insist
that they really did very, very little infertility work at all. And when
they did it was only after vetting couples very closely. Health authorities
competed to look the toughest at screening 'unsuitables'. The head of the
IVF unit at St Mary's Hospital, Manchester bragged that his hospital only
treated childless heterosexual couples who had been in a stable relationship
for three years. West Essex Health Authority topped that with four years.
The Leeds sextuplet case should have served as an example of what National
Fertility Week had tried to illustrate earlier in the month: the inadequacy
of the service. Champion of the infertile, Professor Robert Winston shone
as the one light of common sense when he insisted that to use the Leeds
case as an illustration of an abuse of the system was bizarre. Regardless
of the parents' marital status, the very creation of sextuplets was a disaster
for everybody concerned.
You can bet your sweet life that given the choice Jean Gibbons would rather
have conceived one child than half a dozen. It was adisaster which could
only have happened because of the primitive way in which services are managed
in many hospitals. With proper monitoring the treatment she was undergoing
would have temporarily halted when it became clear she was at risk of a
multiple pregnancy. But as Winston explained to a largely uncomprehending
press, 'In the NHS doctors work with grossly limited and inadequate resources.
Short cuts have to be taken'.
Instead of being highlighted as an argument for a better health service,
Jean Gibbons' case was widely used to reinforce the point that NHS resources
should only be available to the 'deserving', defined as those who not
only have an illness which by general consensus requires treatment, but
also a way of life considered worthy of public support.
When Tim Yeo MP declared that 'there are serious questions about why such
treatment should be provided to a woman who is not married', the only objections
were to his use of the adjective 'married'. Nobody seemed to question the
fact that the medical profession and by proxy the government should have
the right to impose moral criteria for assessing who should and should not
have access to NHS resources. Game, set and match to the government.
Once this principle is established all kinds of provision can be denied
on the basis that the recipients are not deserving. There are already doctors
who give smokers lower priority than non-smokers because they have contributed
to their illness. How long before we have to lose weight, swim every day,
and be married and monogamous for 10 years in order to sign on with a doctor?
On what criteria will doctors decide who is deserving of Hormone Replacement
Therapy, hip replacements or heart by-passes?
The government's economic problems mean that public spending is being squeezed
hard. By introducing a discussion about who does and doesn't deserve the
limited resources available, the authorities pose the provision of care
as a moral problem of who deserves it - rather than a discussion of why the
resources are not available to all. We should have none of it. Jan Vince
and Jean Gibbons should be entitled to infertility treatment without the
humiliation of being vetted to make sure their lifestyle is suitable. Doctors
should be doctors not vets.
Reproduced from Living Marxism issue 57, July 1993