Industry | 2010.08.31
In the name of purity, public funds are wasted on the rich | Simon Jenkins
From IVF to universities and museums, Britain\'s aversion to charging for services punishes women, students and the poor
The Human Fertilisation and Embryology Authority plans to allow payment for donated eggs and sperm for in vitro fertilisation. At present donors receive no more than £250 for "expenses and loss of earnings", resulting in dwindling donations – with at the last count just 1,150 egg donors in the UK and barely 400 sperm donors – to meet a soaring demand from infertile couples.
If we do not pay what the market requires, we will get shortage, profiteering and unfairness. The welfare state has become monumental proof of this. Yet it still treats money as something dirty, likely to bring out the worst in people – except its suppliers. Couples (and even donors) travel to Spain, America, Cyprus and east Europe where regulators are less horrified by money. The price for a cycle of donated eggs in Spain is £740, and in America it can reportedly rise to £3,000. Some clinics now import gametes, while the waiting list for treatment is up to two years and the cost of a cycle can be £15,000. In Barcelona there is no wait and a cost, with travel, of £9,000. Success rates are often better abroad.
Every IVF story asks the Catholic church to comment, knowing it is opposed. So reports on paying for eggs had "experts … warning that the move would see women donating eggs purely for money". What does "purely" mean? Donation is intrusive and merits compensation. There is no mention of men falling victim to such deplorable motives for donating sperm.
Money-loathing is rife in British public service. In higher education the new minister, David Willetts, is confronting the same syndrome. There is rampant overdemand for places, yet the government intends to fine any university that admits more students. Every extra one costs Willetts money because he dare not allow universities to charge market rates as this would relate education, a good thing, with money, a bad thing.
Willetts is the answer to a Leninist prayer. He has a student numbers norm, and the world must obey it. Yet he is not fining overseas student places, which are beyond his moral realm. As a result, universities are rejecting qualified home students in favour of less qualified foreigners. Public money is not being used rightly, to aid poor students, but to subsidise all students to avoid poor British ones "feeling stigmatised". As with gametes, a government fixated on levelling some ethical playing field is stifling supply and punishing demand.
Similar price aversion prevents the NHS rationing by charges, for fear of identifying cash with wellbeing – though curiously not for prescriptions. It prevents state museums from charging lest it identify money with art – though curiously not for "special" exhibitions. It prevents motorway tolls because some Mr Toad in Whitehall thinks "the open road" should be free. It prevents bus companies charging the elderly, however well heeled, because they are thought too decrepit to endure the shame of paying.
The public sector still lurks in the shadow of postwar socialism, of Start-rite shoes, Bisto kids and cod-liver oil. The result is an imbalance of demand and supply, and profiteering by the beneficiaries. Compared with most of Europe, Britain has overcrowded surgeries, desperate universities and jammed motorways, while doctors, dentists, vice-chancellors and road contractors walk away with shedloads of money.
As a former member of the HFEA, I argued incessantly that over-regulation would lead the IVF market, in which Britain was then world leader, to vanish abroad. It would increase the cost, inconvenience and/or danger of fertility treatment for British women. British IVF would become exclusive and expensive. That has happened. To the HFEA\'s credit, it has recognised this.
Most colleagues on the authority at the time, notably the women, refused to make any decision with the taint of filthy lucre. The sale of eggs would expose poor, impressionable women (suborned by evil men) to a temptation their weak natures could not resist. These patronising arguments were like the old debate on abortion. Women could not be trusted to make decisions about their own bodies. It was a socialist state\'s duty to protect them.
As a result the authority spent ridiculous amounts of time trying to "compensate" donors while preventing them from benefiting financially. What should be the mileage allowance for cycling to the clinic? Could women claim for a taxi, or should they use public transport? What was an appropriate level of lost earnings? Yet the authority sneakily allowed women undergoing fertility treatment to pay thousands of pounds less if they shared their eggs. This was blatantly "paying" for eggs.
A government body charged with deciding ethical niceties over the range of embryology research and practice ended by creating its own moral nonsense. Tight regulation made fertility doctors among the richest in the profession and turned clinics into money-making machines.
The only victims were women who needed eggs and could give them. Women were charged exorbitantly by over-regulated clinics and went abroad in increasing numbers, where treatment was quicker, cheaper and, on some evidence, more successful. The only people expected to behave altruistically in this high-profit business were donors.
Many public services – not least hospitals – have made such a mess of privatisation that the present money-loathing is understandable. They have made an equal mess of its concomitant, means testing. But if charging, paying and pricing continue to be seen as morally corrupt, public services will run out of money. Cash that should be spent helping the poor will be wasted on the rich. This is what happens when what should be a dynamic public service is entombed in a ponderous welfare state.
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http://www.guardian.co.uk/commentisfree/[...]24/public-funds-wasted-on-rich
