You can't put a price on a Down's child's life! Families' fury as top doctors say lifetime cost of care to NHS justifies new simple blood test for mothers-to-be 

• Test can tell pregnant woman how likely their baby is to have the condition
• But to keep costs down the test will only be offered in some circumstances
• Doctors said cost analysis should consider the expense of caring for child
• Comments condemned as ‘putting a price on a life’ by families of children 

Senior doctors sparked fury yesterday for suggesting the NHS should work out the ‘cost effectiveness’ of caring for children with Down’s syndrome.

It was condemned as ‘putting a price on a life’ by families of children with the condition.

The Royal College of Obstetricians and Gynaecologists raised the prospect in a consultation into a new test for Down’s which the NHS is set to approve.

The new test – Non-Invasive Prenatal Testing – is 99 per cent accurate at telling pregnant woman how likely their baby is to have the condition.

To keep costs down, the test is likely to be offered only to pregnant women considered at high risk of having a Down’s child.

But the Royal College said: ‘If the decision [to restrict it to high-risk women] has been made primarily on cost grounds, then a more rigorous economic analysis has to be made that includes the lifetime costs of caring for children and adults with Down’s syndrome.’

It added: ‘Such an economic analysis may (or may not) suggest that testing for all is cost-effective.’ 

Yesterday Dr Elizabeth Corcoran, of the Down’s Syndrome Research Foundation, said: ‘It has always been our fear that these types of calculations and economic analyses go on behind closed doors between policy makers, but here it is in black and white.

‘It is utterly shocking that in this day and age someone can put a cost value on someone’s life just because they have a disability. It is worse still that this comes from a respected Royal College that is a professional beacon for doctors.’

Supporters of the new technique, which involves a simple test of the expectant mother’s blood at about ten weeks, say that it will give women more choice and see fewer miscarriages associated with the more invasive amniocentesis tests.

Pregnant women can already have a Non-Invasive Prenatal Test privately, costing between £400 and £900. But campaigners fear that it will spark an increase in abortions, because an estimated 90 cent of women with an unborn Down’s baby opt for a termination.

Testing only high-risk women would keep costs down, but such a regime would inevitably mean some babies with Down’s would be missed – put at 289 a year. As these babies grow up, it will cost the NHS to care for them.

But families say the cost should not be a factor, and that Down’s is not a disease that needs to be eradicated. Colette Lloyd, 43, of Oxford, whose daughter Katie, 18, has the condition, said putting a ‘pounds and pence’ valuation on her child’s life ‘harks back to the dark ages’.

She added: ‘We are told that screening is about a woman’s choice, but clearly this is just a smokescreen for the medical professional to absolve themselves of any responsibility and achieve their cost-saving aims.

‘My daughter’s life is worth far more than any costs she may have.’ 

And Paul Critchlow, 48, of Rotherham, South Yorkshire, said of his 24-year-old daughter Emily: ‘As a parent of a young person with Down’s syndrome, I am appalled at the suggestion that the lifetime cost of caring for children and adults with Down’s should be a factor in determining whether or not they should even be born.’

He said the Royal College had ‘no remit to intervene in this way’, adding: ‘By suggesting that lifetime cost should be factored in, is frankly a step too far and leads us into the murky world of eugenics – who deserves to live and what that life should look like.

‘It is unethical and immoral to even consider the attempt to calculate the lifetime cost of any human being and then measure it against the likely benefit of that person’s life.’

The Royal College’s contribution to the debate came in its response to a consultation being held by the UK National Screening Committee ahead of the test’s expected NHS roll-out. 

Supporters of the NIPT programme say any ‘cost effectiveness’ analysis should also take into account the benefits of giving women greater choice. 

Prof Lyn Chitty, who led an NIPT trial at Great Ormond Street Hospital, has said: ‘One of the fears of NIPT was that we may reduce the number of Down’s syndrome children who are alive – but actually 30 per cent continued with the pregnancy.’

She said these women all decided to keep their Down’s baby, compared to 6 per cent under the current system. 

Prof Chitty added: ‘Introducing NIPT into NHS maternity care means that more women can be safely reassured about the health of their baby without having an invasive test which increases the risk of miscarriage.’

NIPT would lead to 4,870 fewer amniocentesis tests in England and Wales a year, saving the NHS about £337,000 annually, Government advisers predict. 

This, they say, will drive down the number of miscarriages by about 25 a year.

Last night the Royal College of Obstetricians and Gynaecologists declined to comment. But a source insisted: ‘The RCOG is not suggesting the NHS would or could or should save money by calculating the value of a Down’s life.

‘Rather, it is identifying the need for rigorous economic analysis to be undertaken – to fill the void that currently exists in relation to this.’