An English national strategy on HIV, framed as part of a National Health Service response to sexual health needs, was launched for public consultation on Friday 27 July 2001 in London.
Among the most controversial proposals is a suggestion that funding for HIV should no longer be "ring-fenced" within National Health Service budgets.
The paper supports the idea of partnerships between health service agencies, voluntary organisations and local authorities, but it makes no commitments on behalf of any government departments outside the Department of Health.
Unusually, no government Minister attended the launch although the Minister for Public Health, Yvette Cooper MP, did contribute a foreword. This includes a promise of 47.5 million UK pounds in funding over the next two years to support the development of services outlined in the paper.
In para 6.21 the report states: "In April 2002 the special allocation for HIV/AIDS treatment and care and for HIV prevention will be added to health authorities’ main allocations. This reflects the need to bring HIV/AIDS services into the mainstream with other priority areas – in line with the NHS Plan – and will give health authorities more flexibility to meet local needs. To ensure that the current level of services is maintained, the Department will continue to monitor access to services, the standard and quality of the services provided and, if appropriate, the level of investment being made. These additions to general allocations will reflect the patterns of the epidemic rather than simple capitation shares."
Neil Gerrard MP, chair of the All-Party Parliamentary Group on AIDS, comments:
"We know that, even with special allocations, many health authorities often use the money for spending that is not related to HIV. Where it is spent on HIV prevention, health authorities are too nervous to properly fund work with gay men, British Africans and injecting drug users and prefer to fund "untargetted" work.
"If we abolish the special HIV allocations completely, there is a danger that most work with the groups who are genuinely at risk of HIV will fade away. Health authorities will put it to more popular or "acceptable" uses. Reassurances that the Department of Health will "monitor...the level of investment being made" have been shown to be worthless in the past. Our two recent Inquiries into HIV/AIDS have proved this. At a time when new HIV infections are at their highest, abolishing the budgets is a very bad idea."
The report also sets new targets for HIV testing, with a view to increasing the uptake of HIV testing by 60% among GUM clinic attendees, and reducing the number of people who are unaware of their HIV status between now and 2007. It is currently estimated that more than 10,000 people in the UK are unaware of their HIV infection.
Managed networks for HIV care are also recommended so that smaller centres in low prevalence areas can be linked with the expertise of major teaching hospitals and clinics with longstanding expertise in HIV management. The networks will also include primary care physicians, and should provide a focus for training and development.
The report invites responses on many of the issues it contains, along with suggestions on how it could best be implemented. These are needed by 21 December 2001 although work on the Strategy will continue in the meantime.
For more details: http://www.doh.gov.uk/nshs/strategy.htm
The paper is available in full online at http://www.doh.gov.uk/nshs/bettersexualhealth.pdf