Sexually Transmitted Diseases (Hansard, 6 February 2003)

§ Lord Hunt of Kings Heath
My Lords, while there are no plans for a separate national service framework for sexually transmitted and other infectious diseases, we are determined to tackle rising rates of infections. We have developed a sexual health and HIV strategy and an infectious disease strategy, both of which contain a number of measures to develop recommended standards and to improve access to treatment.

§ Baroness Masham of Ilton
My Lords, I thank the Minister for that Answer. A national service framework would set national standards. Is he as alarmed as I am by HIV cases doubling in the past year, syphilis cases trebling and the incidence of many other infectious diseases rising? Is he aware that at the GUM clinic in Leeds there is a six week waiting list?

§ Lord Hunt of Kings Heath
My Lords, I do not recognise the figures given by the noble Baroness but she is right to draw attention to the increase in the numbers of sexually transmitted infections. It is a considerable worry. The publication of a sexual health and HIV strategy in itself will provide the impetus towards a strategy at national level and the implementation at local level of both preventative and treatment services. I understand the noble Baroness's concern about waiting times for treatment. The funding of local treatment services is a matter for primary care trusts. We have made additional money available and we shall look closely at the progress made by primary care trusts in their commissioning decisions over the next year in this important area.

§ Lord Clement-Jones
My Lords, chlamydia infection has risen by 122 per cent in the past 10 years. In the light of that figure, are the Government acting urgently enough in proposing that the national screening programme for chlamydia will come into effect only in 2004–05 at the earliest? Does he believe that moving the 31 Public Health Laboratory Service laboratories to the NHS will improve the surveillance of chlamydia?

§ Lord Hunt of Kings Heath
My Lords, I have no doubt that the improvements we are making within the new Health Protection Agency will lead to much greater co-ordination of services and surveillance at a national level and to close working between the new agency and the NHS at local level. As to the screening programme, we have had two successful pilots—one in the Wirral and one in Portsmouth—and we are now implementing a national screening programme. We are starting with 10 sites and a further 10 will be introduced by the end of this calendar year. I 362 understand the need for speed but there are issues in regard to pacing and staff training. We shall review the progress of the screening programme in the light of the introduction of the 20 sites to which we are committed.

§ Lord Turnberg
My Lords, does my noble friend agree that chlamydia is a serious disease and the single most common cause of infertility, ectopic pregnancy and pelvic inflammatory disease? Up to 10 per cent of young women between the ages of 16 and 24 do not know that they have the infection. The screening test is very simple and treatment is very easy. Does my noble friend agree that we should move along with the screening programme?

§ Lord Hunt of Kings Heath
My Lords, I agree with my noble friend. The pilot screening tests carried out in Portsmouth and the Wirral proved to be very successful. The prevalence in women of the target age range at general practice was 8.5 per cent to 8.7 per cent—a very significant figure. Approximately 95 per cent of all positive cases are known to have attended for antibiotic therapies, which gives grounds for optimism in terms of introducing a screening programme throughout the country. As I said, we are committed to starting with 10 sites, with another 10 by the end of the calendar year.

§ Baroness Gardner of Parkes
My Lords, is the Minister aware that the figures quoted by the noble Baroness, Lady Masham, were presented to the All-Party AIDS Group and were considered to be reliable? In view of the alarming increase in HIV in the past year and the statement that 80 per cent of new cases resulted directly from infections developed in Africa, there is a very serious financial timebomb ticking away. We have now got to the stage where people believe that HIV can be dealt with through retroviral or antiviral drugs and is therefore not to be worried about. However, those drugs will eventually fail and even more expensive ones will be required. Does the Minister agree that it is time for more publicity to be given again to this issue in order to create the awareness that helped to control matters in the past?

§ Lord Hunt of Kings Heath
My Lords, there is a good deal in what the noble Baroness says. One of the reasons for HIV infection rates is complacency, part of which may be due to the fact that there are treatments now which were not available when the disease first hit us. We are committed to proactive campaigns for the promotion of good sexual health. We shall redouble our efforts. I can assure the noble Baroness that we shall very much focus on the point about complacency.

§ Baroness Finlay of Llandaff
My Lords, what provisions are being made to cope with the increase in carcinoma of the cervix which will emerge from HPV infection—that is, human papilloma virus infection— and the probable increase in pressure on infertility services because of the high incidence of chlamydia in young, sexually active girls?

§ Lord Hunt of Kings Heath
My Lords, the noble Baroness raises an important question. We need to 363 embrace these issues in the workforce planning that we undertake on a regular basis, both in terms of the number of people we need to employ in those services and, more generally, in the light of the likely pressures on services in the future. We clearly need to take such matters into account.

§ Lord Soulsby of Swaffham Prior
My Lords, is the Minister aware of the link between sexually transmitted diseases, tuberculosis and multidrug-resistant tuberculosis, especially among foreign-born nationals? Will he ensure that the link is recognised and that the appropriate advice is given and treatment taken? I declare an interest as chairman of the House of Lords Sub-Committee on Fighting Infection.

§ Lord Hunt of Kings Heath
My Lords, I pay tribute to the outstanding work of the noble Lord and his committee. I can assure him that it has had a big influence on the policies developed by my department. He is right to identify the problems with TB. Although notification has reached a relatively low level of around 7,000 cases a year from nearly 50,000 in 1950, that figure is higher than the 5,745 cases notified in 1987. The noble Lord's point is well taken.

§ Lord Ackner
My Lords, does the Minister agree that the figures mentioned today strengthen the need for compulsory medical examination of all those who enter this country? We were told that the Government were looking very seriously at the need for such medical examinations. How far have they got in reconsidering the matter?

§ Lord Hunt of Kings Heath
My Lords, the matter has been considered. The Cabinet Office is currently undertaking a comprehensive review of imported infections and immigration. I do not have a date for when the review will be completed.