Sexually Transmitted Diseases (Hansard, 26 June 2003)

§ Baroness Gardner of Parkes
asked Her Majesty's Government:
How they intend to deal with the increased demand for diagnosis and treatment of sexually transmitted diseases.

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Warner)
My Lords, the Government's 2001 sexual health and HIV strategy contains a number of measures to improve access to diagnosis and treatment for sexually transmitted infections. We have already committed £47.5 million to support strategy implementation and will invest an additional £40 million over the next two years, including investment in genito-urinary medicine clinics to improve capacity and reduce waiting times. To improve the quality of services, we are developing recommended standards for the treatment of HIV and STIs.

§ Baroness Gardner of Parkes
My Lords, I thank the Minister for that reply, but the situation is far from satisfactory. People wish to remain anonymous when they go to seek advice as to whether they are suffering from a sexually transmitted disease. For that reason, the drop-in clinics have proved good, because there is no priority funding from the PCTs for sexual clinics. At present, drop-in clinics are having to close their doors within half an hour of opening, Because the demand is so great. People are being turned away. Those who wait often have to wait three to four hours. There is underfunding for trained consultants in the subject.
Will the Minister either see that more drop-in clinics are funded specifically to deal with this enormous public health crisis, or consider supra-regional funding so that there could be a number of special centres?

§ Lord Warner
My Lords, we anticipate that by 2004 there will be an increase of around 35 trained specialists in genito-urinary medicine. That will make some contribution to the position on waiting times in those clinics. So far as concerns PCTs and the primary care sector, we are trying to shift the balance of power to emphasise much more local decision-making, with the majority of health resources being distributed to 432 PCTs. The spending review settlement provides for a significant new investment for PCTs, and enables them to plan for the next three years. However, it is unrealistic to expect sexual health to be funded differently from other NHS programmes.

§ Lord Clement-Jones
My Lords, the recent report of the Select Committee on Health was a damning indictment of the Government's lack of priority towards sexual health policy. That is only evidenced by the delay in 2001 of the publication of the national strategy for sexual health, the delay in the introduction of accurate nation-wide chlamydia screening, and the delay in the national awareness campaign. When will the Government respond to what the Health Committee rightly called a crisis, by making the problem a much higher priority and adding much greater resources to it?

§ Lord Warner
My Lords, we have said that we welcome the report by the Select Committee on Health. However, it is worth bearing in mind, as I said in my Answer, that we laid out in 2001 a sexual health and HIV strategy. A 27-point action plan was published in 2002 that highlighted what developments would be made, and recommended standards for HIV treatment and care, treatment of STIs, psycho-sexual services and reproductive health services. The HIV standards will be published shortly, and work is under way on other areas.
We do not accept that nothing is being done. The issue is difficult. We have a 10-year strategy, and a very effective campaign— the sex lottery campaign—is being worked on and launched at the moment, aiming to change sexual behaviour among younger people. The key to much of the success in the area is changing that behaviour.

§ Baroness Masham of Ilton
My Lords, is the Minister aware that on 6th February I asked whether a national service framework could be set up for sexually transmitted diseases and other infections? I hope that he will consider that. Will he tell the House why there is such an explosion of the conditions? Is he aware that syphilis rose 500 per cent within the year?

§ Lord Warner
My Lords, we must all be very worried about the rise in these conditions. That is why we have the strategy that do we have, and that is why we are engaged in the sex lottery campaign. Noble Lords may smile, but we are trying to engage in a serious issue with young people, who are in many cases the leading group in terms of the rise in these diseases. We have to engage with young people where they are, and with their value sets and their behaviour.
The lifetime number of heterosexual partners is increasing—which is a major contribution in this regard. In the past year there has been an increase in concurrent partnerships. Although there has been an increase in consistent condom use, the benefits of greater condom use have been offset by the increase in the number of reported partners. We are also seeing 433 some figures reflecting the fact that we are getting better and faster at diagnosing such infections, and are therefore able to produce a treatment response.

§ Baroness Gould of Potternewton
My Lords, first, I must declare an interest as the chair of the independent Advisory Group on Sexual Health and HIV, whose responsibility it is to try to ensure that the 27-point action plan referred to by my noble friend is carried out. Perhaps I may pursue a little further the question of resources. I appreciate the points that my noble friend made about the budget that the Government have already spent. But that would not even cover half the cost of rolling out a chlamydia campaign. I know that there will be a further 10 pilots, but it is important that the chlamydia campaign is rolled out throughout the country.
What inducements will there be for PCTs, in order to make sure that they prioritise the question of sexual health and are given adequate resources to deal with it? My noble friend mentioned the sex lottery campaign. It is a good campaign—I do not want to take away from that—but there is the question of whether we need a much more hard-hitting national campaign in order to make sure that the young in particular understand the consequences of unprotected sex.

§ Lord Warner
My Lords, the department is rolling out a chlamydia screening programme. Ten areas, covering 30 PCTs and over 400 individual testing sites, are involved in the first phase of the programme. Expressions of interest will shortly be sought from a further 10 areas covering a similar number of primary care trusts. Apart from Sweden, England is the only European country currently introducing a nationwide programme of this particular kind. An extra £8.5 million will be spent on chlamydia screening during 2004–05.

§ Lord Skelmersdale
My Lords, the real question the Government have to answer is why it has taken those in the department so long to turn their attention to this problem from yet more reorganisation of the health service and a seeming total concentration on waiting-lists. Is not the time well overdue to have a health promotion campaign stressing the need for abstinence in cohabitation and to use sex education in schools to point out the dangers as well as the joy of sex?

§ Lord Warner
My Lords, work is continuing on strengthening sex education in schools. I do not think the noble Lord can say that we have been sitting on our hands. The strategy was published over two years ago, in 2001. I have already given the House a lot of details of the kind of results that are being produced. All I would observe is that calls for abstinence come, critically at this time, from people of an older disposition rather than from those who are younger.

Baroness Sharpies
My Lords, which age group is most affected by these diseases?

§ Lord Warner
My Lords, the age groups most affected are younger people, between the ages of 18 and 30—that 434 is why we are concentrating the sex lottery campaign on that particular age group. Many of the infections, particularly among women, are found in younger women, under the age of 20.