Cutbacks don’t make for happy bunnies
Spring may be in the air, but chill breezes are blowing through HIV treatment
and care services in the UK.
This month PN reports how mental health and gay men’s support services
in cash-strapped Kensington and Chelsea primary care trust face substantial
cutbacks. Anecdotal reports from around the country suggest a similar story.
For now, it is the soft under-belly of HIV services like mental health that
are bearing the brunt. But that doesn’t mean treatment budgets are not
vulnerable too, particularly outside London.
In this issue, Dr Margaret Johnson tells us about mounting pressure on HIV
drug budgets and how doctors are preparing to defend their right to prescribe
the most appropriate treatments. A key weapon in their armoury is being able
to demonstrate that HIV treatments are cost effective as they allow people
living with HIV to live long and productive lives. Economic studies show combination
therapy to be ‘one of the most cost and clinically effective outcomes
in public health’ with a cost of each life saved of around £7,000
per person per year, compared with around £50,000 for chronic renal
dialysis and coronary artery bypass.
But doctors alone cannot protect non-treatment services like support groups
or mental health services. People living with HIV need to make their voices
heard; just as they did when they got the recently-published HIV Strategy
for London to give more weight to mental health. So on the one hand the NHS
acknowledges there is more need, and on the other it can’t afford to
pay and cuts services.
With the May election looming, all parties are all vying for our votes. What
better time then to get firm commitments and hold politicians to account for
their empty promises about improving services?
Well-funded, high quality HIV treatment and care is not only desirable, it
is also cost effective. It saves money and reduces onward transmission, as
does treating asylum seekers with HIV.
But if we all go mad in the process, collapsing under the weight of stigma,
isolation, loneliness, what’s the point? So we also need to drive home
the argument that even with treatments, people living with HIV may be unable
to live ‘full and productive lives’ if support and mental health
services are cut to the bone.
There is every point in protesting. Last month Kensington and Chelsea PCT
reversed its proposal to cut its HIV specialist community nurse services following
lobbying by UKC and publicity in PN. This month they are cutting back elsewhere.
Last September, hundreds of you answered the call to get involved at the the
‘Am I Doing Something?’ conference in Leicester. Patient and Public
Involvement in the NHS depends on both sides working in partnership to make
the NHS better. But the NHS has to realise that patients will not sit back
and mildly accept major service changes without fuss. New ways must be found
to recognise the legitimacy and value of each others’ positions and
to use conflict constructively. But if all we have is unresolved conflict
through lack of cash (or commitment) then are we back in the bad old days
of ‘health advocacy’ where people with HIV were forced to fight
for every service.
HIV treatment and care in the UK is world class - let’s keep it that
way.
Bernard Forbes, Chairman, UKC
• If your local HIV services are facing cuts why not let PN investigate:
ring 0207 564 2121 or email editor@positivenation.co.uk
