PCTs start to wield axe on HIV services 
HIV services face cut backs this spring as local primary care trusts struggle
to balance their books.
Kensington and Chelsea Primary Care Trust (PCT), which has to make £7
million in savings next year, has already started to make cuts.
Last month the PCT told the psychological medicine unit at the Chelsea and
Westminster Hospital that it faced cuts of over £250,000 next year and
a further £250,000 in 2006-7.
Similar moves to axe its HIV clinical nurse community service were abandoned
last month following successful lobbying by patients, PN and UKC.
The mental health unit, set up in 1989, provides therapy and emotional support
to thousands of people with HIV in London.
Last year, more than 500 HIV positive people were helped by the team led by
psychiatrist Dr Pepe Catalan. The unit provides vital support to people living
with HIV including help with adherence to antiretrovirals and coping with
psychological side effects, depression, death, relationships and sexual dysfunction.
It also works with cancer patients.
The unit has played a key role in keeping down A&E waiting times below
the four hour target by supporting people turning up at casualty in acute
emotional stress.
Dr Peter Carter, chief executive of the Central & North West London Mental
Health Trust, told PN the cuts had come out of the blue and that Dr Catalan’s
team had not overspent.
He said: “We know people living with HIV have complex mental health
problems and much higher rates of depression and suicide than the rest of
the population.
“This service is the last thing that should be cut, with record numbers
of people now living with HIV,” Dr Carter added.
Dr Catalan told PN: “Our service will now have to be run down substantially
and is being destroyed. Does the PCT think that mental health is irrelevant?
“It would be very easy to see the cuts as homophobic, against gay men
with HIV and sex workers. Why are they targeting the easy options?”
Dr Catalan added.
Meanwhile Kensington and Chelsea PCT has confirmed it will be cutting its
£171,000 a year contract with London Lighthouse by £85,000 to
£86,100 a year by 2007.
Westiminster PCT is also understood to be cutting back its contract with the
London Lightouse.
A long-established gay men’s group at the centre looks set to be one
of the casualties of all the cuts.
Meanwhile, SW5, a health agency working with male sex workers in Earl's Court,
also faces £13,000 cuts.
Adam Wilkinson, regional manager, of Lighthouse West London said: “Kensington
and Chelsea is no longer able to finance services for clients all over London,
so they have to cut some funding for Lighthouse West London.
“They are also helping us to seek alternative funding elsewhere and
continue to fund services at Lighthouse West London for borough residents.”
More than half new HIV is heterosexual
Fifty-seven per cent of all new HIV diagnoses were acquired through heterosexual
sex, according to the Health Protection Agency's (HPA) latest report.
Eight out of ten new cases were acquired abroad, predominantly in high prevalence
countries, while men who have sex with men accounted for 28 per cent.
Some of these diagnoses will be in people who have been infected for some
time and are only now coming forward for testing, the Agency said.
And although the numbers are high, there has been no increase over last year's
figures.
New HIV diagnoses in the UK in 2004 are expected to be around 7,000. The Agency
estimated there were currently 53,000 people with HIV in this country but
over a quarter (14,300) remained unaware of their infection.
Dr Valerie Delpech, an Agency spokeswoman, said the world-wide epidemic of
heterosexually transmitted HIV was continuing to have a major impact in the
UK, but HIV transmission between gay men was continuing at a high level.
Moreover, there are now clear signs that heterosexual transmission of HIV
within the UK, although at a low level at present, is very gradually increasing.
The HPA report said these rates should be viewed against a background of increasing
numbers of other sexually transmitted infections (STIs), which shows us that
people are still practising unsafe sex.
It was important “everyone takes responsibility for their own sexual
health, especially those in high-risk groups such as gay men, young people
and HIV positive individuals,” the report concluded.
www.hpa.org.uk
Treat all and save cash - docs tell MPs
Britain's top HIV doctors have told MPs that treating everyone with HIV will
save money and lives. And withdrawing treatment from failed asylum applicant
will contribute to increased HIV rates and NHS costs.
Doctors presented their report Treat with Respect to a special meeting of
the All Party Parliamentary Group on Aids (APPGA) on 8 March.
“At £7,000 a year, the cheapest way to save a year of life is
to provide HIV treatment. This is bloody good value for money,” UKC
Patron Professor Brian Gazzard from the Chelsea and Westminster told MPs.
Preventing onward transmission of a single HIV infection saves the NHS between
£0.5 million and £1 million over an individual's lifetime.
Doctors argued that if HIV were re-classified as a sexually transmitted infection,
it would allow free medical treatment to be offered to everyone.
Last year the Department of Health tightened the rules governing access to
NHS care for people with failed asylum applications or undetermined immigration
status. But there is no evidence people are coming to the UK with the express
intent of using NHS services.
Withdrawing treatment from people whose asylum application has failed would
likely contribute to increasing HIV rates and increased NHS costs, the report
said.
The report authors estimate around 900 people who entered the UK in 2003 to
seek asylum were HIV positive.
The doctors argued this costs the NHS around £15 million or the equivalent
to just three months rent paid on unoccupied properties by the National Asylum
Support Service. Dr Jane Anderson, of Homerton University Hospital, also called
for changes to current asylum policy to stop dispersal of people seeking asylum
without consideration of medical reports from their doctor. She questioned
how anyone could stick to their meds if they are dispersed at short notice
to an area with little experience of providing HIV services. Robert Fieldhouse
Treat with Respect email:
fwalton@ruderfinn.co.uk
UK 'puts profits before human rights'
Activists have turned the tables on Tony Blair by launching their own African
Commission for Britain.
In response to Blair's much vaunted pledges to improve aid and cut debt to
Africa, activists have drawn up a list of actions Britain should take.
The ActionAid report calls on Britain to stop harming Africa by dumping cheap
subsidised exports and putting poor farmers out of business.
It says UK companies violate basic human rights and the environment and collude
in corruption with African leaders.
The poorest countries of sub-Saharan Africa owe $220 billion to western creditors
and are paying more in interest than they can spend on education and health.
“Too many initiatives start with the assumption that 'West knows best',”
said Mrs Taaka Awori, of ActionAid, Ghana.
Among the allegations are that British arms exports fuelled wars in 10 separate
African countries last year and that City of London banks hold billions of
dollars looted by African dictators.
They accuse rich countries of “using aid to reward strategic allies
and pet projects at the expense of the neediest countries”.
Wole Olalaye, of ActionAid, said: “The UK puts profits before human
rights.”
In response, Hilary Benn MP, International Development secretary pledged that
90 per cent of the UK's aid would now go to the poorest countries.
“We stopped tying British aid to goods and services in 2001,”
the minister said.
The African Commission
for Britain www.actionaid.org
news on the side
HIV GBH case goes to appeal
Feston Konzani, a 28-year-old HIV positive asylum seeker jailed by Teesside
Crown Court last May for 10 years after infecting three women, is seeking
to have his conviction overturned by the Court of Appeal.
Disability rights strengthened
Burden of Proof regulations for prosecutions under the Disability Discrimination
Act has been strengthened by the Court of Appeal. The judgement says that
if an
individual has established that there could be a valid case of discrimination,
employers are expected to provide detailed evidence to prove that they
did not discriminate.
Testing migrants slammed
Tory proposals for screening new migrants for HIV and TB were condemned by
GMB union leader, Kevin Curran, as, “the sort of outrageous message
I would expect to hear from the BNP, not a supposedly mainstream party. It's
time to accept we will rely on migrant labour in years to come.”
Scottish assault victims can demand HIV tests
Proposals have been unveiled in the Scottish Parliament to allow victims of
assault to seek information through the courts about whether
their attacker was carrying HIV or hepatitis. The Scottish Police Federation
said officers had to endure weeks of stress and anxiety waiting
for tests on their own blood, following assaults.
HIV testing 'should be opt-out, not opt-in'
HIV testing should not be accorded any special status, argue two senior doctors
in the British Medical Journal (BMJ). They propose that
if a patient consents to be investigated, a doctor can initiate tests aimed
at excluding serious diseases without an in-depth discussion of all possible
results,
provided that the test results would benefit the patient.
STI money 'being diverted'
Government funding earmarked for sexual health is being diverted by primary
care trusts (PCTs) to provide services in other health areas, according to
Professor George Kinghorn of Sheffield Teaching Hospital responding to questions
from the Commons health committee last month.
What NHS tourism?
An investigation among doctors by the HIV Consortium has found that the number
of people receiving HIV treatment from the NHS in London and who were not
eligible, amounted to just 20.
Increase in positive blood donors
The number of blood donors discovered to be HIV positive has doubled, according
to figures obtained by The Independent, under the Freedom of Information Act.
In 2003, 42 people who gave blood were found to be unwittingly carrying the
virus. In 2002, two HIV-infected donations got through the screening process
and were used in transfusions.
Cost of HIV care
Each new HIV patient consumes £12,000 in healthcare costs each year,
according to a recent editorial in The British Medical Journal. “Prioritisation
of sexual health with substantial investment is essential to avoid continuing
deterioration in services, rising HIV transmission and costly consequences
for tax
payers,” the BMJ said.
Crackdown on bogus therapists
Government plans to crackdown on under-qualified acupuncturists and herbal
medicine practitioners, received major support in February. A new government
report suggests that more than nine out of 10 practitioners, patient groups
and members of the public support government regulation of the industry.
Grandfather murders grandson
Kenyan Joseph Wambirwa Mwathi, aged 70, cut the throat of his seven year-old
grandson because he thought the boy was HIV positive. “The boy’s
neck had been severed the way a goat is slaughtered in an abattoir,”
said a witness. Mwathi was sentenced to hang by a Nairobi court in March.
US State Department discrimination
According to papers filed by Lambda Legal in a federal lawsuit, the US State
Department illegally prohibits anyone with HIV from being hired as a Foreign
Service Officer. Lorenzo Taylor, the subject of the lawsuit said that his
HIV was completely manageable.
Eire: STIs up again
According to Ireland’s Health Protection Surveillance Centre, notified
STIs have, once again, increased - the total having trebled over the past
10 years. Dr Mary Cronin said that the increase in reported cases reflected
both unsafe sexual practices and also more sophisticated testing methods.
Corruption in Kenya threatens funding
Corruption, claimed William Bellamy, US ambassador to Kenya, is a primary
reason that only a fraction of the $70 million the US allocated for Kenya’s
Aids programme last year has been spent responsibly.
‘Touching can cause pregnancy’ - US govt
advice
A US congressional report on abstinence-only sex education found the programme’s
materials warn that touching another’s genitals “can result in
pregnancy” and that condoms fail to prevent HIV transmission a third
of the time. US rates of death and disability from STIs are triple those of
other wealthy nations. The Los Angeles Times commented that as a result of
President Bush’s $170 million a year abstention programmes, “US
teens are being taught a bunch of hooey”.
