treatments - issue 87
STATE of EMERGENGY?
In part four of the PN guide to STIs, Henry Grahame-Smith reviews the last ten years of radical change in sexual health services and policies
positive nation

In 1992, the Conservative government launched a national health strategy, ‘Health of the Nation’, which outlined five key clinical priorities: cancer, mental health, coronary heart disease, accidents, and sexual health & HIV. However, the election of a new Labour government, in May 1997, brought a new approach to the NHS. This was fully explained in their document, ‘Saving Lives: Our Healthier Nation’, published in 1999.
The NHS Modernisation Agenda
This government paper heralded a dramatic restructuring of the NHS with the aim of ensuring that health improvement would be integrated into the local delivery of healthcare. It gave the new local Primary Care Trusts (PCTs) responsibility for public health and places them at the centre of planning and developing local healthservices. Health authorities were no more.

Illustration: john clarkson

The list of clinical priorities also changed slightly, with sexual health and HIV being dropped from the list.
Several things probably influenced this, including the fact that the incidence of HIV had not during the 1980s, and there had been great success in the medical advances of HIV treatments made during the 90s.
However, since then, it has become

Illustration: john clarkson

clear that anti-HIV treatments, while increasingly successful in halting HIV disease progression, are not a cure. There have also been sharp rises in the incidence of HIV and other sexually-transmitted infections

(STIs) over the past five or six years.
On World Aids Day 2002, this increase was recently emphasised by the Public Health Laboratory

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