It's official. Britain's sexual health services are in meltdown. A House of Commons select committee report published on 11 June says that we face a growing public health crisis.
Writing in the Guardian, Professor Michael Adler, author of the Department of Health's original Sexual Health Strategy, says: "The picture is one of a progressive decline in the nation's sexual health, with services unable to cope." GUM and HIV services have been starved of funds since expensive HIV drugs started taking a lion's share of the sexual health budget in 1997.
But spending money on drugs alone is a false economy. Since that year, gonorrhoea and chlamydia cases have doubled and syphilis has gone up five-fold. HIV diagnoses have doubled, and gay male diagnoses have suddenly jumped 40 per cent in the last two years. At £15,000 per patient, the HIV increase alone adds £40m to the health bill.
Patients needing urgent attention or tests for these diseases report waits of four, six, seven weeks for a GUM clinic appointment, or all-day, round-the-block queues at clinics that have given up on appointments altogether. It's like the DHSS during the 80s.
Say you're a 15-year-old girl who screws up her courage to go to a clinic because you're scared you've caught chlamydia. You've bunked off school for an afternoon to avoid your mother and classmates knowing, but when you turn up you are given an appointment in six weeks' time. In the meantime, as they often do, the symptoms seem to disappear.
Are you going to make that appointment? Most likely not. But if you don't, you risk pelvic inflammatory disease and possible infertility. One in 10 women under 25 has chlamydia. We could be setting up an epidemic of infertility for the 2010s.
HIV isn't exempt from this debacle. See Dr Mike Youle's SpeakUp for the pressures HIV clinics are facing. More worryingly, some hospitals are refusing outright to put any more patients on combination therapy. Whipps Cross Hospital in East London even trumpeted this as a cost-cutting exercise to the local paper, as if it was something to be proud of. They deny it now, but if true, it either means delaying therapy till patients have perilously low CD4 counts or doing the Home Office's dirty work and consistently refusing lifesaving antiretrovirals to immigrants.
How did we get to this state of affairs? Well, we live in a society which saturates kids with sexual images while at the same time approaching the subject of sex education with squirming paranoia - to quote Michael Adler again, it's "too patchy, too biological, too little and too late". (And God help you if you're gay - you'll just have to pick it up in cybersex chatrooms.)
We're also experiencing the 'Aids rebound' - it's not so terrifying, it's far less often fatal, we don't have Princess Di cuddling 'victims' on front pages any more. So people are less scared and have more unsafe sex. We're returning to the pre-Aids sexual scene of the 70s.
But the Government should have foreseen this. Instead, they took away the special Aids budget, and then split the NHS into Primary Care Trusts (PCTs). These are allowed to spend their budgets how they wish - with a few important exceptions. These are things called National Service Frameworks (NSFs). They cover areas like heart disease, kidney disease, cancer and mental illness and set targets for reducing them. If you're the head of a PCT and don't meet your NSF targets, woe betide you.
But sexual health doesn't have an NSF. A PCT head openly told the manager of one of Britain's biggest GUM clinics: "I'm only going to meet targets if I'll get sacked if I don't." No NSF, no budgets, no PCT heads rolling.
Result? A sexual health service wallowing in Victorian squalor in the midst of the brand new Labour NHS.
Positive Nation joins the chorus: we need more money for sexual health services of all kinds, and a National Service Framework now.
