Health

HIV/AIDS Scaremongering over budget cuts in Derby

hivThe Derby Telegraph reported on Monday 6 January 2014, statements by Roy Webb, the shadow cabinet member for health and adult care under the headline of “Sexual health services cuts ‘could see rise in rates of HIV infection”. ( I have also copied the article text at the foot of this blog post, as well).

Whilst some of the funding was cutting support for a broader range of sexual health promotion causes, a proportion ( amount undisclosed) was to the charity Derbyshire Positive Support. The stated aim of this charity is to provide services “… for people who are HIV positive, their partners, families, friends and carers”. I am sure that some of their material can serve to educate people in pursuit of prevention but that does not seem to be their primary focus.

Mr Webb was then quoted in the article as stating “The withdrawl of contract funding for Derbyshire Positive Support may well, if it follows the national trend, increase infection rates as it has in areas where similar services have been decommissioned”.

As an opposition member of the council this is clearly an assertion with a political agenda as there is no logical connection between a charity that supports people post-infection and the increase in the prevalence of behaviours that causes infection.

This is the letter I sent to Mr Webb on Tuesday 7th January 2014:

Dear Mr Webb

Your comments that were reported in yesterday’s Derby Telegraph in the article “Sexual health services cuts could see rise in rates of HIV infection” seemed to be unnecessarily scaremongering.

 To suggest that a reduction in contract funding to Derbyshire Positive Support “may….increase infection rates as it has in areas where similar services have been de-commissioned” is in danger of misguiding people, given that the number of new HIV infections since 2005 has reduced from about 8000 per year to just over 6000 with an increase from 2011 to 2012 of 140 – a 2% increase after a sustained 25% reduction. How has this conclusion been arrived at? Or has a small statistical variation been used to make a political point?

 The notion stated by the Leicestershire AIDS support services that “cuts will increase the likelihood of death….” is similarly misleading. In 2012, in the whole of the UK, 490 people died from AIDS this equates to about 2 people in Derby. You will be aware that the vast majority of the deaths in the UK result from Cardio-vascular diseases, and cancer – nearly 600 times more people die of these conditions. HIV/AIDS is not the biggest health issue to Derby or the UK, by a substantial margin. Making public comments that imply that there is an impending health issue as a result of funding cuts on a disease that barely registers on the national statistics is wrong.(Note: more people die of hernias in the UK than of AIDS)

 The comment that the savings were “just going to support the councils budget position” is being a bit opaque. Surely the council had options as to which services they could cut, and they chose this one. The question should have been, “what were those options, and what was  the priority decision?”….then we could all form a valued judgement on whether we felt that they had made the right choice of the available options.

 I have no vested interest in apologising for the Labour council’s budget decisions. In fact I would challenge the sense of some of them, however making questionable statements based on spurious suppositions, on such an emotive subject as HIV, as a means of influencing the public, does not help this important debate.

..and this was his reply

 Thank you for your informed and constructive email.

It was never my intention to “scaremonger” rather point out that sexual heath is an issue that should not be taken lightly.

The funding for sexual health comes from the Public Health budget which was recently transferred to the council and ring fenced until 2015/16 .

Ring fencing means the budget is increased over that period, and has been well over the rate of inflation, and is not subject to the budget constraints of the council over that period.

It therefore begs the question why is it being reduced in the area of sexual health unless there is to be an improvement in public health services elsewhere.

As you saw from the newspaper report I have met with a senior member of the public health team and was not informed that any improvements to the sexual health service or any other public health services were likely by reducing these budgets.

The areas covered by this proposed reduction in funding included Genito Urinary Medicine , sexually transmitted infections, pregnancy testing, emergency oral contraception, student support as well as HIV.

Thank you again for your interest in this matter.

I accept his clarification around the “ring fencing” of the Public Health budget, however he has not really addressed the connection with the headline grabbing statement about the link with HIV infection.  This will be the subject of a follow-up letter.

====================================================================================================================

ORIGINAL ARTICLE:

FEARS of an increase in HIV infection rates in Derby if cuts proposed by the city council go ahead have been voiced.

Tory opposition councillor Roy Webb’s comments came after a letter opposing one of the cuts was sent to the authority by Leicestershire Aids Support Services.

The authority is proposing to cut £430,000 from the sexual health budget in the 2014-15 financial year.

The mooted cut was included in its recent consultation on how it will find £9 million of savings on top of £20 million already found.

It says the move would involve “ending service contracts for specialist sexual health promotion services,” and renegotiating contracts for “sexually transmitted infections and pregnancy testing”.

The document adds that the council wants to “refocus free oral emergency contraception to under-18s available to pharmacy outlets only”.

The city council was, on Friday, asked for more details but said it was unable to provide them.

But Mark Tittley, cabinet member for adults and health, said that, if the cuts went ahead, the council “would still continue to fulfil our statutory and moral duty to provide open access sexual health services to all within our community who need them, including people affected by HIV/Aids”.

Mr Webb, who is shadow cabinet member for health and adult care, said part of the cuts would hit Derbyshire Positive Support which gives confidential, stigma-free, support to people with HIV, and their families.

He said: “The withdrawal of contract funding for Derbyshire Positive Support may well, if it follows the national trend, increase infection rates as it has in areas where similar services have been decommissioned.”

A letter to the council from Leicestershire AIDS Support Services carries another warning.

It says: “Cuts will increase the likelihood of early death, and ill-health resulting in high levels of need for costly social care support and can be avoided by maintaining effective local services.”

Mr Webb added that, having met with a “public health official”, it was clear that any savings made in the budget were not going to be used to improve services elsewhere but “just used to support the council’s budget position”.

He said: “I think this a dangerous position to take as the on-going health and social care cost of failing to support these services could be much more expensive than keeping them.”

Mr Tittley said: “It is important to note that if these proposals are accepted by the council, we will still continue to fulfil our statutory and moral duty to provide open access sexual health services to all within our community who need them, including people affected by HIV/Aids.”

No-one from Derbyshire Positive Support was available to comment

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