The Health and Social Care Act 2012 led to a change in responsibilities around HIV prevention and sexual health services in England. Local authorities are now responsible for public health – including the majority of HIV and sexually transmitted infection (STI) prevention services. This includes the legal responsibility to offer open access sexual health services. The NHS (NHS England and Clinical Commissioning Groups) also have some responsibility for HIV and STI prevention.
The placing of public health within local authorities recognised the broader reasons why some individuals have poor health and allowed for services to be linked with other social interventions.
Cuts to services
HIV and STI prevention services are funded by a ring-fenced budget from the national Government to local authorities. This public health budget is being cut by £531 million between 2015/16 and 2019/2020. Whilst some local authorities have maintained or increased funding and focus on sexual health and HIV prevention, other local authorities have made the decision to cut local sexual health and HIV prevention services.
Data from London clinics has shown that in one month in 2017 over 1,000 people were turned away from sexual health services in one London area as the services did not have capacity to see everyone. Over half (54%) of those turned away had symptoms of one or more STIs.
These funding cuts are short-sighted and ill-thought through. They’ll ultimately lead to extra pressures on the health and social care system, as transmission of HIV and STIs continues.
As we start to see the number of new HIV infections reducing we have the real opportunity to get to zero new HIV infections. Some STIs continue to soar with 2017 Public Health England data showing the highest rates of syphilis since 1949 and a significant rise in new gonorrhea infections. We will not end new HIV infections or tackle the STI crisis if there is only limited access to local sexual health services.
What we want
We want the funding cuts to local authority public health budgets to be reversed, and increased funding to be provided to local authorities for public health (including sexual health).
Local authorities must fully fund open access sexual health and HIV prevention services that meet the needs of all local communities.
National and local governments in England must work together if this is to be achieved.
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