Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they will take to ensure that women have control over their sexual and reproductive health decisions through empowering them to (1) negotiate condom use, (2) access pre-exposure prophylaxis (PrEP), and (3) make informed choices to prevent HIV transmission.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The HIV Action Plan is the cornerstone of our approach in England to drive forward progress and achieve our goal to end new HIV transmissions, AIDS and HIV-related deaths within England by 2030. A key principle of our approach is to ensure that all underserved populations benefit equally from improvements made in HIV outcomes, including marginalised women. This includes scaling up HIV testing in targeted, high-risk populations and increasing equitable access to and use of HIV pre-exposure prophylaxis (PrEP).
Initial analysis recently published by the UK Health Security Agency show that HIV opt-out testing in emergency departments in local authority areas with extremely high HIV prevalence has been particularly successful at reaching women with HIV testing. The HIV Action Plan Implementation Steering Group is developing a roadmap to help guide our efforts to improve equitable access, uptake and use of PrEP to meet the needs of key populations at significant risk of HIV, including heterosexual and transgender women, which is expected to be made available by the end of the year.
HIV Prevention England delivers a nationally co-ordinated programme of HIV prevention work designed to complement locally commissioned HIV prevention in areas with high HIV prevalence and for communities at risk of HIV transmission, with a particular focus on women, and includes the promotion of evidence-based HIV prevention interventions such as condom use.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they will take to address factors contributing to higher HIV transmission rates among marginalised women, such as sex workers, transgender women, and immigrants.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The HIV Action Plan is the cornerstone of our approach in England to drive forward progress and achieve our goal to end new HIV transmissions, AIDS and HIV-related deaths within England by 2030. A key principle of our approach is to ensure that all underserved populations benefit equally from improvements made in HIV outcomes, including marginalised women. This includes scaling up HIV testing in targeted, high-risk populations and increasing equitable access to and use of HIV pre-exposure prophylaxis (PrEP).
Initial analysis recently published by the UK Health Security Agency show that HIV opt-out testing in emergency departments in local authority areas with extremely high HIV prevalence has been particularly successful at reaching women with HIV testing. The HIV Action Plan Implementation Steering Group is developing a roadmap to help guide our efforts to improve equitable access, uptake and use of PrEP to meet the needs of key populations at significant risk of HIV, including heterosexual and transgender women, which is expected to be made available by the end of the year.
HIV Prevention England delivers a nationally co-ordinated programme of HIV prevention work designed to complement locally commissioned HIV prevention in areas with high HIV prevalence and for communities at risk of HIV transmission, with a particular focus on women, and includes the promotion of evidence-based HIV prevention interventions such as condom use.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to provide LGBTQ+ relevant mental health services.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
We remain committed to the aims of the NHS Long Term Plan, investing at least £2.3 billion of extra funding a year in expanding and transforming mental health services in England by March 2024. This extra funding will enable an extra two million people, including those who identify as LGBT, to be treated by National Health Service mental health services by March 2024.
The funding includes £110 million to expand adult mental health services including NHS Talking Therapies (formerly known as Improving Access to Psychological Therapies). In 2021/22, there were 1.81 million referrals to talking therapies in England, compared to 1.46 million in 2020/21. 1.24 million referrals started a course of treatment within this year.
We also provided an additional £500 million in 2021/22 to accelerate our expansion plans to address waiting times for mental health services, give more people the mental health support they need, and invest in the NHS workforce.
The Advancing Mental Health Equalities strategy published by NHS England in 2020 helps set expectations for providers and commissioners to identify opportunities and drive forwards improvements to address inequalities in access to and experience of mental health services. The strategy supports local systems to tailor services to meet the needs of their local populations, including LGBTQ+ people. This includes improvements to the quality and use of data and information, for example the Equality Data Quality Guidance to help improve the collection of demographic data in the Mental Health Services Dataset, and a range of initiatives to improve diversity and representation in the mental health workforce.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how the Major Conditions Strategy will promote the importance of integrated physical and mental health treatment for people with long-term conditions such as diabetes and Parkinson's Disease.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Major Conditions Strategy will tackle groups of conditions that contribute most to morbidity and mortality across the population in England including cancers, cardiovascular disease including stroke and diabetes, chronic respiratory diseases, dementia, mental ill health and musculoskeletal conditions.
Dementia, rather than other neurological conditions such as Parkinson’s Disease, has been identified because it is the leading cause of death in women and the second biggest cause of death for men.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to achieve gender parity in their HIV response, to ensure there is equitable (1) investment, (2) priority, and (3) attention, to women in HIV (a) prevention, (b) research, (c) data, and (d) services, in the UK.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
Ensuring everyone benefits equally from HIV developments is the cornerstone of our approach in England to achieve our ambitions to end new HIV transmissions, AIDS- and HIV-related deaths by 2030, as set out in our HIV Action Plan, available in an online-only format.
As part of the Plan, NHS England is investing £20 million from 2022-2025 to support the expansion of opt-out HIV testing in emergency departments in local authority areas with extremely high prevalence of HIV. We are also investing more than £3.5 million from 2021-2024 to deliver the National HIV Prevention Programme which supports communities who are disproportionately affected by HIV, including black African heterosexual women.
The UK Health Security Agency published a HIV Action Plan monitoring and evaluation report in 2022, which tracks progress across priority actions and identifies further efforts needed across the system to improve equitable access to HIV services for key population groups, including women. We continue working together with our delivery partners to ensure equity in prevention, treatment, and HIV care, and we are developing a plan to improve equitable access to the HIV prevention drug PrEP for key groups, including women.
Local authorities in England are responsible for commissioning comprehensive open access to most sexual and reproductive health services, including HIV prevention, testing and access to PrEP, through the Public Health Grant, funded at £3.5 billion in 2023-24. It is for individual local authorities to decide their spending priorities based on an assessment of local need and to commission the service lines that best suit their population.
The Department also funds research through the National Institute for Health and Care Research (NIHR), which recently published an equality, diversity and inclusion strategy, setting out how NIHR will become a more inclusive funder of research and widen access to participation, including for women.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what research they are undertaking into women who are living with HIV and are experiencing the menopause.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Department funds research through the National Institute for Health and Care Research (NIHR). NIHR funded the Menopoz Study which completed in 2018 and aimed to explore the impact of the menopause on HIV-positive women's wellbeing and engagement with HIV care in the UK.
NIHR does not currently fund any specific research into women who are living with HIV and are experiencing the menopause but welcomes funding applications for research into any aspect of human health. Applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money and scientific quality.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure that HIV research (1) addresses specific knowledge gaps around HIV and women, and (2) supports the full participation and meaningful involvement of women.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Department funds research through the National Institute for Health and Care Research (NIHR). Since 2017/18, NIHR has spent £35,679,615 on HIV research and support thereof. There are no current plans to assess the HIV portfolio specifically, but NIHR welcomes funding applications for research into any aspect of human health, including HIV.
NIHR actively and openly support patient and public involvement and engagement in research. Applicants are required to provide additional guidance to ensure that there is an explanation of the relevance and importance of the study from the patient/public perspective. In Autumn 2022, the NIHR published the EDI Strategy 2022-2027, available in an online-only format, which sets out how NIHR will become a more inclusive funder of research and widen access to participation. The strategy refers to guidance produced from the NIHR INCLUDE project, also available in an online-only format, which aims to improve the inclusion of under-served groups, for example those with lower representation in research and clinical trials than would be expected, such as women.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the correlation between reductions in public health funding and increases in rates of (1) syphilis, and (2) gonorrhoea.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
We have not made a specific assessment of a correlation between the Government’s public health funding and rates of syphilis and gonorrhoea in England.
Local government is responsible for commissioning sexual health services through the public health grant, and the Government allocated more than £3 billion for the public health grant in 2022/23. We will announce the 2023/24 public health grant allocations to local authorities in due course.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government when they will publish their Syphilis Action Plan.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
We remain committed to improving sexual and reproductive health, including reducing rates of syphilis, in England and are considering the need for further government plans. In 2021, we published our policy paper Towards Zero - An action plan towards ending HIV transmission, AIDS and HIV-related deaths in England - 2022 to 2025, available in an online-only format, which sets out the actions that we are taking to move towards ending HIV transmissions and HIV and AIDS related deaths within England by 2030. In August 2022 we also published the Women’s Health Strategy for England which sets out our 10-year ambitions and actions we are taking to improve health for women and girls including reproductive health.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to increase the size of the workforce providing prevention services within Sexual Health Services.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
We are considering actions to ensure that the sexual health workforce has the required capacity and skills to meet the sexual and reproductive health needs of the population in multiple settings. Further information will be available in due course.
Local authorities in England are responsible for commissioning comprehensive, open access sexual health services, and it is for them to decide on commissioning arrangements, including workforce skills mix and size, based on an assessment of local need for sexual and reproductive health services.