HIV

Debate between Pamela Nash and Guto Bebb

Tuesday 29th November 2011 Westminster Hall

[Pamela Nash]

I completely agree with the Secretary of State’s remarks. I raised the issue during Deputy Prime Minister’s questions last week. I hope that the coalition will take that aim on board and that it will be raised by the Prime Minister. The all-party group on HIV and AIDS is a member of the “Halve It” coalition that campaigns for levels of late-diagnosed and undiagnosed HIV to be halved in five years through more testing. That will help to stop the spread of HIV, improve health outcomes for those living with the virus, and in the long term save the Government money.

Patients and doctors have a large role to play. A study of people of sub-Saharan African origin in the UK who were diagnosed late with HIV found that three quarters had visited a doctor in the year preceding their diagnosis. Doctors and patients must be more aware of the primary infection symptoms of HIV. Incentivising HIV testing, particularly in areas with a high prevalence of HIV, is vital to ensure that people are diagnosed in time. One powerful incentive would be to ensure the inclusion of the late HIV diagnosis indicator in the Government’s revised public health outcomes framework. We have heard several times that a decision on that will be made later in the year. Will the Minister assure hon. Members that that indicator will be included, or at least say when the Department will reach a final decision?

As I understand it, the Department is investigating the possibility of legalising home-testing kits. I look forward to the outcome of that investigation. It is clear from the House of Lords report that home-testing kits ordered from overseas, usually over the internet, are already in use in the UK. If legalised, that practice could be regulated and allow people to test themselves securely and safely in their own home, again producing savings for public health and the public purse.

How else can we prevent the transmission of the HIV virus? The House of Lords report stated:

“More resources must be provided at national and local levels… The current levels of investment in national HIV prevention programmes are insufficient to provide the level of intervention required.”

Hon. Members may be surprised to learn that the Department of Health currently spends just £2.9 million a year on two national HIV prevention programmes for gay men and black Africans. That compares with an enormous £762 million spent on treatment. Preventing one infection avoids lifetime treatment costs for HIV of between £280,000 and £360,000, but as local service cuts kick in throughout the country, HIV prevention programmes are being reduced.

Under the new NHS structure, local HIV prevention work, campaigns and testing will be commissioned by local authorities, leading—we hope—to additional national campaigns, but I am concerned about the possible fragmentation and subsequent prioritisation of prevention work between HIV treatment that is commissioned nationally by the commissioning board, prevention and testing work commissioned by local authorities, and national campaigns overseen by Public Health England. Within local authorities, HIV prevention work is likely to face strong competition for funding within constrained budgets. A fragmented health care system will not deliver the results that we desperately need, or enable us to make headway against the rising tide of new HIV infections. We do not want a postcode lottery, or for sexual health services to be sidelined because of local sensitivities.

[Guto Bebb (Aberconwy) (Con)]

I congratulate the hon. Lady on securing the debate. In my north Wales constituency there is an HIV respite centre, which is extremely well supported by the local community. The problem that the centre has is that many of the people who take advantage of the respite care are coming in from north-west England and are therefore not funded by the local health authority in Wales—health is devolved. A centre that is able to serve people from north-west England therefore finds it very difficult to secure funding, because it is based in Wales, but its patients are from England. Is that the type of postcode lottery problem that the all-party group could deal with?

[Pamela Nash]

We can certainly campaign on the matter. I will be happy to discuss that with the hon. Gentleman outside the Chamber. He makes a very important point: this issue is not just about the NHS and the Health and Social Care Bill in England, but about achieving agreements with the other Assemblies and Parliaments in the United Kingdom to ensure nationwide consistency in the treatment and support for people living with HIV.

I shall now discuss public awareness in the UK. Twenty-five years ago, Lord Fowler led huge public health campaigns about the virus. Leaflets were sent to every household in the country and there were very visible television campaigns. However, public awareness of HIV has undoubtedly fallen during the past 10 years. For my generation, it is just not a priority any more. Despite the very high increase in the number of young women contracting HIV, when I speak to my friends about this issue I find they rarely regard themselves as at risk.

Unbelievably, earlier this year, an Ipsos MORI poll found that one in five people do not realise that HIV is transmitted through sex without a condom between a man and a woman, and the same proportion do not know that HIV is passed on through sex without a condom between two men.