HIV Testing Week

Steve Race Excerpts

Thursday 13th February 2025 Westminster Hall

[Steve Race (Exeter) (Lab)]

It is a pleasure to serve under your chairship for the first time, Dr Allin-Khan. I congratulate my good friend the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) on securing this debate.

The world is a difficult place for many in the LGBT+ community today, at a time when solidarity is necessary and progress is needed. I hope beyond hope that young people in Exeter are not experiencing what I remember as a young gay man before we made such progress under the last Labour Government.

I am heartened that schools such as West Exe school in my constituency have their own Pride celebrations, but I look with sadness at America, where I know that people who are LGBT feel under siege once again. It feels hard, but on a daily basis we remind ourselves that we are not America, we do not live there and he is not our President—in fact, we have very different leadership here. While Donald Trump is showing the example of American power, our Prime Minister is showing the power of our example. I was proud that this LGBT+ History Month and this National HIV Testing Week, my right hon. Friend the Prime Minister took an HIV test for the world to see. Not only has that been covered on every channel here, but it has been broadcast across the globe.

Let us be clear. We must tackle HIV infections here in the UK, and this Government are taking a pioneering approach, but it is equally important to tackle infections globally. That relies on an unflinching commitment to defending and extending human rights. The global HIV pandemic has demonstrated the importance of addressing human rights violations as a central pillar of driving down HIV rates.

Studies have consistently found that HIV policies that are grounded in human rights achieve superior results over those that are not rights-based. Among gay men and other men who have sex with men, HIV prevalence is five times higher in countries that have criminalised same-sex sexual acts than in those that do not. Access to testing has improved with decriminalisation. In sub-Saharan Africa, gay men and other men who have sex with men have double the odds of ever taking an HIV test in countries that have legalised same-sex relations, compared with countries that have not.

Human rights are increasingly under attack from authoritarian Governments and otherwise democratic Governments whose elected leaders choose to vilify minority groups for political gain. That makes it all the more important that the UK Government take a global lead in advocating for human rights, if we want to reach our commitments on eradicating HIV transmission. The UK should work with other like-minded donors, including France, Canada, Germany and the European Commission, to fill some of the gaps in funding that may emerge in the global response. That means ensuring that strong commitments are made to the Global Fund to Fight AIDS, Tuberculosis and Malaria. On the subject of the Global Fund, I welcome the fact that the Prime Minister stated in an answer just this week to the right hon. Member for Sutton Coldfield (Mr Mitchell) that he has

“long supported it and will continue to support it” —[Official Report, 12 February 2025; Vol. 762, c. 258.]

I am glad that the Prime Minister also said that he would “share details” as soon as he could.

The UK could help to fill the global gag gap and agree a joint plan to respond by focusing aid and diplomacy on human rights and building inclusive healthcare systems. The UK could commit to adding HIV to the agenda of meetings with other world leaders throughout 2025. That could include a meeting with President Ramaphosa on the sidelines of the Canadian G7 to agree how best to use South Africa’s G20 presidency to turbocharge prevention of HIV and AIDS. The Government could empower UK ambassadors and high commissioners to prioritise the protection of universal human rights as part of their commitment to tackling HIV/AIDS, and to global health security.

I pay tribute to the Terrence Higgins Trust for the amazing work it does, not only in getting the Prime Minister to test, but in its efforts to get the country back on track to end new HIV cases by 2030. Imagine the victory it would be if we ended this epidemic in the UK—we would be the first country to do so. It would change many lives forever and inspire action everywhere around the world.

--- Later in debate ---

[Karin Smyth]

I thank my hon. Friend for her comments and her great leadership in her work through the APPG. Some of that work looks very successful, and I will comment on it shortly, because we do need to learn and share from each other.

When it comes to reducing stigma, we have all exposed how old we are in this debate today. I am as old as the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale and perhaps the hon. Member for Strangford (Jim Shannon) and some others. I worked in the health service through the late ’80s. It was a gay man who started raising awareness to me about stigma around HIV and AIDS, and we have come an awful long way. The hon. Member for Strangford and my hon. Friend the Member for Edinburgh South West (Dr Arthur) rightly talked about the role of the stigma, and that iconic moment with Princess Diana was so important. It was so long ago but to some of us it seems like yesterday.

I can give some updates to colleagues. So far this HIV testing week we have given out 13,308 testing kits. That is 13,308 people who now have the power to know their status, take control of their health and contribute to the fight to end new HIV transmissions in England. Last year, National HIV Testing Week delivered more than 25,000 testing kits, achieving great results among communities disproportionately affected by HIV. For example, the uptake of testing kits for black African communities has tripled since 2021. My hon. Friend the Member for Vauxhall and Camberwell Green (Florence Eshalomi) made excellent points about that.

The right hon. Member for Dumfriesshire, Clydesdale and Tweeddale and my hon. Friend the Member for Edinburgh South West tempt me to comment on the Scottish Government’s role in this area. Politics aside, they highlighted a serious point about sharing good practice. My hon. Friend the Member for Cardiff West (Mr Barros-Curtis) made that exact point about the role of the Terrence Higgins Trust. I do not think I knew that Terrence Higgins was Welsh, and I am married to a proud Welshman—something that we share, Dr Allin-Khan —so that looks bad on me. My hon. Friend the Member for Cardiff West made an excellent point about the role of Terrence Higgins’s leadership and the people that came after him to lead that organisation. We need to learn from and work with each other. On behalf of the Department, I commit to continue our work across the United Kingdom to share and learn from best practice. I think that my colleagues across the United Kingdom, whatever political party they belong to, would echo that.

As the Minister here in England, I know that the campaign would not be possible without HIV Prevention England, the national HIV prevention programme, which is funded by the Government and delivered by the Terrence Higgins Trust with local partners. The programme aims to promote HIV testing in communities that are disproportionately affected by HIV, bringing down the number of undiagnosed and late-diagnosed cases. Every year, it runs National HIV Testing Week, a summer campaign to raise awareness of HIV and STI prevention and testing, and much more. We are committed to building on those successes, which is why we have extended the programme for a further year until March 2026, backed by an additional £1.5 million.

Looking to the future, we are making progress to end new transmissions before 2030, but we know that much more work needs to be done to reach our goals. We have had some excellent contributions on that today. Our work is not over until every person, regardless of race, sex, sexuality, gender or circumstances, has access to testing without barriers. I hear the comments made by my hon. Friend the Member for Exeter and others about fear and the historic fear that people have felt. We will not stop until every test is met with care, every diagnosis with treatment and every individual with dignity and respect, regardless of who they are or their HIV status.

[Steve Race]

Does the Minister agree that although we have a cross-party consensus here today and I accept the words of the hon. Member for Sleaford and North Hykeham (Dr Johnson) at face value, the history of HIV action in this country over the last 10 to 15 years paints rather a different picture? We might be closer to eradicating HIV transmissions if the public health grant, which was set in 2014, had had any increases until this Government increased it by 5.5% this year; if the national HIV prevention programme, which started out with a budget of £4 million in 2010, had not had only a £1.1 million budget by last year; if the funding for the HIV helpline had not been abolished in 2012; and if the HIV innovation fund had not been abolished somewhere among the Johnson, Truss and Sunak psychodrama.

[Karin Smyth]

I thank my hon. Friend for that intervention. My hon. Friend the Member for West Ham and Beckton made similar points. The level of cuts to our public services and, by implication, to third sector organisations and their contribution to the fabric of our society—they do work that the public sector cannot get to with groups of people that it cannot get to—is shocking. It was shocking as we went through it. Lord Darzi has given us a good diagnosis of some of those problems. We want to take forward the good work that has been done, but we have inherited a landscape that I wish we had not.

We are very much committed to making progress because we want to build a future where testing is routine, treatment is available to all, PrEP and post-exposure prophylaxis are accessible and no one is left alone in their journey. My hon. Friends the Members for Dartford (Jim Dickson) and for Clapham and Brixton Hill (Bell Ribeiro-Addy) talked about the important role of local government and had some fantastic examples.

To support improved PrEP access and many other critical HIV prevention interventions, the Government have provided local authority-commissioned public health services, which include sexual and reproductive health services, a cash increase of £198 million compared with 2024-25—an average 5.4% cash increase and a 3% real-terms increase. That represents a significant turning point for local health services: the biggest real-terms increase after nearly a decade of reduced spending between 2016 and 2024, as my hon. Friend the Member for Exeter highlighted. I hope that starts to put us back on track.

We are pushing that commitment forward by engaging with a range of system partners and stakeholders to develop our new HIV action plan, which we will publish this year. A number of points have been made about what should be included in that plan, and the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire, will hear that and will work with colleagues here and in the Department to ensure the plan is effective.

I extend my sincerest thanks to Professor Kevin Fenton, the Government’s chief adviser on HIV, who is hosting engagement sessions and roundtables in parallel with external stakeholders, including the voluntary and community sector, professional bodies, local partners and others. We are also working alongside the UK Health Security Agency, NHS England and a broad range of system partners to inform the development of the new action plan, and guarantee that it is robust, inclusive and evidence-based. This collaboration is essential, because we are fighting not just HIV, but the barriers that keep people from knowing their status. We are fighting stigma, misinformation, and inequality in access to treatment and care.

Achieving these goals requires action, because the future is not just something we wait for; it is something we create. That is why, in December last year, the Prime Minister committed to extending the highly successful emergency department HIV opt-out testing scheme, backed by an additional £27 million, as the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale noted. During the past 34 months, more than 2.5 million HIV tests have been conducted through the scheme, indicatively finding more than 1,000 people who were undiagnosed or not in care. These are not just numbers; they are people we might never have reached who are now empowered with access to critical sexual health services. Increasing testing across all communities is a cornerstone of our new action plan and essential to ending HIV transmissions. That is why we must harness the power of HIV testing week.

Before I wrap up, I join the hon. Member for Sleaford and North Hykeham (Dr Johnson) in paying tribute to my hon. Friend the Member for Sittingbourne and Sheppey (Kevin McKenna) for sharing his own experience, which, in motivating his career in nursing—and now his new career—he used to serve and help others. He did that excellently today.

Today, testing is not just about detection; it is about connection. It is about linking people to the care, support and community they need to thrive. It is about ensuring that no one is left behind—and that includes globally. We have committed to supporting the international effort to ending HIV and AIDS, with £37 million towards increasing access to vital sexual and reproductive health services, including HIV testing, prevention and management services for vulnerable and marginalised people across the globe.

Our commitment is unwavering, and our mission is clear. This National HIV Testing Week, let me be clear: a single test can save a life, so let us make testing the norm, the expectation and the action that drives us to a future with no new HIV transmissions.

Community Pharmacies: Devon and the South-west

Steve Race Excerpts

Tuesday 17th December 2024 Westminster Hall

[Rachel Gilmour]

I do agree. In addition to delivering formally commissioned services, pharmacies provide an alternative point of contact for the public for informal clinical advice. The 2024 pharmacy advice audit found that the average pharmacy carries out around 22 informal consultations per day, which is the equivalent of 1.3 million informal consultations taking place in community pharmacies every week.

[Steve Race (Exeter) (Lab)]

I congratulate the hon. Member on securing the debate. From the first day we met we have talked about getting this debate, so I am very pleased that it is happening. I am the chair of the all-party parliamentary group on pharmacy. Does she agree that community pharmacies have a huge amount of potential to support patients with a range of services, which will support the NHS ten-year plan to move more care into the community and help prevent ill health in the first place? That is one of the main roles they can play in the future.

World AIDS Day

Steve Race Excerpts

Wednesday 27th November 2024 Westminster Hall

[Steve Race (Exeter) (Lab)]

I congratulate my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) on securing this debate to mark World AIDS Day. Colleagues have made important points about the huge progress, both medically and socially, that we have made as a nation over recent years, but of course there is always more to do. In 2023, there were 132 people in Exeter diagnosed with HIV and accessing HIV care. It is estimated that around 5% of all people living with HIV in England are undiagnosed, so there will inevitably be people in Exeter living undiagnosed today. I therefore welcome the continued roll-out of opt-out testing to identify and support those people.

I want to touch briefly on two points. First, on the international picture, addressing inequalities in global health requires a country-led approach that puts grassroots communities in the driving seat. It is important, however, that such an approach includes an unflinching commitment to defending and extending human rights. The global HIV pandemic has demonstrated the importance of addressing human rights violations as a central tenet of driving down HIV rates. Today, UNAIDS releases its report into human rights and HIV/AIDS. The report, which includes a foreword by Sir Elton John, demonstrates that the world is not on track to end the HIV crisis, neither is it on track to meet the UN’s targets for societal enablers, which aim to reduce the social and legal impediments that limit access to lifesaving HIV services.

LGBT human rights are increasingly under attack from authoritarian Governments and otherwise democratic Governments whose elected leaders choose to vilify minority groups for political gain. That is becoming a central tenet in the playbook of extremist forces, which makes it all the more important for the UK Government to take a global lead in advocating for human rights if we want to reach our commitments on eradicating HIV transmissions.

Secondly, and very briefly, I want to use this opportunity to thank the many volunteers and activists across our country and around the world who have worked so hard to get us to the position we are in now. From caring for friends and relatives to protesting and setting up activist organisations, the fight against HIV and AIDS has always been led by committed individuals.

In particular, I want to recognise the work of Nick Perry, a much-loved and admired resident of Hackney who sadly and suddenly died recently. Nick was a polymath, an expert amateur historian, a keen advocate for good planning and place, a volunteer for London Pride and, importantly, an HIV education advocate who volunteered with the Terrence Higgins Trust. I recommend to everyone his comedy stand-up segment at Nerd Nite London, available on YouTube, which tackles HIV issues and sexual health in a very accessible way. He was incredibly generous with his time and was a great mentor to me and many others, and will be very much missed by everyone he met. My condolences remain with his husband, Andrew Grace.

People like Nick and many others in this country and around the world will always be the key to our collective ambition to end all new HIV transmissions. We must do everything we can as a Government to support them.

NHS Dentistry: South-west

Steve Race Excerpts

Tuesday 12th November 2024 Westminster Hall

[Steve Race (Exeter) (Lab)]

I am here to speak on behalf of Exeter residents about the parlous state of NHS dentistry in our city after 14 years of the Tory Government, who allowed NHS dentistry to fall into complete disrepair.

We have heard that the south-west is one of the most notorious dental deserts, but most troubling is the proportion of children who get to see a dentist. In Devon, it has dropped by a fifth, from about 61% of children in 2016 to 47% in 2024, well below the English average of 55%. The reality is truly shocking. Across the country, tooth decay is now the No. 1 reason why children are admitted to hospital, and more than 40,000 children in 2021-22 had teeth removed at hospitals across the UK. That is the case in Exeter too. The Royal Devon University Healthcare NHS foundation trust states in its annual accounts that tooth decay is still the most common reason for hospital admission in children aged between six and 10 years old. According to the oral health survey of five-year-old children, more than a fifth of children in Exeter—22%—have tooth decay by the time they are five.

I talked to one of my local primary schools in preparation for this debate, to get the views of its staff. They said that they know of multiple children who have had teeth removed due to a lack of dentistry and then had to miss school. Some children have joined reception with all of their teeth brown or blackened stumps. Children are missing school due to being in agony from toothache and having no dentist, and many families—and indeed teachers—are unable to find an NHS dentist that will take them on. It is truly shocking, and, as with many things, our primary schools do what they can to pick up the slack. This primary school already teaches children how to brush their teeth, and they do so each day in reception. Exeter’s NHS dentist crisis is not just having a detrimental impact on people’s teeth and health; it is having a detrimental impact on children’s education and on our economy. It is also having a detrimental impact on our local A&E department, which is already stretched to capacity. Tooth decay forced 740 patients to attend the emergency department between April 2022 and March 2023, according to NHS Digital data.

Comparing NHS regions, those in the south-west and south-east were least likely to have an NHS dentist and most likely to have a private one. Given that the cost of simply being accepted on to a private dentistry register can be upwards of £70 a month for a small family, before treatments are added in, this is clearly a cost of living issue for many.

As referenced already, the NHS dental budget across the south-west is underspent by more than £86 million in the financial year 2023-24. That is not due to any lack of demand, of course, but largely due to dental practices being unable to work under the current NHS contract, which simply does not cover the cost of treatment. We are asking dentists to deliver NHS services at a loss, which is clearly unsustainable.

Instead of seeking to provide flexibility in the dental contract, as I know some integrated care systems do across the country, Devon ICB simply reallocates that dental funding elsewhere in the budget, despite the fact that it is supposed to be ringfenced. That is causing us further issues in Devon, as the BDA informs me that dentists are leaving the NHS in droves. In Devon, we saw a 9% drop in the number of NHS dentists last year alone.

My residents welcome the Labour Government’s pledge to provide an extra 700,000 urgent dentists’ appointments and to reform the NHS dental contract, as part of a package of measures to rescue NHS dentistry. I know the Department is working at pace to roll out those extra, urgent dental appointments, and to pave the way for a new reformed dental contract.

I met the chair of the BDA recently to talk about Exeter specifically; he stressed that NHS dentists, who are stung by the many broken promises from the previous Government, need the Labour Government to deliver meaningful change, including a clear timeline for negotiations. I know the Government treat NHS dentistry extremely seriously—the Health Secretary made the BDA the first organisation he met after the election—and I was pleased to hear the Prime Minister say recently at Prime Minister’s questions that he would work as quickly as possible to end the current crisis. Given what I know and what we have heard today, for my constituents in Exeter that change cannot come soon enough.