Data on newly acquired HIV infections are not available, but an estimated 5,817 people were reported as newly diagnosed with HIV infection in 2007, compared with 6,769 in 2006. The figures include people with long-standing infections, including many who were infected outside England but who were subsequently diagnosed in this country.
I thank my right hon. Friend for her answer. She will know that there is a serious problem not only with the overall numbers, which, although coming down, were recently still up on the 1997 figure of, I think, 3,000. She will also know about the problem of late diagnosis—people being diagnosed six or seven years after becoming infected, by which time they have become highly infectious and less likely to respond to treatment. She will be aware that London’s strategic health authority has highlighted that big problem and is trying to address it with a target to halve the number of people who are diagnosed late. Will she seek to use her influence to spread that target and practice throughout all health authorities in the country?
My hon. Friend raises a very important point. He will know that the prevalence of HIV in England is one of the lowest in Europe—comparable to that in Sweden, the Netherlands and Denmark. Nevertheless, he is quite correct: about 31 per cent. of those who are infected are unaware of the fact. The steps that the Department has been taking have been, first, to focus on publicising the importance of early testing and on providing extra resources; secondly, to improve timely access to NHS testing, particularly in a variety of settings, not just in genito-urinary medicine clinics; thirdly, to look very specifically at where the highest risks are and to ensure that information and support are provided to those groups to encourage them to come forward for testing; and, finally, to undertake work with those in the voluntary and third sectors, as well as with local health authorities, to try to remove the stigma and the perceived discrimination that many people fear in order to encourage them to come forward.
Has the right hon. Lady had any recent discussions with her colleagues in the Department for Work and Pensions about the growing concerns regarding medical assessments of people with HIV infections, in respect of disability allowances and of fitness for work? It is a growing concern, and it would be very useful if she were to have appropriate discussions with the DWP to ensure that it applies the right tests.
I have not had any discussions recently about that point, but if the hon. Gentleman has specific issues and experience in his constituency I would be very happy if he sent them to me, because clearly we must ensure that medical assessments are conducted correctly, particularly with regard to that very vulnerable group.
I am sure that my right hon. Friend recognises the risks to public health from the greater number of new infections and from people who are undiagnosed. Given that, will she look again at including HIV in the list of infections that are exempt from NHS charges? We must have a balance between the public health risks and the financial costs, recognising that the risks outweigh the costs.
All people who are ordinarily resident in England are entitled to free national health service treatment, including for HIV. My hon. Friend will be aware that that is qualified by exempting categories of individuals from charges under the National Health Service (Charges to Overseas Visitors) Regulations 1989, as amended. He will also be aware that asylum seekers are exempt from charges for all hospital treatment, including for HIV, and will remain exempt for courses of treatment that continue if and when their applications for asylum are rejected. All the points with regard to the threat to public health that he correctly identifies are addressed in the strategies that we use.
The Minister will know even from the Government’s own data that many of the at-risk people to whom she referred are from sub-Saharan Africa. What consideration have the Government given to selected pre-screening of people who apply to move to the United Kingdom through work visas or student visas, or, indeed, as asylum seekers?
The hon. Gentleman will know that the Government have announced that they are investing an extra £2 million, in addition to the moneys already committed to prevention work, to look specifically at groups of highest risk, including gay men and people from African communities. Working through the African communities and the African HIV project, we are addressing particularly the issues that the hon. Gentleman mentions. It is important that people come forward for early testing. It is not necessary to have compulsory testing. We are seeing that testing through the various clinics and measures has increased dramatically—in some cases, by up to 85 per cent.
Does my right hon. Friend agree that there is a danger that as more and more people are living and working with HIV/AIDS, the perception of the disease as being life-threatening recedes, and that any prevention programme therefore needs to recognise that change in perception and to focus very much on the fact that being able to take drugs and in most cases live a long and productive life is not a reason to assume that one is not at risk?
My hon. Friend is absolutely right. With the development of therapies and treatments, it is particularly important that people understand that HIV is still a deadly disease. We particularly need to understand—the Department is taking this forward—which groups in the community may be less aware of the risk, or have a belief that they can live with it, and to target additional information and support to them to encourage them, first, to come forward for testing, and, secondly, to desist from activities that increase their likelihood of HIV infection.