asked Her Majesty's Government:
What role strategic health authorities and primary care trusts have in the follow-up treatment and care for victims of rape; and what training is given to doctors who have responsibility for the forensic examination in pelvic anatomy on how to approach this aspect of medical care.[HL6610]
Neither strategic health authorities (SHAs) nor primary care trusts (PCTs) have any direct responsibility for the follow-up treatment and care of victims of rape.
The role of PCTs is to commission services based on local assessments of need. It is their role to commission a comprehensive and equitable range of high-quality, responsive and efficient services, within allocated resources. PCTs operate within the framework of Department of Health policy; they are held to account for this by SHAs, not directly by the department.
The role of SHAs is to ensure that local systems operate effectively and deliver improved performance, by working in partnership with PCTs and holding them to account for their performance.
However, a number of initiatives are taking place across Government to develop policy and improve practice for victims of rape and sexual assault. One of these is the national sexual violence and abuse stakeholder advisory group, chaired by Home Office Minister Mr Vernon Coaker and Department of Health Minister Ms Caroline Flint. In addition, a national sexual violence and abuse action plan is being developed by the Home Office with the Department of Health and other government departments.
The Department of Health has also been working closely with the Home Office to develop sexual assault referral centres (SARCs), and national service guidelines for developing sexual assault referral centres were published in October 2005. In addition, since 2003, £1.27 million from the Home Office Victims Fund has been spent on new and existing SARCs. SARCs operate in 14 locations in England and Wales, and six more are due to open in the forthcoming year.
The Victims of Violence and Abuse Prevention Programme, run jointly by the Department of Health and the National Institute for Mental Health in England, is working in partnership with the Home Office to develop national service guidelines.
There are no national standards for training of doctors providing medical examinations and aftercare following sexual assault. There is currently no United Kingdom qualification in sexual assault examination and aftercare.
The content and standard of postgraduate medical training is the responsibility of the Postgraduate Medical Education and Training Board, and the General Medical Council's education committee has the general function of promoting high standards of medical education. Both bodies have a vested interest in ensuring that doctors are equipped to deal with the problems they will encounter in practice, including forensic examination of victims of rape. It is not, however, practicable or desirable for the Government to prescribe the exact training that any individual doctor will receive.
However, courses are available for training doctors and nurses to carry out examinations following sexual assault; for example, those run by the London Havens and by St Mary's Hospital, Manchester. To become competent in this area of work, new doctors working in the London Havens:
attend a two-day adult rape course;
attend a two-day child sexual assault course;
attend a one-day court training course;
attend subsequent updates;
shadow examinations conducted by experienced doctors;
conduct their first few examinations under supervision, and have their statements checked by an experienced colleague.