My Lords, our policies to prevent HIV and other sexually transmitted infections are assessed through a number of measures. These include monitoring the local NHS delivery plans, including the national target on 48-hour access to GUM services, evaluation of mass media campaigns and data on new diagnoses from the Health Protection Agency.
My Lords, is it not a fact that the latest figures show that compared with 1998, new diagnoses of HIV have risen by 165 per cent and of chlamydia by 125 per cent, and that inside the health service, money intended for sexual health has been diverted away for other purposes? Is that not a totally unsatisfactory and unhappy position and is it not time that the Government mounted a concerted and properly financed campaign on sexual health in this country?
My Lords, I pay tribute to the noble Lord for his work on and involvement in the 1986 AIDS campaign programme. But the circumstances are different now—much less was known then, and the programme targeted the whole population. We now know that the main area of concern around HIV and AIDS is for gay men and those with contact with various parts of the world where the disease is prevalent, and the programme of action the department has enunciated is targeted at those at-risk groups.
The noble Lord is right to refer to some rises in instances of sexual illness. This is a priority for the Government and a great deal of progress is being made, particularly in developing enhanced GUM services.
My Lords, does the Minister agree that sex education is very important in combating sexually transmitted infections? If so, will he say how the Department of Health and the Department for Education and Skills are collaborating to improve the situation with regard to young people?
My Lords, I agree with my noble friend. I can reassure her that my department and the Department for Education and Skills work very closely together to promote sexual health through the healthy schools programme. It is worth reporting that there has been a reduction in teenage pregnancy rates: between 1998 and 2005, the under-18 conception rate fell by 11.8 per cent, evidence that the programmes that have been developed are proving effective.
My Lords, given that the AIDS Funders Group report showed that services, particularly those of prevention and support, are being stopped and then started again only because different commissioning streams come on stream at different times, does the Minister agree that there is something ineffective and wasteful about the way services are being commissioned by the NHS?
No, my Lords. Local primary care trusts have first responsibility for ensuring that services are commissioned appropriately and it is important that they should do so. Of course we want to see consistency in that approach, but the fact that PCTs have enhanced GUM services and that the target we set for people to receive an appointment within 48 hours has now been achieved—70 per cent as compared with 45 per cent in May 2005—shows that they are having a positive impact.
My Lords, I am referring to the provisional 2005 under-18 conception rate, which is 41.1 per thousand girls aged 15 to 17. That represents an overall decline of 11.8 per cent since 1998. The under-18 conception rate is at its lowest for 20 years, which is very encouraging.
My Lords, I am aware of the effect of the noble Lord’s leadership at the time, which I have already commended and I am happy to commend again. He will know that I was then director of the National Association of Health Authorities and there was close collaboration between him and his department and the National Health Service on those issues. At the time, very little was known about HIV/AIDS, which is why a campaign aimed at the general population was the most appropriate. However, we now understand that the groups at increased risk of HIV sexual transmission remain gay men and people who have had links to countries overseas where there is a high prevalence of HIV/AIDS, such as sub-Saharan Africa. The campaigns that the department is involved in funding are focused on those groups.
Of course, other sexual health campaigns are targeted at the general population, including encouraging the use of condoms and responsible sexual behaviour. Those, too, are very important in ensuring that we grip this issue.
My Lords, my understanding is that uptake of the first dose of hepatitis B vaccine should be 90 per cent by the end of 2006 and uptake of three doses of hepatitis B vaccine in those not previously immunised within one of the recommended regimens is targeted to be 70 per cent by the end of 2006. Clearly, we are working hard to meet those targets. The figures for 2005 are 89 per cent for the first dose of vaccine and 39 per cent for uptake of three courses of vaccine.