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Health: Sexually Transmitted Infections

Volume 802: debated on Monday 24 February 2020

Question

Asked by

To ask Her Majesty’s Government what action they are taking to tackle the spread of sexually transmitted infections in England.

My Lords, I beg leave to ask the Question standing in my name on the Order Paper, and I declare an interest as a trustee of the Bloomsbury Network and a patron of the Terrence Higgins Trust.

My Lords, while we have made progress in some areas, particularly in reducing new HIV infections, we are concerned at the increases in some sexually transmitted infections. To address this, we are working with Public Health England, local government, NHS England and NHS Improvement to develop a new sexual and reproductive health strategy.

I thank my noble friend for that Answer. The desperate truth is that we are fast approaching a crisis in sexual health. Sexually transmitted infections such as gonorrhoea and syphilis are skyrocketing, new infections such as trichomoniasis and shigella are emerging, antimicrobial resistance is on the march, and demand for services at sexual health clinics is vastly outstripping supply as clinics close as a result of brutal cutbacks.

All this was set out in chilling detail in the recent The State of the Nation report from the Terrence Higgins Trust, which underlined how action is needed immediately to deal with this crisis. Does my noble friend agree with the report that the long-term implications of all this are extremely alarming? When will the promised sexual health strategy be published, and what immediate steps will the Government take to improve access to sexual health services in England? Time is not on our side.

My Lords, I completely commend the work of The State of the Nation report by the Terrence Higgins Trust, which the noble Lord was greatly involved with. It points to a serious situation in the nation’s sexual health, but one that the Government take very seriously indeed. It is worth mentioning that consultations at sexual health services between 2014 and 2018 increased by 15%—from 3.1 million to 3.5 million. This has been in part through the use of new technology such as online testing services and delivery kits, which have proved to open up sexual testing to audiences who find attendance at GUM clinics awkward and embarrassing. However, his point on the sexual health strategy is well made. The Government are focused on delivering this strategy at the soonest possible moment. Engagement is ongoing, and as soon as that is wound up the strategy will be published.

My Lords, can I say how much I will miss the noble Baroness, Lady Blackwood, and how much I enjoyed working opposite her? Notwithstanding the noble Lord’s obvious talents, I hope that the Government will find time to appoint a Minister for the health service in this House. May I say how much I agree with the report by the Terrence Higgins Trust, The State of the Nation? Will the noble Lord comment on the lamentable statistics showing a 26% increase in gonorrhoea cases and the highest number of syphilis cases since World War II, which could be to do with the fact that since 2014 sexual health services have been cut by a quarter? When will that be restored?

Undoubtedly, the increases in gonorrhoea, syphilis, chlamydia and genital warts are of grave concern to the Government. None the less, there are huge areas of progress. New diagnoses of HIV have reduced by 29% since 2015, and the HPV vaccination programme has proved extremely encouraging. There is undoubtedly a need to figure out a new strategy for how local councils will deliver sexual health. That is why we have put the resolution of this at the centre of our sexual health strategy, which will be published later this year. Co-commissioning with the NHS will, as promised by the Secretary of State, be a key feature of that strategy and will benefit from the increase in the preventive health budget.

My Lords, does the Minister recognise that while there has been good news for some people on HIV, there is a consistent pattern of higher rates of infection among black and minority ethnic communities? What will the strategy do to tackle that inequality?

The noble Baroness makes a very important point. Engagement with groups from BAME organisations has highlighted that question. There is undoubtedly a change in behaviours around sexual conduct that it is extremely difficult to address. Advertising and engagement with groups play a part, but clearly the problem is more complicated and sophisticated than that. That is why we will put innovation at the centre of our strategy. The HIV Prevention Innovation Fund was an interesting precedent and may be one way in which we can address the kinds of problems that she rightly highlights.

My Lords, the Minister mentions the issue of chlamydia with grave concern. He can write to me if he does not have the figures, but how often is chlamydia clearly implicated in damage in the female pelvis—in other words, in damage to fertility? It is greatly overexaggerated, and it is important to know that, because it causes a great deal of concern and guilt among a lot of women.

The noble Lord’s interest in this area is well known and he makes his point very well. The chlamydia screening programme is reviewing the way in which it looks at chlamydia and the possible implications of chlamydia, and I would be glad to chase down the numbers that he requested.

My Lords, I remind noble Lords that I sit as a non-aligned Member of the House. The noble Lord, Lord Black, is right to talk of the compromised access, which includes difficulties in getting appointments, longer waiting lists and clinic closures. That affects workforce and patient experience. Therefore, what assessment have the Government made of the pressures facing the sexual health workforce in England?

Access is absolutely key, as the noble Lord rightly says. Resources are heavily stretched, and the patient experience is not what one would hope it would be. That said, I reassure noble Lords that the British sexual health provisions in the NHS, although open to criticism, are among the best in the world and we should be very proud of them indeed. I have not been briefed on the impact on sexual health workers, but I would be glad to look out for that information and chase it down.