Local Authorities take on responsibilities for Sexual Health Services; Photo: Renew Leeds

NHS reforms will result in a fragmentation of services around HIV in Hackney and Jonathan McShane, the council’s cabinet member for Health says the implications are “a real worry” for an area with one of the highest HIV infections in the country.

McShane says the reorganisation is a distraction and means the borough will be “losing many talented staff with skills and expertise.”

At a Local Government Association conference in Smith Square, Westminster, May 9, discussing the impact of the reforms on sexual health services, it emerged that Hackney is in the top five boroughs in England and Wales for people living with HIV- eight per thousand. A consultant told East London Lines that 20 to 30 per cent are unaware of their infection.

The high rate of late diagnosis is caused by the stigma felt in communities indigenous to Hackney. “Stigma plays an important role in discouraging people coming forward for testing…We need to promote and normalize testing, ” said Dr Iain Reeves, a consultant Physician in sexual health and HIV for Homerton hospital.

The conference heard that next year local authorities will take on the responsibility for sexual health services. This has caused concern, mainly because local authorities are already facing budget cuts.

Whilst local governments will have a fixed budget for public health in general,  how much of that is allocated to sexual health will be up to them. The reforms are being criticized because of fears they could result in ‘health inequality’ as some health services will be given priority over others.

According to the Terence Higgins Trust, sexual health services currently cost about £700,000 a year, which works out at about a third of local authorities’ overall public health budget. Many sexual health charities and organisations think sexual health services and budgets should be a central part of the government’s public health proposals. This argument was set out in a 2010 public health white paper.

The conference convened by the Local Government Association aimed to explore how health professionals, service providers and charities could work together to provide effective sexual health services for the future. Local authority representatives were also invited to attend, to be able to make informed decisions about sexual health services in light of their new responsibility.

One of the main areas of focus is HIV. The responsibility for HIV will be split; health care and treatment will be commissioned by the national NHS Commissioning Board; and testing, STI services and prevention services will  be funded and commissioned by local authorities.

Health professionals in Hackney tell East London Lines about some of the key issues affecting local sexual health services.

Councillor Jonathan McShane, Cabinet Member for Health, Social Care and Culture, London Borough of Hackney

Are you happy about the changes to the delivery of health services?

Should under 16s be able to get the contraceptive pill over-the-counter?

Dr Iain Reeves, a consultant Physician in sexual health and HIV for Homerton hospital

How important are HIV services in Hackney?

Dr Jose Figueroa, Public Health Consultant NHS City and Hackney

How can we overcome stigma surrounding sexual health?

The SHO-me website: Sexual Health Online for North East London

Hackney has one of the highest diagnoses rates of HIV in the country.

It is also currently taking part in a government practice boundary pilot, where patients can access treatment at practices which are not necessarily local to them. There have been some concerns that the additional influx of patients registering for treatment in Hackney will result in a reduction of services to current local patients.

GPs urged to boycott government health pilot

My HIV: Changes to Health Services website

Full list of City and Hackney NHS sexual health services