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Sexual health services face 'perfect storm'

Eleanor Draeger at work - 16x9
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DRAEGER: 'Health is now competing for funding with roads, schools and pot holes'

Doctors have warned of a ‘perfect storm’ in sexual health as councils impose big changes and deep cuts on services while rates of some STDs (sexually transmitted diseases) skyrocket.

The warning comes from BMA consultants committee dermatology and venereology specialty lead Eleanor Draeger who has become alarmed at the way services have been handled by some councils since they took over the purse strings in 2013.

The official figures reveal councils expected to slash spending on advice and prevention in sexual health by 20 per cent last year compared with 2014-15.

These cuts to vital preventive work come as the national public health agency named ‘worsening sexual health’ in London as one of its ‘biggest’ concerns.

Rates for two major STDs – syphilis and gonorrhoea – shot up by 22 per cent and 15 per cent respectively in London between 2014 and 2015, Public Health England said in a report released last week.


No shelter

London genitourinary medicine consultant Eleanor Draeger said sexual health services had, until recently, been relatively shielded from council cuts but were now facing ‘massive’ reductions.

‘Sexual health has always been a Cinderella service, based at the back-end of hospitals. Now that is going to get worse. Health is now competing for funding with roads, schools and pot holes.’

Services in Dr Draeger’s own local authority area of Lewisham, London, face a 10 per cent cut according to a paper the council put out to consultation in July.

The south London borough hopes to cut costs by adopting a ‘London service model’ that cuts ‘highly specialised services’, expects patients to register for STD tests online and expects GPs to handle more cases.

‘I worry that moving sexual health services out of the NHS and into local authorities has already resulted in a poorer service to patients and will continue to do so,’ said Dr Draeger.


Powerful strains

Dr Draeger added that she was also concerned about reduced access to GUM (genitourinary medicine) clinics with the emergence of more powerful strains of gonorrhoea that required specialist treatment.

‘If we don’t give an effective treatment to patients with resistant gonorrhoea at the right time it is more likely to be passed on,’ she added.

‘If you are cutting access to a GUM clinics by closing some or reducing hours, people won’t be able to access that treatment and there will be an increase in rates and complications of gonorrhoea.’

The first cases of highly resistant gonorrhoea were recorded in the north of England in 2014. The total number of confirmed cases in England until April 2016 was 34.


False economy

BMA public health medicine committee chair Iain Kennedy agreed there was ‘real pressure’ on sexual health services.

‘This is just one of many important preventive services that are being run down as a result of the cuts to public health and other local Government funding,’ he added.

‘Cutting these essential NHS services is a false economy which will only cost the health service more in the long run, while increasing health inequalities.’

NHS England chief executive Simon Stevens has also flagged concerns about shrinkage of sexual health prevention services, warning that cuts would soon pile pressure on other parts of the NHS.

‘If those services diminish, that shows up as extra demand in more expensive parts of the NHS within 12 months, not within 10 years,’ he told the Commons health select committee recently.

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