Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 880-899)



  880. That would have to mean a totally different kind of programme than the one we have got now where you get a couple of lessons for everyone.
  (Ms Buist) I think another problem is the fact that sex education is tokenism and it is taught by PE teachers or English teachers. We have trained English teachers to teach English, we have trained maths teachers to teach maths, so if there were specialists to teach sex education, it would be more than just token information which is largely patchy and left out. I have always felt that they have had an information pack thrown at them and they were told to read out what was on the sheet. They did that in my school. Some people were not very mature about it. I just think that because it is so token, if we got specialists to do it, that would certainly make it a lot more valid.

  Dr Naysmith: How does David feel about it as the only young man on the panel?

  Chairman: A very brave young man!

Dr Naysmith

  881. Should they be taught in separate groups?
  (Mr Morris) I think it should be appropriate to people. Also education about people liking the same sex should be taught as well and a different variety of things. That is my opinion.


  882. Can I just press you on this issue of whether it is better to have separate sessions for males and females because we picked up in Manchester that there is a lot of tittering among the lads sometimes and perhaps less maturity sometimes for obvious reasons, so would you have felt, David, and I do not know what sex education you had in your school, but looking at what you have picked up from the work you have done, do you feel that we should be recommending that it should be done in separate sessions or do you feel that it is quite reasonable to do it in mixed sessions?
  (Mr Morris) When I was at school it was separate sessions. The girls went off and did their thing and the guys went off and did their thing. I think it does not really matter whether it is the same sex or not. Maybe some people prefer it to be separate because then the girls can talk about girl issues and the guys can talk about guy issues rather than being embarrassed about it in front of their boyfriends and things like that. I think it depends on the person.

  883. What is the feeling of the other witnesses?
  (Ms Nicholls) We actually have a recommendation on this, that there should be a multi-agency teacher approach, including specialist teachers and all issues should be raised, including male issues and female issues. Now, this does not just mean that we are going to take the blokes off to talk about bloke things and take the girls off to talk about girl things. The females, the young ladies, should be allowed to get just as much sex education and information on what goes on with a boy as they should with themselves because at the end of the day they are both coming together to have sex, so they need to know what is being offered in both parts. With sex education with the lads tittering, obviously you do always get the, "Oh, that's really funny!", so we were recommending doing different things like role-play, using CD-roms, putting on sports events. It could be something like putting on a football match where every person represents something different. Little things make a big difference when it comes to sex education, especially the difference between different cultures and things like that. My best friend is Catholic and in her school they do not get sex education and it is a really big shame, but obviously everyone is taught about the Catholic religion in RE because you do not just get taught Christianity, but you get taught Buddhism and everything, so why not get taught about everything in sex education. It just seems to be on a one-way track of, "This is what sex is, two people together", and it is not and there are so many other paths which need to be gone down regarding sex education.

Sandra Gidley

  884. Are you saying that what you are taught is actually very mechanical and basic and you do not explore the emotional aspects or the relationship aspects and it is all taught in a bit of an embarrassed way?
  (Ms Nicholls) Yes, it was kind of, "Boy meets girl, girl meets boy. Boy likes girl, boy and girl kiss", stuff like that. I remember the only lesson we had on sexual health, there was nothing about chlamydia or syphilis or anything like that, but it was a leaflet passed around the class about AIDS and HIV which then got taken back to the form teacher at the end of the lesson to use in next week's lesson with a different group.

  885. Do you think that your parents should be educated? I have two teenagers. My daughter can talk to me about anything and my son is, "Oh, Mum!", and it is all very difficult, but a lot of teenagers cannot talk to their parents and the parents find it equally difficult. Do you think there is a need for actually putting a course on for the parents so that they can actually talk about these things more realistically with young people without it all getting reduced to the very personal sometimes?
  (Ms Webley) I think it would be a good idea to do that, yes. I remember once when I was in small school that you got a leaflet about the changes you would be going through and then there was a little booklet for your parents which did explain the changes that we would be going through and how to help us through it which I thought was really good, but since then there has never been anything else. That was just it, so I thought, "That's a good start, but you need to give more information for when the changes occur", but it stopped there.

Dr Taylor

  886. I am more and more interested in the place of the parents, although I think that is going to come up a little bit later. I wanted to go to the Wakefield people to learn a little bit more about the Options clinic. Is this open access, walk in any time?
  (Mr Morris) It is evenings, two nights a week.

  887. Where is it physically?
  (Mr Morris) It is out of town and it is not signposted or anything.
  (Ms Nicholls) It is in the family planning clinic and the worst thing about the family planning clinic is that it is directly behind Wakefield College. Now, no one can see it because it is directly behind Wakefield College, yet there is a door to go into Wakefield College that you can walk straight through and then straight out of the back door and it is there, but no one knows how to go around Wakefield College to get to it and there are no signposts for it or anything.

  888. Is it meant for sexual health matters or for support on any matter for young people?
  (Ms Webley) It is for relationships as well as sexual health issues.

  889. Is there a stigma in going to that or can you creep in because it is so hidden without anybody knowing?
  (Ms Nicholls) The worst thing is that you have got to ask someone where it is to actually be able to get there.

  890. Going on to services for young people with sexual health problems, we have rather skated over the sexually-transmitted diseases. You just began to mention them. We have got to avoid personal questions, so these are very general questions. Do you feel that the education even attempts to cover the risks of the sexually-transmitted diseases? There are lots of shaking heads behind.
  (Ms Hall) When we were doing the questionnaire, I found that more people were concerned about getting pregnant than they were about HIV and STDs.

  891. We have heard that time and time again, that the risks of the infections are felt to be far less than the risk of getting pregnant. If any people in your area had worries about a sexually-transmitted disease or infection, how would they know where to go? Would you know where to go? Is that information available or not?
  (Ms Webley) I would never know where to go.

  892. You would not know where to go?
  (Ms Nicholls) No. This is what we are saying, that there is not enough information or contact numbers for young people. This goes back to the school planners. We say why can they not put a page in the school planner with all the contact numbers on? Advertising is a big part.
  (Ms Buist) It is our job to know, not personally.
  (Ms Nicholls) Why can they not put posters on the back of buses or in pubs and clubs, on the back of toilet doors? Most people come to us because we have been educated on it obviously.
  (Ms Buist) That took a lot, to find out where everything is. The best description I could get was, "It's behind Boots". It was not behind Boots, but then of course there was a great big thing, saying, "Sexual health this way", and there was a winding path you have to go down with everyone looking at you and you just want to say, "I'm just here for research!"
  (Ms Nicholls) The GUM clinic in Wakefield, I had already been there twice before, but I had always gone by car, but this time I had to catch the bus because I was going from college and I could not find it. I asked someone on the street if they knew where the GUM clinic was and they said to me, "The nearest dentist is just down the road"! I gave in and walked to the hospital and they had someone on work experience behind reception and by this point I was bright red. I was not really that bothered, but I thought, "Oh no! People are looking at me now", so I walked in and said, "Can you tell me where the GUM clinic is?" and he said, "I don't know". There was nobody else around, so he had to ring a nurse to come and get me to escort me round. I had to walk all the way through the hospital and I got there, but I actually could have just got off the bus and walked down one street, but there was no signpost to tell me that I could have got off the bus there and walked down that street. If I cannot find it when I have already visited it and I do all my research there, how are young people supposed to find it?
  (Ms Buist) That is something they all ask really, about the level of inaccessibility.

  893. So what would be your ideal service? What would you like? Where would it be? How would you access it? Would it be connected with school or how would you access it?
  (Ms Nicholls) One of our recommendations was that sexual health clinics could be put in other areas, like there could be a sexual health clinic in a sports centre, for example, so everyone knows where the sports centre is, they can go into the sports centre, access the clinic and maybe if they are a young mother, the children can get discounts on activities or they could perhaps get a discount on an activity. Walking into a sports centre, everyone knows where it is, but no one knows what you are actually going into the sports centre for because you are going to the gym, are you not, so it is things like that. We are really trying to push this, for all the services to be under one roof which we know is so terribly difficult because you have got all the equipment, but the worst thing is people going to the family planning clinic and then being sent to the GUM clinic which is about a two-minute walk away, but they cannot find it. Then on the way up there they are panicking already because they have been sent to another clinic, thinking, "Oh my God!" It is a hit-and-miss situation basically. If you can get to the family planning clinic and they can give you everything you want, you are sorted, but otherwise you are not. One of our recommendations is alternative venues, even if it is for two hours a week in a room in a sports centre, like I say, because everyone knows where it is.

  894. That is a very good idea to have it in sports centres. Do you access your own GPs or would you access your own GPs for these sorts of problems or would you try and avoid that?
  (Ms Nicholls) I personally do because it is a family GP and it is a two-minute walk from my house, whereas to get to the sexual health clinic, I have to catch a bus into town, which is another problem for young people because they think they cannot afford it and they do not know that certain clinics do actually refund your bus fares, so that is another thing we are trying to push forward. Our GUM clinic refunds the bus fares and no one knew this, so we said to them, "No one knows", so they have actually put a poster on the wall now, saying, "We will happily refund your bus fares", but no one knew about two months ago that they would do that. It is a big situation that needs a lot of work. It is not something obviously that can just be done overnight, like with the waiting room being swapped around, but it is one of the main reasons why young people will not access services because they cannot get to them. They do not want to go to the GP because it is their family GP or they cannot afford to get there.

Dr Naysmith

  895. There are clinics like that in the Bristol area which operate for a couple of hours in an evening and that sort of thing, but one of the criticisms of them, and there are not enough of them, but one of the criticisms of them is that young people just turn up there because they know that they can get free contraceptives.
  (Ms Nicholls) This is the point that we went through. We have not actually recommended anything on it but it is a point that we went through. The main thing was that we needed to let young people know the difference between protection and contraception to start with and the fact that even if they are only turning up at the Options Clinic to get contraception and to get free condoms, it is better than them not turning up at all.

  896. What we really want is where people will talk about things in a deeper way rather than just collecting free contraceptives. Is that not what we need?
  (Ms Nicholls) Yes. We came up with the Buddy Scheme as well which was one of our recommendations, that perhaps young people could actually work for our Options Clinic; they can be there waiting and, when someone comes, they can sit with them and explain to them what is going to happen and explain to them what they can actually get out of the Options Clinic and even go into the room with them if they wanted them to but again that comes down to confidentiality. If they had someone there to actually talk to them and say what is going to happen, that you can get this, this and this and that you do not need to just come in and get your condoms and leave, that there are a number of other offers you can get from the sexual health clinics that would help the process, then people would not just think of it as a free condom machine which is one of the main thoughts at the moment. People do not know that, at the family planning clinic, you can actually go and talk to a doctor about family planning. It is not all about contraception. You can sit down and say, "Do you think this is the right time for me to go? Is it the right time for me to have a baby?" Obviously this does not involve young people as much, but young people do not know that that offer is there and available to them if they want them.

  897. We saw some clinics in Sweden which is much, much wider than that, where people can go and talk about all sorts of relationship issues and they are comfortable and welcoming places. These are for young people up to the age of 23. There are not many of those in this country and you would obviously want to see more of that.
  (Ms Nicholls) Yes. That sounds like a really good clinic.

John Austin

  898. This has been partly touched on by something Sandra Gidley said earlier regarding the different relationships she may have with her son and her daughter but, in previous inquiries on other health issues, there has been general evidence that women are much more in touch with what is going on in their bodies than men are and are much more likely to talk about that and share that with peers than men or young men are. I do not really want to put Mr Morris on the spot but a number of people have said that young men feel excluded from sexual health services, perhaps through embarrassment or perhaps through lack of knowledge. What do you think can be done to improve services and accessibility for young men?
  (Mr Morris) I think that a number of young men do not go to the services because of this macho thing with their friends and they are embarrassed to go, but I think women are as well. I think that maybe having a separate clinic for guys as well as women in the evening is a good idea. It is mixed at the moment but, if they had one for men and one for women or mixed, they could go to whichever one they wanted to and that would be a big help. Then they would not turn up when their girlfriend's friends are there. I think that would help.
  (Ms Nicholls) There is a well women centre for women obviously and there is MESMAC which is for bi-sexual people sexual health services but, off the top of my head, I cannot really think of a service that is typically aimed at males and males only.
  (Mr Morris) There is one but it is more about rape and trauma for men. That is about it really. There are no male clinics, it is all mixed. There are a number of women ones about and I think that, if there were more male ones, it would be a lot better.
  (Ms Nicholls) Even if it is not so much the well women centre, which is obviously a full centre in itself, and even if it is not a full centre like with the Options Clinic, like Mr Morris said, if it were lads night only at the Options Clinic . . . You could make a joke out of it: "Lads Night Only—you can put the footie on the TV!" Do you know what I mean? For the women, pictures of Gareth Gates, Will Young and what-have-you can be stuck on the wall.


  899. What do you have on your bedroom wall?
  (Ms Nicholls) I have David Hinchliffe on my bedroom wall! It is true. We had his photo taken for the paper and my mum was a bit excited about it because it was all about coming to London, so she put it in a big frame and stuck it on my bedroom wall!

  John Austin: I hope that is not going to devalue any of the evidence you have given us! Lack of judgment and all that!

  Mr Burns: Your street-cred has been undermined!

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