CONTRIBUTION OF VOLUNTARY CARE
173. The Department recognises the vital role played
by the voluntary sector in working with people affected by HIV/AIDS
to providing care and support. It looks to the voluntary sector
as a model for innovative and flexible service provision and has
undertaken to develop "better strategic arrangements for
commissioning voluntary sector services".[160]
174. The Public Health Minister told us:
Clearly the voluntary sector at local level will
be important but we also think the voluntary sector nationally
is very important here in terms of the funding we allocate to
the Terrence Higgins Trust, the National AIDS Trust, and particularly
the work around African communities increasingly ... funding will
still be continued at national level to make sure the very important
work that those national voluntary organisations are doing is
able to continue.[161]
175. We heard from Mr Simon Collins, who has worked
in the voluntary sector for five years. His voluntary organisation,
HIV i-base provides publications to healthcare professionals,
a monthly bulletin for doctors, and a range of patient guides;
as well as a treatment support telephone line for patients and
links to European treatment networks for patient access. We asked
Mr Collins about funding for this work:
It is a very good question. It is very hand to
mouth. Although our organisation has been running for several
years, there is no money in the bank at the end of the month and
it is very difficult to identify a central fund which links to
the NHS given the services we provide.[162]
176. The Terrence Higgins Trust reported that voluntary
sector HIV services were "struggling to meet client need"
and that uptake of its own services had increased by up to 500%
in some areas.[163]
Mr. Nick Partridge of the Trust warned us of potential risks to
voluntary organisations providing HIV/AIDS services posed by the
restructuring of health authorities into PCTs. He compared the
restructuring to the disaggregation of county councils and as
an example of the potential effect on voluntary HIV/AIDS services,
told us that when Avon County Council disaggregated into three
unitary councils, one of the new councils decided that it did
not wish to allocate monies to Terrence Higgins Trust West and
so funding for that unit was cut by 25%.[164]
177. Evidence from Mr Collins and Ms Lowbury reinforced
our worries about the risks to voluntary sector services posed
by the end of ring-fencing and by the devolution of commissioning
powers to PCTs:
If you are losing any specialist commissioning
which included support for voluntary organisations then there
is a concern as to whether those organisations which used to receive
that funding will continue.[165]
And: -
with so many different commissioners, potentially
if the commissioning is devolved to PCT level, one voluntary organisation
which maybe provides services across an area equivalent to a strategic
health authority or more is going to have so many different commissioners
to negotiate the contracts with that they could spend all their
time negotiating contracts.[166]
178. We welcome the Government's acknowledgement
of the voluntary sector contribution to HIV services. We have
received a great deal of evidence to suggest that the voluntary
sector can reach many HIV-positive people who will not access
statutory services. We recommend that the Government reciprocate
the support it receives from voluntary groups in terms of practical
work and policy guidance by supporting voluntary work at both
national and local level. It would be counter-productive if the
Strategy led to any diminution in the funding given to
these bodies. Some HIV services (such as targeted prevention work)
can only be provided by organisations which are very closely in
touch with their communities and these services must be adequately
resourced.
120