APPENDIX 2
Memorandum by Association of Directors
of Social Services (SH 5)
1.1 The Association of Directors of Social
Services (ADSS) is pleased to be invited to submit evidence to
the Parliamentary Hearings, and welcomes a new Government approach
for a national strategy on sexual health and HIV.
1.2 The ADSS is concerned that the strategy
addresses the social and health care needs of a very diverse population
in England and that the changes are sensitively managed. This
is adding to an environment already experiencing rapid change
and uncertainty. It is also important that the implementation
of the strategy takes full account of the successes and lessons
learnt since the start of the HIV pandemic 19 years ago. The key
role of social care and support services in enabling people living
with HIV/AIDS to live longer and healthier lives in the community
needs to be recognised and built on.
1.3 The Government has introduced a wide
range of national initiatives, which Councils and, in particular,
Social Services have lead reponsibility for implementing. They
bring with them significant challenges, including the recruitment
and retention of skilled professionals. Demographic changes also
impact heavily on social care services, and resources must be
set aside for us to respond effectively. Discharging patients
with an AIDS diagnosis without the right support structures in
place defeats the objective of responding to the crisis in waiting
lists in the NHS and good patient care. It is also worrying that
funding to Social Services for promoting independence to provide
support will cease at the end of this financial year. This is
occuring at a time when we face financial pressures and overspends
of £200 million last year which are largely due to the increase
in the number of children coming into care—some of whom
are children of teenage parents and children affected by HIV/AIDS.
1.4 The strategy reads very much as a "medicalised"
report with very little reference to the role of Local Authorities
and Social Services in particular. The document does not address
the community leadership and regeneration roles that Social Services
carries with partners. Our role is to know the needs of diverse
communities and to respond, often not on our own but in a range
of ways and in partnership. This starts with individuals, for
example a mother living with AIDS presenting with a range of cross
cutting themes—an asylum seeker from a war torn East African
country, often isolated and excluded from the wider community,
may experience racial discrimination and harassment and may be
in need of housing for herself and her family. Social Services
professionals work in partnership with many cases such as this
and staff use a range of skills to find solutions. These solutions
are often outside the Health domain and require corporate working
with other parts of Councils.
1.5 Social care professionals play a pivotal
role in the prevention of HIV and other STIs and this is recognised
by the strategy. The strategy however does not address the sexual
health needs of vulnerable young people. Whilst there is encouraging
news about a small decline in teenage pregnancy rates, we would
caution against complacency. The involvement of service users
and the right messengers are key to the delivery of HIV prevention
and there are many good examples such as the London Borough of
Newham "Healthy Alliances schemes", where good practice
can be drawn on.
1.6 We would urge wider promotion of evidence
based models and work with a range of communities and strongly
support the targeting of HIV related work amongst East African
communities. The development of good practice guidelines for working
with African communities is necessary.
1.7 Whilst the document rightly calls for
the involvement of service users in planning there is no mention
of models for facilitating this important principle. Social Services
have much to offer in this respect as highlighted in 4.1 above.
The needs of lone parents, refugees and other hard to reach communities
are often missed, and we would liked to have seen some coverage
of this in the strategy.
1.8 The AIDS Support Grant has led to effective
service responses in England and a review of the ringfencing arrangement
is underway. The ADSS will be part of the early discussions and
it is also necessary for us to be involved in how the additional
£47.5 millions will be allocated to support the implementation
of the national strategy.
1.9 We are hopeful that the strategy will
tackle the spread of STIs including HIV. However, the reduction
in stigma (especially to those communities already experiencing
discrimination and marginalisation) is also important, and leadership
at a number of levels including Government is necessary to achieve
this.
For further information contact: Robert Maragh,
London Borough of Newham, Broadway House, 322 High Street, Stratford,
London E15 1AJ. Telephone 0208 430 5242. E mail robert.maragh@newham.gov.uk
28 May 2002
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