Select Committee on Health Written Evidence


Memorandum by the Association of Directors of Social Services (ADSS) (HA26)

  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 developments in HIV/AIDS and sexual health policy.

  1.2  The ADSS continues to be concerned that the new developments addresses the social and health care needs of a very diverse population in England and that the changes are sensitively managed. There is considerable emphasis on measures to improve the health and well-being of children and young people, including their mental health and the new measures and publicity campaign needs to be age appropriate with emphasis on promoting healthy schools and prioritising SRE guidance in schools and community settings. A "youth offer" that will be the subject of a forthcoming Green paper will include proposals to improve health and provide alternatives to risk taking behaviour. Targeted information and services aimed at young people will need to involve young people in the planning, development and evaluation of this important initiative.

  1.3  All this is adding to an environment already experiencing rapid change and uncertainty. It is also important that the implementation of the new developments 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. It is also vital to engage with disadvantaged communities such as teenage parents in the tackling of teenage pregnancy.

  1.4  The Government has introduced a wide range national initiatives, which Councils and, in particular, Social Services have lead responsibility 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. The impact of reduced funding to Social Services for promoting independence to provide support has ceased and there are ongoing financial pressures leading to overspends of several millions last year which are largely due to increase in the number of children coming into care—some of whom are children of teenage parents and children affected by HIV/AIDS.

  1.5  The personal social care aspects of current policies are missing and with little reference to the role of Local Authorities and Social Services in particular. Nor do they 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 care 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.

  1.6  Social care professionals play a pivotal role in the prevention of HIV and other STIs yet the funding for this work is patchy throughout the country. Whilst nationally, there is encouraging news about a small decline in teenage pregnancy rates, we would caution against complacency as the rates of new conceptions in Inner-London and other metropolitan areas are rising.

  1.7  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 and vulnerable children and young people. The development of good practice guidelines for working with African communities is necessary.

  1.8  The AIDS Support Grant has led to effective service responses in England and future funding must be guaranteed as developments for communities previously not included are underway. The Local Implementation Grant for tackling teenage pregnancy is crucial and funding beyond the next two years must be guaranteed.

  1.9  We are hopeful that the policies implemented at a local level 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 including Government is necessary to achieve this. Despite the reservations expressed above, it must be said that there is more public and policy interest in sexual health than there has been for decades but policy must be genuinely holistic.

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