APPENDIX 20
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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