Examination of Witnesses (Questions 60-63)|
27 JANUARY 2005
Q60 Dr Naysmith: This special budget
for HIV/AIDS which was seen as separate from
Ms Power: The ring-fenced budget.
The money is still there. It is not ring-fenced, but the money
should still be there, plus there are a number of special allocations.
The question is to encourage primary care trusts to use that money
for the purpose for which it was identified and not to move it
into other budgets.
Q61 Dr Naysmith: Some are moving it into
other budgets, is the implication of what you are saying.
Ms Power: Yes, that is right.
And that spills over into the system in that primary care trusts
throughout England are actually taking very different attitudes
around this, and the cases that I have given to you are cases
which we have been able to support, and sometimes we can get people
treated in one place and not another because there is absolutely
no uniformity of implementation around this and it makes healthcare
an extreme lottery. It also means that clinicians are being encouraged
to ignore government regulations, which is extremely unfortunate
and not a good situation, and it means that there are severe health
inequalities emerging for many African people, as Max has been
Dr Sesay: The African HIV Policy
Network is an umbrella organisation that has member organisations,
most of them African-led organisations, providing services across
the country. We have also established African forums and bringing
together regional organisations to work together and to provide
services. Since the removal of the ring-fence, what we have realised,
what we have seen from our membership and what we have got from
the membership of the AHPN, is that a lot of the organisations
have collapsed. They have shut down. These have been extremely
vital and crucial conduits to very hard to reach communities.
They are simply not getting the funding that they need to be able
to provide services to the communities at a time when the government
strategy should be to enhance the capacity of these affected communities.
Those are the contradictions that we are having at the moment.
Q62 Chairman: Simon touched on the politics
of this whole area earlier on and Richard's comment was that you
have made the case completely, and I would concur with what he
has said. Having said that, and in the run-up to a general election
where asylum, immigration, race will be undoubtedly, as we can
see already, play a key part, how do you address the Daily
Mail agenda on this issue and actually get across the important
points that you have put to this Committee today?
Ms Jack: I think one general point
is we need to divorce this discussion we are having today from
general policies on asylum and immigration, because we are talking
about people who are living in the UK already with HIV and, irrespective
from any other debates around immigration, this is about a real
and immediate problem which is not going to go away if those policies
change. I think that is a challenge for us, but I think it is
really important, because, once it gets sucked into those wider
issues, you actually lose the ability to look at it as a very
specific problem that can be addressed quite simply by making
HIV exempt in the same way as other STIs and TB.
Ms Power: This is not just an
HIV issue. A very large part of this for us is co-infection with
HIV and TB. We have a number of cases where people have abandoned
their TB treatment, because they have been billed for the HIV
portion of it, within a couple of weeks of starting it and walked
out into the community still infectious to both conditions and
with TB quite possibly multi-drug resistant because of partial
treatment. That is a very immediate concern. This is about a change
of regulations, not primary legislation. I think it would be something
that could be put in with the next set of regulation changes which
we know are about to happen, and I think it is really important
we encourage the Government to put the public health of the nation
first on this.
Dr Sesay: We would encourage politicians
to be conviction politicians.
Q63 Chairman: That is a pretty old-fashioned
Dr Sesay: I know this can be extremely
difficult with an upcoming election, but I think that, if politicians
are provided with the evidence, I would encourage them, no matter
how difficult it is, no matter . . . well, I do not want to say
no matter what the political price, because that may well be a
high political price to pay, but, when they are presented with
the evidence, it is a case of arguing out the evidence and establishing
a policy, putting in place a policy that is based on the evidence.
One of the things we discussed at the Independent Advisory Group
of the Sexual Health Strategy a couple of days ago was exactly
that, that we know that sometimes the political terrain can be
extremely hazardous for politicians, but if it is based on firm
evidence they should be able to get the facts across, and we can
only encourage politicians to go down that route.
Chairman: We are most grateful to you.
Thank you very much for your evidence.