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Lord Fowler: My Lords, perhaps I may ask one question. The noble Baroness moved rather rapidly over the issue of the tests being looked at by the Cabinet Office. Is the Cabinet Office inquiry going to consider the whole issue of compulsory tests? Is that proposal under consideration? I should be glad to know the position.
Earl Russell: My Lords, I beg the pardon of the noble Baroness. She referred to issues "associated with immigration". Does that mean that she cannot give the assurance I seek; that is, that tests will be based on medical need or risk and not on nationality?
I shall take a few minutes to respond to some of the additional questions that have been raised in the debate. I want to talk briefly about the sexual health and HIV strategy. The noble Lord, Lord McColl, and my noble friend Lord Rea pointed out that there is a close link between sexually transmitted disease and HIV infection, which is why we are spending an additional £47.5 million over the next three years to implement the strategy.
This is the first sexual health strategy we have ever had in this country. It has been designed to address the problems in the round. I should add that the £47.5 million is only a small element of and additional to the £300 million we are spending on AIDS in terms of prevention and treatment. Within that strategy we have five aims relating to HIV, which include reducing transmission, reducing the prevalence of undiagnosed HIV, reducing stigma and so on.
I am delighted to inform noble Lords that we have made much progress in implementing the 27-point action plan agreed last July. Rather than reading out five pages of closely printed text, I shall circulate to noble Lords the information on what has been happening.
I particularly commend the commissioning toolkit, which has been issued very recently indeed, not only on the web but in hard copy. It provides guidance and good practice examples for the NHS on planning and delivering sexual health and HIV services.
The roll-out of the chlamydia screening programme is now in place, a point referred to by the noble Lord, Lord McColl, and relates to capacity building, training, investing in technicians, laboratory services and so on. We now have in place 286 sexual health strategy leads in primary care trusts.
Implementation is the key. By taking away the ring-fencing around budgets we can ensure that on the ground the money will match the need. HIV/AIDS is not evenly distributed throughout the country and, given the variations between them, we need to give local authorities the power to use the money wisely.
We have learnt from the AIDS (Control) Act reports that we need more systematic monitoring and more intelligent use of the information we receive, and we shall monitor more closely in that respect. We are also finalising new recommended standards for HIV treatment services.
We are extremely aware of the need to be not only vigilant in terms of health promotion but to get the message across. That is why the target groups for that message remain gay men and the African communities to which my noble friend Lord Rea referred. We are spending a fair amount of money on the community HIV/AIDS prevention strategyCHAPS for shortwhich includes a mass media campaign aimed at the gay community. It has been sufficiently successful to have been picked up by the United States and Australia.
As regards the African communities, the focus is on culturally appropriate information. Obviously we are funding the African HIV policy network to ensure that we pick up people's concerns. It is operated in a language which will enable them to feel confident about going for diagnosis and so on.
The general population presents the other great challenge of appropriate messages. I am sure that noble Lords will have seen the sex lottery campaign, which will cost about £4 million and is aimed at 18 to 30 year-olds. The Minister in another place said that this has been tested to death, and we are confident that it is reaching the people who need to know about it. That goes alongside better guidance in schools following the Ofsted report, a matter about which the noble Lord is concerned.
I have run out of time. I am grateful to all noble Lords who have spoken with passion, compassion and tremendous expertise. The debate has been enormously valuable. I hope that it will set the record straight from 1604, or whenever it was when politicians stepped over the bodies of those who had died from the plague.
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