Budget Warning Over Record Demand for Sexual Health Services

Peter Russell

September 04, 2018

Record demand for sexual health services last year saw 3.3 million visits to clinics in England, putting a huge strain on the system, local authorities have warned. 

Latest figures show there were 3,323,275 attendances at sexual health clinics in England in 2017, an increase of 13% on 2013, according to the Local Government Association (LGA), which represents 370 councils in England and Wales.

Budget Cuts

The LGA said that £600 million cuts to councils' public health grants since 2015-16, and continuing into the financial year 2019-20, meant longer waiting lists and more people being turned away.

"Cuts to public health funding need to be reversed as this could affect councils' ability to meet further increases in demand and respond to unforeseen outbreaks of sexually transmitted infections," said Cllr Ian Hudspeth, chairman of the LGA's Community Wellbeing Board.

The total number of sexual health screens – tests for chlamydia, gonorrhoea, syphilis, and HIV – rose by 18% since 2013, from 1,513,288 to 1,778,306 in 2017.

The LGA said councils were pleased that people were taking more responsibility for their own sexual health. However, the growth in demand was putting a severe strain on local authority resources.

Unless the Government was prepared to reverse the reduction to councils' public health grants, it would be "hugely challenging" to maintain services at the current level, it warned.

"With capacity and resources already being stretched to the limit, clinics are reporting an increase in the number of lengthy delays and people having to be turned away as appointments are fully booked," said Cllr Hudspeth. "Demand for sexual health services has risen successively for the past 5 years and there is a real risk of waiting times increasing and patient experience deteriorating."

Some Sexual Health Services 'at Breaking Point'

Dr Olwen Williams, president of the British Association for Sexual Health and HIV (BASHH), commented: "Record demand for services, dramatic increases in syphilis and gonorrhoea diagnoses, and the spread of treatment-resistant infection in recent years, mean that many services are struggling to cope, despite valiant efforts from staff."

She warned that services in many areas were at "breaking point" and that further cuts "would almost certainly tip them over the edge."

The Department of Health and Social Care said that decisions on how money was spent were the responsibility of local authorities.

It said the Government was committed to reform local authority finances so that local authorities can keep all the revenue they generate from local business rates and reduce reliance on central government grants. In the meantime, the Government had continued to ring-fence spending on public health to ensure this money is spent only on services that would directly improve public health.

A spokesperson for the department said: "We have a strong track record on sexual health with teenage pregnancies at an all-time low and sexually transmitted infections continuing to fall. Sexual health services and tests are now more widely available online which means people can get tested at a time that suits them – over 11,000 diagnoses from online tests were reported last year.   

"We are giving £16 billion to local authorities for public health services over the current spending period, as they are best placed to understand and meet the public health needs of their local communities."

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