“Sexual Health In The UK Protecting Our Future” Barry Sheerman MP Chairman of the Education And Skills Select Committee House of Commons - Thursday 3 rd March 2005

“Sexual Health In The UK Protecting Our Future” Dr Alison Bigrigg President FFPRHC

“Sexual Health In The UK - Protecting Our Future” 11,000 medical members: All the consultants in family planning and reproductive health About 8,000 GPs Specialists in obstetrics & gynaecology, GUM and Public Health Associate nursing members Within our specialist field the Faculty: Sets standards Provides training an education programmes Promotes research and evidence based practise Represents the interests of our members Core Principles: Informed choice Personalisation Working together Faculty of Family Planning & Reproductive Health Care (FFPRHC)

“Sexual Health In The UK - Protecting Our Future” Current situation of the UK White Paper - Funding: No funding was announced with The White Paper But the Department of Health has secured £300 million for sexual health Will this be used solely to cut waiting times in acute services? What about investment in community services keen to follow principles of The White Paper ?

“Sexual Health In The UK - Protecting Our Future” In November 2004 a Survey was conducted amongst 2750 clinicians: GPs Nurses Obstetricians and Gynaecologists Consultants in Family Planning and Reproductive Health FFPRHC Survey Report 2005 (Conducted by TNS) The aim was to assess current investment, practice and service levels across the country in the area of family planning and reproductive health care

“Sexual Health In The UK - Protecting Our Future” The survey looked at key areas: Investment in family planning services by PCTs Access to contraception Abortion Quality of contraception services

“Sexual Health In The UK - Protecting Our Future” 84% Say NO Investment in Family Planning Services by PCTs 84% of GPs reported NO additional resources or a reduction in level of resource in last year DESPITE + increased demand + increased costs + National Sexual Health Strategy BUT Nearly 90% of all those questioned believed greater investment in community contraceptive & sexual health services is required to improve the UK’s reproductive health statistics

“Sexual Health In The UK - Protecting Our Future” Less than 5% of PCTs have seen strong investment in this area in the past year Of those who reported a decrease in funding nearly 50% said this had led to fewer clinic sites or numbers 34% said there are longer waits for appointments 20% said they have turned clients away from open access clinics due to overwhelming demand Investment in Family Planning Services

“Sexual Health In The UK - Protecting Our Future” Nearly all respondents supported the principle that people should have a choice as to where to go for sexual and reproductive health care: 97% GPs 100% Nurses 94% Obstetricians and Gynaecologists 98% Consultants in Family Planning and Reproductive Health Care Over 90% believe PCTs should offer open access or walk-in clinics Access to Contraception

“Sexual Health In The UK - Protecting Our Future” Investment in Family Planning Services

“Sexual Health In The UK - Protecting Our Future” In theory, contraception has been free at point of delivery in UK for over 30 years: Up to 30% of PCTs now restrict access to some forms of contraception Methods most commonly restricted are new methods and long acting reversible methods Availability of Contraception e.g. 1/3 of GPs and 2/3 hospital specialists reported restricted access to contraceptive implants

“Sexual Health In The UK - Protecting Our Future” Implant Oral Contraceptive Pill Condoms 1 year continuation 82%40%52% 2 year continuation 64%34%42% Urban teens using Implant, pills or condoms (Darney et al Am J O & G 1999)

“Sexual Health In The UK - Protecting Our Future” Urban teens using Implant, pills or condoms (Darney et al Am J O & G 1999) Implant Oral Contraceptive Pill Condoms 1 year continuation 82%40%52% 2 year continuation 64%34%42% PregnanciesNone30%33%

“Sexual Health In The UK - Protecting Our Future” 80% agree with the distribution of condoms to young people as part of the strategy to combat the UK’s high sexually transmitted infection rate BUT 30% of GPs admit condom provision is restricted Availability of contraception

“Sexual Health In The UK - Protecting Our Future” Restrictions have major consequences for individuals and society All forms of contraception are extremely cost effective health interventions Restricted access to end availability of contraceptive methods Why are they being rationed?

“Sexual Health In The UK - Protecting Our Future” 76% of GPs say there is variation in access to abortion services depending on where you live 30% said it was common for a woman to travel outside the area because of inadequate local provision More than 99% of clinicians believe that a choice between medical and surgical abortion is important for women The majority of doctors believe: Community clinics should play a greater role in provision of abortion services Nurses should be allowed a greater role in providing TOP services Abortion services

“Sexual Health In The UK - Protecting Our Future” Our survey shows: Current services are sub-optimal and in some areas of the country not ‘fit for purpose’ New ways of working would improve services throughout the UK Abortion services

“Sexual Health In The UK - Protecting Our Future” 45% of nurses and 40% of GPs thought that there was inadequate availability of training locally Recommended consultation time for a new patient is 20 minutes – only half of nurses and less than a quarter of GPs surveyed can currently offer this 45% 40% Quality of contraception services

“Sexual Health In The UK - Protecting Our Future” Our survey provides evidence of lack of investment in contraceptive and abortion services leading to: Loss of clinic sites and numbers Longer waiting times for appointments Clients being turned away from walk-in services Restricted access to effective contraceptive methods Post code lottery in abortion services

“Sexual Health In The UK - Protecting Our Future” The survey also shows clinicians want the Department of Health to have a stronger involvement in ensuring our ‘Cinderella Specialty’ is treated fairly for the sake of all women and men who use it

“Sexual Health In The UK - Protecting Our Future” Why has this happened? Over the past three generations women’s lives have been transformed by contraception Women now vital to the economy Women no longer have to campaign - have access to all forms of contraception and abortion services BUT Summary Are we taking for granted the services that make it all possible?

“Sexual Health In The UK - Protecting Our Future” Fully supports The White Paper and the Department of Health plans to do its own survey of PCT Chief Executives Is keen to work with the Department of Health to ensure investment goes into community and primary care services Recognises that clinical services alone will not solve the rising number of STIs or teenage pregnancies, but they are a vital component The Faculty …

“Sexual Health In The UK - Protecting Our Future”

“Sexual Health In The UK Protecting Our Future”