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Government cuts hit sexual health care

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government cuts, the King's Fund, analysis, sexual health, RCOG, syphilisCuts made despite significant increases in recent years of some STIs – including syphilis.

Central government cuts have forced councils to reduce planned spending on vital public health services such as sexual health clinics and reducing harm from smoking, alcohol and drugs by £85 million, according to new analysis by The King’s Fund.

The King’s Fund is a charity working to improve health and care in England and help to shape policy and practice through research and analysis.

This analysis was released shortly after the Family Planning Summit 2017 held in London on 11 July.

It is based on Department of Communities and Local Government (DCLG) data, and showed that councils in England are planning to spend £3.4 billion on public health services in 2017/18.

But it said that on a like-for-like basis – used to exclude the impact of changes to how budgets are calculated over different years – councils will spend only £2.52 billion on public health services in 2017/18 compared to £2.60 billion the previous year.

Once inflation is factored in, The King’s Fund estimates that, on a like-for-like basis, planned public health spending is to be more than 5 per cent less in 2017/18 than it was in 2013/14.

And so while the figures show that councils are planning to spend more on some services – including on promoting physical activity and on some children’s services – most services are to face cuts.

This includes reducing spending on sexual health services by £30 million compared to last year – a 5 per cent cut.

Many services that face spending cuts this year have already had to cope with successive years of falling budgets, according to the King’s Fund analysis.

Planned spending on sexual health services, for example, has fallen by £64 million, or by 10 per cent, over the past four years.

This is despite significant increases in recent years in the number of cases of some sexually transmitted infections including syphilis and gonorrhoea – although last year saw a slight fall in the gonorrhoea rate.

These spending reductions follow government cuts in public health funding of at least £600 million by 2020/21, on top of £200 million already cut from the 2015/16 budget.

And that is despite Health Secretary Jeremy Hunt highlighting in parliament last year that making good progress on public health often has the biggest effect on health inequalities.

The Royal College of Obstetricians and Gynaecologists (RCOG) and the Faculty of Sexual and Reproductive Healthcare (FSRH) are deeply concerned by the findings from an analysis carried out by the King’s Fund regarding local councils’ forecast expenditure on public health in 2017/18 in England.

The FSRH and RCOG believe that these findings are demonstrative of a health system that is running counter to the government’s promise to focus on a radical upgrade in prevention and public health services as set out in the Five Year Forward View in 2014 and a case of short-sightedness in the decision-making process that might reverse hard-won public health improvements.

Professor Lesley Regan, president of the Royal College of Obstetricians and Gynaecologists, said: “I am deeply troubled by the planned local cuts to sexual and reproductive health services.

“It is essential that all women and girls have the resources they need to take control of their health and fertility including protection against sexually transmitted infections and unwanted pregnancies – this is among one of the most important investments we can make as a society.

“Funding cuts will inevitably impact on the accessibility of a range of services, including access to family planning and contraception.

“I urge local authorities and the central government to protect public health budgets allocated to local authorities to ensure that all girls and women have access to high quality comprehensive sexual and reproductive health services.

“It is particularly distressing that this analysis of funding cuts comes one day after the highly successful Family Planning Summit, [part of FP2020], in London where international leaders, including our own Secretary of State for International Development, promised to bolster efforts to improve access to family planning.

“Ministers for health at the Summit vowed to hold their own governments to account – we must and can do the same.”

Jane Hatfield, chief executive of the Faculty of Sexual and Reproductive Healthcare, said: “The release of this timely King’s Fund analysis reveals what our membership already knows: one FSRH member has recently reported that self-referral to the local specialist service for long-acting reversible contraception (LARC), one of the most effective methods of contraception, has been stopped, with patients being turned away and told to see their GP.

“However, this policy has not been communicated to local general practices, and in many cases, the general practices are unable to pick up the slack.

“The consequence is that women are not receiving the contraceptive care they need, and the risk of unplanned pregnancies are increased.

“In a moment when the world witnesses our country’s efforts to provide access to contraception to women all over the world in the framework of the Family Planning 2020 summit, this analysis should be considered as a wake-up call that access to contraceptive care is far from a certainty in England.

“Ultimately this will be seen as an expensive mistake leading to unnecessary ill health and unwanted pregnancies, which are entirely preventable.

“The FSRH urges local councils to revise planned cuts to SRH and the central government to re-energise its focus on prevention and Public Health.”

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