Jenny Lennox, Walthamstow CLP, writes:
Last year, Walthamstow didn’t have a sexual health clinic; it had a large multi-doctor practice refusing to provide any sexual health services and a number of other practices providing a patchwork of support. Located in a borough that had stubbornly high levels of teenage pregnancies, repeat abortions and sexually transmitted infections, you would have thought it would have occurred to someone that these two things might be related.
Sexual health had been a low priority for the local PCT, with no one really arguing the case for the necessary spending to provide the support and treatment that residents actually required. A number of local women, along with our MP Stella Creasy, felt concerned enough to start a campaign, and since we began in July 2012, we have forced the PCT to hold two public meetings, got a weekly clinic set up in Walthamstow and ensured that the multi-doctor practice allows the doctors who wanted to provide sexual health services to do so.
But as of April this year, all of this is back up in the air again, because public health, and thus sexual health, is now under the remit of the local authority, and has the potential to become a political football. They will directly fund any stand-alone sexual health clinics, including filling the gaps left by a failure in GP provision.
Clinical Commissioning Groups (CCGs) are not required to provide any sexual health services, and it remains unclear who will have strategic overview of what services GPs provide across the borough. The council will be able to look at the services, but will have no ability to force CCGs to provide them, or hold them to account for their failure to do so.
The budget given to the council to look after public health is based on the historic underspend by the PCT. Despite a decision by the Coalition Government to encourage low spending boroughs to spend more on public health, the 10% uplift in Waltham Forest’s budget will leave them almost 40% adrift of the required spend in 2013/14 and 33.6% adrift in 2014/15, according to the Department of Health’s own figures. Needless to say, boroughs like Richmond and Kensington & Chelsea will have considerably more money than the Government believes they require.
As if all of this wasn’t enough, our local CCG has been having problems. In March, NHS Waltham Forest CCG only received authorisation with legal directions — in other words it has been viewed as failing before it even started. Under the Health and Social Care Act, areas like Waltham Forest, which already had problems with healthcare provision, will continue to have them and, in all likelihood, the confusion and lack of accountability in the new system will mean that things could get even worse.