Feature Sexual Health

Sexual health services: divided and unprotected

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i309 (Published 20 January 2016) Cite this as: BMJ 2016;352:i309
  1. Caroline White, freelance journalist, London, UK
  1. cwhite{at}bmj.com

How are sexual health services weathering the storm in their new local authority home? Caroline White reports

Local authorities in England now oversee the lion’s share of commissioning sexual health services. The rest is left to the NHS: most contraceptive services, for example, are provided by general practitioners and commissioned by NHS England. So how are the country’s sexual health services faring under this new system, not yet even three years old, especially as a painful programme of government cuts begins to bite?

The BMJ sent freedom of information requests to all 152 local authorities in England to uncover what proportion of public health funds they spent on sexual health and to find out how protected services are from cuts. The results (99% response rate) show that the priority given to sexual health varies widely across councils, with spending varying from less than 10% of their public health budget (seven councils) up to 45% (24 councils).

All local authorities suffered an in-year cut of nearly 6% to the public health grant in November and are obliged to make 4% annual cuts to services from April for five years. The freedom of information data that The BMJ obtained (before the cuts were announced last autumn) show that so far only 10 local authorities have cut or restricted access to sexual health services over the past two years, but a further 37 (25% of respondents) indicated that reviews were planned.

Sexual health has been protected partly because many councils are tied into expensive hospital contracts in order to fulfil their statutory duty to provide comprehensive open access contraception and sexually transmitted infection (STI) services. STI testing and treatment services have …

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