Sexual health services are deteriorating under pressure from cuts — while demand is going up

Clinics are closing, moving to less convenient locations and reducing their hours

Cuts to local authority spending have started to bite in sexual and reproductive health services, a new King’s Fund report shows, meaning that services are being reduced as demand increases.

Between 2013/14 and 2015/16, a quarter of local authorities reduced their sexual health spending by 20 per cent or more. In 2015/16 alone, overall local authority spending fell by 3.5 per cent, as part of the £200m cut to public health budgets.

The starkest change involves sexual health services being put to tender, with budgets reduced by up to 40 per cent between contracts.

As a result, health adviser posts are being cut, as are sexual health promotion and outreach services targeted at high risk groups. Reduced tender budgets have led to clinics being closed, moved to less convenient locations or reducing their opening hours.

All this is happening the context of rising demand for sexual health services. Attendance at clinics increased by a third between 2011 and 2015 and diagnosis rates for STIs are increasing.

This case study showcases the incoherence of the the government’s approach to the NHS and care spending. Even without considering the impact on individuals and families, sexual health spending makes clear economic sense. Ensuring access to contraception, STI testing and early-stage treatment dramatically reduces health costs in the long term.

A 2013 study suggested that continuing cuts to sexual health services could cause additional losses of up to £10bn by the end of the decade, while an improvement of services could generate savings of up to £5.1bn.

Nor is this an accidental oversight on the part of government. A King’s Fund blog highlights that ‘the greatest impacts on patient care are happening under the radar’ — in areas like sexual health and district nursing where a gradual decline in the quality of care is unlikely to grab headlines.

But as the growing crisis in adult social care shows, these failures can only be swept under the rug for so long.

See: Parliament considers decriminalising abortion in England and Wales

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