here - United Kingdom Parliament

305WH
HIV
1 DECEMBER 2010
HIV
306WH
community. In evidence put forward yesterday by the
National AIDS Trust, we saw how many people face
discrimination in the workplace due to their HIV status.
AIDS is a complex condition. It affects people physically,
emotionally and psychologically. In that complex mix,
it is important that the NHS is responsive to that and
allows people pathways to treatment that might not
always be the same in every place. I would be grateful
for the Minister’s views on that.
Mr Russell Brown (Dumfries and Galloway) (Lab): I
congratulate my hon. Friend on securing the debate.
Because stigma is still attached to this condition, people
in rural localities, such as mine, will seek advice and
help from further afield, thereby distorting the figures
on the prevalence of the condition in certain parts of
the country.
David Cairns: My hon. Friend is absolutely right. He
represents an area that is not only largely rural but on
the borders of Scotland and England, which brings me
to the point I mentioned at the very beginning. I imagine
that many of his constituents will be accessing HIV
services in Carlisle, for all sorts of reasons, but partly
due to the stigma still associated with the condition.
They do not want to access services in small villages and
towns. Ultimately, we have to get to a situation in which
there is no stigma, prejudice or discrimination and
people can happily access GP services for a long-term
managed condition, as people with diabetes, asthma
and other long-term managed conditions can. Until
such a time, we have to be sensitive to these issues.
Another reason why people are wary about always
accessing services through GPs is the lack of awareness
and understanding that many GPs demonstrate. Part of
the reason why we have so many late diagnoses is that
GPs do not pick up the telltale signs often enough. An
alarming number of people had seen their GP on many
occasions during the 12 months before they were eventually
diagnosed as HIV-positive, and it was not picked up
that they might have been HIV-positive. An astonishing
number of people had been in-patients in the 12 months
preceding their diagnosis; they were almost certainly
HIV-positive while they were in hospital, but it was not
picked up.
A lady recently got in touch with the all-party group—a
middle-aged, professional, white lady—who had suffered
serious recurrent health problems for two years and had
seen numerous clinicians, including a GP on many
occasions, before anyone thought to offer her an HIV
test, which brings me back to the point that the hon.
Member for Cardiff Central made. That lady was a
textbook case: she had every symptom and yet her GP
never thought to offer her an HIV test. That is clearly
happening across the country, which explains why we
have 22,000 people who are HIV-positive, but do not
know it. It is not the case that none of them ever visits
their doctor—they regularly visit their GPs, perhaps
they even go into hospital as in-patients, and yet their
status is not picked up. That is a public health disaster
because the ability of those people to infect others is
much greater than it would be if they were receiving the
correct course of ARVs.
We need assurance that, within the restructuring,
GPs will get very good guidelines and necessary training,
and be encouraged to offer people an HIV test in the
routine manner suggested earlier, to tackle undiagnosed
HIV.
Jenny Willott: Will the hon. Gentleman also suggest
that we need to tackle the stereotypes about the kind of
person who might have HIV? That is one issue for
people who do not go to their doctor, or who do go but
whose GP does not pick up on it. As the hon. Member
for Mid Derbyshire (Pauline Latham) mentioned earlier,
GPs may not think that a middle-aged, heterosexual
white woman is likely to be HIV-positive. We need to
tackle those stereotypes.
David Cairns: The hon. Lady is correct. Part of the
education of GPs must be about looking at the symptoms,
not only what the GP imagines a typical at-risk person
would be. Having said that, we need to show that those
within high-risk groups of people are being tested as well.
The tremendous progress that has been made in
testing in the past few years is truly astonishing. Someone
can be tested and have the result in less than a minute. I
hope that he will not mind me mentioning it, but the
hon. Member for Brighton, Kemptown (Simon Kirby)
saw this first-hand last night when he received a test
through the services provided by the Terrence Higgins
Trust in the House, and he had the result in less than a
minute. Testing is not the long drawn-out process it was
years ago, but can be done much more quickly.
Finally, on care and support, people are living longer
with the virus, which is a very good thing, but it brings
with it challenges and complications—physical, emotional
and mental. It is very important that we understand the
need to have a strategy for people living longer with
HIV. The AIDS support grant is no longer ring-fenced,
and I am not arguing that it should be re-ring-fenced,
but I am arguing strongly for it to stay within the grants
that go to local government as a specified budget line.
In that way, local people can hold their local authority
to account in exactly the way that the Secretary of State
outlined yesterday. It is his belief that local people
should be able to see the services being provided for
them, and argue for services. If the AIDS support grant
disappears as a title altogether and is subsumed into the
general pot of money that local government gets, local
people will not be empowered to come forward and
demand the kind of services for which money is being
made available.
In conclusion, I hope that the Minister will address
some of the concerns about the AIDS support grant
and the Government’s vision for it. I hope too that she
will be able to calm some of the fears and uncertainties
out there on how HIV services are to be commissioned,
how they will be accessed, and how they will be supported
under the new NHS that the Government have in mind.
Mr Edward Leigh (in the Chair): Order. Five Back
Benchers have intimated that they wish to take part. I
intend to call the wind-ups at about 3.30 pm. Hon.
Members can do the maths, so I ask for brief speeches
from now on.
3pm
Mike Weatherley (Hove) (Con): I congratulate the
hon. Member for Inverclyde (David Cairns) on securing
this important debate, whether by skill or fortune.
The Hove and Brighton area has one the highest rates
of HIV in the UK. Many of my constituents live with
the virus, and others have friends and colleagues that do
so. It is a great privilege to speak up for them on any
day, but especially on world AIDS day.