Sexual health care cuts will stop me helping survivors of rape and FGM

This article was taken from: https://www.theguardian.com/society/2018/sep/06/sexual-health-care-cuts-stop-helping-survivors-fgm

By Guardian news

Women will bear the brunt of these funding shortfalls. As a doctor, I know we’re cutting off a lifeline for them

A record number of visits were made to sexual health clinics in England in 2017, the equivalent of an extra 1,500 attendances a week since 2013. It couldn’t be coming at a worse time for UK women.

But why is this bad? Surely it’s good news that more people are getting tested? The issue now is that government cuts mean we who work in sexual health can’t cope with demand.

Sexual health and contraception services are no longer funded by the NHS directly, but by local authorities – a change that was implemented by the government in 2012. Due to planned cuts of £600m by 2021 to the UK public health budget, councils are now struggling to fund their local services, meaning we do not have the resources to provide the care our communities need.

As a doctor working in sexual health clinics, this comes as no surprise. The waiting room is always packed, some patients waiting hours to be seen. And while patients state their reason for coming is “just a check-up”, so often this is their in to discuss concerns altogether more sinister – coercion, intimate partner violence, female genital mutilation (FGM) or addiction.

Part of my job is to assist triaging the crowds – a fancy word for saying who gets to be seen and who doesn’t. It’s a part of the work I hate most. In a better resourced environment, we’d be able to see people more quickly and seize the opportunity to attend to all patients’ needs. I wince when I think of those patients who’ve been bumped to next week, or who simply left because the wait was too long. What help did they need and will they come back another day?

And as is so often the case, women look set to bear the brunt of these inexcusable shortfalls. Contraception provision is already suffering and this is just the start. In 2016/17, 32 local authorities closed contraceptive services, nearly three times more than the year before. Over a third of UK local authorities plan to reduce the number of clinics able to deliver contraceptive services in the future and some services have limited contraception access by age – because if you’re over 25 and get pregnant, that’s OK right? There is no sugar coating what this action represents. It is the removal of women’s rights to plan their lives, enjoy sex for pleasure (not procreation) and to continue the battle towards equality.

What further breaks my heart is the number of women I’ve met in clinic who have disclosed a rape, sexual violence or coercion for the first time. Removal of access to our services is cutting off a lifeline for the 500,000-plus women sexually assaulted in England and Wales each year, plus the 138,000 men. In one month alone I met two women who had undergone FGM in childhood without even realising it. They couldn’t explain why sex was so painful, their periods so problematic. Having access to our service at the right time meant they could be referred to specialist services – a truly life-changing encounter. How can under-resourcing services like this be acceptable?

So what does the government have to say? It has shamelessly reassured the public, reminding us that more online STI testing is available than ever before, that teenage pregnancies are at an all-time low and printing monetary figures that look big but in reality fall desperately short. Increased access to online testing is a boon for certain non-complex populations, but it doesn’t fix the lack of expertise needed for patients needing something more.

nd in the meantime, the sexual health community holds its breath for the inevitable rise in unplanned pregnancies and for antibiotic resistant strains of gonorrhoea to become commonplace.

Working in sexual health is such a privilege, but without the proper resources, we can’t deliver what the country needs. At a time of global concern, when women’s reproductive rights continue to be unforgivably swiped from underneath them, why aren’t we hitting back? For professionals and patients, a sad day has arrived. I really hope someone will listen.

• The British Association for Sexual Health and HIV has started a petition asking the government to reverse the damaging cuts to the public health budget