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