6. Statement by the Cabinet Secretary for Health and Social Services: The Public Health Wales Review of Sexual Health Services

Part of the debate – in the Senedd at 5:47 pm on 17 April 2018.

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Photo of Vaughan Gething Vaughan Gething Labour 5:47, 17 April 2018

On the final point about the HPV vaccine, we'll continue to take advice from the relevant joint committee on the evidence base for undertaking any additional steps. We've already announced in this term of this Government—I believe it was Rebecca Evans in her former role who announced the extension of vaccination for men who have sex with men. There is still an ongoing debate. I know there are active members of the medical profession engaged in sexual health work who believe that the vaccine should be extended, but that is not a view that is currently supported by the relevant expert joint committee that every Government within the UK takes advice from. If the position changes—and I've said regularly in this place that there are times when you absolutely must be led by evidence, and the very best clinical evidence and advice—if the position changes on the evidence and advice, then the Government will change its position. So, I'm happy to give that assurance.

I recognise what you say about education and prevention, and recognising that, actually, much of this is still about how we persuade people to reconsider the choices that they make. These aren't just adolescents making these choices, there are adults of a variety of ages who are making choices, and part of the challenge is how we have an effective education and prevention approach with those people. It's part of the reason why, in looking at the PrEP study, it wasn't simply about deciding to deliver the medication, it was also about looking at how that fits in with other services, about some of the conversations that need to take place about what is and isn't a risky behaviour and how to see that as part of it.

You'll recall the rather obnoxious Daily Mail attack that suggested that PrEP was a licence to be promiscuous. And that isn't what it is, it's actually a means of understanding how we successfully treat people to prevent further infection in very practical terms. I'm confident it would save the national health service money and would allow people to make different choices about how they're able to live and enjoy their life. But there is an honest need to look at how we persuade and have that conversation with people about the choices from a behaviour point of view.

I recognise what you and Andrew have both said about the demand on the service, about our levels of outcomes, our ability to maintain excellent outcomes, and we can't simply rely on the workforce being ultra committed and continue to run further and faster. Actually, the challenges around consistency and access were a large part of what persuaded the Government to undertake the review. So, that is work that we're absolutely doing, and if you look at the recommendations and the commentary in the review, we do see, not just the organisational challenge and a drop in the services, but a greater role for primary care, and the thing about how those services can be delivered and making better use of a whole primary care group of professionals.

I go back to what Angela Burns said earlier—not every person may want to go to their pharmacy to receive part of their sexual health and contraceptive services, but a range of people will do, because almost every pharmacy, particularly all those that have an enhanced service, have the ability for people to go and see someone in a private room within the practice. When I have my medication review at a pharmacy walking distance from this building, I go into a private room, no-one knows what we're there to talk about and so it is a private consultation space. There will be a range of people who I think will be confident in going to different settings to receive part of the service. That is consistent with our broader drive to get people to use other healthcare professionals and not simply default to go and see the doctor, whether that's in a hospital or in general practice.

So, I recognise the challenges that are real and are there and I'm confident that, in taking forward the work in response to the recommendations of the review, we will have a series of logically worked-through recommendations about how to do this, with a costed implementation plan. And the assurance that Members have is that the board is going to continue to be overseen by the chief medical officer; it isn't simply a matter of politicians deciding to do what we think is the right thing to do without the proper evidence base and without the best and most up-to-date clinical evidence and advice.