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 5:57 pm on 17 April 2018.

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Photo of Jenny Rathbone Jenny Rathbone Labour 5:57, 17 April 2018

I very warmly welcome your commitment to allow misoprostol to be administered at home. That's excellent news. I just wondered if you could elaborate on what work your officials will need to do and the timescale for doing it, as we're not talking about revising the Abortion Act, we're talking about extending the location of where a medical abortion can be administered, namely at home. As this has already been done successfully in Scotland and is already available to women who have an incomplete miscarriage here in Wales, it doesn't feel like a very complicated process, but I agree that it requires political commitment, and I thank you for that.

It's excellent to see that teenage pregnancies have halved, but there were still over 1,000 in 2016, and it does obviously beg the question about the quality of the sex and relationship education that is available in schools, which, obviously, your report indicates is not part of the review, but it's clearly an issue we need to take up with the Secretary for education, as it's vital that young women and young men understand when they're making informed decisions about relationships and where they can get contraception if they need it. I can see that that's a particular problem in a rural area, if a young person doesn't drive or hasn't got a car—very difficult to access the correct services.

I represent a very young constituency. I've got three universities in Cardiff Central, so I have, I think, the constituency with the largest number of students across the UK. I'm particularly concerned, and have already raised with the chair of the health board, about GP practices who're very keen to recruit students as their patients, but aren't necessarily providing the services that patients will need. It is obvious that young people arriving at university are going to need sexual health services, and they include rapid access to a clinic for sexually transmitted diseases, because things like chlamydia can obviously cause infertility if not treated. So, I'm a bit confused by recommendation 5, as to why it wouldn't be standard in a practice that has a large number of young people in it, which are the ones where there is an accumulation of young people, why they wouldn't, as standard, have those sorts of clinics available. Because I have had students telling me about real difficulty getting the medical advice they need, because they know they've got a sexually transmitted disease, and so delay in getting the right treatment, obviously, can make it worse in the meantime. 

In terms of access to pregnancy advice, if somebody falls pregnant, (a) do all pharmacies make the morning-after pill available? Because obviously people do make mistakes and realise very quickly that they might have got themselves pregnant by mistake. But I also want to understand why it's necessary to go via your GP if you think you want to argue the case for an abortion. Why is it not possible to go straight to the pregnancy advice and termination service? That is something that I also raised with the health board.

One of the issues that is quite concerning is the point that was flagged up in the report about the all-Wales data collection of sexual health diseases, because it seems to me essential that we have this information. Otherwise, how else can public health respond to an outbreak of chlamydia or gonorrhoea unless they've got accurate information about who is being treated for these diseases? 

And in terms of the really very welcome information that no new cases of HIV have been found in people who have been given PrEP, I wonder, then, what justification there is with continuing with a national trial rather than making PrEP available to anyone who is at risk of HIV. If it really is that good, why are we still doing a trial?