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Last Updated: Friday, 3 November 2006, 10:46 GMT
Family planning starved of funds
By Jane Dreaper
BBC News, Health correspondent

Family planning consultation
Services face cuts
Experts claim there is a crisis in contraception with family planning clinics having to close or turn some patients away.

Doctors say money that should be reaching these specialist clinics is being diverted by local managers as they deal with deficits.

They are calling on ministers to urgently publish the results of a national audit of contraception services, which was promised two years ago.

The government insists sexual health is still one of its NHS priorities - with an extra 40m being allocated for contraception services over two years.

In a clinic in Balham, south-west London, packets of the contraceptive pill are being labelled and plastic gloves are being laid out.

And along with this standard equipment, there are piles of paper.

Protest

Dr Penny Oakeley, a family planning consultant, has been gathering signatures from the women who visit, to protest about cuts to the service's budget.

"We've managed to get loads and loads of them in each session," she says, as she flicks through the lists of signatures. "They say they're liking the access and they're liking the atmosphere."

Dr Oakeley won't be replaced when she retires later this month, and the service in Wandsworth is facing cuts of more than 100,000 over the next 18 months.

"This is a large sum of money for our small service - and this will mean making lots of clinic cuts," Dr Oakeley said.

"At the moment all the clinics are over-subscribed. There will be a lack of access for everybody - all ages."

I put it to her that some parts of the NHS are facing tight times at the moment - and surely her service needed to make a contribution to the savings?

Cost effective

"We've had cut after cut in the last 20 years," said Dr Oakeley, "but this is one of the most cost-effective services - it's a preventive service."

It is for primary care trusts to determine the services they provide, to meet local needs
Caroline Flint
Public health minister

Ann Radmore, chief executive of Wandsworth Teaching Primary Care Trust, said: "Family planning is a priority - our goal is to identify a new, more efficient model.

"We will work to identify savings at the same time as making sure that effective family planning services are available to the public."

In the waiting room, women tell me they value the clinic.

Victoria has just moved to the area, and so she isn't registered with a GP. She has come to get some contraception.

"I think it's an essential service - people need the expertise," she said.

Convenient service

Veronica is a 58-year-old widow, who has come to have a cervical smear test.

This threat to services is across the country
Dr Meera Kishen
Royal College of Obstetricians and Gynaecologists

She said: "It's so difficult to get an appointment with the doctor At least here you can walk in - and when you're working, it's very handy because you can come in the mornings or evenings."

And contraception is a highly important matter for mother-of-four Lucia.

She is at the clinic because she had a partial molar pregnancy last year. This had the potential to turn into a malignant tumour.

"It's very important I have a coil fitted, so I don't get pregnant again," she told me. "I can't take the pill and I'm allergic to condoms.

"I phoned my doctor three times, but they are saying they can't see me for four weeks.

"In that time I could be pregnant and my life could be at risk again - but the clinic was able to see me straight away this morning."

Lack of awareness

Dr Meera Kishen is president of the family planning faculty at the Royal College of Obstetricians and Gynaecologists.

She told me: "This threat to services is across the country. We know of four large areas where significant or even total closure of community services are being discussed.

"It is a combination of both local ignorance and lack of awareness, as well as national guidance."

Community clinics often provide valuable training, and Dr Kishen believes that undermining that role poses a risk to true contraceptive choice in the future.

Family planning experts want the government to publish a long-awaited audit of what services are actually available.

Caroline Flint, the public health minister, told me the results of that exercise will be made public before the end of the year.

She said: "It is for primary care trusts to determine the services they provide, to meet local needs.

"We have provided resources - as well as targets and levers - to make sure sexual health does get a priority.

"Redesigning sexual health services for the future may, in itself, not be a bad thing - for example, if we can see contraceptive services joining up with ones that provide testing and treatment for sexually transmitted infections.

"Organisations that are involved with sexual health need to also lobby at a local level to raise demand for why these services are important."


SEE ALSO
Sex diseases 'not PCT priority'
13 Jan 06 |  Health

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