Prevention Better Than Cure?

6th June 2016

Prevention Better Than Cure?

-Ivor Caplin-

Just when the hapless Health Secretary thought things couldn’t get any worse he and the Tories are plunged into an argument that even they surely didn’t want. I am not reflecting on the after-effects of the Junior Doctors action or the chasm in the Tories as the Referendum veers its way to a conclusion.

No, the Tories’ next target in Health is a group of healthy people who the NHS can keep healthy in the future just by commissioning a single drug.

The community affected is predominately the LGBT community. We all know the real thoughts of most Tories about LGBT rights, after all this is the party of Section 28 and constant attacks during the Thatcher/Major governments. All of those attacks were finally ended by the biggest change in equality in this country ever; by Tony Blair in 1997.

The argument that Hunt and NHS England have chosen is the provision of PrEP (Pre-Exposure Prophylaxis), effectively a preventative drug (also known as Truvada) that is 86% proven to stop the transmission of HIV to gay men who are currently negative. It is freely available in the USA, France, Israel and even in some parts of Africa but not in the UK after a shocking decision taken by NHS England on behalf of Mr Hunt.

This drug would be the biggest game changing moment since the 1980s in terms of HIV/AIDS prevention. None of us thought this day might ever be here but it is and now is the time for proper and effective decision making. But instead the weak-kneed Health Secretary and his acolytes in NHS England choose to ignore the facts and make a decision based, we can only assume, on absurd political reasons.

“Why?” is the question everyone is now asking. Especially when the Government knows that its refusal to authorise its use on the NHS means that from today seven men in England EACH DAY will become HIV positive. They could or might have been protected by the provision of PrEP.

In classic Hunt style (well known to journalists and junior doctors) he has made no comment about this decision. For the record, the use of PrEP is supported by a robust period of clinical trial and by a business case which shows savings – YES savings – to the Health budget.

So you might have expected the Labour leadership to be all over this issue. After all this is about the NHS providing prevention rather than cure. Instead with some notable exceptions Labour under Corbyn has been silent on the issue. The party that fought for LGBT rights so passionately 25 years ago is now seen as in league with the Health Secretary on this matter. On Twitter it is ‘Where is PrEP?’ but could easily be ‘Where is Labour?’

As I said there are some notable exceptions. Catherine West has written to Hunt leading the way for the Labour Health team. Also Mike Freer the Tory who chairs the APPG continues with Lord Cashman to be very active in this area. The other major intervention has been from the Labour politician with the biggest mandate in Britain now; Sadiq has made his position regarding the decision very clear. Even the PM has said he wants the matter sorted. So, how about telling Hunt to do so, Prime Minister? Or is that just more fine words?

What needs to happen is that this drug should be made available widely within the very near future. To those who have been on the clinical trial (known as PROUD STUDY) they should be guaranteed continued provision of PrEP for as long as necessary and all patients on the trial must be permitted to continue on the trial. Labour should wake up to the political consequences if they are not seen to be supporting the LGBT community. So, let’s have an urgent question in the House to Hunt, hmm?

After all when Parliament returns this week nearly 50 men may now be HIV positive in the last recess and all of this would have been prevented by PrEP.

There are no excuses and the Government and the Opposition are both in the dock here and under trial. Urgency is needed to save people from infection. That is exactly what the NHS was set up to do in 1945 and the undermining by Hunt is a disgrace.

No more words no more enquiries – just the action that is needed to stop HIV at last.

By Ivor Caplin

Former Defence Minister, 2003-2005

Please note: articles and posts on ‘Middle Vision’ reflect the views of the individual authors and not of all involved in ‘Middle Vision’

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