Last year, I was asked by The Crescent, an organisation which provides support to people living with, or affected by HIV/AIDS, to become a Patron of their charity, and to become involved in the fundraising that goes with providing such services. I naturally jumped at the opportunity, having been moved witnessing the incredible help and support they provide it's service users.
Over the past 12 months, I have become fully aware of how difficult a situation organisations like The Crescent are finding themselves in, with local authorities pulling back the finance they make available to such services, with terrifying knock on affects that are far spread. But it needn't be that way...
HIV/AIDS support services in Hertfordshire have undergone a radical change in the last 12 months. For almost 25 years these services were provided by two agencies, one in the east and the other, The Crescent, in the west. The reason for this, in the main, was because of the geography of the county, coupled with the fact that transport links from east to west are very poor.
For many years this worked well, with The Crescent covering the west (where the majority of PLWHIV reside) working closely with the two major GUM clinics in St Albans and Watford General Hospital.
The Crescent is ideally situated in St Albans with excellent transport links to surrounding towns by road, and rail, and under 20 mins by train to central London. The other agency is situated in Ware, just outside Hertford, a small rural country town with considerably poorer access opportunities.
Funding for these services came from NHS Hertfordshire and Hertfordshire County Council in a joint commissioning arrangement lead by the County Council. Funding for the social care element came from the AIDS Support Grant (ASG) provided to each local authority for this purpose.
This grant was ring fenced, meaning that the local authority could only spend this money on HIV related support services. However this ring fencing was removed in late 2010 and as a result left the money vulnerable to reallocation for other purposes, unrelated to the original intention.
The grant was rolled into a larger grant or settlement, provided to each local authority, but the amount of the grant was still identified to indicate that it was provided for this purpose, and so local authorities should continue to spend it accordingly.
In late 2011 the National Aids Trust published a report highlighting the concerns of many, that local authorities were already siphoning off this money, or intending to do so, and that services were being cut as a result.
At the very time Lord Fowler, who was chairing a House of Lords Select Committee on HIV and Aids made a report from which he indicated a real need to increase investment in such services.
In late 2010 Hertfordshire County Council (HCC) decided to review services in the county. They initially suggested that a 25% saving would need to be made by both services and even though this could potentially cause problems, plans were put in place to accommodate this without impacting on front line services.
However in January 2011, HCC decided to cut all funding for The Crescent. They then awarded a contract to the other agency, Herts Aid, to provide a countywide service. This came as a shock, and somewhat of a surprise to The Crescent, given that the idea only a month before was to make savings. It was also a surprise that the agency chosen was the one located in the least accessible part, and in an area with the least PLWHIV in the county.
This decision was taken without any consultation to those affected. Even the council's own impact assessment, which is supposed to include the views of stakeholders and interested parties, took place over a weekend in the first week of January, appearing to be just a box ticking exercise.
The end result was a service that could never work, and has failed miserably. Services in the east are still as they were before the change, however in the west there has been very little of consequence offered for PLWHIV at all.
The Crescent is a member led organisation, where those living with HIV are employed as staff, and also are elected to the board of trustees, and are therefore by definition, representative of those most affected.
In early 2011 a survey of The Crescent's members asking if they wanted to transfer to the other provider brought a resounding no. Instead they insisted on fighting the decision, and so embarked on a campaign to do so.
It had been suggested that this was all merely a case of economics, and that savings had to be made, but it's simply not true. HCC received £508,000 this current year from central government specifically for HIV support, and next year this will increase too; yet they are spending a fraction of this.
The Crescent appreciates that savings need to be made; but do they need to be this extensive? Surely, from the £508,000, there is enough money available to fund both services in Hertfordshire, as was the case prior to 2011?
The Crescent has repeatedly drawn attention to the plight of PLWHIV in Hertfordshire and has gained fantastic levels of support from some of the most influential people in the land. However it seems that Hertfordshire County Council are not paying any attention.
Lord Norman Fowler, former Secretary of State for Health, and architect of the original 1980s Don't Die of Ignorance public awareness campaign said in a statement released to support our Healthy Futures fundraising appeal:
"I fully support the work by the Crescent in St Albans for people living with HIV, their partners, families and friends. Over the last nine months I have been chairman of a Select Committee of the House of Lords on HIV in the United Kingdom. This is a crucial health issue and organisations like The Crescent totally deserve our support."
The Crescent is still supporting more than 300 people with no funding at all and has seen a five fold increase in people seeking HIV testing compared with the same period last year. They continue to receive new referrals from various health and social care agencies, plus people seeking help, advice, training and support on a daily basis.
They are continuing their campaign to educate and inform people about HIV and fighting stigma. As part of this, they have members featuring in the Stand Tall Get Snapped campaign, which is an exhibition in London's Soho to mark the 30th anniversary of the death of Terrence Higgins and the official recognition of HIV as an epidemic. It aims to show that HIV is not just a white gay male issue and that it can affect anyone, of any age, gender or sexual orientation.
Hertfordshire County Council can, quite easily, avoid causing unnecessary stress and hardship to those living with HIV in Hertfordshire by reinstating some funding to The Crescent now.
The Crescent hopes that now a new Chief Executive, Mr Wood, has been appointed at the County Council, a more balanced view will be taken on the support needs of PLWHIV in Hertfordshire. They are calling on him to see sense, and meet with them and discus the situation further, something his predecessor, Caroline Tapster, refused to do, sending others in her place.
Not forgetting that those most affected cannot, as a result of the stigma that so unfairly blights the lives of those affected by HIV, come forward and be seen. They, on the whole, cannot write in to a newspaper, or to the County Council to complain for fear of disclosure. They are the hidden victims of this unnecessary meddling and penny pinching, being carried out by those who are unaware of how difficult it is for them to speak out.
It's shameful that this should continue, particularly when there is no logical reason to allow it to do so. There is ample funding for these services and it's clear that a county wide service will not work.
Hertfordshire County Council, show that you have more interest in this crucial health issue as the likes of Lord Fowler and so many others have done. Don't leave people in Hertfordshire suffering from HIV/AIDS alone, without support.