We set up the HIV awareness charity Saving Lives to promote HIV testing and public health. We believe passionately that one in four of those with HIV in the UK not knowing their status is too high a figure, and that public advocacy and awareness-raising can have a positive benefit on the health of us all, and on the perception of HIV more widely.
On the other hand, I am a doctor working in the NHS. We co-operate with colleagues across the NHS day in, day out. And, when we are concerned that not just the excellent HIV service it provides but the entire edifice is under threat, it's worth voicing our opinion on that issue, too.
Everyone should read this post at Open Democracy by Nicola Cutcher and Lucy Reynolds: "Regulations laid last week will turn England's National Health Service into a competitive market", say the authors. "They appear to contradict assurances from the Coalition government on one of the most central elements of the Bill".
On 13th February, the government introduced the secondary legislation known as 'Section 75' of the Health and Social Care Act 2012, proposing a compulsory competitive market in the NHS. I've written elsewhere about the potential consequences of privatisation of HIV and sexual health services. In this light, section 75 is very frightening, and should be fought.
I believe the NHS provides a gold standard service of care to our HIV patients. Yes, I also admit we are likely not the cheapest service there is - but the NHS is about patients, about quality, and about care. It's about joined-up working not fragmentation. A health service should not just be about cost.
Under the new regulations of the Health and Social Care Act 2012, and particularly section 75, our service will have to be tendered - pitting colleague against colleague, private companies against the NHS. This will not power patient-centred care.
We are doctors. We do health. We do not have armies of lawyers and specialists in tendering and procurement at our disposal. We would rather invest in nurses, dieticians and pharmacists - and I would rather see patients than have to fight for the survival of our HIV service.
If you agree, please sign this petition. If you can, ask your MP to sign Early Day Motion 1104. If you work in the NHS, consider signing this open letter. The pressure we can apply is already working. Let's keep at it, and save what I believe to be superb services.
Campaigns like Saving Lives will all be for nothing if the clinical acumen of commissioners is wasted in debates about cost and competition. Clever tender documents are not excellent care. The NHS should never lose sight of its real focus: providing excellent services, free at the point of need, whenever a person is diagnosed - with HIV or any other condition.