I've had some good conversations lately with many people over what faces us as a community over the coming years. Is HIV going to loose its "specialised" commissioning status? As you may or may not know funding for HIV into clinics and hospitals is to a certain extent 'ring fenced' as it meets the definition of a 'complex' medical issue. If funding for HIV becomes non-specialist in terms of its funding this means, locally, it will have to fight with other health issues such as diabetes for funding. Of course how much a local hospital or Primary Care Trust will give the HIV service provision will be influenced by local factors. This raises many issues on the quality of continuing care, access to treatments etc.
I also remain extremely concerned with the proposed introduction of treatment tarrif's. Combined with the above it raises further issues placing funding before care.
We have seen as evidenced by postings on here how much social care provision has depleted for PLWHA (People Living With HIV/AIDs). Accessing community care has become increasing more difficult. Some initial statistics prove worrying and we are trying to get some comparative data to get a handle on how bad it is.
No meaning to sound like a well known comedy but I believe in local services, provided by local people for local people. Funding for the HIV third sector is becoming increasingly tight and we are seeing the demise of good local services. It may be that we have too many HIV groups providing advocacy and services and we as a sector need to come together more. Either way HIV is not as high on the political agenda as it once was. Yes you hear about the international picture but in the UK it is extremely difficult to get exposure on our issues. A belief by the civil service that really HIV/AIDS is now "sorted" and of course these same people advising decision makers in the form of ministers.
The lauded "Right to Control" part of welfare reform would have been and was seen as a very positive step forward for disabled people. However since the green paper the key components that would have delivered radical and empowering powers for disabled people has been so watered down by government the bill will end up achieving little and certainly may in fact may it more not less difficult for disabled people to have more control with less "red tape". From the forums I have been to it is now seen as dis-empowering.
At time of writing our saving grace has been the Lords who are amending the welfare bill thus delaying its final passage. Our hope is that if government want this passed there will be more concessions on the bill and a move back towards the initial promises.
The Equality Bill is in progress and very important. As with most problems there is a scope of law to be applied. Problems with benefits may bring in several separate acts and thus you need to try and keep a handle on what is happening. We have and will continue to be active on this especially arguing our case where possible.
The tightening of "belts" in the NHS, Funding etc .. means a tougher time ahead. Some of the changes will be innovative in nature to cope and I hope the long term prognosis will be positive for us. However I am only too aware that we must keep up with the changes to ensure that our issues are not compromised in this financial climate.
The Chelsea & Westminster is going to expand its HIV service provision with new building and an increase in the size of the dedicated HIV ward and day care centre. The plans will make for a 'model' environment for people who need to be in hospital because of their HIV. This is encouraging.
Well I have rambled on for a bit. Thank you for reading and as always I wish you well.
John.
