Hospital admissions for sexual health problems are rising due to budget cuts in England

People are being hospitalized for sexual health problems that are easily treated in local clinics, experts have warned. Some municipal budgets will be cut by up to two-thirds in ten years.

A Council analysis of English council spending on sexual health care shows that cuts have been made nationally by more than a third since 2013, despite a rise in the number of consultations for sexually transmitted infections (STDs). English councils spent £9.58 per head on sexual health care – including STD testing and treatment, contraception and advice – in 2022-23, up from £14.41 in 2013-14, taking inflation into account.

Spending has been cut in real terms in every municipal region since 2014-2015. In almost every municipal area, the number of cases of gonorrhea has increased since 2017, and in 71% of areas the number of cases of syphilis has increased.

Nationally, the number of cases of gonorrhea and syphilis reached a record last year, with 146 gonorrhea diagnoses per 100,000 people. That was an increase from 58 in 2013, while the number of syphilis diagnoses rose from 6.4 to 15.4. Meanwhile, hospital figures show that the number of admissions for syphilis and chlamydia doubled between 2013-2014 and 2022-2023, while the number of gonorrhea admissions tripled.

Dr. Claire Dewsnap, consultant in genitourinary medicine (GUM) in Sheffield and outgoing chair of the British Association for Sexual Health and HIV (BASHH), said: “The fact is that it is quite ineffective to spend money on treating people who have had to go into being admitted to hospital because they had gonorrhea joint infections, when they could have come into their service very cheaply and been treated very quickly. And that applies to everything we do.”

The cuts to services – which have disproportionately affected younger, poorer and black populations – are now also affecting older people, she said.

“People over the age of 60 are now more likely to develop late-onset HIV infection and the rate of syphilis among these people is rising. The age at which people develop syphilis and gonorrhea is increasing. It used to be thought that this was something that really only affected young people, but now it affects a much wider age group.

“But in reality, this is a story about inequality and how it really impacts people who don’t have the power and autonomy to work their way into the service sector because there just isn’t the access that used to be.”

Advice, prevention and promotion services have suffered the biggest cuts, with net spending falling by 44% since councils were made responsible for public health in 2013. Meanwhile, STD testing and treatment fell by 33% and spending on contraception by 30%.

For example, some local cuts may be due to improvements in service delivery STD tests that can be ordered online are cheaper than in-clinic appointments, and have improved access for some patients. Dr. However, Dewsnap said expenses have been reduced largely due to efforts to reduce personnel costs, which make up about 80% of service budgets.

The period between someone contracting an STD and all their sexual partners receiving treatment is “getting longer and longer,” she says, resulting in more and more infections being spread.

“Ten years ago we would track down every partner of someone with chlamydia. We just can’t do that anymore,” she added.

She described gonorrhea and syphilis as the “canary in the mine” because they spread more quickly and cause more obvious symptoms and complications.

Data published by the UK Health Security Agency shows that the number of consultations at sexual health services is at record levels. Nearly 4.4 million consultations were recorded in 2022, 21% above the level of 2018 when data was first available.

Combining lower and higher local authority spending, the areas that have seen the biggest declines in sexual health spending are the London boroughs of Redbridge and Harrow (by 68% and 58% respectively) and Bolton (by 57% decreased). %).

David Fothergill, chairman of the Local Government Association’s community wellbeing board, said: “Local sexual health services are facing an unprecedented increase in demand, while funding levels have fallen.

“The public health grant that councils receive has been reduced by £880 million in real terms since 2015. This has resulted in a reduction in municipalities’ ability to spend on STD testing, contraception and treatment.

“Investments in sexual health help prevent long-term illness and unwanted pregnancies, reducing pressure on our NHS and improving the health of people in our communities.”

Dr. Dewsnap called for funding to be restored, but warned that such a large number of trained medical staff have left that “even if suddenly a lot of money comes into the sector tomorrow, which is very unlikely, you can’t increase that workforce overnight.” can be replaced the other day. ”.