Policy responses and statements
- Name of organisation:
- Department of Health
- Name of policy document:
- HIV related stigma and discrimination - Action plan
- Deadline for response:
- 31 March 2006
Background: The need for action to tackle the stigma associated with HIV was identified in the National Strategy for Sexual Health and HIV in 2001, and a commitment to publish an HIV stigma action plan was made in the strategy’s implementation action plan in 2002. During the interim period, while this action plan has been in development, things have not stayed still. The National AIDS Trust undertook the ‘Are YOU HIV prejudiced?’ campaign, and more recently the development of resources for health workers and employers. Stigma and discrimination have featured explicitly in a wide range of guidance, recommended standards and good practice for those working in the HIV field, including the Recommended Standards for NHS HIV services.
The Department of Health welcomes comments on this action plan especially from people living with or affected by HIV.
COMMENTS ON
DEPARTMENT OF HEALTH
HIV RELATED STIGMA AND DISCRIMINATION - ACTION PLAN
The Royal College of Physicians of Edinburgh is responding to the Department of Health on its consultation document HIV related stigma and discrimination - Action plan. We have pleasure in commenting on a document we regard as a welcome action plan for a deserving group of people and patients.
The action plan sets out a clear remit and sets an agenda. All suggested interventions are relevant and valuable. The document is well referenced, and the College welcomes the legal framework that is clearly expressed, that will help patients and professional carers alike.
Intervention 1: The Dissemination of Information
The College welcomes the intention to review and update the health promotion toolkit (paragraph 50). It would be helpful to give a clear deadline for this exercise to occur, and indicate what aspects of stigma and discrimination should be addressed.
Sexual health and HIV leads in Primary Care Trusts are tasked with including action to address stigma within the strategic aims for sexual health and HIV (paragraph 53). Since this is currently one small part of a larger portfolio, it would be useful to provide sexual health and HIV leads with specific and measurable outcomes against which to measure their progress.
Intervention 2: Acquisition of Skills
The suggested production of a guide to rights and entitlements of people with HIV is an essential and highly relevant component of the action plan. Its format, structure and production will require careful consideration, as will issues of language and methods of dissemination.
Intervention 3: Counselling Approaches
Currently, the action plan indicates the importance of counselling being available. It would be appropriate to ask the commissioners of sexual health care in local Primary Care Trusts to ensure that appropriate counselling for stigma and discrimination issues is made available.
Intervention 4: Greater Involvement of People Living with HIV
The report correctly outlines the opportunities for those living with HIV to have input into the development and commissioning of services. Greater involvement of people living with HIV in a wide variety of groups is key to reducing stigma, and the Department of Health may wish to consider commissioning research into the current barriers to such participation and how these barriers may be overcome.
Intervention 5: Challenging Discrimination
It may be difficult for individuals to know where to start when they feel they may have suffered discrimination. It would therefore be important to ensure that the proposed Guide to Rights and Entitlements (paragraph 57) includes clear guidance for a user of services on what to do and where to go if an individual feels they have suffered from discrimination.
The action plan as it currently stands does not make specific mention of resource, although it has achieved clear distinction between HIV-related strategy and relevant other strategies. Nevertheless, it would be right to make mention of other policies, such as social inclusion, narrowing health inequalities and empowerment of excluded people; and human rights (specifically, NHS education on induction for its staff). The document should also link HIV-related stigma and discrimination to relevant client groups. In addition to the gay and MSM groups, there are students, women and refugees. Finally, in referring to other strategies, those carrying blood borne viruses, injecting drug users and former drug users will be in need of opportunities to access services, and should be aware of opportunities set out in the action plan.
In terms of the challenge set in paragraph 83, the College would like to see:
1) Service investment - in design of services, integration with appropriate generic services including primary care and local specialist services that invite easy access, good means of through-care, adequate training opportunities for health professional staff, local audit and action on user perspectives, emphasis on holistic care, and continuity across the service and geographical boundaries.
2 a) Monitoring dataset for national and local use, which would primarily be the NHS's responsibility.
3) Engagement with the media, a subject which is almost entirely missing in the plan, with specific action points to monitor and challenge media treatment that encourages HIV-related stigma and discrimination, to influence current affairs and agendas, such matters as soap story lines and mass circulation editorial policy.
In conclusion, this action plan is a welcome and well drafted document. We suggest some additions and references to other policies, and the recognition that resources and clear expectations are required locally to devote to this plan in order for the positive and welcome commitments to be seen through to sustained delivery.
Copies of this response are available from:
Lesley Lockhart,
Royal College of Physicians of Edinburgh,
9 Queen Street,
Edinburgh,
EH2 1JQ.
Tel: 0131 225 7324 ext 608
Fax: 0131 220 3939
[31 March 2006] |
