Leading clinician warns of funding crisis associated with UK primary care trusts

The following is an edited version of a letter sent by Dr Anton Pozniak, Chairman of National Association of Providers of AIDS Care and Treatment (PACT), to fellow HIV clinicians warning of the danger of a funding crisis associated with the commissioning of services by Primary Care Trusts.

I would like to draw your urgent attention to the fact that there is going to be a Health Select Committee review of GUM/HIV services in July and September/October. The health service reviews are extremely important as they can have a major impact on the way that governments and others might perceive our specialities and on the way we practice our speciality.

My personal feeling is that, as far as GU Medicine is concerned, there is a crisis that has already begun because of the lack of manpower, bricks and mortar, the increasing number of patients, which will be fuelled by education campaigns and we have to reach targets for the sexual health strategy.

In HIV the major issues are similar in terms of manpower and resources but also in the way that HIV is funded. The major problems which will arise out of Primary Care Trust commissioning, the London problem because of the consortium arrangements, reimbursement and logistics because of our open access, pay, spiralling drug costs et cetera. Voluntary organisations have a great role to play in providing evidence about difficulties for their clients in receiving standardised care, the whole refugee situation, and access to new therapy.

Comment

Changes to the structure for funding HIV treatments and services have been public knowledge for some time, and were supposedly open to public discussion and consultation. However, the responses from both HIV-positive patients groups and medical professionals have consistently warned that devolving HIV care from current specialised centres of excellence to be determined by PCTs comprising of GPs with little or no understanding of the issues involved, appears to have been completely ignored.

That these concerns are being highlighted so strongly now amongst the UKs leading doctors should be even more of a concern to patients.

Guarantees should be put in place to ensure the new PCTs to at least match current HIV/AIDS budgets for the next 2 years until they develop experience of the real costs involved in this area of healthcare. An effective system of register and control for commissioning of specialist services should also be demanded.

Without this patients may easily loose the option to choose their own treatment centre and quality and choice of treatment will become even more budget-based than it is already.

Lobbying to hospital and health authority executive, health commissioners and politicians at all levels is crucial to raise awareness of the risks involved