Speeches by Beales.

“On service resilience, Matt and Zara, Mpox was an extra pressure on the system, and the system responded. What is your sense of the system’s resilience and ability to deal with the potential challenges from other new sexual health outbreaks or challenges in the future?”

“I am conscious that that is slightly straying into my colleague’s question; we will come back to workforce challenges, because my colleague is going to ask you about that. Very quickly, I want to ask about your and the system’s understanding of the challenge around chemsex. Tim or Rob, from a leadership and a commissio…”

“Thank you for joining us. I have some questions about funding, prioritisation and service resilience. In one sense, sexual health services doing far more with much less is a success story. Their productivity with real-terms reductions in funding is a lesson for the NHS about doing much more with constrained budgets, bu…”

“I suppose we have moved to opting out, on the basis that we should not say, “Do you need a condom?” or “Do you need a HIV test?” because of the stigma associated with that. Do you have any data on the numbers of free condoms that are available, or on the number of people who would like a condom but cannot afford to pur…”

“Should we be asking people whether they want them? I got told, “Here’s your bag.” They were everywhere. It was so easy to just grab some and have them.”

“Once. When I was coming into sexual awareness, you couldn’t really move for free condoms. Every time you went to a clinic you left with a bag, whether you liked it or not. Every bar that I went to had free condoms in baskets everywhere. It was so easy to access affordable condoms. Even in some schools at the time, you …”

“On condom use, I remember being young once—”

“The Committee has seen in evidence and on a visit capacity being freed up through the channel shift online, but we have had feedback that the increased complexity of the patients being seen has not been reflected in the provision of extra resource or even the level of resource being maintained. If anything, health educ…”

“How much of that has flowed to sexual health services?”

“Is it acceptable for one area to close all its services in sexual health? When we visited recently, we heard that Enfield, for instance, was considering closing its last service, on the basis that people could go elsewhere. Is that acceptable?”

“How is the Department holding to account commissioners for meeting population need, and assessing that properly?”

“In terms of meeting that need, are you assured that that process is working, that areas are being scrutinised, and that commissioners and local authorities are investing to meet need in sexual health services?”

“Thank you. Tim, looking at leadership and co-ordination at a national level, what do you think the Government, or the Department of Health and Social Care specifically, could do to better co-ordinate and support sexual health services to carry out their functions?”

“Should the Department of Health and Social Care be clear that that has to reach sexual health services proportionately, bearing in mind what we have just heard?”

“You talked about assessing and responding to need. Do you have a sense of what the unmet need is at the moment? We heard from the first panel about mystery shopping in our constituencies. It seems that, rather than responding to needs, a lot of our constituents who are symptomatic in a walk-in sense just cannot access …”

“Zara, is there anything that you would want to see to make the system more resilient to future outbreaks of Mpox or similar things?”

“I want to come back to you on the point about councillors because it is important to draw a line under that. I take your experience, but would you say it is not just councillors who are making decisions in this space? Ultimately, professionals are doing needs assessments and recommending services. A lot of programmes a…”

“Is there a need for the national strategy that we have heard about to pick up this area and to provide the system with some more leadership? It is complex, we do not understand it and no one is routinely collecting the information. As you say, in that interrelationship between the many different services, they may or m…”

“Should we have clearer national leadership and mandation of collecting information in A&Es and the coroner service on when admissions and deaths may relate to chemsex?”

“Looking at the funding reductions, we saw in excess of £200 million of real-terms cuts from 2013 to 2022, as well as quite a substantial drop in the spend per head on sexual health services. The whole health and care system has faced constraints, with increasing demands and budgets not increasing in line. Do you feel t…”