People Diagnosed with HIV

Part of Private Members' Business – in the Northern Ireland Assembly at 12:30 pm on 29th November 2016.

Alert me about debates like this

Photo of Paula Bradshaw Paula Bradshaw Alliance 12:30 pm, 29th November 2016

I beg to move amendment No 2:

Leave out all after the third "HIV;" and insert "calls on the Minister of Health to support this prevention work by bringing forward proposals to ensure that everyone in Northern Ireland has access to vital pre-exposure prophylaxis medication on the same basis as the rest of the United Kingdom; and further calls on the Minister to support Positive Life in the development of a centre of excellence at its new headquarters.".

I thank the DUP for bringing this important motion to the Chamber. We clearly welcome the motion. I visited Positive Life's new centre in my constituency during the summer and heard in detail about its range of services, programmes and campaigns. I am delighted to see the organisation get the credit and exposure that it deserves today.

We were very cautious about the amendment that was to be proposed by People Before Profit. That is partly because it merely reflects the motion and, in effect, restricts its scope — we must not move away from the fact that HIV can affect anyone, not just people in the LGBT sector — but mainly because it does not include in the equation the vital issue of the pre-exposure prophylaxis medication, commonly known as PrEP. I therefore ask the proposer of the first amendment to consider allowing it to fall to allow the issue to be advanced in order to demonstrate that the Chamber is not just about words but action.

Last year, 103 people were diagnosed with HIV in Northern Ireland. That is 103 people and their families who did not know how their lives — their relationships, friendships, employment prospects and life chances — were to be affected.

We can reduce that number. One way of doing that is through medication designed for people who do not have HIV but who are at a very high risk of getting it. That medication is called pre-exposure prophylaxis (PrEP), a daily pill that has a very high efficacy in preventing infection.

We need to be realistic. People who have contact in certain circumstances with people who are HIV positive, not least those who are in relationships with them, are at risk. I strongly support the belt and braces mantra of Brook — a voluntary health and well-being association — that PrEP should not be seen as a replacement for the need for condoms to prevent the spread of sexually transmitted infections (STIs) and, obviously, crisis pregnancies.

I will give a bit of background on, and UK context to, PrEP. It was established in the courts in August this year that NHS England has the power to commission PrEP and that it would cost about £15 million a year. In Northern Ireland terms, that means that the cost would be about £500,000. The average lifetime cost of treating someone with HIV is set at around £300,000, so even if people do not like the thought of this in moral terms, I ask them to look at it in economic terms and the cost to the public purse.

Supporting our amendment does not mean that PrEP will become available immediately. Work has to be carried out into pilot projects in England to assess how it can be commissioned most effectively and most appropriately. That, essentially, takes away any risk that might incline people to be cautious at this juncture, as there will be time to see how it could be implemented in the overall transformation of health and social care services in Northern Ireland.

I will make two points on how the amendment ties in neatly with that reform. First, PrEP is a classic case of prevention in action and is exactly in line with the Bengoa report and the Minister's road map. We cannot claim to be moving towards prevention being a fundamental part of our health service if we do not stand proactively at the forefront of issues in support of preventative medication such as this.

Secondly, the Minister could be proactive. Indeed, she may even be able to fulfil one of her innovation projects over the next few years by offering to get involved with NHS England's assessment process. I do not know how viable that would be at this stage, but if we wish to take that idea forward I cannot see NHS England not agreeing to it.

With regard to the motion, which we have left intact in our amendment, I re-emphasise that the rise in the number of people being diagnosed might indicate that more people are coming forward. Whatever it indicates, it shows that more people would benefit from a prevention programme that includes appropriate medication. That is a point that our amendment reinforces.

I also warmly welcome the emphasis on the need to remove the stigma, an issue mentioned by my colleague on the DUP Benches. Perhaps we are still victims of the advertising campaign of the 1980s, which had such a significant impact but which no longer reflects the reality of the condition. An awareness campaign, recognising that the stigma can be quite marked in Northern Ireland, would be very helpful.

The amendment serves to reinforce the motion and ties in with the themes highlighted by Professor Bengoa, and I hope that the Assembly gives it its full support.