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Lord Hylton: My Lords, I thank the noble Baroness for her reply. Is she aware—I expect that she is—that torture has recently been used in some 60 countries, with the result that about half a million torture victims are living in the United States of America? The United States Government are keen to increase funds for rehabilitation.

The noble Baroness is very persuasive. Can she convince the European Union to restore its cut of 7.5 million dollars, which has left 30 medical centres without support in places where they are often the only source of help?

Baroness Symons of Vernham Dean: My Lords, I am aware that torture is a terrible scourge. It is important not only to support the victims of torture, but to try to deal with the whole problem by preventing torture

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from happening in the first place. The European Union does not fund the UN Voluntary Fund for Victims of Torture. Instead, it funds individual rehabilitation centres, both inside and outside the EU, through the European Initiative for Democracy and Human Rights. The United Kingdom pays 17 per cent of the funding for that European initiative. Much of its efforts are directed not only to victims of torture, but to dealing with the problem before it can get a hold.

Lord Avebury: My Lords, is the Minister aware that a number of NGOs that provide direct assistance to the victims of torture all over the world recently wrote to the head of the human rights commission, Mr Sergio Vieira de Mello, opposing any suggestion that the fund be amalgamated with other trust funds under the control of the UN? Will she assure the House that the Government will uphold the political independence of the UN Voluntary Fund for the Victims of Torture, which has been its most valuable asset?

Baroness Symons of Vernham Dean: My Lords, the independence is enormously important, so I take the noble Lord's point, but I stress that there are a number of different ways to tackle the terrible problem. That is what I hoped that my initial Answer implied. After all, there is the OSCE's anti-torture programme, the African Commission on Human Rights, and also our own projects in the United Kingdom. Another way to tackle the problem is being undertaken today by my right honourable friend the Foreign Secretary. With the noble and learned Lord the Lord Chief Justice, he is launching a new handbook entitled Combating Torture.

Baroness Rawlings: My Lords, following the noble Baroness's very clear answer to the noble Lord, Lord Hylton, and given that some of the rehabilitation centres may have to close, what are the Government doing to replace them? Will victims of torture be left without support?

Baroness Symons of Vernham Dean: My Lords, I will look very carefully at the numbers of the centres that may close. I assure the noble Baroness that I take the point very seriously. There are number of different ways in which we are trying to tackle the problem. I absolutely agree with the implication of her point—that people should not be left high and dry—which is important. However, my central argument is that it is enormously important to tackle the causes of torture. I have been able to specify the booklet launched today, and I hope that noble Lords will also be pleased to know that today we are signing up to the optional protocol to the convention against torture. That is another very important step in developing our armoury.

Lord Elton: My Lords, the noble Baroness mentioned our own domestic programme. Does that refer to the Medical Foundation for the Care of Victims of Torture? If so, would she consider, either in

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her own department or elsewhere, extending some funding to that organisation, which does invaluable work and is very short of funds?

Baroness Symons of Vernham Dean: My Lords, I cannot tell the noble Lord whether our domestic programme comprehends that. I have details of six or seven projects that the department has told me are covered by the programme, but that project is not mentioned. I shall ask the department for further details and write to the noble Lord.

Sexually Transmitted Diseases

3.14 p.m.

Baroness Gardner of Parkes asked Her Majesty's Government:

    How they intend to deal with the increased demand for diagnosis and treatment of sexually transmitted diseases.

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): My Lords, the Government's 2001 sexual health and HIV strategy contains a number of measures to improve access to diagnosis and treatment for sexually transmitted infections. We have already committed 47.5 million to support strategy implementation and will invest an additional 40 million over the next two years, including investment in genito-urinary medicine clinics to improve capacity and reduce waiting times. To improve the quality of services, we are developing recommended standards for the treatment of HIV and STIs.

Baroness Gardner of Parkes: My Lords, I thank the Minister for that reply, but the situation is far from satisfactory. People wish to remain anonymous when they go to seek advice as to whether they are suffering from a sexually transmitted disease. For that reason, the drop-in clinics have proved good, because there is no priority funding from the PCTs for sexual clinics. At present, drop-in clinics are having to close their doors within half an hour of opening, because the demand is so great. People are being turned away. Those who wait often have to wait three to four hours. There is underfunding for trained consultants in the subject.

Will the Minister either see that more drop-in clinics are funded specifically to deal with this enormous public health crisis, or consider supra-regional funding so that there could be a number of special centres?

Lord Warner: My Lords, we anticipate that by 2004 there will be an increase of around 35 trained specialists in genito-urinary medicine. That will make some contribution to the position on waiting times in those clinics. So far as concerns PCTs and the primary care sector, we are trying to shift the balance of power to emphasise much more local decision-making, with the majority of health resources being distributed to

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PCTs. The spending review settlement provides for a significant new investment for PCTs, and enables them to plan for the next three years. However, it is unrealistic to expect sexual health to be funded differently from other NHS programmes.

Lord Clement-Jones: My Lords, the recent report of the Select Committee on Health was a damning indictment of the Government's lack of priority towards sexual health policy. That is only evidenced by the delay in 2001 of the publication of the national strategy for sexual health, the delay in the introduction of accurate nation-wide chlamydia screening, and the delay in the national awareness campaign. When will the Government respond to what the Health Committee rightly called a crisis, by making the problem a much higher priority and adding much greater resources to it?

Lord Warner: My Lords, we have said that we welcome the report by the Select Committee on Health. However, it is worth bearing in mind, as I said in my Answer, that we laid out in 2001 a sexual health and HIV strategy. A 27-point action plan was published in 2002 that highlighted what developments would be made, and recommended standards for HIV treatment and care, treatment of STIs, psycho-sexual services and reproductive health services. The HIV standards will be published shortly, and work is under way on other areas.

We do not accept that nothing is being done. The issue is difficult. We have a 10-year strategy, and a very effective campaign—the sex lottery campaign—is being worked on and launched at the moment, aiming to change sexual behaviour among younger people. The key to much of the success in the area is changing that behaviour.

Baroness Masham of Ilton: My Lords, is the Minister aware that on 6th February I asked whether a national service framework could be set up for sexually transmitted diseases and other infections? I hope that he will consider that. Will he tell the House why there is such an explosion of the conditions? Is he aware that syphilis rose 500 per cent within the year?

Lord Warner: My Lords, we must all be very worried about the rise in these conditions. That is why we have the strategy that do we have, and that is why we are engaged in the sex lottery campaign. Noble Lords may smile, but we are trying to engage in a serious issue with young people, who are in many cases the leading group in terms of the rise in these diseases. We have to engage with young people where they are, and with their value sets and their behaviour.

The lifetime number of heterosexual partners is increasing—which is a major contribution in this regard. In the past year there has been an increase in concurrent partnerships. Although there has been an increase in consistent condom use, the benefits of greater condom use have been offset by the increase in the number of reported partners. We are also seeing

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some figures reflecting the fact that we are getting better and faster at diagnosing such infections, and are therefore able to produce a treatment response.

Baroness Gould of Potternewton: My Lords, first, I must declare an interest as the chair of the independent Advisory Group on Sexual Health and HIV, whose responsibility it is to try to ensure that the 27-point action plan referred to by my noble friend is carried out. Perhaps I may pursue a little further the question of resources. I appreciate the points that my noble friend made about the budget that the Government have already spent. But that would not even cover half the cost of rolling out a chlamydia campaign. I know that there will be a further 10 pilots, but it is important that the chlamydia campaign is rolled out throughout the country.

What inducements will there be for PCTs, in order to make sure that they prioritise the question of sexual health and are given adequate resources to deal with it? My noble friend mentioned the sex lottery campaign. It is a good campaign—I do not want to take away from that—but there is the question of whether we need a much more hard-hitting national campaign in order to make sure that the young in particular understand the consequences of unprotected sex.


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