HIV support ‘at risk’ from council cuts

VITAL services for Scots with HIV are under threat as councils make cutbacks to save money, the outgoing head of a leading Aids charity has warned.

David Johnson, who is leaving Waverley Care after 17 years at the helm, said huge progress had been made in the treatment of HIV in the last two decades, with many patients still alive today despite what was thought to be a death sentence when diagnosed.

But he said one of his biggest disappointments was the “disengagement” of many local authorities who were no longer providing HIV-specific services such as welfare advice and social work, at a time when demand for these was likely to grow with an ageing HIV population.

Johnson said the charity’s respite care service, Milestone House, was also under threat again as Edinburgh City Council reviewed its support of the home.

“One of my disappointments is that we have made these great advances medically, and on the back of that you would have expected people to be looking at the social implications of an HIV diagnosis and for councils to be thinking of the implications for their services,” Johnson said.

“And yet what we have increasingly seen is a disengagement from many councils on the HIV front, at a time when actually the call on their services is likely to grow.”

Councils were increasingly trying to merge HIV-related care into other mainstream services to save money, he insisted. “A number of councils no longer fund HIV-specific services, so you no longer have welfare rights advisers specifically for people with HIV.

“Edinburgh has done an amazingly good job over the years when you think that it was once deemed the Aids capital of Europe – but even here yet again the future of Milestone House, our respite unit, is being reviewed, with queries over whether the council is able to continue with it.”

The review of Milestone House, which is mostly funded by Edinburgh City Council and costs £500,000 a year to run, is looking at the needs of those who use it and whether they could be cared for at home or in the community. But if the council funding were to be pulled, the service would be closed, Johnson said.

“There is an irony, as the social care needs grow because people are living longer with HIV, that the funding at the council level across Scotland has steadily reduced.

“They will say we are taking care of people through mainstream services, but I think the experience of a lot of people is that the mainstream services don’t work for them.”

One example of a service that had been cut was the dedicated social work team for people with HIV in Fife, known as Fife Positive Support. “Fife Positive Support has now been absorbed by mainstream social work teams,” Johnson said. “So there has been a move away from having dedicated services for folk with HIV.

“All the evidence shows that HIV is here to stay.

Across Scotland we are likely to have 400 new diagnoses a year and every new diagnosis you are talking about, as well as the personal impact on people’s lives, is probably going to cost the NHS £250,000 for their lifetime care.”

The Convention of Scottish Local Authorities said councils were facing deficits in their funding and had to reduce budgets. A spokesman said: “We have got to take some of the demand out of the system. “At the end of the day, councils have to have a balanced budget so have to make the decisions appropriate for their local needs and circumstances. There are no sacred cows.”

One HIV sufferer, who has used Waverley Care’s respite services for three years, said shortages of funding and staff cuts meant they could not provide as much as they once did. The 53-year-old from Edinburgh said: “I spend two weeks at Milestone, and then have four weeks at home.

“It gives me peace and relaxation and a chance to recharge the batteries. If they closed Milestone I can’t see them opening another residential centre, so we’d lose that service, which would be devastating for so many people. It is our only means of support.”

An Edinburgh City Council spokesman said: “Milestone House was originally established as a hospice for people with HIV. However, with significant advances in medication and care, people are living longer and it is used very occasionally for terminal care.

“Its main function is a respite unit and in line with our health and social care strategy we are looking at how a wide range of services could be more appropriately delivered – for example, as a community-based model.

“We have already started talking to service users about future provision and expect to start an official consultation exercise in the summer which will help drive forward our service for people with HIV.”