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Tuesday, 10 July 2012

Contraception: Action on Access

Today, the All-Party Parliamentary Group on Sexual and Reproductive Health published it's report Healthy Women, Health Lives? The cost of curbing access to contraception services. Their inquiry found that there were significant restrictions on access to contraception services in many parts of the country, meaning that some groups of women – particularly, women over the age of 25 and women who were away from their borough of residence – found access to contraception difficult. They also found that in some areas, the number of available methods of contraception were restricted. The report recommends that any restrictions on the basis of age, residence or method should be removed as a matter of urgency – all women should have access to the full range of contraceptives and contraceptive services.

A thread that runs throughout the report is concern that “efficiency savings” within the NHS are leading to contraception services being cut, and to restrictions in provision. This is despite the fact that investment in contraception services has enormous financial benefits in reducing the number of unwanted pregnancies – it's estimated that for every £1 spent on contraception services, £12.50 is saved. Restrictions on the basis of residence (e.g. only allowing women who live within a certain area to access contraception services there) are likely to be financial, due to the way services are funded on a geographical basis. Other restrictions, such as only allowing the less expensive varieties of the contraceptive pill to be prescribed by clinicians, have a very obvious financial rather than clinical motive.

Additionally, services are being shut or redesigned with restricted access, so that some women are unable to access specialist Contraception and Sexual Health (CaSH) services, and can only access contraception through their GP. This will have the biggest impact on young women, women from ethnic minorities, and women from deprived areas, who are the greatest users of specialist CaSH services. The report is clear that the programme of NHS efficiency savings is directly resulting poorer access to contraception services for women.

There is also significant concern that the new commissioning arrangements being brought in with the Health and Social Care Bill will have a negative impact on access to contraception services. The report found that clinicians felt that the way sexual health services will be commissioned under the new arrangements is still very unclear, and this lack of clarity over the future was limiting the scope for improving services. This is particularly the case because a crucial policy document, which was supposed to be published last year, has still not been published.
Although not directly mentioned in the report, a further concern on the future of CaSH services is the Health and Social Care Bill's provision for the entrance of provide providers into the NHS. Virgin Care has already shown a significant interest in providing CaSH services, and has taken over contracts for the provision of CaSH services in a number of areas (Virgin sexual health services – you couldn't make it up!). The types of rationing and restriction of contraception services that we are already seeing may become more widespread as services are taken over by private providers whose number one priority will be making the most profit possible. This will mean that they may well only provide what they are contractually obliged to, rather than what is best for women, and decisions such as the type of contraception to offer may be increasingly based on cost rather than need.

Those campaigning for access to contraception (and that, by the way, should be everyone campaigning for the rights of women!) must watch these new developments very closely in order to make sure that access to contraception is not further eroded by cuts, commissioning changes, and private providers.

RHUL Feminism Society believe that contraception is a feminist issue. We want to see “Action on Access” to increase access to contraception for all women. We've recently blogged on the Save the Children campaign “Girl Power Saves Lives” which illustrates how access to family planning is a crucial part of saving children's lives. We also blogged a few months ago about the experiences of some of our members in accessing emergency contraception – if you are are from the local area and have any stories, we'd love to hear them.

Whilst we're on the topic of contraception, the British Pregnancy Advisory Services are currently running an absolutely brilliant scheme for residents of Greater London, where, after a quick chat on the phone, they will send you a FREE morning after pill (emergency contraception pill) can keep in case you need it. We think that this is fantastic, and the kind of innovative and accessible scheme that women need. Thanks, BPAS!

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