Health and Social Care Bill

My Lords, I will be brief. The amendment aims to remove an anomaly in the law which is both absurd and damaging. As the Select Committee on HIV and Aids said in its report, the priority with HIV should be prevention. For every case we prevent we save, in financial terms, about £300,000 in a lifetime’s treatment, as well as the human cost of that lifetime’s treatment. Antiretroviral drugs preserve life, and thank God for that, but they do not cure. The vast majority of national health service treatment for HIV is free, but the present law charges for treatment for a small group of people in this country, which has obvious and, frankly, baleful, effects. First, if the charges result in no treatment, it is dangerous to the individual and endangers his own life. Secondly, it means that the man or woman affected is likely to spread the disease to others and add to the casualty list, although effective treatment reduces onward transmission by something like 96 per cent. Thirdly, such a charging law acts as an obvious deterrent to people coming forward for treatment and testing, which is the whole aim of policy, and negates it. Therefore, the effect of the present law is against all the policy aims of public health—a point very strongly put by the National AIDS Trust, to which I pay tribute. What is the current position? Most people in England who live with HIV have free access to treatment. The exceptions who are charged for treatment are refused asylum seekers, visa overstayers and undocumented migrants. Many of these people are destitute and, frankly, unable to pay for the essentials of life, let alone for expensive HIV treatment. The treatment of those with HIV contrasts with the free treatment given for TB and all the other sexually transmitted infections, with the exception of HIV. As regards the other sexually transmitted infections, the Government rightly take the view that charging for treatment would undermine all the efforts to prevent spread. Public health considerations come first. The only exception is HIV.