It is a great pleasure to serve under your chairmanship, Dr Allin-Khan. I am grateful to the Backbench Business Committee for granting this debate during National HIV Testing Week in England. Each year, the campaign funded by the Department of Health and Social Care, and delivered by the Terrence Higgins Trust as part of the national HIV prevention programme in England, brings us together to raise awareness of HIV and to promote regular HIV testing, in particular among the groups most affected by HIV. It is always the way that Parliament works that this debate coincides with a debate on LGBT+ History Month, although the two subjects are so linked.
Over the Christmas recess, I was reading Alan Hollinghurst’s book “The Line of Beauty”, which brings home the fact that, at that time in the 1980s, a test was potentially a death sentence. People dreaded going for one, because of the result it might bring and the impact on their life and the lives of their family and those close to them. We have moved on to be able to say with 100% certainty that, if someone gets a positive result from an HIV test —which people can do in their own home—treatment means they can have a normal life expectancy and cannot pass the virus on. That remarkable fact is what makes this a generation that can end new HIV cases across this country.
I encourage everyone in the Chamber, across Parliament or watching these proceedings to take part in the current campaign and to order a free HIV test. I was particularly pleased to see the Prime Minister take a test and demonstrate how straightforward and lacking in process it is. Many people still think a test might involve needles and health service professionals, but a test can be taken at home with an easy-to-access kit.
I thank the right hon. Member for his excellent opening remarks. Does he agree that the Prime Minister taking that test in Downing Street highlights the issues around stigma and the fact that people can test safely within the confines of their own home, without anyone else or the glare of a clinic? It is that person and the test kit, with sample results.
I absolutely agree with the hon. Lady, who is one of my co-chairs on the all-party group on HIV, AIDS and sexual health. She has done so much to promote this issue, particularly among difficult-to-reach groups in the black and minority ethnic community and among women, and I commend her for that. I agree absolutely: taking a test, as I have done many times, is a routine matter that, in essence, involves merely pricking a finger and delivering a small amount of blood. That can be returned anonymously, and the result comes back without anyone else being involved. Were any issues to arise from the test, the person would know that proactive and supportive contact would generally be made with them.
Normalising HIV testing is crucial if we are to find the 5,000 people across the UK living with undiagnosed HIV. Central to that is opt-out testing in emergency departments. I am proud that with parliamentary colleagues on the all-party parliamentary group, and with the help of Sir Elton John and the amazing campaigning of HIV charities, we won the case for a £20 million investment in opt-out testing in England in 2021 and for a further £20 million for expansion to 47 more A&Es in 2023.
Since its routine introduction in 2022, opt-out testing has been an incredible success in normalising HIV testing in the health sector. Across 34 emergency departments over just two years, nearly 2 million HIV tests have taken place. In its first 18 months in London, Brighton, Blackpool and Manchester, more than 900 people were newly diagnosed with HIV or were found, where they had been lost to HIV care. A further 3,000 were found to have hepatitis B or hepatitis C.
This approach also relieves pressure on the health service. Data from Croydon university hospital found that when it first started opt-out testing, the average hospital stay for a newly diagnosed HIV patient was almost 35 days. Within two years, the average stay was just 2.4 days.
I remind Members that they should bob—as they are doing—if they wish to be called in the debate. Given the number of Members who wish to speak, and to ensure that everybody gets to say what they wish to, I suggest an approximate time limit of five minutes. We will move to the Front-Bench spokespeople at about 2.28 pm. I call Jim Dickson.
It is a pleasure to serve under your chairship, Dr Allin-Khan. I pay tribute to the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) for securing this important debate and for his excellent speech.
We are here because of the work done by the excellence Terrence Higgins Trust, which, with the Department of Health and Social Care, runs the vital National HIV Testing Week campaign. It provides a vital staging post towards the goal, which we all share, of ending new HIV infections by 2030. This week, as the right hon. Member said, anyone can order a free postal HIV test, and I encourage anyone listening to do so. I was pleased to be able to take a test myself just next door, on Tuesday, at the excellent event run by the Terrence Higgins Trust.
I welcome the goal set by the last Government to end new HIV cases by 2030, and I am pleased that the new Labour Government have commissioned a new HIV action plan for England, which is expected to be published in the summer, to make that a real prospect as we approach 2030. As I am sure other hon. Members will agree, if we are to meet this ambitious target, it is crucial that we find the estimated 4,700 living with undiagnosed HIV in England, as well as those across the UK, and ensure that they are getting the lifesaving treatment they need and cannot inadvertently pass on the infection. It is clear that that will happen only through testing.
In my previous life as cabinet member for health in Lambeth, we worked very closely with the Elton John AIDS Foundation to introduce the world’s first social impact bond focused on bringing people living with HIV into care. We worked with a coalition of third-sector organisations across the three boroughs of Lambeth, Southwark and Lewisham to ensure that health settings earned outcome-based payments each time they identified someone either newly diagnosed with HIV or someone who had stopped treatment, and linked them back into care. Our brilliant GPs across the three boroughs carried out opt-out testing to accompany this set of changes. The results were dramatic: over three years, more than 265,000 people received HIV testing, and more than 460 south Londoners living with HIV entered treatment. More than 200 people received a new HIV diagnosis and attended their first treatment, and 250 who had stopped treatment returned to care.
It is a pleasure to serve under your chairpersonship, Dr Allin-Khan. I congratulate the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) on bringing forward this important debate and on the work he continues to do with my hon. Friend the Member for Vauxhall and Camberwell Green (Florence Eshalomi) on the APPG.
While we will spend most of this afternoon’s debate speaking about the goal to end new HIV transmissions by 2030, I feel it is important to recognise just how far we have come in our understanding of HIV and treatments for it, and in our education and awareness raising. We have seen so much progress in the fight against HIV since the 1980s crisis. Although there is still a way to go, it is through open discussions, such as the one we are having today, that we have been able to reduce the number of HIV cases in the UK down to an estimated 113,500. But it is thought that 4,700 people are unaware that they are living with HIV, and that is why it is vital that we continue to push to increase testing. We know that when caught early HIV is treatable and that the quality of life of those living with HIV is far better than it was back in the ’80s. Unknowing carriers risk not only not getting the treatment they need or getting it too late, but unknowingly infecting others. Testing is easy, quick and can save lives.
We know that testing among men who have sex with other men is high. This is incredibly encouraging, but we must do more to increase testing among heterosexual men, heterosexual and bisexual women, and the trans and non-binary community. The stereotype that HIV is only something that affects men who have sex with men is not true. In fact, the increase in infections in 2023 was attributed to sex between men and women, with a 35% increase among heterosexual men and a 30% increase among heterosexual women.
We should be doing more to encourage testing among all groups. That means greater investment in local and community-based public health initiatives, so I am pleased that the Government are investing in local government public health. I am particularly pleased to hear about the £38 million that is being awarded to my borough of Lambeth, which will go a long way towards supporting people with HIV, preventing HIV and funding other public health initiatives that the borough runs.
It is a pleasure to serve under your chairship for the second time this week, Dr Allin-Khan. I thank the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) and the co-chairs of the APPG for all the work that they do.
I also echo calls from hon. Members for the funding for global work that is being shamefully cut back by the new US Government to be found from within this country. I ask the Minister to look at the pressure that is also being put on, and the funding that is being withdrawn from, wider rights-based groups, which we spoke to yesterday in a fantastic and interesting roundtable. There are many groups working in the global south to support LGBT rights and reproductive rights, which include healthcare. The impact of the cutback more widely will be on health, and we owe it to those groups to ensure that we are doing what we can to make up for what the American Government are so awfully doing.
I am pleased to join this important debate and to support HIV testing week. I absolutely commend the efforts being made by so many MPs, including the Prime Minister, to promote HIV testing. That is great to see. As an MP for Brighton, I am proud of the work of the Terrence Higgins Trust—which is partly based in my constituency, not far from my office—for making this a bigger event every year, and more and more inclusive. I recently visited THT to see first-hand the incredible work it is doing to end new transmissions of HIV, supporting people to live well with HIV, and challenging the stigma and all the things that go around that. Its work with partners in my city, like the pioneering Lawson unit at the Royal Sussex County hospital and the local HIV charity, the Sussex Beacon, is all so exciting.
Opt-out testing was mentioned. The emergency department at the Royal Sussex has been doing that testing since March 2022. It has since been rolled out nationally in areas of very high HIV prevalence. In Brighton, the team at the Lawson clinic has identified 16 new HIV diagnoses in recent years. That sounds like a small number, but the impact for each individual is absolutely massive. They are all people whose HIV will almost certainly have gone undetected up until then. All the work that is being done to normalise testing as part of a trip to A&E, when blood is drawn, does so much to reduce HIV stigma, help people, and save and improve lives.
It is a pleasure to serve with you in the Chair, Dr Allin-Khan. I will certainly try to keep to three and a half minutes.
As we mark National HIV Testing Week, we unite to promote regular HIV testing, particularly among those most affected. Despite significant progress, we are advised by the Terrence Higgins Trust, the National AIDS Trust and the Elton John AIDS Foundation that, as has already been said, we are not on track to meet the goal of ending new transmissions of HIV by 2030.
The latest data from the UK Health Security Agency shows a plateau in the decline of transmissions among gay and bisexual men, and a rise in new transmissions outside of London. To reverse the trend, we must scale up HIV testing and find the estimated 4,700 people living with undiagnosed HIV in England. The Brunswick Centre in my area plays a pivotal role in this effort. Its work in providing support, education and testing services is of huge value. It offers a safe space for individuals to get tested and receive the care they need. By partnering with local communities, the Brunswick Centre ensures that everyone has access to lifesaving information and services. I join the HIV community in calling on the Government to invest in year-round online HIV and STI postal testing services, and to continue opt-out HIV testing in emergency departments.
We must also address the stigma that prevents many from seeking care. Everyone living with HIV deserves to feel safe and supported in every healthcare setting. On the issue of stigma, I commend my senior parliamentary officer and the secretariat for the APPG on HIV, AIDS and sexual health for their outstanding work in combating stigma and educating us on the actions we must take to address this crucial issue. Together with the dedication of organisations like the Brunswick Centre, the Terrence Higgins Trust and others, we can achieve the goal of ending new HIV cases by 2030 and be the first in the world to do so. Let us make HIV testing a routine part of healthcare and ensure that no one is left behind.
It is a pleasure to see you in the Chair and to serve under your chairship this afternoon, Dr Allin-Khan. I thank the Terrence Higgins Trust for partnering with the Labour African Network to host a fantastic event on Monday that highlighted why it is so important for us to continue testing, and especially to get the communities that do not often come forward to test. It was good to hear so many people at that event highlighting why that is so crucial. That was the first engagement of the new Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton); it was a really good event for her to attend.
I also want to highlight the visit to University Hospital Lewisham that I conducted in February 2022 to look at its opt-out testing with my hon. Friends the Members for Clapham and Brixton Hill (Bell Ribeiro-Addy) and for Lewisham East (Janet Daby). I was struck by the age of someone that had been lost to HIV; she was an elderly woman in her 80s. That is why it is so important to test.
I thank all hon. Members for their comments and my wonderful APPG co-chair, the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell), for his opening speech. I want to focus my remarks on a critical issue that affects our communities: HIV and its impact on the black communities in the UK. Despite significant advancement in HIV prevention and treatment, black communities continue to face disproportionate rates of HIV diagnosis and late detection. That disparity is not just a statistic; it represents the lives affected by systematic inequalities, stigma and a lack of culturally appropriate services.
I want to highlight the work of the London HIV Prevention Programme, which is taking vital steps to address the disparities through new outreach work aimed at black Londoners. Under the banner of Do It London, that programme is designed to increase HIV awareness and encourage regular testing to provide robust support for those living with HIV. By partnering with trusted communities, it ensures that its efforts are culturally sensitive and effective.
I congratulate the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) on leading today’s debate. I am my party’s health spokesperson, so I make it my business to come to health debates. Indeed, I think I have missed only one debate on HIV in the 14 years that I have been here.
Health is a devolved issue, so there may be different guidelines surrounding access to testing and to testing itself, but we all have the same goal wherever we are in this great United Kingdom of Great Britain and Northern Ireland. England could be the first country in the world to reach the goal, but we are currently not on track, so perhaps the Minister will tell us what action will be taken to ensure that happens.
In Northern Ireland, there has been a significant increase in testing in recent years. Efforts have been made to promote early intervention and treatment. The Public Health Agency in Northern Ireland revealed that in 2023, a record 92,635 tests were conducted. Given that the population is 1.9 million, I think that is very significant. That is a 5% rise on 2022, and it is the result of a massive commitment by us—health is devolved to us—to ensure early detection.
On the other hand, the number of new HIV cases has also risen. In 2023, there were 101 cases—67 men and 34 women—which was a 41% increase on 2021. I know the numbers are small, but the percentage is quite worrying. It is alarming that some of those cases were linked to injecting drugs, so will the Minister give us some idea of how we will address that issue? It is not just about physical exchange; it is also about the use of drugs, so what can be done to stop that? Sharing a needle is a cause of HIV for some drug users, and that concerns me.
The right hon. Gentleman referred to the ’70s and ’80s—I am of an age that I can remember them very well. Historically, HIV was a stigma, and it was Princess Diana who helped to take away some of that. I always remember that she met people with HIV, sat alongside them, shook hands with them and drank out of the same teacup, and that dispelled some of the concerns that people had, so we are thankful for that.
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I am proud that the last Government were the first to fund opt-out testing. I am also pleased that in November the Prime Minister announced further funding to extend the testing intervention period. That will bring to 89 the number of hospitals funded to routinely test for HIV anyone who has their blood taken in the emergency department.
As a Scottish MP, I want to be able to tell hon. Members how we are leading the way in addressing the HIV epidemic in Scotland, but unfortunately that is not quite the case. There are good news stories. Early action to make pre-exposure prophylaxis—PrEP—freely available on the NHS has helped to drive down new transmission of HIV in Scotland. Year round, everyone in Scotland has access to free at-home HIV testing, which is made available through the Terrence Higgins Trust testing service and funded by the Scottish Government. In 2023, a landmark campaign delivered by the Terrence Higgins Trust addressed the stigma that we all know surrounds an HIV diagnosis. It is astonishing that that campaign was the first of its kind since the tombstone adverts four decades ago. I hope that that important work to combat HIV stigma continues in Scotland and across the rest of the UK; it cannot be a one-off.
However, for all this success, the reality is that progress towards achieving the historic feat of ending new HIV cases in Scotland by 2030 is now at risk. I have mentioned the resounding success of emergency department opt-out testing in England, and the role that that will play in helping to get the NHS in England back on track towards reaching zero new HIV cases by 2030. The clear evidence is that opt-out testing works, yet Scotland is still to adopt the same universal approach to HIV testing. As it stands, no area designated as high prevalence, such as Glasgow and Edinburgh, is benefiting from the opt-out testing programme. I have again written to Scotland’s Health Minister, Neil Gray, to ask that that be reconsidered.
An estimated 500 people are living with undiagnosed HIV in Scotland, and a growing population of people are living with diagnosed HIV but are no longer accessing vital treatment and care. If we are to succeed in getting to our 2030 goal across the UK, we must reach each and every one of those people. Every day that emergency department opt-out HIV testing is not on offer, opportunities to find and support people living with HIV are being missed.
Although Scotland is clearly not within the Minister’s remit, I hope that she, the public health Minister and the Health Secretary will use opportunities to raise this issue with the Scottish Government and to highlight their own successes. As she may know, the Scottish Government are keen to highlight what they perceive to be health failures in England. This is a great opportunity to highlight a health success and to call the Scottish Government out on their own approach.
That also applies to HIV testing week. For this week to be most effective, it should apply across the United Kingdom, so that we can benefit from the positive publicity that came from the Prime Minister’s test. That is not available to people in Scotland, because HIV testing week is not happening there this week, despite my calls last year for it to be extended to Scotland. There is a testing week in Wales, but it is not as co-ordinated on a UK basis as we would want to see. Such co-ordination would allow everyone to benefit from promotional campaigns such as the excellent one in Parliament this week, which the Terrence Higgins Trust facilitated for Members of the House.
I very much recognise the work of Terrence Higgins Trust Scotland and Waverley Care, which I had the great pleasure of visiting at its premises in Edinburgh recently. They are doing a great job, but when we have National HIV Testing Week, it needs to be across the whole United Kingdom. Testing is the only way we know to find a person’s HIV status, and that is why the current campaign, testing week and interventions such as opt-out testing are so integral to our HIV response.
We are now five years away from 2030, and in no part of the UK are we on track to achieve our goal of ending new cases of HIV. Getting there will require cross-party working, and we have always worked cross party on the all-party parliamentary group, which has the highest number of members of any APPG in this Parliament and has been around for over 30 years. Many Members across Parliament work tirelessly in that group to ensure that we reach the 2030 goal, and I am sure the Minister will tell us more in her response about what is being done to achieve that.
I know that this is not directly within her remit, but it would be remiss of me not to mention testing in other countries. We have heard about HIV testing week here in the UK, but poorer countries rely on the Global Fund to Fight AIDS, Tuberculosis and Malaria, and particularly the United States President’s Emergency Plan for AIDS Relief, which it funds along with the US to deliver testing and treatments. We know that the future of US funding is, at best, uncertain. This country has always been at the forefront of the Global Fund, and leadership on this year’s replenishment is important. I was pleased to hear what the Prime Minister had to say yesterday about Gavi and vaccinations, and I hope he will be able at some point to give a similar commitment on the Global Fund. I hope all Members would agree that it would be quite wrong if we were to achieve the target in the UK, but just left poorer countries and the rest of the world to get on with it and, in fact, go backwards as a result. I make that call in relation to the wider issue.
I encourage anyone to take a test. It is very straightforward and easy, it will help to identify those we do not know about and it will help us to achieve that 2030 goal.
I am proud of the work done across local government in the fight against HIV/AIDS. In Lambeth, for instance, the council has led London boroughs on commissioning of the London HIV prevention programme. We were in the forefront of the successful campaign to get PrEP provided free on the NHS for all those who needed it, and the council continues to jointly commission, with our neighbouring boroughs, work with marginalised groups to reduce stigma and thereby increase awareness of HIV and the need to take tests.
I support the Government’s aim of ending new HIV cases in England by 2030, supplemented, it needs to be said, by the Mayor of London’s great work in ensuring that the capital is a fast-track city. However, that date is only five years away and, like the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale, I worry that without a dramatic increase in testing, we will not get there. I was pleased therefore that last month the Government announced an expansion of the number of hospitals carrying out HIV opt-out testing, including Darent Valley hospital in Dartford, in my constituency. I welcome the service that will be made available to my residents as a result.
I hope that the new HIV plan for England, expected this summer, will build on that expansion and bring the increase in opt-out testing we need to find all those unknowingly living with HIV. The incredibly welcome 5.4% increase in the public health grant for 2024-25—that is £200 million, which is the biggest increase for many years—will strengthen this work, alongside so many other areas in which we need to tackle health inequalities.
I would like to end by paying tribute to all the charities working so hard to tackle this issue, including but not limited to the Terrence Higgins Trust, the Elton John AIDS Foundation and the National AIDS Trust.
My hon. Friend the Member for Dartford (Jim Dickson) spoke about the important role that councils play, and it is a crucial role indeed. They encourage testing and are well-poised to target the right communities and areas to increase awareness, and they can tailor messaging in the way that is needed. The work of local councils and community-based organisations has really helped to increase testing rates and reduce stigma. It has also helped to ensure that as many people as possible know their HIV status, and the recent round of Government funding will continue supporting that work.
I hope to see more from the Government on the international front. We must actively look to support international efforts to stop HIV transmissions, especially at a time when President Trump is running his reckless review of American aid and has put the future of the US President’s Emergency Plan for AIDS Relief in the balance. Any credible attempt to end HIV transmission must include a global response. When it comes to ending HIV transmission, we are not an island. Ending new cases here will only last for so long if we are not contributing to efforts to end them abroad. Where the US is stepping down from efforts to tackle global HIV transmissions, we should be stepping up.
As it stands, we are already not on track to reach our target of ending new cases by 2030, but I hope that today we will hear insights from the Minister on the steps the Government are taking to increase testing and to end new cases in the UK and abroad. As I am sure other hon. Members do, I eagerly await the Government’s new HIV action plan in the summer.
Brighton also has some groundbreaking digital pathway work happening. The locally co-designed HIV app EmERGE has been a big success. It is a European project centred in Brighton, and I am told that people absolutely love it. There are about 720 people using it for PrEP access, appointments and support. This innovative approach has helped ease the pressure on local services and freed up about 1,000 local appointments per year. That is fantastic work, making all our money go further and helping people to cut their transmission risk without fuss and bother. That is what we all need to be working towards.
Let us be clear: zero transmission of HIV is possible by the target date of 2030. The work in Brighton that I have just described proves that. I truly believe that Brighton could be the first place in the UK to achieve that target, given the comprehensive work going on. I know that hon. Members in the Chamber are aware of all of that, and I hope the Minister will set out how a roll-out of that model across the UK will be funded.
I want to give a shout-out to Marc Thompson, the lead commissioner for LHPP. He brings his personal passion and lived experience to that initiative. As a black, queer Londoner and HIV activist, Marc understands the unique challenges that our communities face. His dedication is a testament to the importance of having voices from within the community leading the charge.
I also want to put on record my thanks to Fast-Track London, One Voice Network, NAZ, LGBT HERO, METRO, Positive East, Sophia Forum and the 4M network for the work they do to provide services not only in my constituency, but right across London. We need an approach that is informed by the communities affected. Do It London is leading the way by allowing black Londoners to shape the services designed for them.
We must also recognise that HIV is not just a health issue, but a social issue. Black communities have historically been under-represented in prevention and support. We must build trust and address black HIV services and outdated stigma. By prioritising those efforts, we can reduce HIV rates and improve health outcomes for black communities. Together we can create a service that works towards the goal of no more HIV by 2030.
Testing for HIV of course must be discreet. There are numerous sexual health clinics across Northern Ireland, and indeed across the United Kingdom, that offer sexual health advice and testing. In addition, more discreet, self-testing kits are available, so we should be looking at some of those things.
Early diagnosis is key to ensuring that treatment can be started quicker. Treatment can reduce the viral load, which means that the disease becomes untransmissible. The hon. Member for Vauxhall and Camberwell Green (Florence Eshalomi) and the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale mentioned HIV in third-world countries, and I agree with their sentiments entirely. The Elim church in my constituency of Strangford deals with people with HIV in Swaziland in Africa, and a choir comes over every year to do some fundraising. Every one of those young children with lovely voices received HIV from their parents when they were young, but the good thing is that they are now HIV-free as long as they have the drugs, so there is a way of going forward.
Charities, agencies and church organisations do their best to provide support. I have seen and understand what they can do. I very much look forward to hearing from the Minister. I hope she can work in parallel with her counterparts in the devolved nations to ensure that we tackle HIV together and meet our 2030 goals.