Call to scrap VAT on contraceptives

Tax on over-the-counter contraceptives should be abolished in efforts to cut unwanted pregnancies and sexually transmitted infections, Government advisers said today.

The Independent Advisory Group for Sexual Health and HIV said that VAT on all such contraceptives, such as condoms and the morning-after pill, should be axed in order to promote consistent use.

In its first annual report, the group said the cost of contraceptives was "high and prohibitively expensive" for many people.

In particular it said that the cost of condoms was much higher in the UK than other European countries and it called on the Government to increase access to free condoms in the NHS.

The experts made 29 recommendations on sexual health, calling for ministers to move it up the agenda to address soaring rates of STIs, high levels of teenage pregnancy and to reduce regional variations in abortion provision.

In 2003 there were more than 2 million visits to UK's genitourinary medicine (GUM) clinics.

Infections such as chlamydia, often called the silent infection because it can have no symptoms, soared by 193% between 1996 and 2003, with around 85,550 cases diagnosed in England alone in 2003.

Baroness Joyce Gould, the group's chairwoman, said it was time to recognise that good education, services and support would improve the nation's sexual health and impact on the public's overall physical and mental well-being.

"Some believe sexual health issues to be a kind of Pandora's box of sins unleashed on a permissive society.

"It's time to de-stigmatise sexual health and properly deal with what is and will continue to be a very real consideration for public health," Baroness Gould said.

The experts also backed up Department of Health guidelines on the provision of confidential sexual health advice and treatment for under-16s.

There has been widespread criticism that parents are being kept in the dark about their children's sexual health, with cases of youngsters having abortions without their family being informed.

Despite this, the group said that primary care trusts (PCTs) should continue to provide confidential sexual health services to under-16s.

"Young people who need contraception and/or testing for STIs must have easy access to services, and need assurance of confidentiality in order to access these services.

"It is therefore vitally important that confidentiality is well-publicised and understood," it said.

The report noted that access to abortion services across the country varied greatly and should be made more equal.

The advisers said that on-the-spot pregnancy testing should be available in primary care so that pregnancies could be picked up quickly.

"Lack of availability of on-the-spot pregnancy testing in primary care can lead to delayed diagnosis of pregnancy and reduce the option in the choice of method of providing abortion - early medical or surgical," they said.

The group recommended that all PCTs ensure women have access to early medical and surgical abortion, and a minimum of 90% of abortions should be paid for by the NHS.

There has also been criticism that long waits at GUM clinics have added to rising rates of sexual disease.

The group said that the Department of Health should set a 48-hour target for access to specialist GUM services.

It added that PCTs should be measured and accessed based on how well they complied with this target.

The report said that, as rates of HIV were still rising, HIV testing should be routinely offered and recommended to all patients at GUM clinics.

It also called for targeted campaigns to highlight the advantages of HIV testing.

Toni Belfield, director of information at the fpa (Family Planning Association), welcomed the group's recommendations.

"In particular, we welcome the recommendation that the NHS should prioritise sexual health and urge the Government to take the lead on this through its forthcoming White Paper on public health.

"We also support the proposed expansion in availability of free condoms and the reduction in VAT on over-the-counter contraceptives," she said.

"The report also emphasises the urgent need for an integrated approach to sexual health promotion, which includes comprehensive sex and relationships education and effective contraceptive services.

"Such an approach must be fully resourced to deliver improvements, and we call on the Government to further increase investment in sexual health services and health promotion strategies."