Don’t tell me this Budget is for everyone – thousands living with HIV have been totally ignored

The government needs a better plan for marginalised minorities given the expected economic shock of coronavirus. I suspect they’ll be labelled ‘niche’ and slashed instead

On the day of the government’s Budget announcement, it is distressing to see that the Mildmay Mission Hospital – London’s only HIV hospital – faces closure.

Despite claims that the UK has met its UN target of 90-90-90 (meaning that, in the UK, 90 per cent of those living with HIV will be diagnosed, receive treatment and have an undetectable viral load) thousands of people either do not know they are living with HIV or are not responding to treatment.

We have made great strides in reducing the mortality rates for people living with HIV and new infection rates, particularly within the gay male community. Thanks to PrEP (which makes it impossible to contract HIV) and antiretrovirals (which prevent the onward transmission from someone living with HIV) the outlook has changed.

However, the needs for HIV services have not gone away; they have simply evolved. We are looking more now at longer term care, increased need for mental health services for ongoing stigma and additional, more specialised care for those who have ended up with longer term neurological issues – at the Mildmay. Actions speak louder than words and the potential closure of Mildmay shows even NHS England has misunderstood the ongoing needs of people with HIV.

Mildmay was a core part of service provision at the height of the AIDS crisis. However, it shouldn’t be saved because of its historic value, or Princess Diana’s famous visit; it should be saved because it still provides much-needed services for those living with HIV who do develop complications. By all means, we could look at alternative provision – perhaps saving money by moving it – but it is still vital in treatment.

This is a budget-cutting measure, pure and simple, and, as far as I see it, is indicative of some latent residual homophobia within NHS England. The total cost of Mildmay is £5m – a tiny slice of the NHS budget and, in fact, 8 per cent of what the NHS spends prescribing paracetamol. Yet it is being cut. NHS England already has a poor record on homophobia. When HIV advocates were arguing with NHS England about a full roll-out of PrEP in England, the NHS allegedly briefed the media that children might not get life-saving treatment if the NHS had to pay for it.

I have little confidence that the NHS is looking out for this marginalised and often stigmatised group. The Mildmay provides very specialised neurological services for people living with HIV, and it seems that nowhere within these closure plans is an alternative being discussed. If that is the case, we aren’t losing a treasured memento, we are losing a vital service for some of the most marginalised people in society.

As with the government’s rumoured dropping of the Gender Recognition Act, when issues become controversial, they get side-lined. And when an issue is already marginal, there is little confidence in the government to steer this ship correctly.

The real test for this new government is whether its pre-election rhetoric will be put into practice when we see the budget this week. There were some fine words from the prime minister on how this would be a budget for all, looking at taking care of those who lent him their votes, with an increase in spending across the board. That includes additional sums for the NHS. It’s fair to say that we have seen some backtracking already on this, such as the “oven-ready” plan on social care – so oven-ready in fact, it’s still eating corn in the coop.

Despite what the prime minister likes to assert, no amount of optimism can help those with complex illnesses, and no amount of bumbling buffoonery can mitigate the hurt and suffering that this government would cause with the Mildmay’s closure.

The government needs a better plan, particularly given the expected economic shock of coronavirus. We need to think harder about more complex and controversial services for those with HIV, mental health or trans issues, and put some brain power in there. Instead, I suspect that there is a serious risk that a populist government may take this opportunity to cut services that are seen as “niche”, as a sleight of hand move.

Given that the Department of Health has established the HIV Commission (together with Terrence Higgins Trust and the National AIDS Trust) to eliminate new HIV infections by 2030, it would be great if the government stood behind this move and, in this budget, committed the resources needed to eradicate this disease once and for all, taking with it the stigma of HIV and consigning its terrible effects to history.

Steve Wardlaw is chairman of Emerald Life, the first insurance company ensuring equality for all, particularly women and the LGBT+ community, and a prominent LGBT+ activist