What’s Happening To The UK’s Sexual Health Centres

When you need the morning after pill, the alternative to pissing money away in Boots is the sexual health centre. Yes, that mecca of white paper bags packed with Durex condoms and muted daytime TV. Since picking up microgynon (don’t even) as a teenager, through to panic appointments after hooking up with someone who turned out to be the world’s most promiscuous man, sexual health centres have been a fixture of my sex life. They are not, however, so sacred to some people. Analysis of Tory budget cuts to the health sector anticipate a removal of roughly £40million from sexual healthcare services this year. This in turn is expected to impact on already rising rates of STDs and, significantly, long-term contraception measures like the coil, which are speculated to become less accessible in lieu of cheaper alternatives. As our hard-won protection against accidental baby-making wanes, the future for female sexual autonomy appears increasingly bleak. If accessibility is taken away, it’s women who will suffer the physical, emotional, social and economic consequences. If you get pregnant, you’re most likely going to be the one paying over the counter at Boots for the emergency contraceptive. Because how often do men feel their faces prickle as they whisper at the front of the line to someone in a white coat that yes please they’d like to spend £20 on the morning after pill. This extends beyond contraception too – government data collected on STDs also reflects “higher testing rates in females.” And this statistic resonates; I can hardly count the times friends have relayed stories expounding how much emotional stress – either through pregnancy scares or STD scares – that they’ve used up on men who roll on, roll off and go to sleep. It’s easy to get angry, quickly; we have been born into an intoxicatingly stale culture which genders reproductive responsibility. Still, beneath those cultural attitudes, there have always been places where discussions about sexual health and gender are being had openly and intelligently. A couple of years ago, I found out about the Margaret Pyke Centre in Kings Cross, the kind of place your mum knows from when it existed in Soho in the '80s – an outstanding example of how fantastic sexual healthcare can be delivered quickly, efficiently and informatively. The centre specialises in research into female contraception, and in my case they were more helpful in 10 minutes than any appointment I’ve had with my local GP or heard from others, like the horror stories of women being denied their pill prescriptions because of conflicting opinions over what’s ‘healthiest’ for a female body. In fact, general practitioners go to MPC for training and frequently refer patients to them. I had a pregnancy scare once and headed straight to the MPC, swanning out on to Pentonville Road an hour or so later reassuringly un-pregnant and tested on the alphabet of STDs.

Last month, however, after 40 years of practice and a recent rating of "outstanding" from the Care Quality Commission, Margaret Pyke lost its funding. The CNWL NHS Foundation Trust (which organises its budget) decided that, in the face of cuts, the simplest response would be to close it down altogether. Supporters have pointed out a concerted lack of effort on the Trust’s behalf to consider numerous viable alternatives, also drawing attention to unclear and misleading survey questions and a generally confusing representation of data. Regardless, after months of tension and decades of service, the centre met its match in the Tory Budget of 2015/ 2016. Politicians are stealing our sexual liberty, and getting away with it. Despite the Trust’s decision, a brilliantly run campaign to save the MPC did manage to secure many objectives going forward, and their consistent determination is rousing. The presence of groups like Save MPC prove there are people refusing to take so-called austerity measures lying down. Thanks to the efforts of amazingly dedicated service users and staff, many of the employees and research facilities from Kings Cross will be relocated to the Mortimer Road Market Centre in Bloomsbury.

One of those people is Dr Jayne Kavanagh, who led the campaign. She told me she believes the decision to re-locate the centre’s services “definitely” signals a trend in the gradual dismantling of systems of support across the country. She firmly agreed that,“Sexual and reproductive health services are being downgraded and even disappearing altogether as a direct consequence of central governments cuts to the public health budget.” On top of that, the Conservatives are pushing to move sexual health commissioning from the NHS to local authorities, which puts services at the mercy of local government as opposed to informed medical professionals. Ideological austerity is fucking us, and it too is refusing to pay for the morning after pill. As fun as it is to reel off a sentence like that though, the actual consequences of limiting accessibility are not quite so snappy. Not to freak you out (though it should) but diagnoses of gonorrhoea have gone up 100% over the last five years, according The Guardian. Syphilis has seen a slightly less but still notable rise of over 50% and everyone’s favourite, herpes, is up too. This is frightening because really, what was that lump? On top of those fun statistics is an additional concern that the more expensive, long-term forms of contraception like the coil or the implant won’t be so swiftly re-prescribed. Chris Wilkinson, president of the Faculty of Sexual and Reproductive Health, told The Guardian that he anticipates a rise in unplanned pregnancies as a result. The Save MPC campaign has been quick to remind the public that every £1 spent on contraception saves the NHS £12.50 in the long run, but that kind of forward thinking seems to be of little use to our government. As centres across the country strive to modernise sexual healthcare services to a global standard, where we can wake up to a text message giving us the all clear or walk in to one place for comprehensive testing, the government’s lack of support belies an inherent disinterest in the political ramifications of social care and the NHS as a wider institution. Emily Butler, one of the dedicated service users from the Save MPC campaign, who has kept me in the loop since the closure was announced, sees this as the start of many changes to how this country is able to provide sexual healthcare. “Having a place of specific expertise in contraception and sexual health doesn’t fit in with the government’s ideas,” she explains, outlining a “transformative” plan they’re set to release in September which will restructure sexual healthcare clinics into one-stop-shops specialising in everything. While that sounds like what we have already, in terms of research, it’s not at all. “They’re saying that the research teams [on a newly combined site] can work together and that if you pool the numbers, you have more people, which is surely better. But you’re talking about people who are working in completely different areas. This way, you’re going to lose expertise that has taken nearly five decades to build up.”

Even if you ignore the importance of research, the physical loss of centres will add to an increasingly unsafe situation. Across the country, women are already demonstrating a frustration over accessibility, with a growing number buying emergency contraceptives from unreliable sources online (including eBay). Consolidating and limiting centres will only add to the counter culture flourishing around our health service. While brilliant new facilities continue to fight for funding from local councils nationwide, fears that contraception will begin to be prescribed “on the basis of financial viability, postcode lottery, and policy directives” – as The Telegraph put it – paint a rather more bleak picture of our prospective sexual liberty. The key point to bear in mind is that the closure of one outstanding sexual health centre in the capital is not accidental, nor is it mourned by the government. The image they’re keen to push is that they’re consolidating services as a way of expanding them – deheading a rosebush to make way for more flowers. But there are very few flowers blooming in the future of the NHS, just a bit more freeing up of central London real estate (this is what happened last time the centre was moved.) What we’re experiencing is a decided attack on our sexual freedom, and specifically in the case of the MPC, an attack on research into female contraception and safety. What do you call a society without free, modern, accessible healthcare for women? Let’s never find out.