Your worship the Mayor, distinguished guest, attendees, good morning. Let me begin by saying what a
wonderful presentation we just had.
I am delighted to be here. I want to thanks Greg Ussher, Margaret McCloughin, Patricia Durr and he Metro Centre as well as all the partners and members of the consortium for inviting me to take part at this your 7th National LGBT Health Summit.
I want to begin by saying that access to healthcare is a test of a society’s values. It is a signifier as to what sort of society you are and what sort of things you believe in.
It is quite common for people to say “we should take the politics out of healthcare.” But, actually, you can’t take the politics out of healthcare, because there no more political subject than the
provision of healthcare and access to health care. It is no coincidence that one of the most
ferocious debates, across the Atlantic, in American politics has been about
health care reform. There is no more political subject.
And what I wanted to speak about today was the need for a whole person approach to LGBT health and well being.
I want to talk at greater length about what was previously said about the achievements there have been in the lifetime of everybody at this conference.
We have achieved an equal age of consent, there has been an end to the ban on LGBT people serving in the armed forces, we have ended discrimination against Lesbian and Gay partnerships for immigration purposes, given Lesbian and Gay couples the right to adopt children, scrapped the homophobic section 28, banned discrimination in the workplace and for vocational training, included homophobia in the definition of hate crimes, increased sentencing for homophobic hate crimes, produced and
implemented the gender discrimination act and created civil partnerships.
Now let me pause here and say I remember, because I was the equalities minister at the time when Ken
Livingstone, the then Mayor of London, introduced civil partnerships at a
London level and everyone was steeled as to the outcry ad the complaints and the hate mail and the campaign in the Daily Mail, and actually it was received perfectly positively.
The reason I say this is because this is one of the instances where public opinion and the public mood has been in advance of where politicians were at the time. And it was because Ken successfully
introduced it in London without any outcry that a Labour government went on to
make it law.
We have also outlined discrimination in goods and services, with no exceptions, launched a campaign
in the UN against discrimination on the basis of homosexuality, awarded rights
for fertility treatment on the NHS, introduce the Equality Act, and I have lived to see a Conservative Prime Minister call for gay marriage and fighting his own activist on the issue. And
a whole number of out, and I stress the word out, Gay Conservative cabinet
Now almost all of the advances that I mention happened under a Labour Government. I make that point, not to make a party political point but, to remind you that although these advances
were brought forward by the state and although these advances were brought
forward under a Labour government, the truth is none of this would have
happened without activism at the grass roots.
Recent research from Stonewall shows GP’s have a lack of the basic facts of Lesbian and Gay people’s lives. Stonewall’s research also found that 3% of gay and bisexual men attempted to
take their own life, in the last year, compared to just 0.4% of men in general.
Half of gay and bisexual men experienced at least one incident of domestic
abuse from a family member or partner since the age of 16. 1in 4 gay and
bisexual men have never been tested for sexually transmitted infections and
41% of LGBT people over 55 live alone, compared to 28% of heterosexual people of the same age.
On this issue Cameron has put his cards on the table. I was shocked when the government announced that they were going to cut housing benefit provision for young people under 25. They
must understand that this means that many young gay people who are forced out
of their family home for reasons of stigma, for reasons of anxiety, it’s a big
issue. Particularly in London because those people will end up with nowhere to stay, because what are you to do if you have to leave home at 18? How are you going to fund your housing? What is
going to happen to you?
It’s quite clear that this government and IDS [Iain Duncan Smith, Work and Pensions Secretary], they
looked at it, it must have been brought to their attention, but they simply
There’s a broad context in which we are looking at public health and the LGBT community today. There are broad issues around isolation, there are broad issues around an aging community, and
there are broad issues about mental and wellbeing. I can say on behalf of Labour’s health team
particularly Andy Burnham [Shadow Health Secretary and Former Health
Secretary], that mental health is a particular issue for us.
He made a speech earlier this year where he spoke about his vision for a New Deal for mental health and in that he includes the LGBT community. Because we are all subject to stereotypes and one of the stereotypes of the LGBT community is that everyone has a great time partying, everyone is having fun, fun, fun and this can lead to complacency.
When talking about the trust
that LGBT have in their healthcare providers it is important to point some
facts out. 1 in 11 of LGBT people over 55 has taken drugs within the last year
compared to 1 in 50 heterosexual people. And 1 in 6 LGBT people over 55 are not
confident that there GP and other health services would be able to understand
and meet there needs. That is the background against which we meet this
I started by saying that we have seen progress made, but it is clear that when you look at the figures,
certainly that the Stonewall survey and other surveys have been able to put forward, that there is still a very long way to go.
Some of the general issues, I think, are about a lack of confidence that some LGBT people in their GPs.
Dominic Davis, the director and founder of Pink Therapy, the UK’s largest independent counsel organisation working with gender and sexual minority
clients, was quoted in the Guardian as saying,:
“If you don’t feel you can trust your doctor you’re not going to disclose to them. We have quite robust research to show that shows significantly poorer mental health amongst gay men, lesbians
and transgender than in the general population. The result of living as a stigmatised minority is that you self harm.”
The other issue apart from a lack of confidence and a lack of trust sometimes in health care professionals
is the issue of isolation. Many of us can remember the big AIDS campaign which
the Tory government ran in the 1980’s with crashing tombstones and thunder
bolts. I think the sense then among healthcare professionals was that people
who AIDS were not going to live there three score years and ten. One of the
transforming things about the landscape in relation to HIV is we now know is
that people with HIV and AIDS victims can actually live there three score years
and ten and plus. We need to pay more attention to the kind of support that we give to the LGBT community as it ages.
On this issue we also have to ask not just will local authorities have the money to acknowledge the unique health and social care needs of LGBT people, set ambitious and radical public
health goals, design public health promotion policies that are more inclusive of gender and sexual health diversity.
We also have to ask do some of these councillors including some of the ones serving on committees and Health and Wellbeing boards actually have the knowledge to commission services for
LGBT people and identify the purposes that their public health intervention
I am concerned that some key LGBT health issues may in some cases be overlooked. Either because some town hall officials overrule the Director of Public Health decisions and use the
public health money to back phil cuts?? or, unlikely as this may seem, because
a few councillors are not entirely sympathetic to the needs of LGBT people.
I am anxious that we get some kind of draft policy position on public health including LGBT health out by
next spring, which is the point when public health reverts to local authorities.
I look at this by thinking about the future.
The NHS has to move from just focussing on the sexual health of men who have sex with men. I’m not saying that this not a very important issue, but you have had this kind of narrow
focus for too long and, as a result, the LGBT community can be invisible, in
terms of policy, in other areas of policy and in other areas of public health.
And I think that is why, beyond sexual health, LGBT experience of the NHS often
leaves much to be desired.
Now we know that organisations like the Metro Centre Ltd and other have a brilliant record of engaging with LGBT people and trying to tackle homophobia, heterosexism and other forms of
social exclusion which have a significant impact on Lesbians, Gay men, Bi-sexual and Transgender people.
But it’s time for the NHS, new Commissioning Boards, Public Health England and all the new statutory bodies created by the Health and Social Care Bill to publish their own plans as to how
they intend to commission services especially designed for LGBT people.
If LGBT people are not confident these new organisations take their issues seriously they are unlikely to want to engage with them, trust them or answer their questions honestly.
The lack of sexual orientation
monitoring by health services means there remains a distinct lack of
information, as opposed to supposition, about the health and social care needs
of LGBT people.
Collecting robust data is the first step, a firm foundation, on which the new public health system can improve the services it offers LGBT people.
I have argued for evidence based public health policies in the area of obesity, evidence based policies in the area of alcohol control and abortion and I argue today for evidence based
policies in relation to LGBT health. And one hopes that in the hurly-burly of
the reorganisation the importance of research is not lost on anybody.