BASHH

To be honest I thought this blog would never get beyond the initial trial episode but imagine my surprise when I heard that there had been more than 800 posts in response to my last missive... 'They all really care I thought', truly touched. Until I realised at approximately 799 were either in Russian or offering the once in a lifetime opportunity to purchase various sex aids. Oh, and the remaining one was from a man wanting to buy me. I kid you not. I'm seriously considering the offer depending on the NHS planned Consultant salary cuts...

But I'm renowned for my tenacity (second only to my passion for shoes) so I'm back and raring to go. And what's the big topic this time? Well, there's only so long that I can get away without mentioning the ongoing, vicious HPV vaccine debate, especially in light of the recent press release from BASHH citing that 'over 9 out of 10 UK sexual health clinicians would advise paying privately for a vaccination for their daughters which Government will not fund, rather than accept the alternative treatment, which is available on the NHS'. It's a strong statement overall, and I'm willing to pin my flag to the mast and say that it's not before time. We're not a huge clinic here, but we do see at least 800 patients a year with genital warts and few are left psychologically unmarred by the diagnosis. I was touched by how little the general public members who have not had genital warts understand about their impact when I was teaching the medical students last week. I was talking about HPV and the vaccination programme when one of the students raised his hand to ask a question. 'So let me understand this.....' he said slowly, '...the only extra thing that the quadrivalent vaccine does is prevent what is essentially a cosmetic problem...' It was clear at that point that he had never seen, never mind had genital warts but after some further discussion (admittedly using some clinical photos for an ...ahem... helpful visual demonstration) he too couldn't understand why on earth we're not vaccinating against HPV 6 and 11.

And I think the problem is an age old one for our speciality. Patients just don't talk to anyone (except us!) about their genital warts. They're not 'glamorous' 'sexy' or even 'deadly' medicine so they don't make the headlines like the big hitters of other medical specialities. And they're not the sorts of conditions that can easily be represented in magazines or newspapers because firstly their intimate location precludes any photographs appearing, and secondly because no one wants to be associated with them. It's okay to have 'Womens Need' or some such magazine publishing a story about Maria and her gargantuan fibroids with the patient smiling proudly beside the surgical excision specimen but you'll never see a story about Cherry and her irksome genital warts.

So what's the answer? I wish I knew. What I do know is that it's our job to be advocates for our patients, to stand up for them when they cannot, for whatever reason, do it for themselves. I have seen too many patients devastated by the diagnosis of genital warts, with far reaching psychological and sexual consequences. I'm sure that we all have. So I applaud the efforts of this speciality, and BASHH, to convince the government to change the vaccine used in the programme to one which could also prevent so many cases of genital warts. I wasn't so optimistic a year ago. I always think of government ministers as being a little like referees - even if they make the wrong decision they can never admit it or reverse it no matter how ludicrous it is. But we now have a new government so there is new hope. After all, there's nothing a new government likes better than to pour scorn on the previous ones policies so everyone is a winner with this one! Let's hope it happens...

And for those of you reading this who are not GU Physicians spare a thought for us the next time you're plonked next to one at a dinner party. Firstly, we don't get invited often as you can imagine... but more importantly, although genital warts might not seem like appropriate dinner table conversation remember that we are really doing is speaking on behalf of a huge number of people who have no voice themselves.

More soon...