Sexual health - what happened 100 years ago was remarkable
Dr Elizabeth Carlin
26th May 2017
The more I think about this the more I realise how remarkable and inspired the changes that took place in sexual health 100 years ago were - they transformed sexual health care dramatically by simple yet effective action. So 2017 is a special year for BASHH to celebrate the past, consider the present and look to the future.
The need for Public Health (Venereal Diseases) Regulations
In July 1916, the Local Government Board issued the Public Health (Venereal Diseases) Regulations. This began the process of providing free, confidential diagnosis and treatment for sexually transmitted infections (STIs).
The Regulations were the enactment of the recommendations of the Royal Commission on Venereal Diseases, which issued its report in 1916 after three long years of work. At that time syphilis death rates were 22-46 per million, 17% of pregnancies in families with syphilis resulted in miscarriages or stillbirths, 30% of children in blind schools were there due to syphilis and 50% of infertility in women was due to gonorrhoea.
Added to this mix was World War 1 and an explosion of STIs - during the war about 5% of men in Britain’s armies were infected with an STI and over 400,000 British or allied troops were admitted to hospital due to a sexual infection.
Although trench foot embodied life in the trenches, men were much more likely to have an STI.
The foundations of a specialist sexual health service
Specialist clinics were rapidly established following the introduction of the Public Health Regulations and, bolstered by military medics returning from active duty, they went from strength to strength. The clinic network that was established formed the basis of the sexual health service as we know it today.
The following year, in May 1917, the Venereal Disease Act was passed. The legislation prohibited unqualified people from treating venereal disease and the advertising of remedies. This led the way for appropriate training and competency of those managing people with STIs and for robust clinical governance. These principles are embedded in BASHH’s work programme - check out the latest educational events, including the annual conference in Belfast 18-20 June 2017 @ BASHH Conference 2017 and the STI Foundation Programme @ www.stif.org.uk.
So the two pieces of legislation dovetailed together and dealt with different aspects of controlling and treating sexual infections.
Going full circle with a return to Local Authorities
More recently, the Health and Social Care Act 2012 transferred the commissioning of sexual health services to the Local Authorities. This has brought us full circle, returning sexual health to the organisations that originally issued the Regulations! This time though there are the added factors of tendering and performance indicators to contend with.
Never has co-operation, collaboration and communication been more important to ensure that appropriate services are provided, within limited financial resources, for all those who require them.
Celebrating the centenary
To mark the centenary of the venereology legislation a fantastic series of events have been arranged - driven by the hard work of BASHH members and new collaborators. Thank you to all!
You may have already noticed the ‘vignettes’ in the Sexually Transmitted Infection journal and the ‘historical’ slots in the BASHH scientific meetings.
I’m looking forward to the special scientific meeting on the 6 June 2017, which will be followed by a flagship evening event at the House of Lords. It’s great that there’s been so much enthusiasm from BASHH members for this event and even better that we have been able to accommodate the demand.
I’m delighted that BASHH has a new collaboration with the National Archives that will be delivering a really fascinating programme of activities as part of the centenary celebrations. The National Archives not only has a fabulous resource online www.nationalarchives.gov.uk but also an amazing centre in Kew. Have a look at my ‘photos to see why it’s well worth a visit not only for the archives but also for the setting!
The National Archives is hosting free talks on venereal disease and World War 1 and we are helping to promote these as well via our BASHH twitter feed. We are also working with them on a podcast inspired by the first prosecution under the 1917 Venereal Disease Act. I’m absolutely delighted that Stephen McGann will be featuring in this. You may recognise Stephen from Call the Midwife (Dr Turner), Blood Brothers, The Hanging Gale, Footloose …… and now on our very own BASHH/National Archives production!
Closer to home at the BASHH annual conference, we will launch a centenary video documenting key achievements in sexual health that I hope the public, as well as health workers, will enjoy. Our partners here have included the fabulous Terrence Higgins Trust and we are all excited to see this come to fruition.
We have made huge inroads into improving public health over the years, have pushed forward the boundaries of diagnostic testing and treatment, and we have trained and educated many. Perhaps, most importantly we have a committed, enthusiastic and resilient network of clinicians who are dedicated to securing the best they can for their local populations.
The Public Health Regulations and Venereal Disease Act enshrine principles that I believe in and that are as applicable to today’s sexual health service as they were a hundred years ago.
If you have other suggestions or ideas for the centenary year please contact me at firstname.lastname@example.org so we can make this a time to truly celebrate, educate and promote our specialty and good sexual health.
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