Analysis of the latest local government revenue and outturn data by the Advisory Group on Contraception has found that contraception spending power has fallen 18% in real terms since 2015/16. Whilst spending has increased from last year, without government investment in the public health grant funding remains significantly below 2015/16 levels.
These cuts are happening at the same time that:
- Demand on local sexual and reproductive health services is increasing;
- Abortion rates in women over 30 are steadily rising; and
- Prescribing rates for the most effective long-acting reversible contraception (LARC) methods have plateaued.
The AGC has been tracking cuts to contraceptive services since 2015, undertaking annual audits of local authority spend and contracting. Reviewing the latest data, members are increasingly concerned that national cuts to local authority budgets have put unsustainable pressure on commissioners to deliver more services to more people, with less money.
Early findings from the AGC’s annual Freedom of Information request audit revealed that the proportion of councils reducing the number of sites delivering contraceptive services has continued to accelerate from 9% in 2015/16 to 26% in 2018/19. A further 18% of councils have planned closures in the current year, 2019/20. Overall, more than a third of councils commissioned fewer sites to deliver contraceptive services in 2018/19 than they did in 2015/16.
The reasons cited by local authorities are multi-faceted, ranging from cuts to the public health grant, loss of trained staff and service quality issues, through to the closure of general practices and changing models of service delivery towards more integrated sexual health services.
Whilst closures to sites can in some cases help to improve the quality of services, there is a lack of data to understand the impact of service disruption on women’s ability to routinely access contraception. This is particularly true of vulnerable and hard-to-reach groups, where the AGC’s audit found a notable gap in data on health outcomes and experiences of accessing care.
Ahead of the General Election and the formation of a new government, the AGC is asking all political parties to commit to protecting women’s access to comprehensive contraceptive services and reversing the damaging cuts to the public health budget since 2015/16.
Dr Asha Kasliwal, President of the Faculty of Sexual and Reproductive Healthcare and AGC member, said: “Cuts to contraceptive services are putting women’s right to access the full range of contraceptive methods at risk. This is particularly true for women who require specialist and outreach services – those who are the most vulnerable in society. When cuts hit the frontline, these are the services that disappear first. Whilst we welcomed the Government’s commitment to increase the public health grant next year, only a long-term funding settlement that commits to fully funding services across the country will reverse the damage of five years of cuts.”