Auckland has the highest concentration of people with HIV in the country - taking away their access to specialist health lets down those most vulnerable, Dr Peter Saxton said.

Despite HIV and syphilis cases at record high levels, sexual health services are being cut by the Auckland District Health Board, critics say.

The DHB insists the changes will actually increase staffing numbers and improve services, focussed around "patient-centred, self-directed care."

The ADHB's decision on a restructure of its sexual health services was leaked to the Green Party and shows the number of Auckland Regional Sexual Health Services senior medical staff will be cut by nearly 40 per cent, reducing the number of appointments available and cutting the number of clinics. They are replaced by nursing level staff.

Louie Douvis Sexual health physicians are concerned that staffing cut backs will result in delayed and ineffective care for those who need it most.

Under the DHB's cuts Auckland will have just one specialist per 500,000 people.

An Auckland District Health Board sexual health physician said sexual health was already stigmatised enough, and cutting access to care would only make things worse.

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* Proposed 'cost-cutting' of sexual health services dangerous, doctors say



The official decision, leaked by a member of the DHB's staff, showed clinic hours were set to change and the number of senior medical officers was to be reduced, with more training given to nurses for nurse-led clinics.

GETTY/CHRIS JACKSON People are at risk of not receiving adequate sexual care after staffing cuts to regional health services, an Auckland District Health Board physican said.

After numerous letters and submissions were made to health board bosses from employees and independent organisations, senior medical officers were shocked by their decision, the staff member said.

"[ADHB] just refuted everything."

"They didn't address any of our concerns, and gave us no reason as to why this is going on."

"It's like 'alternative facts'," she said, in a reference to the term used by US President Donald Trump's administration to insist untruths are reality.

She said the nurses do not have the level of specialised care needed and doctors will need to be called in for consults, resulting in delayed and ineffective care.

"If you've got an infection - the sooner you get treated, the better, but that might become more difficult now," she said.

Green Party health spokesperson Julie Anne Genter said the "smoke-and-mirror" tactics to hide funding cuts are not working, and sectors are at their breaking points.

"These cuts are incredibly short-sighted," she said.

"Short term savings are going to cost more in the long run."

Genter said the National government's approach to sexual health care, and funding of the health sector in general, has been inadequate.

"Health hasn't been prioritised, and now there is a real concern that people won't be able to get the help they need."

Dr Peter Saxton, director of the Gay Men's Sexual Health research group, advocated against the cuts, and said they were going to hurt those who were vulnerable the most.

Young people, Maori and Pacific people, and gay and bisexual men are priority groups for sexual health services, and will bear the brunt of staffing cuts, he said.

"These people are voiceless and some are embarrassed," he said.

"The ADHB are not acting on their behalf."

"It shows a general lack of regard toward the most vulnerable groups in society."

It is alarming, he said, considering more than half of new HIV cases are in people who live in Auckland.

"Precisely the time that we need this in Auckland, they're cutting the service," Saxton said.

"It's face-palm stuff right now."

People with HIV, syphilis and other sexually transmitted infections and illnesses need specialist care and low barriers to accessing care, which will not be the case, he said.

Syphilis is at epidemic levels - the number of reported cases was five times higher in 2016 than it was in 2013.

In 2013, there were 41 reported cases of syphilis in New Zealand, 85 cases in 2014, 152 cases in 2015 and 206 cases in 2016.

Sexual health is becoming more complicated, with HIV and syphilis at epidemic levels, but also with the reintroduction of "novel" sexually transmitted diseases like lymphogranuloma venereum, a variant of chlamydia.

Saxton said there is a specific need for sexual health services to be properly resourced.

"What we need right now is more urgent action, not cuts."

"There is no relationship between what the DHB has proposed and the actual health problems."

An Auckland District Health Board statement said that after an "extensive consultation process", the decision was made to "adjust" the sexual health staffing model.

The changes will increase staffing numbers overall by 1.4 full-time employee positions, and will establish the roles of Nurse Practitioner, Healthcare Assistant, and Clinical Lead for Sexual Assault.

Alex Pimm, general manager of Auckland DHB’s Adult Community and Long Term Conditions Directorate, said in the statement that the consultation took place with employees and key stakeholders to "create a service that is focussed around quality, patient-centred, self-directed care."

Pimm said the DHB are working with affected staff members and their union representatives, "if applicable, on a transition plan.”

The changes to Auckland Sexual Health Services, including the Sexual Assault Assessment and Treatment Service (SAATS), will ensure a responsive service that meets the specialist sexual health and sexual assault care needs of the metro Auckland population, the statement said.

“The new structure will mean patients can be seen quickly for the screening and treatment of STIs. When needed, the service can be flexed to meet demand.”

A secondary statement from the Auckland District Health Board said the service will continue to work with primary care and other agencies to ensure all Aucklanders can access appropriate sexual health services for their needs.