When money issues threaten to shut down agencies

The Herts Advertizer.  July 2, 2011: The HIV clinic threatened with closure after losing the majority of its funding has vowed to stay open after committed staff pledged to remain with the St Albans centre.The Crescent lost most of its funding from the county council when a decision was made to offer a single county-wide service which was awarded to HertsAid, whose headquarters are in Ware. The Crescent, which provides those living with HIV and their families with support and advice, was shocked by the news and has campaigned to have the decision overturned. “

Iain Murtagh: It was with great dismay that we discovered this year that the funding for our work was being cut dramatically. County Council and NHS Hertfordshire decided to cut one of the two HIV support agencies in this county. That agency is The Crescent. I work there.

The Crescent is a confidential open access charity which has been providing care and support for those living with, or affected by HIV/AIDS since 1988.

It also provides community based point of care instant result HIV testing, counselling, emotional and financial support, mentoring, complementary therapies, peer education and training, free condoms and lube.

All users of the Crescent become members of it and therefore have voting rights.We employ positive people as staff members, volunteers and trustees; in many ways we are a service run by and for people with HIV.

Based in the historic city of St Albans Hertfordshire with a satellite office in Aylesbury in the neighbouring county, members are distributed over a wide geographical area.

(Hertfordshire covers 634 square miles of Eastern England with a population of approximately 1,108,000 people, the neighbouring county of Buckinghamshire is slightly larger in size but has a population of approximately 740,000.)

The geography presents us logistical challenges as whilst links to the north and south of Hertfordshire, for example, are good, those from east to west are not so impressive. Both counties, in the main, are semi-rural, despite being only 20 miles from London.

Reaching MSM (men who have sex with men) can present problems. They are not clustered in one area or suburb, but spread across the counties in numerous small towns and villages. In order to reach them a number of methods have to be used, We advertise in clinics and work with local police to identify areas where MSM gather. These include a gay pub and a gay club and cruising areas, where we distribute information on HIV, promote testing and provide free condoms.

In order to reach our local African communities it is necessary to work with church groups, community leaders and also to approach African venues such as hairdressers in order to gain access to communities that are often closed to outsiders, primarily using peer education to spread the message.

We worked extensively on the Ubuntu Hunhu report which examined the needs of the Black African community in Hertfordshire. This highlighted the need for an increase in the availability of peer education programmes for this community, like those provided by the Crescent.

Working with the African organisation NAHIP (National African HIV Prevention Programme) we employed an African outreach worker in to support this section of the community. With targeted events hosted at a number of different locations and the training of peer educators, we were able to reach further into this community than before.

This is quite labour intensive work, but with the mixture of volunteers/peer educators and a few key staff we were able to provide this service over this wide area at a fraction of the budget allocated from central Government for HIV/AIDS support.

It was with great dismay that we discovered this year that the funding for this work was being cut dramatically (despite the allocation from central Government being increased) as a result of the “ring fencing” of the ASG (AIDS Support Grant) being removed so that local authorities could spend the money on other priorities. The ongoing reorganisation of the NHS (National Health Service) and subsequent budget cuts also played a part in this.

As a result the County Council and NHS Hertfordshire decided that they would reduce funding and cut one of the two support agencies in this large and relatively wealthy county. As a result a disparity in service provision has arisen in the public funded provision.

The remaining agency is located in the east of the county, in a very rural part where transport links are very poor, and therefore, as previously mentioned, those living in the west of the county cannot access easily unless they are able to drive, even then for most is a journey taking hours.

Some satellite services have been provided in the west, but these are located in drug and alcohol clinics and not dedicated HIV support centres, so the risk of disclosure is far greater. Also the services are only available during the working week and during the day for a maximum of three hours (total provision is now 8 hours per week spread over 3 locations,) whereas the Crescent provided a minimum of 37 hours of open access per week, in a dedicated building, with events in the evenings, and at weekends too.

When asked if they wanted to transfer to the new service our members (service users) refused. The staff too refused to transfer to the new provider as they believed that the interests of the members was better served by retaining the open access service, even though without secured funding our future was not good.

The worst aspect of this whole situation is that at no point were those most affected, the positive people of Hertfordshire, asked how they would like their service structured in light of cutbacks. Only after the event was their opinion sought, and when aspects of their opinion did not coincide with the plan already drawn up, the opinions were discarded.

As a result Hertfordshire has a two tier service; those in the east can access services just as they always did, and those in the west have suffered a dramatic cut. The opinions of service users now used to justify the new service are drawn from those in the east who have not experienced any drop in service. The opinions of those in the west, including those of Members of Parliament and the press, are ignored.

All at the Crescent are determined to carry on and are actively seeking funding from alternative sources to do so. We feel that this is our duty. If we had closed in June, as was expected at the time, those 300 or so people we support would have been left high and dry.

The irony is that there was no need to remove one service entirely. The cuts could quite easily have been accommodated whilst still retaining a far better service than is now being provided.

For those of you still yet to experience the chill of cutbacks please be aware,you may really need to fight your corner, and make sure the voice of those you are there to support is heard loud and clear before decisions are made. We didn’t get the opportunity to stop this as it was really rushed through, but my advice to you is to watch those funding you closely. You never know, you may be next…

Iain Murtagh Head of Operations/Project Manager, The Crescent Support Group

You can read about the fight to save The Crescent here.