Editorial: PCTs dragging their feet over access to LARCs

The UK teenage pregnancy rate is the highest in western Europe. It is more than twice as high as Germany, double that in France and seven times higher than the Netherlands.

What's more, rates of teenage pregnancy vary within the UK, with those living in socially deprived areas significantly more likely to become teenage parents.

No wonder, then, that the government has spent the past decade trying to tackle the issue, seemingly with limited success. A key part of this has been a push on long-acting reversible contraceptives (LARCs).

NICE has recommended the wider use of LARCs, they are in the QOF and, in February this year, the DoH released £20.5 million to promote the use of contraception to tackle teenage pregnancy - £7 million of which was assigned to raise awareness of LARCs.

Despite all this, according to sexual health experts, PCTs in England are still not properly funding contraceptive services or training for fitting IUDs and implants. As a result, figures obtained by GP show that access to LARCs remains patchy to say the least.

This is apparently because of one depressingly familiar reason - cost.

Over the past decade, primary care organisations (PCOs) have become increasingly cost conscious - a situation that is likely to become even worse as health spending is squeezed after 2011.

Sexual health, along with most public health initiatives, is always bottom of the list of priorities because results are hard to measure and the real effects may not be seen for years. Even when money is handed out for these services it rarely reaches the place it should because it is not ring-fenced. It is swallowed up into the wider budget.

But the evidence supports the use of LARCs. Switching just 7 per cent of women from oral contraceptives to LARCs could prevent 73,000 unwanted pregnancies. This is why they are recommended by NICE.

PCOs have no excuse. They have the money and the evidence. Therefore, they should be funding services and training to improve access to LARCs, especially in areas with high teenage pregnancy rates.

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