Tuesday, 20 November 2012

Tales from a big place: Australia's first national sexual and reproductive health conference

Yesterday I spoke at Australia's first national sexual and reproductive health conference in Melbourne - my presentation: Tales from a little place - learning from the UK.

I always get a warm welcome from colleagues in Australia, and this trip is no exception. It is always interesting to prepare a presentation, particularly for an international audience, and we really have learnt a lot over the last 15 years or so, and have an enormous amount to be proud of.  Our teenage births declined by 35% during the life of the teenage pregnancy strategy.  Whatever the small group of opponents claim about the teenage pregnancy strategy, that is a roaring success. 

But when asked the inevitable question about whether England will sustain the progress during the current political and economic environment, whereas two years ago I would optimistically say that we could with the right drive and leadership, it is much clearer now that a lot of the intelligence and knowledge held in people is being lost, and that the strategic leadership so critical is in often absent. Clearly that has potential dire consequences for young people's sexual health.  But what I am able to say, of course, is that Brook and FPA, along with other organisations and individuals will do our utmost to ensure we continue going forwards (cue plug here for www.wecantgobackwards.org.uk).

The conference has been truly outstanding and here are some of the things I am taking away so far;

That much more needs to be done to address and improve the sexual health of Aboriginal and Torres Strait Islander communities for whom the data shows much worse sexual health outcomes.  And the flip side of that is there is some truly remarkable work going on to promote positive sexual health and strengthen the resilience of communities.  I heard examples of stunning work helping communities get on with 'the business of living' and developing positive opportunities for open and honest discussion.  James Ward, a leading Aboriginal Health Researcher called his talk 'Focusing on the 'Rights' rather than the wrongs of Indigenous People to improve sexual and reproductive health outcomes'.  He emphasised powerfully that the starting point is always a deficit one when it comes to Indigenous People, but that it is to all our shame that sexual health outcomes are so much poorer in these communities. If you closed your eyes and listened to his passionate plea to trust in young people from Indigenous Communities it could easily have been anyone of a number of us talking about the poor perception of young people in the UK.

Professor Rob Moodie gave some lessons from for Sexual and Reproductive Health from his time on the National Preventative Health Taskforce.  His key messages - progress take time and if you watch any journey it is small steps. He showed the timelines and critical steps/points on the journey in relation to smoking and road trauma to illustrate his point. He followed this with key advice - need the three A's Advocacy, Advocacy and Advocacy, and three P's - Persistence, Persistence and Persistence.

He also asked where the men were in the promotion of sexual and reproductive health (having recently been at the centre of a heated discussion because I was one of three men discussing contraception and confidentiality on R4's Today Programme the irony wasn't lost on me that the first session of the conference was all men - and was therefore very pleased when todays plenary session was an all women line up!)

The afternoon panel on abortion was fascinating. Medical Abortion is just being introduced into Australia and there is a lot of optimism that it will do much to improve women's rights. I had not realised that Australia had such a diversity of abortion legislation and policy which ranges from positive following legislative change in Victoria in 2008 to incredibly restrictive in Queensland based on laws from the 1890s.  Some really incredible advocacy and determination to improve women's choice including that of www.childrenbychoice.org.au  and so much of the discussion albeit with nuance that is reminiscent of the challenges and issues familiar in the UK and Ireland.  And as with Northern Ireland, MSI has played an important role in improving women's choice here in Australia.

I was treated to an evening out by a group of people - old colleagues and new - from both South and Western Australia. One of the doctors in the group used to work at Brook in the East End and Brixton in the 1980s so that was a real pleasure to find out more about how Brook and working in sexual health services for young people used to be.  

This morning's session was incredibly inspiring - first up Professor Vansesenbeek from Rutgers in Holland.  Completely demonstrating everything she described about Dutch culture and ways of being in her presentation Ine explained that if you want young people to be responsible then you have to have three things - sexuality education, youth friendly services and an enabling environment such as openness in the family, good parenting, a robust health system. 

She showed how Dutch young women are the best at Double Dutch - using the condom and another form of contrception together and reminded me of the importance of renewed discussions in Brook and the UK more widely about how we help young people understand Double Dutch is important and even 'cool'.

Ine explained that whilst sexuality education is not mandatory there is a conviction that formal education is needed and that it must be rights based, pragmatic and positive. She reminded us that the importance of SRE cannot be measured simply in health outcomes - it is also about rights and emancipation and sexual self esteem.  And we also should not overestimate what it can do because behaviour is determined by more than SRE.

Ine talked about parenting and positive parenting, but I was intrigued by the research and stopped making notes so I will come back to this but here her key message is Dutch parents are good parents, they are authoritative not authoritarian and focus on connectiveness with a liberal morality, and that their children report being happy children.

Finally she emphasised young people must be taught by parents,schools and communities about internal control - the ability to think for oneself, to develop critical awareness and competence.  Look at the evidence, it speaks for itself that the Dutch have got a lot right and we can all really learn from them.  For my money its about the enabling environment - the prevailing culture that we can and must learn most.

Next up Anne Mitchell from Australian Research Centre for Health, Sex and Society.  Anne has done an enormous amount on gay young people and sexuality education and it was great to hear a presentation with the word excitement in it.  She outlined 4 concepts that excite her in improving sexuality education as we move forward;

1. Thinking about healthy sexual development and what it means so we can set some clear agreed goals for sexuality education
2. Taking a strengths based approach which recognises that in the main young people manage their sexual health well and generally make good decisions and that we need to develop SRE that can help develop those strengths
3. Using a sexual ethics framework as outlined by Carmody which builds the ability to care for self, being aware of the possible impact of desires and wants on others, being able to negotiate and ask, and reflect
4. Moving beyond sexual rights and recognising that sexual rights are human rights and that if you take this approach you recognise sexual health inequalities are often the basis of systemic discrimination - this really resonated with James Ward presentation yesterday.

Finally in this morning's session, Dr Ailsa Gebbie, all the way from Edinburgh who outlined the brilliant work that has taken place in Scotland to develop an integrated sexual health strategy, Respect and Responsibility, and the development of the Chalmers Centre, the fantastic integrated sexual health centre in Edinburgh. I felt proud to be British as Ailsa described the work, the commitment and the persistence that has been required to develop such a brilliant service and integrated approach more broadly. 

Ailsa emphasised the importance of leadership, agency buy in to shared and common goals, the investment in services, in training, in capacity and in data use to drive improvements. And she set out some of the challenges ahead including keeping sexual and reproductive health a priority - a constant challenge for all of us in the context of differing needs and limited resource - and ensuring that they reach those at highest risk of sexual ill health.

An inspired conference so far, and still an afternoon to go.  


Sunday, 18 November 2012

Past, present and future: Brook and FPA's Parliamentary Reception

Last week Brook and FPA held their second joint parliamentary reception which in the age of social media we hashtagged as our #xeslords reception. The reception was hosted by Baroness Massey of Darwen, Brook's president, and the Baroness Gould of Potternewton, FPA's president.

It hardly seems plausible that our last joint parliamentary reception with FPA was almost 18 months ago. How quickly time flies and how quickly things can change. And there is no doubt that things are changing fast in the sexual health world: the combination of national strategies on teenage pregnancy and sexual health and HIV ending, the policy approach of localism, public spending cuts and the increasingly loud voice of the minority who are ideologically opposed to gay equality, abortion, contraception and sex and relationships education is creating an uneasy world in which we could be going backwards when it comes to sexual rights and sexual health outcomes.

And this is alarming and wrong.  We cannot afford to go backwards - it is morally, socially and economically wrong. It is of grave concern to both Brook and FPA that we are hearing increasing numbers of reports that services are being reduced and contraceptive choice is being restricted.  We have therefore launched @xescampaign including the www.wecantgobackwards.org.uk website which is a 'trip advisor' type site which enables people to tell us their experiences - both good and bad - of accessing sexual health and contraceptive services to enable us to do our advocacy and campaigning work effectively.

Speaking first about the present, Baroness Massey talked of the enormous effort that has gone into the partnership between Brook and FPA. She thanked the teams for making the partnership work and I was proud of the teams hard work. Baroness Massey also talked of the importance of adopting a holistic approach and learning the lessons from across different issues to find new ways of working in the future. She concluded by reminding us that sexual health is often the Cinderella service and that it cannot continue to be such.

Duncan Selbie, CEO designate of Public Health England spoke next.  He thanked FPA and Brook for the important work they do to promote sexual health, highlighted the challenges of having less money, transitioning to a new system and said he would find it unacceptable for sexual health to remain a Cinderella service. He said he would be accountable in his role for promoting positive sexual health.

Eve Martin, Chair of Brook, up next promised that we would hold him to account because we believe so passionately in positive sexual rights and sexual health. Eve had the honour of presenting the first Brook and FPA Parliamentarian of the Year award to Stella Creasey MP. Stella had led an outstanding campaign to ensure women in Walthamstow could access contraception in the borough. Unfortunately Stella Creasey was lost in the House and could not find us, but when she did arrive she accepted the award on behalf of the 'Women in Walthamstow' who had played such a critical role in the fight for contraception to be available in their borough.

This is a remarkable campaign to need in 2012 so I was pleased when after the presentations Duncan Selbie commented that it was a great campaign but one that should have been unnecessary. All of us, I am sure would agree.

Val Day, Chair of FPA went next and talked of another outstanding contribution to sexual health - this time by that of FPA's President Baroness Gould who had just celebrated her 80th birthday. Val described just some of Baroness Gould contributions including her work as a Pharmacist, the national abortion campaign, the Women's National Commission and most recently as Chair of the Independent Advisory Group on Sexual Health and HIV.

Baroness Gould concluded the speeches with the delightful announcement that she has decided to write her memoirs, of which a part will be about sexual health, tracking the long and windy journey that Baroness Gould has been on in the fight to promote and protect sexual health and HIV policy over the past few decades. She thanked the team at Brook and FPA for making the event happen and Reckitt Benckiser for their support for the event.

We couldn't have had a better group of speakers who in just over 20 minutes highlighted that we need to be vigilant and ever watchful to ensure the hard fought rights that have been won are protected, that the excellent progress is not lost and that we do not go backwards.  The xes: we can't go backwards campaign is much needed.

Throughout the evening we had politicians, sexual health professionals and supporters of Brook and FPA work being photographed to show their support for the XES campaign - if you have a story - good or bad - to tell about your experience of services please visit www.wecantgobackwards.org.uk and follow us @xescampaign

Twitter @simonablake @brookcharity @besexpositive @xescampaign

Tuesday, 6 November 2012

Happy Birthday Sex Education Forum - my long tweet

This is really a substitute for a long tweet - Tomorrow is the Sex Education Forum's 25th Birthday Party and I am really sad to not be able to make the bash.  The Sex Education Forum was eight when we first met and now like then, I have rather fond feelings.  I agree wholeheartedly with what is stands for, I think SEF is quite remarkable in the way it brings people together in pursuit of a common aim, and I am proud to have been involved over the last 15 years or so.

The SEF matters to Brook because SRE matters so much to young people. Over the last year young people volunteering at Brook have supported what the research has told us - that current SRE is not good enough and they want more on relationships, emotions and sexualities.  They have therefore launched the @besexpositive (www.besexpositive.org.uk) campaign which sets out their desire for 21st Century SRE.

I have written a blog for the Sex Education Forum which will be published in due course and that tracks some of my highs and lows but in summary raising a glass and celebrating 25 years is important because the Sex Education Forum now, like then, is a body of organisations and people passionate about children and young people's rights to sex and relationships education.  And the Forum now, like then, is working with another successive government that is unwilling to make SRE statutory in schools which would go a long way to ensuring all children's entitlement to SRE. 

So the Forum may be 25 but its job isn't done and all of us must stand together for the next 10, 15 or 25 - however long it takes until that aspiration is a reality - to ensure that sex and relationships education is good enough for all children and young people.  

Happy Birthday SEF!

Friday, 2 November 2012

"The difference I can make to one person can be everything" - a guest blog from Shelby Halliwell, Brook Volunteer

Pete Lawson - introduction

Boards need to listen to young people. It’s as simple as that. Not just by having young trustees, but by providing opportunities to get trustees out into projects, and get young people into the boardroom, to present and discuss and challenge. It’s only through getting the widest and deepest perspective that we can get the clearest picture of what we do and why we do it, and go on to make the best decisions. Decisions that have young people’s needs at their heart.

We had a great board meeting earlier this month, with a chance to learn more about the fantastic BiteSize Brook programme. Dean Cattell, a member of Wirral’s education team, and Shelby Halliwell, a young peer educator, came and spent an hour taking us through several BiteSize exercises, giving us a taster of what it must feel like to be a young person taking part in a session. I always find it inspiring to see any of Brook’s skilled professionals in action – we have the best staff in the sector, whose passion, dedication and skills are second to none. The exercises they took us through were fun, lively, provocative, informative, challenging, and beautifully designed. Both the materials and the trainers are a real credit to Brook. I wish I’d had that when I was at school.

It is equally inspiring to see the journeys that our young people go on. Shelby is clearly an articulate, passionate, and highly skilled youth worker in the making – any pupils who are lucky enough to be trained by her are in for a real treat. It was humbling and moving to have her share her story with us, from when she first came into contact with Brook to where she is now, and so we asked her if she would mind us sharing it. Her story, in her own words, is below. For me, it’s a beautiful, impassioned reminder of why we do what we do.

Shelby Halliwell – a young person and youth worker’s perspective on Brook BiteSize

Thinking back to when I was a year 9 pupil attending school, I got the opportunity to experience a BiteSize session facilitated by Brook’s education team. During the BiteSize session I gained a great deal of knowledge based around Sexual Health and Relationships Education (SHARE) as well as sexuality and homophobia. My friends and I found this an eye opening experience which enabled us to lower the social barrier when talking about these issues. It enabled us to communicate easily with the workers involved and to freely and comfortably voice issues, concerns or opinions we may have had at the time or even not known or understood we had until informed of potential situations in present and future social/sexual relationships.

I personally found it extremely helpful as I was struggling with issues surrounding sexuality and homophobia at the time. Without a doubt my favourite zone in the BiteSize session was and still is ‘Work It Out’ as this zone helped me to understand that as a young person it wasn’t wrong to be different, I didn’t deserve homophobic comments and there was nothing to be ashamed of.  Shortly following the day of the BiteSize event I felt confident enough with my new knowledge to come out to my peers as a member of the LGBT community.  Personally, I think that without Brook’s guidance and understanding I would have lead myself down a negative path battling with homophobia and depression. But thankfully Brook altered my opinion as well as many of my peers.

As a result of the BiteSize I was able to feel confident enough to become a member of the ‘Work It Out’ youth group run within Brook of an evening. This helped me to feel more secure within myself, my sexual identity and allowed me to develop relationships with other young people experiencing similar situations. The most positive outcome of all the help and support I received from Brook, Response and other organisations I feel is the realisation that supporting and guiding young people was something I not only enjoyed, but I am passionate about, this helped me to forge a career in youth work that benefits not only me but other young people in my surrounding community.

When offered a chance to enrol on the SHARE project and become a peer educator for Brook Wirral I jumped at the chance.  I took it in my stride to be the best I could be.  During the programme staff members began to comment on my natural ability and passion for the work, and this enabled me to run BiteSize zones confidently and effectively with minimal staff support. I began to then see BiteSize events from a staff member’s perspective while still maintaining the previous experience and views from once attending as a young person. I feel this gives me a well-rounded understanding of how and why the zones are run the way they are and have the effective, useful content they do. I now frequently get the opportunity to see the difference our sessions make in young people’s lives and the positive effect this has on negative opinions and topics that may have seemed taboo in the past.

I can safely say that without the confidence and knowledge gained within Brook I would have never been offered the chance to embark on the gap scheme and be in the process of studying for my qualification in youth work practice. Without Brook and the incredible work we do I wouldn’t be here today, I wouldn’t be proud of my achievements and the work I do to give back to our community and help other young people as Brook has helped me.

I was recently told a story that has had a significant impact on me. I was told this story by Helen Corteen, our Centre Manager. This is the story…

One day, an old man was walking along the beach in the early morning and noticed the tide had washed thousands of starfish up on the shore. Up ahead in the distance he spotted a boy who appeared to be gathering up the starfish, and one by one tossing them back into the ocean.

He approached the boy and asked him why he spent so much energy doing what seemed to be a waste of time.

The boy replied, "If these starfish are left out here like this they will bake in the sun, and by this afternoon they will all be dead."

The old man gazed out as far as he could see and responded, "But, there must be hundreds of miles of beach and thousands of starfish. You can't possibly rescue all of them. What difference is throwing a few back going to make anyway?"

The boy then held up the starfish he had in his hand and replied, "It's sure going to make a lot of difference to this one!"

This story made such an impact to me personally and professionally because the reason I want to do youth is to help young people, I know there are thousands of young people in need out there but if I can make a difference to just one, it makes all the hard work and dedication worth it. If I can reach out to someone who needs my help and change their life for the better just as brook has done to mine then I can be proud of the person I have become. I may not make a difference to everyone, but the difference I can make to one person can be everything.