Monday, 14 July 2014

Brook and PHE launch new C-Card guidance

Today we are launching new Condom Card distribution scheme guidance in partnership with, and funded by, Public Health England, C-card condom distribution schemes. Why, what and how.

In the introduction to the guidance, Prof Kevin Fenton of Public Health England says “we need an open and honest sexual and reproductive health culture, in which condom use is simply the norm”. A C-card scheme is a great way to support young people – they simply have to get hold of a card, have an introductory session on correct condom use and sexual health from a scheme advisor, then afterwards show their card at any participating outlet in order to get a supply of free condoms.

The guidance says, “What many young people want most from a C-card scheme is a trusted adult with whom they can discuss sex and relationships. That’s why practitioners involved in the C-card scheme are skilled at working with young people in a non-judgemental and appropriate manner, and can refer them safely to other more comprehensive or targeted services.”

C-card schemes are a great practical illustration of one of Brook’s core principles – trust young people – as they empower young people to make informed decisions about safer sex. A C-card scheme brings them into contact with networks of people and organisations who can help them with a myriad of issues alongside and including sexual health, through direct support or through signposting to related services.

C-card schemes provide an opportunity to start conversations about sex, relationships, and overall wellbeing with all young people and in particular with young men, who are often less likely than young women to visit health services or to be willing to open up about such issues to a health professional or a youth worker. Youth services which are part of a C-card network may find that their attendance rises, while pharmacies within a C-card scheme also often report a boost in business from young people, who may open up about any other health issues which are playing on their minds when they come in to pick up their free condoms.

From a public health perspective, C-card schemes are vital - we know that in England, condom use among sexually active young people ranks poorly when compared with other European and North American countries, and we must seek to change this. The Department of Health’s 2013 Framework for Sexual Health Improvement in England places a strong emphasis on prevention of sexually transmitted infections and reductions in unplanned pregnancy rates – condom use has a key role to play. The financial investment in a C-card scheme is more than repaid in savings to the public purse, through reduced social costs as well as better sexual health and general wellbeing outcomes among scheme users.

There really is no downside to C-card schemes, and I very much hope that this revised guidance, with its step by step instructions and best practice case studies, will help strengthen the quality and quantity of C-card schemes as part of an integrated package of health services and care for young people.

The guidance can be downloaded from www.brook.org.uk/c-card.

Brook is the UK’s leading young people’s sexual health and wellbeing charity, with services in England, Scotland, Northern Ireland and Jersey. In 2014 we are celebrating 50 years since we opened our doors. We have three key activities: clinical and support services, education and training, campaigning, lobbying and advocacy and last year we helped over 270,000 young people. www.brook.org.uk Twitter: @BrookCharity @BeSexPositive @Simonablake

Sunday, 15 June 2014

SRE is not and should not be controversial.

There is lots to enjoy reading about this article from Jane Martinson -www.guardian.com/education/2014/jun13/teachers-sex-education-mandatory-subject-compulsory-schools-porn-sexting 

The article comes on the back of an important campaign from the Sex Education Forum.  #SREItsmyright (find out more here www.sexeducationforum.org.uk/it's-my-right) .  As you would expect I completely agree with Jane's position that SRE should be compulsory and with the Head, Tom Sherrington quoted who says 'we need to decide what schools should be teaching beyond the main curriculum, what the priorities are for the next generation; I, for one, think sex education should be right at the top'.  

I agree SRE has the lowest of priorities when it comes to scrutiny, that on line porn has added to the urgency of us talking more openly about sex and relationships with young people at home, school and in the community. I also know that many children, young people, parents, carers and schools work together really well to provide excellent SRE. 

I would caution against defining SRE as in crisis, however, because if it is in crisis now, then we must surely say it has always been.  And when things are in crisis people often panic and can seek to resolve the wrong thing. If choosing to describe SRE as a in crisis lets be very clear the crisis is in the failure to make PSHE statutory and improve the system. It is not a crisis of knowledge about what works or in the content (eg the myth of porn and sex lessons for 4 year olds) . 

Yes there is great urgency to improve SRE. Yes there are real challenges as technology evolves at a pace. Yes we have to do more to improve understanding of healthy relationships and positive behaviours and yes,  I, like so many others may be frustrated with the repeated failures to put PSHE on a statutory footing. We do not have substantive evidence that on the ground delivery is worse than it ever has been. On the contrary we know that in some schools it is better than ever. But the reality is we simply do not the evidence of the picture nationally. What we do know is that many practitioners are working hard to make sure children and young people get their entitlement to PSHE and that we have stronger evidence of effectiveness than we have ever had.  

Children and young people have right to PSHE as set out in the UN Convention on the Rights of the Child. There is an urgent need to address violence, exploitation and abuse, as well as develop confident children and young people who can enjoy their sexuality and take responsiblity for their relationships. This is why there is such a broad based consensus and high levels of support for PSHE from children, young people, parents, carers and professionals. And that is why we have to get SRE firmly on the curriculum where it belongs as part of a robust Personal, Social and Health Education and Citizenship curriculum (where, incidentally, (British) values would also be discussed). 

To do so, we must not collude with the idea that SRE is controversial. It just isn't. It is under resourced, low priority in many schools and objected to by the very vocal, very tiny minority but for most the controversy is that children and young people are repeatedly failed by successive governments failure to make PSHE statutory. At a recent event hosted by the Lord Speaker, Baroness D' Sousa, she expressed her surprise that SRE is so patchy. That is my experience of talking to many parents and grandparents who, like children and young people are often incredulous that there is no statutory requirement to deliver very much (only the biological) and that  it can be so patchy. 

Finally teacher training: if you are trained and confident in SRE it is only as complex as teaching and learning about any issue. That is why teachers must be trained and supported to deliver SRE just as they are Math and English.  That is why SRE must be compulsory and that is why I urge you to visit www.sexeducationforum.org.uk/it's-my-right and take action now. 

Despite the best efforts of many, compulsory SRE is part of the mid to long game. In the meantime this SRE Advice from Brook, PSHE Association and Sex Education Forum will help you develop and implement 21st Century SRE www.brook.org.uk/supplementaryadvice 

As an aside not once has a boy (or girl) fainted or keeled over during a lesson I have ever run about menstruation, or indeed any other topic within SRE. 

Thursday, 22 May 2014

Guest Blog from Rianna the Founder of Shine Aloud

This is a guest blog by Rianna Raymond-Williams who set up Shine ALOUD

I always knew I wanted to be writer, but after countless work experiences and placements in the media industry, I couldn’t find myself just settling for one publication. From beauty to celebrity news, finance to politics, art and album reviews, I had done it all, but I still wasn’t happy. My experience working for the Terrence Higgins Trust as a Sexual Health Assistant highlighted to me that there was a problem amongst young people when it came to sexual health. Not only were the young people I engaged with misinformed about the facts, but simply discussing partners and relationships made them feel uncomfortable, which for me was a huge light bulb moment! I would often find publications on sex and relationships too formal, biological and overall boring. They were not age appropriate or young people friendly which for me, as a young person myself, was very disengaging! I wanted something that was educationally compelling yet fun and interactive.

I started Shine ALOUD magazine on an internship in 2011, I approached the editor of the publication I was interning at with my idea and he was very supportive in helping me to create a flat plan for the magazine. The flat plan helped me to think about what articles would be in Shine ALOUD, who the target audience would be and overall, it lead me to think about what I wanted people to gain from engaging in the publication.

With a £300 O2 Think Big Grant, article and artwork contributions from close friends and journalism student and of course a helping hand in design from a media colleague of mine, Shine ALOUD was created. Initially, I hadn’t thought beyond the first issue, it was simply just a mini project I had started before my second year of university began, but the response and feedback I got from readers after the first issue showed me it was a much needed resource.

I continued to release Shine ALOUD on a quarterly basis through 2011 – 2012 whereby I began to create partnership with various sexual health promotion companies and charities, youth empowerment organisation and youth media enterprise across London. Shine ALOUD quickly became a sexual health publication for young people, by young, with the aim of educating and entertain youth about sex and relationships combined with arts and culture. I received cash injection and business support from Zeon Richards, The Alec Dickinson Trust, Starbucks Youth in Action, Business in the Community and most recently Lloyds Banking Group, as a result of me enrolling on the Start Up Programme with The School for Social Entrepreneurs which I am currently on.

Thankfully Shine ALOUD has attracted an audience of over 28,000 people, all of whom are avid readers and followers of, which for me is a demonstration of its need and want in the community! My plans for the future are to make Shine ALOUD an international social enterprise.

Firstly, by producing a sexual health publication regionally across the country, thereby allowing young people to gain skills in media through creating and producing a quarterly publication, in addition to maintaining a virtual online website. Secondly, I hope to deliver sexual health awareness workshops across youth provisions and in and around the community, thereby allowing young people to gain qualifications in sexual health awareness and youth work, providing them with the opportunity to gain transferable skills for the working work and further develop as professionals.

And lastly to embark on cultural exchanges with young people overseas, providing education to those who most need it across the globe, thereby allowing young people to meet other young people internationally and discuss how and why sexual health agendas differ. Shine ALOUD aims to empower young people to make informed choices regarding sex and relationships.

Shine ALOUD – Sex & Relationships with a different tone! Rianna is now running a crowd funding campaign to raise money to take Shine ALOUD further. To support her on her journey of raising £10,000 follow the link below: Shine ALOUD UK: The Sexual Empowerment of Young People! (http://igg.me/at/FundShineALOUDUK/

Tuesday, 6 May 2014

Mirror, Mirror - why we must be challenged and stretched

Last week I attended a Dove Foundation Poetry Event at Selfridges as part of their 'All types of Beautiful Project'. I went expecting to be read poetry by Hollie McNish - simple - I was going to listen and watch, enjoy, applaud and leave. It was much more powerful than that. I and many other PSHE fanatics talk about the importance of PSHE being both memorable and challenging for young people. Our worry that PSHE is often information heavy and personal development light. The same is true of adults learning. To grow we all need to be stretched and challenged, and to leave an experience intrigued and inquisitive, hungry to stretch ourselves further and find out more.

Mirror Mirror wasn't quite the listen, watch, discuss and applaud workshop I expected (with hindsight I should have read the details more closely). First I was the only man in the room at an event that was exploring beauty. Second apart from enjoying Pam Ayres reading poetry (probably affiliation with her West Country accent) it really hasn't been my thing. Unless of course you count the three poems I wrote for a school poetry anthology aged 7 when I was in Mr Spillers* class (one about a jumble sale with a forlorn teddy, one about a hamburger with juicy rivulets of gravy and one about a dentist and the horror of drilling and amalgam).

After reading some introductory poems from her collection Hollie set to work creating an experience that would challenge participants through both the process and content. First we had to find someone we didn't know as a partner. Let's call mine Zoe. Then we had to take it in turns to be their model for them to draw our face and vice versa. We were tasked with really focusing on some particular details and features. Then we were encouraged to get a 'poetry head on' by describing a woman's lips (a volunteer from the group had to stand in front of us whilst we got more and more descriptive. I felt for her.)

From our drawings we had to choose three things to write a sentence about. All the time there were hushed whispers, low squeals, resistance, anxious looks. All the time we were cajoled, supported and pushed to 'just try' because it would be alright.

Then we had to ask each other 4 ‘banal’ questions about everyday life. I asked how Zoe travelled around London, whether she preferred broccoli or cabbage, how often she tends to go to the cinema and whether she is a thumbs up or naysayer to twitter. She asked me whether I sang in the shower, lived in a flat or house and my favourite music. From this we wrote short poems. We then

1. had to read them to each other
2. read the poem about us while looking in a mirror
3. sit in front of everyone while your partner read the poem about you
4. read out the poems about our partner to the rest of the group.

The workshop was in equal measures tortuous and sensationally good - I haven't been stretched and challenged in quite that same way for a long way. It was tortuous as a result of my confidence - an internal talk about whether what I could draw or write would be good enough - in fact if I am honest an internal talk that said there was no way I would be good enough (and my drawing was spectacularly crap but my poem was alright). That feeling was overwhelming for a lot of the workshop. There was a lot of internal chatter going on. It was only really at the end when both Zoe and I, and I suspect many others were able to say 'that was good'. I shall remember that experience for a very long time.
Hollie's poetry was stunning to listen to. In just the few poems I heard she covered a whole host of issues about beauty, about growing old, about pregnancy and about being a woman - a great resource for working with all young people and young women in particular. Google 'Cupcakes or Scones' and 'Megatron' and you can see them on You Tube. Hollie runs similar workshops in schools and other settings too. I would sincerely recommend her. You can find her on twitter @holliemcnish

The experience taught and reminded me

1. That PSHE and personal development opportunities for young people have to be magnetic and thrilling. Young people are no empty vessels that need filling with information – our challenge is to create experiences that light fires.
2. That teachers and others working with young people must be able to do group process well – people can only stretch themselves when groups work well. Groups only work well with skilled facilitation that holds the ring, makes it safe and confidently enables, cajoles, encourages, rewards and challenges

3. That as professionals we can often get ourselves stuck in traditional learning modes – seeking out events to gain knowledge rather than stretch and challenge ourselves and our teams right the way across our organisations. Senior managers and leaders can helpfully think more creatively about how we develop confident people who know themselves and think for themselves.

4. That personal development must comes in lots of different shapes and sizes - as organisations we can do more together to create opportunities for peers to learn, to share, to play and to grow.

5. That in order to really thrive we must put ourselves to be in uncomfortable situations, to sit with our discomfort and to learn from it.

6. That i quite like poetry after all. My May 2nd resolution: to put myself in more uncomfortable places and see what happens.

*Mr Spiller was my favourite ever teacher. I was 7 and I adored him. It felt like he believed in all of us and he built relationships with all of us. He got excited, angry and disappointed with us and for us and because of that relationship he stretched and challenged all of us. Sticking with the poetry theme he told Kevin that he could be the future Poet Laureate like Sir John Betjaman. He taught us that life should always be an adventure.

Follow us on twitter @simonablake @brookcharity @besexpositive

Saturday, 29 March 2014

Proud of #BeingBrook

At least a year in the making it seems rather unbelievable that #BeingBrook - Brook's staff training and networking event for all staff at the Palace Hotel, Manchester is over. Planned within an inch of its life I cannot do justice to it here. As the contributors provide reports and actions I will publish anything which may be interesting or useful here, along with links to photos, videos and other records of the Event.

It is our 50th birthday year. We have merged 17 organisations touching every single team across the UK and Jersey in one way or another. #BeingBrook was a chance to draw a line in the sand after our major change programme has finished, aswell as say thank you for the tenacity, resilience and professionalism of Brook people who worked tirelessly to ensure young people continue to receive excellent services throughout.

It was also a chance for everyone to put names to faces, to share, to learn, to teach and to inspire each other; a chance for teams to input their thinking and creativity into big strategic issues, aswell as receive important training and updates. #BeingBrook was about rewarding, recognising and celebrating Brook people and their talents and to ultimately improve our work with young people.

I know what talking to 450 people feels like, but never had it felt quite like this. As I stood at the podium to talk to 450 'Brookies' my breath was suspended for a few seconds and it was hard to take in the moment, photograph it in my mind and speak. In my welcome speech I reminded us all of Brook's journey over the last 50 years and just how far society has changed - the legal framework for free contraception and services and for equality is in place (same sex marriages of course became legal today, at last). We are still nowhere near there with sex and relationships education law, policy or delivery. That remains a really big challenge. The next 50 years has to be about improving education so everyone, whatever their identity, can grow with confidence and trust. Only then will we achieve our mission of enabling young people to enjoy their sexuality without harm.

In my welcome I was able to a) acknowledge that despite best efforts we hadn't always got everything right through the change programme b) to apologise where we had got it wrong c) to assure staff that whilst some pain was inevitable it was never our intention to upset and d) thank everyone for sticking with us, focusing on young people throughout and ensuring services were not disrupted, whilst all the time helping Brook continue to develop and improve.

There were four training zones on day 1 a) safeguarding b) digital services c) health and well being and d) organisational values. Then young people from our participation group and Naomi, head of participation and volunteering took to the stage to talk about their work across the organisation. We saw first hand the difference volunteering makes to young lives. Time after time the young people talked about how the opportunities Brook provides are helping build their confidence - stood talking to 450 people was some evidence of that. We were told in no uncertain terms by Rebecca that young people are vital on staff interview panels because it helps cut through the bullshit. 'We can see if they really like young people. If you don't look at me through the whole interview and then say you like young people I won't believe you'. Good call. They were quite simply remarkable and completely deserved their standing ovation.

Our Chair and some trustees - including our newly appointed young trustees - Claire Taverner and Charlotte Warner joined us for the evening where dinner was served in the Grand Room. It always amazes me how people can cater so well for so many people. After the meal people headed to bed, to the bar or to dance. I was delighted that despite the late night networking that went on, most people were ready to start at 9am on day 2. Day 2 we worked in professional groupings. I facilitated the receptionists group and had a great time learning about the similarities and differences in approaches and on occasion being provocative. I considered it CEO privilege.

There were many magical moments over the two days - seeing people connect, meeting people, connecting people and watching lightbulb moments. The energy was palpable. Initial feedback has been really quite extraordinary. One person reflected what many others voiced to me; 'I have never been in a room with so many like minded people. Not once in my career have I ever felt part of something or so valued. I have learnt so much by talking to different people, about where we are going and I am excited to be part of that'.

As we were leaving when everything had gone seamlessly, one of my colleagues said 'I don't know any other organisation who would have taken on the organisation of an event like that themselves.' I suspect he is right. And our #BeingBrook planning and organising team, the Brookmakers, our National Consultation Forum and everyone who helped coordinate and deliver the event deserve the most enormous gratitude. The delivery team were as good, if not better, than any agency I have ever used. The Palace Hotel, Manchester were brilliant. If you have a big event, I recommend them. And thank you also to our sponsors - CM Print, Virgin Media, Esteem, HRA Pharma, Durex and Consilient Health without whose ongoing support #BeingBrook would not have been possible. Finally, thank you to Jon Dunn, commissioner of our services in Manchester for joining us to say a few words before dinner.

I know everyone who organised and facilitated the Event left exhausted. As did many of the teams as they travelled back home. Check the #BeingBrook timeline for evidence of inspiration, enthusiasm and exhaustion in equal measures.

I never forget what a privilege it is to be CEO of such an important organisation as Brook. I felt that privilege and pride intensely this week. An inspiring bunch to spend 24 hours with. If you get the chance I recommend it. 

Friday, 21 March 2014

The UK Sexual Health Awards 2014

Simon Blake at the UK Sexual Health Awards 2014
Me opening the ceremony @ #SHUK2014!
The UK Sexual Health Awards 2014 took place at the glittering 8 Northumberland venue last Friday 14 March. The third time the Awards have taken place, they were bigger and better than ever - thank you to all who attended, and to the Brook and FPA staff who worked so hard to make the Events the stunning success that they were. I have lost count of the number of people who have congratulated me and the team on the Awards and all the organising team, the judges and the venue staff really deserve a lot of credit. I am already looking forward to the 2015 Awards.

I urge you all to read through the list of winners: a totally inspirational lot.

I hope you like the photo at the top of this post - it and all other official photos from the Awards can be viewed and freely downloaded from our Flickr page.

Brook Ambassador Zoe Margolis
In between enjoying a delicious meal, laughing at brilliant host Jenny Eclair's jokes, chattering away with old friends and new faces, congratulating all our brilliant winners and finalists, admiring the beautiful d├ęcor, and applauding until my hands ached we did some tweeting. You can read a Storify that tells the story of my #SHUK2014 here.

Below are the two speeches from the winners of the Lifetime Achievement Awards from this year's ceremony: Dilys Cossey OBE, and Dr David Paintin. Dilys delivered her moving and scintillating speech herself, while sadly David was too ill to attend the Awards - I was honoured to deliver his speech in his stead.

As Brook celebrates its 50th birthday year, it is wonderful to hear from two people who were there at our founding in 1964. Dilys and David gave sharp and poignant reminders of exactly why Brook was established, of how much the world has changed (in terms of sexual health as well as gender equality, acceptance of gay people, social mores and much, much else) in half a century, and of what still remains to be done. Both speeches moved many of those watching to tears, and gave us goosebumps - especially when David spoke of the behind the scenes work required to pass the Abortion Act in 1967, and when Dilys called for abortion to be decriminalised.

Speech by Dilys Cossey OBE, recipient of a Lifetime Achievement Award

Dilys Cossey OBE delivering her acceptance speech
It is a great pleasure and honour to accept this award and to receive it with my long-term colleague David Paintin. I have known David for half a century – we started off together in the Abortion Law Reform Association in 1964. It has been a huge privilege to be a member of the team working for so long in this field with committed colleagues – with people like David and Ann Furedi. There was never any doubt about the value of what one was doing.

It is a particular pleasure because it comes from friends and colleagues in FPA and Brook known over many years. I have always valued Simon Blake’s attentiveness and courtesy to a Brook ‘oldie’. And Audrey Simpson and I go back a long way in FPA and Brook. I would like to congratulate both of them: Audrey on her persistence in tackling the thorny issue of the precise legal status of abortion in Northern Ireland, and Simon for his imaginative and confident leadership of Brook and piloting change in choppy waters.

I would also like to say thanks to Ann: she and I had unforgettable years working together in the Birth Control Trust fighting the forces of darkness.

It is good to see here tonight a few familiar faces: Alison Hadley, Harriet Gill, Mary Crawford, Jackie Boath and Jane Hughes. These are the people who have made Brook work so well at the grassroots.

This year Brook is 50. Next year is the FPA’s 85th birthday and in four years time Bpas will be 50. So, as everyone is getting older, just as I am, Simon granted me a special dispensation to say a few words. I thought it would be appropriate to make some observations about how times have changed.

In sexual health terms the 1950s, when I was growing up, were the Dark Ages. Contraception was not part of NHS provision – it was patchily available for married women through FPA and some local authority clinics; abortion was illegal (Mike Leigh’s film Vera Drake is an excellent illustration of the situation); male same-sex relationships were illegal; divorce was difficult and expensive; there were two choices for single young women who got pregnant: a shotgun marriage or giving up your baby for adoption. Many resorted to backstreet abortion. Some gay men committed suicide. Looking back sex, other than in heterosexual marriage, was closely connected with guilt, fear and shame.

Set against that background, my experience in 1961 just before I got married of visiting the FPA clinic in Walworth, South London, later a Brook clinic, is unsurprising. Alas, I did not sport a sparkling engagement ring on the third finger of my left hand, and the volunteer receptionist was suspicious, to say the least, thinking I was up to no good. So, she grilled me not only on my personal details, but those of my intended, and of the date, time and place of our nuptials and our future address. Reluctantly I was allowed in and joined other women sitting minus knickers, suspender belts and stockings. I finally got my diaphragm and cream, after a couple of brisk questions from the doctor about enjoying sex and when I was going to have a family. I subsequently learned that care had been taken to check whether I actually did get married.
(l-r) Jenny Eclair, Dilys Cossey, and Ann Furedi

But things were beginning to change. The sexual Zeitgeist is captured in the opening lines of Philip Larkin’s poem, “Annus Mirabilis”:

Sexual intercourse began
In nineteen sixty-three
(which was rather late for me) –
Between the end of the Chatterley ban
And the Beatles’ first LP.

 The 1960s were a period of substantial social and sexual reform – mainly in the 1966-70 Labour government under Harold Wilson - and set the legal framework still broadly in place today for abortion and same-sex relationships. I was witness to Brook’s birth at the FPA 1964 AGM, and over the years it has grown into a sturdy adult. In the 1970s contraception became available free-of-charge on the NHS – and by some miracle remains so. But the sands constantly shift: in the 1980s HIV AIDS was a huge challenge, as were Mrs Gillick’s legal action against the Department of Health and the anti-abortion lobby’s bitter opposition to legalisation of embryo research. Section 28 was a long, long struggle. Financial cuts and structural changes in the NHS continue to threaten provision. And the issue of sex and personal relationships in education remains unresolved.

Although society and its attitudes have changed profoundly in the last half-century – I think this is an instance where the phrase ‘Things ain’t what they used to be’ is positive, not negative – there will, in my view, never be a time when one can relax. That is why Brook, FPA, Bpas and Education for Choice are so important because they are the main guardians of the legacy. I like the message in the ‘XES: We Can’t Go Backwards’ campaign and Brook’s 2019 aim on sex, sexual equality and sexual health.

At the same time there is, in my opinion, a duty to push boundaries for what we believe in. My personal view is that we should be talking about broadening the terms of reference of discussion on sexuality to include the concept of sexual rights as well as sexual health, and on the abortion front about the decriminalisation of abortion - I think that this is something Wendy Savage will be talking about at the Abortion Rights AGM at the end of March.

Many battles are won, but the war continues. And, looking around, I am encouraged to see so many young people and from such a range of different interests. I am confident that together you are a formidable group. Thank you again for my award. Good luck – may the force go with you!



Speech by Dr David Paintin, recipient of a Lifetime Achievement Award

I am very honoured that Brook and the FPA have chosen me to receive a Lifetime Achievement Award. There have been great advances in sexual and sexual rights during my lifetime. In 1930, the year I was born, women were expected to become wives whose role was to support their husband, become his sexual partner and the mother of his children — he earned the family income and she was his housekeeper. Marriage was costly for women— in 1930, 356 died from the complications of unsafe induced abortion and a further 2,126 died in childbirth. When I qualified as a doctor in 1954, pregnancy was much safer but the status of women had hardly changed. Their sexual behaviour was regulated by the stigmatisation of unmarried mothers and their children; safe abortion was available only at considerable cost from a “Harley Street” gynaecologist. Few family doctors would advise on contraception and family planning clinics were strictly for women who were married or were about to be married. Embarrassed men obtained condoms from barbers, chemists’ shops or by mail order for delivery in plain brown parcels. Even when used carefully, the barrier methods were relatively ineffective — failure rates are estimated to have been from 5 to 15% per year.

There have been great advances since then. Oral contraception and IUCDs became available in the 1960s — making love could now be enjoyed without risking an unplanned pregnancy. This tuned in with an increasing awareness that women should have equality at work, and the right to run their own social and sexual lives. There was growing acceptance of premarital sex and long-term relationships that resulted in children. But unwanted pregnancy remained a problem — the sexual response is instinctive, powerful and difficult to control — it is challenging to be “responsible”, especially when young and inexperienced. This is still true in 2014. But help is at hand —contraceptive methods have improved dramatically — hormone -releasing IUCDs and subcutaneous implants that are acceptable to most women, last for several years and are almost 100% effective.

Up to the early 1970s, women were still dying from unsafe abortion — about 29 each year from 1960 to 1964. David Steel’s Abortion Act of 1967 put the back-street abortionists out of business. Now, women with unwanted pregnancies had only to convince two abortion providing doctors that having a child at this time would threaten her or her children’s physical or mental health and could take her actual or foreseeable circumstances into account. The annual numbers of legal abortions increased dramatically. Deaths from unsafe abortion fell, ceasing altogether in 1975 —the need for unsafe abortion had gone. The NHS could not meet the demand for terminations and some private gynaecologists charged disproportionately large fees. This was remedied by members of the Abortion Law Reform Association when, in 1968, they founded the not-for-profit organisations, Bpas in Birmingham and PAS in London. From 1981, now joined by Marie Stopes International, these charities were allowed by the Department of Health to provide free abortion through contracts with the NHS. Abortion services improved nationwide — in 2012, the NHS provided 97% of all the abortions for women living in England & Wales, 35% by NHS staff and 62% through contracts with Bpas and MSI (PAS had merged with Bpas in 1998).

The beautiful venue, 8 Northumberland
Community family planning services expanded rapidly. The need of young people to have a service of their own was recognised by Helen Brook —she opened her first centre in 1964. In 1973, Parliament voted for contraception to be provided by the NHS, free of charge and irrespective of marital status or gender. Offering help with contraception has become a routine part of post-abortion and post-natal care. The Margaret Pyke Centre, founded in 1969 by Lady Medawar, has pioneered specialist training for health professionals. Contraception and legal abortion are now part of the basic education of doctors and nurses.

A network of dedicated people initiated and developed these improvements in reproductive health. The Abortion Law Reform Association —ALRA— founded in 1936, was at the centre and Professor Dugald Baird, Regius Professor of Obstetrics and Gynaecology in Aberdeen, the most medically influential of the pre-war members. My conviction that abortion should be legal and accessible was the result of joining his unit as a trainee gynaecologist in 1956. At that time induced abortion in Scotland was controlled by common law; Dugald Baird had been advised that, acting in good faith to preserve the health of the woman, he was able to provide abortion for social reasons. He convinced me that unwanted pregnancies should be terminated safely by a doctor. He understood that many women had very limited control over the sexual demands of their partners, found diaphragms and condoms difficult to use and that unwanted pregnancies were inevitable. For him, health was as declared by the WHO in 1948, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”— a woman’s health was clearly in danger if her present social circumstances made her pregnancy unwanted. It was after spending an afternoon with Dugald Baird in the autumn of 1966 that David Steel finally decided the wording of the crucial clause in his Abortion Bill.    
                                                           
I joined ALRA in 1963 when I moved to London as a lecturer in obstetrics and gynaecology at St Mary’s Hospital Medical School. ALRA had just been reinvigorated by Diane Munday, Madeleine Simms, Vera Houghton and Dilys Cossey. It was Vera Houghton, the chair, who recruited me in 1965 as one of the medical advisors during the parliamentary debates that resulted in the Abortion Act of 1967 — my support for abortion provision and fertility control continued from then until now. I was free to speak and support legal abortion in writing, in public meetings and interviews on radio and television, because I had no private practice — my clinical work was entirely within the NHS. Over the years, I have been a member of many committees and advisory groups. These include the Birth Control Trust, PAS, Bpas, Brook Advisory Centres, the Department of Health and the Royal College of Obstetricians and Gynaecologists. With the support of Richard Beard and Connie Smith, I provided an NHS abortion service for Paddington and North Kensington — ably continued by Kate Patterson after my retirement — a Paintin Unit for early medical abortion was opened at St Mary’s in 2005. I made legal abortion part of the teaching of medical students at St Mary’s, and was a regular speaker on the Margaret Pyke family planning courses and at medical meetings all over the country.                 
                                                                                       
Ann Furedi, Bpas
As soon as abortion became legal, the ALRA team realised it was necessary to defend the Act from restrictive amendments, and to make contraception more accessible. The Birth Control Campaign, led by Alastair Service and Dilys Cossey, successfully lobbied Parliament in 1973 to make free contraception available through the NHS to all persons irrespective of gender or marital status. The Birth Control Trust was formed in 1972 by Vera Houghton, Alastair Service and Madeleine Simms — I was a committee member and a trustee. Caroline Woodroffe was the first chair and was followed by Vera Houghton when Caroline replaced Lady Brook as chief executive of Brook Advisory Centres. I took over from Vera in 1981 and remained in post until 1998, but the achievements of BCT were due to initiative and energy of Dilys Cossey, with a major contribution from Ann Furedi in the 1990s. Our objects were to help women to find abortion services and to inform politicians and journalists whenever fertility control was in the news. We organised meetings for health professionals, journalists and for parliamentarians in committee rooms at Westminster, and published a series of booklets. The BCT draft contract for abortion services in the early 1990s became the outline for contracts between the not-for-profit organisations and the NHS, and was the forerunner of the RCOG Guideline: The Care of Women Requesting Induced Abortion. We supported the introduction of many services, such as clip sterilisation, emergency contraception and medical abortion. The Co-ordinating Committee in Defence of the 1967 Abortion Act (CO-ORD) was an ALRA/BCC/BCT initiative and brought together the many pro-choice pressure groups during the procession of restrictive private member’s bills in the 1970s and 80s. Doctors for Women’s Choice (DWCA) was begun by Judy Bury who saw the need for a group of doctors willing to support legal abortion, and to take part in radio phone-ins and television discussions. Wendy Savage has kept the membership together for many years and, through her vigorous and sustained initiatives, has made DWCA an influential public voice.

Many others have had important roles, particularly, Lord Houghton (Douglas Houghton), Malcolm Potts, Peter Diggory, Wendy Savage, John Guillebaud, Ian Jones, and the professors trained or inspired by Dugald Baird — Sir Alec Turnbull, Sir Malcolm MacNaughton, David Baird and Alan Templeton. I was only one of the many behind the improvements in reproductive health and sexual rights.

David Paintin, 8 March 2014

Wednesday, 5 March 2014

Cornwall adopts the Brook Sexual Behaviours Traffic Light Tool *whoop whoop*

8 years ago I was invited to talk at a conference and workshop programme in Australia as an expert on young people and sexual health.  What a treat for a Cornish lad who never really knew what he wanted to do at school, let alone have hopes of being an expert in anything.

I was working at NCB and three days before going to Australia I had been appointed as CEO of Brook Central. I had spent the past year doing a series of Teenage Pregnancy and Parenthood seminars as part of the Research in Practice series. Through that series I had become increasingly worried and unsettled by the lack of confidence many professionals had about the range of 'healthy and normal' sexual development and sexual behaviours, and those we should be concerned about. The result was professionals in different disciplines making a mixed bag of referrals (or not) without any consistent standards across Local Authorities meaning some young people got excellent support and others were not. 

The trip to Australia was fascinating in all sorts of ways and I learnt a lot. Given my experience with the RIP seminars, I was most excited Family Planning Queensland had developed the most fantastic Safeguarding Traffic Light Tool which helps professionals working with children and young people to identify, assess and respond appropriately to sexual behaviours. It uses a ‘traffic light’ system, of Green, Amber and Red to increase professional’s confidence in understanding healthy and unhealthy behaviours: I knew it would be a useful tool to bring back to the UK.

Fast forward almost 8 years and imagine my delight to be the key note speaker yesterday at a conference in Cornwall (my home land) to launch the adoption of Brook Sexual Behaviours Traffic Light Tool by Cornwall County Council as the safeguarding assessment tool the children's workforce will be using with regard sexual behaviours.  This is a partnership endeavour between Brook and the Reducing Teenage Pregnancy Team, in particular, the coordinator, Lex Gainsbury, with the support of the Cornwall Safeguarding Children's Board and Cornwall Health and Well Being Board.  The launch marked the beginning of 70 professional training sessions to train the workforce in using the tool.

I am really excited at this pioneering approach to adopting the tool.  Director of Public Health, Felicity Owen and Lead Member for CYP Services, Councillor Andrew Wallis were clear this should be about improving consistency of education, support, assessment and referral by increasing professional confidence in understanding and assessing healthy and unhealthy behaviours. I look forward to hearing the learning and hope other Local Authorities will follow this visionary path set by Cornwall

You can find out more about the tool at www.brook.org.uk/traffic-lights. If you want to discuss how we can support you to adopt the tool please contact georgia.johnston2@brook.org.uk

I want to acknowledge the kindness of Family Planning Queensland for giving permission for us to develop and adopt the Tool for the UK context, to everybody involved in the developing, piloting and evaluation of the UK tool and the Department for Education for funding its development. I also want to congratulate the vision and foresight all of the partners and the Brook team in Cornwall for adopting this tool.

As the backdrop to the tool I presented about the importance of a positive overall culture is required if we are really going to safeguard young people's sexual health and promote positive health and well being. That culture must be one where we have expectations for them and value their developing sexuality and people across a spectrum of gender and sexual identities.  Good Personal, Social and Health Education is absolutely vital to this, and that is why, in partnership with PSHE Association and Sex Education Forum we published new Supplementary Advice to the Secretary of States Statutory Sex and Relationship Education Guidance last week - you can download the SRE Advice here www.brook.org.uk/supplementaryadvice


An absolutely inspiring day. The final cherry on the cake for me yesterday: being on home ground Mum and Dad came and saw me speak for the first time ever. They were cute, looked after royally by Kerry in particular and having seen the team in action are now fully fledged Brook groupies. Most importantly, I can now say hand on heart we have had a proper conversation about sex.