London. Positively Irish Action on AIDS fights back against "market management" defunding

Commissioners’ defunding no April fool’s joke

On 1 April 1996, the Inner London HIV Health Commissioners’ Group (ILHHCG) announced its decision to cease all contracts for the Positively Irish Action on AIDS (PIAA) organization’s services to Irish people.

This decision is the result of what ILHHCG calls "market management," to force HIV groups to swallow the bitter pill of cuts in HIV care and treatment services announced by the UK Department of Health in December 1995.

In the Department’s doublespeak, "market management" was going to "promote stability of HIV provision throughout London" and to "maximize diversity of services within resource constraints by coordinating shifts of resources." Translated, this meant defunding PIAA.

PIAA’s largely volunteer staff emphasizes that PIAA is the "only frontline service for Irish people affected by HIV/AIDS." The ILHHCG had concluded in a recent evaluation that PIAA is a "client-focused and -owned service, an extremely well-run organization... [which] meets the needs of a client group who are otherwise hard to reach..."

ILHHCG’s arguments for decommissioning PIAA are that Irish people’s needs can be met by mainstream services, that resources will be redirected to mainstream services to ensure appropriate services, and that "market management" uses the "best evidence" to ensure that reductions have a "minimal impact on people living with HIV."

For PIAA, such "spurious arguments" contradict years of research and organizing and "demonstrates a lack of commitment to Irish needs." The group is urging that ILHHCG postpone their decision until they have undertaken a "proper assessment."