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ENHANCING SEXUAL WELLBEING IN SCOTLAND - A SEXUAL HEALTH AND RELATIONSHIPS STRATEGY: Analysis of Written Responses to the Public Consultation
CHAPTER 18: CONCLUSION
NATURE OF THE RESPONSES
18.1 This report has discussed responses to the consultation exercise on the Sexual Health and Wellbeing Strategy. 1,394 responses were received, from medical and social Health Professionals, organisations representing young people, young people themselves, Equalities Groups, Faith Groups, Individuals, and other groups. It must be borne in mind that the responses do not constitute a representative sample. The analysis has sought to report on comments from all groups, however well represented they were as a proportion of the responses overall.
18.2 It must also be remembered that respondents tended to comment primarily on issues in which they were interested. The number of comments varied considerably by recommendation, responses were not based on 'closed questions' (i.e. questions with a limited number of response options such as 'yes/no' or 'agree/disagree') and they varied greatly in depth and nature.
KEY POSITIVES
18.3 A few elements of the Draft Strategy were seen as very positive by significant minorities of responses. Some of these positive points contradict the key concerns raised by other respondents.
The Draft Strategy promotes a positive role for parents
Support for the implementation of McCabe Report Recommendations
The Draft Strategy acknowledges the major influence of the media
The Draft Strategy has a comprehensive/broad/holistic approach
The Draft Strategy is very positive about teaching young people about relationships
18.4 There was also general support for the notion that action is required to improve sexual health and reduce the incidence of STIs and unwanted pregnancies and general agreement among Health Professionals that the broad approach outlined by the Draft Strategy was generally appropriate (but with reservations over resources and the fit with existing structures and services)
18.5 As is clear from the discussion above, the majority of responses (particularly the Individual responses) focussed on a few, key elements of the Draft Strategy but did not make any comment on other elements of the Draft Strategy. It is likely that some of this lack of comment is because not every respondent read the Draft Strategy in full. However, it is probably safe to assume that, in some cases, where no comment was made it is because the proposal was either relatively uncontroversial or was irrelevant to the situation of the respondent. Areas which did not generate much comment tended to relate to clinical services and service delivery (apart from access to terminations and the provision of contraception and the Morning After Pill to young people).
18.6 Generally, there was qualified support for the proposals relating to:
Wider influences on sexual health and the role of the media
Implementing an integrated tiered approach (with inclusion of the voluntary sector)
Lifelong learning for adults (but with reservations about a SHAW approach to sexual health)
Meeting the needs of those facing the greatest barriers to sexual health (apart from some concerns about whether this entails easier access to contraception for young people)
Specific actions to reduce STIs
Supporting access to services (apart from concerns about easy access to terminations and clinical services in schools)
Leadership and accountability (although further clarity is required)
Clinical targets for sexually transmitted infections
Education and CPD (with adequate resources)
Developing an evidence base for future work (although many respondents feel that research should be undertaken about effective models of SRE before anything is introduced).
KEY AREAS OF CONCERN OR DISAGREEMENT
18.7 Certain elements of the Draft Strategy emerged as key areas of concern and it is important to note the strength of feeling about these issues.
18.8 There was strong feeling that there should be more emphasis on abstinence and that the Draft Strategy should not reject the abstinence only approach
18.9 There was widespread concern that the Draft Strategy does not enough focus on marriage, relationships, family, love, fidelity etc. There was strong support for the idea of a Draft Strategy which promotes or encourages the notion that sex should be kept for marriage.
18.10 Similarly there was much support for the idea of trying to encourage young people to delay the start of sexual relationships until they are older and in a secure relationship.
18.11 There were particularly strong feelings in relation to the targets relating to termination - especially the targets to enable termination within 3 weeks of consultation (with the further aim of reducing this to 1 week by 2006). These largely fell into two categories. First, some respondents strongly believed that termination is inherently wrong and should not be allowed. Second, some believed that termination might sometimes be an appropriate option but that women needed more time (and counselling and information) to make such an important decision. It was also felt that not enough recognition of the medical and emotional impact of termination was included in the Draft Strategy.
18.12 Many parents and grandparents believed that the Draft Strategy contains elements which undermine the role of parents and that it does not place enough emphasis on the importance of parenting.
18.13 There were strong negative views in relation to the idea of introducing sex and relationship education to younger children. However, some of this opposition appeared to be driven by the negative presentation of the issue in some sections of the media, as respondents mentioned opposition to providing sexually explicit material to pre-school children).
18.14 There was strong opposition among Individuals and Faith Groups in relation to links between clinics and schools. Much of this negative opinion was based on the misconception that such clinics would be providing the Morning After Pill to young girls but there was still opposition, even if this were not the case, as it appeared to respondents to condone provision of contraception behind parents' backs.
18.15 A high number of responses believed that the Draft Strategy should have focused more on morality and appropriate behaviour.
18.16 There were also strong feelings in relation to the position taken in the Draft Strategy in relation to heterosexual and same-sex relationships. Many respondents believed that heterosexual relationships should not be promoted as the norm.
18.17 It was felt by many that aspects of the Draft Strategy appeared to promote sexual 'promiscuity' and experimentation among young people
18.18 There was a significant lack of consensus relating to the effectiveness of Healthy Respect. Some respondent groups were very positive about it but many parents and Faith Groups considered that it would be wrong to introduce Healthy Respect, as they believed its approach has already proved to be a failure. However, as previously noted, Healthy Respect is currently being independently evaluated and no final decision has been made about its future or how learning from the project should be taken forward.
18.19 Other key concerns related to funding, resources and the apparent lack of inclusion of many existing services and organisations. In particular, the voluntary sector (for example Couple Counsellors) felt they had been largely left out of the service delivery models.
18.20 There were criticisms of the presentation of the Draft Strategy Documents, with many respondents - both lay and professional - saying they found it difficult to follow. There was also a perception that the Summary did not accurately reflect the content of the Draft Strategy. It was felt that further explanation and interpretation of the Draft Strategy would have been useful.
18.21 In additions to criticisms about the layout and presentation of the Draft Strategy, there were concerns about the way the consultation has been undertaken. These concerns mainly came from parents, grandparents and representatives of schools who felt that more attempts should have been made to consult with schools and parents, and a copy should have been sent to every parent or at least every head teacher
7.
18.22 Some representatives of Equalities Groups believed that the Draft Strategy should have been available in different formats such as oral and graphic
8.
18.23 A key criticism of the Draft Strategy among professionals was its lack of specific details in relation to implementation of the proposals. Many questions were asked about how the proposals fit within existing frameworks and strategies and it was felt that a detailed implementation plan was required with key target dates, milestones and resources identified.
DIFFERENCES BETWEEN RESPONDENT GROUPS
18.24 As we have seen in the previous chapters, there were key differences in attitude among the different respondent groups. Although the considerable majority of respondents agreed with the Draft Strategy that action was required to deal with the growing problems of unplanned or unwanted pregnancies and sexual ill health, there was concern from some respondent groups about the approach laid out in the Draft Strategy for addressing these problems.
18.25 Generally, Health Professionals and Equalities Groups were broadly positive (with qualification) about the recommendations in the Draft Strategy while Faith Groups and Individual respondents were much more negative.
18.26 For example, the considerable majority of Social and Medical Professionals were overall positive about the Draft Strategy with just a few reservations and issues. Key concerns among Health Professionals related to staffing and resources.
18.27 Similarly, two thirds of the Equality Group responses were broadly positive with qualifications.
18.28 Representatives of Education and Young People were more divided in their opinions than the Health Professionals, with around a third being overall positive but almost half being negative about the Draft Strategy.
18.29 Faith Group and Individual respondents were generally negative about the Draft Strategy, with at least half being negative overall. Additionally, in most other cases, although it was not possible to ascertain the overall view on the Draft Strategy as comments were only made on one or two elements, the comments which
were made were negative.
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