for health care in Wales because it would result in a better managed service that was closer to patients. Mr Hunt also allowed the area's health authority to be, retained as the purchaser for Pembrokeshire's health services. He admitted that this was largely due to pressure from local people, who were against Welsh Office plans to create a new West Wales Purchasing Authority, a move that would have meant scrapping Pembrokeshire Health Authority. The trust, which is based at the main hospital, Withybush, in Haverfordwest and two smaller hospitals in Tenby and Pembroke Dock, was supported by staff. All staff were invited to meetings about the trust bid in April this year, at the end of which they were given ballot papers. Just under half of the 1840 staff voted, with more than 600 in favour.of the management plan to'become Wales's first self governing trust. But a vote of consultants working in Pembrokeshire, conducted around'the time that news broke of 600 job losses at Guy's Health Trust, was close. The consultants were only 15-11 in favour of the idea of a trust. Opposition to the trust came from Labour prospective candidate, Mr Nick Ainger. He admitted that public meetings held throughout the three month consultation period had been poorly attended but pointed out that few people in the area seemed to understand the government's health reforms. During the consultation period Pembrokeshire Health Authority sent a leaflet to 40 000 homes in its area telling people about the trust application. The Welsh Office received fewer than 100 replies. But Mr Ainger said that a poll of almost 4000 people had shown that 93% were against the trust plan. The health authority believes that trust status will have several advantages for patients. At the moment patients have to travel to other health authorities for services like ENT and dermatology, but, as a trust, there are plans to expand and offer a full range of services. There are also plans for a new hospital for the mentally ill within three years. -JAMES DAVIES, freelance medical journalist, Wales

Aids education in schools Aids education in schools is currently "haphazard, too little, and too late." That was the message from health and education experts at a conference last week organised by the National Aids Trust to mark World Aids Day. Pupils are taught the mechanics of reproduction in biology classes, but personal and social education, the classes in which sex education, AIDS, and HIV are often covered, is not mandatory. Last month the Secretary of State for Education, Kenneth Clarke, announced that, from September 1992, AIDS and HIV would be included in the national science curriculum for all 11 to 14 year olds. But factual information, suggested

BMJ

VOLUME 303

7 DECEMBER 1991

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Barna-rdos' Advice aimed at teenagers from the Terrance Higgins Trust and Barnardos

Dr Roger Ingham, deputy director of the Institute for Health Policy Studies, was not enough: "The national curriculum has not increased the ability of young people to deal with HIV or to negotiate safer sex practices, he says. "Perhaps we should encourage schools to publish rates of pregnancy and abortion rather than exam results to see how effective education is." A MORI survey of 4000 teenagers aged 16-19 carried out for the Health Education Authority (HEA) in 1990 showed that 41% did not see any reason to change their lifestyle because of AIDS. More than 30% had had full intercourse by the age of 16. Doreen Massey, from the Family Planning Association, which is currently developing a sex education charter, said that "information is not enough; people don't learn from that alone." The report of the National AIDS Trust youth initiative, Living for Tomorrow, found that the sixth formers from eight major English cities received most of their education on AIDS and HIV from television. But some school governors, to whom responsibility for determining sex education policy has now devolved, may judge on moral grounds that it is not appropriate for their pupils to receive such education. Even if they consent, teachers are often reluctant, ill prepared, and afraid of being in contempt of section 28 of the Local Government Act, which criminalises the promotion of homosexuality, when discussing HIV and AIDS

issues. To make matters worse, funding for the local education authority training grant scheme, which pays for training costs and supply teachers' salaries, has been cut by 64 5%, from £3dIm to £11m. Funding for health education coordinators, who advise on the delivery of health including sex education, is scheduled to end in March

bility." He denied that guidance for teachers and lack of resources were a problem and added that sex education was a "sensitive area." One of the sixth formers who took part in the National AIDS Trust youth initiative might have disagreed with Mr Clarke: "Sex education has to talk about reality. You can't censor life, you can only censor education." -CAROLINE WHITE, technical editor,Journal ofClinical Pathology

How left wing is the NHS support group? William Waldegrave, Secretary of State for Health, is seeking to blunt a thorn in his side by alleging left wing bias in the NHS Support Federation, the pressure group formed to oppose the NHS reforms. In response to a political questionnaire circulated by the federation Mr Waldegrave posed five questions of his own. The first asked if the federation's founder and chairman, Professor Harry Keen, was a lifetime member of the Labour party. Professor Keen says that he has been a Labour party member for many years but knows that other leading members of the federation are Conservatives and Liberal Democrats. He says he is willing to ask about this in detail if Mr Waldegrave will announce the political affiliations of "the chair and shadow chairpersons" of each trust hospital's board. Another question was whether the federation or any of its inaugural groups received funding from left wing councils or political lobbying organisations. The reply was negative in respect of the federation. The funding of group members was stated to be "their own affair." The federation had claimed in an advertisement that there were cash limits on general practitioners' budgets for drugs. Mr Waldegrave said: "You must know full well that this is not true. Why do you insist on deceiving and frightening patients in this way?" Professor Keen replies that an increasing number of general practitioners are reluctant to prescribe expensive drugs. Indicative prescribing limits are set too low and are carefully policed, with persistent offenders possibly having to face a service committee hearing. Asked where the federation stands on Labour's health policies, Professor Keen says that it will campaign for better standards and funding for the NHS whatever the government of the day. -JOHN WARDEN, parliamentary correspondent, BMJ Correction

1993.

The Week

Defending the government's record on AIDS and HIV education at the conference, Kenneth Clarke said: "Education about HIV and AIDS will be effective only if all those involved accept their share of responsi-

In last week's journal Hart wrongly cited Maidstone Health Authority as having reduced the numbers of NHS abortions it would purchase. We apologise for this mistake; the health authority should have been

Medway.

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