The new minister replacing Fowler, John Moore was not in fact to have a particularly auspicious
period at the Department of Health and Social Security. Up until that time he had been very much seen as a rising star within the Conservative Party, even being tipped for the premiership role at one time. He was very successful as a facilitator for the Thatcher government’s privatisation programme but when he then tried to extend this into the management of the National Health Service, he begun to encounter opposition from all sides. He was effectively demoted in 1988, through loss of the health portfolio and then finally sacked from his cabinet post in 1989.
Kenneth (Ken) Clarke followed, when he was appointed the first Secretary of State for Health when the department was created, out of the former Department of Health and Social Security in July 1988. Clarke, with backing from John Major, persuaded Thatcher to accept the controversial “internal market” concept to the NHS. Clarke claimed that he had persuaded Thatcher to introduce internal competition in the NHS as an alternative to her preference for introducing a system of compulsory health insurance, which he opposed.
He told his biographer Malcolm Balen: “John Moore was pursuing a line which Margaret [Thatcher] was very keen on, which made everything rely (on having) compulsory medical insurance. I was bitterly opposed to that…The American system is…the world’s worst health service – expensive, inadequate and with a lot of rich doctors”. However, in her memoirs, Thatcher claimed that Clarke, although “a firm believer in state provision”, was “an extremely effective Health minister – tough in dealing with vested interests and trade unions, direct and persuasive in his exposition of government policy”.
However, there was a lot going on, on his watch; enough to keep him very occupied and the targeted wide scale campaigns around HIV/AIDS were not repeated by the Department. It was clear by then that in reality the main communities being affected were gay men & drug users. Whilst it was recognised that important work needed to be carried out in terms of preventative messages to these groups, it was felt that these would be better placed if overseen from a ‘distance’.
In that period there was only one national agency that could really have taken on this role. It was the Health Education Authority. Previously The Health Education Council, (HEC) it had developed national advertising campaigns based around a range of specific health issues, working in tandem with several advertising agencies and been responsible for a number of very successful adverts. In particular, the most famous is probably the ‘Pregnant Man’ advert. This advert celebrated its 50th birthday recently and is still fondly remembered by old timers as being one of the most effective health messages ever. The issue it tackled (challenging men to take responsibility for casual sex and treating women with respect,) is almost as relevant today in its way, than in 1970 when it appeared. In fact the advert was conceived by the agency Satchi & Satchi in 1969 but its press based image of an apparently pregnant man, sent shock waves through the establishment of the time. Government advertising had never tackled the subject of sexual health with such bold frankness before.
Since its first appearance on 12 March 1970, ‘The Pregnant Man’ has become one of the most iconic adverts ever created. Receiving many accolades (and often on display at the V&A museum as part of its cultural collection) it is widely recognised for promoting a significant shift in men’s attitudes towards contraception. And its message is as thought-provoking today as it was fifty years ago.
However, by 1987 that was seventeen years previously, with little work completed since then that had been quite as good or well received, having been produced. The HEC had developed a leaflet about ‘AIDS: What everybody needs to know‘ (inter departmental memos about the proposed leaflet from February 1986) by 1986 which was reasonably clear and factual, talking about the disease mainly affecting ‘homosexual men’ but not doing so in a excessively stigmatising way. In April 1987, the Council’s functions were transferred to the new ‘Health Education Authority’, (HEA) which was created as a special health authority of the National Health Service and it continued in existence until it too was wound up in March 2000 (and most of its functions, (apart from the public information function, which went to Health Promotion England), were passed to the newly-created Health Development Agency.
So for thirteen years, the HEA had a budget assigned to it from the Department of Health and responsibility for the promotion of related advertising and information campaigns in a variety of different health related areas. It had produced its first generic ‘AIDS’ leaflet in 1985 in fact but just before it transferred, there had been agreement that the new HEA would also have responsibility for a new area of expertise, that of HIV/AIDS.
It was also agreed that there would be specific parts of its yearly budget set aside for campaigns based at particular target groups affected by HIV/AIDS, and specifically at gay and bisexual men. At the time, fully five years into the pandemic, there had still been no nationally targeted campaigns anywhere in the world, aimed at gay men. In the same way that the ‘Cleancut’ safer sex video Protective Gear for the Terence Higgins Trust had been the first video aimed at gay men in the world in November 1986, it is hard to believe now that after years of this dreadful illness affecting the gay community, with so many deaths, nothing of this nature had yet been attempted by governments.
It was not thought that any community organisation was ready to take on the challenge of producing such nuanced campaigns; in practice the obvious one would have been the Terence Higgins Trust I suppose. Despite some delving, I have not managed to ascertain exactly how much thought was given to this possibility within the DoH at the time. If discussions occurred, it is possible they may not have been minuted. It is however true that at the time they had no history of producing national campaigns of the scale envisaged and I also suspect there was concern about the successful management of content that was likely to be produced. The only ‘communication organisation’ THT had worked with at that point was in fact ‘Cleancut’, my own video company (though they went on to work with others like Mike Esser’s ‘Pride’ Productions in the next few years). In the event, given what I know now, it was probably for the best that this did not immediately happen (indeed THT went on to host and manage innovative local work aimed at gay men, funded through the HEA in a few years, by hosting the London young gay men’s MESMAC project, of which more later) but I am willing to stand corrected and open to debate on this- still sensitive- subject.
The HEA Aids programme team consisted then of its slightly formidable Director, Susan Perl, who had a robust CV with a history of planned Parenthood work for many years, her Deputy Dr Mukesh Kupila, to offer medical expertise and knowledge to the team and also under her leadership, a number of project managers, of whom the one assigned to the ‘MWHSWM’ area, the gay and bisexual men’s work, was Derek Bodell. The plan however was to recruit a further full time worker, a project officer, to assist in the rollout of this area of work and this was duly advertised in the gay press in July 1988.
Sex, love and life (The Sacrifice) 3.03 Rolling in the deep- stepping into the HEA
