A large East Anglia college has asked its local health clinic to run a sexual awareness and advice service on campus for its students.
Staff at Suffolk College insist that the "revolutionary" approach to sexual awareness should be adopted nationally, if colleges are to help stem the tide of unwanted pregnancies and sexually-transmitted diseases. It has asked the NHS sexual health clinic, based at Ipswich Hospital, to run Bodywise, an on-site service for prevention, treatment and education.
Senior clinician Peter Greenhouse says: "Young people are most likely to suffer from sexual health problems. Nine out of 10 infections are acquired between the ages of 15 and 25 and most unwanted babies are conceived under the age of 20. Colleges therefore represent the largest concentration of those at highest risk."
Bodywise provides confidential care and advice on contraception, sexual problems, unwanted pregnancy, sexually-transmitted diseases (including HIV) in a sympathetic, non-judgmental setting, he said.
It is backed up by an educationalhealth promotional package which supports this care "in a consistent co-ordinated fashion".
The clinic has a doctor and nurse team experienced in all relevant fields, including counselling. A health centre management committee is drawn from student services, the student union, teaching staff, general practitioners and clinic members.
The educational component is seen by the college as an essential part of good pastoral care, said David Scott, head of student services. "With sexual health on the national agenda, it must be on the local agenda. We must get people comfortable with sexual issues - saying no, saying yes, negotiating for what they want."
With a student roll of 35,000, and 13,000 students of markedly different ages and backgrounds attending daily, the college recognised that help and information was needed both for the sexually-active and the inexperienced.
The local hospital is a considerable distance from the college, says Lillian Power, senior counsellor at Suffolk College and a member of Suffolk Health Authority.
She says: "Experience has shown that many young people are reluctant to go to GPs on sexual matters. In these circumstances, colleges become the obvious sites for looking at health care. The concept of bringing service to college, rather than the reverse is not revolutionary. After all, banks have been bringing their services to us for years. But what we are doing is a revolution in healthcare."
So far the reaction to Bodywise has been very positive, she adds. "No one is saying that we are just encouraging promiscuity. It is all being done very calmly, not as something people are frightened and ashamed of."
Some students who were initially sceptical agreed it provided an important service. Phil Bryant, a 19-year-old business student, says: "Students were worried about confidentiality. They were scared to talk about sex. This is being overcome."
Margaret Storrie, vice-chair of the National Association for Pastoral Care in Education says that "since incorporation, local education authorities have no input into colleges." Consequently initiatives are individual, and dependent on the priority that each institution chooses to afford the subject.
Other colleges express concern about sexual health care, but, with the exception of Suffolk College, none have, or have considered having, an integrated health care and health education service.
In some cases, provision for students appears to be minimal: one London-based pastoral services officer says: "We don't really have much. We were going to have a Health Day last year but there was a strike so it didn't come off. "
Many have links with health or health education trusts. Tutorials, induction days and counselling sessions are the main sources of face to face information. Colleges, like Brunel, have an advice and guidance centre where student welfare problems are addressed. "The welfare work is quite broad, including finance, personal issues, drugs and sexual health." says welfare officer, Andrew Burton. "I'll refer them on to agencies that are better qualified to deal with it."
Brunel invites such associations as the Brook Advisory Service and the Family Planning Association to be present at its freshers' fair. It also stresses its tutorial system as a means of providing pastoral care.
A tutorial system is, however, dependent on the degree of knowledge and accessibility of individual tutors, and these are not primarily chosen for their expertise in the field of sexual health. One college business studies tutor says: "I am continually being approached on issues such as abortion, relationships, even HIV counselling, and of course I do my best, but it's not from a position of strength."
A lot of institutions have no medical services on site. Annette Zera, principal of Tower Hamlets College, says: "We put our money into advice, counselling, benefits information. After all, very few people are taken ill in college. But we do have a social responsibility to provide information. "
At South East Essex, Tony Pitcher, who admits to "rather reluctantly" having members of the local health care trust in to give students advice, does not agree. He says: "We did have a member of the teaching staff as a general purpose counsellor, but now there's a very clear policy that we don't have an open-ended commitment to give students counselling on anything they want. It gives the wrong messages."
* Britain has the highest teenage pregnancy rate in Europe - the second highest in the western world after America, Government health statistics show. Every year 64 out of every 1,000 women aged 15-19 become pregnant, the majority of these pregnancies being unwanted.
* A general decline in the prevalence of sexually transmitted diseases following the HIV education campaigns of the 1980s masks a rapid rise in the rate of infections among women in this same age group.
* Young people between the ages of 15 and 25 are most at risk of suffering physical or mental harm due to sexual relationships. But this group which represents the greatest proportion of the population of FE colleges has no automatic right to sexual health education or guidance from these colleges.
* The Government's Health of the Nation White Paper in 1992 earmarked sexual health as one of its five key areas.It is an issue that has to be addressed individually by colleges, without benefit of guidelines or quality control.
* The Department for Education and Employment says: "There is no statutory duty on FE colleges to carry out any pastoral care provision. The department doesn't provide guidance - it is up to them if they wish to use their budget for pastoral care."