Health Check: 'Aids opened up the discussion of sex'

Which is the greatest sexual taboo? It may sound like a Trivial Pursuit question, but with sex diseases at a record high the prize for tackling it could be a lot bigger than any you win in a pub quiz.

Which is the greatest sexual taboo? It may sound like a Trivial Pursuit question, but with sex diseases at a record high the prize for tackling it could be a lot bigger than any you win in a pub quiz.

I learnt the answer in 1990, when the Aids scare was at its height in the UK, and there is no reason to think it is any different now. I went to see a researcher at the University of Essex who was studying sexual behaviour in gay men. One of the extraordinary things about Aids was the way it opened up the discussion of sex. Almost overnight, British squeamishness disappeared and it became possible to talk about the exchange of bodily fluids in polite company.

Nowhere was this clearer than in the gay community, who faced the biggest threat and so had most to gain from open discussion. But the researcher told me one issue remained taboo, even in the gay community. That was the link between sex and money.

He said "sex and money" rather than "sex for money" because this was not about prostitution. But it was about, to put it in the parlance of the time, who had the biggest wad. Often an older man with a job and an income would take in a younger man without either as his lover. Money might never be mentioned but it was an unspoken factor in the relationship. It could not be discussed because it was about the unequal balance of economic power.

Many heterosexual relationships are the same, of course. Diamonds may be a girl's best friend in the West but in the developing world a pair of trainers or even a decent meal will do. Reading the latest UN Aids report last week, which highlighted the importance of giving women and girls in Africa the economic and social power to escape the clutches of sugar daddies, I was reminded of the Essex research.

But no attention is given to this issue in sex education here. My teenage daughter says she and her friends never let boys they do not know buy them drinks in a bar because it sends the wrong signal. She prefers to keep the playing-field level. The aim of sex education is to equip young people with the means to negotiate their relationships and keep control. How is that possible unless there is discussion of the role of money?

It is nearly December and the party invitations are coming in fast. Cue also press releases advertising cures for bad breath. A spat broke out last week between rival private clinics about where bad breath originated - in the gums or the tonsils - with one offering laser treatment to zap those nasty niffs.

I was at a Christmas party some years ago in a Government department where there was the customary ring of hacks clustered in circles round each minister, talking animatedly. All bar one, that is. In his case the hacks were not arranged in a circle but in two lines either side, allowing the minister to address the gap between them. When I joined the group I discovered why - he had exceptionally bad halitosis.

Happily, his social handicap did not harm his career. He later became Prime Minister.

I went over the handlebars of my bike last week and squashed my face on a car. The young doctor who stitched me up at the Royal Free Hospital was 25, two years out of medical school, with just the right combination of energy and sensitivity. But as I was lying on the table while he worked away on me, he told me something that almost made me fall off.

For decades, junior doctors have had one overriding complaint about the NHS: their absurdly long hours. Gradually these have come down, and in August new rules were introduced limiting them to a maximum of 56 a week.

Now, young doctors like Chris Groombridge, who put me back together, have a new complaint. Their hours are not long enough for them to get the training they want to become surgeons. Junior doctors complaining their hours are too short? There truly is a revolution under way in the NHS.