The role of the HEA was always going to be controversial. It was created in 1987, after abolition of the Health Education Council, to allow explicit campaigns on Aids and other issues to be conducted at arm's length from Whitehall and Westminster (though always subject in the final instance to ministerial veto). Now the HEA seems destined to pay the price for its outspokenness.
The authority's fate will be announced during the next few weeks. The signs in Whitehall are that it will be reorganised. Its powers will be reduced, it will lose its guaranteed annual pounds 36m income and be forced to bid against other agencies for specific project contracts and the payments that go with them. As a result, the HEA is likely to lose many of its 200 staff and find its ability to criticise government curtailed.
Brian Mawhinney, the Health Minister, is the person sitting in judgement. His distaste for parts of the HEA's work is well documented, although he is said to have a high regard for some of its campaigns - in particular its anti-smoking drive.
But the minister is a non-smoking, non-drinking Evangelical lay preacher from Belfast. Two months ago, he condemned as 'smutty' one projected HEA publication, Your Pocket Guide to Sex, directed at teenagers, and forbade its distribution. Bought by Penguin and published last week, it turns out to be a relatively restrained work, though it employs four-letter words freely.
Dr Mawhinney was said to be doubly angry because HEA staff members had not warned him of the impending publication: it was drawn to the minister's attention by a journalist. He believes that the non-executive members of the HEA were told of its existence only at the last moment. When they protested, they were told it was too late to cancel publication.
Ministerial displeasure over that episode was aggravated by the previous appearance, also without the foreknowledge of the Government, of a far more sensational publication, The Best Sex Guide. This was a glitzy one-off magazine published last December in co-operation with Radio 1, to coincide with World Aids Day. Aimed at 16- to 26-year-olds, 500,000 copies were produced to be distributed at concerts, clubs and student unions.
The Best Sex Guide could not have been more calculated to infuriate Dr Mawhinney and the moral right. For example, it made no mention of the fact that a homosexual act committed by or with an under-21-year-old was, and remains, a criminal offence. To compound this omission, the guide virtually ignored abstinence or monogamy. To many critics, the magazine appeared to be driven by two beliefs: that young people will read and understand such works only if the language employed is gratuitously crude and that promiscuity should be accepted as the social norm.
The charges against the insubordinate quango brought by Dr Mawhinney and his ilk go to the heart of the 'back to basics' debate. On the one hand, the HEA is accused of promoting the condom culture - the belief that promiscuous 'screwing' is fine as long as you 'play safe'. Yet it is also accused of playing the officious nanny, producing politically correct warnings about, say, how little alcohol one can safely drink, or claiming that HIV/Aids 'does not discriminate'. A senior civil servant described the staff of the HEA as 'veggie do-gooders with a mission to save the world'.
As he ponders the authority's fate, Dr Mawhinney has more than his own moral agenda to guide him. He also has a secret but apparently highly critical report commissioned by the Department of Health last summer and headed by former Tory MP John Lee. It is thought the minister will accept the inquiry's recommendations and axe the authority.
According to one of those closely involved: 'We want a far leaner body, demonstrating in a continuing manner its right to remain a player.' Another said: 'We do not consider it appropriate for a body fully funded by the taxpayer to conduct major campaigns against government policy.'
The report will recommend that the HEA or its successor should no longer receive its automatic annual subvention of pounds 36m for its work on Aids awareness, sex education, anti-tobacco and alcohol campaigns and the like. Instead, a slimmed-down version of the authority - to be called the Health Promotion Commission, and no longer a statutory authority - would be expected to bid against specialist charities and other institutions, including commercial concerns, for detailed government contracts. And if the new Health Promotion Commission did win a contract, it would usually be expected to commission work from, say, a professional public relations agency instead of producing it in-house.
So if Dr Mawhinney wants a new sex guide, he will commission one from the HEA's successor - or elsewhere - specify its contents, and pay up only when he approves the text.
At the HEA's headquarters in London there is an air of defiance. 'Certainly not,' responded Fran Considine, a spokeswoman, when I asked whether the authority had expressed regret for commissioning Your Pocket Guide to Sex. A senior staff member dismissed that whole episode as 'the press getting excited over the use of the word 'sex'.'
But Spencer Hagard, the chief executive, accepts that 'the climate has changed significantly' since Your Pocket Guide to Sex was commissioned. He has already given instructions for the authority to be restructured to function as a commissioning agency, bidding for government contracts and purchasing services from lobby groups or commercial enterprises. He confidently expects to head the successor body.
It remains to be seen whether this is a fundamental enough purge to satisfy right-wing critics. According to David Green, 'It would be pointless merely to change the title over the door. Far better to start again from scratch, with a new agency.'
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