The closure of Auckland-based Herne Bay House in November has left a gap in care services for HIV+ people. A few weeks after the closure, the AIDS Foundation held a community meeting to ask, where to from here? A flier advertising the meeting summarised the all-important questions: to all those who are getting too unwell to cope at home, or just in need of a well-earned break, who is going to help and where? Eamonn Smythe, the Foundation's National Positive Health Manager, co-ordinated the meeting. It was attended by approximately twenty people, with submissions from groups like Body Positive Canterbury who were unable to attend. Smythe says there was an acknowledgement at the meeting that palliative care services had moved beyond the need for an independent HIV-focussed provider like Herne Bay House. "It's because of the numbers," he says, "and also because things have moved on in the last 20 years, really. Most palliative care facilities are perfectly willing to accept people with AIDS, whereas 20 years ago that wasn't the case. That's really good, that's positive. It means that if there is a need for palliative care, there's access across the country for that." Where the loss of Herne Bay House will be felt is in the area of respite care and social services. "We decided that we need more information," says Smythe. "I'll be forming another meeting in February, we're going to get a GP and the CART [Community Assessment and Rehabilitation] team to come in, so that they can go through the processes on how people can actually access existing respite facilities. There are existing faculties out there, but most people in the group didn't know how to access them." Herne Bay House also acted as informal support network for HIV+ people, and a drop-in centre. Smythe says the Foundation is now floating the idea of plugging this gap themselves, using their own premises. "We could open our facility here," he says. "We've got a deck, we've got a pool, we could maybe open it up into a drop-in centre. But it needs more discussion about whether this is the right place to do it." Meanwhile, what has the Auckland City Mission been developing to replace the services lost in the closure of Herne Bay House? Louise Walker is the Clinical Services Manager at the Mission, and was managing Herne Bay House in its final months. She says a number of initiatives have been discussed. "We have primarily looked at providing community based or home based services," she says. "We've talked to a lot of people, and we still have some consultations to do, but we're looking at a very small, multidisciplinary team to go into people's homes. The overwhelming request we've heard so far is for very practical in-home care." The Mission is also looking at respite care services. "If someone's family or partner is needing a break from caring for someone, we could help provide some of that respite," says Walker. The Mission is looking at hired specially trained nurses for this purpose, due to the variable quality of agency nurses. "One crying need we heard from our Herne Bay House experience was people needing social and emotional support, so we're also looking at providing some psychological intervention where needed and requested," Walker says. Perhaps surprisingly, given their stated commitment to continuing to provide services for those living with HIV and AIDS, no representative from the Auckland City Mission was in attendance at the Foundation's recent care meeting. Walker says it wasn't possible to make the November meeting, but she has made a commitment to attend the next one in February. Chris Banks - 3rd January 2006