Ahead of May’s election, Scotland’s sexual and reproductive health leaders are calling on an incoming Scottish Government to put high‑quality, accessible care at the top of its agenda to reduce health inequalities, improve public health and strengthen the country’s economy.
For the first time, The College of Sexual and Reproductive Healthcare (CoSRH), the Royal College of Obstetricians and Gynaecologists (RCOG), the British Association for Sexual Health and HIV (BASHH), and the British HIV Association (BHIVA) – which collectively represent more than 3,000 sexual and reproductive healthcare professionals across Scotland – have come together to publish Improving Scotland’s Sexual and Reproductive Healthcare: A Joint Manifesto for the Next Scottish Parliament.
While the manifesto acknowledges Scotland’s progress through initiatives like the Women’s Health Plan and the Sexual and Blood‑Borne Virus Action Plan, it also makes clear that the system is under real strain.
Demand for services has risen sharply, including a 50% increase in abortions in less than 10 years, rising rates of sexually transmitted infections and HIV testing numbers surpassing pre‑COVID levels. Yet this surge comes at a time when resources remain limited, and workforce pressures continue to grow. These pressures are creating longer waits, busier services and widening gaps in care.
Without decisive action, these pressures risk deepening existing disparities in health outcomes, particularly for women, young people, minority ethnic communities, and under served populations.
The manifesto urges immediate action from the next Scottish Government on five priority areas to improve SRH, HIV, maternity and abortion care across the country:
1. Integrated sexual & reproductive healthcare;
2. Investment to improve maternity services;
3. Deliver the HIV Transmission Elimination Plan and ensure equitable access to STI and BBV testing and treatment;
4. Reduce gynaecology waits and improve care pathways;
5. Implement the recommendations of the Review of Abortion Law in Scotland Expert Group and guarantee access to abortion care up to 24 weeks for all who need it.
Dr Sinead Cook, Chair of the CoSRH Scotland Committee, said: “Scotland has made real progress in women’s health and sexual health, but far too many people still face long waits, limited access and avoidable barriers to the care they need and deserve.
“Improving access to high‑quality sexual and reproductive healthcare not only benefits patients and service users, it also strengthens Scotland’s economy by reducing time lost to poor health.
“That’s why investment in abortion care, menopause care and sexual and reproductive healthcare more broadly must be a priority for the next Scottish Government.”
Dr Alison Wright, President of the RCOG said: “We very much hope that Scotland’s next political leader will seize the opportunity to build upon the strong foundations already laid through the Women’s Health Plan, the review of Scotland’s maternity services and the recommendations of the Review of Abortion Law in Scotland.
“Maternity staff are working under extreme pressure; caring for increasingly complex pregnancies, whilst facing ongoing workforce and resource shortages that affect the provision of safe, personalised care. At the same time, unacceptably long gynaecology waiting lists, rising demand for abortion care, and inequalities in access to sexual and reproductive health services, present significant challenges.
“Addressing the five priority areas set out in this manifesto will enable the next Government to deliver meaningful change where it is most urgently needed for women. We look forward to working with the next Scottish Government and our colleagues across Women’s Health and Maternity services in Scotland, to turn these ambitions into practical improvements in care.”
Dr Graham Leslie, Chair of the BASHH Scottish Branch, said: ““Sexual health and HIV services play a vital role in Scotland’s public health, yet they are operating in an increasingly challenging environment, exacerbated by workforce pressures and persistent inequities in access and outcomes.
“This manifesto sets out clear recommendations to strengthen prevention, expand access to testing and specialist genitourinary medicine, and deliver the HIV Transmission Elimination Plan. With sustained commitment and prioritisation, political leaders can deliver a legacy of world‑leading sexual health and HIV care for everyone who needs it across Scotland.”
Dr Tristan Barber, Chair of the British HIV Association (BHIVA), said: “BHIVA looks forward to ongoing commitment from the next Scottish Government in delivering success for the HIV Transmission Elimination Plan.
“This means funding and removing barriers to equitable access to prevention, testing, and treatment, making all readily available as a fundamental part of routine healthcare. We must also continue to challenge the persistent stigma that keeps key groups on the fringes of the health system, especially women and those from ethnic minorities.
“For those who acquire HIV, early testing and rapid engagement with treatment and care is crucial to both preventing onward transmission and enabling these individuals to live a long and healthy life.
“The next Scottish Government has an opportunity for Scotland to be the first UK nation to achieve the UNAIDS targets of zero HIV transmissions, zero HIV related stigma, and end late diagnosis and HIV related deaths. Scottish Government in achieving these goals.”
