Thank you, Deputy Presiding Officer. In November 2016, the then Minister for Social Services and Public Health, Rebecca Evans, commissioned Public Health Wales to undertake a comprehensive review of sexual health services in Wales. The year-long review was carried out in consultation with a wide range of stakeholders, and overseen by a sexual health programme board, chaired by the chief medical officer. The final report has been published today, and I'd like to thank Public Health Wales for the collaborative way in which they have undertaken the review, and, of course, all those people who contributed to the review.

The Welsh Government remains committed to the continual improvement of sexual health and well-being in Wales, and to the provision of services that meet the needs of our population. Here in Wales, we have made tremendous strides in recent years in reducing teenage pregnancies. There was a 50 per cent reduction between 2010 and 2016, from 2,081 teenage pregnancies in 2010 to 1,061 in 2016. But the number of sexually transmitted infections in Wales remains considerable. In 2016, there were more than 12,000 infections diagnosed in the 64,000 people who sought care.

Chlamydia remains the most common infection, although we continue to see both syphilis and gonorrhoea in those who engage in risky sexual behaviour. Sexual health services in Wales also continue to diagnose new cases of HIV. The maximum number of new diagnoses of HIV in any one year was in 2014 when 186 new cases were identified. By 2016, this number of new cases was 141. The downward trend needs to continue. Last year, I decided to begin a national trial in Wales to deliver pre-exposure prophylaxis for HIV. This has been very successful to date, and there have been no new cases of HIV in those receiving PrEP.

Studies show that the majority of sexually transmitted infections can be prevented. If prevented or treated early, the chances of experiencing medical problems can be greatly reduced. Those healthy outcomes can only be achieved if all individuals have access to responsive services. The Public Health Wales report acknowledges the significant contribution that sexual health services in Wales make to the prevention and the treatment of sexually transmitted infections, and the provision of contraception. The sexual health workforce in Wales are committed to deliver excellent services against ever-increasing demand. The recent successful introduction of PrEP in Wales is a further tribute to the professionalism and the dedication of that workforce.  

My vision for sexual health services in Wales is one of modern services meeting the needs of all users. The review identifies a number of areas for further improvement, which will help to achieve this, particularly in respect of access and inequality. And the review recognises the needs of particular groups and how they access services. It also highlights the variation in ease of access to services and in some service provision across Wales. There are some communities disadvantaged through a lack of service provision, in particular rural communities and prisoners, and there is an inequity of provision of termination of pregnancy services. The report recommends that, as a priority, health boards in Wales have a robust understanding of the needs of their population and systems, and put resources in place to deliver services to marginalised and vulnerable groups more widely.

In addition, all health boards will want to understand, and I would expect them to understand, the contribution that the implementation of new patient pathways and technologies—for example, online triage, self-testing and point of care tests—could make to improving patient experience and reducing some of our current service pressures. The report also points to the need for enhanced surveillance systems that support all-Wales data collection by having a common IT platform supporting specialist sexual health services.

An important element of the review was to consider the current arrangements in respect of sharing of patients’ sexual health records between sexual health clinicians and wider healthcare providers. The review concludes that relevant information should be shared amongst the healthcare professionals who have a relationship with the individual patient and that consideration should be given to revising or replacing the existing legislation governing information sharing.

Whilst there is a wide range of groups and partners that have a role to play in improving sexual health, the report highlights the potential for an enhanced role for primary care and community pharmacies in sexual health provision. An example could be in delivering over-the-counter oral contraception and to extend the provision of long-acting reversible contraception.

I have listened very carefully to the views of clinicians, women’s groups and the views from across this Chamber. I have instructed officials to start work immediately on how we can amend the legal framework to allow for the treatment for termination of pregnancy to be carried out at home, in line with recommendation 7. Termination of pregnancy is a legal healthcare entitlement in Wales and a woman’s right to choose must be respected and access to services improved.

My officials will now work with stakeholders to develop a fully costed and timetabled implementation plan. The sexual health programme board, chaired by the chief medical officer, will remain in place to support and oversee implementation of the service improvement recommendations over a two-year period. I will of course ensure that Members receive regular updates on the progress of implementation.