Scottish Government high level action plan in response to the Committee on Economic, Social and Cultural Rights

17: Health and access to healthcare

Thematic Tags

Right to health; Mental health; Rurality; Gypsy/Traveller ; Migrants; Refugees and asylum seekers; LGBTQI+; Gender identity; Maximum available resources; Digital access

Concluding Observation 51a

The Committee recommends that the State Party, along with the devolved governments […] Strengthen measures to ensure universal health coverage in practice by increasing resources for the National Health Service, securing sufficient qualified medical staff, ensuring access to adequate medical equipment and infrastructure, reducing waiting times, improving health services in remote and rural areas and removing stigma and informational and technological barriers to access to health for Gypsy, Roma and Traveller communities, undocumented migrants and asylum-seekers and to lesbian, gay, bisexual, transgender and intersex persons in relation to gender identity-related healthcare, particularly in Scotland, guided by the Committee’s general comment No. 14 (2000) on the right to the highest attainable standard of health.

Context

We acknowledge that the National Health Service (NHS) needs renewal and reform to remain sustainable amid rising demand. On 27 January 2025, the First Minister outlined plans for health service renewal, to ensure long-term sustainability, reduce inequalities, use digital technology effectively, and improve health outcomes. In March 2025, we published the Operational Improvement Plan aimed at enhancing healthcare delivery by improving access to treatment, reducing waiting times, and shifting care from hospitals to primary care. This plan is backed by an investment of £200 million.

In June 2025, we jointly published two frameworks with COSLA. The Population Health Framework focussed on prevention, taking a cross government and cross sector approach to improving the key building blocks of health and reducing health inequalities for the next decade; and the Health and Social Care Renewal Framework focused on prevention and community involvement to enhance the sustainability, efficiency and accessibility of health and social care services in Scotland.

We are implementing targeted strategies to reduce health inequalities by ensuring timely care for those most in need. Since 2023, we have invested over £3 million in the highly targeted Inclusion Health Action in General Practice (IHAGP) programme, which provides additional funding to over 60 general practices in high-deprivation areas in the NHS Greater Glasgow and Clyde Health Board, which has the highest concentration of refugees and asylum seekers in Scotland. IHAGP implements practices to tackle healthcare and health inequalities through practical actions. The Equity in Screening Strategy and Action Plan (2023-26) aims to address disparities across national screening programmes for better access and outcomes among underrepresented groups.

Since December 2022, we have invested over £6.3 million to support work to improve the delivery and accessibility of NHS gender identity services in Scotland. More than £5.2 million of this has been allocated directly to NHS health boards with gender identity clinics, to support them to increase their capacity and reduce waiting times. In 2023, we awarded a grant of £256,000 to the University of Glasgow to establish an ongoing programme of research on long-term health outcomes for people who access gender identity healthcare in Scotland.

Key Actions

We are allocating £21.7 billion in 2025-26 for health and social care, with over £110 million directed at reducing the longest waits in specialties like trauma and orthopaedics, imaging, cancer treatment, and ophthalmology, as well as funding an additional 213,000 appointments, surpassing our target by over 60,000.

We are providing £200 million in funding to increase capacity, reduce delayed discharge, and enhance patient flow. National Treatment Centres (NTCs), a network of healthcare facilities across Scotland which provide extra capacity for planned in-patient care and day case treatments and diagnostic services, will further boost care, particularly for long-waiting patients. NTC activity is projected to grow from 20,000 procedures in 2024-25 to over 30,000 in 2025-26.

We will develop a Healthcare Inequalities Action Plan by the end of 2027. This will include actions such as developing the General Practice Healthcare Inequalities Programme to reduce barriers to accessing care; developing practical guidance on equitable care, including guidance on addressing causes of low engagement in healthcare; and supporting health inequalities training and education for health, social care and social work professionals.

We continue to invest in general practice Community Link Workers (CLWs) through the Primary Care Improvement Fund. We have invested over £12 million on CLWs to sustain service levels. There were 342 whole-time equivalent CLWs in post at 31 March 2025 and we are reviewing national policy to better align CLWs capacity where there is greatest need, primarily areas of high deprivation.

We are funding the Scottish Deep End Project £124,371 in 2025-26. The Project supports GPs working in some of Scotland’s most deprived communities through peer support, practice-sharing and research, with the aim of improved health outcomes for patients.

We are funding the National Centre for Remote and Rural Health and Care £3 million to March 2026. This centre is supporting the delivery of improved care for remote, rural and island communities across Scotland, with a focus on reducing health and wellbeing inequalities and improving primary care and community-based workforce and service delivery.

We are contributing £155,000 in 2025-26 towards the funding of the Community Health Workers programme. The programme is led by the Minority Ethnic Carers of People Project and supports Gypsy/Traveller communities across several health board areas. Community health workers are members of the Gypsy/Traveller community who play a pivotal role in acting as a bridge between the community and the health system to improve healthcare access and break down barriers.

We continue to fund LGBT Youth Scotland over £68,000 in multi-year funding as part of our action to implement the Sexual Health and Blood Borne Virus Action Plan. LGBT Youth Scotland are working to ensure that LGBTQI+ young people have improved awareness around sexual health and wellbeing and increased access to this information to address inequity in sexual health care.

We have established a ‘Task and Finish’ group to design a sustainable long-term model for young people’s gender identity services. The model will emphasise holistic, person-centred care and shared decision making and will be shaped by the recommendations in the Chief Medical Officer’s Cass Review report. The group is expected to sign off on a new target operating model for young people’s gender identity services by the end of 2025.

We will drive improvement following the publication of an independent evaluation in August 2025 of the impact of our funding to health boards for improvement work to their gender identity clinics. With our NHS partners, we will continue to work constructively and collaboratively to address issues and build on improvements to date.

Concluding Observation 51b (Mental Health)

The Committee recommends that the State Party, along with the devolved governments […] Strengthen mental health services and support systems by allocating sufficient resources, strengthening community-based support, undertaking initiatives to destigmatize mental health issues and implementing targeted measures for groups disproportionately affected by mental health problems.

Context

Our joint Mental Health and Wellbeing Strategy with COSLA sets out our long-term vision and approach to improving the mental health and wellbeing of everyone in Scotland. The delivery plan and workforce action plan detail the initiatives underway to address each of the strategy’s ten priority areas. To ensure effective governance and oversight, we have formed the Mental Health and Wellbeing Leadership Board which consists of diverse partners from the public, private, and third sectors at both local and national levels to support the delivery of the strategy, delivery plan, and workforce action plan.

Our ten-year suicide prevention strategy and action plan set out a clear plan to reduce suicides in Scotland and to address the inequalities which can contribute to suicide. To ensure that our suicide prevention work has real impact, our approach prioritises people who live in high-risk settings, for example prisons and those who have a higher risk of suicide, like Gypsy/Traveller communities. We have doubled investment in suicide prevention to £2.8 million and we are working closely with COSLA to set out a clear plan to reduce suicides in Scotland and address the inequalities which lead to suicide.

We recognise that social isolation and loneliness is a public health issue, which can affect anyone at any age or stage of life. In March 2023 we published our Social Isolation and Loneliness Plan (2023-2025) to take forward the delivery of our strategy for tackling social isolation and loneliness and building stronger social connections. Within the first 100 days of the Parliament, we provided £1 million to support projects tackling social isolation and loneliness, including helplines, befriending, and practical support.

Key Actions

We will develop a refreshed Mental Health and Wellbeing Strategy Delivery Plan in 2026. It will contain a focused selection of strategic actions that will make the most significant progress towards our overall vision for health and social care reform, including strengthening mental health services and support and tackling stigma.

We will also publish a renewed Suicide Prevention Action Plan covering 2026-29 in 2026, ensuring it builds on the progress we have made to date, and maximise our shared impact in reducing suicide deaths.

We will fund the Mental Health and Wellbeing Fund for Adults through the Fairer Funding for the Third Sector Pilot which has been allocated a further £15 million in 2026-27.

We continue to work with NHS boards to meet the Child and Adolescent Mental Health Services waiting times standard (that 90% of children and young people start treatment within 18 weeks of referral) and clear backlogs by December 2025. Despite the standard being met nationally in the last three quarters, performance still varies across NHS boards. We are providing enhanced support to those not on track to meet the standard, providing access to professional advice, and ensuring they have robust improvement plans in place, and monitoring their implementation. We have also commissioned and reviewed performance trajectories for when NHS boards will meet the standard and clear long waits.

We published the National Specification for Eating Disorders in November 2024 to support both the NHS and local services to deliver person-centred, safe and effective care for children, young people and adults. We continue to work closely with NHS boards to support the specification’s phased implementation, and to improve services and support for people impacted by eating disorders in Scotland. We have also established the National Eating Disorders Network which will further support implementation.