Change can be unsettling, especially when the process seems to be occurring too quickly or, as ironically in Wales, too slowly. Back in 1999, the newly formed Welsh Assembly committed itself to improving the sexual health of the three million population of the principality. Wales at that time had eight consultant genitourinary physicians working in 14 clinics, rather than the 24 suggested by the Royal College of Physicians staff planning team based on consultants per head of population. In 2000 A Strategic Framework for Promoting Sexual Health was published.¹ The action plan aimed to:

• ensure all young people in Wales receive effective education about sex and relationships as part of their personal and social development

• ensure that all sexually active people in Wales have access to good quality sexual health advice and services

• reduce rates of teenage pregnancy in Wales

• reduce incidence and prevalence of sexually transmitted infections in Wales

• promote a more supportive environment that encourages openness, knowledge, and understanding about sexual issues and fosters good sexual health

• strengthen monitoring, surveillance, and research to support future planning of sexual health services and interventions.

In response, the 22 local health boards …