Chamber and committees

Thank you, Mr Sweeney. I think that you might have the same sense that I have that there is a lack of ownership of the actual direction of the pathway to a solution. That seems to be the point.

PE1865, by Roseanna Clarkin, Lauren McDougall and Graham Robertson, calls on the Scottish Parliament to urge the Scottish Government to suspend the use of all surgical mesh and fixation devices. I apologise for the fairly long preamble. The petition has had something of an airing in the Parliament in connection with the bill on compensation for transvaginal mesh surgery that was recently passed. The petition calls on the Parliament to suspend the use of surgical mesh and fixation devices while a review of all surgical procedures that use polyester, polypropylene or titanium is carried out and guidelines for the surgical use of mesh are established.

The petition was last considered on 17 November 2021 and at that meeting the committee agreed to write to the Minister for Public Health, Women’s Health and Sport and to the Shouldice hospital in Canada. Responses have been received from the minister, the Shouldice hospital, Sling the Mesh campaign and the petitioners.

I am delighted that Jackie Baillie is still with us this morning and I welcome Carol Mochan MSP, who joins us online; both members wish to speak to the petition. Before I bring in my colleagues, I will provide a little bit more of the background, which I apologised for the length of a moment ago.

In 2019, the Scottish Health Technologies Group carried out a review into the use of mesh in primary inguinal hernia repair in men. The review concluded that, compared to non-mesh procedures, using mesh resulted in lower rates of recurrence, lower rates of serious adverse events, and similar or lower risk of chronic pain. The advice for NHS Scotland was, therefore, that surgical mesh should be used in elective repairs in inguinal hernia in adult males.

The SHTG review was subsequently expanded to include women, examining the outcome of mesh versus non-mesh surgery in a variety of groin or abdominal wall hernias. The Scottish Health Technologies Group concluded that current evidence supports the continued availability of surgical mesh for elective repair of primary ventral hernias, incisional hernias, and primary inguinal hernias in adults in Scotland. The group recommends, however, that consideration should be given to patient preference and that patients should also have access to alternative hernia treatment options such as non-mesh—suture and natural tissue—repair.

The chief medical officer has also undertaken a number of activities relevant to the petition, including: writing to the board chief executives and medical directors to draw their attention to the SHTG report’s findings; asking health boards to consider the availability of non-mesh surgery within their health board, and how any skills gaps can be addressed; asking health boards to consider the development of local clinical groups and broader clinical networks for the management of complex cases; and asking medical directors to remind clinicians of their obligations under the principle of realistic medicine, of informed consent and of the importance of recording both the content and outcome of such discussions.

With regard to the issues raised about the quality and authenticity of certain materials being used, the minister states that the Scottish Government contacted the Medicines and Healthcare Regulatory Agency in 2018, which confirmed that there was no new evidence to prompt regulatory action and that the products in question remained acceptably safe when used as intended.

The committee also wrote to the Shouldice hospital in Canada, as the leading experts in natural tissue repair. In what I thought was a fascinating submission, Shouldice states that in its own practice, surgical mesh is not used unless absolutely necessary and that has led to it being used in less than 2 per cent of cases. The hospital specialises exclusively in abdominal wall hernia repair. It states that where the body’s natural tissue is strong enough to support the surgical repair, natural tissue repair should always be used and where underlying patient tissue is poor, surgical mesh may be necessary in some femoral and large incisional hernia repairs. All the hospital’s surgeons are trained to do a natural tissue repair as their first choice; natural tissue repair should be the first choice for all primary inguinal hernias, most recurrent inguinal hernias, most femoral hernias, most epigastric and umbilical hernias, and small incisional hernias.

Shouldice also notes that since mesh was introduced in the 1980s, the recurrence rate for inguinal hernia repair—more than 85 per cent of most of its hernia repair—has not improved. There has been a staggering increase in post-operative complications not seen prior to mesh. Chronic and debilitating pain and other severe complications such as mesh shrinkage, mesh migration, and related nerve entrapment are widespread. There are no side effects of tissue repair if it is done correctly. Training for surgeons on the natural tissue technique ranges from three months for an experienced fellowship general surgeon to six to nine months for an inexperienced general surgeon.

The Sling the Mesh campaign shared the results of its recent survey of its 9,300 members with experience of vaginal, abdominal, pelvic, rectal, hernia mesh and mesh following mastectomy. It notes that one in four have considered taking their life,?six in 10 suffer depression, one third have been forced to give up their work, one in four now need a stick to walk, and one in 14 now need a mobility scooter or wheelchair.

In their submissions, the petitioners welcome the information contained in the Shouldice hospital submission and ask for further information to be sought on the use of protacks, which are devices used to fix mesh to soft tissue. The petitioners believe that there is evidence to suggest that a considerable sum of money has been spent recently procuring hernia mesh and other fixation devices and they feel that that money could have been spent on investigating and teaching natural tissue repair. The petitioners also query why mesh is still being bought and why clinicians are not yet accurately and systematically recording the effects of such material on patients.

We have gathered quite a lot of evidence since we last considered the petition. I invite both Jackie Baillie and Carol Mochan to contribute ahead of comments from committee members.

I want to be clear. Are you recommending that we close the petition? The issues are sufficiently important that we would very much encourage the petitioner, Katrina Clark, to contribute to that inquiry, which will no doubt encompass related issues when it is convened in due course. Is that correct?

Our second continued petition is PE1855, which is on pardoning and memorialising those convicted under the Witchcraft Act 1563. The petition has been lodged by Claire Mitchell QC, and at this point I must, on behalf of the committee, apologise to her. There was an oversight, in that appropriate notice was not given about the petition coming back to the committee this morning, and the opportunity to submit further evidence to us was therefore lost. I think that, later in the proceedings, we will be seeking to keep the petition open, and we therefore look forward to receiving that submission.

PE1855 calls on the Scottish Parliament to urge the Scottish Government to pardon, apologise and create a national monument to memorialise those people in Scotland accused and convicted as witches under the 1563 act. We last considered the petition at our meeting on 1 September 2021, when we decided to seek further information from the Scottish Government and the petitioner on whether the royal prerogative of mercy could be used to achieve a pardon. The petitioner seeks three things—a pardon, an apology and a national memorial for those convicted under the 1563 act—and further detail on all of that has been provided to colleagues in their papers.

In relation to the pardon, the petitioner suggests that the royal prerogative of mercy is not a suitable vehicle for achieving the petition’s aim, stating that

“we are not looking for a pardon in individual cases by the Queen”

as

“The prosecutions were carried out by the Scottish State.”

The petitioner also states that an application to the Scottish Criminal Cases Review Commission to pardon individual people would not be competent as there would be

“no-one that could be considered to have a ‘legitimate interest’ in terms of the Criminal Procedure (Scotland) Act 1995”,

given the fact that centuries have passed since these events happened.

Instead, the petitioner suggests there is a need for the Scottish Government

“to legislate to provide a pardon for all those convicted.”

The petitioner draws parallels with the Historical Sexual Offences (Pardons and Disregards) (Scotland) Act 2018, which provided

“a collective and posthumous pardon.”

The petitioner suggests that the committee should ask the Scottish Government

“to provide a public apology to those convicted of witchcraft, making it clear that those convictions ought not to have happened and that these people were not witches.”

In its submission of 4 November 2021, the Scottish Government accepts that

“while the SCCRC can consider posthumous applications made on behalf of a convicted person ... by someone who would have standing to bring an appeal on their behalf, in practice, this will almost certainly not be possible”.

In terms of the royal prerogative of mercy, the Scottish Government advises that

“the First Minister will not generally consider recommending to Her Majesty a free pardon under the RPM process until the person’s appeal against their conviction has been dismissed, or leave to appeal has been refused, and any application to the SCCRC seeking to have the case referred to the Appeal Court has been rejected.”

In a further submission from the petitioner dated 5 December 2021, she suggests that the committee might wish to consider a committee bill on this topic. Since then, we have received a submission from Natalie Don MSP, who has indicated that she intends to bring forward a member’s bill to allow for a pardon to take place. However, she notes that the two other asks of the petition—that is, to seek a public apology and to create a national monument—will not fall within the scope of her bill.

I hope that my microphone has been working for the past several minutes, otherwise there is a lot that I will have to repeat. On the assumption that it has been, I ask members whether they have any comments with regard to the action that might be taken.

That being the case, although we note the BMA’s submission, we are minded to keep the petition open and to write to the Scottish Ambulance Service and the Scottish Government in the terms suggested by Mr Sweeney and supported by Mr Stewart. Is that agreed?

Members indicated agreement.

The next continued petition is PE1891, which was lodged by Lewis Alexander Condy and calls on the Scottish Parliament to urge the Scottish Government to ensure that all children have the opportunity to learn to swim by making it a statutory requirement to provide lessons in the primary school curriculum.

I am delighted to say that we are joined by our colleague Foysol Choudhury MSP. Good morning, Mr Choudhury. I will invite you to speak in a minute or so but, before I do so I will provide a bit more background to the following proceedings.

We previously considered the petition in November of last year, when we agreed to write to the Convention of Scottish Local Authorities to seek data on how many schools provide swimming lessons as part of the curriculum. We also wrote to the Royal Society for the Prevention of Accidents and Scottish Swimming.

COSLA’s submission states that, currently,

“There are no local or national mechanisms in place”

to collect the data, and notes that the delivery of swimming lessons can depend on factors such as access to facilities, cost and delivery model. The latest figures, which are pre-pandemic and are for 2018-19, suggest that

“21 Local Authorities were offering swimming activity through the Active Schools Network.”

Scottish Swimming notes in its submission that

“there were over 106,000 children enrolled in learn to swim programmes ... prior to the pandemic”.

The submission also highlights data that suggests that

“there is a direct correlation between a child’s socio-economic background and their opportunity to learn to swim.”

Scottish Swimming states that it has submitted a proposal to the Scottish Government in support of a programme of school swimming and is currently involved in discussions with sportscotland on its potential development.

We also received a submission from the Royal Society for the Prevention of Accidents, which highlights the need for any swimming programme to include consideration of outdoor water survival skills.

The petitioner suggests that the current policy of allowing councils to choose whether to provide swimming lessons is unfair, leading to many children missing out or being forced to take private lessons, which might be inaccessible to lower-income families or those living in rural areas.

Before I turn to members of the committee, I ask Mr Choudhury whether he would like to comment on the petition’s aims.

Thank you for those very helpful comments.

We have had quite a comprehensive discussion this morning. I see no indication that other committee members wish to come in, so I thank Foysol Choudhury for joining us this morning.

I think that we will keep Mr Condy’s petition open and write as David Torrance has suggested, but I suggest that we also include some of the themes that Paul Sweeney has talked about and highlight not just the teaching of swimming as people would traditionally think of it in controlled environments such as swimming pools but the life-saving benefits of what one might call, for want of a better description, wild swimming in its widest sense and as described in the conversation that we have just had. It might go slightly broader than the range of the petition, but we could look at what more might be done to progress the issue in a way that would save lives, even though ultimately the petition’s objective with regard to swimming pools is slightly impractical for certain local authorities. There is certainly a very important issue at the heart of this.

Do members agree to keep the petition open and to seek further information on the basis that has been proposed?

Members indicated agreement.

Once again, I thank Mr Choudhury for joining us this morning.

PE1912, on funding for council venues, has been lodged by Wendy Dunsmore. It calls on the Scottish Parliament to urge the Scottish Government to provide councils with the necessary additional revenue to run essential services and venues.

It is worth noting that the SPICe briefing on the petition, the Scottish Government’s submission and the petitioner’s submission were all written before the Scottish Government budget 2022-23 was published, which happened on 9 December 2021. Key points from a separate SPICe briefing on local government finance that was produced following the budget’s publication include the facts that, once additional revenue and capital grants are factored in, the total local government settlement increased by £603 million, or 5.1 per cent, between 2021-22 and 2022-23; and that there will be a real-terms increase in provisional revenue allocations for all local authorities, except Western Isles Council, Shetland Islands Council and Orkney Islands Council, which all experience small real-terms reductions.

In his submission, the Minister for Public Finance, Planning and Community Wealth highlights the 2021-22 settlement of £11.7 billion, stating that it provided “a cash increase” in local government spending. The petitioner’s submission is a collective response to the minister from Unite, Unison and the GMB. Although they recognise that local authorities make decisions about service provision and delivery, they note that those decisions are not without

“unfair challenges caused by a real terms reduction of funding”.

The petitioner’s submission also points out that, as much of the £11.7 billion settlement figure is ring fenced for Scottish Government commitments, it is therefore “not technically available” for local authority spending decisions.

I invite comments from colleagues.

Our last new petition is PE1916, which requests a public inquiry into the management of the Rest and Be Thankful project and was lodged by Councillor Douglas Philand and Councillor Donald Kelly.

As promised, I am delighted to welcome back Rhoda Grant for the final petition this morning. I will come to her shortly.

The petition calls on the Scottish Parliament to urge the Scottish Government to instigate a public inquiry regarding the political and financial management of the A83 Rest and Be Thankful project, which is to provide a permanent solution for the route.

Transport Scotland explains in its submission that, following a number of landslides across Scotland in 2004, a nationwide Scottish road network landslides study was carried out. The study concluded that the A83 Ardgartan to Rest and Be Thankful is one of the most highly ranked debris flow hazard sites in Scotland.

In 2012, Transport Scotland commissioned a study to identify and appraise potential options to minimise the effects of road closures. The final A83 route study, which was published in February 2013, explains that the decision was made to progress with the red option, as it was considered at that time to offer the best performance and the most cost-effective way of meeting the study’s objectives. Those objectives included maintaining the existing alignment of the A83 with a range of landslide mitigation measures such as additional debris flow barriers at locations where the landslide hazard was considered highest; the improvement of hillside drainage adjacent to and under the road; and the introduction of vegetation and planting on the slope.

In its submission, Transport Scotland provided a range of data that shows the number of days on which the various stretches of road in and around the A83 were closed due to landslides. The data shows that the events that occurred in 2020 and 2021 were significantly larger in scale than any of the previous events.

Following that, several new measures were introduced to make it quicker, easier and safer to open the road should it be closed by a landslide. In 2020, a consultation exercise was carried out to consider 11 route corridor options to address issues at the Rest and Be Thankful route. More than 650 people provided feedback, and the Glen Croe corridor was chosen as the preferred route.

The Transport Scotland submission advises that

“timescales for completion of a long term solution to the issues at the Rest and Be Thankful range from 7–10 years”.

In the interim, Transport Scotland advises that work is progressing

“to look at a medium term resilient route through Glen Croe”

and that

“that work will seek to develop a finalised proposal by Autumn”

this year. The submission states:

“Since the A83 Taskforce was set up in 2012, meetings have been held every 6 months”

and that “a substantial project update” is due

“at the next Taskforce meeting in early 2022”.

A project-specific web page has also been launched on the Transport Scotland website.

Against that background, I am happy to invite comments from Rhoda Grant.