Chamber and committees

Are we content with those proposals? We will keep the petition open and we will write to the organisations as summarised. I thank Mr Whitfield for joining us this morning. We will hear and consider the petition further when we have received responses to those inquiries.

That concludes the open part of this morning’s meeting. I thank those people who have been following our proceedings and we will now move into private session.

PE1860, which was lodged by Jennifer Morrison Holdham, calls on the Scottish Parliament to urge the Scottish Government to amend the Prescription and Limitation (Scotland) Act 1973 to allow retrospective claims to be made.

The petition was last considered on 17 November. Members will recall that, in her previous submission, the Minister for Community Safety advised the committee that the Scottish Government does not hold data relating to the exercise of section 19 of the Prescription and Limitation (Scotland) Act 1973 and that the Scottish Courts and Tribunals Service cannot interrogate the information that it holds, as it is held in a court interlocutor. The committee therefore agreed to write to the minister to ask how the Scottish Government intended to address the data gap identified by the petition. I think that we were all quite surprised by that. The minister promised to write once again to the Scottish Courts and Tribunals Service to raise the issue with it.

The minister also notes that section 19A empowers the court to disapply the time limit and that this discretion is unfettered, stating:

“what matters is the circumstances in which the courts have exercised the discretion, not necessarily the number of times it has been exercised.”

I thought that the response that we received from the minister was the one that we might have hoped to receive the first time round. Are there any comments?

Indeed. I do not know when we can expect the minister will have written, but we will chase that up until we get an understanding of what has progressed.

We move on to consideration of continued petitions. The update that I have to give on one or two of the petitions is quite lengthy, so I apologise in advance for giving uninterrupted speeches—I do not often make those in the chamber.

Our first continued petition is PE1804, which was lodged by Alasdair MacEachen, John Doig and Peter Henderson on behalf of Benbecula Community Council. The petition calls on the Scottish Parliament to urge the Scottish Government to halt Highlands and Islands Airports Ltd’s air traffic management strategy project and to conduct an independent assessment of the decisions and decision-making process of the project.

I am delighted to welcome Liam McArthur, who joins us online this morning, and Rhoda Grant, who is back with us in the committee room. Both are with us to speak to the petition. Before I come to them, I will offer a little more background.

The Scottish Government’s latest submission provides an update following the assurance of action plan that was conducted in the week commencing 25 October. The plan was set in the context of HIAL’s announcement that a framework for discussion had been agreed with Prospect, the trade union, to establish a new way forward for the implementation of the ATMS programme. It noted that programme delivery activities were largely paused to enable further delivery options to be appraised.

The submission confirms that the digital assurance office, the portfolio, programme and project assurance team and HIAL would continue to liaise to ensure that appropriate assurance arrangements are planned in as decisions are taken on the programme’s direction.

In its most recent submission, HIAL explains that, as a result of those developments, all industrial action was suspended while talks continued. In addition, new ATMS working groups were established with 27 air traffic colleagues from across several airports to help detail the benefits and risks of a potential way forward. The first of those groups met on 6 December.

At the end of January, HIAL announced that the HIAL board had agreed

“the future strategic direction for the ATMS programme. This will comprise a centralised surveillance operation for Sumburgh, Kirkwall, Stornoway, Inverness and Dundee airports, based at HIAL’s existing approach radar facility on the Inverness Airport Site. Air traffic tower services will continue to be provided locally at each of these airports.”

A late submission from one of the petitioners, commenting on the detail of that announcement, has been circulated to members. In summary, the petitioner raises concerns about the timescales for the new developments; the £9 million that has been spent so far; the implementation of surveillance radar; the timeline for Inverness to be granted controlled airspace; whether HIAL intends to introduce controlled airspace at Dundee, Stornoway, Kirkwall and Wick and, if so, when; and moving Benbecula and Wick from air traffic control to aerodrome flight information service. He is also concerned about what will happen to New Century house, the building that was bought to house the combined surveillance centre and remote tower centre.

The petitioner asks the committee to correspond directly with the Civil Aviation Authority regarding the issues raised and would welcome the opportunity to discuss his concerns with the committee in person. I understand that we heard from the petitioner two years ago.

Like others, I got quite excited when I saw “Reporting Scotland” feature announcements in relation to the petition and thought that maybe we were seeing progress of some kind. However, the petitioners are underwhelmed, to say the least.

Before the committee considers the petition, ask Liam McArthur and Rhoda Grant whether there is anything that they would like to update us on, although we do not want to hear the original submissions all over again. Mr McArthur, I will come to you first. Is there anything that you would like to update us on?

Do committee members wish to comment?

I thank Jackie Baillie for her helpful and comprehensive suggestions. Our original thought was that we might write to the cabinet secretary again but, given the focus in Scotland on the environmental agenda and the importance of the issue, it seems to be the sort of issue that the committee was designed to pick up, make some running with and interrogate in some detail.

I welcome the suggestion that we have the cabinet secretary before us, and I am happy to concur with the other suggestions that Mr Sweeney made. The photographs that we have been given are helpful in illustrating what an invasion can look like. I am happy for the cabinet secretary to have sight of those before she comes to give evidence, so that there is an understanding of the practical reality.

Were the petitioners responsible for those photographs, Ms Baillie?

Unfortunately, Mr McArthur has been called to another meeting, so we do not have his further contribution to hear. Do members of the committee want to comment?

Do members agree with that suggestion? We could reference the members’ business debate to which Mr Allan drew attention. There is wide cross-party interest in the issues underpinning the petition. We will see what the cabinet secretary says in response. It may well be that that leads to an evidence session on the issue at a later date.

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.