Chamber and committees

Perhaps, as I have come to the matter as a consequence of the petition and have followed some of the work that has gone on in the Parliament, I can ask a question that will help me understand the broader issue. Do we know how many people are diagnosed as autistic in Scotland? If so, do we know whether there are any regional variations? You have mentioned the disparity of approach between local authorities, but does that influence our understanding of the number of people diagnosed with autism or is that not a by-product of the variable approach? Do we have a fairly clear idea about this?

Thank you very much. At this point, I should tell the committee that we will be taking evidence from ministers at about 11.30.

David, you have already suggested that we write to Police Scotland, the Crown Office and Procurator Fiscal Service, the Equality and Human Rights Commission and the Scottish Courts and Tribunals Service. We agree to do that. On the back of my comment, you have suggested that we also write to the Scottish Government to ask for validation of the actual prosecutions that have taken place in such circumstances. I presume that, when the Scottish Government talks about the use of prosthetics, such a crime could be committed by a male or a female. I would like to understand the reality of the analysis, rather than just the theoretical and technical aspects of the issue.

May I interrupt? Terry O’Kelly has now joined us on audio. Given that you have just addressed that point, perhaps he will elaborate on it.

I have two brief supplementary questions, after which I will go back to the minister and then to other colleagues.

First, what is the timeline for introducing the pathway for recording information? Secondly, you referred to the transformational advance that you felt was made by the introduction of mesh. Do the skills still exist for a non-mesh surgical option to be offered?

If Hugh McAloon and Jacqueline Campbell want to come in at any point, they should try to catch my eye through the perspex screen between us. I can just about see you, despite the reflections.

Thank you, minister. I acknowledge and applaud the Government’s forthcoming bill on transvaginal mesh. That is a complete and comprehensive response to an earlier petition that, in the light of the bill, we were able to close at an earlier meeting. That petition was lodged by Elaine Holmes, one of my constituents, and Olive McIlroy. Having spoken to them, I know that they are really pleased. They have had meetings with the Cabinet Secretary for Health and Social Care and have been reassured by the approach that the Government is taking.

My final point in relation to transvaginal mesh is that, at a recent meeting of the Parliament’s cross-party group on chronic pain, which I attended, although there was enthusiastic recognition of the bill, one or two women were concerned that some of the problems that had been experienced some years ago, with clinicians suggesting that some of the problems were illusory, were resurfacing and that they were being encouraged to request a mesh option. I point that out to the minister. It would be helpful to ensure that, at all times, we do not lose sight of future concerns of women who might be considered for such an option, given the various actions and prohibitions that the Government has put in place. I know that redress, recovery and restitution will be at the heart of the forthcoming bill.

When we first considered transvaginal mesh, there was a claim that there was a lack of evidence to support the concerns of the original petitioners and an assertion that there was an appropriate level of informed consent. I am struck that those two phrases reappear in the submissions that we have received. There is mention of a lack of evidence of concern about the use of mesh more widely, particularly in males. We know that men can, in general, be less forthcoming about their health concerns. I know that many men watched with interest the way in which women were able to come together and represent effectively the issues relating to transvaginal mesh.

The cabinet secretary referred to the lack of evidence, and the minister referred to the Scottish Health Technologies Group’s report, which says that the advice for NHS Scotland was that

“surgical mesh should be used for elective repair of inguinal hernia in adult males, following a process of shared decision making and informed consent.”

What process is in place to identify difficulties that have arisen? There was no such process for women in relation to transvaginal mesh. What is the process of giving informed consent? In the case of mesh in women, the process was published, was available in general practitioner surgeries and was very much to the fore of conversations that subsequently took place with patients. With respect to the matter that we are considering today, how are those two issues properly covered and reflected?

Do you have a supplementary, Mr Sweeney?

Do members have any other comments?

Yes, we can do that, too.

We will keep the petition open, as it touches on issues that require to be clarified. We will consider the petition again when we have received responses from the various parties to which we have agreed to write.