Chamber and committees

The final continued petition that we are considering this morning is PE1845, on an agency to advocate for the healthcare needs of rural Scotland. For the petition, we are joined again by Emma Harper MSP and Rhoda Grant MSP. You are competing with each other this morning to ensure that you are with us for the same number of petitions, but we are glad to have both of you.

The petition was lodged by Gordon Baird on behalf of Galloway community hospital action group and it calls on the Scottish Government to create an agency to ensure that health boards offer fair and reasonable management of rural and remote healthcare issues. The petition was first considered in January 2021 and the clerk’s note outlines the work that the session 5 committee carried out on the petition.

The written submissions on the petition highlight some of the issues experienced by rural and remote communities as they try to access medical care, including patients being required to take long, often awkward journeys for not only critical care but routine out-patient appointments, of which I think we have all heard examples from colleagues in the chamber at various question times; outreach clinics to rural communities being dependent on individual consultants rather than organised programmes; and a failure by key organisations to understand the importance of dispensing GPs to rural and remote communities.

In alphabetical order, I will take Rhoda Grant first.

Item 2 is consideration of new petitions. It might be useful for anyone who is following the proceedings to know that, as a standard working practice, the committee used to meet and then agree to ask the Scottish Government for its views on a petition. Now, as a matter of course, the committee writes to the Scottish Government and other stakeholders to ask for their views on petitions, in order that, when considering a petition, the committee is as informed as possible for each meeting. I would not want anyone who is following our proceedings or any petitioner to think that that unduly influences the committee’s subsequent discussion or consideration. It allows us to have at least a basic understanding of the Government’s reaction to the petition, along with the response of other stakeholders.

The first new petition, PE1854, which has been lodged by Keith Park on behalf of the MS Society, calls on the Scottish Government to

“remove the 20 metre rule from the proposed adult disability payment eligibility criteria or identify an alternative form of support for people with mobility needs.”

The adult disability payment is due to replace the personal independence payment in Scotland from summer 2022, following a pilot scheme that will take place in spring 2022. Under the principle of safe and secure transition, the Scottish versions of the Department for Work and Pensions disability and carer benefits will, at least in the short term, have much the same rules as their DWP equivalents. In its submission, the Scottish Government states that it consulted on the draft regulations for adult disability payments between 21 December 2020 and 15 March 2021. The Scottish Government has advised that it will review the responses to the consultation and, if required, adjust the draft regulations in light of the feedback.

The Scottish Government’s submission highlights that the DWP has been clear that, in order for ADP to be considered a comparable benefit to PIP, and to ensure that Scottish clients remain entitled to various reserved payments, it must be delivered on a “like for like basis”. The submission notes that

“any changes which widen eligibility risk DWP deciding that ADP is not a comparable benefit to PIP and withdrawing automatic entitlement to reserved payments from Scottish clients.”

As such, it advises that while the period of transition from PIP to ADP is on-going, it has decided

“not to make any significant changes to eligibility criteria before ADP is launched.”

The submission advises that the Scottish Government is focusing on the significant changes it can make

“to how disabled people in Scotland experience accessing disability assistance, such as providing additional application channels and replacing assessments with person-centred consultations.”

The Scottish Government has committed to facilitating an independent review of ADP in 2023, one year after delivery has begun, which it believes will enable all of the eligibility criteria to be considered

“in the round rather than any changes being made in a piecemeal way.”

In their submission, the petitioner points to the Scottish Government’s consultation on proposals for ADP, highlighting that, in their responses, people with disabilities and organisations working on their behalf identified the need to remove the 20m rule. The submission notes that in the Scottish Government’s proposals for ADP, it is not argued that the rule is an effective way to measure mobility.

In response to the risk of ADP not being considered a comparable benefit to PIP, the petitioner argues that changing the 20m rule to a 50m rule would not impact on passported benefits on the basis that an enhanced rate of mobility, compared with the standard rate, does not entitle individuals to any additional DWP benefits.

That is quite complicated, but also direct. Do members have any comments?

PE1865 calls for the suspension of all surgical mesh and fixation devices. It is a new petition and has been lodged by Roseanna Clarkin, Lauren McDougall and Graham Robertson. The petition calls on the Scottish Government

“to suspend the use of all surgical mesh and fixation devices while ... a review of all surgical procedures which use polyester, polypropylene or titanium is carried out; and ... guidelines for the surgical use of mesh are established.”

In his submission, the Cabinet Secretary for Health and Social Care has stressed the seriousness with which the Scottish Government takes all issues relating to mesh. He has outlined the actions that the Scottish Government has taken in relation to the use of transvaginal mesh for the treatment of stress urinary incontinence and pelvic organ prolapse. We discussed those things in our consideration of the first petition this morning.

The cabinet secretary has also highlighted the high vigilance scrutiny protocol, which was introduced for some other procedures, including abdominally inserted mesh for pelvic organ prolapse, and the research that was commissioned by the Scottish Government into the use of mesh in inguinal hernia repair, which concluded that

“mesh resulted in lower rates of recurrence, fewer serious adverse events and similar or lower risk of chronic pain”

than non-mesh procedures. As a result, the cabinet secretary does not believe that there is evidence to justify a pause in the use of relevant devices.

In response, one of the petitioners has highlighted the many personal testimonies that have been shared with the committee, detailing the life-changing effects of having mesh procedures. The submission suggests that not all patients are being given sufficient information to be able to give fully informed consent. Neither does it seem that all surgeons are clear about when it is appropriate to use mesh.

Since the publication of our papers, we have received two additional submissions from the petitioners. The first details key questions to which the petitioner seeks answers. The second highlights the importance of the Cumberlege review and asks why more progress has not been made in delivering on its recommendations—which, from memory, I believe the Scottish Government accepted, in full, in a response that it made in the chamber.

It is important also to emphasise, for those who have followed mesh procedures historically, that the petition relates to all mesh procedures—for men, women and children—and is distinct from the petition that we considered previously, which related to issues that affect women’s health exclusively.

The petition is new and is important. Do colleagues have any proposals that we might consider?

I am happy to do that and to keep the petition open on that basis. Is that agreed?

Members indicated agreement.

I am struck by the words in the response from the cabinet secretary that there are

“fewer serious adverse events and ... lower risk of chronic pain”

than for non-mesh procedures. I think that we received exactly the same testimony in relation to the original mesh petition at the first point of hearing. Until people knew that there was an issue to speak out about, it was not much in the public domain.

I think that the committee is inclined to make such a request. We might say that we will raise progress on the recommendations that the Cumberlege review made on mesh at the same time as we pursue the fresh issues.

PE1866, which was lodged by Daryl Cooper, calls on the Scottish Government to introduce legislation so that wheelchair users can face frontward when travelling on a bus.

The Scottish Government has explained that legislation that governs bus travel for wheelchair users is reserved to Westminster and is dealt with in the Public Service Vehicles Accessibility Regulations 2000. The submission highlights that, as part of the UK Government’s recently published national bus strategy, “Bus Back Better”, it has committed to completing a review of the regulations by the end of 2023. The review is expected to be wide ranging and to consider the extent to which the regulations effectively support access to services and how they could be improved.

In response, the petitioner has highlighted that the regulations are in place

“to enable disabled people to travel safely and in comfort.”

He argues that being forced to travel in a rear-facing space might not be comfortable for disabled people and that it should not be for bus operators to choose whether wheelchair spaces are rear facing. Do members have comments?

Our final new petition this morning is PE1868, which was lodged by Laura McKain and which calls on the Scottish Government to provide support to single parents by increasing the council tax discount available to single parents from 25 per cent to 50 per cent and lobbying the UK Government to create a working single parent tax allowance and a household income-based child benefit.

In its submission, the Scottish Government highlights its commitment to reforming council tax and measures that it has in place to support low-income households. Those include the council tax reduction scheme, which provides relief to just under 500,000 low-income households, and the Scottish child payment, which pays £40 per week per eligible child. The Scottish Government has committed to extending eligibility to under-16s by the end of 2022. The Scottish Government argues that the Scottish child payment, alongside the best start grant and best start foods, could provide more than £5,300 of financial support to families by the time that their first child turns six.

Having had a chance to consider the submissions, I wonder what suggestions members might have as to how to proceed. It is quite a complicated matter. There appears to be a determined course of action that has been put in place by the Scottish Government. It has committed to extending eligibility. It does not have the competence to intervene on matters relating to UK income tax if they are beyond the responsibility of the Scottish Parliament. The Scottish Government has indicated that it is supporting 500,000 low-income households.

As important as the issue is, I am not immediately clear as to what further course of action lies open to us, having now sought and obtained the views of the Scottish Government. I do not know whether colleagues are minded to close the petition on that basis, or whether you feel that there is some further avenue that we could possibly explore.

You made reference to a survey. Is that a new survey?

I am pleased to say that Rhoda Grant has a season ticket to the Citizen Participation and Public Petitions Committee this morning. She joins us, along with Liam McArthur MSP, for petition PE1804, which is on Highlands and Islands Airports Ltd’s air traffic management strategy. The petition, which was lodged by Alasdair MacEachen, John Doig and Peter Henderson on behalf of Benbecula community council, calls on the Scottish Government to halt HIAL’s air traffic management strategy project and to conduct an independent assessment of the decisions and decision-making process of the ATMS project.

The clerk’s note summarises the extensive actions that were taken on the petition during session 5, which included holding oral evidence sessions with the petitioners, representatives of HIAL and the then Cabinet Secretary for Transport, Infrastructure and Connectivity.

Since the petition was last considered, we have received four submissions: two from HIAL, one from the cabinet secretary and one from the petitioners, all of which have been circulated as part of our meeting papers.

I invite our two visiting MSP colleagues to comment before committee members do so. Since he has been waiting for his moment in the sun, I invite Liam McArthur to comment first.