Chamber and committees

The bill is about reimbursement for women who have already paid for surgery. You represent the specialist mesh centre in Greater Glasgow. I read that 20,000 women had mesh implants in Scotland in the past 20 years and that some 600 have suffered agonising or debilitating complications. Can you assure the women watching this meeting that the specialist mesh centre will take a clear, person-centred approach? That would address some of the issues. Jackie Baillie mentioned one woman whose appointment will not be until July 2022. Is there a way to expedite that, so that there will be a truly person-centred approach?

Good morning, cabinet secretary, and thank you for giving us your time this morning. Given that the bill is on cost reimbursement for mesh removal, I am interested in women who have been affected and have already paid for surgery. Would women who raised the money through a crowdfunding platform still qualify for reimbursement?

Are you saying that women would not be excluded if they had been partially funded through a crowdfunder but were able to supply evidence that they had paid for a flight or transport or whatever from their own means?

Good morning, everybody. I am interested in how the fact that the specialist mesh removal service exists has been communicated to the health boards. How do they know that it exists?

I have a couple of wee follow-up questions. Last week, we heard that some general practitioners might need help to diagnose mesh complications. What help is being provided to primary care to enable GPs to know that the service exists? What help and support will be given to GPs so that they are better able to refer?

I welcome the opportunity to speak in this important debate and I congratulate my colleague Collette Stevenson on securing it.

Menopause matters. I agree that menopause has always been, at best, stigmatised, ignored or treated as a joke—aye, Rona Mackay is right—and, at worst, used as a way to degrade women.

Women are not a homogeneous group, and the impact of the menopause can be very different—there is certainly no one-size-fits-all experience. Menopause treatment, too, can vary significantly; it is a complex area, with new observations and medical advances continually being made.

I welcome that the Scottish Parliament was the first Parliament in the UK to hold a Government debate on the menopause. That debate, in 2019, was led by Christina McKelvie, as members said. I also welcome that a Scottish National Party Government was the first Government to direct national attention to reducing menopause stigma and improving treatment. It was right to do so.

Some women experience menopause at a significantly younger age, either naturally or because of surgical or medical intervention, for example as a result of an oophorectomy as part of cancer treatment. For many women—around 10 per cent, according to research from the University of Manchester—the negative impact of the menopause is life changing. As Gillian Mackay rightly said, it can even prevent women from attending work.

Research that informed the Scottish Government’s women’s health plan, which sets out action to tackle menopause stigma and support women who are going through the process, highlighted that women and girls are unprepared for the changes that menopause causes and often experience menopause in silence. I welcome that the Scottish Government’s work is beginning to make a difference by making menopause the subject of national debate—just as we are doing here, right now.

Collette Stevenson, Gillian Martin and Rona Mackay said that we need more research. I highlight the work of Dr Lisa Mosconi, a neuroscientist at New York University who specialises in the study of women’s brains and the impact of the menopause. Dr Mosconi’s research presents the relationship between menopause and Alzheimer’s disease and shows that women’s brains age differently from those of men, due to the brain’s interaction with hormones. For example, men have a lifetime’s supply of testosterone, on the whole, whereas a woman’s supply of oestrogen reduces at around 50 years old—although that age is not set in stone.

The key side effects of the menopause, which members described—night sweats, hot flushes, memory lapses, anxiety and insomnia—start not in the ovaries but in the brain. Oestrogen increases cerebral blood flow and aids in the provision of glucose to the brain, so without it the neurons can start to slow down and age more rapidly. In some cases, that can lead to the development of amyloid plaques, which are a key indicator of Alzheimer’s disease. Plaques might affect the brain’s hypothalamus, which controls the body’s temperature, thereby causing hot flushes and so on.

I find Dr Mosconi’s research very interesting. She has said that more research needs to be done. There should be a continued focus on the complexity of menopause and its impact on some women and not others.

Menopause is a medical process, as members said. It is a normal fact of life and we need to discuss it. I welcome the Scottish Government’s women’s health plan, which commits the Government to ensuring that women have access to specialist menopause services for advice and support if they need such services in the context of menopause diagnosis and management. I also welcome that the Scottish Government is working on a national public health campaign, which NHS Dumfries and Galloway has picked up through its menopause matters programme.

Menopause covers much more than just a physical transition; there are mental health implications. It impacts every aspect of our lives as women, individually and collectively, and we must do all that we can to reduce the stigma and improve treatment. Menopause matters and should be discussed.

As we are now approaching winter, when more people will congregate indoors, where coronavirus and other viruses such as flu are more transmissible, will the cabinet secretary provide assurance that there are adequate resources in test and protect Scotland to cope with increased demand? Will he reiterate how important it is to continue to regularly self-test using lateral flow tests, which are free of charge?

Will the cabinet secretary join me in thanking Dumfries and Galloway Council, including the D and G virtual operations support team and the emergency services, for their response in addressing the more than 80 reported incidents across D and G?

I welcome the Deputy First Minister’s visit to Annan tomorrow. Will he commit to continuing to engage with the community to hear what it wants, and to working with the local authority to ensure that flood defence schemes across the whole of Dumfries and Galloway are fit for purpose and can protect communities from severe impacts of flooding in the future?

I thank the minister for that detailed answer. Last week, I visited Alpha Solway in Dumfries, which has, supported by the Scottish Government, diversified its business model to production of personal protective equipment, including medical face masks for our national health service, during the pandemic. Can the minister outline further how the Scottish Government can promote its support for manufacturing in Scotland—including through Skills Development Scotland—as a positive career destination, and what action the Government is taking to ensure resilience in the Scottish supply chain?

As the cabinet secretary has noted, huge funds have been donated to NHS charities during the pandemic. We also know that our boards are under intense pressure, including financial pressure, so what safeguards are in place to ensure that the funds are used as they were intended to be used?