Chamber and committees

I agree with David Torrance. This petition requires to come to an end, as we have gone through that journey. As we have already heard, over the next three to five years, things will improve, but, as you indicated, convener, there might be fresh issues to be considered and, if there are issues that Rhoda Grant and the community want to explore, that could be done via a new petition.

Minister, you touched on the need to try to create facilities to support individuals. Canada gives us a good example of what can be achieved. I appreciate that you want to ensure that medical support is given to individuals at the closest point, but some degree of specialisation may still be required, perhaps by creating a unit or expertise in the field for clinicians. That should be considered, as it could help to iron out some of the difficulties that we have seen. It would be good to get your views on that.

Minister, you talked about the risks and the benefits, but, in all this, the word “complications” seems to be the problem. Many individuals have given us their testimony that they took the information that they received in good faith and went through the process but then, three, four or five years on, their situation became so difficult that they ended up with a real problem. You talked about consent in the process, but communication is an issue. I believe that anyone who goes in and gets medical support and advice will take it on board, but they may not realise what complications could occur perhaps three, four or five years later, and the damage that could be done.

We have seen the same thing with the hernia situation. People believed, in good faith, that having the mesh put in was the right thing to do because that is what they were advised to do at the time, but it ended up not being the right thing, and that has put them in a really difficult and dangerous situation.

It would be good to get clarity as to how that aspect is communicated, in order to ensure that individuals make the right choices and are not steamrollered by a doctor or clinician who says, “We believe that this is the best treatment for you.” People take such advice in good faith, but, years later, as I said, they may find that that treatment should not have happened.

Mr O’Kelly, do you want to answer some of that question?

Following on from the comments from both the minister and Mr O’Kelly, do we have some understanding of mesh itself? Different types of mesh may well undergo different processes. How have we been investigating and taking steps to analyse some of the mesh products themselves, to look at what defects they might have?

Has the Government, or have clinicians themselves, had a look at any of the history to find out whether there are defects that occur with specific types of mesh products, which might be more susceptible or more problematic for individuals? If we are aware that certain products might be more susceptible than others, that might reassure people in the future that the mesh that is being put in will be better, because it is not of a type that has a track record of causing issues in the past.

Minister, perhaps you can answer first.

We have heard that, in some situations, individuals had one mesh for a hernia put in but it had to be removed; they then had a second one put in and, since the second attempt, things have been better. They have not experienced the same complications since the first mesh was removed and the second one was implanted. Is there evidence, in your experience or that of others, of that happening when one mesh is removed and then replaced with a new one? Is it common or just an ad hoc situation that occurs with certain individuals?

Bruce Adamson, you talked about the support mechanisms required to ensure a dignified, friendly and respectful approach to managing and progressing the process for a 16 or 17-year-old. Do you believe that we have that at present? Does the bill ensure that someone who is 16 or 17 will be well treated in the process?

Malcolm, in your opening remarks, you said that it might not always be possible to balance the various aspects, that creative ways of ensuring that no one is left out needed to be found and that consultation on the issue should be meaningful and respectful.

Last year, sportscotland—jointly with the other UK sporting councils—issued guidance. There were found to be two polarising issues. On one side, there was a view that trans people should be included in sport and that there should not be any restriction, whereas others saw that trans inclusion should be subject to regulation to ensure fair sporting competition. The UK sporting councils advised that there should be some kind of balance, but they also indicated that bodies should define their own rules, using a framework to interpret the guidance, which would help to support outcomes for each sport. How are sporting bodies in Scotland being supported to ensure that trans inclusion in sport is balanced with the requirements for fairness and safety?

Hugh, do you have any comments on that balance? Malcolm has given examples of types of sport that might have a different attitude or might have to go a different way, because of the nature of the sport or the competition that is involved.

Good morning, panel. The bill also covers the issue of residency and provides that those born or “ordinarily resident in” Scotland will have the opportunity to apply for a gender recognition certificate. Concerns have been expressed that that might mean that trans people from other parts of the United Kingdom might choose to come to Scotland to apply for a certificate, either because of family circumstances or because they do not have a supportive network at home.

My question, which is for Bruce Adamson first and then Ellie Gomersall, is: do you believe that that is a potential concern? Please also give us your view on the requirement for residency as it relates to 16 and 17-year-olds.