Meeting of the Parliament

Meeting date: Tuesday, March 7, 2017

Official Report 915KB pdf

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Topical Question Time

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Independent Review of Transvaginal Mesh Implants

To ask the Scottish Government what its response is to the resignation of two members of the review group into the use of transvaginal mesh. (S5T-00420)

This is a complex issue, and the review has had to consider carefully a wide range of evidence and views. I am aware of and concerned about the resignation of two of the review group’s members, and I hope to meet them soon to hear their concerns directly. In addition, I plan to meet the chair of the review group separately, so that I can discuss the matter with her. I have asked that the chief medical officer attend both meetings.

I am grateful to all the group’s members for their expertise and considerable efforts over the years. The independent review continues its work to produce its final report, which we expect it to publish this spring.

Elaine Holmes and Olive McIlroy are two of the bravest and most honest women I know. Despite chronic pain and disability as a result of mesh implants, they have put their hearts and souls into the review group on the use of mesh implants, in the hope that no other woman in Scotland would experience what they and hundreds of other sufferers are going through. They wrote to the review group weeks ago to raise concerns and copied in the cabinet secretary, but they have received no reply.

Olive and Elaine resigned from the review at the weekend: first, because secret meetings, from which they were excluded, have been taking place for the past 10 months; secondly, because the draft report to which they signed up in October 2015 has been fundamentally rewritten and overturned; thirdly, because key information has been removed from the report; fourthly, because critical new evidence has been omitted; and fifthly, because there is no mention whatever of the reclassification of mesh by the European Union.

In the light of those concerns and many more, does the cabinet secretary agree that the review has been completely compromised? Does she agree with Elaine Holmes and Olive McIlroy that the review can no longer be regarded as independent?

First, I record my thanks to Olive McIlroy and Elaine Holmes, whom I have met on a number of occasions. They have worked very hard to raise the issue and they have achieved a great deal. For example, a patient helpline was established, due in no small part to their campaigning. In addition, the chief medical officer wrote to health boards in 2014 requesting that they suspend the procedure pending the independent review’s final report, and she recently wrote to every health board to seek assurances that fully informed consent has been sought in every case in which the procedure has been carried out. That such things have come about and issues have been taken forward are down to the efforts of Olive McIlroy and Elaine Holmes.

Neil Findlay knows that the review group and its report are independent of the Government. The group is dealing with a range of complex issues, and since its interim report was published, additional evidence and reports have been put into the public domain. I think that we all accept that the final report must take account of the additional evidence. It is therefore not surprising that some changes have been made.

That said, the issues that Neil Findlay raised, on the concerns that have been expressed and the accusations that have been made, are the very reason for my meeting Olive McIlroy and Elaine Holmes, so that I can hear directly from them their concerns about the process.

None of us has seen the final report—I have not seen it, and I want to reserve judgment until it has been published. However, I assure Neil Findlay and other members that I will listen very carefully to the concerns that Olive McIlroy and Elaine Holmes have raised.

I hope that, as someone who has supported the mesh women throughout the process, I will be able to come along to the meeting with the cabinet secretary when it happens.

Mesh is a global scandal. It is the subject of one of the biggest class actions in Australian history and there are more than 100,000 cases in the United States courts, with individual claims adding up to tens of millions of dollars. In Scotland, it will be the subject of the biggest-ever action against our national health service; currently, 400 cases have been lodged.

Mesh implants are permanent and difficult to remove. When they go wrong, the results are devastating. Why on earth would an independent review fail to consider all up-to-date information, irrespective of whether the research is pro-mesh or anti-mesh?

None of us has seen the report, so I do not think we know whether the report has considered all that information. I am meeting Olive McIlroy and Elaine Holmes to hear their concerns about the issues. I will also meet the chair of the review group is so that I can address some of these issues with her, as well. I am happy to meet Neil Findlay, and indeed any other member who wishes it, to discuss the issues.

What is important is what comes from the final report, once it is published, in terms of guidance to clinicians. The chief medical officer will be a key person in that, which is why I want her to be involved in the meetings that I will have with Elaine Holmes and Olive McIlroy, and with the chair of the review group. Where I can, I want to reassure Olive McIlroy and Elaine Holmes that I want them to be involved in the action that will flow from the report, in addition to the action that has already been taken. I will discuss that with them when I meet them.

I concur with everything that Neil Findlay has said. Elaine Holmes is a constituent of mine; indeed, she was my “local hero” at the opening of Parliament last year. The campaign that she and Olive McIlroy have led, through the Public Petitions Committee and Parliament, has been quite exemplary, in view of the tremendous pain and suffering that they have gone through and which they continue to represent on behalf of thousands of women across Scotland.

Only a few weeks ago, the First Minister gave me a categoric assurance that there would be no interference in the review and no whitewash, and yet, since the ladies’ resignation, I have been contacted by others in the review group who are astonished at the wholesale removal from the report of certain chapters.

The eyes of the world are on Scotland. We have the only Government and we are the only country that is undertaking a fundamental review of the procedure. I have to hope and believe that the report will give justice to the women concerned and that it will truly still be independent. Fundamental questions are currently being asked about whether we can have confidence that that will be the case.

First, as I said in response to Neil Findlay, I absolutely recognise the efforts of Olive McIlroy and Elaine Holmes. In my answer to Neil Findlay, I outlined some of the actions that they have already secured as a result of their campaign, and some of the assurances that the chief medical officer and I gave the committee on the back of their evidence and their campaign. Some very practical things, including the patient helpline that has been established and the chief medical officer’s letters to health boards, have come on the back of the campaign that Olive McIlroy and Elaine Holmes have undertaken. I want to pay tribute to them.

With regard to the First Minister’s assurance, there has been absolutely no interference in the review group. I have not seen the final report. I have, of course, seen the comments and concerns that have come from Olive McIlroy and Elaine Holmes, and I am concerned about them. That is why I have offered to meet them as soon as possible to hear in more detail and directly from them their concerns about the process.

As I said to Neil Findlay, what is important at the end of all this is that we make sure that whatever guidance is given to the NHS and clinicians is based on the most robust evidence. I am really keen—as I said to Neil Findlay—to have Olive McIlroy and Elaine Holmes involved in taking that forward, so I will discuss that with them in more detail when I meet them.

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Aberdeen Asset Management and Standard Life (Merger)

To ask the Scottish Government what impact the proposed merger between Aberdeen Asset Management and Standard Life would have on Scotland’s economy. (S5T-00421)

Aberdeen Asset Management and Standard Life are two leading firms in Scotland’s financial services industry. We welcome the intention to grow their business in Scotland, to build on the expertise and skills of both companies and to strengthen Scotland’s global reputation for fund and asset management.

The First Minister spoke yesterday with both the chief executive officer of Aberdeen Asset Management, Martin Gilbert, and the chief executive officer of Standard Life, Keith Skeoch, to discuss the proposed merger of the companies. The new company, which will reportedly be the largest fund manager in the United Kingdom and the largest active asset manager in Europe, will be a key player in Scotland’s financial services sector and will continue to be a very important contributor to Scotland’s wider economy. I warmly welcome confirmation in the joint press release that the combined group will be headquartered in Scotland.

We will engage with both companies as the merger progresses, to discuss their plans for employment and investment in Scotland in the light of the anticipated savings that have been set out. I note that the merger is still subject to shareholder and regulatory approval, following which an integration period will begin. I have been in contact with both companies and, in the event that the plans for the merger are confirmed, the Scottish Government stands ready to support the new business and its employees to ensure that what should be a world-class investment group has a bright future, and to help the business grow its activities in Scotland.

It is important to reflect that the announcement potentially puts the combined company in a particularly strong position to weather what continues to be a disruptive time for the asset management sector globally.

I agree with the minister that the proposed merger is an exciting opportunity to create a Scotland-headquartered, world-leading investment house that will help to entrench Edinburgh’s reputation as a financial centre. That said, the minister will be aware that there are concerns about the employment impacts of the merger. From the discussions that have been held with Aberdeen Asset Management and Standard Life, in what timescale does the minister expect there to be announcements about future workforce planning for the new entity, and when will the staff be made aware of those?

I recognise the concern that there will be in such a situation, when there may be a significant change in the companies. I cannot dictate the timing that will be followed—there are shareholder and regulatory interests, and we must allow the internal processes to take place. Nevertheless, as I mentioned in my initial answer, subject to shareholder and regulatory approval, there will be an integration period that will include much more detailed work involving the workforce itself.

It is important to stress that, in discussions with Standard Life and Aberdeen Asset Management, I have been made aware that both institutions are trying to create a world-class investment group and to grow the business. I hope that that gives confidence to the workforces of both companies. We warmly welcome the confirmation that the headquarters will be in Scotland, which is obviously of great value to all of us in the chamber.

I am aware that companies such as Standard Life Investments not only have been working to reduce their cost to income ratio to record increased profitability but have increased employment. It is not necessarily the case that cost reduction leads to a loss of employment; indeed, it can be positive in terms of increased head count. Standard Life as a whole has seen growth in its assets, revenues, profit and cash held, and has also managed to increase its head count.

We remain of the view that the development could be an entirely positive one, but we await the decision of the shareholders and the regulator.

I am sure that we all welcome the indication that the headquarters of the new entity will be based in Edinburgh. How will the Scottish Government ensure that the economic conditions in Edinburgh are right to help secure the future of this very important new business and the many thousands of jobs that it will support?

We are conscious of the need to maintain Scotland’s competitiveness as a location, and we work closely with stakeholders in the financial services industry to understand their concerns and where they are looking for investment to underpin growth in the sector. In financial services, we are working on fintech, which is of particular interest to companies across the sector, and I am working with stakeholders to ensure that Scotland remains at the forefront of that development in the sector and can capitalise on those opportunities. More generally, we are working with the City of Edinburgh Council and Aberdeen City Council to ensure that we have a competitive business environment for our financial services industry.

I declare an interest, in that I worked for Standard Life in 2002 and 2003.

I was pleased to note the assurances of Martin Gilbert of Aberdeen Asset Management that there will be an emphasis on growing the new business and utilising skills within both companies following the completion of the proposed merger. What relevant discussions has the Scottish Government had over the potential for growth and for further job creation in Scotland’s financial services industry, particularly here in Edinburgh?

Both companies have been on record as stressing that the merger will bring together their complementary interests. In large part, they are complementary to each other.

The Scottish Government is working closely with the sector to promote Scotland as a centre of excellence in financial services, and the Financial Services Advisory Board, on which the First Minister sits alongside the Cabinet Secretary for Economy, Jobs and Fair Work, Keith Brown, and me, is an important forum for us to engage with the industry in. We must ensure that the conditions for the industry are as good as they can be.

Scotland is internationally recognised as the most important UK financial centre outside London and the south-east, offering a breadth of services including global custody, asset servicing, banking, investment management, corporate finance, general life assurance and pensions.

We have a broad-based financial sector that is not locked into a particular aspect or subsector. The Scottish Government will continue to support the financial services industry in maintaining its real strength and adapting to change. As I said in my initial answer, I believe that the merger could potentially create a new business that is world class and able to be resilient in the face of what can be quite challenging conditions for the financial services industry globally. Indeed, the merger will perhaps help the company to capitalise on any new opportunities that are presented by developments in areas such as fintech.

I echo Ben Macpherson’s comments about the focus on jobs and growth and his welcome for the prospect of the new, merged entity. The minister is right to point out that the merger will happen in a challenging context. During a recent visit, I was told that Standard Life alone has hundreds of thousands of customers in Germany, so passporting rights and maintaining access to those customers in Europe is vitally important. Can the minister describe the representations that the Scottish Government has made to both the United Kingdom Government and the European Commission about maintaining full passporting rights, which those retail customers require, over and above simple equivalence arrangements?

My colleague Michael Russell has taken forward the recognition of the important issue of passporting in his discussions with UK ministers around the implications of Brexit for the financial services industry. It is worth stressing that 26 per cent of employment in Edinburgh, part of which Mr Johnson represents, is in the financial services industry. I am therefore sure that the industry will be of great import to Mr Johnson—and to Mr Macpherson and other members who represent Edinburgh.

The financial services sector is clearly important to Scotland as a whole, and its direct contribution to our economy cannot be overstated. Now that the UK Government has made clear its intent to leave the single market, we believe that it is essential that it sets out exactly how it intends to protect the financial services industry and, indeed, Scotland in the forthcoming negotiations. The Scottish Government will explore differential options for Scotland, as I am sure that the member knows. The Scottish Government is considering all possible steps to ensure Scotland’s continued relationship with the European Union, including seeking an agreement that will ensure that Scotland retains single market membership, even if the rest of the UK leaves.

However, we are keen to engage with UK ministers to ensure that they understand the importance of financial services to Scotland. I have met Lord Price in my own context to stress the sector’s importance, and I will continue to do so.