Chamber and committees

The National Complex Mesh Surgical Service assesses patient needs and, where appropriate and subject to shared decision making and informed consent, performs mesh removal surgery. To date, 135 mesh removal procedures have been undertaken by the Service. Many women make the choice following assessment and discussion with the specialist team to follow a conservative pathway of care and do not undergo surgery.

The needs of patients and their goals may differ and therefore their definition of success will vary too. The removal of mesh is often only part of the treatment journey, with further reconstructive surgery depending on clinical need taking place at a later date. Patients may also have other needs which require to be addressed by other members of the clinical team.

The service is required to comply with normal clinical governance mechanisms in place within NHSGGC to provide an assurance that the service being delivered is safe and of an appropriate quality.

Crown Estate Scotland received £756 million in option fees from the initial ScotWind auctions in 2022-23. As set out in the 2022 Resource spending review, and subsequent budget publications, these funds were initially profiled to be drawn down by the Scottish Government over a three year period as follows:

2022-23 - £96 million

2023-24 - £310 million

2024-25 - £350 million

The final drawdown for 2022-23 was £96 million as planned. Drawdowns for 2023-24 and subsequent years are only finalised at the very end of March when the Scottish Government has more certainty over its financial position.

At the time of the 2024-25 Scottish Budget the planned drawdown for 2024-25 was decreased to £200 million reflecting the need to ensure sufficient funds were available to balance the 2023-24 financial position. Given the recent improvement to the 2023-24 position it is now likely that this will not be required in 2023-24 and therefore may be used to support future financial years.

The Scottish Government recognises land is one of our most valuable assets. That is why the Scottish Land Rights and Responsibilities Statement articulates the Scottish Government’s vision for the ownership, use and management of land, setting out how we see the balance between the rights of landowners, managers, local communities and society at large.

Moving forwards the legislative requirements, such as those set out in the proposals for the upcoming Land Reform Bill and other voluntary based measure such as the Scottish Land Commission’s Good Practice programme, will all play an important role in meeting our objectives for land reform. Whilst the Regional Land Use Partnership (RLUPs) pilots were established to test and explore locally appropriate approaches to land use, the scope of the pilots was not to consider or challenge matters of land ownership or rights and responsibilities.

The report of the Transvaginal Mesh Case Record Review underlined what was already an important agenda for the Scottish Government: to improve care and services for women who are experiencing complications as a result of a transvaginal mesh; and, to ensure that the NHS continually reinforces good practice in confirming and recording patient consent and the treatment offered to patients. Progress continues in a range of connected activities relevant to Professor Brittons’ recommendations.

The recommendations made align with the practice that is embedded in the operation of the Complex Mesh Surgical Service, and through NHS Scotland more generally. We continue to work with NHS colleagues to ensure that women can access the care that they need, are fully supported by their GP and other clinicians, and have access to information they need to make informed decisions about their care.

The Chief Medical Officer wrote to Health Board Medical Directors on 10 October to draw their attention to the report of the Review and to the failings it identified, and to require them to seek assurance through local clinical governance committees that measures are in place locally to prevent a recurrence of the failings identified, and to assure the quality of processes connected to patient consent and record keeping. With regards to more recent patient records she reviewed, Professor Britton herself noted she was encouraged by the improvement in practice, with increasingly robust consent processes in place.

Work continues in other areas including enhancing information available to patients, credentialing of clinicians in mesh removal and improved data gathering.

The Scottish Government therefore considers that it is taking appropriate action to embed the report’s recommendations with regards to healthcare services in Scotland.

The Scottish Government recognises land is one of our most valuable assets. That is why the Scottish Land Rights and Responsibilities Statement articulates the Scottish Government’s vision for the ownership, use and management of land, setting out how we see the balance between the rights of landowners, managers, local communities and society at large.

Moving forwards the legislative requirements, such as those set out in the proposals for the upcoming Land Reform Bill and other voluntary based measure such as the Scottish Land Commission’s Good Practice programme, will all play an important role in meeting our objectives for land reform. Whilst the Regional Land Use Partnership (RLUPs) pilots were established to test and explore locally appropriate approaches to land use, the scope of the pilots was not to consider or challenge matters of land ownership or rights and responsibilities.

I have asked Gerard Hart, Chief Executive of Disclosure Scotland to respond. His response is as follows:

Disclosure Scotland run regular training courses aimed at organisations who work with children and young people and cover a range of topics regarding safeguarding and working with children and young people.

We also target newly registered organisations and signatories to ensure that they have a fuller understanding of safeguarding processes when they start to use disclosure products including the Protecting Vulnerable Groups (PVG) Scheme.

Since 2019, Disclosure Scotland have held 198 events to support organisations in understanding their legal duties in relation to PVG referrals about people who have displayed harmful behaviour towards children and young people. These have been attended by 1978 delegates from 979 different organisations.

We have also run 129 events entitled “Helping Employers Recruit Fairly” which aims to broaden the understanding of information disclosed by Disclosure Scotland, how to implement better risk assessment processes and make informed recruitment decisions. These have been attended by 1402 delegates from 390 different organisations.

All of Disclosure Scotland’s training products provide delegates with a range of materials to support their role in working with children and young people including links to downloadable guidance that is regularly reviewed and updated to ensure organisations have access to the most up to date information.

Child abuse and neglect have significant detrimental effects on children and young people’s emotional, physical and mental health, social development, education and future employment.

Scotland’s approach to child protection is set within the “Getting It Right For Every Child” (GIRFEC) approach to planning and providing support and care to children and families. The GIRFEC approach supports prevention of child abuse and neglect by driving forward a multi-agency approach to working with and supporting children and young people.

The National Guidance for Child Protection in Scotland 2021, updated in 2023, provides information to support practitioners to identify and respond to cases of child abuse and neglect. We are also developing national multi-agency training on inter-agency referral discussions (IRD), which are the start of the formal process of information sharing, assessment, analysis and decision-making following reported concerns about abuse or neglect of a child or young person. This will further support practitioners to prevent and intervene early so risk and harm to children and young people is recognised and acted on quickly and effectively.

We continue to learn from good practice both in Scotland and internationally to deliver positive action to reduce child abuse and neglect including initiatives like Scotland’s baby box, the Best Start Grant, Best Start Foods, Parent Club and universal free school meals for children from primary 1-5.

The Scottish Government is committed to making sure that the necessary resources and support are available for professionals and volunteers working in child protection roles.

We are working with partners and the workforce who support children and families to improve the skills, knowledge and shared values of all those who contribute to the national outcomes for children, young people and families through the implementation of Getting It Right for Every Child, UN Convention of the Rights of the Child, The Promise, and through delivery of our Early Child Development Transformational Change Programme.

The National Guidance for Child Protection in Scotland was updated in August 2023 and supports everyone who works with children, young people and their families in Scotland by outlining responsibilities and expectations regarding child protection. The National Guidance will be updated as necessary to remain up to date with significant legislative, policy or practice changes.

Last year, we commissioned the Scottish Social Services Council to lead on a refresh of the Common Core training framework for the workforce providing support to children, young people and families. The Framework focuses on the core skills, values and learning the workforce requires to deliver holistic family support and rights-based practice in accordance with UNCRC and GIRFEC principles.

We have also worked with partners on the development of NHS Education for Scotland eLearning resources to support health professionals in their child and adult protection roles. In 2022 four eLearning modules were published on Turas Learn, thereby improving accessibility to high quality learning and consistency in practice across Scotland.

Furthermore, we continue to work with partners to support the workforce to develop a wider trauma-informed approach to the provision of care. As part of the National Trauma Transformation Programme (NTTP), we continue to rollout 'Transforming Connections', a tailored ‘Trauma-Skilled’ level training and coaching package, to people who work alongside care experienced children and young people in priority sectors of the Children and Families workforce in Scotland.

To support the child protection workforce with learning and development, the Scottish Government is funding a National Learning and Development Co-ordinator post for two years. The post holder has worked with a stakeholder group and Scottish Government colleagues refreshed the National Framework for Child Protection Learning and Development in Scotland, which was published on 1 March 2024, and to develop a range of resources for Child Protection Committees (CPCs) which will be made available on a Knowledge Hub site later in March 2024. CPCs are the key local bodies for developing, implementing and improving child protection strategy across and between agencies, bodies and the local community.

I have asked Gerard Hart, Chief Executive of Disclosure Scotland to respond. His response is as follows:

Disclosure Scotland run regular training courses aimed at organisations who work with children and young people and cover a range of topics regarding safeguarding and working with children and young people.

We also target newly registered organisations and signatories to ensure that they have a fuller understanding of safeguarding processes when they start to use disclosure products including the Protecting Vulnerable Groups (PVG) Scheme.

Since 2019, Disclosure Scotland have held 198 events to support organisations in understanding their legal duties in relation to PVG referrals about people who have displayed harmful behaviour towards children and young people. These have been attended by 1978 delegates from 979 different organisations.

We have also run 129 events entitled “Helping Employers Recruit Fairly” which aims to broaden the understanding of information disclosed by Disclosure Scotland, how to implement better risk assessment processes and make informed recruitment decisions. These have been attended by 1402 delegates from 390 different organisations.

All of Disclosure Scotland’s training products provide delegates with a range of materials to support their role in working with children and young people including links to downloadable guidance that is regularly reviewed and updated to ensure organisations have access to the most up to date information.

The Scottish Government aims to engage with children and young people wherever appropriate during the development and review of child protection policies and services.

Throughout the recently updated , national-guidance-child-protection-scotland-2021-updated-2023.pdf (www.gov.scot) it is continuously emphasised that at a local level, staff working in child protection should engage positively with children and families during delivery of services. A resource is also currently being developed by Scottish Government in collaboration with the Centre for Excellence for Children’s Care and Protection (CELCIS) which will provide an accessible source of information on the guidance specifically for children, young people and families. This resource is being co-designed with children and young people.

The Bairns’ Hoose Bairns' Hoose - Children and Young People Participation and Engagement Plan (www.gov.scot) describes how children and young people will be involved in the development and implementation of the Bairns’ Hoose in Scotland.

More broadly, the Children and Young People’s Participation Framework offers an approach that ensures a range of children and young people are involved in the wider work of the Scottish Government. This includes a particular focus on those identified as being seldom heard, furthest from their rights, or vulnerable because of factors related to their personal development, features of their family life, or because of wider influences that impact on them within their community. Any engagement with children and young people around child protection policies and services will follow the principles of the CYP Participation Framework.