Seòmar agus comataidhean

I am grateful for the opportunity to appear before the committee again.

I met both petitioners yesterday. Roseanna Clerkin is personally affected, as one of the individuals who has suffered from debilitating chronic pain and life-altering injury after undergoing a mesh procedure. Lauren McDougall’s mother, who has now passed away, was also affected, and I know that the committee has received testimonies from many other individuals who have been affected.

As the committee knows, the mesh used in hernia operations is different to transvaginal mesh, but many of the issues are similar, and they affect both men and women. However, there is a lack of data on the extent of the problem. That is why the petitioners are asking for an independent review; they want that data to be gathered, and the use of surgical mesh and fixation devices to be suspended until such a review has been concluded.

I have submitted freedom of information requests to every health board in Scotland, because I wanted to know the number of patients who were treated for hernias using surgical mesh and who had been readmitted to hospital following complications that arose from mesh. Most health boards did not provide information, but some did respond. NHS Ayrshire and Arran revealed that 8 per cent of all patients who were implanted with mesh to treat a hernia in its hospitals were subsequently readmitted due to complications arising from the mesh, while NHS Lanarkshire said that the figure was 10 per cent.

That data suggests that the petitioners are right to highlight the need for a review to explore the issue further, yet the Scottish Government continues to refuse to engage with them—indeed, the minister and the former minister refused to meet with the petitioners directly. Given that lack of engagement with the petitioners by Scottish ministers, I urge the committee to consider asking the Cabinet Secretary for NHS Recovery, Health and Social Care to appear before the committee and give evidence so that we can consider the issues further.

As I have indicated, I do not plan to press amendment 23 to the vote. However, I fear that this is not an issue that will go away, because the injuries that are suffered by the people who are affected are significant. The minister is, of course, the decision maker in this matter. I look forward to engaging further with her on the issue, and I strongly urge her to meet campaigners and to give further consideration to these matters.

Amendment 23, by agreement, withdrawn.

Section 12—Power to require information

I lodged amendment 23 having worked with campaigners who are suffering from debilitating chronic pain and life-altering injury after undergoing a mesh procedure.

Members will be aware of previous debates about transvaginal mesh and the detrimental impact that it has had on many lives. The mesh that is used in procedures such as hernia operations is different, but a significant number of people who have had hernia mesh procedures are experiencing health issues that are similar to those that were faced by women who were implanted with transvaginal mesh.

I have been contacted by a number of women and men who are affected. However, the lack of data means that we cannot establish the true scale of the issue. I have tried to gather data on the issue by submitting freedom of information requests to every health board in Scotland. I wanted to know the number of patients with a hernia who were treated with surgical mesh and who were subsequently readmitted to hospital because of complications arising from the mesh. Most health boards did not provide that information, but those that did supplied data that is concerning. NHS Ayrshire and Arran revealed that 8 per cent of all patients with a hernia who were treated with surgical mesh were subsequently readmitted to hospital because of complications arising from the mesh. In NHS Lanarkshire, that figure rose to 10 per cent.

Campaigners such as my constituents Roseanna Clarkin and Lauren McDougall have sought meetings with successive ministers to discuss an independent review of the use of surgical mesh and fixation devices in the national health service. So far, ministers have refused to meet those campaigners or to recognise the need for an independent review. I hope that my probing amendment will enable the minister to reconsider the issues and the need for a meeting, and to look at the case for an independent review.

Amendment 23 would require the patient safety commissioner to undertake an investigation into the use of surgical mesh within the first year of their appointment. The purpose of the investigation would be threefold: it would establish the scale of use of surgical mesh to treat hernias; it would provide data on the number of patients with a hernia that was treated using mesh who have subsequently been readmitted to hospital because of complications arising from the mesh; and it would outline the number of complaints that health boards have received from patients about complications arising from mesh and the details of those complications. The patient safety commissioner would then be expected to reach a conclusion on whether NHS Scotland should suspend the use of surgical mesh to treat hernias.

I do not intend to press amendment 23 to a vote today, but I will listen carefully to what the minister says. I hope that she will engage with people who have been affected, look into the issues further and explore the need for an independent review.

I move amendment 23.

I will ask about workplace issues. We previously heard a lot of evidence about the difficulties with recruitment and retention that are linked to pay and conditions and, indeed, even to the remuneration of those who are running small—[Inaudible.]. Today, we have heard further evidence on some of the other financial struggles that the sector faces. What do you think the Scottish Government do about that?

On the point that Beverley is making, which she covered in the First 4 Kids submission, does she have any proposals for how some of those ideas could be taken forward—in relation to people who are working in childcare also having roles as classroom assistants, for example? Does she have any practical suggestions about that?

Given that there is probably a limited amount of money, decisions will have to be taken. Are the witnesses of the view that it is right for the Scottish Government to target things in the way that it is doing? Is it making the right decisions, or would you criticise its approach or say that the issue needs to be looked at again?

I think that Matthew Sweeney wants to come in.

Do the witnesses have any specific proposals with regard to eligibility criteria that focus on tackling and reducing child poverty? Obviously there are advantages and disadvantages to focusing on some issues, particularly low incomes. There are arguments, which I think Irene Audain was putting forward earlier, for focusing more generally on all working parents, both those currently in work and those who are not. What do you think are the advantages and disadvantages of prioritising groups? Is it better to have a more universal approach?

The Scottish Government has said that it is planning to focus provision for one and two-year-olds on those who need it most. As you will know, the expansion of school-age childcare is also focused on those on low incomes. What do you think of eligibility criteria and the impact on child poverty? What can we do to maximise the impact on child poverty?

When officials gave evidence, they said clearly that, currently, no 16 or 17-year-olds could legally be moved into secure units, because of the disposal of the court. However, it would be helpful to ask the Scottish Government for confirmation that that remains the case and for a commitment that it will continue to be the case that 16 and 17-year-olds will be held in secure units wherever possible. If, for whatever reason, that is not possible, the committee should be advised through the Government’s writing to alert us to the fact that there has been a change.

I have a further point, which is about data and women in custody. The committee has discussed such issues many times and has expressed concern on numerous occasions, both publicly and in our private sessions, about the lack of data that is available to us and the difficulty in carrying out our scrutiny work when we do not have an understanding of the profile and the nature of the people who are being incarcerated in this country.

The Scottish Government’s intention seems to be to reduce the number of women in custody, but, in reality, that number is increasing, and there seems to be concern that it will continue to increase. It would therefore be helpful to get more information from the Scottish Government about the profile of the women who are held in custody and the reasons why there might have been an increase. There might be a range of reasons for that. I do not want to speculate in this meeting as to what those might be, but we need an explanation from the Scottish Government.

It is far from clear whether the Bail and Release from Custody (Scotland) Bill will make any difference to the number of women who are remanded. We were told yesterday that the current figure for women on remand in the prison estate is 37 per cent. That is high, and it is very unclear whether the bill will make any difference to that. It would be useful to find out whether the Scottish Government believes that the bill will make any difference to the number of women who are held on remand and why it remains the case that so many women are being held in the prison estate.

We know that the new custody units have, at maximum, been at only 53 per cent capacity, which tells us that, at other times, they have been less than half full. The committee should write to express concern about that. I fully understand that the issue has now been raised and that the Scottish Prison Service is considering it, but those custody units have been open since August.

Committee members were very impressed by what we saw when we visited the units—there has clearly been massive investment, financially and in other ways, in those facilities, so it is important that they are a success. We should express our concern in the strongest terms about the fact that they have not been used to their full capacity and call for urgent action in that regard.

We know that people are put in custody not just because of the legislative framework but because of the lack of alternatives to custody. In relation to the alternatives to remand reference group, we need a great deal more detail about what the Scottish Government is doing to ensure that there are genuine and robust alternatives to custody. We know, for example, that people who are given community service orders are often not required to carry out the measures that are set out in their sentence.

We need a shift in resources into alternatives to custody if the Scottish Government is to be successful in enabling the courts to dispose of cases in other ways. When we look at the budgets, we see that the money for that is not being provided. The direction of travel is the wrong one: the amount of money that has been provided for alternatives to custody is going down instead of up. We should express in the strongest terms the need for the Scottish Government to shift resources now if it is to have any success with its stated strategy.