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I did write to you, Mr Swinney, and I got your reply last month. You gave me two pages of very general advice. However, that did not address the specific issue that that man’s GP has told him not to get a booster at the same time that the NHS, without asking to look at his medical records, has told him, “Sorry, you are not eligible for an exemption.” I am slightly confused about how somebody can reach that conclusion about his personal circumstances without liaising with his GP.

I have a specific follow-up question that arises from the case of one of my constituents who had quite a serious adverse reaction to the second dose of the vaccine. I know that that is rare, but it does happen. He then went to his GP, who advised him not to get the booster. His concern was that, if he was required at some point in the future to provide certification of full vaccination status, he would need to get an exemption. He then applied for an exemption, but he was told that he was not eligible. However, nobody spoke to his GP and nobody asked to see his medical records. He is now in limbo, because his GP has told him that he should not get a booster, but he is not entitled to an exemption. Where does he go from here?

Some of the statistics that you have given us are stark and, as a gentleman of a certain age, I am in that category of those who have missed their bowel-cancer screening. I therefore recognise what a problem this is.

In your submission, Dr Perez-Reche, you are a bit more definitive than citing just anecdotal evidence; indeed, you are quite clear that there is evidence of patients presenting with more acute conditions. What have you found?

Good morning. It is fair to say that concerns have been raised with us about the proposed change. The Scottish Association of Social Work, for example, has said that witnessing the signature of a named person provides an opportunity

“to verify the named person ... inform them of the role, allow them to ask any questions, ensure they”

understand

“the responsibilities and to confirm that they are competent and able to perform the functions correctly. This is particularly important since there is little guidance around the role and responsibilities of a named person.”

What is your response to those comments? Do you have any concerns that removing such a requirement will mean that people taking on the responsibility of being a named person will not be fully advised of what the role involves? Perhaps Dr Chopra can respond first.

Dr Chopra, before I bring in Dr Smyth, perhaps I could ask a brief follow-up question. Should a named person nominee be required to declare that they understand their role, rights and responsibilities?

I put the same question to Dr Smyth.

Good morning. I would like to follow up on the convener’s questions, both of which are important.

On the data question, the submissions from Chest Heart & Stroke Scotland and Macmillan Cancer Support both make the point that there is anecdotal evidence of people who have been suffering from heart disease and stroke in one case, and from cancer in the other case, presenting later at hospital but, so far, it is only anecdotal and there is not enough data.

First, can Peter Hastie from Macmillan Cancer Support elaborate on that? Also, when would you expect the data to appear? Then perhaps I can go to Dr Francisco Perez-Reche, whose paper suggests that there is a bit more concrete information available rather than just anecdotal evidence.

If there is time, I would like to ask another question following up the convener’s first line of questioning on access to GPs. I direct my question initially to Rob Gowans from the Health and Social Care Alliance Scotland. When we speak to the British Medical Association about access to GPs, it assures us that GPs are working harder than ever, that GPs are still seeing patients and that there has never been a problem for patients getting to see a GP. However, the evidence that we hear from people such as you—it is in your written submission—is that the public are concerned that people have not been able to get GP appointments or have been reluctant to approach a GP. How much of that is a supply issue? In other words, has it been difficult to get appointments with GPs because of Covid restrictions? How much is it a societal and cultural issue whereby people have not sought GP appointments, because they are concerned about leaving the house and catching Covid, or because they feel that there has been so much emphasis on Covid that they do not want to distract GPs from dealing with Covid patients to deal with what they might view as a more trivial matter? Do you have any insight on that?

I will go back to Professor de Londras to explore further the issue, which we touched on earlier, of the use of the made affirmative procedure. You covered that in detail in your written evidence and you are clearly critical of the overuse of the made affirmative procedure. From a practical point of view, how would you amend the bill that is in front of us in order to reduce the reliance on the made affirmative procedure, which is clearly an objective that you want to achieve?

Thank you. Professor McKenzie Skene, can we have your view on that?