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Is that a public plan?

That is helpful.

That is a considerable complement.

As colleagues have no further questions to ask, I thank you very much for a fascinating opportunity. It is amazing what the world’s worst pandemic has led us to being able to explore across the world more easily, as we have become familiar with this virtual technology. Otherwise, it is not a conversation that we would have thought to have or been used to having.

On behalf of the committee, I am incredibly grateful to you for the time that you have given us and the evidence that you have presented.

Is there anything that you would like to say that we have not touched on?

Thank you; that is very helpful.

My colleague, David Torrance, will ask our fourth question, which explores the controlled trials and the low recurrence rates. He will ask a couple of questions that follow on from what you have just said.

Good afternoon and welcome to this exceptional meeting of the Citizen Participation and Public Petitions Committee. This is the committee’s eighth meeting in 2022.

We have only one agenda item, which is consideration of continued petition PE1865. The petition was lodged by Roseanna Clarkin, Lauren McDougall and Graham Robertson and calls on the Scottish Parliament to urge the Scottish Government to suspend the use of all surgical mesh and fixation devices while a review of all surgical procedures that use polyester, polypropylene or titanium is carried out, and while guidelines for the surgical use of mesh are established.

We last considered this petition on 2 February 2022, when we agreed to take evidence from the Shouldice hospital, in Canada, following representations that we received. We understand that it is the only licensed hospital in the world that is dedicated to repairing hernias, and it has been a supporter of natural tissue hernia repair for more than 75 years.

I am delighted to welcome Dr Fernando Spencer Netto, the chief surgeon at Shouldice hospital, and I thank him on behalf of the committee. Dr Spencer Netto joins us virtually—of course, all of us are appearing at this meeting virtually, so we are collectively all virtual.

We have an apology from Fergus Ewing MSP, who is unable to join us today.

Members would like to explore a number of questions with you, Dr Spencer Netto, so we will launch into that. However, I will begin by saying that Scotland has been very much at the forefront of the international discussion on transvaginal mesh repair procedures. Considerable angst and trauma was caused to an incalculable number of women, many of whom were told that they were imagining their suffering and that there was no option other than the mesh that had been fitted. In seeking to remedy that, the Scottish Parliament passed the Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Act 2022, which will facilitate women travelling to wherever specialist services are available for the removal of that mesh—including to the United States, where specialist services are available in Missouri.

Consequential to that, we have received this petition, which seeks to extend the interest in and potential impact of alternatives to mesh treatments in relation to hernias. The committee is incredibly intrigued and interested in experience from Shouldice hospital, so, by way of an introduction, could you tell us—and the many people who are watching today’s meeting and who will be interested in the discussion that we are about to have—about the work of your hospital, so that we can better understand it from your perspective as its chief surgeon?

The issue that we have had reported by so many people is what happens as a consequence of the use of mesh. In addition to my involvement in the whole question of mesh, I have been a member of the cross-party group on chronic pain. One of the obvious consequences of the use of mesh is the number of people who have presented, post-procedure, with life-crippling, intolerable pain. What is the post-operative life experience of the patients who undergo the procedure that you promulgate?

I understand that.

I am happy to do that, too.

We are going to get some recommendations from the organisations that we are going to. I do not think that we want to be in the deepest darkest hinterlands on a Wednesday morning, abandoned in the forest with a compass. I am not quite sure where we would end up.

We will move to questions, because that may bring out some of the reservations that you still have. We will see what comes up as we do that. The first question tees that up. What concerns do you have about the agreement between HIAL and the Prospect trade union on the future development of air traffic control? How might those concerns be addressed?