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a) Assessment of the potential impact of the COVID-19 pandemic; The Scottish Government continues to monitor evidence on the Four Harms of COVID-19. These are the direct impact of COVID-19, other health impacts, societal impacts, and economic impacts.

We are using this information to inform decisions about COVID-19, including how we move through phases of the Coronavirus Route Map .

The virus will impact different groups of people in different ways, and our society will be affected in different ways over time. We’re carefully monitoring the data and regularly update new evidence to COVID-19 in Scotland (data.gov.scot) .

b) Assessment of the potential impact of COVID-19 vaccines on i) Menstrual Cycles; The Medicines and Healthcare products Regulatory Agency (MHRA) have reviewed reports of menstrual disorders and unexpected vaginal bleeding suspected as adverse reactions to vaccination with the three COVID-19 vaccines currently being used in the UK: Pfizer/BioNTech, COVID-19 Vaccine AstraZeneca and COVID-19 Vaccine Moderna.

These reports have also been reviewed by independent experts of the Commission on Human Medicines’ COVID-19 Vaccines Benefit Risk Expert Working Group and members of its Medicines for Women’s Health Expert Advisory Group.

A range of menstrual disorders has been reported as suspected adverse reactions after all three of these COVID-19 vaccines including heavy bleeding, delayed periods and unexpected vaginal bleeding. The number of reports of menstrual disorders and vaginal bleeding is low in relation to both the number of females who have received COVID-19 vaccines to date and the background rate of menstrual disorders generally.

ii) Menstrual Health; The current evidence does not suggest an increased risk of either menstrual disorders or unexpected vaginal bleeding following vaccination with the vaccines reviewed (Pfizer/BioNTech, COVID-19 Vaccine AstraZeneca or COVID-19 Vaccine Moderna). The advice from the NHS remains that the benefits of the vaccine outweigh the risks for most people. The MHRA will continue to closely monitor reports of suspected menstrual disorders and vaginal bleeding with COVID-19 vaccines.

Healthcare professionals are advised that anyone presenting with menstrual disorders and/or unexpected vaginal bleeding following COVID-19 vaccination should be treated according to clinical guidelines for these conditions, as usual.

The safety of all vaccines and medicines is monitored by the MHRA on a UK-wide basis. This includes reports from the Yellow Card Scheme which allows health professionals and patients across the UK to flag up suspected adverse reactions to any vaccine or medicine, as well as reports from worldwide use and on-going scientific evidence.

If a woman is concerned about changes to her period, she is advised to speak to her GP, especially if she experiences bleeding after menopause.

Collective bargaining agreements are a matter for CalMac, its employees and the recognised trades unions. In the case of any additional ferries secured by CalMac through a “time charter”, the crews of these vessels are not employed by CalMac and are not covered by collective bargaining agreements which are currently in place with RMT and Nautilus. Any agreement with the Unions would be a matter for the vessel operator in that instance.

The Scottish Government aims to reduce the diagnosis time for endometriosis. The Scottish Government’s soon to be published Women’s Health Plan (WHP) includes a number of actions to improve access to appropriate support, speedy diagnosis and best treatment for endometriosis.

While there are no plans at the moment to introduce a waiting time guarantee and standard for endometriosis diagnosis and treatment we will continue to work with people with lived experience, Endometriosis UK and Public Health Scotland to identify realistic targets to measure improvement. The existing waiting times standards and guarantees for elective care continue to apply. NHS Board elective activity continues to remobilise at a safe pace, ensuring capacity remains in place to respond to the impact of the COVID-19 pandemic as required.

The Scottish Government’s Women’s Health Plan (WHP) will be published shortly and includes a number of actions to improve access to appropriate support, speedy diagnosis and best treatment for endometriosis.

Work is already underway by the Modernising Patient Pathways Programme, as part of the Centre for Sustainable Delivery, developing a Pelvic Pain Pathway for Scotland, starting with endometriosis.

In the last year, Endometriosis UK were funded by the Scottish Government to carry out research to identify the challenges to diagnosis in primary care and implementation of the National Institute for Healthcare and Excellence (NICE) guidelines on endometriosis. This work has included updating endometriosis content on NHS Inform and the delivery of a webinar to support primary care to implement the NICE guidelines.

Information on the endometriosis waiting times in each NHS board is not currently available. Public Health Scotland are working with officials and Endometriosis UK to analyse national and board-level data to understand what information is available to assess current waiting times and identify future data needs that could be used to measure improvement in waiting times.

Green Jobs Fund comprises two tranches of money – £50m which has been baselined into our Enterprise Agencies capital funding; and £50m under the direct control of Scottish Ministers. As of 25 June 2021, no specific projects have been funded for 2021-22. Scottish Enterprise are currently in the process of a green jobs call to business. The first application window, offering grants between £50k and £500k, closes on Thursday 1 July. Awards will be made in early September 2021. Highlands and Islands Enterprise and South of Scotland Enterprise are directing their support towards businesses already within their knowledge base and expect to make related awards by the end of September 2021. The policy for the second tranche of funding is currently under development and we expect to make related awards in October 2021.

We continue to develop our COVID-19 vaccination communication strategy and marketing campaign.

To date the following groups have been targeted, in order, through communications:

• those aged over 80 – through targeted letters
• care home staff and residents and health and social care staff through letters, leaflets, and care home staff and resident posters
• those eligible over 50 – targeted by a national advertising campaign
• those 18-49 – targeted by a national advertising campaign
• those under 30 – targeted by a national advertising campaign to encourage early registration for vaccination
• vulnerable and seldom heard audiences – through stakeholder engagement including liaison with a wide range of groups and communities via trusted voices.

We also continue our Roll up your sleeve COVID-19 communication and campaign activity, and accurate up to date information is available from NHS Inform .

We remain on target to decarbonise rail passenger services in Scotland by 2035 as set out in the Rail Decarbonisation Action Plan published July 2020.

Good progress is already being made to decarbonise the East Kilbride and Barrhead routes, Borders line and Fife Circle (providing services to Leven) as a first phase of delivery. Development work is also progressing on the wider decarbonisation plan including decarbonisation/electrification infrastructure and electric, battery and hydrogen rolling stock.

Updates on progress will be published as the strategy develops, key elements of which will also form part of the Strategic Transport Projects Review 2, with phase 1 having been published in February 2021.

Regarding part (b) of the question, I refer the member to the answer to question S6W-00852 on 1 July 2021. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers .

Each of the three specialist centres in Scotland are accredited by the British Society of Gynaecological Endoscopy and to maintain accreditation are required to demonstrate they have the appropriate clinical teams in place. The Scottish Government does not hold information on how many staff are employed in each of the three centres in Scotland or what the average waiting time is for each centre.

The Scottish Government does not hold information on how much funding has been provided for endometriosis (b) treatment and (c) care in the last 14 years and how much will be allocated in each of the next five years. This is the responsibility of local NHS boards through their existing NHS budgets.

(a) Research

In recognising the importance of research to improve diagnosis and treatment the CSO has invested £162,000 in a study on laparoscopic treatment of endometriosis based at the University of Edinburgh. It is also funding a £30K Postdoctoral Clinical Lectureship: Precision treatment and drug repurposing to reduce endometriosis-associated pain in women.

Additionally, the CSO contributes financially to United Kingdom-wide research programmes that are run by the National Institute for Health Research (NIHR), which enables researchers in Scotland to apply to those programmes. NIHR have invested £6.8 m to support 4 additional studies on endometriosis, being led from Scotland.

CSO also provides funding (about £66k p.a.) for the NHS Research Scotland Reproductive Health and Childbirth Research Speciality Group to support delivery of high-quality clinical research in Reproductive Health and Childbirth in Scotland, which includes supporting research studies on endometriosis.

Applications looking at the underlying causes, diagnosis and treatment of endometriosis are welcomed. In common with all other applications, these would go through CSO's standard independent peer review process.

Population estimates by the Scottish Parliament are held by National Records of Scotland and I refer the member to the following link: https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/population/population-estimates/2011-based-special-area-population-estimates/spc-population-estimates.