 Good morning, we are general questions. Is there a question on Neil Findlay? To ask the Scottish Government how many women in the last year have been treated with mesh or tape products to treat pelvic prolapse or stress urinary incontinence. Cabinet Secretary or Secretary, LEE Rocket有點 дыed. 2013-14, till the end of March 2014, 1,360 women had a mesh implant procedure for either stress urinary incontinence, pelvic organ prolapse or both. mhysh ymgyrch yn ymgyrch yn bwysigol ac yn polypropolain mhysh? The answer that the cabinet secretary gave was not in the last year, but I understand why. On 17 June last year, I like Neil told the Petitions Committee of the Parliament that huge survivors that he was suspending the use of mhysh for the treatment of those conditions. On 16 July, the deputy chief medical officer Francis Elliott wrote to health boards and dengweld i'n bwysig i ddechrau gwahanol i ddynnu gwahanol i ddweud yn ddechrau g да Moncwil, i ddredd o'i boblach o wneud i wneud i ddynnu gwahanol. A karnaith cyfraitwch yn ymddangas mewn cyflawn eraill hefyd, fe fydd yr ystyried arweinydd am gweithio gael y cenderfyn a fydd yn dechrau i ddynnu gwahanol i ddynnu gwahanol i ddynnu gwahanol i ddynnu gwahanol sy'n gefnfyn gyrdd. I'm very concerned that women have suffered complications following their surgery and that's why, of course, we set up the independent review announced by the previous cabinet secretary on the 17th of June. All health boards who carry out these procedures have considered this request and almost all have suspended these procedures. The review is analysing the number of women who have undergone these procedures in Scotland and the number of complications, and from that information we'll be able to consider the level of underreporting and I will be able to give Neil Findlay figures beyond March of 2014 and I'll write to him about that. In terms of the issue of clinical trials, the clinical community fully endorsed medical research in this field is the most credible way to answer what are legitimate clinical research questions and improve the care of patients. Of course, it's only where women have agreed to participate in a clinical trial that they're fully aware of the fact and associated risks, so no one is going into clinical trials without all of the full information. The acting CMO did write to all health boards on 20 June requesting that they consider suspending mesh implant procedures, as Neil Findlay knows. That request to health boards has been framed in the strongest possible terms, but that has to be balanced against the wishes of those women who, having fully considered the risks, prefer to continue with the procedure. Consultants are providing additional counselling and are using the new patient information and consent leaflet developed by the expect group to make sure that any woman who wants to go forward understands the risks. Those are difficult issues to balance, but I hope that Neil Findlay will understand that the letter to health boards was in the strongest terms, but individual patient choice still remains as an option. The cabinet secretary will be aware of the growing number and size of successful compensation claims regarding mesh implants in America. In addition to the pain and suffering caused by those implants, does she therefore give her concern that, notwithstanding the cabinet secretary's instruction to health boards to stop those treatments, some health boards are still using mesh implants that may leave open Scottish health boards and, ultimately, Scottish Government to compensation claims? As I laid out in my previous answer, health boards have been given a very strong letter from the acting CMO about the suspension of the procedure. However, if individual patients in discussion with their consultant and full knowledge of the risks decide that they want to go ahead, that is obviously a discussion that the patient would have with their consultant. Meantime, of course, in terms of looking at the issue more fully, the regulation of medical devices, including implants, is within the remit of the Medicines and Healthcare Products Regulatory Agency, which is the UK body responsible for regulating all medical devices. It works with the European Commission on those issues, and it has responsibility for the regulatory framework. We follow the guidance in exactly the same way as other UK countries. Evidence is required before suspension is mandatory, and the current European Commission has not proposed a change to that, so that covers that issue to some extent. Should that change, and then, of course, the situation would change here in Scotland, as we would follow that advice, Scotland has written to the European Commission seeking assurances that the results of the research that it is carrying out at the moment will be acted upon swiftly. As I say, I will be meeting some of the women concerned on 23 February. I will listen to their concerns. Anything more we can do, obviously, we will do, and I hope that that reassures the member. 2. What progress is making towards meeting the target of 11 per cent of demand for heat being met by renewables by 2020? The most recent UK data on which progress towards our renewable heat target base shows that, in 2.12, renewable heat generation equated to 3 per cent of Scotland's non-electrical heat demand up from 1 per cent in 2009. Claudia Beamish I thank the minister for his answer. I would like to turn our thoughts to actual district heating, if I may. Colleagues on the Economy, Energy and Tourism Committee received evidence highlighted in their report to the draft budget this January that Scottish renewables and others were concerned that Scotland is, and I quote, still very far off meeting its target for district heating and that the committee wished to relay a plea for a step change and investment in renewable heat. Can the minister tell me his response to that plea and also how many of the recommendations of the expert commission of November 2012 are at present being actioned? I acknowledge Claudia Beamish's interest in this matter. I will look at the evidence given to the EET. We accepted all but one of the recommendations of the expert committee. We are dealing to make progress with all of them. I have chaired an expert commission on district heating on 11 November. We have a target of 40,000 homes to be supplied with affordable low-carbon heat. We are working very closely with local authorities, housing associations and the NHS to deliver district heating schemes, retrofitting it to existing buildings is expensive, complex and logistically challenging, but we are making progress in Glasgow, Aberdeen and Wick. I want to see, as Claudia Beamish sees, a step change so that Scotland can see, like Denmark, district heating, forming part and parcel of the way in which we provide heating for our homes for people in this country. 3. Jackson Carlaw To ask the Scottish Government what action it is taking to improve survival rates from brain cancers. The Scottish Government is committed to ensuring that people with brain cancer receive the best possible care, early detection and appropriate timely referral is key to improving survival rates through our £30 million detect cancer early programme and the refresh of our Scottish referral guidelines for suspected cancer. We are working to increase the number of brain cancers detected at the earliest possible stage. The cabinet secretary will know that the survival rates from brain cancers are depressingly low with only 15 per cent of those surviving. It is the biggest cancer killer in Scotland of those under 40 years of age. Will the cabinet secretary join me in congratulating my colleague Cameron Buchanan, himself a brain cancer survivor, on the success of the recent gala dinner that he organised for the brain cancer charity, which raised just short of £20,000, all of which will go to research? Perhaps even the finance secretary will double that before the day is out, but will she agree to contact Health Department elsewhere in the UK with a view to jointly promoting and encouraging internationally further research into what is sadly regarded by the pharmaceutical companies as an orphan condition in research terms, in order that we look forward to genuine progress through research into improving survival rates for both brain cancers and other cruel conditions such as mutant motor neurone disease? First of all, can I join with Jackson Carlaw in congratulating Cameron Buchanan on the work that he has done around this? It is absolutely very important. Again, it highlights the importance of research. I am very happy to also write to the other health departments around a co-ordinated approach. What I can tell the member is that the chief scientist office recently announced funding of £225,000 for a research project led by Professor Anthony Chambers at the University of Glasgow, which is due to start shortly. The purpose of the project is to evaluate the clinical potential of a novel treatment strategy for one of the most common and lethal adult brain tumors. I am sure that the member will know that most cancer research in Scotland is not funded by the CSO, but by Cancer Research UK, which does a huge amount of crucial work in that area. Of course, the CSO provides funding of around £440,000 a year to the Scottish Cancer Research Network. There is some good work happening in that area. More can obviously be done. I am very happy to write to the other health departments to see whether we can co-ordinate further action. John Finnie To ask the Scottish Government what steps it is taking to encourage industry to move from road haulage to rail freight. The Scottish Government is committed to encouraging the transfer of freight from road to more sustainable modes, including rail. That is why, in the current rail funding settlement to 2019, a £30 million Scottish strategic rail freight investment fund has been made available over and above the funding for the rail network as a whole. The separate freight mode shift grant schemes, which continue to operate, take together this substantial package of investment and funding will help to encourage growth in rail freight and support our vision for a greener and more efficient transport network. John Finnie I thank the minister for that response. The far north line carries nuclear fuel, unfortunately. It is no longer able to cope with existing or indeed potential traffic. Oil tanks travel to a layer of 75 per cent fuel due to restrictions on one of the viaducts. Lower platform wagons to take higher containers have been banned due to track conditions. What is required is dynamic loops, faster points and improved signalling. Will the minister agree to press network rail to significantly improve line speed and capacity on the far north line, please? John Finnie Yes, I will. I will look into the specifics of that case. Certainly there are rail improvement works that are working with network rail. We will proceed with on the line, but if there is further pressure required, I will certainly apply it. Paul Martin I ask the Scottish Government if it will order a review of the national accommodation strategy for registered sex offenders. Margaret Burgess The Care Inspectorate and HM Inspectorate of Constabulary in Scotland are carrying out a review into how well the public is protected by the current multi-agency protection arrangements for assessing and managing the risk posed by registered sex offenders in our communities. Those will include an assessment of how effective the responsible authorities are in the discharge of their statutory duties, including adherence to national guidance such as the national accommodation strategy for sex offenders. When the review is completed later this year, a report along with the appropriate recommendations will be published. Paul Martin I think that the word review has been used on a number of occasions since the murder of Mark Cummings over 10 years ago. I think that the word review has been used on a number of occasions. I think that it has been recognised on a number of occasions and as a result of a number of reviews that have taken place, that sex offenders are disproportionately allocated housing in deprived areas, particularly Glasgow. Is that still the case today as we speak? Margaret Burgess I understand and appreciate his long-term concerns on the matter, but how is registered sex offenders in the community an important part of the risk assessment process? The location and the type of accommodation will always be determined by the circumstances of the individual offender and the risks that they may present to the community. Rodd Campbell Thank you, Presiding Officer. Current MAPPA guidance indicates that registered social landlords do not have to assess and manage the risks but have to co-operate with those that do. Does the minister believe that current guidance is adequate in relation to registered social landlords? Margaret Burgess As the member indicated, registered social landlords have a duty to co-operate under the MAPPA arrangements. Their role is to contribute to the responsible authorities' management of risk by allocating housing that has been assessed as manageable for released offenders. The extent to which the duty applies in practice will depend on the nature of the accommodation that any landlord has available and the extent to which the responsible authorities consider that such accommodation would help to manage a risk in any given case. Fflusimeth Donaldson Question 6, in the name of Fflusimeth Donaldson, has been withdrawn, and the member has provided an adequate explanation. Question 7, Michael McMahon. Michael McMahon Thank you. Diolch yn fawr, Scottish Government. What plans it has for people assessment in schools? Fflusimeth Donaldson Minister of Education, Alice Rallon We are committed to improving outcomes for all children and young people. In order to raise attainment, it is important to be able to demonstrate success and identify my challenges in order to understand where improvements need to be made. That is why, in schools, teachers already gather evidence on pupils' progress across a range of learning and the Scottish Government and local authorities are always looking at good practice wherever we find it. Michael McMahon I thank the minister for his response, but does the minister agree that there can be no dispute? There is a significant difference in attainment between children and Scotland's most deprived areas and those in better off parts of the country. All of us want to see progress being made in relation to closing that gap. It has existed for far too long. Can the minister tell us how he intends to measure any improvements, especially among primary school pupils? Michael McMahon I do not think that there will be any disagreement between the member and I about the importance of closing that attainment gap. I think that it has long been acknowledged that one of the central aims of curriculum for excellence and one of the central aims of this Government is to ensure that everyone has an opportunity to succeed and fulfil their full potential. Schools are always measuring their progress on closing that gap. I have, for instance, been in conversations with Education Scotland about the role of school inspections around that area. There are many other activities, for instance, in-site. The benchmarking tool allows schools to make meaningful comparisons with each other about what they are doing to make sure that their policies and our policies are all centred around closing the attainment gap where they exist. Kevin Stewart To ask the Scottish Government what discussions it has had with its partners about railway timetabling and capacity in the north-east. Derek Mackay We meet regularly with Nestrans, the regional transport partnership for the area, and other partners representing issues in the north-east to discuss a full range of railway issues, including timetabling and capacity. The next meeting with Nestrans is currently taking place. Kevin Stewart I thank the minister for his answer. In 2013-14, north-east stations accounted for 3.35 per cent of Scotland's patronage, compared to 2.44 per cent in 2004-5. There has been significant growth at all eight stations, notably Port Lethan, 350 per cent growth, and Inverruri, 290 per cent growth. In the case of Inverruri, we have seen passengers rise from 128,000 in 2004-5 to 500,000 in 2014. Derek Mackay Can the minister assure me that growth will be taken into account when rail investment resources are allocated? Can he commit to looking at increasing station numbers, rolling stock and services in the north-east so that rail patternage can continue to grow? Derek Mackay I can, Presiding Officer, give that reassurance. We have accepted there were issues with the current franchise in terms of demand, and that is why work was in place for capacity and crowding issues. We will do more of that with the new franchise. There are commitments on stations, journey times, reliability and new rolling stock, and I am sure that that will be the answer that the member sought. Cameron Buchanan The answer is a lot shorter than the question. To ask the Scottish Government whether it plans to introduce new initiatives to help people with chronic migraine disorder. Cameron Buchanan All clinicians in NHS boards in Scotland are expected to be aware of and adhere to guidelines published by the Scottish Intercollegiate Guidelines Network. Sign, guideline 107, diagnosis and management of headaches in adults November 2008, provides clinical guidelines for the management of headaches, including chronic migraine. Cameron Buchanan Thank you. I thank the minister for her response. Is there any new money being put aside for this research? Is the Government aware how widespread this disorder is and how often it leads to prolonged absence from the workplace? Cameron Buchanan The chief scientific office has responsibility for encouraging and supporting research into health and healthcare needs in Scotland. The CSO responds primarily to requests for funding research proposals initiated by the research community in Scotland. We are not currently funding any research project on the cause or treatment of chronic migraine. However, we would welcome research proposals in this area, which would be subject to the usual peer and committee review. Margaret McAulch To ask the Scottish Government what its position is on the review of out-of-hours GP services in NHS Lanarkshire. Margaret McAulch To ask the Scottish Government what its position is on the review of out-of-hours GP services in NHS Lanarkshire. Shona Robison The Scottish Government is liaising with NHS Lanarkshire and being kept abreast of progress with the review of out-of-hours services in their health board population area. I would expect the outcomes of the review to be in line with any recommendations arising out of the Scottish Government's recently announced national out-of-hours review, which is to be led by Sir Lewis Ritchie. Margaret McAulch NHS Lanarkshire intend to make their out-of-hours service more centralised than their A&E service. Are the Scottish Government concerned that this could lead to extra pressure on A&E from patients presenting themselves at emergency rooms who are better dealt with in a primary care setting? Shona Robison To Margaret McAulch, the consultation is on-going, and it is very important that the views of the public in Lanarkshire are listened to. As part of that, of course, with the national out-of-hours review that I referred to in my initial answer, that any emerging direction of travel and findings and recommendations, we would expect NHS Lanarkshire to come into line with those recommendations with their local out-of-hours review. It is important that any steps that they take around out-of-hours do not impact elsewhere in the system, and, of course, we would be probing that carefully indeed.