 I remind members of the Covid-related measures that are in place and that face coverings should be worn when moving around the chamber and across the Holyrood campus. The next item of business is a stage 1 debate on motion 2234, in the name of Humza Yousaf, on the Transvaginal Mesh Removal Cost Reimbursment Scotland Bill. I would invite members who wish to speak in the debate to press their request to speak buttons now. I call on Humza Yousaf to speak to and move the motion. I am pleased to open the debate on Transvaginal Mesh Removal Cost Scotland Bill. I would first like to thank the Health, Sport and Social Care Committee, so ably convened by Gillian Martin MSP, and to all the members for their thoughtful consideration of the bill, for the report and, of course, importantly, for their support for the general principles of the bill. I am also very grateful to the Finance and Constitution Committee and the Delegate Powers and Law Reform Committees for their consideration of the bill also. I also want to take this opportunity to thank everyone who has taken time to express their views on the bill and evidence to the committee or, indeed, to me directly. In particular, I would like to thank a number of affected women who have taken part in focus groups about the bill. I know that every single member will agree with me when I say that it is because of the courage of the women affected that we are at this very point, but it should not have taken them to have to retell their own stories. I am grateful to all those women who have, over the years, shared their experience and helped to shape this bill. It would also be trelis of me not to recognise the excellent cross-party efforts that have highlighted the plight of those women, in particular, to highlight the contributions of Jackson Carlaw, Alex Neil and Neil Findlay, as well as the latter two, who are no longer in this Parliament. The bill that the Government presents today is a narrow bill with a limited function, which in all likelihood will be directly relevant to only a very few people. However, it would be equally fair to say that the impact on those very few people would be very, very significant indeed. It brings the Parliament's attention back to the traumatic experiences of a substantial number of women in Scotland who have suffered pain and distress after having mesh implanted. Many of us have heard directly from women about the physical symptoms, but also the mental distress that they suffered, which was often made worse because they felt that their experiences were simply not taken seriously enough when they sought help. The Government and the NHS are working now to improve the care that we offer those women. In particular, there is now in Glasgow a national specialist mesh removal service, which has been offering a full mesh removal since July 2020, and so far it has provided 33 women with mesh removal surgery. At the Glasgow centre, new surgeons have been recruited and there are now four euro gynaecologists allowing women more choice over who they are treated and, of course, the option to be treated by a surgeon not previously involved in their care. The service also benefits from contributions from dedicated nurses, physiotherapists, pharmacy staff and a clinical psychologist. However, let me see clearly and unequivocally I completely understand that there are a number of women who have lost trust in our NHS. I will work hard, I know that the service will work hard too, to rebuild that trust, but I also know from having talked to a number of mesh survivors that they feel that that trust has broken beyond repair, and I am sorry for that. Alongside the national specialist service, the Government and the NHS are also working to make it possible for women to be referred to surgery in NHS England and also in the independent sector. Therefore, women seen at the national centre who do not want surgery in NHS Scotland will have the choice to be referred to a specialist centre in England or, indeed, to independent providers. I announced in July that two providers byre health care in Bristol and the Mersey hospital in Missouri have been selected to provide those choices. Since the summer, NHS Scotland services have been working to finalise contracts. NSS has in particular been seeking to make sure that arrangements for surgery are supported by other services that will meet emergency and wider medical needs. I do appreciate that the wait since July has undoubtedly been frustrating for women who have already had to wait a considerable period of time, but I hope that the Parliament will agree that it is essential to have all the right care in place, particularly when women may have to travel some considerable distance. I know that I have now spent a fair bit of time talking about matters outside of the scope of the bill, but I know that those issues are important to the women affected and, indeed, to members right across the chamber. Although arrangements for referral to the independent sector are planned, with arrangements to the independent sector, it is planned that it seems to the Government right to reimburse women who have already and already had arranged removal privately, paying, of course, from their own pocket. The bill before the Parliament therefore gives ministers power to reimburse the costs borne by women who, in the past, have entered private arrangements for transvaginal mesh removal surgery. Section 1 of the bill establishes that power. It gives power to reimburse the costs of the person who underwent the surgery and those of a companion where there was one. Section 1 and 2 together give the power for the Government to develop a scheme by which payment be made and for that scheme to be laid before the Parliament and published. Let me now turn to some of the issues that were raised in the report by the committee, which I responded to on Monday. The committee proposed that women who had mesh implanted in Scotland but who then arranged to have it removed, having moved out of Scotland, should be eligible for reimbursement. The Government agrees with that view in principle and will therefore table appropriate amendments at stage 2. The committee has also asked the Government to consider whether there might be some change to the cut-off date before which arrangements for private surgery have to have been made in order to be eligible for reimbursement. The date is proposed at present to be 12 July of this year, because that is the date that the Government confirmed which providers have been selected as preferred bidders to provide surgery in the independent sector. However, I did promise to reflect on this matter further and I will do so in absolutely good faith. I have explained in the Government's response that I will consider whether it is reasonable now to adjust that date and I will confirm the Government's position at stage 2. I have also considered the committee's implicit recommendation that the reimbursement scheme be made in regulation. On that, I should say that the Government is not convinced that making the scheme in regulations would involve further delay for women who have already had to wait, as we all acknowledge in some cases years for reimbursement. I am not convinced that, in this case, the merits of greater parliamentary scrutiny outweigh the priority of offering assistance to the women involved as quickly as possible. However, I appreciate that members and the committee will want to understand how the scheme will operate in practice, so I will make available a draft of the scheme to the committee before stage 2, if the Parliament agrees to the bill today, as I suspect. I hope that the committee finds the Government's response to its report helpful, constructive, and, as I have said before, the suggestions that I have made and the compromises that I hope we have made show our good faith. I should add that the Government will also reflect on this debate today before we take any finalised positions in relation to our stage 2 amendments. I look forward to considering important points of detail with the committee at that stage 2 debate. In closing, I can only imagine the distressed that has caused women to use their own funds, often quite considerable amounts of money, to seek private surgery for mesh removal. I met a number of those women, both in my capacity as Cabinet Secretary for Health and Social Care, but also in a constituency level 2. I suspect that every single member—in fact, I suspect that every single member of this Parliament has, at the very least, had correspondence from a constituent. I am sure that every single one of us has been moved by the plight of those women. It is wrong that women felt that their only option was to dig deep into their pockets, some of them having to take out loans, some of them having to borrow money from friends and family. I think that all of us can agree that it is wrong that those women felt that this was their only option. The Government is determined to ensure that women never have to feel this way again. The successful passage of this bill will put in place a scheme that will make sure that those costs are met and women involved are no longer at a financial disadvantage. I look forward very much to working with colleagues across the chamber to make that a reality. I appreciate the co-operation that we have had with the committee and its members. I therefore move the general principles of the transvaginal mesh removal cost reimbursement Scotland bill to be agreed to. I now call on Gillian Martin on behalf of the Health, Social Care and Sport Committee. Over the years, we have all heard countless accounts of the complications of transvaginal mesh and its lifelong effects, even after the mesh has been fully or partially removed. Countless physical damage, countless psychological trauma and, for many countless years of suffering, both in the past and still to come. As the convener of the Health and Social Care and Sport Committee, I am pleased to speak today on our report on the transvaginal mesh removal cost reimbursement Scotland bill. Up front, I want to say that this bill could not and does not undo the physical or psychological trauma that those women have faced and continue to face as a result of mesh complications. The bill has been introduced for a very specific purpose, as the cabinet secretary has just outlined. We, as a committee, support that purpose, and that is to reimburse individuals who have paid to have transvaginal mesh removed from their body using private healthcare settings. As a result of their experiences, it is very apparent to anyone who has listened to the women affected that they have lost trust in a system that is meant to care for them. Those women have not experienced the compassion, choice and control that they should be entitled to expect from that system. In the past, they have not felt empowered to discuss their complications or treatment options or to be actively involved in decisions about their care. As a result of that, many have gone down the road of seeking private treatment. We have heard that the Scottish Government is taking steps to ensure that, in the future, women will have that choice and control over their care, including options to have transvaginal mesh removal surgery undertaken by independent providers. We welcome that. The committee considers the key principle of the bill is to ensure fairness for all individuals in relation to transvaginal mesh removal services in Scotland. It is unfair and unreasonable for women who have already had surgery to meet the financial costs of removal surgery themselves when that option will be available to women free of charge in the future. The bill seeks to rectify that unfairness. The committee supports that intent and, more broadly, we support the general principles underlying the bill. Our report concentrates on areas where we think that the bill, as it is currently drafted, might need to be clarified to make sure that it achieves that fairness for the women affected. In some areas we put forward recommendations to strengthen its intent. Before we go into detail about those recommendations, I would like to take a moment to thank all those who assisted the committee in our scrutiny, those who responded to our call for views and those who gave evidence in person or online. I would particularly like to thank the women who spoke with us in a private session facilitated by the health and social care alliance and they told us about their experiences of transvaginal mesh complications. They were very grateful to them and we are in absolutely no doubt how difficult it must be to have to recount those experiences time and again. Evidence from that meeting and in our call for views suggests that there are still areas of uncertainty around the bill and that continues to be a source of some anxiety. In particular, our report recommends that greater clarity is needed around the residency criteria set out in the bill. As it stands, women who were not resident in Scotland at the time of their original mesh surgery but who lived here when their mesh removal surgery was arranged would be eligible for reimbursement. However, in contrast, women who were resident in Scotland at the time of their original surgery where the mesh was used and put into their bodies but who lived elsewhere when they arranged mesh removal surgery would not. The Scottish Government has told us that it has not received any correspondence from women in this situation. However, it acknowledges that a number of women who may ultimately apply for reimbursement under the bill is unknown. It is reasonable to assume that the Scottish Government might not have heard from everyone who might be covered by the bill and it is also reasonable to assume that there may be some women affected who do not yet know about the bill. The committee believes that if it means even just one more woman can be helped that the bill should be amended to include all those women seeking reimbursement for mesh removal surgery who originally had their mesh implanted by the NHS in Scotland. That should be irrespective of where they were living when that mesh removal surgery was arranged. We also heard from a number of women describing themselves as the in-betweeners. Those are women who are in the process of arranging treatment privately or who are currently waiting for their private surgery to take place. The introduction of the bill has caused some confusion and concern for those women. In short, they are unsure whether they will be eligible for reimbursement and the additional costs from travel restrictions and delays particularly imposed by the Covid-19 pandemic have added to that anxiety. They want reassurance that their costs will be reimbursed if the bill is passed. According to the bill, a cut-off date to qualify for reimbursement will be specified as part of the details of the scheme. We are told that that date is likely to be 12 July 2021. The Scottish Government has suggested that this would be a date when individuals could be reasonably expected to be aware of the availability of the new specialist mesh service as the preferred route to mesh removal surgery. However, there is a gap between 12 July when the outcome of the procurement exercise for the service was announced and the conclusion of contracts with independent providers, which remain under negotiation. There is a risk that a relatively small number of women will fall through the gap and therefore be judged ineligible for reimbursement. We do not think that it is fair that those individuals should be obliged to cover the cost of the surgery themselves. We thank the cabinet secretary for his indication today and when he was in front of our committee that he is willing to look at this. We understand that there cannot be an open ended period and that there must be an end date, but we would like that the proposed one be reviewed given what I have just outlined. I am grateful for Gillian Martin to give way and I very much welcome her very powerful speech and support of this. With regard to the end date, did the committee consider whether or not the date of commission of the alternative methods that are going to be recommended in fact should be the cut-off date? Because then women know that there is a certainty that there is an alternative route to having the vaginal mesh removed surgically. I guess that that is implicit in what I have just said. There is that gap there. We have not specified what we think the date should be, but we have asked the Government to look at it again just in case there are any women caught in that gap, so I take your point. The committee recognises that much of this detail is due to be set out in the scheme itself rather than the face of the bill and our report highlights areas where we consider a flexible approach that is needed to ensure that spirit fairness is achieved, including how and what costs will be reimbursed, what evidence will be required and who can apply and we hope to see that reflected in the final scheme. As a Parliament, we also want to ensure that we are given appropriate opportunities to scrutinise the details of that scheme before it enters into force. I am very grateful to the cabinet secretary for committing to provide the Parliament with a draft version of the scheme prior to stage 2. My committee will want to look at the details of that draft and to ensure that those reflect the stated objectives of the bill and the underlying principle of fairness. We realise that this is not something that the Government is compelled to do by the parliamentary process, so we appreciate that extra level of scrutiny that has been offered to us. We have also highlighted areas where we would like to see further clarity for the women concerned and scheme administrators. The process of applying for reimbursement should not cause additional stress and anxiety for those who are applying or managing the scheme. While the bill is not about the specialist mesh removal services or referral pathways currently in place or under development in Scotland, it is inextricably linked to them. We have heard that there is still a long way to rebuild faith and trust between NHS Scotland and the women affected. We would like to see public campaigns to publicise the reimbursement scheme that is created by the bill and the complex mesh national surgical service, and the committee plans to take an active interest in both going forward. In conclusion, the committee supports the general principle of the bill. It is a necessary and important step to ensure fairness for women affected by transvaginal mesh and the breakdown in trust that they have experienced during treatment by NHS Scotland. We are keen to ensure that the bill progresses through Parliament quickly to ensure that the women can be reimbursed as soon as possible. I am very grateful to the cabinet secretary for having provided such a quick response to our stage 1 report. I set out in that response, we look forward to seeing further improvements to the bill at stage 2, reflecting our key recommendations. I thank you, and I thank you to my members for my declarational interests as a practicing doctor. It is not every day that parties are on opposite sides of the chamber CITI. It is even rarer for us to find common ground twice in one week. Today, there is every reason why Parliament must stand united. United to fully support Scotland's brave women who have suffered so greatly following complications from transvaginal mesh surgery. The very least that we can do together is to ensure that any women who receive this treatment in Scotland would be compensated for the money that they have paid out for mesh removal surgery, even if treated overseas. Mesh, usually made from synthetic polypropylene, was supposed to reinforce damaged tissue when treating pelvic organ prolapse or stressed union continence, which is usual after childbirth. It is a procedure used across Europe, in the United States and afar since the 90s, but the failure rate associated with this procedure is a gynaecological scandal. Complications from mesh include nerve damage, chronic pain, vaginal scarring resulting from the erosion of the product inside the body. There have been cases of organ perforation when the mesh has been exposed inside the vagina and some women have died. As complaints from patients and families turned into lawsuits, authorities around the world began to act, and, by late 2017, Australia and New Zealand were the first to ban transvaginal mesh. Since 2018, no vaginal mesh implants have been carried out in Scotland. Over a 20-year period in Scotland alone, over 20,000 women underwent mesh surgery and thousands of beliefs have suffered in varying degrees from the effects. Some 600 women resorted to taking legal action. As the health committee has heard in person, and I would like to place on record my thanks to those brave women with harrowing experiences of mesh surgery and so many face scepticism, they were simply not believed when they were crying out for help, the debilitating pain, infections, reduced mobility, autoimmune issues, difficulties with intimacy and psychological strain. They were simply not believed. It is no surprise that so many women sadly lost trust in our NHS, and they are out protesting in Glasgow right now. Even when they were offered mesh removal surgery, many turned their backs on our NHS and went elsewhere, and understandably so. In practice, that meant using private healthcare providers in the UK and abroad. That is because, until this year, there was no referral route from our NHS system to independent healthcare providers. My only plea to the cabinet secretary is to speed through the next stage of getting women who have not had surgery through to assessment and removal surgery quickly and not having a long wait. Until only recently, they have had to arrange everything themselves. Some would use up their family's savings, borrow money or crowd source for funds, anything to stop the agony. Since this summer, we are at last making headway. In July, the Scottish Government agreed to meet the cost of the private treatment to remove transvaginal mesh. Costs will cover the procedure and travel expenses, somewhere between £16,000 and £23,000. The Scottish Government is now in the process of procuring the services of private providers to remove mesh from women who want it removed. They will have choice to have surgery out with the NHS in Scotland and will be funded by the Home Health Board, though I do hope that women take up the opportunity to take it here in Glasgow. Turning to today's legislation, the transvaginal mesh removal cost reimbursement bill, we strongly support this bill and I think we are all in agreement. Legislation, though, can have unintended consequences. That is why we spend so much time here and in committee on the details. If I may, I would like to highlight a few points for clarification, as it stands that the bill only covers women currently residing in Scotland, not those who are now living in another country. That said, I am reassured that the cabinet secretary has just said that he agrees that it is too narrow a requirement and that, upon a second reading of the bill, he will consider an appropriate amendment at stage 2. As this is a compensation bill, we need to ensure that fair and proper claims are reimbursed. We need to avoid unintentional rendering of a claim ineligible because of reimbursement. I just wanted to put on record a clarification. He referenced an amount per surgery just to confirm—although we have amounts, he is right in the financial memorandum—just to absolutely confirm in case there are, and I am sure that there are women listening. If the bill is, hopefully, passed, there will not be a cap on any application. If they have reasonable costs that are eligible for the scheme, there is not a £23,000 cap. That figure is just there for the financial memorandum, just to make that clear. The cabinet secretary was very clear when he came to the health committee that there was no cap, and I did not intend it to sound as though there was a cap. As this is a compensation bill, we need to ensure that fair and proper claims are reimbursed. We need to avoid the unintentional rendering of a claim ineligible for reimbursement. That said, so many of our women have been trying to cope with the personal financial consequences of undergoing expensive private medical treatment. We need to get down to business as quickly as possible so that they can apply for compensation as soon after an act comes into force. There are some questions, however, including whether executives of deceased can make a claim. I understand that the cabinet secretary does not consider it to be advantageous to the women affected for the compensation scheme to be specified in regulation, as just said just now, preferring instead an administrative scheme, which is quicker to implement and easier to amend where appropriate. Given the urgency to move the bill into law, I support this position. I look forward to hearing from members across the chamber this afternoon, and it is my wish that we find common ground when we come to vote—common ground for the second time this week. I would like to make it absolutely clear that the Scottish Conservatives support the principles of this bill, and we will work together to speed this through Parliament. I thank my fellow members of the health, social care and sports committee who are all here today for their work on the bill over recent weeks. I welcome the opportunity to open the debate for Scottish Labour, as our party has been at the forefront of the issue for years, with particular recognition being afforded to the former member for Lothian Neil Findlay's efforts to get justice for the women affected by mesh. He and other parties across the chamber recognised early that here was an unspeakable injustice, and we simply could not let it pass. Before I begin my comments in the bill, may I share in the recognition for the women who have campaigned relentlessly to keep this issue on the agenda here in Scotland? Efforts that have increased awareness of this serious problem, not only here but across the UK. It is their campaigning, which has meant, unlike so many others, who never receive the compensation that they deserve. Women are close to justice on this issue. It is a brilliant story of courage and tenacity, and one that Scotland should be proud of. But only by saying that we got it wrong in the first place and rectifying those mistakes can we truly embrace that pride. Certainly only after those who have been out of pocket have the record set straight. Every member of this Parliament should take time to recognise the efforts of those women and reflect on the steps that we are taking to get us here, not least so that we do not make the same mistakes again. We can never split celebrate enough serious democratic engagement by those at the sharp end in our society, and I encourage other groups who feel that they have been treated unjustly to come forward. This is your Parliament, and it is our duty to help you. I just want to thank the women again, as many have, who forced us to listen to them. Thank you for coming forward, thank you for making us listen, and thank you for sharing your stories. I know that that must have been difficult. The Health and Social Care and Sports Committee is recommending that the general principles of the bill is supported, and my party shares that recommendation. As a member of the committee, I have been impressed with the detail and care that has been taken over the bill, and I think that we can all agree that the general principles are both moral and just. A quick timetable to get this over the line is necessary, as the women affected by mesh have suffered more than enough, and I will be looking for guarantees, as you have, surrounding that as we proceed. It is our duty now to make certain that the bill delivers on its promises of fairness. Although the financial implications may seem relatively small, for those that it has helped, it is worth an imaginable amount that equates to the recognition of their fight and the fact that they were right all along. During our session on the committee, I was struck by the lens that many women have gone to in order to get their mesh removed, and we have heard some of it. We know from a good number that that included travelling across the world. We heard in committee stories of women travelling across the world having to live in hotel rooms before their operation, then again after their surgery, because they are required to stay on for treatment. We can all imagine just how much we would all wish to be home and be with our loved ones while we were recovering. People did not commit to such steps lightly, and, as a result, we cannot approach the issue lightly. That is not to say that there are not concerns that need to be addressed in the bill. Great clarity, and we have had some recognition, is needed in terms of making it plain, who will qualify for mesh reimbursement and who will not. Throughout the process, I have been contacted by women who find the proposals difficult to understand or imprecise, and that is something that we can adjust to ensure that no one misses out, and it has been addressed both by the convener and by the cabinet secretary. Just a bit of peace of mind can go a long way, and I am glad that we are addressing many of those worries during the committee hearings and here in the debate. Equally, there are some hidden complexities that many people observing this debate from a far minute have not considered, but we have been considering in the chamber. There is a strong case for individuals who have their original mesh surgery undertaken by NHS Scotland but who were not ordinary residents in Scotland at the time of their surgery removal. I believe that they should also be eligible for reimbursement, and I would hope that the minister will again reassure us on that and that future information on the bill will include that. The last thing that anyone wants is for us to end up with another situation where those women feel ignored by the system or, indeed, short-changed. I and others have made this point very clearly to the cabinet secretary and committee, and I am assured that that will not be the case. However, the Government can equally be assured that any deviation from those expectations will not be accepted by Scottish Labour or the women involved. The cabinet secretary has been quite rightly committed to being flexible in determining what costs will be reimbursed under the terms of the bill, but the committee has argued that much greater detail is required for it to gain cross-party support perhaps at later stages. However, we have been reassured today that the cabinet secretary is accepting the points that have been made by the members, and I trust that that will be realised. In closing, Scottish Labour will support this bill at stage 1, and if the reasonable expectations of the women affected are not sufficiently made, we will seek amendments to ensure that the principles laid out today are delivered before the bill passes. I again thank everyone for the hard work, everyone who has been involved in the bill, and I look forward to the next stages. I look ahead to some serious life-changing legislation that we can all be proud of. Thank you, Presiding Officer. Thank you very much, Presiding Officer. It gives me great pleasure to rise for the Liberal Democrats in support of the general principles of this bill at stage 1. Before I do so, Presiding Officer, may I say that in my short career as an MSP, I cannot really remember another issue that I think captures the universal support, concern and horror of this chamber as this particular issue when it comes to domestic health scandals. Can I also take a moment to recognise the valiant work of people like Jackson Carlaw, Alex Neil and Neil Findlay in bringing this to our attention and introducing us to some of the survivors of the mesh scandal? Nobody can forget who met them when they came to Parliament, the abject pain but profound dignity with which they conducted themselves. I welcome this bill to Parliament. It has the potential to provide some further closure to women at the heart of this who have already taken the step to have mesh removed privately. I would like to take a moment to remember why we are here in the first place and why this is so necessary. Four years ago, I was contacted by a constituent of mine who gave me permission to share her story. In 2010, after suffering very mild issues with incontinence, Kathy was referred by her physiotherapist to our consultant who suggested that she should undergo a marvellous new procedure. Somewhat bewildered, she was asked to sign a consent form then and there. She said—I think that this is very characteristic of many women's stories—that it felt like she was entering some kind of clinical trial, although it was never spelled out to her quite like that. In fact, nothing was properly spelled out to her. Despite being booked in for the most invasive trans-oburator tension-free vaginal implant, which is secured via spikes through the obdurator muscle, she received very little information other than that procedure would cure her of her incontinence. When Kathy woke after surgery, she could not move. The nerve damage that she had sustained to her obdurator muscles radiated pain through her abdomen, legs and back. Her condition was so bad that when she was discharged, she would not allow her son to drive at more than 30mph along the bypass. She tried to call the hospital for three days after being discharged and throughout the following week but never received a callback from nursing staff or doctors. When Kathy visited her doctor, she was told that the pain might be related to the fact that she stopped smoking at the time of her operation and that she should try to cut out fat out of her diet as a means of helping. At no point did any medical professional suggest that there may be a physical problem with the mesh implant. All told, Kathy went a full five years of trying to cope with abject pain before the cause was identified as the mesh implant itself. A routine check-up with her gynaecologist revealed that the tape was in too tight on the right hand side and as such was constantly tearing at her obdurator muscle. On seeking the advice of her surgeon, she received the devastating news that because her tissue had grown around the implant, it could not be removed without further significant nerve damage. Had someone taken her call at the hospital in the days after her operation, perhaps a reversal or a correction could have been performed then and there. So imagine her horror at receiving that news and also consider that she, like several others, had been told at the time of surgery that mesh plastic would simply melt away over time. Once the cause of Kathy's pain was identified as the physical obstruction in sight here, she was heavily medicated with gabapentin and that drug had such a soporific effect on her on her daily life, it forced her to retire from the job that she loved long, long before she had planned to. Kathy's implant has had a significant impact on her mobility, her intimacy with her partner and her mental health. The mesh implant has devastated her quality of life and she has left with the options of making do or having it removed potentially far greater nerve damage and result in pain. She is far from alone in feeling like that and we have heard so many times that countless other cases like it. I am sadden that it has taken us so long to get to that point to reimburse those people who have taken the step to have that harmful mesh removed privately. Even that bill will not give my constituent back that quality of life, that period of life that she has lost to her. I do not want to downplay the importance of this bill. It is important. We will support it. Financial reimbursement is an essential part of regaining the trust of so many victims of this scandal and recognising the harm. I think that Carol Mocken was absolutely right that this bill sends a very important signal to those mesh survivors that we see you and we hear you and we recognise what has been done to you. The uncertainty surrounding who might be eligible for reimbursement as a result of this bill is a cause of concern. I think that that has been recognised. We are also concerned that it might actually only impact on a very limited number of people. We will work to help improve it as we transit through Parliament. I want to explore—and perhaps this is a meeting that I will have offline with the Cabinet Secretary if he is so willing—to see whether the reimbursement could be extended to survivors of hernia mesh removal, as well who paid for that privately. I have had a number of cases that I have raised with his predecessors about people in equally debilitating pain as a result of hernia mesh implants. At present, it was not within the scope of this bill. I do not imagine that that is a huge number of people, but certainly the issues are much the same. I recognise that I am running out of time, Presiding Officer. We have to offer more than more words in this chamber, and until now that is all that we have been really able to do. I think that it is fair to say that we have been talking about this for years. Dr Veronikas has been on the table for years. We have known about him for years, but it is only recently that these procedures have started to take place. I think that it is a shame that we have only managed to do 33. I recognise the limitations that we face, however. I hope that we will be able to increase the rate at which we help people far faster. I will finish by saying this, Presiding Officer, if I may. To the survivors of the scandal, I say this. What you have been through is an outrage. No one should have to suffer so much physical or emotional pain because of a procedure that they were reassured would increase the quality of life. You deserve so much more, and I am so sorry that you have been successively let down by the Governments who were supposed to protect you. This is one of the worst medical scandals in the history of this country. We must offer more, and we must do so urgently. We now move to the open debate. I call Stuart McMillan to be followed by Craig Hoy. Thank you very much, Presiding Officer. At the outset, I welcome this bill and appear tribute to everyone who has campaigned on the issue, but most importantly, the women who have campaigned for justice. I thank the Scottish Government for listening and for acting. I also congratulate the members of the health, social care and sport committee for their excellent stage 1 report. They have captured the bill well and their recommendations are very much welcome. I have dealt with three constituents who have had mesh complications. Every one of those ladies had their lives adversely affected in many ways. I have a great deal of correspondence with the Scottish Government, on behalf of one lady in particular. She is called Michelle, and I have permission to highlight her today. The bill offers a great deal of hope for Michelle and many other women. The physical pain and mental challenges that these women are living with daily cannot be imagined. Add to that is the loss of trust in our NHS services as referenced throughout the report. There is no wonder that many women look beyond our NHS trying to reclaim some of their old lives back. Not one of my constituents with mesh problems believe that they will get their old lives back fully, but a life of less pain and progress towards reclaiming their lives will be a positive outcome for some. This is why the first sentence in the recommendation that paragraph 9 to do is so important. I quote the committee supports the principles of fairness, equity and parity, which, in its view, underpin the bill. If the bill's aims are that and they clearly are, then the discussion about how women have or will fund mesh removal treatments is redundant in my opinion. Not every person has tens of thousands of pounds in their savings bank, therefore I have to raise finance somehow. For some it will be boring from friends and family, for others it will be bank loan or maxing out a credit card, for others it will be selling items or organising funerals and nights to bring in extra resources. Another example will be to use a crowdfunding platform. I know that Michelle had many of those examples, but she was struggling to deal with the pain and wanted to reclaim some of her life. At some point in time, just about every MSP as a candidate to get elected to this parliament will have undertaken a crowdfunder. Why can we do that, but there appears to be a concern that women in pain cannot? It makes absolutely no sense to me. I therefore welcome the recommendation of paragraph 69, but I also note the comments attributed to the cabinet secretary in paragraph 68. It is clear that there are many unknowns regarding the bill, i.e. how many women will be eligible for the scheme, how many women will pursue the mesh removal treatment and the actual cost for each woman and the travelling companion. That is where it is extremely challenging for the cabinet secretary and the Scottish Government to produce a financial memorandum with absolute financial clarity. That is where the stage 1 report asking for a reassessment of estimates is perfectly reasonable. The paragraph 87 in the report makes the recommendation about an appropriate level of scrutiny to take place with regard to future subordinate legislation about the proposed scheme. As a convener of the Delegated Powers and Law Reform Committee, I can see how using the affirmative procedure would be beneficial in this instance, but I also accept, as the committee itself did in paragraph 10, that the committee has been keen to ensure an appropriate balance between enabling effective scrutiny of the bill, while not unduly delaying re-embossment to those affected. I note the comments from the cabinet secretary today and, in his reply to the committee, that the regulations—if they were regulations—could actually be more time-consuming, and therefore the administrative scheme could actually be a lot quicker. The final point that I want to address is the self-titled in-betweeners that I suggested in paragraph 33 in the report. I also note that I welcome the paragraph 35 in the report highlighting, and I quote the cabinet secretary's intention that anyone who made their own arrangements for treatment outside of the NHS on or before the announcement on 12 July 2021 will be able to apply for re-embossment, regardless of whether or not that treatment has already been carried out. However, the committee recommendations in paragraphs 39, 14 and 41 are really important, particularly the call in paragraph 40, asking the Scottish Government to, and I quote, demonstrate appropriate flexibility in the definition of making an arrangement for mesh removal surgery. The clarity surrounding the making and arrangement will, I hope, provide absolute clarity to Michelle and other women. I note that dialogue and communication took place prior to 12 July between Michelle and the professor that she had an operation with, but the agreement and also the operation were signed after 12 July. I welcome the statement from the cabinet secretary and provide that greater clarity regarding the post-12 July situation and also when the procurement exercise, which was announced also on 12 July, and the dates when the contracts are established in addition to the pathways open to referrals. My considerations in this bill are solely for Michelle and other constituents I have spoken to. Nothing would be able to change the experiences that she has suffered and had to endure, but, with the greater clarity and passing of the bill, I hope that she can have a future that is more positive. We, as a Parliament, owe them that. As a new member, I am pleased to be able to speak in this debate about what is a short but landmark piece of legislation. This is legislation that has taken too long to come, but it is nonetheless legislation that I hope might still stand out as an example of what this Parliament can achieve when we work with and on behalf of our constituents. I pay tribute to the women who have got us to this point and also to colleagues in this chamber, such as Jackson Carlaw and previously Alex Neil and Neil Findlay, who became their voice in this Parliament. As we have heard, the bill establishes a scheme to reimburse people who have made their own arrangements to have transvaginal mesh removed. From the outset, let us recognise that those were women who faced scepticism when complaining about adverse effects, women who felt they were not believed, women who experienced distress and who often experienced very long periods of time before remedial surgical intervention could take place. Many elective representatives, whether MSPs, MPs or councillors, have been contacted by constituents living with the terrible consequences of transvaginal mesh. Mesh that was used to treat problems often linked with childbirth, including stress, urinary incontinence and pelvic organ prolapse. Shockingly, the worries over mesh were all too often dismissed by some in the medical profession as women's problems. This was lax, this was negligent, this was insensitive and this was wrong. And yet it continued in some cases for nearly or over 20 years. And let us be in no doubt that the action of some in the medical profession exposed women to avoidable harms for too long. In July 2020, in her review into the avoidable harm caused by mesh, Baroness Cumberlidge, in her inquiry looked into the pain and suffering that women, often very young women, were forced to endure. As we have heard today, this included severe and chronic pain, recurrent infections, mobility issues and incontinence. It highlighted complications including prolapse, bowel problems, sexual difficulties, fatigue, depression, PTSD, suicidal feelings and sometimes death. Tragically, women also reported that mesh complications led to relationship failing and family breakdown. It resulted in a loss of employment families losing their homes and it led to financial hardship. All life changing, Presiding Officer, but all avoidable. I thank the minister for his thoughtful and open-minded response today at stage 1 and welcome his willingness to look at any enhancements or amendments to this bill at stage 2. Today, I want to take this opportunity to commend the many women in the support groups that they established around the world. They were tireless, brave and committed campaigners who spent years raising the alarm about the consequences of mesh implants. Those women did not give up and did not go away, even when, deep down, they felt shut out and ignored, but their commitment eventually led to a breakthrough in this Parliament. The petition presented to the Parliament by Elaine Holmes and Oliver McElroy on behalf of the Hero Voice campaign means that today we are considering the bill at stage 1. The petition called for suspension in the use of transvaginal mesh and a full evaluation of safety concerns. It also made the case for the introduction of fully informed consent throughout Scotland. It called for the improved reporting of complications after surgery and a national register of all procedures linked to international registers. In 2017, the Scottish transvaginal mesh implants independent review recommended stopping the process altogether, and since then, the pop transvaginal mesh surgery has been restricted to research trials only. However, let us not look at the tragic and justifiable loss of trust that many women felt and some continue to feel towards some in the medical profession and our NHS. They felt isolated, saw their concerns dismissed and many then sought removal surgery outwith and often well beyond the boundaries of the NHS. They went to private providers at home and abroad and secured funding through a range of means. It is worth noting that there was no available referral route to independent providers and that today the Scottish Government acknowledges that and recognises the lack of trust and the reasons behind it. The legislation rightly conceits that the circumstances are exceptional and that reimbursement for both the cost of surgery and associated travel and other costs is fully justified. However, the bill's consultation process also raised several concerns about the eligibility of who can apply for the scheme and many of those have been touched on already today. As Stuart McMillan noted, there is a question mark surrounding some of the sources of funding used for private treatment, for example whether women should be eligible for reimbursement if they receive money via crowdfunding. Although the Scottish Conservatives strongly support the bill, we believe that further clarity is needed on the issue of the eligibility criteria. I also welcome Gillian Martin's call today that, once the bill is passed for wide promotion of the reimbursement scheme, we should, however, never lose sight of the fact that we are dealing today with women who were badly let down, women who faced devastating life-changing consequences as a result. We have a responsibility to ensure that they receive the best and the most appropriate treatment available. We have a duty to help them to rebuild their lives. I look forward to the concerns raised at stage 1 being addressed as the bill makes its way through this Parliament because, for mesh sufferers, the legislation cannot come a moment too soon. Now is the time to fully deliver the care, the compassion, the compensation and, hopefully, the closure that the victims of transvaginal mesh so rightly deserve. I was a member of the Public Petitions Committee back in 2014 when the issue of probably propylene mesh medical devices was brought to the committee's attention by Scottish mesh survivors. To this day, I vividly recall the passion and the strength of feeling of all the women that gave their time to attend their meetings, to give evidence and recount their stories and personal experiences. It is thanks to the tenacity and bravery of his women that we are here today, discussing the introduction of transvaginal mesh removal, cost reimbursement, Scotland Bill and the significant number of steps that the Scottish Government has taken to offer assistance and better help women harmed by vaginal mesh and complications arising from it. As a current member of the health and social care support committee, I am delighted to see a bill introduced that aims to give the powers to the Scottish ministers to reimburse persons who have entered into arrangements privately to have paid to have the transvaginal mesh removed from their body in relation to the cost of removal surgery and also reasonable connected expenses. Before it was halted in 2018 by NHS Scotland, we used polypropylene mesh medical implants to treat pelvic organic prolapse and stress utenory incontinence left many women with life changing complications and facing multiple operations to remove it from inside their bodies. Recognising by his Government of the suffering and considerable harm caused as a result of complications arising from the use of transvaginal mesh and its determination to do everything within its powers to help was affected, it is hugely encouraging. We have already taken a decisive action on mesh and now in Scotland is the first UK country to reimburse people for private treatment previously sought. Before coming here today, I spoke with a constituent who was dealing with the trauma caused by her mesh implant for over five years. She was fitted with implants following a front and back prolapse in November 2016. By February of 2017, the mesh had come loose, resulting in her uterus hanging outside her body, starting a chain of visits back and forth to gynaecologists and attempting to find someone to help. Everyone recognised the impossible situation that she was in but no one could offer a solution. In her words, her life effectively ended in 2017. Living with extensive daily bleeding, double incontinence, a constant exhaustion and a sizeable uterine tissue bulging outside her body meant that she had to give up work and lost contact with family and friends. She went from being an outgoing social woman to someone who physically couldn't leave the house. I don't think that any of us can truly appreciate the mental strain that this must have caused. After many years of solitude and a bid to live a normal life by tenning a family function, she reports fasting for an entire day and night beforehand in hope that she might be able to enjoy her occasion. Despite this, she lasted only one hour before having to call family and friends to sister to leave discreetly for an instant of bowel incontinence. Needless to say, she didn't attend any more events. She has recently found a surgeon who has offered some hope and is now on the first steps of a journey that will hopefully see her quality of life begin to improve. It is clear to see why some women felt let down by the NHS and felt we need to seek private arrangements to have transvaginal mess removed. A daily stress caused by imaginable pain, accompanied by difficulties posed by incontinence issues, led many to pay in a region of £20,000 to travel to private clinics to pay for treatment. I highlight her story today, but it was easy to get lost in numbers. We have to look past the data and the statistics and the costs to see real people beneath. To the personal experiences of mothers, daughters, sisters and families, all the costs of country whose lives have been negatively affected by life-changing complications and pain, many of whom have ended up in wheelchairs, have endured multiple organ trauma or extensive nerve damage. All have a story to tell, many of them harwain, but it is our duty to listen. Earlier this year, we saw a case record review begin, which is looking into concerns raised by patients about their medical records. As we move forward, the continuing work of the review for women who have raised their concerns about whether a case record has accurately affected treatment that they have received, specifically in relation to full and partial removal of mesh, will be vital too, ensuring that the affected women's voices are heard. By giving women an opportunity to set out their concerns, have their records reviewed by clinicians to allow for discussion, explanation and mutual understanding. I truly hope that those women get the answers that they need about their situation. In conclusion, I am delighted to see the introduction of the bill and fully support the recommendations in the report, which I hope the Government takes on board. In particular, the recommendations that any scheme must include a flexible approach to reimbursement that takes account of individual circumstances. Those women have already been through so much and I believe that the time is long overdue for all women who need their mesh removed to have it done and to compensate affected women for the cost of private mesh removal surgery. I pay tribute to hundreds of women who came together and have campaigned tirelessly to highlight the suffering caused by effects of probably plain mesh implant surgery. I look forward to the progress of the bill and to working alongside all colleagues to ensure that no other women will have to endure the dreadful experience that mesh survivors have had to endure. I call Katie Clark to be followed by Evelyn Tweed. Thank you, Presiding Officer, and it's a pleasure to speak in this debate and welcome this bill. I congratulate all those who have campaigned for this legislation over such a long time. I also welcome all the contributions that have been made so powerfully here today. Like others, I have met mesh survivors and I have found even hearing about some of the experiences of the women directly affected harrowing. The details of the massive life-changing implications that they have often said have ruined their lives and the considerable pain that women have endured as a result of the use of mesh are difficult to forget, and therefore the bill is clearly very welcome. I hope that it will help the women who were involved who were affected, and in particular I hope that it will be welcomed by the Scottish Ness survivors campaign. I hope that all the women who are affected by vaginal mesh removal will receive the treatment and the appropriate expenses in the way that MSPs wish them to do. However, there are many other mesh survivors who are not covered by this legislation and we also must not forget them today. Another petition has been lodged in this Parliament, which refers to some of the other women and also men who have been affected by the use of other mesh procedures such as hernia mesh, recto mesh and mesh used in hystorectamase. I suspect that others have been contacted by constituents who have been adversely affected by those types of procedures and are asking for actions similar to that proposed in the bill today. I hope that the Government will listen to what it is saying and to the review that it is asking for for all those forms of procedures also. I hope that the Government will adopt a similar approach to those individuals as they have to the women affected by vaginal mesh that we are discussing today. The issue was first raised in this Parliament in 2013 and has been regularly raised since that time. The fact that it has taken so long to get this to the point where we have a bill in front of us today is important. We know that the independent medicines and medical devices review, which was led by Baroness Cumberlidge, looked at those issues, and indeed many of the steps that the Scottish Government is putting into effect today are based on the recommendations of that review report. One of the issues that that report looked at was the way that women are treated when they raise health concerns, and we have already heard about how women were not believed and how women were not listened to. That is not just an issue in relation to this form of mesh procedure, but it is something that many of us have been aware of and have experienced over many, many years. I think that there are many lessons that we all have to learn, and Government has to learn from the way that the vaginal mesh has been treated that are relevant to many of the other situations that women are in in the health service. Another recommendation from the review report was that manufacturers should be involved in contributing to the cost of redress, but it does not look like the Scottish Government is getting any money from manufacturers. There are a number of manufacturers. Ethicon is one of those manufacturers and is a subsidiary of Johnson and Johnson, and I use that company as an example. We know that they are losing court cases. At one time, Ethicon faced more than 40,000 transvaginal mesh lawsuits, which were based on their negligence in relation to transvaginal mesh devices, but also bladder sling complications. A number of those lawsuits have been successful, and according to their 2020 annual report, there were still 14,900 pelvic mesh lawsuits outstanding. They have agreed to pay £117 million in 41 states in the United States of America, and the District of Columbia agreed to settle claims in relation to deceptive marketing of pelvic mesh products in October 2019. The bill is, of course, in its initial stages. I hope that, during the course of the bill, we will look at all the issues that are being raised today, but we will also look at the responsibility that manufacturers have in their process and how we make sure that women who are affected by those procedures get justice from Government but also get justice from some of the others who have been negligent and have failed to respect and provide adequate services for women who are facing difficult situations. I hope that, during the course of the bill, we will be able to explore those issues and strengthen the legislation. As a member of the Health, Social Care and Sport Committee, I am pleased to take part in this debate. I welcome the cross-party support that I have heard today for the general principles of the bill. I thank the women who have come forward to share their experiences. That could not have been easy. Without their assistance, we would not have been able to uncover the serious damage that transvaginal mesh surgery has caused, and not just physically, but emotionally, mentally and financially. As other members in this chamber have expressed, the damage and pain endured by women as a result of mesh implants cannot be understated. Lives have been turned upside down, mental health destroyed, finances stretched to the brink, all whilst putting up with daily and excruciating pain. For the women at the centre of this crisis, following medical advice seemed the obvious thing to do. We would all have done the same. We accept the advice of our medical professionals who are acting on the best information available to them. Living with issues such as stress, urinary incontinence and pelvic or organ prolapse, they trusted the medical guidance to have mesh, also known as transvaginal tape, implanted into their bodies. We know that mesh can cause severe pain in the lower abdomen, sometimes leaving women unable to walk. We must accept that, occasionally, our health service professionals will get things wrong. That is inevitable, and so it was absolutely right to permanently halt the use of TVT and apologise to the women affected. When something goes wrong, the most important thing is to put it right with due diligence and care, and as fast as reasonably possible. Over the past few months, I have heard heart-breaking testimonies detailing not just the physical pain but significant mental and emotional trauma as well. For some, this pain has been so severe that it has been forced to fund private healthcare through remortgages, bank loans, credit cards or borrowing from family and friends or crowdfunding. For those women, many who are still in substantial debt, time is of the essence. There can be no further delay. I, like others in this Parliament, have listened to those women, but more importantly, the Cabinet Secretary and the Scottish Government have listened. I am sure that every member in the Parliament will support this bill and its fast-tracking, so that those women do not have to wait any longer as they have waited long enough. The Government has confirmed that women who arranged mesh approval surgery will be eligible to apply for reimbursement, and it does not matter if the surgery was successful or not. I completely understand for the women who have been through such traumatic experiences that compensation for corrective surgery might not be enough. We must do more to put right those wrongs and build back the trust. To ensure that patients receive treatment that they have confidence in a procurement process is under way to allow appropriately qualified surgeons outside the NHS to perform removal for patients in Scotland. That said, this is clearly an exceptional situation. Our brilliant and dedicated staff in the NHS have learnt from those past mistakes. The complex pelvic mesh removal service is now established in NHS Scotland to allow everyone affected to get the treatment and the care that they need. I am also pleased to see that the Health and Social Care Alliance will undertake a patient focus group to understand patients' views on how the scheme of reimbusment might work in practice. The feedback from that will play an important role in shaping the scheme. I welcome the Scottish Government's response to the committee's stage 1 report, which accepts the bulk of the recommendations that are put forward as the Cabinet Secretary has outlined today. I also note the urgency in which the Government wants to act. I note the Government's intention under the bill to take a proportionate and flexible approach to the provision of evidence of costs incurred. That will provide much reassurance to the women involved. I also note that some points will be considered in the draft scheme and look forward to seeing that. Sadly, transvaginal mesh was used regularly in Scotland before 2014. It was also used in the rest of the UK and across the world. Scotland is the first UK country to reimbus people for private treatment, and I am pleased that the Scottish Government is once again leading the way and taking decisive action to make people's lives better. Thank you to my colleagues in committee and across the chamber for welcoming this bill to Parliament. As a member of the health, social care and support committee, I am very pleased to be speaking in this debate and in support of the bill at stage 1. I wanted to start by thanking the women who came to give evidence at committee and all those who have campaigned tirelessly for justice. I cannot imagine the impact that this has had on your lives and those of your families, and I am in awe of your continued determination. I also want to thank those MSPs and former MSPs who supported the women last session, including those affectionately known by mesh survivors as the mesh catairs—Alex Neil, Neil Findlay and Jackson Carlaw. I am keen, as I am sure many of my colleagues across the chamber are, that we get a reimbursement system that is flexible enough to ensure that no one is unfairly penalised. Many of the women who paid for their own mesh removal did not anticipate being reimbursed. For many, that will mean that they no longer have food receipts or proof of taxi journeys, for example. The committee also raised concerns about the potential restrictiveness of both the proposed cut-off date of the scheme and the residency requirements, and I am pleased to hear the commitment of the cabinet secretary on the residency element. We heard at committee that, for some of those going to America for surgery, Covid has delayed those trips, and I hope that we have a contingency in place to ensure that no one falls through the gap between the cut-off date for the reimbursement scheme and the start date of the new private surgery contracts. A point that I thought was well made at committee by Jackie Baillie. For some of the so-called in-betweeners for medical reasons, they may not be able to wait for the new contracts to be in place if mesh was compromising organs or causing unbearable pain. If that legislation is to achieve its intended purpose, we must avoid women falling through the cracks. As the committee report notes, the bill documentation does not address the question of whether cases where private removal surgery has not been fully or partially successful will be reimbursed. I believe that no survivors should be penalised for not having had a successful surgery. For some women, full mesh removal will not have been possible. Emma Harper made the excellent point at committee that it will be difficult to measure success. Is it 40 per cent mesh removal, 60 per cent or 90 per cent? Some may have had private exploratory surgery to be told that their mesh could not be removed, and I believe that they should still have their costs reimbursed. We must ensure that women are not excluded from the scheme due to circumstances outwith their control. We also need to take account of the fact that some women will not have been able to afford the cost of private removal surgery and will have not expected to be reimbursed, so they did not pursue private treatment. As the committee report notes, those women may have experienced the same breakdown in trust between them and the NHS and may understandably be upset that they have been further disadvantaged than by their inability to pay up front. We must ensure that trust is rebuilt between them and the health services. Some women will have borrowed money from family and friends to pay for their surgery. I strongly feel that they should not be excluded from any reimbursement scheme. Some women had to leave employment due to the debilitating effects of mesh implantation, and some of their partners will have become full-time carers. They may not have been able to secure a loan and so should not be penalised for having to turn to family and friends for help. I appreciate that there may be difficulties in securing evidence for informal donations as opposed to a bank loan, and I welcome any comments from the minister on how those issues could be worked through. In committee, I raised the importance of supporting mesh survivors' mental health and asked whether consideration has been given to reimbursing private medical costs related to mental health treatment. Some mesh survivors may have lost confidence in the Scottish NHS as a whole and they may want to seek private treatment for what has been, for many of them, a traumatising event. If the bill is about writing a wrong, I think that we need to consider other forms of treatment and support the women who have had to seek as a result of their mesh surgery. I also have concerns about the residency requirement. I believe that women who received their original mesh surgery when they were resident in Scotland should qualify for reimbursement under the scheme. Some women may have moved away from Scotland after their original surgery due to a breakdown in trust between them and NHS Scotland, and I do not believe that they should be penalised for that. As the committee report notes, greater clarity is needed around this if the bill is to adhere to the principles of fairness and equity. I would like to close by saying that I look forward to working with members across the chamber as the bill progresses. We have all heard the devastating impact that mesh implantation has had on many of the women affected. It is vital that the bill establishes a comprehensive, fair scheme that does not result in mesh survivors falling through the cracks, and we owe them that at least. I would like to start by thanking the cabinet secretary and the members of the health, care and sport committee for their work in bringing the bill to the chamber. More than anyone, I would like to take a moment myself to thank the women who have campaigned so tirelessly on the issue. It is no exaggeration to say that the bravery shown by the women involved in this debate has been inspiring. Prior to my election, I followed this debate very closely, whether Westminster or Holyrood and listened with concern, disbelief and anger at the accounts of those women who have suffered and continue to suffer as a result of transvaginal mesh implants. I read testimonies from the women who informed Baroness Cumberledge's inquiry and found their accounts striking, highlighting wider issues in how patients are communicated with. No one is listening, the patient's voice is dismissed. I was never told the failure of informed consent. It is therefore important today to acknowledge the invaluable work of advocacy groups such as the Scottish mesh survivors group and Alliance Scotland for their role in progressing this issue. The reports published by Alliance Scotland in 2019 and 2021 provided a platform for mesh survivors to collate their lived experiences and present their irrefutable findings. It is safe to say that their voice is finally being heard loudly and clearly in this chamber. Indeed, listening to mesh survivors is central to today's bill. It has taken too long to get here, but I am pleased that the steps taken to reach this point have resulted in mesh surgeries in Scotland dropping from 2267 in 2009 to the current day, when no further vaginal mesh surgeries have taken place in Scotland since 2018. The Scottish Government now seeks to continue its work into redressing the wrongs suffered and, in turn, rebuilding the trust that has understandably been lost. Thankfully, today's debate moves this conversation forward again and is now focusing on how best to expedite the satisfactory resolutions for those women still suffering the consequences of this treatment, whether they be physical, mental or financial. Costs in each case are substantial, estimated between £16,000 to £23,000, significant sum by anybody's standard, let alone for many of the women who could not afford this but, in desperation, absorbed that heavy financial burden in the hope of alleviating the daily agony that they endured. The simple fact that the legislation proposed aims to not only assist the women who still require corrective surgery, receive it in a manner that they are comfortable with but also allows for reparations is something that transcends political affiliation and I welcome the cross-party support on this issue. I therefore welcome this bill at stage 1 and the Scottish Government's continued commitment to ensuring that every woman in need of corrective surgery due to transvaginal mesh receives it. It is performed by a surgeon they have full confidence in, while also removing the financial burden that so many have been left with who merely sought to take control back over their lives. It is important that the women who are forced to seek private arrangements to remove the transvaginal mesh are reimbursed for the cost that occurred. At the scheme moves forward as soon as possible. Presiding Officer, I would like to thank those who stepped forward and an act of courage and provided evidence about the complications with the mesh and the later arrangements that they made to have it removed. Such an act could not have been easy thing to do but their strength and convictions have led to this important issue being debated here today in Parliament. I am very grateful to follow on from some of the excellent heartfelt speeches that we have heard today in the chamber from all parties. The bill before us today does far more than just reimburse women who have suffered from this procedure. It corrects our wrong, particularly for those women whose painful side effects and complications were not taken seriously. Concerns about the severe and painful complications arising from the use of the mesh have been reported since the mid-2000s. Just today, a survivor told the STV news that feels like you are getting sliced. I would sooner go through childbirth again with no gas in ear and no drugs. The pain is chronic. It is there all the time and you cannot switch it off. It exhausts me. Some days I do not get out of bed. I have got to use walking sticks and I have a chair. When I get up, I am off balance. While those words may make many of us uncomfortable, the simple matter is that those women went through years of pain with no support. We cannot forget them. I am happy that the special service has been in operation and established a multidisciplinary team of skilled professionals. I look forward to reading the service review next month. I fully support the bill and the objectives of the bill that seek to ensure fairness and consistency of the treatment for all individuals in relation to the mesh removal service in Scotland and the falling scheme for reimbursement. However, it is certain that there must be more clarity within the bill to ensure that its objectives are met, beginning with residency criteria and timescales. On residency, the current state of the bill excludes those who have their mesh fitted in Scotland and later, had the mesh removed while residing in another country. I welcome the cabinet secretary's comments today on agreeing to table an appropriate amendment at stage 2 on the residing criteria. As those people deserve to be reimbursed, at the end of the day, they suffered, they were ignored and they had to take matters into their own hands. It is the Scottish Government's responsibility to ensure that those people are compensated. In relation to timescales, the bill in its second stage must also address people who are currently awaiting or in the middle of organising treatment privately. It is our duty to ensure that we begin to build back the trust between those individuals and the NHS, not break it. Presiding Officer, across the chamber today, there is broad support for this bill, and as there should be, but that does not mean that we cannot discuss any concerns about the detail of the scheme. Therefore, I fully support the bill and its objectives, and I welcome the cabinet secretary's comments today on looking at adjusting the cut-off date and tabling the appropriate amendments at stage 2 on the residing criteria. Presiding Officer, it took a decade for those women to be recognised and believed. However, we must not wait years to deliver the support and pain relief that those women are so desperately in need. Therefore, we look forward to working cross-party to ensure a timely and smoothly delivery. I welcome the bill to Parliament today. I have been attempting to navigate through the absolute nightmare of living with mesh for 12 years. This is a heartbreaking testimony of Isabel from Presswick, a constituent of mine who has got in touch when there was nowhere else to turn, after years of suffering because of the mesh implant. She has given me permission today to tell her story. 12 years ago, Isabel received the implant in the hope that it would improve her quality of life after the birth of her second child. The mesh, which had been around for a number of years before that, was hailed as a revolutionary treatment for women, suffering from stress in continents or prolapse, issues that arise from having children. Isabel's surgery was to correct a prolapse bladder. Fast forward to now, and Isabel has had to have six surgeries to correct the damage, to remove the mesh and a hysterectomy. Every day, she continues to live with chronic pain in her legs, her buttocks, bladder complications, erosion of tissue and, sadly, the original problem, the bladder prolapse. The pain was so great that she had to call time on her 30-year career in education. It is not just Isabel. We have heard countless stories today of women with severe and constant pain in their abdomen, stomach, bladder and limbs. We have heard stories about women in wheelchairs and, sadly, deaths. The women going through this living hell have had to fight every step of the way to get help. Through evidence sessions and inquiries, sharing the most intimate details of the medical history and to be still in pain with nowhere to turn, only five centimetres of mesh was ever removed from Isabel, with the mesh centre in Glasgow discharging her, saying that there was nothing more that they could do. Earlier this year, women were promised surgery in England and the US to correct the wrongs of the mesh implant caused, but we must do more. We must act quicker. As women say, they feel like they have been forgotten about. The weight to see these specialists sometimes can be up to two years. Women are suffering day to day and two years is an eternity and we must be prepared to pay for the damage that this has caused. Day to day living is getting harder for Isabel. She's left no stone unturned in her pursuit of a better quality of life. Finally, Isabel has turned to me. It is important that I be the last of this chain. I need to find a solution for Isabel and I'm all too acutely aware of what that solution is, it's money. For some women, the announcement gave them hope, something they felt they'd given up on a long time ago. But we need more than hope, we need more than promises, we need action. The mesh removal bill seeks to reimburse women who have paid for the procedure themselves, including costs of travel, whether it be to Bristol or the US. The cost of the procedure could be between £16,000 to £23,000, which we've heard previously, and for many people like Isabel, that money just isn't there to pay for these costs up front. We must remove all barriers to this surgery that seeks to give some quality of life back. Isabel told me, because of the on-going complications and chronic pain, the youngest daughter has never really met the real me. She describes that as the worst of all the side effects. We cannot turn back the clock, but we can correct this going forward. We need to streamline the pathways that ultimately will give Isabel her life back, a concrete achievable timeline. Her daughter can't afford to wait another two years to meet the real Isabel. I'm grateful that the Scottish Government is helping women through this bill, however today I ask that we go further, make referrals quicker, make decisions quicker, put contracts for the removal in place and putting funding in place across the board, not just for those who can afford it and pay up front. I welcome the health committee's recommendation to the bill for further detail from the Scottish Government on campaigns to publicise a complex national surgical service training for primary care staff on mesh complications and person-centred approaches for supporting individuals through treatment, including pre- and post-operative support. I'd also like to ask the Cabinet Secretary in instances such as Isabel if my constituent does not wish to have further surgery in Glasgow and wishes to choose her own consultant such as Dr Veronica's to carry out the procedure, would the Scottish Government consider supporting these women to bring peace of mind and a conclusion to their ordeal? It's only fitting that I end with Isabel's words. Many older mesh survivors have been through the system and have been discriminated against and ignored. Time is running out. I welcome the first stage of this bill as we move forward to rectify the situation. Thank you very much, Ms Brown. Before calling the final speaker in the open debate, I remind members that anybody who has contributed to the debate needs to be in the chamber for their closing speeches. With that, I call the final speaker in the open debate, Martin Whitfield, for six minutes. I'm very grateful, Deputy Presiding Officer, and I'd like to extend my thanks to the committee for their report on this. However, I also want to put on record, of course, my admiration for those women that have fought with dignity and determination to get this chamber where it is today. And I know that this debate would not be taking place but for the bravery of the Scottish mesh survivors and indeed both their demand for this bill but also that phenomenally powerful willingness to share their personal stories. And can I congratulate Siobhan Brown and indeed her constituent, Isabel, on allowing her story to be shared because it's through those stories that we actually see the significant impact of those events that happened over a decade ago and carried on. That willingness to share is so important so that people who are unaware of the suffering can empathise and see what has happened. Let me say from the outset that we were fortunate to have a national health service that is free at the point of use. And throughout this pandemic we have seen the very best of our NHS here in Scotland and its heroic workforce. However, we must hold our hands up and accept mistakes were made with many, indeed far too many women being failed when their transvaginal mesh devices were inserted by NHS doctors and as such and to this day many women are reluctant to return to those very same surgeons and have the device removed. I sympathise with them, I understand that and it will take a long, long time for the trust to be rebuilt between the NHS and those women. And for this reason and many more, I'm supportive of the overall aims and principles of the bill. Women have gone through a traumatic experience since having their mesh fitted and it is right that the Scottish Government covers the related costs that have been incurred in removing the device and after all it has taken us a long time to get to this point, perhaps too long. So in the short time that's left, Deputy Presiding Officer, if you'd allow me I'd like to pose a few questions to the Cabinet Secretary and the Minister not to raise any disagreement but to seek advice. Today in Glasgow mesh survivors felt the need to protest outside the new Victoria hospital in Glasgow and part of that protest is in respect of the length of time that's been indicated to them. They may have to wait for initial assessments and there is a talk of up to two years. There are members of the mesh survivors group that are there today who have had their appointments cancelled with just a week's notice. These are the very women we are asking to seek again and to trust our NHS and I know there are challenging problems, we are all aware of that but I think for this particular group of women so much more should be done to bring reassurance and confidence going forward. In the Cabinet Secretary's opening he talked about the 33 women who have received their mesh removal operations now. Would it be possible to tell us how many women are still waiting for mesh removal and finally we have heard today from a number of speakers about the challenge that exists over the date that's being anticipated to go in this bill and I welcome obviously very much so the Cabinet Secretary's willingness to reconsider this but I wonder whether comment could be made if that date couldn't be the date of commissioning the ongoing surgery and that way we would know that all of the women's survivors will be covered up until the point that there is an alternative suitable and supported method to see a journey to the end of the problem that we are at. Can I welcome all of the speeches that I've heard today particularly those that have shared the very very powerful testimony of those individual women who have suffered from this. We should not have been in this place but we are and it is now for this Chamber to show that there is a way out but that has to be done swiftly so that trust in the NHS can be reassured. Thank you Deputy Presiding Officer. Thank you very much indeed Mr Whartfield. We now move to closing speeches. I know that Gillian Mackay isn't present in the chamber and I would expect an explanation for that in due course but with that I ask Paul Cain to wind up for around six minutes Mr Cain. Thank you Deputy Presiding Officer and in closing for Scottish Labour I wish to begin by reflecting the strong consensus I think we have heard in this debate today. Stage 1 of this bill marks a significant milestone in what has been a long painful and difficult journey for so many. The cabinet secretary rightly opened by reflecting on those who have brought us to consideration of this bill today and I too wish to pay tribute to the steadfast determination of Scottish mesh survivors who have bravely told their stories and campaign for this bill and other measures to support all those affected. Having heard myself, some of the testimony in committee, I am struck by the bravery of women recounting the trauma they have experienced and lived with not only to effect change for themselves but also to effect change for the many others who have had the same experiences. As we have heard they have repeated these stories time and time again which I am sure we all agree is a hugely difficult thing to do and extremely courageous. I too will join colleagues in paying tribute to MSPs past and present who have worked on this issue and brought us to this point, particularly Jackson Carlaw, Alex Neil and Neil Findlay. I thought the convener of the committee, Gillian Martin, spoke powerfully when she said that this bill couldn't and doesn't undo the trauma and that trust in a health service for some has been irreparably damaged. I think what she said about choice and control for those women over their bodies and their lives is key to all our considerations, whether in this bill or more widely, on this issue. Indeed, as deputy convener of the Health, Social Care and Sport Committee, I commend the work of all those involved in scrutinising the bill and, like the convener, thank all those who gave evidence, particularly those with lived experience who were supported by the Alliance. Sandesh Gohani spoke of the fact that many women simply haven't been believed for such a long time. I think that he is right to highlight the fact that many took extraordinary action in order to fund their treatment spending savings or taking costly loans—anything really—to stop the pain. In line with the consensus that we find across this chamber, Scottish Labour is supportive of the overall aims and principles of the bill. My colleague Carol Mawkin, in opening spoke of the power of our democratic process and, I think, the duty upon all of us to use the power of this place for the good of those we represent. Alex Cole-Hamilton echoed this, I think, in his powerful recollections of how Parliament has approached this issue over the years. Indeed, we have heard many powerful stories from colleagues this afternoon on how the experience has impacted their constituents. Stuart McMillan spoke of Michelle and raised the issues of the lens that women have gone to in order to fund treatment. I think that he made a very important point about crowdfunding, which was echoed by Craig Hoy. It is clear that further clarity is required for women who funded treatment via this route or other fundraising routes. Indeed, the committee has called for that clarity from the cabinet secretary, so I do hope that he might begin to address that in closing. David Torrin spoke of the life-changing or, indeed, very sadly, the life-ending experience of his constituent, where she felt that her life had come to an end. I think that it was very difficult for us to hear that this afternoon, as Pam Gossel alluded to, but I think that it brought into sharp focus the reality of so many. Siobhan Brown did similar in telling Isabelle's story. I hope that whatever else we do in this place, we always seek to do anything that we can to, at the very least, make life more livable for any women affected. My colleague Katie Clark and, indeed, Alex Cole-Hamilton raised the issue of the use of mesh in other procedures and referenced other petitions before this Parliament. I do believe that those merit the attention of the cabinet secretary, and I am sure that he will want to reflect on that more widely as we move forward. I think that it is clear from today's debate that, although the principles of the bill enjoy broad support, further clarity is required in some areas as we move forward in the bill's process. I welcome the cabinet secretary's response, as Gillian Mackay and other members of the committee did, on the issue around residency requirements. I hope that he will look at the timeline requirements as he has committed to do in his opening. Ms Mackay also referenced the so-called in-betweeners and referred to my colleague Jackie Baillie, who made the point at committee when attending as my substitute. I think that the point is that we want a system where no one is left behind, and I think that that point has been well made across the chamber this afternoon. Indeed, I am sure that the cabinet secretary will cover that in summing up. Martin Whitfield posed, just at the close of the open debate, some important questions for the cabinet secretary around waiting times, around mesh removal and, indeed, the protests that are occurring today in Glasgow. I know that he will also want to say something on that in concluding in order to give confidence to Martin Whitfield and to colleagues that those issues are being looked at very much in the round, and again that we are trying to get it right for absolutely anyone who has been affected by those issues. In concluding, we should do all we can to hold on to the consensus that has been established, not only today in the debate around this bill, but I think that over the many years leading to this point, we must acknowledge that there is more to do and we must never forget the pain and suffering that has been caused, the duty that we have in this place to make an attempt at reparation and the courage of those women who have fought, despite their own trauma, to try and bring light to a very dark experience in the history of our health service and to try and ensure that this should never happen again. Thank you very much indeed, Mr Rocain. Given the time in hand, I invite Jackson Carlaw to wind up for a generous seven minutes. Thank you, Deputy Presiding Officer, and can I start by saying that I genuinely feel a considerable pride in our Parliament this afternoon, and not without some emotion contributing to this debate. Over three parliaments, three sessions, eight long years, we have tried to bring forward and bring justice to the women who have survived the mesh scandal. Had it been, as I observed in an earlier debate, similar to the thalidomide scandal, where the injuries and injustice suffered were all too visible, then it might have been easier to get this issue thoroughly discussed. However, in the early days of this Parliament, when it first arose, I have to say that there was a squeamishness and a reticence to actually talk about what was the most sensitive of issues for many women. It was the heroism of those women. Frankly, and the mention has been made of Alec Neill, Neil Findlay and myself, our determination to speak in the bluntest and most graphic way possible in order to break through this reticence, to have people understand just how important it was that Parliament faced up to this issue. While Shakespeare might have sent Mark Antony to bury Caesar and not to praise him, I would never suggest that I would ever talk about burying the cabinet secretary. He can scooter himself to disaster all on his own as we know, but I am here to praise him quite unequivocally this afternoon, not only for fulfilling the commitment of his predecessor, Jeane Freeman, in bringing this bill to Parliament, after five health secretaries have wrestled with the issue. In the way in which he addressed the issues in his opening speech this afternoon, the flexibility that he has shown and the will-ending that he has had to meet with the women concerned and with others who have pointed out concerns that they might have with the bill and his determination to see all those addressed at stage 2. I take all that at face value and really look forward to helping in any way I can to facilitate the progress of this bill. It is not the end of the mesh argument, as people have pointed out. Professor Allison Britton is undertaking a full mesh case review. The Baroness Cumballage's recommendations are still required to be implemented in full, and the Petitions Committee at the moment is considering a fresh petition on the wider application of mesh. Although, as the minister has identified, we should not just draw an immediate parallel between the use of mesh and other procedures and the particular issues that arose as a result of the transvaginal mesh scandal. That led to the fundamental concern about what women in Scotland were being told. Mention has been made of Neil Findlay. He has been texting me during this debate. I did ironically ask him if that constituted lobbying, which I hope will be not lost on other colleagues. When the cabinet secretary made reference to the Glasgow Centre, who has maybe done about two or three dozen mesh removals, there is this concern of the women and of those of us who have been involved with this issue. What exactly was their training? Where were they trained? In what removal techniques have people in the Glasgow Centre been trained? And by whom were they subsequently accredited to be competent in those practices? Because it was those same women, yes, of course. Very grateful, Jackson Carlaw for taking intervention. Do you not think that it also points to a wider issue about women not being believed when they come forward with health issues? This is something that we should be looking at in the round as well more generally. Yes, I absolutely do. I sat along with David Torrance when we heard evidence in committee right back in the Petitions Committee, where one fundamental specialist said that only a couple of women were involved, with 60 women sitting behind them, while he said it. There really has been a fundamental disconnect. Mention has been made of Elaine Holmes, who brought forward the petition in the first instance, who said, I had been discharged from NHS Greater Glasgow and Clyde after two mesh removal attempts. I was told that I was mesh free and that I would likely lose my leg if I had any more surgery relating to the transorbitor mesh implant. I did every test scan possible and had exhausted all options. After much research and pleading from my family, I contacted Dr Veronica as he was my last hope. Thank God I did. He removed 22cm of offending mesh, having been told that all her mesh had already been removed. That is why the women, so many of them, have confidence in Dr Veronica, who contacted me today ahead of this debate. I do not want to introduce any note of difficulty, but here is what he said in conclusion of a letter that he has sent to the interim medical director of NHS Scotland procurement, commissioning and facilities today. Respectfully, he says, I see no progress, I only see delays and detours. As stated in my email on 28 October, I do not believe that we have made any progress since March 2019, when Terry O'Kelly first contacted me or since First Minister Nicola Sturgeon personally called me. The solution is either expedite and facilitate the care of the suffering women who wish my services or just tell them that NHS Scotland cannot help them to receive care outside of Scotland. He goes on to say that he is desperate for what appears to be a slightly dead hand of bureaucracy in trying to drill down to the details that we need to overcome this. It probably does need the cabinet secretary to take a personal interest in what is being done possibly in his name to ensure that we get to the point where Dr Dionysus, as Veronica's, believes that he has got a contract that is fair and operable and allows those women to go to Missouri to have the treatment concerned. I thank Jackson Carlaw for coming away. I have seen Dr Veronica's response. I should say that we actually had a helpful response from him just recently. I think that there is progress being made, but I can give an absolute assurance of two things. One, that I do personally take an interest in and vover in this issue. If it means speaking to Dr Veronica's personally, I would do that. For the women involved, I also want to give an absolute assurance that we respect Dr Veronica's expertise. Of course, if that is their choice, when it comes to the referral process, a woman's choice of where they want to get treated should be the absolute primary consideration. I thank the cabinet secretary for that assurance, and it is the delivery of that assurance that we have absolutely got to ensure that follows the delivery of the bill. I thank Gillian Martin for that incredibly comprehensive contribution that detailed some of the residual questions. I think that she is absolutely right. There are some women who have maybe not yet declared the fact that they are people who would like to have mesh removed or others who may not yet be aware of the bill. Like Martin Whipfield and others, we have to be careful about the date that we identify as the cut-off date for any procedures or application for procedure in future. I also thank all the other contributors to the bill. David Torrance, the veteran of that long exchange in the committee, Katie Clark, Gillian Mackay, Craig Hoy, Cokab Stewart and Siobhan Brown, who brought us Isabel's experience—a typical, unfortunately, all-too-typical example of what many of the women have endured. I really want to finally thank, at this last minute of the debate, both Alex Neil and Neil Findlay, Rona Mackay, Angus MacDonald, David Stewart, former colleagues of ours, Joanne Lamont and the Presiding Officer, who was in the chair earlier, all who did terrific work in promoting this issue over the last three parliaments. Elaine Holmes, Olive McElroy, Lorna Farrow, Claire Daisley, Karen Neil, Nancy Honeyball, Gillian Watt, Isabel McLafferty, all women I have been proud to stand with. Those women have got the most affection and love for one another, attending their Christmas dinners where they were, and absolute mutual support in ensuring that the morale of those women was sustained and that their efforts were sustained. However, let's not also forget Michelle MacDougall, who died of cancer. She couldn't get chemotherapy because of the consequences of six previous hernia mesh operations. Eileen Baxter, the first woman to have the removal of mesh as the cause of death on her death certificate. That isn't just something women are still currently enduring. That is something that has led to the deaths of some women. It's opened up questions about how women are believed in health. It led to many women who at the start didn't believe there was hope for them but fought to stop this happening to other women fighting for years through their pain, and this bill now offers them the justice they deserve. Thank you very much indeed, Mr Carlaw. I know that Neil Findlay is still making interventions from a sedentary than a remote position. Unfortunately, he will not be able to raise points of order through a similar route. I call on the minister to conclude the debate for around eight minutes. I'm pleased to have the opportunity to close today's debate. I think that it's important firstly to recognise and acknowledge the efforts of all the women who have campaigned for better services for those with complications from mesh surgery. Their dedication and fortitude has been admirable. I hope that all of the improvements that the cabinet secretary described earlier will mean that women now will have access to more of the help that they need. The intention of the bill that we are discussing today is therefore, I hope, clear that we want to ensure fairness for those options that were not available in the past and who paid for their treatment out of their own pocket. As I turn now to some of the detail that we've discussed today, I want to thank all of the members who have contributed to this afternoon's debate. I think that what is clear is that although some members have quite rightly raised some important points and have asked some probing questions, we all want the same thing. We want to ensure that we do right by those women who have suffered. Like the cabinet secretary, I would like to extend my thanks to the Health and Sport and Social Care Committee for their consideration and support of the general principles of the bill. I fully appreciate that women will be frustrated at the length of time between the Government's announcement and the successful bidders on 12 July and the final contracts being agreed. I can assure you that NHS national services Scotland is working hard to finalise those arrangements as quickly as possible. I'm sure that you'll all understand, however, that there is a balance to be struck between concluding the agreements quickly and making sure that all aspects of wraparound and emergency care are provided for in those agreements. However, as indicated by the cabinet secretary, the Government will consider this matter further and intends to confirm its position about a cut-off date at stage 2 should the Parliament agree to this bill at stage 1. In its response to the stage 1 report, the cabinet secretary is committed to considering the issue of residency further as well and bringing forward an appropriate amendment to the bill at stage 2. The cabinet secretary has also agreed, in his response to the stage 1 report, to provide the committee with a draft of the reimbursement scheme and that draft will provide in detail in relation to the meaning of the term arranged while still showing the scheme administrator's flexibility to take into account the individual circumstances. The Government considers this approach preferable to delay in making regulations. It's intended that the scheme will be administered by the NHS national services Scotland to already administer the mesh fund and the Government will work closely with NHSNSS in the coming months as we make more detailed plans for administration. NSS will be given sufficient resources to manage the scheme effectively. The intention of the bill is to reimburse the full cost of surgery along with reasonable travel and accommodation costs for both the person undergoing surgery and for a person who travelled with them as support. However, it's not anticipated that the reimbursement will be given for luxury accommodation, for example, or first-class travel, and that's why there's a caveat about reasonable costs. For other expenses such as food, the intention is to give women a choice over whether they want to evidence their costs or are able to evidence their costs or instead want to receive a cap rate per person per day. That's to ensure the flexibility that we all agree is important here and is in direct response to feedback from women who told us that they want a straightforward process. A number of people raised the issue of crown to funding and donations from family. The purpose of the scheme is not to reimburse those who donated money to help someone with a cost of surgery. The Government doesn't intend to reimburse moneys received through online funding platforms such as crowdfunding, where it would be difficult to include indeed impossible to identify the donor in any case where the donor would not have expected repayment. It is the intention that applicants will be asked to declare any such moneys on their application form and their reimbursement payment will be reduced accordingly. Further consideration has been given to the matter of money received informally from friends and family members. On reflection, the Government feels that it would be unreasonable to request details of private arrangements. Accordingly, applicants will not be asked to declare these donations when making an application to the scheme. It is, of course, then up to individuals to repay any moneys received as they see fit. The Government will make every effort to ensure that those who are eligible to apply for reimbursement are made aware of the scheme. The issue of qualifying surgery came up during the debate. The qualifying surgery has to have had the principal purpose of wholly or partially removing the mesh, but that is regardless of the outcome. We expect to undertake a range of methods to publicise the scheme, including press releases, social media, through the Alliance and NHS Inform. The bill requires that the scheme is laid before Parliament and published. On the Glasgow centre, we fully recognise that GPs and other local clinical staff need to be aware not only that the service in NHS Greater Glasgow and Clyde exists, but also what it offers in terms of services so that they are then able to explain this to women who present with mesh complications. Health board accountable officers for mesh have been involved in the development of the centre and have a continuing role to play in ensuring that local health boards are aware of the service and what it can offer. The national specialist mesh removal centre has been and will continue to be developed with patient and public input. The pathway of care will continue to be a key focus for the Government. It must take into account the patient experience. Nursing specialists and physiotherapists from the specialist centre are linked with their counterparts and local health boards to ensure continuity from PEERY to post-operative care. The Government has asked the health and social care Alliance to take forward work in developing a patient-focused map of the care pathway, and that will be created from a patient perspective that will help future patients to understand the referral process and what it means for them. We all know that Covid-19 has had a significant impact on our health services across Scotland, and it has meant that health boards were not always able to run out patient clinics or provide other services within the sort of timescales that we would want and expect. We absolutely acknowledge that that means that some women have regrettably had to wait far longer than we would ever wish to wait to be assessed in the service in Glasgow. Regarding Martin Whipfield's question, I understand that there are around 17 women waiting for surgery in Glasgow. I believe that Glasgow clinicians were due to confirm that figure to the committee, but their correspondence is not yet noted on the committee's website. I want to give our assurances that we are absolutely fully committed to working with NHSNSS and the national specialist mesh removal centre to look at ways to improve the speed of referral and processing through the Glasgow centre. On the issue of hernia mesh removal, which was raised by a number of people including Mr Cole-Hamilton, he is correct that it is out with the scope of the bill. Jackson Carlaw referenced my appearance at the petitions committee, where I made clear that while there were some common ground, there is not exactly the same situation arising from the use of mesh in other areas. The evidence was presented at the petitions committee, and at present the Government does not consider that there is evidence that might justify a pause in the use of the relevant devices. To summarise, in January 2020, the Scottish Health Technologies Group published a report that examined the use of mesh in primary and guainol hernia repair in men. That concluded that, compared to non-mesh procedures, using mesh actually resulted in lower rates of recurrence, fewer serious adverse events and similar or lower risk of chronic pain. The SHTG is currently undertaking further work on the topic of hernia repair in men. The report on that is expected imminently. Once we have a copy of that report, we will consider the recommendations and share that with relevant officials and health boards, specialist associations and, of course, the petitions committee. I committed during my appearance that I would re-attend the committee, should that be helpful. On the issue of other gynaecological uses of mesh, at the same time the halt on transvaginal mesh was introduced, the then-CMO introduced a high vigilance protocol for the use of mesh in other sites. That resulted in the appointment of accountable officers who are responsible for oversight of that protocol and who have continued to meet regularly to improve services for those who are affected by mesh. It is really important that we note that those are complex and long-established procedures and there are very few, if any, viable alternatives. However, it is absolutely crucial that the most stringent safety measures are adopted with patients fully aware of the risks and benefits of such a procedure before deciding on their treatment. Jackson Carlaw mentioned the introduction of a GMC-approved credential on mesh removal surgery. The Scottish Government wrote to both the Royal College of Obstetricians and Gynaecologists and the GMC to express our support for the introduction of a GMC-approved credential on mesh removal surgery. As specialist centres are established across the UK, credentialing will define the skills required to perform mesh removal surgery and to set out how those skills can be acquired and assessed. By formally recognising the skills of our surgeons, credentialing will provide assurance for patients and the service and will reduce the risk of harm and will help to improve public confidence. I agree that a number of members raised the issue that the way that women were not listened to in relation to mesh. I agree that it was indicative of a wider problem of health inequalities that women experience. I believe that that is one of the reasons why we have brought forward the women's health plan. It is ambitious. We are making tangible progress, but we have much to do. It is a starting point, not an end. Finally, do I have time to raise one final point that was raised in the debate? In response to the Cumberland report, the Scottish Government called on the Her Majesty's Government to consider the establishment of a redress agency that was funded by Olivia & Manufacturers. HMG rejected that recommendation in its response, but it is still considering its position on redress in individual instances. On behalf of the cabinet secretary and myself, I would like once again to thank all those who have contributed to bringing the bill to this point. Looking ahead, I look forward to detailed scrutiny in stage 2, where the points raised by members today can be considered. We will also reflect on the debate today here in finalising our approach to stage 2. We know that work still needs to be done to rebuild women's trust in the services available here in Scotland. We hope that the work currently being undertaken by the Government and by NHS Scotland to improve the care offered will help to restore women's confidence in the services available here. However, for those who wish to be treated elsewhere, we are working to ensure that there is a clear referral pathway to either a specialist centre in NHS England or to an independent provider. In order to ensure that anyone who has previously played from private mesh removal surgery that they will not be financially disadvantaged, the Government considers it fair and reasonable to have in place a scheme that will allow those women to apply for reimbursement of the past costs. I therefore commend the general principles of the bill to Parliament. Thank you. That concludes the debate on the Transvaginal Mesh Removal Cost Reimbursement Scotland Bill. It is now time to move on to the next item of business, which is consideration of motion 2167 on a financial resolution for the Transvaginal Mesh Removal Cost Reimbursement Scotland Bill. I call on Marie Todd to move the motion. Thank you minister. The question on this motion will be put at decision time. The next item of business is consideration of business motion 2251 in the name of George Adam on behalf of the parliamentary bureau setting out a business programme. I call on George Adam to move the motion. Thank you minister. No member has asked to speak on the motion and the question is that motion 2251 be agreed. Are we all agreed? The motion is therefore agreed. The next item of business is consideration of nine parliamentary bureau motions and I ask George Adam on behalf of the parliamentary bureau to move motions 2252 to 2259 on approval of SSIs and 2260 on designation of a Leeds Committee. All moved, Presiding Officer. Thank you minister. The question on these motions will be put at decision time. Yes, I am minded to accept a motion without notice under rule 11.2.4 of standing orders that decision time be brought forward to now and I invite a member of the parliamentary bureau to move the motion. The minister for parliamentary business. Thank you minister. The question is that decision time be brought forward to now. Are we all agreed? We are agreed. There are three questions to be put as a result of today's business. The first is that motion 2234 in the name of Humza Yousaf on the transvaginal mesh removal cost reimbursement Scotland bill be agreed. Are we all agreed? The next question is that motion 2167 in the name of Kate Forbes on a financial resolution for the transvaginal mesh removal cost reimbursement Scotland bill be agreed. Are we all agreed? The motion is therefore agreed. I propose to ask a single question on nine parliamentary bureau motions. Does any member object? No member objects. The final question therefore is that motions 2252 to 2260 in the name of George Adam on behalf of the parliamentary bureau be agreed. Are we all agreed? The motion is therefore agreed. That concludes decision time and we will now move on to members business.