 As a presenting officer, I expect government announcements on important policy issues to be made to the Parliament in the first instance. I was therefore concerned to discover this morning that the First Minister was making a statement to the media on Scotland's place in Europe. Members of the media therefore had the opportunity to question the First Minister on the document before members of the Parliament. The bureau considered that at its meeting today and has agreed to consider the broader issues of announcements to in the new year. However, the Minister for Parliamentary Business wishes to update Parliament on this afternoon's statement. Minister, there is not a change of business. I think that it is appropriate to take this opportunity to inform the chamber that the First Minister will give the statement this afternoon on Scotland's place in Europe. Thank you very much. We now turn to the next item of business, which is topical questions. The first question is from Neil Findlay. To ask the Scottish Government how many women have had transvaginal mesh implants since it requested NHS boards to suspend their use in June 2014. Cabinet Secretary, Shona Robison. The independent review on transvaginal mesh implants is in the process of producing its final report. The report will be published early in the new year and will contain the information that is asked for. The Scottish Government has made clear that health boards should consider suspending the use of synthetic mesh products and surgery for pelvic organ prolapse and stress urinary incontinence until the review makes its final report. The request to suspend procedures will remain until the independent review's recommendations have been put in place. In light of the Scottish Government's request, the number of women receiving mesh implants has fallen. However, if women are experiencing very distressing symptoms and still want to proceed, then I want to give my reassurance that prior to a decision to have a mesh implant, all clinicians are expected to have a detailed discussion with their patients with the risks that are explored and explained so that a shared decision can be made and fully informed consent is taken. I should also stress that any woman who has concerns about her implant should call the NHS helpline, which was specially set up last year, or alternatively should not hesitate to contact her GP or surgeon. Neil Findlay. Organ damage, loss of kidney, bladder removal, excruciating, constant chronic pain, pelvic inflammation, pierced vaginal wall, nerve damage, mental breakdown, reliance on wheelchairs and walking aids, husbands and partners injured during intercourse and family and marital breakdown. Just some of the devastating life-changing consequences experienced by women who have been implanted with transvaginal mesh and failed by some health boards, some health professionals, the MHRA and manufacturers whose arrogance and complacency on mesh has been startling. Now we find, according to the media, another 400 Scottish women have been implanted since the so-called Scottish suspension in 2014. What message does the cabinet secretary have for those women and will she now make it clear to NHS boards that should follow the line of some health boards and ensure that no other women are fitted with mesh, pending the findings of the Government's working group? As Neil Findlay will be aware, the Scottish Government has no authority to withdraw those products. That is the role of the MHRA and it has not done so. The Scottish Government knows of nine health boards that have carried out the stress urinary incontinence procedures. As I explained in my first answer, and as we said way back at the beginning, and I think I said at the health committee at the time, that if women wanted to go ahead with these procedures, then in full consultation with their clinician, with absolute clarity and information about the risks, then a woman could still make an informed decision to do so. That is a discussion between the woman and her clinician. That has been clear all the way through this process. I would hope that Neil Findlay, as I said in my initial answer, will welcome the independent review of being published early in the new year. We need to wait and see what it says, but meantime it is very important that women are fully informed of the risks. As I said, if any woman has concerns, she should phone the NHS helpline, which again was specifically set up last year in consultation with some of the patient group that I have met on a number of occasions, who Neil Findlay has also met, who have been extremely helpful in making sure that we can get to a position where that full information is given to women so that they can make an informed choice about whether or not they would go ahead with a procedure. Neil Findlay? Given what we know about mesh, given all the complications that have been highlighted, would the cabinet secretary agree with me that it is not a procedure that she or I would recommend someone getting? As I said, it is not a banned product or procedure. The Scottish Government has no authority to withdraw the products involved. The MHRA has not done so, and therefore it is important that the information that clinicians give to women who are in this position and who may be considering having the procedure that they are fully informed of the risks is the proper way to proceed. Obviously, we are waiting for independent review on transvaginal mesh implants that is coming in the new year. Once we get that information, I would be happy to meet Neil Findlay and indeed meet again with the patient group, who, as I said earlier, have been extremely helpful in this process in making sure that women have the right information. They were the ones who asked for the helpline that we set up. It is very important that women make an informed decision. Those decisions are not taken lightly, but, as I said in my initial answer, where women are experiencing very distressing symptoms and still want to proceed, it is very important that they do so with informed consent. That is what has been put in place, and the chief medical officer has been making sure that that is the case. Jackson Carlaw. Because of the issues that we are discussing, we have tended to talk about those in the most careful tones. In the Australian Parliament last month, Senator Darren Hynch gave an absolutely blistering speech in which he lambasted the medical watchdogs and manufacturers for once again letting down women. He compared the scandal of mesh implants to Thalidomide. I include the MHRA. I know that there is a UK body, but when we took evidence from him and the Petitions Committee, it turned out that their detailed analysis amounted to three postgraduate students doing a desktop exercise for two weeks at a cost of £20,000. We all in this Parliament welcomed the Scottish Government moratorium when it was announced. Many health boards have respected that moratorium. Can we conclude other than that those health boards who have not have willfully acted putting women's lives at risk? I do not think that that is fair. I noted what Jackson Carlaw said about HMRA. He will be aware that, on at least two occasions now, I have written to MHRA making clear some of the very strong views that have been expressed in this Parliament about their role as a regulator. However, we cannot get away from the fact that it is the job of the MHRA to regulate medical devices across the UK and that so far it has not issued a medical device alert regarding the implants concerned. That means therefore that the Scottish Government does not have the authority to withdraw those products. That lies with the MHRA. We find ourselves in the position that we find ourselves in, which is why, of course, Alex Neil issued the guidance that he issued and that I have supported. All along, it is making very clear that, where a woman decides in full consultation with her clinician that, despite all the risks of being explained to her, she still wants to go ahead with the procedure because of the very distressing symptoms that she may be experiencing, that that is a situation that had to be allowed to go ahead because it was an agreement between the clinician and the woman involved. As I said to Neil Findlay, it is important that we get the independent review in the new year. I would be happy to meet with Jackson Carlaw to discuss the findings and recommendations of that report once we get it. Dylian Smith. Thank you, Presiding Officer. I have been listening to Cabinet Secretary's response to colleagues. Could I ask the Cabinet Secretary if she is confident that all of the women who have been fitted with this mesh since the moratorium in 2014 have agreed to this procedure after being fully informed of the many and often horrendous risks of the procedure? Have all of them been fully informed? The chief medical officer had made it very clear at the time. When the chief medical officer and I appeared in front of the health committee at that time, what was made very clear is that women would require to be fully informed of the risks of the procedure. That is exactly what I would expect every clinician to do. If Elaine Smith or anyone else has any evidence that has not been happening, I would be very concerned about that. The chief medical officer was very clear in her guidance to clinicians that that is what should happen in every case so that women would be making informed decisions. If Elaine Smith has evidence to the contrary of that, I would want to know about that. To ask the Scottish Government for what reason it has downgraded its forecast of revenues from the residential element of lands and buildings transaction tax. Forkast tax receipts from residential LBTT and equivalent taxis elsewhere in the UK are regularly reviewed in light of new data and improvements in methodology. The 1718 budget forecast of residential LBTT for the next four years are lower than in the 1617 budget, in part because of the wider economic trends over the past 12 months. Forkast for LBTT, published for the 1718 draft budget, has been independently scrutinised and approved by the Scottish Fiscal Commission. LBTT is forecast to raise more than £2.2 billion over four years, of which the residential element will raise more than £1.2 billion. I thank the cabinet secretary for his response to the office for budget responsibility. I was estimated that the take from stamped duty land tax in the rest of the UK is likely to fall by 5 per cent over the next three years. The Scottish Government predicts that LBTT receipts residential in Scotland for the same period are likely to fall by some 46 per cent. Given that that represents a figure of some £833 million, which is potentially lost to the public finances, why did the Scottish Government not listen to all the property experts who warned them at the time that, in setting the rates too high, they would depress activity in the property market and therefore reduce the tax take? Will they now reconsider the level of tax rates? I have to say that Murdo Fraser has been consistently wrong on LBTT. In the previous financial year, we generated more resource than was forecast. It is the nature of economic forecasts to give us a range, but in terms of the OBR, what they have said about this particular tax in the UK equivalent, stamped duty land tax, SDLT, is one of the more volatile sources of receipts. In recent years, SDLT's receipts have been a large source of fiscal forecasting errors. In line with that, we have revised our SDLT forecast disproportionately more than any other major tax. I have to say that the LBTT in Scotland has been operating well. Do not just take my word for it, but take the finance committee's word for it, on which Murdo Fraser is a member. Thanks to the cabinet secretary. Of course, the finance committee was saying that the operation of the system has been working well, not that the tax take was in line with the expectations, and, as he knows, for the first-year residential tax take from LBTT, it was 32 million below originally predicted. However, he does not just need to listen to us, Presiding Officer. Why does he not listen to the First Minister's hand-picked chair of her growth commission, Andrew Wilson, who accepts the link between the rates of LBTT and the low and falling tax take? Perhaps the cabinet secretary will tell us that, given that we are now facing three quarters of a billion pounds less for the public finances than we were expecting under LBTT, which public services are going to be cut as a result of his Government's incompetence? I say again that I have engaged with stakeholders and experts in the field, and I would challenge what Murdo Fraser is saying about the composition of the tax. I think that he should be welcomed that over 90 per cent of people who are purchasing properties are paying no tax or less tax than they would under the previous regime. I think that there is economic growth, but our forecasts have been laid out clearly in our methodology document, but, of course, we will keep an analysis of that and monitor the housing market. However, Mr Fraser will also know that there is no evidence of distortion in the market, as, again, even the finance committee agreed with. As the case, we will monitor the position, ensure that we are properly funding our public services, and we will refine the tax rates as required. It will be evidence-based, but all the evidence to date has said that the system is operating well in some of the financial impacts that we face as a consequence of the economic situation. I agree that, despite the dark productions from the Conservatives prior to its introduction, the outturn data for LBTT shows that the number of transactions in all price bands that are taking into account the effect of Forstall and has continued to increase year on year. In fact, the number of transactions in the highest property bands has increased strongly, showing the decision to ask those in the most expensive properties to pay a bit more of property transactions to help fund public services was the correct decision. It certainly is the case that the outturn figures have shown that LBTT raised £425 million in 2015-16, compared with our original pre-Forstalling forecast of £381 million. It is a fair question and a fair point to look at the nature and the composition of the transactions to see what is happening in the market. I commit to continue to do that, to ensure that the tax system is having the right effects. However, it is the case that the composition is largely unchanged in terms of the transactions that it was before LBTT.