 Vlogurau ar y cyflusoedd mai니다, cyflusoeddau mewn cerddig am ymgylchol, hopon o Gwbeth Mwgwyr ond ei wneud o'r cyflusoedd i Wneud chi'n gweinyddol i'i gyda ni yn dod. Felly, mae'n cerddig ar eich cyflusoedd yn gweinyddol. Felly, mae'n cyfeindio i'r cyflusoedd i gyfan gwyllwysgau i gweinyddol i ganddig o gweinyddol i'r cyflusoedd am gweinyddol i gweinyddol. cyfan, gynonion, ychydigiaeth, hayddwyr, a'u'r cyffredinadau i'n cael ei gyfarthu i gael y cyfriddwyr. Felly, rydyn i fyddwch o'u pobl i ddiogelio i digwydd hwnnw, ac dwi'n ibadoddiad gynonion i Meysglasgofyd yw bod yn 2021. Maen nhom i adderwianthaethu plast i gwybod hynny, rydyn ni fyddwch i gawis I i dweud hynny i dyma, ac rydyn ni'n ganddygen i gydwch i gael y cwmgafol, i ddim os bywyddu allanol. I've said it before but I'd like to put on record again my thanks to my team, Lynn and Karen, for their support and to constituents in Cunningham South for the understanding and well wishes that they sent. Now, after a year back at work, it felt like an old decay time to share some of my story. I am grateful to the Sunday Post for helping me to do that and to Tracy Brice for the kindness and respect that she showed me in her reporting. I fully understand that the experience that I had of diagnosis and then life-saving treatment for cervical cancer will not have been the same as other women's. I am acutely aware of just how lucky I was to have all the resources, support and love that I needed to get well. However, there is one thing I think I can confidently say on behalf of women who have experienced cervical cancer and it's also the reason why this year I'm speaking up and supporting Joel's cervical cancer trust in their biggest-ever campaign. That thing is that we wouldn't want anyone else to go through what we did. Effects of treatment, although it's life-saving, can be life-changing and long-lasting. If cervical cancer is something that we can prevent, end and eradicate, then we must. Joel's cervical trust is calling for government commitments to elimination with strategies to ensure that no one is missed out or left behind. In screening and immunisation, we have powerful tools to do just that. In my local area health board, Ayrshire and Arran cervical screening coverage is 71.7 per cent. The latest coverage for Scotland is 69.3 per cent, with women in our most deprived areas being least likely to take part in screening. There'll be a number of reasons why women don't attend when invited and it's really important that we understand so we can take action to address that. There might be practical considerations. Time of work can be difficult for some people, particularly those in precarious and low-paid employment. Likewise, travel the cost or time to get there. Generally, women might feel apprehensive or uncomfortable about the test itself. For one in three women, survivors of sexual violence, it can be particularly difficult. I'd like them to know that they're not alone. The EVE appeal has fantastic guide for survivors of rape, sexual assault and sexual abuse, with tips for the appointment itself and communicating needs to healthcare professionals. Crucially, they also have a guide for healthcare professionals. I commend it to all those who are interested in providing that essential trauma-aware support to women. A ferret article published on January 22 found that 440,000 eligible for cervical screening in 2020-21 hadn't had a smear test in the last three to five years. Those most likely to miss screening were aged 25 to 29, along with, as I mentioned before, those in deprived areas. There are wider issues around inequality to deal with health. My own experience of accessing tests and treatment made me acutely aware of just how challenging it would be if I didn't have someone to run me there, if I didn't have a job where I could, to a certain extent, manage my own diary and schedule things in. I'd be keen to hear from the minister what work is being done by Government to understand and address the inequalities in uptake. That won't just be helpful for cervical cancer, for all cancer, screening and treatment, but for all areas of health. I want to thank colleagues who supported that motion. I look forward to hearing contributions from people and colleagues this evening. I'd also like to thank everyone who attended the events that were sponsored by myself and Carol Mock in MSP with Jo's cervical trust. It was really good to see so many local press releases going out and awareness being raised locally around the country. I'd like to urge the Scottish Government to continue on the path to elimination. I know that there is good news to tell here in Scotland. We need to press forward and keep going on with that. I also think that we need to redouble our efforts to re-inequality. It will save lives and to individual women and indeed everyone. I want to immunise your young people, to women, to attend your screenings when invited. Crucially, don't ignore symptoms or bleeding that are different for you. It could save your life. Congratulations, Ms Maguire. We move to the open debate. Given that unusually we have two members' debates this evening, I'd be grateful if members could stick to their speaking allocation so that we're not concluding too late this evening. I start by calling Tess White to be followed by Emma Harper up to four minutes. I'd like to thank Ruth Maguire for securing the parliamentary time for such an important debate. Tragically cancer is a major cause of death in Scotland and all of us have likely been touched in some way by its impact. I know all of us long for the day it's eliminated for good. It's a sobering thought that two women in the UK died today from cervical cancer. Another nine women and their families are coming to terms this evening with the diagnosis of cervical cancer. Some are mums, some face the devastating prospect of losing their fertility as part of their treatment. But there is hope and that is through the cervical screening programme and the HPV vaccination programme. On the latter, I was struck by figures reported by Joe's Trust that cases of cervical cancer have fallen by 97% amongst women in their 20s due to the vaccine. In Scotland, I understand uptake rates of the first dose of HPV have consistently exceeded 90% as Ruth says and that is to be welcomed. But uptake levels for surgical screening are not as high as it's just been pointed out and that is where improvement is most needed. Public Health Scotland data is only available for the period up to 31st of March 2021 but it shows an uptake rate for cervical screening was 69.3% amongst eligible women and worryingly, as Ruth Maguire says, the uptake has declined in recent years and is especially low amongst women aged between 25 and 29. Ruth also flagged the multiple barriers to accessing a screening appointment. Anxiety and embarrassment can mean that women delay or decide not to do it. Experience of sexual trauma, as Ruth Maguire pointed out, can also prevent women from being screened, while there are issues of accessibility for women with a disability. Pain and fear of the result can also act as obstacles. We must do everything we can to address these barriers and it's important that we see leadership at the highest levels. I know Joe's Trust and other charities were vocal in their calls for the urgent appointment of a women's health champion in Scotland and bizarrely this role was promised by the SNP as a medium term action as part of the women's health plan which itself is only intended to cover the period 2021 to 2024. I'm pleased to see the position has now been filled by Professor Anna Glaesia but like many others I was deeply frustrated by the time lost over the prolonged appointment process. I know Professor Glaesia is keen to focus her work on the men's pause, endometriosis and polycystic ovary syndrome. I hope too that she will work with health boards and charities to improve cervical screening uptake and to explore new ways to facilitate this process. In the meantime I urge all eligible women to please please book a cervical screening appointment when the letter arrives it could save your life. Thank you. Thank you very much Ms White. I now call Emma Harper to be followed by Jackie Baillie up to four minutes Ms Harper. Thank you Presiding Officer. I congratulate my colleague Ruth McGuire on securing this debate and on her very powerful opening speech and I know she's sitting right behind me. Presiding Officer we know that the human papillomavirus HPV vaccine helps protect people from HPV related cancers including cervical cancer and in the first study of its kind funded by Cancer Research UK rates of cervical cancer and women in their 20s who were affected, who were offered the bivalent CERV vaccine at age 12 to 13 in England were 87% lower than those who did not receive the vaccine. This is why it's so essential to vaccinate all those who are eligible so that we can make sure we can improve uptake and they can receive their vaccine. The HPV immunisation statistics for Scotland for the school year 2021 to 2022 show that HPV vaccine coverage has increased in 2021 to 2022 compared with the previous year but the numbers are not equivalent to pre-pandemic levels in all areas and there is still significant regional and local variation. Coverage of the first dose of HPV vaccine for S1 pupils increased in 2021-22 with overall coverage rates of 73.5% compared to 52.1% in 2020-21. So by the end of S2 86.4% of females had received their first dose. So while those statistics are welcome I would ask the minister to ensure that the Scottish Government is doing all that can to enable HPV vaccine take-up. Presiding Officer I want to touch on screening also. We know that screening is key to both preventing cancers developing more widely as well as detecting cancers at an early stage when treatment is more likely to be successful. Cervical screening aims to identify whether a person is at a higher risk of developing cervical cell changes or cervical cancer enabling people to access treatment more quickly. Self-sampling as part of the screening for HPV is one of the areas that I've been pursuing. I know that the Scottish Government is pursuing this also. In the last session of Parliament I was made aware that 6,000 women had defaulted on their invitation to attend their screening smear test in Dumfries and Galloway. 6,000 women were being missed on their smear test screening. So I met with doctors William Forson and Heather Currie who along with their team were attempting to improve screening numbers by introducing a self-sampling approach that they wanted to test the effectiveness in addressing the women who were failing to accept and attend their invite to screening. That has now been picked up by the Government, I'm pleased to hear, and the benefits of self-sampling mean that home tests away from clinics and GP practice offering people a choice of place. No interruption to work, no travel to appointment needed or other barriers to take up of cervical screening. We've heard already that some women do find intimate examination of having a smear test very difficult, painful, distressing and embarrassing. So self-sampling for HPV is one way to help to increase screening uptake, especially for women in remote, island and rural areas like my south Scotland region. I was one of the defaulters contacted by NHS Dumfries and Galloway and I did have the opportunity to take part in the self-stair trial. So I'd be grateful if the minister could provide an update on the status of home sampling and whether there are any findings about its success as we move forward. Presiding Officer, during lockdown I attended Joe's cervical cancer online meeting with women who were part of the Wigdonshire Women in Charity group. The presentation was excellent, the Joe's trust representatives were absolutely fantastic and they basically supported continuing to engage and support women to take up their screening. I also encourage women to do the same and again I thank Ruth Maguire for securing this debate and I look forward to the minister's response. Thank you very much Ms Harper. I now call Jackie Baillie to be followed by Gillian Martin up to four minutes. Let me begin by thanking Ruth Maguire for securing this important debate and thank her for sharing her experience. Can I also take this opportunity to commend the work of Joe's cervical cancer trust? Presiding Officer, let me apologise to the chamber as I have to leave early to chair a cross-party group and I am grateful to you for permission to do so. I believe that members across the chamber are united in the belief that cervical cancer can and should be beaten once and for all, but statistics show that we are unfortunately going backwards when it comes to ending this disease. The roll-out of self-sampling is too slow, those with abnormal smear tests face weights of a year for colposcopy appointments while inequalities for women in the poorest communities continue to rise. The World Health Organization calls for 70 per cent of women globally to be screened regularly for cervical cancer, but according to Public Health Scotland, women from the most deprived areas of the country are less likely to take part with uptake reaching only 63 per cent and 45 per cent of women, as we've heard, between ages 25 and 29 have not attended a screening at all, which suggests that younger women are less likely to come forward for their smear test. So there are several reasons why that might be happening. It can be down to an experience of trauma, concern around pain or inaccessible GP practices or even a lack of information and time. That is why Jo's cervical cancer trust has asked the Scottish Government to roll out new tests like HPV self-sampling. The trust surveyed over 800 professionals working in and alongside cancer prevention, and 70 per cent said that they thought that HPV self-sampling was the biggest opportunity to eliminate cervical cancer in the UK. While it's important to ensure that clinician-led screening is still encouraged and supported, allowing for self-sampling will certainly begin to address the lone numbers of people coming forward. Tackling cervical cancer will not happen by addressing screening uptake alone. The process for addressing abnormalities and examining the cervix in the aftermath of a smear test is extremely important, and stats show that women are being failed here when it matters most. Waits for follow-up culposcopies in NHS Greater Glasgow and Clyde continue to soar. During cervical cancer awareness week, I raised the case of my constituent, who had a smear test in February 2022, which showed abnormal cells. She had to wait a year for the follow-up culposcopy, and I received a letter from the cabinet secretary wishing her well for an appointment at the end of January, which was cancelled. We really need to do better for women. My constituent told me that it's been really tough on my mental health. I was left questioning if the delay would have a detrimental outcome for me. FOIs have revealed that the longest wait for a culposcopy across NHS Greater Glasgow and Clyde is currently 48 weeks. In comparison in neighbouring Lanarkshire, over the past six months, no one has had to wait more than 10 weeks for a culposcopy. In NHS Lothian, the second biggest health board in Scotland, the average wait was just short of nine weeks, so there's a real postcode lottery in people women's experience across Scotland. The figures for Greater Glasgow and Clyde are shocking and actually far worse than the rest of the country, and this is an area where health inequalities are worsening and should be addressed as a matter of urgency. So cervical cancer is a treatable disease. I welcome the improvement in HPV vaccination, but we need to do more. The Scottish Government must tackle screening inequalities and screening uptake and fund further research and address wait times for culposcopies, particularly in NHS Greater Glasgow and Clyde. Only then can we hope to beat cervical cancer once and for all. I want to thank Ruth Maguire for leading the debate and securing it. Anyone who knows Ms Maguire will know that no, she doesn't like to talk about her own situation in her work. I'm under no doubt of what's taken for her to talk about the disease that she's had to deal with in this public for them, but thank you for that. As everything Ruth Maguire does, it's about helping other women. That's just what she does, and I'd like to assist her in that in a small way by outlining what women should be looking for. When it comes to cervical cancer, knowledge is power, so I'm very glad for the opportunity to help spread awareness and encourage others to take the necessary steps towards reducing their risk for this preventable disease. Cervical cancer is preventable, and it can be treatable, if found, early enough, but those symptoms can mask themselves as something else that can be brushed off as the kind of curveballs that our reproductive systems throw as women from time to time, not least in your 40s and your 50s. Not everyone will show symptoms, but it's still crucial to be aware of them. I'd like to highlight them, because I do feel that sometimes when we do these types of debates, even if one person is watching the recording of it on Facebook afterwards, or one person is watching it live and actually goes and takes up that smear test invitation, it's worth it. Here are some symptoms that could be a sign, vaginal bleeding that's unusual for you. It could be during or after sex, between your periods or after the menopause, just having heavier periods than usual. Any changes to discharge from your vagina? Pain during sex, pain in your lower back, between your hip bones or in your lower abdomen. Those symptoms can be caused by other conditions such as fibroids or endometriosis. If you've got that, you may just pass them off as being part and parcel of that, but it is important to get checked by a GP if the symptoms change or get worse. I'd also like to emphasise that some of those symptoms can be present in women who are about to go through the menopause or going through the menopause. Women around the age of 40 or older might experience pain or unusual bleeding, and that's a thing about us women. We put up with quite a lot with our bodies. We get used to a certain amount of pain, a certain amount of discomfort, then we often just struggle on and just pass it off. Don't do that because you need to find out what's really going on. Sometimes there are no symptoms, and that's why screening is important, particularly in detecting any abnormalities as early as possible. While we've taken steps in the right direction to prevent cervical cancer in Scotland, I share others' concerns for the uptake on screening invitations. It's been mentioned by others that around one in three women won't take up the invitation for screening, but the facts don't lie. Every week in Scotland, around six women will learn that they have cervical cancer. It's the most common cancer in women between 25 and 35 years old, and that screening might prevent you from having to deal with that disease. However, I would like to end with some good news. The good news item number one, my friend Ruth McGuire, is back in action after her treatment and thank goodness for that. Number two, in the future, the disease that she had can easily become one of the rarest with all our daughters having had the HPV vaccination. Cervical cancer may one day be eradicated, but it won't go away on its own. We've got to make sure that we get our daughters vaccinated. We've got to make sure that we take up those screening invitations. However, my thanks goes to Ruth McGuire for today's debate and for bringing Joe's trust into the Parliament a couple of weeks ago. I thank Ruth McGuire for securing this important debate today. As a largely preventable disease, we are fortunate to live in a time when we have access to early detection and prevention strategies for cervical cancer. The HPV vaccine was approved in 80 countries by 2007 and, as of October 2019, 100 countries worldwide vaccinated against HPV as part of the regular vaccine schedule. The uptake of the vaccine in Scotland is about 84 per cent. This is an incredible achievement, and Scottish data has shown that diagnosis of cervical cell changes decreased by 89 per cent in people vaccinated against HPV, but we still need to do more. The cervical screening programme is a powerful tool to detect cell changes prior to them becoming cancerous, and that is where we need to see improvement. It is worrying to hear that one in three women do not take up the screening invite. To improve those numbers, we must identify and address the barriers that people are faced with. Fear of the procedure itself, embarrassment and lack of knowledge about the implications of smear results undoubtedly play a role in individuals avoiding or delaying their smear invitations. That is compounded by the current pressures facing the NHS, causing a lack of appointments and often long waits. Unfortunately, the more disadvantaged groups of our society are again worse affected. We know that people with learning or physical disabilities and individuals from disadvantaged backgrounds are less likely to attain smear appointments. There is already excellent work being done to tackle those problems. Strategies such as self-sampling programmes to enable at-home testing show promising results. They allow those for whom traditional methods of screening may be unsuitable to have the option to get checked. The NHS and relevant charities already do a fantastic job. Their awareness campaigns, staff screening clinics and online resources continue to help to increase awareness and push towards the WHO global strategy for cervical cancer elimination. We have the tools and knowledge to eradicate the disease, but the reality is that two women in the UK continue to lose their lives every day from cervical cancer. Cancer is something that affects all of us, whether personally or through someone close to us. Cervical cancer is one of the few cancers that we currently have the ability to detect and treat at such an early stage. That is why we need to push for the change that will make this disease a less common reality for women not only in Ayrshire, Scotland but around the world. I would like to encourage all women to take up their cervical screening invites. Your health is important and this simple procedure, taken at the right time, could make all the difference. To conclude, I urge everyone to continue speaking about this important topic and, when invited, to take up your offers for vaccination and screening—their quick steps that could literally save your life. Presiding Officer, my throat has been struggling all day, so I will try to keep this brief. I want to join colleagues in paying tribute to Ruth Maguire to thank her for tabling the motion and making this debate possible, but for speaking about something that is deeply personal to her. Those of us who know Ruth know that she is a modest person and is feeling uncomfortable about doing this, but we thank her for putting herself out there and putting her pain and experience out there. I know that her family and friends and loved ones who will be listening and watching will be feeling very proud of her and we are all glad that she is back in the Parliament. I was very struck by something that Ruth Maguire said in her interview with the Sunday Post when she said that she did not have time to have cancer. That really stopped me in my tracks that Sunday morning when I read that. I think that that is a theme in today's debate, but also in the recent event that happened in Parliament that I was not able to attend due to a funeral. I did share the cross-party group on women's health where we heard again from another woman about her experience, her reality and that issue about not having the time because as women we still often put ourselves at the back of the queue, we are juggling work, we are juggling childcare, caring responsibilities and so much more. That issue, that theme about time, I think that we all have to get real because life is short and it is precious and we have to look after ourselves. I am really glad that Ruth Maguire made that point in her interview. The other woman that I want to speak about in my brief remarks is Emma Keyes, who is a constituent of mine. Emma is a young mum, she is now 31, she has three children, she is a very busy, energetic young woman and those of us who have met Emma are inspired by her. I want to remind the minister, because I know that the minister gave her time to meet Emma, but to let the minister know that Emma has not gone away, she is a survivor, but she is very much fighting to make sure that, as others have said today, that we get there in terms of not just talking about elimination strategy, but we really pick up the pace on this. Emma just wants to remind the Parliament and the Government of her story. After being diagnosed with cervical cancer and understanding that this is a preventable cancer, it sickens me that other women have to go through this. If we get the right testing implemented, that increases uptake and fewer women will have to hear those dreaded words, you have cervical cancer, fewer women will have to face harsh treatments resulting in fertility loss, which was Emma's experience. Emma goes on, HPV home testing kits give us a better chance to treat a precancer stage, as opposed to this horrible cancer diagnosis for a younger age group. If we can increase the uptake with HPV home testing as has been shown in the trials, then why would we not roll this out sooner? That will literally save women's lives and take away the many barriers that come along with smear testing. That is what Emma had to say. Like others, I am keen to hear from the minister about where we have got to following the trials in Dumfries and Galloway, how we can speed this out, and how we can make sure that, whether it is in Parliament and Government or in our own lives, that we make the time to treat this seriously and use all the tools at our disposal to eliminate cervical cancer. Thank you. Thank you very much. Siobhan Brown, to be followed by Calm walking up to four minutes, Ms Brown. Thank you, Deputy Presiding Officer, and thank you to my colleague Ruth Maguire for bringing this important debate to the chamber this evening. I also commend Ruth, who recently also hosted a dropping event for Parliament for Joe's Cervical Cancer Trust and highlighting the end of cervical cancer campaign. Joe's Cervical Cancer Trust was set up by James Maxwell in memory of his wife, Joe, who died from cervical cancer at the age of 40 in 1999. Following Joe's diagnosis in 1995, Joe and James had difficulty finding good information about every aspect of cervical cancer. It was their hope that, one day, everyone had easy access to the best and most up-to-date information. Most importantly for Joe, it was her wish that women affected by cervical cancer would have the opportunity to communicate with others facing similar challenges. It is encouraging that, over 20 years on, Joe's Legacy still lives on, but there is still work to be done. Funding from the Scottish Government's screening in equality fund in 2022 enables a charity to offer training, information and support to health boards in Scotland to address inequalities in cervical screening uptake. As we have already heard, sadly, women from the most deprived areas are less likely to take part in screening, with uptake only 63 per cent compared to 74 per cent in the least deprived areas. As we know, younger women are also less likely to attend screening, particularly those aged between 25 and 29. No woman should be left behind when it comes to cervical screening. I am going to mention tonight somebody that we are all all aware of from many years ago. It is Jade Goody effect on cervical cancer screening. The reality TV star lost her life to cervical cancer in 2009. Her battle was a very public battle with her diagnosis coming two days after she was set to appear in the Indian version of Big Brother in August 2008. She had a test before her appearance because her symptoms included pain in the legs and heavy bleeding. In September of that year her cancer was deemed life-threatening and she had a radical hysterectomy and started chemotherapy and radiotherapy. There was also a documentary at the time called Jade's cancer battle, which was aired on television. She died on 22 March 2009 and she was only 27 and the mother of two young boys. Her legacy, however, would prove to be something powerful at the time. If we take a step back, when it was first announced that her cancer was terminal, medical authorities across the whole of the UK announced a surge in requests from women, particularly young women, for cervical screening. Jade Goody did have the ability to reach women that some campaigns in awareness drives just could not and her fight brought home the importance of a cervical smear test and her legacy did save lives. Sadly, as time has gone on, that effect has worn off and it is also so important why we have to continue to highlight the importance. It is important that women, young and old, know the signs and symptoms of cervical cancer and the importance of screening when offered. We need to have the conversation continue and telling personal stories can be really difficult and I applaud the bravery of everybody keeping the conversation alive. If it saves one life, it has been worth it. For some of the conversation, the conversation will be a reminder, but for younger women it might be a new conversation. So to everyone, women who may listen to this, when the smear test letter comes through your door, please, please ensure that you make your appointment. Yes, it can be embarrassing, yes, it can be slightly uncomfortable, but it's over in 10 minutes and it could save your life. One in three women don't attend their smear test and we must change this. It needs to change if we are going to save lives. So let me tell you the symptoms again, unusual bleeding, pain in your back, your legs and just look out for out of the ordinary system symptoms. As previous speakers have mentioned, each year in Scotland, 323 women are diagnosed with cervical cancer and 95 women lose their lives. 93% of cervical cancers are preventable through screening, it just has to be caught in time. So when the letter appears again, let's say, please don't ignore it, please take time to brook your screening because it could save your life. I thank Ruth Maguire for bringing this important debate to the chamber today, and I am sorry that I am not in the chamber at home. I just want to make a short contribution because I know that we have a lot of business to get through today. My first point is that it was an absolute honour to co-host with Ruth Maguire the drop-in event for MSPs with Joe's Cervical Cancer Trust in celebrating the Cervical Cancer Prevention week. It was crucial that members had the opportunity to learn of statistics in their own region relating to cervical cancer, HPV vaccine availability and uptake, as well as the general work of Joe's Trust. The report, published by Joe's Trust last month, titled We Can End Cervical Cancer, raises some concerning points, notably highlighting that incidence rate in Scotland per 100,000 is higher than in any other part of the United Kingdom and over three times higher than the WHO target. It is important that we take that very seriously. It also indicates, as we have heard from many of the speakers, that those in the most deprived areas are, by quite some distance, less likely to attend screening appointments, which brings more concern when Joe's Trust tells us that 50 per cent of incidence of cervical cancer in the UK are women who have never been screened. Yet, again, we see that health inequalities in Scotland are deep and divisive, and I bring to the chamber quite a lot the point that they are taking lives. That is why I have repeatedly asked the minister about self-sampling, and I am really pleased tonight that so many of the members have raised it. We know that it is thought to be one of the most important among the five top priorities in terms of screening, that screening programmes across the UK have been indicated that that is the label that the cancer charities feel that it could help with. Just to close, I also wanted to ask the minister about the pilot project in Ayrshire and for people with physical disabilities, because again, we have spoken about the fact that health inequality exists there for women with physical disability. I am hoping to go and visit the service there with Joe's Trust, and I hope that the minister will see that as an important step in making sure that we get that right for those women. As I say in the interests of time, I will close there. I thank everybody for their contributions. I thank Ruth Maguire again and the minister for responding. Thank you very much indeed, Ms Moppen. I now invite Marie Todd to respond to the debate. Minister, up to seven minutes please. Thank you very much. I want to thank my good friend and colleague Ruth Maguire for raising that motion in the chamber today and for sharing her personal experience and also for my colleague's important contributions. Raising awareness of cervical cancer prevention is absolutely crucial if we are truly to achieve prevention of this disease. It is a unique and exciting opportunity to entirely eradicate a cancer that affects so many, and I am determined that we do all that we can to achieve this. There are a few different aspects that work together to help us in preventing cervical cancer, and as outlined in the motion, the World Health Organization has identified three key targets that will move us towards eliminating this disease. I am working very closely with my officials in progressing work in relation to the who targets with regard to screening, HPV, vaccine and treatment. Firstly, cervical screening is a key element to ensure that those who are developing cancer are treated as early as possible, whether that be at an early stage of cancer or even identifying pre-cancerous cells. As I often reiterate, this is the one screening test that catches cancer before it is even cancer. For screening, the World Health Organization targets states that 70 per cent of women screened using a high performance test by the age of 35 and again by the age of 45. In Scotland, overall screening uptake is consistently above 70 per cent in women in the 35 to 44 and 45 to 49 age group, but screening uptakes below 70 per cent in younger age groups. As many have mentioned in women in the two most deprived SIMD quintiles, that is not good enough. Across all of the World Health Organization targets, it is not enough for us to meet those at a general population level, but we have to work to ensure that we do so for all of our population. One of my top priorities for the screening programme is to continue to increase overall uptake, but also to reduce inequalities. As we all know, the factors that drive inequality are complex and they defy even easy solutions, but I am passionately committed to closing the gap and so too is the screening community in Scotland. We have awarded £456,000 to Jo's Cervical Cancer Trust to support their vital campaign work on cancer, and that includes work to raise awareness of the screening benefits and to tackle and understand key issues around access and uptake. This month, we have worked with Public Health Scotland to support other partners to promote Cervical Cancer Prevention Week. For all the cancer screening programmes, we have committed £2 million over the past two years to take a more sustainable and systematic approach to reducing inequalities. That has empowered health boards to take action at a local level to meet the needs of specific populations. Nationally, it has supported improvement in communications with screening participants and the collection and analysis of data so that interventions can be better tailored for maximum impact. Those inequalities are driven by complex factors and work is also on-going to develop a long-term strategy to address those. In preparation for a UK national screening committee recommendation, all the members in the chamber will be aware that there has been no recommendation yet from the UK national screening committee on cervical self-sampling, but we in Scotland continue to lay the groundwork for introducing cervical self-sampling, which has the potential to remove some of the barriers that can deter people from attending screening. It is a complex undertaking and we are awaiting, not very patiently, I agree, both consensus on the most appropriate test and how to use it, and I see a lot of potential benefits to it. One very powerful example of this is victims of sexual violence, who absolutely could benefit from this in the safe environment of their own home, and we are doing all that we can to ensure that we can respond quickly to the NSC advice once it publishes. Of course, the cervical self-screening is not the entire solution, so we already have self-screening or home screening kits for bowel cancer and we do not get 100 per cent participation, so it is one very important step forward, but it is not the entirety. Key findings for cervical screening as a result of the inequalities project find that methods that were successful in increasing uptake were using locations that feel safe, familiar and convenient. That is an obvious for self-screening. Targeting defaulters, which is what self-sampling pilots are looking to do, is an important part of that work, and flexibility in delivery. If we continue with sampling cervical screening at GP practices, what about providing out-of-hours clinics? In Forth Valley, they did an interesting work. Thank you. Picking up those themes around inequality and the need for flexibility, we hear a lot from women who have real trouble having the conversation with their employer, their manager, getting time off work. I wonder what discussions the minister and Government are having with employers and trade unions about how we can remind people of fair work principles and to make sure that, particularly for those women who are in precarius work and low-paid work, they are not facing additional barriers, because that is the reality for people in our communities. Absolutely. I thank the member for that intervention. I thank her for raising awareness of that issue, as well as raising awareness amongst employers and trade unions and things. Forth Valley did this interesting project where they sent reminder letters to 8,000 women for cervical screening, giving them the option of booking an evening or a day appointment, and 282 women attended in total, prompted by those letters. 80 per cent of those were from areas of higher deprivation, so that increase in flexibility is absolutely vital. As a result of that, a few practices are now offering regular screening clinics as a matter of course. The cervical screening toolkit aims to address falling attendance rates and a lack of understanding of cervical cancer, and the toolkit highlights the importance of vaccine and is leading with new digital assets and raising awareness of HPV and cervical screening testing as the benefits to do so. The HPV vaccine, while the World Health Organization sets a target of 90 per cent of girls to be fully vaccinated by the age of 15, in line with the JCV advice, the HPV vaccine programme was introduced for girls in Scotland in 2008, 1 September. 1 January this year, a new single-dose schedule was introduced. I am absolutely certain that reducing the complexity of the dose schedule will increase the uptake, so it is eligible for a single-dose vaccine up to your 25th birthday. We envisage that that programme change will increase the number of people coming forward and completing their vaccine schedule, because it will remove that requirement to be recalled to have a second one and to manage follow-up appointments. In fact, the one-dose HPV vaccine coverage is currently over 91.5 per cent for girls in S4, which will, from 1 January this year, be considered to be a completed course of HPV. Prevention is the main aim, but it is really important that we ensure that our diagnostics and treatment pathways are maintained for those who need it. We know that the earlier cancer is diagnosed, the easier it is to treat and even cure, which is why we continue to invest in our detect cancer early programme in response to the issues that Jackie Baillie raised, access to colposcopy. Urgent cases continue to be prioritised and completed within four and five weeks, but I absolutely agree that it is not good enough. The health board is recognising the anxiety that the long wait is causing, and they are taking on locums to tackle the backlog. As we have heard this evening, the Scottish Government, along with all of us here, is absolutely committed to encouraging those who are eligible for cervical screening to engage with the screening programme. I want to be clear, if anyone has any symptoms or suspicion of cancer, they should get checked. To support cervical cancer prevention week, we have run social content on the Scottish Government's VC channels throughout the week, and I want to thank all of our partners that help us in achieving those goals. We are going to continue to work together to further improve our awareness of cervical cancer and increase participation in cervical screening. Thank you very much minister. That concludes the debate. It is time to move on to the next item. There will be a brief pause while front bench is changed and we will move on to the next item of business.