 Golwch, ond ganwch yn byw. Dyna ni gyd, môl o'r drafod hwn nifer o unrhyw. Rwy'n credu'r ddweud gennych Ff內 Wesapartric yn ystyried hwnnw, yn ystafell sydd daddwyrr yn adroddiadau yr oedd Llywodraeth Cymru, o wahol y Llywodraeth yn ysgrifennu Llywodraeth Cymru. Felly, yn gyntaf y dwylo, rwyf i hi'n clywed i'w ddweud i'r ddydd ganri, i ddweud i ddweud i ddweud i ddweud i ddweud i'r ddweud i'r ddwylo. Diolch yn fawr, fawr i ddim yn ei fawr, a wedi'i gydag ei wneud, dyma gysylltu'r cysylltu i gydag i ddamen nhw, sef, eu gwneud i chi gael, UK, a Fawr i chi gael, Gwnaethgail, Merthyr, yng Nghymru, ddim i ddwylliant i gael i ddim yn ei fawr, I am gyda'r gyffredinol o'i gwneud i chi'n gwneud i chi ddim yn ei fawr i gael. Ar gyfer y cyf abusedun i chi'n gwneud i chi gael i chi gael? Adu i chi gael i'n gwneud i chi i chi gael i chi gael i chi gael i chi, of transvaginal mesh implants, since the Cabinet Secretary for Health and Well-being called for this on 17 June 2014. I recently met women who have experienced complications and have asked that the acting chief medical officer writes again to health boards this week, requesting that they consider suspending these procedures until the independent review has reported. The CMO originally wrote to health boards in June 2014, requesting this following the former Cabinet Secretary's decision regarding these procedures. In requesting this, I recognise that a small number of women having discussed options with their clinician will still want to proceed. That may be because they are experiencing extremely difficult symptoms. In those instances, the women's concern must fully consent to be completely aware of the risks and having considered alternatives. I have also requested that health boards follow a protocol to provide assurance that this process is being followed in every case. I will be working with women concerned to develop an outline protocol. Jenny Marr. I think that it is fair to say, Presiding Officer, that there is extreme confusion as to what the Scottish Government's position is over this, because women left Parliament last June, understanding that the then health secretary found these operations to be completely unacceptable and understood that no more would happen. We found that since then, 166 operations have taken place. This weekend, Shona Robison seems to have guaranteed Scottish women that they will not now take place. Will any more mesh operations take place in Scotland, and is her guarantee any firmer than the one given last June by her predecessor? There is no confusion other than perhaps in the mind of Jenny Marr, and let me explain why that is. Since 17 June, until the end of September last year, health boards carried out 76 mesh implant procedures for stress, urinary and continence, while the numbers for pelvic organ prolapse are too small to report due to the risk of disclosure. Prior to that request to suspend health boards, we are carrying out around 1,500 mesh implant procedures annually for stress, urinary and continence, and 350 procedures for prolapse. There has been a dramatic reduction in those number of procedures. As I explained in my first answer, where women who ask for this procedure to be carried out in consultation with their clinician, aware of all the risks and having explained to them what the alternatives are, decide in that full knowledge that they want to proceed, then there is nothing that we can do to stop that. It is very important that the women that I met with understood that fully. In fact, that is why they took part in drafting the patient information leaflet so that the women concerned would have that full information to be able to make an informed decision. The women that I met with fully understood that. That is why, of course, we are going to make sure that the protocol is followed, because I want to make sure that in every case it is informed consent. That is why, in agreement with the women that I met with, they wanted to make sure that there was a protocol and wanted to be involved in the development of that protocol. Further and finally on this, the regulation of medical devices, including implants, is reserved to the Medicines and Healthcare Products Regulatory Agency. That is the body responsible for regulating all medical devices in the UK. They have not banned mesh implants. In fact, they have said that there is no evidence that these implants are unsafe, so they are not a banned product. Because of that, while we can ask health boards to suspend, and that would be my preference, where a woman explicitly asked for this procedure in consultation with her clinician, in full awareness of all the risks with informed consent, that is what should happen. The women that I met with fully understood that. John Scott Thank you, Presiding Officer. Given the growing number of compensation claims in America, does the cabinet secretary share my concerns about potential compensation claims in Scotland, especially in the light of several health boards having ignored? I let Neil's advice to stop such operations, 166, of which have taken place since that advice was given. I do not think that it would be appropriate for me to pass judgment on compensation claims. That is obviously a legal matter. John Scott will be aware that the independent review is looking at all of the evidence that is looking at the work that the EU has carried out and will be reporting in May. Our suggestion to boards is that the suspension of procedures should be in place until that report comes in May. As I explained in my answer to Jenny Marra, where a woman wants to go ahead with that procedure, which is a procedure that is not banned and the MHRA is the regulatory body overseeing those procedures and has said in their view that there is no evidence that those implants are unsafe, with that explicit informed consent and aware of all the risks, there is nothing that a clinician can do to say no to that woman as long as she is absolutely clear. That is why the protocol that we are developing at the moment is to make sure that that conversation is absolutely clear about alternatives, about risks and it is fully informed consent. In May, when we get the independent review, I will be happy to come back to Parliament and inform members of what that review says and the action that we would take from then on in. Last week, the petitions committee heard that several multimillion-pound payouts have been made in the United States, while mesh is still being used. What assessment has the Scottish Government made of the risk to NHS finances of similar action being taken here? How many cases have been lodged in the courts? Will she publish in space the Scottish Government's risk assessment of both the procedure itself and the financial implication for the Scottish health service? Finally, if everyone understood the policy in June, why is she re-announcing the same policy in March? As I said to John Scott, I am not going to comment on compensation claims. That is for a matter outwith this chamber. However, as I have said to Jenny Marra and John Scott, the MHRA, which regulates medical devices, has not banned this product, so it is a product that is available. Therefore, I have explained in quite a lot of detail today under what circumstances, in terms of clinical judgment, if the member would allow me to finish without interruption, that would be helpful. The very clear procedures for agreement of informed consent to that procedure and Neil Findlay should be aware that women have actually been writing to us saying that they have benefited from this procedure. The reason that we have asked for the suspension is that, in the light of the independent review, we believe that we need to look at all the evidence and come to some conclusions. That will be happening in May. The chief medical officer wrote again to boards to remind them of our position. We think that it would be better for boards to suspend those procedures, but we recognise that the individual women will have the right to ask for that procedure to take place. As long as it is informed consent, knowing all the risks, with the protocol that I have described, that is the way that we will proceed. Is the cabinet secretary aware that Dr Maguire of the MHRA last week gave evidence to Parliament expressly declined to support her call for a moratorium? In support, he cited a report in October 2012, which turned out to be a short review conducted by three people and led by a librarian in 2012, two years earlier. Does she agree that she has the unequivocal support of us all in this chamber in that the precautionary line that she has adopted, which is to call for a moratorium on these operations, is evidenced by the many women in Scotland who have experienced dreadful difficulties and injuries as a result and that, frankly, the MHRA's reliance upon a two-year-old study, which was nothing more than a literary review, is quite disgraceful? Cabinet secretary, I am aware of the evidence that the MHRA gave to the committee. Clearly, we are not in control of the MHRA in terms of the report to the UK Government. They have the power over the regulation of medical devices. We do not have direct powers to remove mesh products from use in NHS Scotland. The MHRA has its position on this, which, at the moment, is that there is no evidence that those implants are unsafe. However, as you will be aware, there is a lot of other research going on. The EU is looking at this matter in detail. The independent review that we have commissioned and which will report in May will look at all of that and will help to guide where we go from there. As I have said to other members, I am more than happy to come back to the chamber in whatever format would be most appropriate to discuss the matter further at that point. I want to put on record my thanks to the women involved, who have done a tremendous amount of work on the patient information leaflet. They are working with us on the new helpline that NHS 24 will provide and are working with us on the protocol. I want to put on record my sincere thanks for them in the very difficult circumstances that they find themselves in. Question 2, Patrick Harvie. To ask the Scottish Government what concerns it has regarding reports that an anti-Muslim demonstration is to be called by an organisation describing itself as Pagida Scotland. Police Scotland's monitoring of social media has revealed that Pagida intend to hold a static demonstration in Edinburgh on the evening of Saturday 21 March. Police Scotland are taking this event very seriously and closely monitoring developments. Public safety is paramount, and those who seek to demonstrate must behave in a lawful manner or face prosecution. I spoke with chief superintendent Mark Williams, police commander for Edinburgh earlier today, and he has provided assurances that all steps are being taken to ensure that no issues arise out of Pagida's proposed demonstration. Police Scotland has powers available to them under the Public Order Act 1986 to ensure that public safety is protected and that order is maintained. Those who seek to incite violence will be dealt with firmly and reported to the Crown. The Scottish Government fully supports Police Scotland in taking all appropriate and proportionate action required. I speak for all of my colleagues in the Scottish Government, and I am sure all members of the chamber when I say that we do not tolerate Islamophobia or any other form of hatred or hate crime. We will not tolerate extremists who peddle hatred under the guise of protecting society. I am grateful to the minister for his answer, and particularly the last part of it, which properly addresses the threat that those organisations pose across Europe. We have seen some Governments in Europe make the mistake of aping or giving ground to the hard right and racist xenophobic movements. That is a strategy that is doomed to fail. Others have given clear leadership and said that this movement is not welcome in our countries, and I hope that the Scottish Government will continue to do that. Given that the organisation expresses as part of its aim to ridd the islands of Islam, is it not clear that this is a movement that poses explicit threat to Muslim citizens in this country, and any organisation of this nature clearly raises public safety concerns that must be addressed and taken very seriously? The member raises an important point. The Muslim faith is an integral part of Scottish society, and it is part of the rich, multi-interfaith relationships that we have within Scotland, and it is an important part of Scottish society. Any organisation that seeks to unpick that or try to exploit it should not be tolerated in any shape or fashion, and it will certainly not be tolerated by the Scottish Government. Pachyda and the message that it seeks to peddle, the message of hatred that it seeks to peddle, should not be tolerated in any shape or fashion, and I can give the member and the chamber an assurance that Police Scotland will deal with this issue in a robust and proportionate way, but also as a Government. We are a Government that believe in a tolerant society, and the faith of Islam has an important part to play within Scottish society. Alongside the important work that will be taken forward by Police Scotland in dealing with this particular issue, we will also be to offer reassurance to those members of the Muslim faith within Scotland, and in particular within Edinburgh as well, prior to and after this particular demonstration. I can also give the member and the chamber an assurance that Police Scotland and the Scottish Government will provide the local community, the local Muslim community and the Muslim community in Scotland with all the necessary reassurance that they require. Patrick Harvie? I thank the minister again for that answer. Does he agree that many Muslims in this country and in many European countries not only feel under threat and marginalisation from these aggressive hostile movements against them, but also from an expectation that it is for them to continually apologise for acts of extremism that they have never sought to condone or support? Does he agree that it is something that the Scottish Government must work across departments, including with the Department of Education, to ensure that all young people growing up in Scotland are given a sense of an inclusive Scotland and one in which those values of tolerance and respect are important? It is not just about responding to the movement of hatred, but building an inclusive sense of the kind of Scotland that we wish to build in the future. Cabinet Secretary for Health and Sport not only should we be robust in how we tackle issues of hatred in our society. Patrick Harvie is right that it is also about promoting community cohesion and partnership. That is an important element of the work that the Scottish Government takes forward in the GYR. Justice director and my colleague Alex Neil are helping to work in support with those in our faith groups in Scotland. Some of the meetings that I have already had with individuals in the Muslim community is about providing that reassurance, that the whole issue is not about Muslims having to apologise for their appalling behaviour in acts of barbarity by certain individuals and organisations who conduct these under the guise of being Islam or Muslims. It is about Muslims in this country being seen as being a valued member of our society and that they should not feel themselves in any way having to apologise for their appalling acts of other people in other parts of the world or even should ever come to our own shores. The work that myself and my colleague Alex Neil will be taking forward is to continue to offer that reassurance. I should also add that I think that our media is also an important part to play in getting that message across, not expecting Muslims in Scotland to apologise for the barbaric actions of those in other parts of the world. That is certainly the message that I have taken out to the Muslim community, and it is a message that the Government will continue to take out to the Muslim community as well. Does the cabinet secretary think that it would be entirely appropriate for the city of Edinburgh council to use whatever powers it has to prevent this demonstration taking place, giving that the whole purpose of it is to foster Islamophobia and to stir up hatred against thousands of Muslims who live in Scotland and who contribute so much to Scottish life? We have already been in contact with the Edinburgh city council on this matter, and they have had no contact from Peketa. The reason being is because it would appear that they are not intending to have a march as such for which they would require permission from the council. What I can assure the member of is that both Police Scotland, Edinburgh city council and the Scottish Government will take forward the measures that we consider to be appropriate. It is still an early stage in terms of having the full details of this, but from the discussion that I had with the chief superintendent today, you can be assured that both Police Scotland and Edinburgh city council are taking this matter very seriously and will take forward measures as they see appropriate when they get further information on the nature and the potential scale of this demonstration. Does the minister agree with me that, in the light of recent events of antisemitism and Islamophobia, that it is essential that we safeguard the freedom of speech and join me in commending the UK Government's work to ensure that all of us, regardless of religious or racial background, feel safe and respected in our country? I recognise that freedom of speech is a fundamental human right and we all have a duty to protect it, to respect it and to uphold it. However, I should also add that it is not an absolute right and it must not be exercised in such a way that it has an impact on the rights of others. That is why there is a clear difference between that of legitimate public protest and gatherings that, from gatherings that intend to stoke up racial hatred and to cause fear and alarm within our communities. There is a difference and that difference should be appropriately recognised. I associate myself with all that the cabinet secretary has said. On the point of freedom of speech, how do we get the right balance, does he think, between allowing freedom of speech and yet preventing hate speech from groups like that? There is no straightforward way in which to do that, as a member will properly recognise. Although in upholding that human right of freedom of speech and expression, it is not an absolute right that you can have disregard to the offence and injury that you may cause to another, particularly those who might wish to incite racial hatred and racial violence and to create fear and alarm within our communities. We have to make sure that we are alive to those issues and to respond to them at the appropriate time. What the member in this chamber can be assured of is that, where we believe, actions have been taken that are about promoting racism and about causing fear and alarm within our communities, appropriate measures will be taken both by law enforcement agencies and other partners who work to promote community cohesion within our communities and to make sure that communities and individuals do not feel alienated as a result of those types of events. To ask the Scottish Government what its response is to the findings of the research commissioned by the Welfare Reform Committee, which suggests that parents and disabled people are being hit hardest by the UK Government's welfare reforms. Minister Margaret Burgess, this report highlights the scale of the damage inflicted by the UK Government's cuts and changes and adds to the growing evidence base around the negative impacts of welfare reform in Scottish households. Those changes are placing parents and disabled people under intolerable strain as they struggle to cope with the changes being introduced. The Scottish Government is doing all that it can to help those affected, and we are investing around £296 million across 2013-14 to 2015-16 to limit the damage of the reforms. While we cannot fully mitigate all the effects of welfare changes within the powers and resources that we have, we will continue to make the argument for a fairer welfare system. The report gives further evidence that some of the most vulnerable members of society are losing out. Before we include the impact of harsher sanctions regimes, which we already know is increasing the impact on the incomes of lone parents and disabled people, does the minister agree with me that, given the scale of income that is lost through the benefit cuts, the UK Government must urgently investigate claims of DWP's imposed pressure on staff to apply benefit sanctions, sanctions that are quite clearly impacting on the incomes of the most vulnerable in Scotland? I certainly agree with the member. I think that we are in a situation where we have a Government in the UK that is so far removed from the reality of what is going on within communities throughout the country. We have a Government that will not accept the evidence that has been put in front of them regarding sanctions and food banks. We have organisation after organisation lining up to produce the evidence for the UK Government who refuses absolutely to accept it. We have even seen the churches intervening to say that some of the sanction regime in particular and the target set for it are inhumane, yet the UK Government still plows on. I would want to say that this Government is totally opposed to that and accepts that austerity does not reduce inequality. The minister may be aware of a recent article on the Scotsman poverty as a child protection issue, written by Harry Stevenson, who is president of the Social Work Scotland, in which he poses the questions. Can you imagine the despair of parents who are fully aware of being unable to meet the basic needs of their children? Can you imagine the impact of an indignity of living in long-term poverty? Most importantly, can you imagine the impact of children's confidence and self-worth? Given those comments, in addition to the growing evidence about welfare reform policies, what message has the cabinet secretary sent to those UK parties who voted for continued austerity in the UK budget? I could say very clearly that I would say to him to think again, but clearly that is why our First Minister argued last month that we need to bring an end to the austerity agenda of the Tories and Labour and instead increase public investment. By £180 billion compared to the Tory plans in the UK over the next four years, it is only by ending austerity that we will be able to bring an end to the need for food banks, an end to the suffering that people are having through the benefits sanctions. The Government wants to see the economy grow and reduce inequalities, and to do that we have to end austerity. Would the minister not agree with me that, while we all understand that welfare reform is a long and hard but necessary road, it is one that we must tread? Further, with regard to her comments regarding the use of sanctions, is it not appropriate to acknowledge that, in the previous cycle, sanctions peaked in 2007 under a Labour Government, and that that peak, while it was exceeded in 2013 and early 2014, now represents a peak that the use of sanctions has fallen off largely because of the will of those who claim benefits to abide by the rules and carry out the necessary requirements to seek work as part of the process? What I was saying to the member is that I do not believe that punishing people on benefit is the result, it gets the results that we are looking for. We want to encourage people to take up work and comply if they are able to do so. I have to say that the member is shouting across that it is working, but the evidence that we are getting from those in the front line and the stories that we are hearing and seeing in our constituencies' offices day and daily are telling me very clearly that it is not working. You do not force people to do something that is what the UK Government is trying to do. We know when we get churches saying that that is not right to standing up for the people because they see that it is not working. It is punitive, it is unfair, it is impacting in children, as Clare Adamson indicated in her question. It is impacting in children and it is impacting in the most vulnerable, so no, I do not agree with the member. Many thanks. That concludes topical questions. We now move to the next item of business, which is stage 3 proceedings on the welfare funds Scotland bill. In dealing with the amendments, members should have the bill as amended at stage 2.