 The final item of business today is a member's business debate on motion number 11190, in the name of Kevin Stewart on Hepatitis C. This debate will be concluded without any questions being put, and I'd be grateful if those members who wish to speak could press the request to speak buttons now please. I call on Kevin Stewart to open the debate in seven minutes. Thank you very much, Presiding Officer. I'm pleased that Parliament has the opportunity today to debate Hepatitis C, and I'd like to thank all of the members who signed the motion and have made this possible. I'd also like to thank the Hepatitis C Trust, Hepatitis Scotland, HIV Scotland and ABV for providing briefings for this debate. Scotland has been hailed as a world leader in tackling Hepatitis C, and we have been really successful in tackling the virus, and we must recognise the work of successive Scottish Governments of various political hues for their handling of the issue. However, we know that nearly 40,000 people in Scotland are infected with Hepatitis C virus, a blood-borne virus that can cause fatal liver damage and cancer if it is left untreated. We know that about 45 per cent of folk with Hep C in Scotland remain undiagnosed, and that only about 3 per cent of those with the virus receive treatment each year. We know that Hepatitis C affects people from our poor communities much more than those from richer erts and perts, with some 75 per cent of sufferers coming from the lowest to socioeconomic quintiles. A recent Hepatitis Scotland and HIV Scotland report found that welfare changes had resulted in 58 per cent of people surveyed with Hepatitis C and HIV experiencing poorer mental health, 48 per cent suffering poorer physical health, 45 per cent struggle to pay fuel bills and 39 per cent struggle to buy food. However, enough of the statistics, I want to talk about real people, and I am grateful to the Hepatitis C Trust for providing me with some folk stories. Nigel's story is that he had a blood transfusion while he was a cameraman in Afghanistan. That blood transfusion saved his life some 13 years ago, but during the transfusion, Nigel contracted Hepatitis C. He says, before I was diagnosed, I had no idea of the stigma which surrounds Hepatitis C, but it leaves you feeling alone and fearful. I got a mixed reception from people when I told them some were calm and cool about it while others were quite put out to say the least. One of the best things that happened to me was meeting someone else who told me that they had it too. Suddenly, I knew someone else in the same position as me, and that helped. The treatment was grueling, although I know that it affects people differently. For me, it took a lot out of me, both mentally and physically. I had severe depression and had terrible skin rashes, nausea and aching. I did feel quite ill at certain points, but I believe that it was all worth it because I feel so much better now. Petra says, I was diagnosed with Hepatitis C in 1991. I believe that I contracted it in my 20s when taking drugs through the sharing of needles. When I was diagnosed, not much was known about the virus, so I did not seek any treatment. It was not until 2003 that I began experiencing problems, including a lack of concentration and an inability to learn new tasks at work. I was diagnosed with chronic Hepatitis C infection in 2004, and although my liver was not yet severely damaged, I was keen to rid my body of the virus and prevent myself from constantly worrying about infecting others. I began 24 weeks of treatment, which, unfortunately, was not successful, something that left me shattered and depressed. I underwent a 48-week course of treatment in 2011 and, thankfully, successfully cleared the virus. Since being cured of Hepatitis C, I have dedicated myself to helping people in Scotland with the virus through working with the Hep C Trust and various patient organisations, such as the National Parents Forum. I still suffer the after-effects of two courses of interferon-based treatment. My hope is that, with the new treatments now becoming available, we can move away from interferon-based therapies, diagnose and treat all those in Scotland with the virus and ensure that Scotland is the first country in the world to eliminate Hepatitis C. Mark says that I find it hard to live with Hepatitis C for lots of reasons. Know that my risk of getting cirrhosis, liver cancer and a list of other life-threatening conditions goes up every day. The clock is ticking. I also live with reduced energy and sometimes hit a wall where I just plain run out of gas. The brain fog is another difficult symptom of Hepatitis C, with loss of concentration, focus and memory and a tendency towards depression and low moods. I feel a reduced ability to cope with stress and I live with the knowledge that I could infect someone else. I am a reservoir for a fast mutating virus and I could hurt someone. Those are some of the stories of people, Presiding Officer. I said at the very beginning that we have a fairly good international reputation here in Scotland for dealing with Hep C. In order to maintain our international reputation, the revised sexual health and blood-borne virus framework that is being published this summer must be as ambitious as possible, ensuring access to new treatments and explicitly committing to the elimination of the virus is a serious public health concern. To do that, we must also educate and make the public aware of Hepatitis C in order to reduce and eliminate newly acquired infections. We must ensure that we diagnose all of those living with Hep C and ensure that they are treated promptly. I believe that the World Hepatitis Alliance summit is being held in Glasgow this September, offering the Scottish Government the perfect opportunity to highlight its world-leading efforts and to showcase its highly ambitious plans for addressing Hepatitis C, which will hopefully be contained within that revised sexual health and blood-borne virus framework. Hepatitis C is preventable, treatable and curable. Let's make sure that we do all that we can to eradicate the virus from Scotland and to export our good practice globally, and hopefully we will soon see a Hepatitis C-free world. Many thanks. We now turn to the open debate speeches of four minutes, please. I call Malcolm Chisholm to be followed by Colin Kear. I would like to congratulate Kevin Stewart for bringing forward this important motion. He's quite right to praise the current Government for the work that it has done on Hepatitis C, but he generously refers to the previous administration as well, because I think that there has been a lot of continuity. Right from the start of the Parliament, we had the SNAP report, the Scottish needs assessment programme report of 2000, and that led in due course to the two action plans and then to the sexual health and blood-borne virus strategy, and we're going to have another iteration of that very soon. I think that there has been continuity, and I noticed the Hepatitis C section of the framework. The first sentence actually quoted me, so it's not often I get a chance to quote myself, but I said then that in 2004, Hepatitis C is one of the most serious and significant public health issues of our generation. I think that that is still true, but there has been a lot of progress since then. One of the issues, of course, has been the development of the new drugs of which Kevin Stewart referred to, because a lot of people—I'm sure that we've all spoken over the years to people—have had treatment, have complained about the side effects and, after effects, in fact, have interfered in based therapies. We have to welcome the new treatments. Obviously, they are extremely expensive, and I know that this is an issue for Lothian. In general, their acute medicine budget has increased by 15 per cent in the last year, and I don't know what percentage of that is to do with Hepatitis C, but there are significant costs there. I'm certainly not arguing for those drugs to be discontinued, but there may be a case for the cost of acute medicines to be taken more into account in terms of the distribution formula for health board budgets. I give way. Would Mr Chisholm agree with me that sometimes in terms of health economics we don't take in the full account of the difference that that treatment will actually make, and the fact that it will give people the ability to go back to work and be less reliant on benefit. We should take a joined-up approach, and hopefully the UK Government can help in this regard, to take a joint-up approach to actually deal with those serious illnesses, because in actuality it may well be and it will well be that the cost of treatment is minuscule compared to the economic situation that can be brought out of treating people. Malcolm Chisholm, I'll give you your time back. I'm sure that Kevin Stewart makes an important point. He also has given us some of the statistics, which are still quite alarming, because it's not just the overall numbers of nearly 40,000 with chronic Hepatitis C, but half being undiagnosed is obviously a matter of concern. We're told of those diagnosed 75 per cent are not in specialist care. There are still big challenges, but, as Kevin Stewart and I have emphasised, there's been great progress around prevention, diagnosis notwithstanding the challenges around developing optimal treatments, around care and support. Those were the kind of themes of the action plans. There's a good emphasis in the framework on the strong inequalities, health inequalities dimension and stigma. Those are two very important relatively new priorities that are flagged up in the framework. With Elaine Murray sitting beside me, I'm reminded of the excellent work on health inequalities in Dumfries prison by the Nursing at the Edge initiative, which focuses on people in prison with Hepatitis C in terms of diagnosis and treatment. Of course, many of those with Hepatitis C have contracted it through injecting with drugs, which is why a lot of the prevention activity is around that, but we can't forget in this debate the several hundred who contracted it from blood products. That whole issue was of great concern in the early years of the Parliament, and it led, in fact, to Xgracia payments, which were started by the Scottish Parliament and copied by the UK Parliament. Clearly, we all know that the Penrose inquiry is going to report in March, so we must be mindful of the issues of that very complex situation. We all look forward to reading the conclusions of that report, but I believe that it will also lead to demands for further payments, certainly after constituents of mine still contacted me about that. I think that we mustn't forget the large number of people who contracted Hepatitis C in that way, and we must do all that we can to meet their specific needs and circumstances. I add my congratulations to my colleague Kevin Stewart for bringing forward that motion, and I certainly support the principles laid in it. Hepatitis C is presented a major challenge to our health services over many years, and there is no doubt that it still remains a major challenge, but there is light at the end of the tunnel in terms of possible treatment. When doing a bit of research for this evening's debate, I was going through the endless statistics and reports wondering where to go with the speech, and Kevin Stewart gave some excellent personal examples of the problems that are faced by sufferers. It happened to be in Monday evening that I met an acquaintance that I had not seen from my school days, and we did not know that he was not living in Scotland any more down in England. As we carried on our general pleasantries talking about what we were doing, he was quite surprised to find that I found myself here. I happened to mention that I was taking part in this debate, and he went a bit quiet on me and sort of said, well, Luke, I actually, I've been diagnosed with this, and it was a wee bit of time ago. We carried on the conversation, as you can imagine. He felt a bit uneasy about it. He didn't explain how or where he contracted the virus, but he was clearly excited by the advance in the drugs, which may help him in coming years. After a period of time in talking very general terms, he started to open up, explaining how difficult it was to explain to his family how he was infected, and it's absolutely clear that there were stresses within the family when this happened. The long-term fears were hitting him, how it was going to affect him, what was the effect going to be in developing relationships in the future, all these things. People are having to say not just who suffer from hepatitis C, but other afflictions as well. He then went through a period where his concern was replaced by anger and dispersed with periods of depression, and that's why I see many sufferers seem to go through this state of anxiety, obviously modern anxiety. He joined a support group in the Midlands of England, where he eventually managed to get himself in some degree of order. Thankfully, he's in a stronger state of mind now than he was not a lot long ago. Assuming that most people go through this, we can see why groups such as Waverley Care here in Edinburgh are so important within our communities. Outreach work has been vital, getting into the communities and dealing with the groups who are at a higher risk of infection. Getting people to talk and for those diagnosed making sure that help is available. Of course, this description I've given is oversimplistic. Some people lead chaotic lifestyles, maybe they're not clear or no, they're suffering from hepatitis C. There's also the issue of dealing with those who are within the prison system or those who are continuing to be hooked on drugs, which bring additional pressure with regards to the practical difficulties surrounding treatment. I pay tribute not just to the present Scottish Government in their efforts but also to the previous Scottish Government, including Malcolm Chisholm for the work that they've done. I was delighted to hear his contribution, which is helpful as ever. The Scottish Government, I see, has provided something in the region of 28.7 million funding each year towards the sexual health and bloodborne virus frameworks since 2011. I believe that that was a to an answer from Jackson Carlaw that that came from. With around 14.5 million allocated annually to support activities on viral hepatitis, but of course the real shining light comes in the form of a cure. The old regime of interfering based treatment certainly isn't perfect. New drugs now available in past for use will give the possibility of ending the scourge of hepatitis C. Time will tell. With the commitment of the Scottish Government through the new drugs fund, that will undoubtedly make a difference in providing the drugs required. Kevin Stewart's motion raises a number of excellent points. I commend Mr Stewart once again for his motion and based on a positive end for something that has caused misery to many. I support his motion. Many thanks. I now call Anne McTaggart to be followed by Nannette Milne. I am pleased to have the opportunity this evening to contribute to this debate as hepatitis C is an on-going matter, which is of great concern to many of my constituents in Glasgow. Therefore, I thank Kevin Stewart on securing the time in the chamber this evening to discuss this issue. This is a hugely important year, just as important as it was 20 years ago when I first studied the implications of hep C through working within the addiction field. This year has the publication of the revised sexual health and blood-borne virus framework, the staging of the world hepatitis alliance summit in Glasgow in September, and the anticipated availability of a host of new treatments that promise cure rates up to 95 per cent. Although Scotland has made progress with hepatitis C action plan and inclusion of hepatitis C virus in the sexual health and blood-borne virus framework, which is internationally acclaimed, I believe that there is still more to be done. Recent treatment targets have not been met, and further action is required unless that action is taken. Hep C will remain a significant public health concern and will result in higher rates of liver disease and cancer at a great cost, not only to the individuals but to the health service also. As Kevin Stewart mentioned in his speech, it is estimated that 45 per cent of Scottish chronic hep C infections go undiagnosed. Risk of transmission remains high and will remain so without concerted action to test and treat those people who are infected. Glasgow has the highest prevalence rate in Scotland for hep C, with 40 per cent of all diagnosed cases being in the Glasgow and Greater Clyde area. I have recently been contacted by two of my constituents who have hemophilia. They have contracted to hep C as a direct result of being given contaminated blood products by the NHS, and the hepatitis C has left them with cirrhosis of the liver. My constituents are concerned that the treatments that are currently available in the NHS are less successful than some of the treatments that are available abroad, and, as such, believe that all hemophilia acts in this country should be entitled to receive the most effective drugs and treatment, regardless of cost and country in which they are administered. The Scottish Government should seek negotiations with the pharmaceutical companies regarding the cost of those drugs. My constituents also state that sufferers of hemophilia are unable to secure life insurance because of their medical condition and expected shortened lifespan. As such, I believe that, in such circumstances, the Scottish Government should take responsibility for the payment of life insurance policies to offer stability and security to their families after death. I have written a letter to the Cabinet Secretary of Health regarding both of those cases that I am currently dealing with, and I am still awaiting her reply. In conclusion, crucially, hepatitis C is preventable, treatable and curable for the majority of patients. With new, more effective drug treatments soon to be available, hepatitis C can be eliminated in Scotland, provided that there is a Scottish Government commitment to do so to prolong the lives such as those ones, as my constituents. This discussion about hepatitis C is well timed, just a few months before the planned renewal of the Scottish sexual and bloodborne virus framework. I congratulate Kevin Stewart for bringing it to the chamber at this time. I think that the issue is of such importance that it merits a full parliamentary debate, and I hope that the Scottish Government will consider that as it develops its new framework in the next few months. As we know, hepatitis C blights the health of a significant number of people in Scotland, many of them living in deprived communities, and a high proportion of them are people who have used or who currently use injected drugs, who are homeless, or who come from countries where the virus is endemic, such as parts of Asia or Eastern Europe. It is of concern not only that nearly 40,000 people in Scotland are known to be infected by the virus, but that this is little more than half the population sought to be carrying it, who have no idea that they are infected until they develop the signs and symptoms of serious liver disease. The statistics are alarming, with only 28 per cent of chronically infected HCV patients attending a specialist treatment centre in 2013, and almost 240 per cent increase in liver-related deaths in the past 15 years among people diagnosed with the virus. 21 per cent of the 98 liver transplants carried out in Scotland in 2013 at an average cost of £40,000 each, being due to hep C related liver damage. Worryingly, less than 40 per cent of people confirmed as having the virus have had their genotype tested, which is crucial if they are to be given the most appropriate therapy for their condition. Just 3 per cent of Scotland's nearly 5,000 GPs have completed level 1 or 2 of the RCGP certificate in the detection, diagnosis and management of hepatitis B and C in primary care. There is good news, however. As we know, Scotland recognises a world leader in the battle against hep C through its hep C action plan and the integration of hepatitis C into the framework of 2011-15, accompanied, of course, by the investment essential to achieving the goals of that framework. Since the hep C action plan was published in 2006, the number of annual diagnosis has increased by a quarter. More than 6,000 people have been started on treatment, and 45 million pieces of clean injection equipment have been distributed. However, despite the significant progress, recent treatment targets have not been met and further action is needed. Otherwise, hep C will remain as a significant public health concern, resulting in higher rates of liver disease and cancer at great cost to the NHS in Scotland. In last week's 2020 vision for the NHS debate, the Cabinet Secretary for Health said that she was looking to plan for the NHS well beyond 2020 and would welcome positive suggestions. I would therefore put forward consideration the target that is suggested by the Hepatitis C Trust of eliminating hep C in Scotland by 2030. That is a reasonable target, given the increasing availability of new drug treatments being approved by the SNMC, which, particularly when used in combination, are highly effective in eliminating the virus. My pleat of government would be for it to consider giving its commitment to a strategy for the elimination of hep C, which aims to reduce the incidence of new cases to zero, to raise public awareness of the virus, with a particular but not exclusive focus on injecting drug users, to diagnose all those living with hep C and to endeavour to ensure that everyone diagnosed as being infected with the virus will have prompt access to the treatments that are most appropriate for them and full support throughout their treatment. The SNMC has already approved a number of new drugs for the treatment of hep C, and more are in the pipeline. I would be interested to hear from the minister and her response to the debate if those new treatments will qualify for the new medicines fund currently in place and hopefully to be extended beyond 2016, depending of course on available funding and political will. If the excellent work of recent years is built on and co-operation continues, as suggested in the motion between the Scottish Government, the NHS, the third sector and pharmaceutical companies, then I have no doubt the elimination of hep C as a serious public health concern in Scotland can be achieved in the foreseeable future. Once again, I commend Kevin Stewart for securing time for this important debate. Thank you, Presiding Officer. Perhaps at the outset, since the motion refers to pharmaceutical companies, I declare that my nephew Joe works for one, albeit that she lives in Sweden, but then it is an international industry. It should look quite interesting statistically. We are told that there may be up to or approaching 40,000 people in Scotland with chronic infection from hep C. Statistically, that means that one member of this Parliament has hep C. We recognise that there is a social discrimination and we are perhaps not the most likely cohort of people to suffer from it, but it gives a context and a perspective to the spread of this particular disease. Of course, we can be exposed to this disease not simply because we have been sharing needles in the use of drugs, but through our use of blood products. I myself, some 30 plus years ago, was injected with gamma globulin precisely because I was travelling to areas where there were a wide range of infections that might attack my immune system and it was thought proper to boost it before I went there. That has meant that my blood donating years came to an end about 15 years ago and for many years I could only give my blood for plasma. So far, so good. I do not think that there are any particular signs that I have that sort of infection, but then one of the difficulties with this particular virus is, of course, the difficulty in diagnosis and it can sit dormant and undiagnosed for a very long time. The liver is one of the more difficult organs of the human body to treat. 30 or 40 years ago, serious conditions of the liver essentially could not be treated, palliative care would be given. It was often the third cause of death in car accidents and when people's livers were ruptured because basically they bled to death, you could pack it, but it did not really do very much good because the liver did not heal itself very effectively. Today, we are in a different position. We have got the possibility of liver transplants. We have a relatively wide range of pharmacological interventions with varying degrees of success. It is a tribute to the pharmacological companies and the support that the NHS has given to people suffering from hep C that we see people who recover, for whom the virus is eliminated from their system and who are restored to good health. In that basis, I hope that we see much more of that in the future. With the pancreas and the liver, we have got two organs of the body that can cause great difficulties. The virus says that we are increasingly allowing how to deal with. Hopefully, we get on to dealing with prions, the cause of CJD, which is of course why I was stopped being allowed to give blood. I congratulate Kevin Stewart on bringing forward this excellent debate. It is timely, it is informative. I am certainly going away having learned a great deal from the contributions of people here. Of course, I congratulate the trust that looks after and supports people who suffer from hep C because when you have conditions that are both highly variable and often relatively invisible over long periods of time, but carrying with them a degree of social stigma, having that kind of support is a immense value to people who suffer from it. I hope that they continue to provide that kind of support for many years to come, but I hope that even more we eliminate the disease and their efforts become entirely unnecessary. I congratulate Kevin Stewart on securing this very important debate. I think that we all recognise the importance of the debate and the issue of how properly we support people who are affected by hepatitis C. I was particularly struck by his comments reading out people's stories about the extent to which health is not just about drugs, but it is about how you can share with others who are facing the same challenges. I hope that, in whatever debates we have, we ensure that support for people goes beyond simply ensuring that they have the right drugs, but we allow them the space to address the challenges that they face with whatever their condition is. I was interested to learn about the medical advances and the funding challenges of tackling hepatitis C. It is good to see progress, it is good to see work being built on from the past and taken forward now. It is not often that I would say this in here, but I feel that there is a sense of optimism in Kevin Stewart's contribution about the sense of which people are pulling in the right direction and making a difference. However, it is inevitable, as Malcolm and others have reflected, that we also think about the impact of the use of contaminated blood and the consequences for those who then contracted hepatitis C and other conditions as a consequence of that. We know how important it is to tackle this disease, but I trust that the Deputy Presiding Officer will permit me to add some thoughts specifically on the issue of contaminated blood. There is one of the many helpful briefings that we received in this debate that says, anyone who looks dispassionately at the issue feels that the state has a moral duty to the infected. As someone who was in the first Parliament elected in 1999, this is, of course, an issue that has been politically live since the Scottish Parliament itself opened. A lot of time and energy has been used in addressing this challenge, but for too many of those affected, it feels that insufficient progress has been made, and everyone here will know of those who are still actively campaigning on those issues. The reality is that still many questions and significant issues remain unresolved. I struck a recent presentation, I think, hosted by Richard Lyle in the Parliament, where a very powerful presentation by those who were campaigning on the question of the impact of contaminated blood in people's lives. We could be in no mistake the degree to which anger and passion still remain there, determined to have those questions addressed. But even more powerful for me was the direct meeting that I had with a constituent of mine who wanted to talk about the impact on her and her family of losing a family member, a loved one, as a consequence of his having contracted hepatitis C. He was haemophiliac and, as a child, was given contaminated blood. I want to take this opportunity to share my constituent's thoughts, giving voice to a desire that I think not just she has, but others to make sure that the really significant questions are answered. My constituent outlined the reality, and we have heard or mentioned already, of the stigma associated with being found to have hepatitis C or HIV for that matter in the 80s and 90s. I know that we have made huge progress, but still more has to be done. However, at that time, the consequence was that her loved one could not share with the broader family or with friends the truth of his condition. They could not speak to anybody else and inevitably the pressure on them as a couple became immense. The person suffering was silenced and the immediate family could not take or share their anxieties or fears with anyone else. I think that they recognised that. It was not just a physical condition, but there was emotional distress that came with that too, which lived out as long as the person lived. Anger at not getting action, but also a sense potentially of giving somebody the guilt of being the parent who had sanctioned the transfusion in the first place. Those are all issues that are immensely powerful in people's lives as a consequence. Huge hope and expectation on the Penrose inquiry. We know, and it has been highlighted already, the significance of the question of compensation. That is absolutely right and understandable. However, for my constituent, more than anything, they want answers. How could that have happened at all? Even when problems were recognised, did the system continue to be reckless with a consequence for very many people? In relation specifically to Penrose's reporting, how will families be briefed on its findings? What will the Scottish Government do to ensure that they know very quickly what those recommendations are? What will be the timescale for implementing recommendations? How will the compensation issues be pursued? I hope that the minister can reassure us that the Government, at the most central case, addresses more centrally the case of anger that the state must have a responsibility to those who suffered so grievously and for so many people who still continue to live with the condition or to live with the pain of having lost somebody in these circumstances. I hope that, across the chamber, we want to see massive progress in addressing the whole question of hepatitis C, but in particular the findings of Penrose come as a comfort to those who have been campaigning for so long. Can I now invite Maureen Watt to respond to the debate, minister, in around seven minutes, please? Thank you very much, Presiding Officer, and I'm grateful to have the opportunity to provide closing remarks to this debate. It's been a very interesting discussion, and I'm pleased that all of us recognise the importance of the issue. To all those members who spoke and gave individual case studies and people that they knew who suffered from hepatitis C, I think that it brings it to life and shows that the personal stories bring the real problems faced and the stark realities faced by those who suffer from hepatitis C. Can I just deal with Joanne Lamont's questions? I am not going to get into the whole Penrose inquiry in this member's debate. That is obviously for another day when the inquiry is published. I am sure that it will be brought to the floor of this chamber and dealt with specifically in that. This is a very significant time, as many have mentioned, for hepatitis C. Nowhere else in the world can say that it is in any better position than Scotland to take advantage of recent developments. It might be useful to say a few words briefly of what we have done in Scotland. Others have mentioned that the work began in the first and second parliaments and recognised Malcolm's work. A lot of what we do now is down to the Hep C phase 2 action plan, which was launched in 2008. As a result of that action plan, we have more than doubled the number of people who commence treatment every year and have significantly improved access to testing and care services. As some people have mentioned, it needs to be a very holistic approach. Importantly, we have also continued to invest in prevention services, including injecting equipment provision. That is critically important because treatment cannot stand alone, and if we are to have the best public health impact, we need to invest in prevention. We have seen a real reduction in the number of new Hep C infections in injecting young drug users. We have also seen a real change in the epidemic curve and a reduction in the number of people infected in Scotland. Those results speak for themselves, and they have done so in international scientific literature and in public policy discussions. Scotland is now rightly seen as a world leader in this area. Our action plan has been described by the World Hepatitis Alliance as a model of good practice. Scottish leaders have presented on the action plan at the European Commission in Brussels, at the World Health Assembly in Geneva and at the White House in the United States. More recently, the Scottish Government has supported the World Health Organization in the development of its global hepatitis programme. Scotland really is leading the world, and we should celebrate that. The Hep C action plan, as some have mentioned, came to an end in 2011. However, hepatitis continued to be a priority for this Government, and that was reflected in the sexual health and blood-borne virus framework, which was published in 2011. All government investment in support for hepatitis C was maintained under this new policy. That framework has been a great opportunity to bring together viral hepatitis, HIV and sexual health, and to develop a more holistic approach to prevention, treatment and care. It also maintains a strong focus on the needs of the patient, which I will say a bit more about, but it recognises the importance of the relevant cross-cutting policies. As others have mentioned, the framework comes to a conclusion this year, and that gives us an excellent opportunity to build on the strengths of the policy over the past five years, while taking into account of how the landscape has changed since 2011, how we have progressed towards delivering our outcomes and what current epidemiology tells us. We will publish a refreshed framework later this year, and work has already commenced on that. Hep C will continue to be a key priority. Indeed, I chaired a meeting of the National Sexual Health and Bloodborne Advisory Committee just last week, where there was a very good discussion about the future of hepatitis C policy. The discussion at that group related to the work of the treatment and therapies subgroup is an expert group that my predecessor established to provide advice to government on priorities in the light of the new therapies that are now becoming available. That group will report back to the National Advisory Committee in the coming months, and we will ensure that the advice is taken into account of when drafting the new framework. It will take into account that there are new drugs, much better drugs, and we will use that obviously in taking forward where we go from here. A key point to make is that the expert group includes representation from patient groups. If there is one thing that sets the Scottish Government approach apart from other strategies elsewhere in the world, it is that we engage proactively with our patient groups. We did that through the development of the action plan and the framework, and we are doing it now as we think of the opportunities and challenges of the new treatments. We very much take the view that we work in partnership with the NHS and the third sector, but also very much with patients themselves. In conclusion, the Scottish Government continues to be ambitious for Scotland. We are world readers in this area, something that we are very keen to remain. Whilst at times that might mean making difficult decisions, we will continue to work with patients and professionals. We want to now be using the language of elimination and eradication when we talk about hep C in Scotland. A few years ago, that would have been an impossibility. It is now a very realistic ambition, and I am happy to drive that forward. Thank you, minister. That concludes Kevin Stewart's debate on hepatitis C, and I now close this meeting of parliament.