 Felly, yng Ngwchser mewn llawer yn lliwyr arlaffol i Gwladol Llywodraeth, o blofydd cychwynion gwneud o gyrfaen y dystiolaeth yma sgwr, oherwydd i g份 i gael i gyd uchydigon y Cymru. Felly, yn gwanfaen y tystiolaeth o arfer iawn, oherwydd i gyd i gael i gael i gael i gael i gael i gael i gael. Yn cyfeilio bryd ymgynghwyl, mae'n teimlo'n gwyffrwyr 503, yn y neud George Adam, o gyda'r bwrddol yng Nghymru, o gynnig maen nhw i gyd. anyone who wants to speak against the motion should press the that motion 503 be agreed. Are we all agreed? The motion is therefore agreed. The next item of business is a statement by Marie Todd on cervical screening. The minister will take questions at the end of her statement, and so there should be no interventions or interruptions. I call on minister Marie Todd. Thank you, Presiding Officer. I regret I am here to inform Parliament of a serious adverse event in the Scottish Cervical Screening programme. In December 2020, an NHS board conducted its annual invasive cervical cancers audit and discovered that a very small number of women had developed cervical cancer after being wrongly excluded from the screening programme following a hysterectomy carried out over 20 years ago. I am extremely sorry to say that one of those women has died. Can I offer my sincere condolences and wholehearted sympathies to the women and their families and offer them the absolute reassurance that this Government treats this issue with the utmost seriousness? The board has contacted those affected to apologise and to offer further discussions with clinicians. I know that this will be enormously distressing to them, and, along with many of you, they will question how it happened. That is why I am now updating Parliament on what we know about the errors and how we are responding. To prevent causing undue anxiety and distress to the women involved, I have waited until the NHS has completed the first part of a national review before making this statement. Presiding Officer, those are complex matters, and I ask you and the members of the chamber to have patience while I explain the background and nuances. The Scottish Cervical Screening programme began in 1988 and routinely invites everyone with a cervix between the ages of 25 and 65 for regular tests. People may be invited up to the age of 70 to follow up a test that requires further investigation or treatment. Anyone who has had a total hysterectomy involving the complete removal of the uterus in the cervix can be excluded from screening as there is no risk of cervical cancer. However, those who have had a sub-total hysterectomy, where part of all the cervix remains, should continue to be screened. That is true no matter how small the remaining part of the cervix is. While that will be of little comfort to the women and families affected, the incorrect exclusions were uncovered as part of our quality assurance processes that require health boards in Scotland to conduct regular audits to review the cervical screening history of all patients diagnosed with cervical cancer. Once those exclusions were discovered, NHS National Services Scotland assembled an adverse event management team of senior gynaecologists, pathologists and public health experts, among others, to address the problem. At their direction, all NHS boards conducted an urgent review to assess the risk of other people having been incorrectly excluded. Unfortunately, the review confirmed that there are instances where exclusions have been wrongly applied across Scotland. It also revealed that this is an extremely complex issue, spanning a number of decades and involving a variety of potential errors. The first hysterectomy-related exclusion dates back to 1959, almost 30 years before the screening programme began. I must therefore say that there is more to do to uncover the full extent of this issue, but I will update on what we know and has been done so far. Firstly, immediate remedial work to address the failure has been completed. NHS Scotland has strengthened procedures to ensure that the full details of hysterectomies, including whether or not the cervix was completely removed, are clearly recorded and communicated to the cervical screening programme. Secondly, no other routine audits to date in NHS boards have found any further instances where someone has developed cervical cancer after having been incorrectly excluded from the programme. Thirdly, the adverse event management group identified as an immediate priority, a review of individuals who had been excluded from the cervical screening programme, but whose records indicate that they had a subtotal hysterectomy. There are around 1500 individuals in this group. Of those, around 500 had hysterectomies before 1997, which are recorded in an older part of the medical record system. Their records are being fully reviewed, but this is a time-intensive process and is not yet complete. Today, therefore, I will focus on the audit of more recent records, but I assure you that work is proceeding urgently to review the records of those who had subtotal hysterectomies before 1997. I know how concerning this will be. I do not want to minimise the seriousness of this incident, but I do want to provide reassurance that the risks of cervical cancer are low. In the UK, fewer than 1 in 100 under 1 per cent of women and people with a cervix will develop cervical cancer in their lifetime. I hope that the actions that I outline now will demonstrate that we are doing everything possible to provide effective support for anyone who has been incorrectly excluded. At the direction of the adverse event management group, a multidisciplinary team was assembled in each NHS board to check the hospital records, laboratory records, GP records and screening records of everyone excluded from screening since 1997, despite having a subtotal hysterectomy recorded. That work is now complete. Of this group, over one third have been correctly excluded and no further action is needed. However, 220 individuals within the eligible age range for screening were excluded in error. The NHS has written to them individually to apologise, to explain the situation and to offer personalised advice. GP practices have been asked to prioritise each of them for a timely screening appointment, and I expect those to take place within a few weeks. There are also 149 individuals whose records are unclear about what type of hysterectomy was performed. Their health boards have written to them to explain and to apologise and to offer a gynaecological appointment and a screening test, if appropriate. Similar letters have been issued to 65 individuals who were incorrectly removed from the programme and who are now over the age range for screening. Where necessary, the Scottish Government has provided funding to health boards to run additional clinics so that those requiring gynaecology appointments can be seen within the next four weeks without impacting on other services. A very small number of individuals have left Scotland. We are working with our UK counterparts to contact those people and advise on the next steps. Lastly, 152 individuals within the group are now deceased. A full audit of those records is under way. I know that anyone who receives a letter about this may be extremely anxious, and I am sorry about that. The Scottish Government has provided additional funding to Jo's Trust so that anyone who is concerned can contact them and receive free and comprehensive support. They can be contacted by calling 0808 802 8000 or emailing helpline at joestrust.org.uk. More information about cervical screening is available on NHS Inform. Work is also under way to consider the appropriateness of around 200,000 exclusions that have been based on total hysterectomies. I must stress that the vast majority of hysterectomies carried out in Scotland are total. Therefore, we can be confident that the majority of hysterectomies are correct. However, based on our current findings and the range of errors involved, I hope that members will agree that it is prudent to look more closely at them. Once the work is complete, NHS health boards will write to anyone who requires further investigation. Although I know that people who have had hysterectomies may be concerned, I urge them to wait for this work to finish and not to contact health services in the meantime, unless they are worried that they have symptoms of cervical cancer. Finally, because we must learn from this incident and prevent future occurrences, we have alerted the other UK nations. We will work closely with them as investigations proceed. Before I conclude, I will say a few words about the screening programme. While today's announcement will be worrying for those who have been directly affected and for others who have had a hysterectomy, screening continues to be the most effective way of preventing cervical cancer. Cervical screening is not a diagnostic test. It aims to detect cell changes before they become cancerous. It saves 5,000 lives in the UK every year and prevents 8 out of 10 cervical cancers from starting. The incident does not detract from that, nor does it take away from the quality of screening tests or their findings. In fact, it is because the screening programme is so effective that we are doing all that we can to ensure that no one is excluded from it when they should not be. If you are due to make or attend a cervical screening appointment, I urge you to do so. If you have not attended a screening before or missed your last test, please contact your GP surgery to arrange one. Meantime, I urge everyone, whether affected by the issue or not, to be alert for symptoms of cervical cancer. Anyone who is experiencing unusual discharge or bleeding after sex between periods or after the menopause should contact their GP practice immediately and not wait for their cervical screening appointment. Those symptoms are not usually caused by cervical cancer, but it is important to have them checked. Further information on symptoms is available on NHS Inform. This incident will be profoundly worrying to many people. For the women and families that I referred to at the beginning of my statement, it has had devastating consequences. Nothing I can say can undo that. However, I commit to you today that everything that we do surrounding this incident will be guided by three principles. Our focus will be on identifying and providing the appropriate support and care for anyone who has been wrongly excluded. We will be open, transparent and welcoming of the scrutiny that this investigation rightly deserves, and we will learn from this so that it cannot happen again. On that basis, I reiterate that our immediate priority is to ensure that screening or gynaecological appointments are offered to everyone already identified as having been incorrectly excluded. The audit of anyone excluded from the programme who had a subtotal hysterectomy before 1997 will continue, and I expect that anyone excluded in error will be contacted in August. Investigations into the other hysterectomy-based exclusions will continue. Wherever there is concern, we will act, and wherever further changes can make our processes more robust, we will implement them. I have offered meetings to Opposition spokespeople, however, if any MSP would like to meet to discuss this issue, I am more than happy to do so over recess period. I will, of course, update Parliament again shortly after recess. The minister will now take questions on the issues raised in her statement. I intend to allow around 20 minutes for questions after which we will have to move on to the next item of business. It would be helpful if members who wish to ask a question were to press their request to speak buttons now. I call Annie Wells, who is joining us remotely. Thank you, Presiding Officer. I thank the minister for her statement. What she has just shared with the chamber is deeply distressing news, and my heart goes out to the families of women who has tragically lost their life and all those women affected. As the minister says, many women will be concerned after today's revelations, and I echo her statement that anyone concerned should contact Joe's cervical cancer trust. The minister mentions that there were around 500 hysterectomies before 1997, which are recorded in an older part of the medical record system. Can I ask the minister how long will it take for a full review into their records, and how long and has any of them been completed already? The same adverse event management team that oversaw the review of the post-1997 group will continue to oversee the review into those who had their sub-total hysterectomies before 1997. That expert group includes very senior and very experienced clinicians, pathologists and public health experts. The work of auditing the records will be carried out by individual health boards, as was the case for the participants who had sub-total hysterectomies after 1997. That work has already begun, and I hope that it will be concluded by the end of July, and that those who are identified as wrongly excluded will be contacted very shortly after the work is completed. Jackie Baillie Presiding Officer, this is, of course, an extremely serious situation, and our thoughts are with the women who have been affected. The truth is that we do not yet know the full scale of this error, but it could impact on many more women than the 220 excluded from the screening programme since 1997. It is, of course, critical that women are contacted urgently and offered information and support. Why was that not picked up by audits of the screening programme in the past? When all the women affected will not just be identified but be seen by a clinician, will there be additional specialist clinics in every health board area? Of course, she will be aware of the concerns already about capacity—a significant backlog in screening with something like 180,000 tests delayed because of the pandemic and delays now of six months or even more for those who have been screened and need treatment. Can the minister tell me what additional resources will be provided urgently to cope with this serious situation as well as catching up with the backlog? Jackie Baillie As I said in my statement, around 500 cases, I think that it is 434 people, have been contacted this week. However, because of the range of errors involved, we think that it is very prudent to go back and examine the records of all women who have had hysterectomies just to ensure that there have been no errors occurring. That means that the number of women who might be involved could be larger. In my statement, that number is about 170,000 women, but bearing in mind that the vast majority of women who have hysterectomies in Scotland have total hysterectomies, we expect that the vast majority of those women will have been correctly excluded. I know that it is uncomfortable to have to wait to be contacted, but we are working as fast as we can to resolve this issue. In terms of additional resources, we recognise that the number that is involved is around 200 women has been asked to attend their GPs for a screen. I do not expect that to produce an undue burden on general practices. There will be very few who have more than one woman involved. In terms of those two groups of women who have been called and given an appointment at the hospital, we have provided extra resources to several health boards who wanted to put on additional clinics to ensure that that did not impact on the services that are being prescribed. In terms of the invasive cancer audits, the new national methodology was introduced in 2014. Health boards were doing audits before that, and I can only say that no cases have been found through that national audit system until 2020. Jackie Baillie raises some points that I wanted to mention. I will dig a little deeper. This is clearly worrying for women affected in their families. I understand from the minister's statement that the women have been contacted to take forward next steps of their care. Should there be any woman who is concerned that they may have been affected and has not heard anything, can the minister outline what support is in place for them to raise those concerns? The minister mentioned Joe's trust, but might that contact with them lead to referrals? Given that, right now, there are general concerns that GPs are not doing many face-to-face appointments, can you give reassurance that not only are affected when they are being contacted, but they are being given urgent and one-to-one personal appointments? The women who have been wrongly excluded have been contacted by letter. Those letters went out on Tuesday this week, so they should have arrived yesterday or today. Those letters highlighted to the women that they were to telephone. If they were required to make a GP appointment, they were to telephone and to highlight during that telephone call that they had been contacted by letter and wrongly excluded. We also sent letters to all of the GPs of those women and we have briefed a whole variety of professional groups, including medical directors, directors of public health, NHS boards, NHS executive directors of nursing, GPs, Royal College of Obstructions and Gynaecologists, Royal College of GPs, Royal College of Nursing and cervical screening programme leads in all four nations in Ireland. The reason for that briefing is to make sure that everybody is aware of just how high a priority those women are. At every stage in the system, we have also added a computer tag to their records so that at every stage of the system, as those women progress their way through the process of checking the situation for them as individuals, they should be prioritised and fast tracked. Thank you, Deputy Presiding Officer. Thank you to the Minister for Advanced Sites of her statement and a declaration of interest. I am a practicing doctor. My thoughts and prayers go out to the women and their families that have been affected by this terrible error. This is simply awful. It might shape women's faith in the cervical screening programme. As a GP, I must be clear that attending your cervical screening is vital. I promise you that the swab that I take performs early warning detection of potential cancer, so please attend your appointment and do not be put off. Plus, if you experience any symptoms, please contact us on your GP. Minister, is this a failure of coding by the operating surgeon or is this a more systemic wide issue or is it an IT issue? I thank the member for that question. We have looked, as you might expect, very closely at the points where the errors appear to have occurred. There are potentially four points where errors have occurred. There has been for some women a mismatch between the operation proposed and the operation which was actually done. That is usually for technical reasons, which occurred during the surgery. As a consequence, a proposed total hysterectomy becomes a subtotal. That fact might not be noted in the discharge summary, and instead the discharge summary letter will be based on the theatre list, i.e. the planned operation. The GP will see this and request removal from call recall. A second error that has occurred is that subtotal procedures might be incorrectly coded in theatre again, reflecting a mismatch between the proposed and the actual operation, or simply a misunderstanding of what a subtotal procedure actually is. There has also been some incorrect coding in labs, so subtotal specimens might contain some cervical tissue and be incorrectly coded as total hysterectomies when these patients are being considered for continuation on call or recall. Finally, the patient may have been removed from call recall despite accurate information being conveyed to primary care following surgery where the cervix is retained. There are many reasons why women might be reluctant to attend their screening tests ranging from difficulties in attending or being examined due to physical disability, cultural and language barriers, lack of awareness and uneasiness. What action is it taking to break down those barriers and help more women to attend their appointment when called? I thank Emma Harper for that question. Those are indeed complex issues and I am mindful that there is not a single solution, but I also agree that those are very important matters to tackle. I can outline some of the work that is already happening. In initial sample taking training, NHS Education for Scotland provides information for sample takers to help them to address the potential issues in assisting disabled people at their cervical screening appointment along with many other groups where there may be barriers to screening. Further advice for sample takers is also set out in national guidance. If someone is unable to leave their home for a cervical screening appointment, an NHS board can use a multidisciplinary team member to provide support that will allow them to have their sample taken. That is done on a case-by-case basis, depending on the needs of the individual. The Scottish Government has also made funding available through its inequality fund to health boards to allow them to tackle inequalities in access to screening. In addition to the £5 million that we have made available over the past five years, we will be exploring how best to use an additional £2 million over the next two years to drive long-lasting sustainable change in the cancer screening programmes. That will align with the work of the national screening oversight, which also has a key focus on tackling inequalities across all of our screening programmes and is developing a strategy to do so. This is obviously a serious failure that must not be allowed to happen again. I would like to ask on behalf of those women who had sub-total hysterectomies before 1997 to reassure the women that I would like to press for a date that the audit of those cases can be completed. How long will it take for the individuals affected to be contacted, and finally, where those individuals may have passed on due to complications relating to cervical cancer? Will those families be contacted? I thank you for that question. I can assure you that we are working absolutely as fast as we can through those records in order to identify the women who have been wrongly excluded pre-1997. I am afraid that I cannot give you an exact date, but we aim to have that work completed by the end of July and we aim to inform those women as soon as we possibly can after that. I would expect that to be early August. In terms of women who may be deceased, if we are conducting an audit of all women who have died of cervical cancer and we will certainly examine whether they are involved in the incident, if they are, the NHS will get in contact proactively with those families in order to explain the situation. Kenneth Gibson to be followed by Julian Mackay Thank you, Presiding Officer. Human papilloma virus is known to cause 99 per cent of all cervical cancers, as well as cases of head, neck and anal genital cancers. An HPV vaccination programme was introduced for S1 girls in 2008 and boys in 2019. Can the minister provide an update on how lockdown has affected the implementation of the HPV vaccination programme over the past 16 months and how that will be taken forward? I am afraid that I cannot have that data right in front of me. I am certainly willing to write to the member and update him on that issue as soon as I possibly can get my hands on those figures. I now call Julian Mackay to be followed by Christine Grahame. Thank you, Presiding Officer. I, too, would like to extend my sympathies to all those who have been affected and their families. I note the minister states that the risk of cervical cancer is low and that cervical screening is the best protection against cervical cancer, but many women's confidence in the programme will have been undermined by today's announcement, particularly when we are hearing more about how women's health problems are being missed, ignored or misdiagnosed. What urgent action will the minister take to restore confidence in the cervical screening programme and encourage women to continue to attend their appointments? I thank the member for that question. Undoubtedly, we have to ensure that women have confidence in the system. As members have said, it is an extremely effective way of preventing cancer. Around 5,000 lives are saved every year. We just recently had cervical cancer week. We saw the Scottish Government buildings here in Edinburgh lit up for that. There is a regular campaigning conducted by Jo's Trust, Jo's Cervical Cancer Trust, and later in this year we, the Scottish Government, will be conducting a campaign to alert women of the practicalities of the screening programme and to highlight just how important it is to have your cervical screening. I note from the minister's statement that some of the women are now beyond the eligibility age range from screening, which I think is 64. Not just for those women, but for other women. Can I ask, given that the life expectancy for women in Scotland is over 80, if there is any scope for extending this automatic screening eligibility to at least age 70? I thank the member for that question. At present, screening can extend up to age 70 for those who have a non-routine result that requires follow-up or treatment, so those high-risk women are screened up until the age of 70. The UKNSE keeps the eligible age ranges for screening under review, using the best available evidence. Scottish ministers would, of course, work to implement any change that that committee recommended. I extend my condolences and thoughts to the women and their families who have been affected and recognise that, for many women and their families, that statement will be a source of significant anxiety. The minister mentioned possible funding. Is she able to say how much funding the Scottish Government has allocated to health boards for extra appointments and how much has it set aside? Given the obvious anxiety that this will cost to patients, will the minister consider additional funding for health board-level health lines so that patients can inquire about their own records and therefore avoid GP surgeries being possibly, but understandably overwhelmed by calls from worried women and their families? Four health boards have requested funding to provide additional clinics as follows Lanarkshire, 28,000, Lothian, 8,098 pounds, Greater Glasgow, 5,000 pounds and 5,700. No other boards have requested funding, but we are happy to keep the situation under review and will provide further funding if needed. We have also provided some extra funding to Joe's cervical cancer trust. I fully appreciate just how worrying this will be for people who have been affected. Everyone affected will receive a personalised letter from their health board apologising for the situation and providing information about the situation at the incident and the cervical screening. Joe's cervical trust has made the helpline available, so that helpline is available nationally for women to call. I would advise against women contacting their GP to find out if they have been affected. I would assure them that anyone who has been identified as incorrectly excluded from the programme, because they have a subtotal hysterectomy, will receive a letter directly from their health board. Some of them will be asked. Those who are within the age range for the screening programme will be asked to contact their GP to make a screening appointment. The one exception that I would give is that our advice remains that people should contact their GP straight away if they experience the symptoms of cervical cancer. Those symptoms are unusual discharge, bleeding after sex, between periods or after the menopause. Those symptoms are generally caused by something else, but it is vitally important that women experiencing those symptoms attend their GP and have them checked out. Alex Cole-Hamilton, to be followed by Jackie Dunbar. This will be deeply alarming news to many women. It is a tragic reminder of the importance of robust screening programmes. If there are regular audits as she says, how this was missed for so long, why are women only hearing about this now if it was first detected in December 2020? Can I also ask if all of the 1500 women are aware that their records are currently under review? As I explained, the invasive cancer audits, there was new national methodology introduced in 2014, and health boards were doing audits prior to that. In 2020, that new methodology of auditing invasive cervical cancer identified the problem. Scottish Government has only known about the incident since March. The adverse event management team that was established by the NHS to deal with the issue met for the first time on 9 March and sent to work immediately to determine the scope of the incident and how best to support those who were effective. That expert group, as I have said, brings together senior gynaecologists, pathologists and public health experts, as well as senior system leaders in screening. It established that the immediate priority was to find out how many of those excluded from the cervical screening programme had had a sub-total hysterectomy. Multidisciplinary teams were established in every single one of Scotland's NHS boards, which looked in detail at the medical records of those who had been excluded from the cervical screening programme, despite their records indicating that they had undergone a sub-total hysterectomy. That was a painstaking process that involved cross-checking, a range of electronic and older paper records, including operation notes, pathology reports, hospital discharge letters and GP records. That took several weeks to complete. As well as establishing who had been affected, the group also determined that correct care pathways and ensured that arrangements were in place so that everybody receives the same information and the same treatment wherever they are in Scotland. As I mentioned before, that included making an IT flag, an IT update to flag the records of anyone affected so that any further investigation of treatment required as a result of the incident will be prioritised. That took several weeks to arrange. I feel that it was absolutely vital that the NHS took the time to understand and accurately understand each person's circumstances and to make sure that arrangements were in place before we wrote to anyone to make them aware that they might have been excluded in error. To do otherwise, I believe, I would have compounded anxiety with long delays or uncertainty about how their cases would be managed. I also extend my sympathies to all those who have been affected. Worry and research conducted by Joe's cervical cancer trust has shown that only half of those who have HPV on their cervical screening results know what it is. Last week, being cervical screening awareness week, can the minister outline what action can be taken to tackle the stigma and confusion surrounding HPV and increase awareness for women who have been diagnosed and across the wider population? Let me agree with the member that it is absolutely vitally important that we raise awareness of just what HPV is, what it means to have HPV. Joe's cervical cancer trust has told us that HPV is the topic that they hear most about through their support helpline, with callers often being confused, anxious and upset about what it means to have it so that we know that there is more work to help people to understand those issues. NHS informs already has information to help and support people and Public Health Scotland regularly does work to raise awareness on issues around cervical screening. For example, during cervical awareness week this month, it shared information and posted on social media. The Scottish Government has also funded Joe's cervical cancer trust to carry out work to raise awareness of HPV and its implications for screening. I expect that that work will pick up pace throughout the year. Finally, as I mentioned later in the year, we hope to launch our own campaign to raise awareness of cervical screening. We will work to accompany that with wider messaging around HPV. That is indeed a deeply concerning statement. I would like to ask two points. First, when were Scottish ministers first made aware of this serious adverse event? Given the fact that, sadly, this is not the first time that we have heard of errors in the service screening programme last year in NHS National Services Scotland, we had to apologise for a two-month delay to around 15,000 patients for screening invitation letters due to what they referred to as a technical fault. Given the pressures that the NHS is currently under, how are ministers working to reassure women that the programme is fit for purpose? Is the minister also going to look at undertaking a review of the screening programme? I would say that we have worked really hard. We were first made aware—as I said in a previous answer—in March this year, on 9 March 2021, officials were made aware and ministers were also informed on the same day. Everyone involved has worked extremely hard to identify the women involved and to firstly ensure that the systems are corrected so that the error could not be made again going forward. Secondly, to ensure that we could correctly identify the women and contact them with high-quality information and provide access to tests and screening at their GP, if appropriate, and gynaecological appointments, if that was the more appropriate route. At the moment, that is our highest priority to absolutely ensure that we are completely aware of who is involved and to contact them as quickly as we can and to ensure that they have an appropriate pathway going forward. The situation is indeed deeply concerning and our thoughts are with all those affected. I appreciate what the minister has said about funding for the Jewish Trust helpline to support anyone who is concerned, but can she confirm that the funding will last for as long as it is needed and that all sufficient resources will be given to Jewish Trust to ensure comprehensive individual support? Further to that support, can she advise what has been provided to GPs and other health professionals who may be the first point of contact for women who are in the midst of remobilisation from Covid? I thank the member for that question. It enables me to put on record that I am extremely grateful to Jo's cervical cancer trust for running their helpline. They have enormous expertise in supporting people who may have questions and concerns around screening or the risk of cervical cancer. We have given them extra funding to ensure that they can cope with the extra calls that we anticipate. We have been more than happy to discuss with them should they require more funding. As I mentioned, the letters to the women affected who have been wrongly excluded from the programme went out on Tuesday. At the same time, letters went directly to their GPs. The letters to the women not only had details personal to them but an information leaflet with general information and frequently asked questions for women. The similar format was covered for the GPs. We sent the GPs information and we also sent them a set of Q&As. As I listed in a previous answer, we have contacted very many people within the health boards and various colleges, royal colleges of different professions, to ensure that everyone who women might ask, as far as we possibly can, about their own situation, will be well armed with information to reassure them and give them confidence that their care is in safe hands. We will have a short pause to allow for change of appeal before we move on to the next item of business.