 I remind members of the Covid-related measures that are in place and that face-covering should be worn when moving around the chamber and across the Holyrood campus. The final item of business is a member's business debate on motion 1569 in the name of Rachel Hamilton on endometriosis. This debate will be concluded without any questions being put. I would ask those members who wish to speak in the debate to please press their request to speak buttons now, and I call on Rachel Hamilton to open the debate. First, I'm truly delighted to be able to speak tonight, and I'd like to thank my parliamentary colleagues for supporting the motion. A lot of people don't know what endometriosis is, and some find it difficult to pronounce as we may find out tonight, so I'd like to open tonight's debate by quoting a young woman from the Borders who lives with endometriosis. She says, Endometriosis is a cruel disease. To live with endometriosis is living with a constant feeling of guilt, worry, feeling alone and misunderstood. It is a crippling pain, the type that slowly but surely takes everything away from you, meaning you cannot plan ahead. It is a constant pain, a constant anxiety that can be dismissed for almost eight years before someone believes that your pain is actually real. She goes on to say, Living with endometriosis can be like survival for many, waking up each day with immediate and intense pain, being betrayed by your own body repeatedly and unpredictably. This woman's experience is backed up by a recent survey conducted by the BBC, which also found that of the 13,500 women who responded, the majority felt that the condition has badly impacted their mental health, career and their education. Furthermore, endometriosis costs UK £8.2 billion in loss of earnings, healthcare costs and costs to the welfare system. Here are just some facts that I would like to share. Endometriosis affects 10 per cent of women. That is over one and a half million women in the UK. This makes the condition as prevalent as asthma and diabetes. The impact of the long-term health condition can be detrimental to all areas of life. It takes an unacceptable eight and a half years to be diagnosed. Many feeling that they have been dismissed by health professionals with their pain and symptoms normalised. Endometriosis is the second most common gynaecological condition in the UK. Sadly, the cause of endometriosis is unknown and there is no definitive cure. I want to see change and I am glad that I have the support of so many colleagues here tonight. I could not hold this debate without paying tribute to Sir David Amos. Sir David worked tirelessly to raise awareness and improve services for those affected by endometriosis, including as the chair of the Westminster APPG on endometriosis. In recent years, his work was crucial in ensuring greater public awareness and understanding of the condition. The APPG was launched in 2018 to raise awareness, and the group brought together parliamentarians across Westminster from all the political parties to debate the key issues affecting people with this dilapidating condition and investigate how patients can receive the support that they need. They produced a report in October 2020, which analysed the correct and current approach in the UK to endometriosis, and it concluded the following. First, there must be commitment to drive down diagnostic times. We can all agree in this chamber that eight and a half to nine years diagnostic waiting time is outrageous. Secondly, they concluded that there must be access to appropriate care. The nice guideline on endometriosis treatment and management was issued in 2017 and has been adopted across the UK, but not yet implemented. The APPG called on the Government and NHS commitment in each nation for implementation of the guidelines and the corresponding nice quality standards on endometriosis to provide a baseline for endometriosis diagnosis, treatment and management. As a first step, a gap analysis of endometriosis service should be undertaken as recommended by the group. There also needs to be recognition that more needs to be done to ensure inclusivity and equality of access to services. Most importantly, raising awareness is crucial, and that is what we are doing today, and that is what my colleagues are doing, and I am grateful for that. The APPG noted that there needs to be a better system in place to recognise that what they are experiencing are symptoms in order to seek help. So, moving to the devolved action here in Scotland, work is under way to help people within endometriosis, but there is still a long way to go, and that is why we are talking about it today. Currently, three endometriosis specialist centres exist and were planned to provide specialist endometriosis coverage for the whole of Scotland. However, they are currently being commissioned as local services and for local capacity, and it has been difficult to get a referral if you live in a different health board area. For some, that can mean no access to specialist treatment, even if suffering from deep endometriosis. The Scottish Government's women's health plan published last year includes a number of actions to improve access to appropriate support and speedy diagnosis and best treatment, and work is under way by modernising patient pathways programme as part of the centre for sustainable delivery, developing a pelvic pain pathway for Scotland, starting with endometriosis. However, the fact remains in Scotland that our wait time is eight and a half years, which is totally unacceptable for people like my constituent who is suffering so dramatically from this condition. I welcome the commitment to reduce waiting times for diagnosing endometriosis to 12 months within this Parliament, however, I fail to see a robust pathway to achieve that because of the lack of data and detail from the Scottish Government. Through lodging parliamentary questions, I found that there is a total lack of information at government level on endometriosis, and that is what I found. Currently, endometriosis waiting times in each NHS board are not available. The Scottish Government does not hold information on how many staff are employed in each of the three centres in Scotland or what the average waiting time is for each centre. Furthermore, the Scottish Government is unable to identify the total number of people who have been diagnosed with endometriosis in the population from routine healthcare data, and therefore cannot provide figures for the required breakdowns by NHS board, age cohort and deep endometriosis. If we are seriously to tackle this disease, we need the right information, and I urge the Scottish National Party Government to give us a detailed plan and timeframe. I want to pay a particular mention tonight to Taya McReady and Becky Lee and thank them for all their hard work in raising awareness of endometriosis. I look forward to working with them and my colleagues David Mundell MP and John Lamont MP, who recently took part in a debate at Westminster on endometriosis. I also want to thank Endometriosis UK for all their work, and I fully support their chias of the Government. They rightly point out that we need faster diagnosis, reducing diagnosis time to an average of four years by 2025 and under one year by 2030. However, the Scottish Government wants to go beyond that, and we do not need more detail on that. There is also a greater need to ensure that there is a baseline in endometriosis care with everyone with endometriosis in Scotland being able to access care and support in line with the nice guidelines. It leads me on to expand this, which I have not got time to do today, but maybe for another day we need to see better menstrual wellbeing in education, such as mandatory age-appropriate menstrual wellbeing education in all Scottish primary and secondary schools. I would appreciate if the minister and cabinet secretary could update what progress, if any, has been made on these ars to date. In conclusion, Presiding Officer, there has to be more attention to focus on reducing endometriosis waiting times with urgency. Together, Presiding Officer, we can fight this horrendous disease and help women live a better life through the research of better treatment and meeting these targets. Thank you, Ms Hamilton. I now call Emma Roddick, who is joining us remotely. We have Ms Roddick. Excellent. I do not know if Ms Roddick can hear me. Please pause for a second. We can't hear you, Ms Roddick. So I think what we will do is we will now go on to Scottish Gohani and then we'll seek to come back to Ms Roddick. Apologies for that. Mr Gohani, up to the room next, please. Thank you. A declaration of interest, I'm a practicing GP, and I have a further declaration of interest that's not in my register of interests. I'm a man, and I don't know what a period feels like. I don't know what endometriosis feels like, but as a GP I can tell you that my patients really suffer. We've heard Rachel Hamilton tell us that 10% of women have endometriosis. That's 1.5 million Scots who have chronic pelvic pain, who have period pain affecting their daily life, deep-rooted pain after sex, and psychical gastrointestinal symptoms. What's that? That's pain on passing bowel motions on a psychical basis. Psychical urinary symptoms, what's that? Well, that's blood or pain when passing urine, infertility. Risk factors are early periods not being pregnant and a family history. I want to just very briefly tell you about a patient of mine, a working woman who basically had to give up her job. The reason she had to give up was because every month she had to take time off work because she could not cope with what was going on. She was crying. She was depressed. She was given multiple different painkillers, multiple different antidepressants. She was unable to get herself pregnant. You can see the vicious cycle. Every single thing that I've said makes the next thing even worse. We treated her with painkillers. Eventually we've run as the diagnosis and she ended up in surgery and had laser treatment and did actually have some improvement. I've read out the symptoms to everyone and it seems pretty obvious endometriosis would be the diagnosis here, but each symptom came to us separately. Each symptom was a different consultation and that is some of the problems that we are experiencing. Women might not seek help and that's a concern. Going back to my decorations, a man, I simply could not put up with the symptoms I described and I don't understand how women can put up with it but women do put up with it. It's because they're not believed. It's because they turn up and they tell GPs, they tell health professionals they've got problems and they're dismissed and it's unbelievable that that happens now but I know it does and I've given you an example from my very practice where it has happened. What I want to say is if there's anyone out there listening, any women who are suffering the symptoms I've described, please do not suffer in silence. Come forward, see your GP and most importantly keep a diary of your symptoms because if you have a diary and you can present it to us it makes it more obvious. When I read out the list of symptoms it was more obvious what the diagnosis was so please do that, come and see us and do not suffer. Thank you. I know I'm going to try to go back to Ms Roddick. I'm assured that she is online and ready to go and that broadcasting is going to function or not as the case may be. Excellent. I'm now calm as Roddick, up to four minutes please. Thank you very much Presiding Officer and IT. First can I also thank Rachel Hamilton for bringing this motion forward. Not only am I glad that endometriosis is being discussed here again, I'm really glad that it's being discussed outwith an awareness month. We need people who are seeking assistance with what is a chronic and often excruciating condition to be treated with respect and due pace, regardless of when they present, which means that a greater awareness is needed particularly amongst health professionals, employers and schools year round. Awareness is improving and I think that we have to acknowledge the work done by many incredible third sector organisations in getting us to that stage, including endometriosis UK. I regularly meet representatives from the North Highland group and was told this morning that they've now reached 129 members. I also discussed with a fellow endow warrior a number of stories, including one woman who had to give up her job while waiting for surgery and another who finally got surgery and many around her cried with relief when she did. It really is a big deal that many people in the Highlands and Islands will now be aware of endometriosis before they are diagnosed with it and know where to go to get peer support, whether that's for dealing with the NHS, understanding their condition or just having someone else who understands how much it can affect a life. As endometriosis doesn't just mean painful periods, it can mean debilitating pain throughout the month, it can mean loss of employment, loss of organs, loss of fertility and so much more. It means that even when you're on effective treatment, an unrelated but familiar cramping feeling can cause intense terror and trauma. Just today, a woman had to cancel meeting with me, said, because simply travelling yesterday had caused a flare-up. It doesn't just affect a few people, while even the estimate quoted in this motion, 10 per cent, is one in 10 women. We have to remember those who aren't included in the statistics. There are people being turned away with more paracetamol every few months, people presenting to A&E to be put on morphine just to be able to breathe properly and not getting followed up, both situations that used to be regular experiences for me. We have to remember, and I was glad to hear recognition of this from a GP in the chamber today, that there are still thousands of doctors who brush off cries for help and tell teenagers that it's normal to be curled up on a bathroom floor in Agony and vomiting and passing out with this clear underlying belief that it's basically a case of hysteria or a dislike of PE. The issues that I've outlined so far have a devastatingly isolating effect across the board, but I do think that it is intensified if you live in a rural area or far from the nearest hospital that can offer treatment. I'm aware in particular of a number of women in rural Highlands and Caithness who, after what we all know as a long wait, have to make preparations for a lengthy trip to Rhaigmoor for hysterectomy or other procedure. Child care is arranged, cover agreed at work, petrol money exchanged and a last minute cancellation of that appointment can feel like the whole world has fallen apart. Like most who have spoken already and after me, I am heartened by the women's health plan and commitment to reduce the time that it takes to make a diagnosis. Alongside that, we have to make sure that a diagnosis means treatment, not years or even decades of waiting for a solution while in pain and sacrificing the life that you want to live. Once again, I thank the member for raising the motion, look forward to hearing the response and commit to joining her and others in keeping on the pressure for endometriosis support. I thank Rachael Hamilton for bringing the important debate to the chamber, and I know that she has championed this cause over many years. As we have heard, endometriosis is thought to impact a staggering one in ten women worldwide, with endometriosis UK highlighting that its impact can be seen from puberty to menopause and in some cases can last a lifetime. That painful, often debilitating condition impacts so many women in our country and across the globe, but awareness of it, as we have heard, remains low, and it is not given the prominence that it deserves. That debate tonight will take steps towards raising awareness of endometriosis, but we must go much further. We must listen to those who have lived experience of this condition and experts such as those at endometriosis UK to deliver what they believe is necessary to improve day-to-day life for those who currently live with the condition and those who may live with it in the future. That means that members like me must hold the Scottish Government to account, ensuring that it reaches its targets to reduce the shockingly high current diagnosis time of over eight years to under a year. We must also fight for equal access to proper care and ensure that all women have a central point of support that can provide assistance relating to the impact of endometriosis. I welcome the work and the commitment that I see from Mary Todd on the women's health plan. While progress has been made on that, we must acknowledge much more needs to be done. I think that it is fair to say that faster for those women would benefit. We must also commit to providing age-appropriate menstrual wellbeing education only by removing the stigma surrounding discussion on the topic of menstrual wellbeing while we raise awareness and tackle the issue that is staring us in the face. By definition, endometriosis is a condition where tissue similar to the line of the womb starts to grow in other places such as the ovaries and the fallopian tubes. Its main symptoms include painful periods, pain in the lower back and abdomen, pain during or after sex, difficulty becoming pregnant and discomfort when going to the toilet, and it causes many women to have a long time of suffering and often social mental health problems. One of the main difficulties highlighted by those with lived experience and by endometriosis UK and by a wide range of healthcare professionals is that such symptoms can be attributed to so many other conditions and illnesses. The complications are often missed or take a long time to be diagnosed. Therefore, it is vital that we call for greater research into the presentation and causes of endometriosis to allow women to be provided with high-quality treatment at a much quicker rate than it presently happens. Indeed, we must also hope that such research also brings forward alternative treatments and, at some point in the future, a cure. There is a significant amount of work already being undertaken in our communities by individual groups and organisations that we have heard from others. I have also had the pleasure of meeting with groups such as the group in the Scottish Borders, which are doing a tremendous amount of work to support those who are living with the condition and to hold us, decision makers, to account and also those in the health services. We must commend the work that individuals and organisations do because, without their support, advice and advocacy, many more women would have faced the difficulties alone. I once again thank the member for highlighting to the importance and raising awareness of the condition and also thank members who have spoken in the debate. I hope that tonight's debate is not the end but the start of heightened focus in the Parliament and beyond for this condition. I congratulate Rachael Hamilton on securing this important debate and pay tribute to the women and girls across Scotland who suffer from endometriosis, many of whom will be awaiting a diagnosis and are not yet aware that what they are feeling is a condition that they should be diagnosed with and treated for. We are all grateful to Endometriosis UK for its research and campaigning and support groups. I commend the quite formidable endo warriors that I have known over the years for their indomitable spirit, even those who had joined me in one of their marches through Glasgow. It is vital to continue raising awareness and drive through the changes that we want to see. Five years ago, I led the last dedicated endometriosis debate during which many primarily male contributors to the debate admitted that they had no prior knowledge of the widespread but little-known disease. However, 21 years ago, since Annabelle Goldie first raised this important matter in Parliament. Now that Elaine Smith has retired, I am the last remaining member who spoke in that debate more than two decades ago. However, while they make up with this change, there has changed beyond recognition. Can we say that the treatment of endometriosis sufferers has too? Every endo warrior clinician or even MSP will agree that the answer is possibly but at a glacial pace. The purpose of my own debate was to press the Scottish Government to establish a third accredited endometriosis unit in Scotland, which, following much post-debate discussion and deliberation, was to establish in Glasgow three years ago with the necessary specialist staff to serve the women of the west of Scotland, following early units developed and based in Aberdeen and Edinburgh. I want to thank Aileen Campbell and Jeane Freeman for all their hard work and tenacity in taking this forward. More units, however, are essential, of course, from Inverness to Ayrshire to Dumfries. The opening of the new unit was followed by the Scottish Government's women's health plan, a UK first, which aims to reduce the average length of time it takes for an endometriosis diagnosis for an often fraught, painful and drawn-out average of eight and a half years. There is much work required to cut this under a year by the end of this Parliament. Based on clinical feasibility, the Scottish Government is right to set such an ambitious target. We now look forward to a more detailed description of exactly what steps will be taken and when. I know we will receive more detail in June when more significant headway will have been made in gathering information. Today, too, hopefully, in the ministerial response, we will hear of progress. Information is crucial, and I know that many colleagues will agree that communication is a hugely important factor to constituents suffering with endometriosis. That is why we must normalise talking about endo, collecting accurate and relevant data, publicising what we have and communicating better. Currently, a search for endometriosis on the Public Health Scotland website returns zero results. When trying to find the ministeral wellbeing toolkit in the Royal College of General Partitions website, the page is not working. Those basics must be fixed if we want endometriosis patients to know they are valued and being taken seriously. From what I understand from women with endometriosis, and I do know a number of such women, it is so much more than physically painful. As we heard from Emma Roddy, it is mentally draining to feel that you have your story over and over again to tell, as if you are being doubted. Losing your focus at work because of the constant pain, frustration and uncertainty and the general quest for answers is exhausting. Does he agree with me as a man that if 10 per cent of all men were in the situation that 10 per cent of all women are in, something would have been done long ago? That adds to the urgency of the action that we must now take. We all have mothers and many of us have sisters, daughters, wives, partners and female friends. For my view, it is absolutely critical that such a devastating disease is addressed with greater urgency. It must be absolutely bearable for sufferers and, as has already been said by Sandesh Gulhani, I do not know how women get through it, but they must. No one denies that endometriosis is there since karate and notoriously difficult to diagnose and treat. I do not believe that any of us hold unrealistic expectations about that, but it is now a matter of urgency that women and girls have spread the long and arduous path that so many of us have had to navigate before them. Let me emphasise once again that you do not have to suffer from endometriosis to recognise that too many women are suffering too much, too long. We can all offer support, listen and campaign to raise awareness and ensure that women are being heard and receive a better service. I know that I will. To anyone out there who is awaiting a suspected diagnosis of treatment, I say that please know that faster helping a better experience is on its way. There are hundreds of people including elected representatives of all parties who care and are working to improve the service that they are receiving. The Scottish Government's women's health plan contains a firm commitment to you. Let's look forward with determination to it being fulfilled. Thank you. Due to the number of members who wish to speak in this debate, I am minded to accept a motion without notice under rule 8.14.3, to extend the debate by up to 30 minutes. I now invite Julian Mackay to move a motion without notice. Thank you. The question is that the debate be extended by up to 30 minutes. Are we all agreed? We are agreed. Thank you. I would now call Beatrice Wishart, who is joining us remotely, to be followed by Evelyn Tweet. Up to four minutes please, Ms Wishart. Thank you, Presiding Officer, and congratulations to Rachael Hamilton on securing this important debate. So much has already been said about the impact that endometriosis has across all aspects of life, and I make no apology for repeating some of what has already been highlighted today. I want to start by outlining exactly what is at the heart of this discussion, is the lives of women and girls. Endometriosis is a condition where tissue, similar to the lining of the womb, starts to grow in other places, such as ovaries in the fallopian tubes. Symptoms, amongst others, include painful or heavy periods, painful bowel movements and pelvic pain, an estimated 1.5 million women in the UK are affected, and that is similar to the number of women who have diabetes. Yet on average, as we have already heard, it takes eight and a half years to receive a diagnosis. Eight and a half years of pain, missing out, uncertainty, eight and a half years of explaining, how tiring must that all be? The breakdown of relationships because the pain and struggle is too hard to comprehend. The misogynistic dismissal of women's issues, or it's just painful periods, or even worse, is perfectly normal for women to experience pain. The long waiting lists, the postcode lottery of treatment. There's a serious problem with delays for getting an initial appointment with a consultant, and Covid has only made these long waits even longer. Non-urgent appointments have been delayed because of Covid, but for endometriosis patients it's not non-urgent. One person told me that, while their GP has been good, the doctors had to go through various other options before referral to a consultant, rolling out cysts, IBS, food intolerances, and after over a year following their GP's referral, they're still to receive an appointment. I've also been told by women how endometriosis has made them infertile and how the inability to have children affected their marriages. As high as 30 to 50 per cent of women affected by infertility have endometriosis, and I've heard stories of years on painkillers that don't help. One woman had to have an ovarian tumour removed, but it turned out not to be cancer, but endometriosis, the size of a small orange. She eventually had a full hysterectomy after years of struggling with chronic pain. The Scottish Government's women's health plan is set to directly address endometriosis, and we must ensure that it improves lives and shortens waiting lists. It has no definite cure and the cause is still unknown, and so we need to support research to better understand the condition and develop more treatments. There is support out there, as we've already heard, such as the North Highland support group for endometriosis UK. I met with its development officer, Christine Campbell, as its support network includes Shetland. A midwife and former constituent of mine lived with chronic pain for years before being diagnosed and starting treatment for endometriosis, and with the help of the charity, she started a petition for menstrual wellbeing to be taught in all schools. It's important for both boys and girls to learn how female bodies work, so we can all better understand and support those with conditions like endometriosis, polycystic ovary syndrome and premenstrual dysforic disorder. Those medical terms will rightly mystifying and scary to many. So, like my former constituent and endometriosis UK, I want instead to encourage openness about what is normal and not normal for those menstruating. Unfortunately, too many are led to believe that the debilitating symptoms are just something to put up with, and too many school days embed suffering from intense pain. If our young girls are forced to take one week off every month from the debilitating pain, they will miss out on so much of their education and be radically behind their schoolmates. Encouraging openness and breaking down taboos around women's health issues so that those affected know when to seek help is so important, misconceptions need addressing and medical staff need training to spot the signs sooner. Plainly, we need to do more than averaging eight and a half years for a diagnosis for endometriosis, but working together I'm sure we can make progress. Thank you. Thank you. I now call Evelyn Tweed to be followed by Gillian McCall before minister. Thank you, Deputy Presiding Officer, and to Rachael Hamilton for raising this important debate and for highlighting a condition that affects so many women in Scotland, including myself. I have endured endometriosis all my adult life, resulting in chronic pain and at times misery. I sought help for many years, but the pain that I experienced was generally dismissed as normal. One day in my late 30s, the pain reached a point where I collapsed at work, was taken to A&E, and finally received the support and diagnosis that I needed. I had endured 15 years of pain without an answer. I don't want any other woman to go through what I went through. What is striking about this disease is the sheer number of women who are suffering right now and don't know it. As Rachael Hamilton noted, one in 10 women have endometriosis. What a huge number. A survey for an all-party group inquiry into endometriosis in 2020 found that, in Scotland, prior to diagnosis, 61 per cent of people with endometriosis visited their GP 10 times with symptoms. 43 per cent of people had had five hospital appointments, and 55 per cent had been to A&E. Stacey, a young woman from Flynn in Stirling, battled endometriosis from the age of 13. Stacey's pain would be so unbearable that she would collapse in class and be sent home. Stacey often felt that the teachers just didn't believe her. In a bid to ease her pain, Stacey eventually had a hysterectomy aged just 25. Now, Stacey is 34, and she still deals with regular and painful symptoms. She had hoped that the hysterectomy would help, but it hasn't. She now has no cervix, full of pain tubes, ovaries or uterus, though she feels extremely fortunate that she managed to have her children before the treatment. What Stacey's and many other women's stories underline is that the awareness of this condition is critically low. Delays and diagnosis not only mean years of physical and mental distress, but if left untreated, it may result in infertility. We have to ask ourselves the difficult question of why is something that is so common, so destructive, still so regularly dismissed or undiagnosed? Having that much pain is just a not normal. Attitudes need to change. It was very good this evening to hear Sandesh Gohani's words. GPs are often a woman's first point of call. I very much welcome the commitment to reducing waiting times for diagnosis from over eight years to under 12 months by the end of this Parliament and making this issue a priority. Tragically, the fact remains that, even when you are diagnosed, there is still no cure. In the treatments that I were offered going on the pill, staying on the pill or having a baby. In the first time, I was asked if I wanted to have a baby, I was 18. I was a student, I had no partner and I thought that this is not something that I am going to be considering at this present time. It begs the question, why is treatment for something that affects so many people still so lacking? I look forward to hearing how the Scottish Government intends to meet their diagnosis targets, how endometriosis will be treated and how health inequalities in general will be challenged. As a nation, Scotland can be proud of its commitment to equality, so let's make endometriosis treatment another thing that we can be proud of. I thank Rachel Hamilton for bringing forward this important debate. As we have heard already, around one in 10 women suffer with endometriosis. It can affect fertility, cause chronic pain, depression, fatigue and can severely impact the quality of life of those who suffer with this condition. The actual cause of endometriosis is unknown, there are several potential risk factors or triggers but none of those fully explain why some and not others develop this condition. It can last between puberty and menopause or it can last much longer. It is estimated that endometriosis costs the UK economy £8.2 billion a year. Many will feel the financial impact through lost days of work or not being able to work at all and for many of those who have endometriosis the quality of life impacts will be severe. The mental health impact of endometriosis needs more recognition and better support. The current average time to diagnosis is 80 years and this, as we have all recognised, is too long and I welcome the commitment in the women's health plan to reduce this to less than 12 months. There are many gynaecological conditions which have some similar symptoms and lengthy waits to be diagnosed. To ensure that we get everyone the correct help and treatment we need to reduce diagnosis times across the board and raise awareness of the specific conditions. In previous women's health debates many of the MSPs that spoke noted that at some point they felt their symptoms weren't taken seriously. We need to address why this is happening otherwise those who are suffering will continually not come forward to raise their symptoms. I want to take this opportunity to thank the MSPs and campaigners who worked to bring this condition to the forefront last session. We have seen wider recognition as a result and I am sure that there are many people who are now seeking support for their symptoms after seeing that others are experiencing them too. It is so important that we continue to talk about our experiences and break the stigma around talking about gynaecological issues and the symptoms that they cause. Rachel Hamilton earlier mentioned menstrual health and not having time to elaborate further, so I hope that others will indulge me for briefly covering another gynaecological issue. I have previously asked about ensuring that polycystic ovarian syndrome is appropriately recognised in the women's health plan. It takes on average three years for a diagnosis and on average those seeking help will see three doctors before being diagnosed. Similar tendrimatriosis, without intervention symptoms can deteriorate and serve as a risk factor for other conditions such as heart disease. Symptoms can include irregular periods, fertility issues, weight gain or issues such as losing weight and herstuism, which is excessive body hair growth, which is usually dark and coarse. In the world that we live in, where appearance is so routinely judged, this can severely impact women's confidence and their mental health. Often those seeking help are simply told to lose weight and that will resolve their symptoms with no recognition of the increased insulin resistance that can come with PCOS. One of the main tests for diagnosis is to test for different hormone ranges and to be suffering these symptoms and then to be told that you cannot be given a diagnosis as your hormones are borderline okay leaves you feeling adrift and helpless. I am currently one of those seeking a potential PCOS diagnosis and I want to do more alongside those raising awareness and treatment standards of endometriosis. For those who are struggling with their symptoms, whether that be endometriosis, PCOS or any other gynaecological condition, you are not alone. Your weight or your body hair does not define you. Choose to embrace it, choose to deal with it, do not let society shame your body. It is the one that gets you around during the day and whether you have hair on your arms, your face, whether you have a period or not, it does not reduce your worth. We need to break down the societal stigma as we work to ensure that our health services are able to diagnose and treat appropriately in a timely manner. We need to allow GPs time to research and update their knowledge. The entire health service is under extreme pressure and I think that it would be negligent not to acknowledge the impact the pandemic will have on our ambitions for treatment times. That does not mean that we should not be striving for quicker diagnosis now, but I think that it is important to be realistic. I would like to conclude by thanking Rachel Hamilton for bringing this forward and to all colleagues who have been sharing their stories this evening. It has been a real pleasure to listen to the debate so far. I want to congratulate Rachel Hamilton for securing the debate and attracting so many MSPs to take part. I was quite struck by Emy Roddick's observation that it is good to have the debate out with Endo Awareness Month, so we have to continue to do more of that. However, for anyone listening who has an interest because they live with Endo, whether they are diagnosed or otherwise, it is important that they not just feel encouraged but see that we are determined to see action. Like other colleagues, I welcome the women's health plan. It is a positive development in Scotland. I hope that there will be a breakthrough. My party has certainly campaigned for that to happen, but we need to see a real plan now. How are we going to achieve this really important ambition of reducing diagnostic waiting time from around eight and a half years to 12 months by the end of this Parliament? When the minister responds, I hope that she will be able to give us a lot more detail and reassurance, because that is really key. None of us wants to build up people's hopes and expectations just to continue a lifetime of disappointment. I was reflecting on some of the things that I had been involved in last year during Endo Awareness Month in March. Everyone just shared a personal story about being told as a young woman as a teenager to just get pregnant. Last year, I tweeted that it is appalling that women are still being told to get pregnant as a way of treating endometriosis, and that is because some young women in their 20s had shared that experience on BBC Radio Scotland. I think that it is really good that we have Dr Sandish Gohami taking part tonight, although he will probably want to share what he has heard tonight with other GP colleagues and clinicians. We have some first-class clinicians and specialists in endometriosis here in Scotland, but we are just not, I do not know, cascading the good practice of knowledge enough. Too often, women and other people, including trans and non-binary people who also experience endometriosis, are just not being believed. That brings me to a point that others have made tonight, which is about menstrual health and wellbeing education. I know from previous letters from myself to Jeane Freeman and others in Government that the Government takes a view that they cannot mandate things in the curriculum, but I think that we have to get serious about that and work with schools and young people to make sure that people have all the information and tools that they need at an early age. I also want to join Michael Hamilton in paying tribute to Sir David Ames for all that he did in Parliament to shine a light on endometriosis. The all-party parliamentary group does some really important work and is the chair of the post-party group in Scotland and the Scottish Parliament on women's health. I hope that we can continue to work together. Kenny Gibson has given us a bit of a chequered apothatistory of previous debates in Parliament. It was Kenneth Gibson who encouraged me to start up the women's health cross-party groups. I would like to thank him for that, and I hope that we will see more men getting involved. Last observation from me is that we should focus on the things that we do get right in Scotland. Tomorrow marks the first anniversary of the period products deprovision Scotland Act, receiving royal assent, and that is now on the statute book. I want to thank everyone who lives with endometriosis for sharing their experience in relation to that bill. It was about making sure that we improve access to products, but it was also about sharing people's stories so that we can get that right in the workplace, in education and here in Parliament. I encourage MSP colleagues to become endometriosis-friendly employers like me. It is really easy to do, and it is an important conversation to take into your region and constituency, so get in touch with endometriosis UK to see how you can sign up to do that as well. Again, thank you to Rachael Hamilton. It is great that everyone is taking part tonight, and hopefully when we hear from the minister we will begin to see that there is a plan to put those really important ambitions into practice. I want to thank Rachael Hamilton for moving this important motion and welcome the opportunity to respond on behalf of the Government this afternoon. The contributions from members across the chamber have been really powerful and I am grateful to hear them, but I want to welcome particularly the personal contribution from Evelyn Tweed. Her story will resonate with so many people and it is such a powerful thing to use your own personal experience to make progress in this place, so thank you. Thank you to Gillian Mackay for raising the almost-to-boo issue and speaking so powerfully about stigma and highlighting very clearly why it is so difficult to make progress on those issues. I am grateful to Beatrice Wishart for the mention of the North Highland Endometriosis Group and my constituent, Christine Campbell. They are the most incredible group of women that I have met with them myself and they are absolutely unafraid to speak truth to power, and let me tell you that I am grateful for it. Endometriosis has a very devastating impact for so many women in Scotland. It is estimated that the condition affects one and a half million women in the UK, but it can be difficult to diagnose. In part due to the diverse symptoms and the lack of non-invasive diagnostic procedures, the symptoms can be debilitating and impact on all aspects of women's lives, their relationships, work, education and mental health. I am really proud to say that, in August 2021, Scotland became the first country in the UK to publish a women's health plan and that it is committed to improve access for women to appropriate support, speedy diagnosis and best treatment for endometriosis. I am certainly grateful to the minister for giving way. As you know, Rachael Hamilton cannot intervene in this debate, so I am being a proxy for her in asking the minister whether she is confident that the Scottish Government promised to reduce waiting times for diagnosis from eight and a half years to less than 12 months is achievable in the lifetime of this Parliament. I am very confident that we will make progress on this issue. I join with all the members who have contributed today in recognising the barriers to receiving support and in recognising the long waiting times for diagnosis. We are absolutely committed to reducing the diagnosis time and ensuring that the best possible advice and support is available for women throughout the diagnostic process. We have been taking positive steps to improve the diagnosis and wait times. I am pleased to share that a new endometriosis care pathway has been developed by the modernising patient pathways programme, adapted from the NICE guidelines for endometriosis. That pathway will support healthcare professionals to recognise the symptoms of endometriosis and provide a timely, standardised, referral care pathway for women with suspected endometriosis to secondary and tertiary care for those who need it. The pathway will enable women to be more informed and empowered to make choices about treatment and management. Alongside the pathway, endometriosis UK are developing a leaflet to explain the process for diagnosis, which will be available online and for GPs to give to patients that have symptoms of endometriosis but have not yet received the diagnosis. We recognise that reducing the time to diagnosis alone is not by itself an effective measure or demonstration of improved health and wellbeing outcomes. We are going to continue to work closely with endometriosis UK and Public Health Scotland to analyse the data to help to indicate the reasons for blockages for treatment and support at a primary care level. To establish a baseline, as Rachael Hamilton mentioned, to measure progress that will be meaningful for all women and their families. Endometriosis UK is producing a report available shortly, which will provide an overview of the data and service provision in Scotland and its recommendations. I look forward to receiving the findings of that, and I give my assurance that those will be acted on. I want to pause for a moment to pay tribute to Sir David Amos. Sir David was the chair of the all-party parliamentary group on endometriosis ever since he launched it in 2018, and he worked tirelessly to raise awareness and to improve services for those living with the condition. His dedication and his determination during the time as chair led the APPG to undertake the inquiry on the improvements that need to be made to ensure that those with endometriosis receive the care and support that they deserve. The actions in our women's health plan reflect those recommendations, and we are aligned in our vision to drive down diagnosis times and to improve access to care. I would like to assure the chamber that work is going on to deliver the actions in the women's health plan and to take the necessary steps forward to improve health outcomes for women. We will soon be convening the first meeting of the women's health plan implementation programme board to ensure that progress is achieved at pace with a detailed implementation plan published by spring this year, the first progress report published in autumn this year. Importantly, we will also continue our lived experience engagement to ensure that women's voices and experiences shape the implementation of the plan. We will strengthen collaboration across the regional specialist endometriosis centres using these hubs to support local delivery across health boards. We will also continue to build collaborative relationships with endometriosis third sector organisations and support groups in order to help to deliver the women's health plan actions. We will work with Public Health Scotland and partners to analyse the available quantitative data to allow us to identify the gaps in national data and where improvement is required. While being mindful of the impact that the pandemic continues to have on health boards, we will gather local qualitative data to help us to understand the immediate pressures around waiting times for outpatient and inpatient endometriosis care. Finally, we will continue to support the implementation of the endometriosis care pathway and we will explore opportunities to partner with endometriosis UK and other lived experience groups to raise awareness and consider ways to support the diverse needs of people with endometriosis. Presiding Officer, I like to close this debate by thanking those who have contributed today. I am listening. I know that we have taken positive steps but I know that there is still a great deal more to do. I would like to assure the chamber that we will continue to work with our partners to implement the actions in the women's health plan and to bring about real and transformational change for women with endometriosis. I want to end by thanking those with lived experience who have helped us to shape the actions in the women's health plan and continue to share their stories helping us and everyone out there to understand what we could achieve within the lifetime of the plan.