 Good morning, everybody, and welcome to the third meeting of the sixth session of the Scottish Parliament of the Citizen Participation and Public Petitions Committee. We're going to have two items in the agenda today for the first time consideration of continued petitions from the previous Parliament and then a consideration of new petitions. We will be joined by a number of parliamentary colleagues who have an interest in some of the petitions that we are considering as we go forward. Our first item in the agenda is consideration of continued petitions, which we have 10, all of which are being carried forward from the last session of Parliament. Firstly, PE1517, polypropylene mesh medical devices, a petition I've had some engagement with myself. The first continued petition today has been lodged by Elaine Holmes, who I should say is a constituent of mine, and all of McElroy on behalf of Scottish mesh survivors. Here our voice campaign. The petition calls on the Scottish Government to suspend the use of polypropylene transvaginal mesh procedures to initiate a public inquiry and or comprehensive independent research to evaluate the safety of mesh devices using all evidence available, including that from across the world. To introduce mandatory reporting of all adverse incidents by health professionals, to set up a Scottish transvaginal mesh implant register with view to linking this up with national and international registers, to introduce fully informed consent with uniformity throughout Scotland's health boards and to write to the MHRA and ask that they reclassify transvaginal mesh devices to heighten alert status to reflect on-going concerns worldwide. Our meeting papers outline some of the many actions that the committee has taken since this first petition was first lodged in April 2014. This includes a report, a chamber debate, as well as several evidence sessions, and in these sessions the committee has heard directly from witnesses, including among others, two cabinet secretaries for health, chief medical officers of the day, as well as key figures in the medicines and healthcare product regulatory agency, Dr Dionysius Veronicus, a surgeon specialising in pelvic mesh removal in the United States, and so memorably, of course, from the petitioners themselves. Our papers also highlight the recent introduction by the Scottish Government of the Transvaginal Mesh Removal Cost Reimbursement Scotland Bill, part of the Government's programme announced yesterday. The bill will allow the Scottish Government to set up a scheme that could reimburse people who have paid private healthcare costs to have their transvaginal mesh implant removed, and it could also cover travel costs and hotel accommodation paid in relation to the surgery. In their most recent submission, the petitioners state that they are heartened. The Scottish Government's Women's Health Plan for 2021-24 highlights the importance of learning from the mesh crisis. They also highlight some questions that they have regarding the treatment women suffering with mesh complications can't access. With that, I wonder if colleagues would like to come in. David Torrance. Thank you, convener. This is over seven years now, as the petition has been around session four, where I was there at the beginning, session five, I've seen it through, and now in session six. We've taken over a hundred written submissions, several oral submissions. We've had debates, as you said, in Parliament, and lots of questions about this issue. I would like to put on record two of petitioners and all the women who have turned up. This is a big thank you to them. It's probably some of the most emotional evidence I've ever had to take in my time sitting on any committee. To them, for their perseverance, I would like to say thank you very much, because we've got a result for us. It's maybe taken a lot of years and a lot longer time than the petitioners would have liked, but finally we have got the result. I would like to say thank you to them and everybody who has supported them. I would like to close the petition under rule 15.7 of standing orders. Any other colleagues would like to come in on this petition? Hello. I would like to say that there's now hope that the progression of the bill can be the final chapter of the horrific trauma. There are still a number of outstanding questions, but I'd also like to play tribute to your work, Jackson, on the mesh implants. Well, thank you for that. I'd like to say to many of the women who may be watching this morning a huge thank you for everything that you've done really over seven years, a third of the lifetime of our own Parliament pursuing this extraordinary health injustice. To our former colleagues, Alec Neil, Neil Findlay and also Joanne Lamont, who is the convener of the Petitions Committee did terrific work in the last Parliament. I think it's been one of the most significant petitions that this Parliament has progressed. It's had implications and ramifications that have been watched and felt in countries across the world. All of it was down to the original petition led by two women, as I said, Elaine Holmes, the constituent of mine and Olive McElroy, but so many other women as well. In closing this petition, I think there are one or two questions that we might still ask, but in closing this petition, I'd actually like to take the unprecedented step of inviting all colleagues on the committee to give these women a round of applause because I think what they have done has been quite remarkable. Thank you. I think that we have formally closed that petition. We are joined by Emma Harper and Eleanor Whitham MSPs this morning for our second petition, PE161, the upgrade of the A75 PE1657, the upgrade of the A77. We've heard from other colleagues as well, but we'll be coming to them shortly. This petition, by Matt Halladay and Donald McCarrie, respectively, calls on the Scottish Government to upgrade the A75 Euro route to dual carriageway for its entirety as soon as possible. 1657 calls on the Scottish Government to dual the A77 from air whiplets round about south to the two ferry ports located at Cairn Ryan, including the point at which the A77 connects with the A75. As I said a moment ago, we have Emma Harper and Eleanor Whitham with us this morning as well. During its consideration of the petitions, the Public Petitions Committee took evidence from the Minister for Transport and the Islands in 2017 and received 31 written submissions. Our meeting papers summarise a number of written submissions, including the submission from the then Cabinet Secretary for Transport, Instructure and Connectivity, which was raised at the last consideration of the petitions. The written submission detailed investments made into the A77 and the A75, the second strategic Scottish transport project review in the Dumfries and Galloway area, and the parallel study, which engaged with stakeholders and considered the rationale for improvements to transport in south west Scotland. The UK Government has already committed £20 million to developing projects identified in Sir Peter Hendy's union connectivity review interim report, including upgrading the A75 between Gretna and Strunrar. In its most recent submission, Donald McHarrie, the petitioner for 1657 points to research conducted for the strategic transport projects review, which highlighted that the current A77 is behind the current required standard. The submission notes that in the week commencing Tuesday 24 August, there were two fatalities and two casualties between the A77 and A71 for a diversionary route, causing the south west corner of Scotland to be completely cut off to traffic to the north. The petition is calling for the committee to hold around Table and Strunrar, as discussed by the session 5 committee, in order for members to hear first hand about issues raised in this petition. Finlay Carson, MSP, hoped to be able to attend, however he is currently convening another parliamentary committee and he therefore sent the following. I have been a long-term advocate for improvements to both the A75 and the A77 and I have given evidence at the committee on numerous occasions stressing the need for action and not further delay. The convener's group met the First Minister on 13 November 2019. The First Minister said that she would respond to the petition in writing and that she would use PE1610 as a case study to describe the process that the Government goes through to reach decisions. Despite repeated requests for information from the committee, no response, as far as I am aware, has been received. I am quoting from Finlay Carson's submission. Secondly, in the light of current continuous problems, particularly on the A77 at Carlock wall, I would like the committee to consider a stakeholder meeting as previously suggested. It should include the Cabinet Secretary for Finance and the Cabinet Secretary for Net Zero, Energy and Transport and the Transport Minister. That is the introduction. If I may, I will now come to our two colleagues who might want to add to our deliberations before we consider what steps to take next. I am looking to the two of you. I will go to Emma Harper first. Thank you for having us attend today. This is a really important petition. Like my colleague Finlay Carson, I have had numerous questions in chamber. We have had three debates in the past five years in the previous session. That has great interest for people in the south-west of Scotland. The A75 and the A77 are main arterial routes for connecting us to the European Union, and I absolutely agree that they need to be improved. I am interested today in how we are going to move forward with this petition because I am aware of the south-west roads review that is feeding into the strategic transport review, which is imminently due for release, and I am keen to see what improvements the Government will be committing to. We have also had Michael Matheson, when he was Cabinet Secretary, in Strinrar, meeting both members of the A75 and the A77 action groups. We were able to hear from him earlier when Michael Matheson was made transport secretary. I am aware that some of the challenges that we have been doing—freedom of information requests around is safety, collisions, fatalities and trying to use that kind of argument and evidence for investing in those roads. We know how many lorries are on those roads when ferries arrive and when they depart. For me, I am keen to see that whatever the Petitions Committee can do to chivee along the Government to make action and make improvements on both roads. If you have a view on the suggestion made in session 5 of a round-table discussion, there has been—I know that the Cabinet Secretary for Transport had met petitioners here in Parliament and then at Strinrar. The Strinrar meeting was one that I organised and all colleagues were invited to that as well because I wanted to be clear that this is not a political issue, it is an issue of safety, transport and access. If the strategic roads review publication is imminent, it would be probably worthwhile hearing that first rather than another round-table meeting. I know how concerned the transport minister is right now and he knows that there is a high level of concern from people in the south-west of Scotland. I imagine that this is your first engagement with the Public Petitions Committee, but I invite you to add your thoughts on the petition. Good morning, everyone, and thank you, convener, for giving me the opportunity to address the committee this morning. As the very new MSP for Carrot, Cymru and Dyn Valley, it was very imperative that I speak today in support of the petition's desire to see significant improvements to the A77 as the majority of the single lane section of the route lies within my constituency boundaries. I travel the route often, and I know firsthand of the frustrations that can be felt when stuck behind a platoon convoy of HGVs, or when scheduled roads repairs or serious accidents cause delays and lengthy diversions via rural road infrastructure, which in some cases results in the absolute agony and heartbreak of another fatality being reported. Sadly, as the conveners mentioned, in recent weeks we have lost yet more lives on this stretch of road, and I extend my heartfelt condolences to the families involved. I understand also fully that the geography of the stretch south of Ayr is very challenging, as it is very beautiful. At places it hugs the coast and offers the most spectacular reviews, but at times these stretches offer the most frustration too, as driver impatience crosses rash decisions sometimes with serious consequences. Several years ago, I experienced a near crash whilst travelling the route to my caravan with my then five-year-old son in the car. A driver frustrated by a slow-moving lorry decided to overtake, and I found myself hurtling head-on at a vehicle at speed. Thankfully, the driver managed to knit back in front of the HDV and I kept control of the car, but 17 years later I can still recall the feelings of helplessness and terror at the time. Like the folk of Mabel, I am delighted to see the progress of their much-thought-after and anticipated bypass, and I just know how many benefits they are going to see from this huge infrastructure investment. Currently, large HDVs crawl through the town mere feet from pedestrians in buildings, making it difficult for residents or visitors to enjoy the historic town. The bypass has enabled a multimillion-pound town-centre regeneration project to kick off, and I know that, along with greatly improved air quality—which is massively important—the town will see a renaissance of town-centre vibrancy. Like so many other small towns and villages from Minishan to Cacosweld and from Garvern to Ballantrae, they also see their daily lives impacted by the high volumes of HD traffic enroute to the port of Cairnwyan, and it is imperative that improvements are made that mean tourism, trade and commerce are continued unimpeded, but local lives are protected and communities nurtured. I understand fairly that we need to await for the publication of the STPR2 recommendations, and it is my hope that we shall see significant investment in the south-west that is long anticipated and much needed. All options need to be on the table, including moving freight on to rail and off the roads, dualling, bypasses, additional crawler lanes. In this new Brexit era, the A77 and the A75 are the gateway routes to the EU, and we cannot underestimate their importance. Colleagues, would anybody like to make any contribution? I think that, in the first instance, there is an argument certainly for this petition remaining open, and it is the case in keeping it open of just considering what further actions we might take. Tess White? I would just like to say that we have had four MSPs who have got Emma Harper, Eleanor, Witton, Finlay Carson and Sharon Dowie, four MSPs who talk about, as Eleanor said, safety, transport and access. It is disappointing that we have not seen progress despite numerous requests, so I think that progress does need to be made on this. I think that we should keep the petition open, but I think that we should write to Cabinet Secretary for Net Zero Energy and Transport seeking an update on the progress of strategic transport projects with view to and request an indication as to when phase 2 outcomes will be announced. We can also write and ask him about his views on the UK Government upgrading the road. As for the round table, I think that I would like to wait until we get these written submissions back to see if we should go ahead and hold the round table. I mean, I was struck by Emma Harper's advocacy of holding off the round table until we see a little bit more about where things go, but reserve the right still to come back to that. I think that we take forward, I think that we are just clear that we are writing to the UK Government about the A75 route, but are the committee colleagues agreed on that? I am generally supportive of the idea of dualling of the national trunk road network for safety reasons. Sometimes it is conflated with environmental concerns, but the safety implications of dualling on trunk roads is critical. A wider issue that I would appoint that Elena raised about the issue of rail substitution, a wider assessment of the condition of being able to move freight from the ports at Cairnwine and Strunmar on to rail, is worthy of consideration. I also think that something that is lacking, certainly on the west coast, is a port strategy generally, and I think that there needs to be a consideration about the utilisation of some of the first of Clyde ports further north, such as at Greenock, for moving freight on to the motorway network, which would help to relieve pressure on the Ayrshire trunk road network. All of these things are considered in isolation, so perhaps it might be worth writing to the relevant ministers to ask for that to be brought into the consideration of the strategy, particularly when the STP is strategic transport review. I think that we really need to look at that in a wider sense, because there really is not a consideration about ports infrastructure in the west of Scotland and how that is managed. It is effectively a free market, but it has significant public costs that are not properly accounted for. It is probably straying slightly beyond the parameters of the petition itself, but I can see the relevance to it, notwithstanding. Obviously, we are coming to this as a new committee, it is a continuing petition. I do not know whether those issues were previously explored or whether Mr Sweeney has identified some issues that we could seek some further opinion on from the Scottish Government, which we can do. I should just clarify that it is to the Scottish Government that we are asking for a view on the UK Government's proposals in relation to the 75, not to the UK Government itself. Are we happy with that? We move to petition 1662 to improve treatment for patients with line disease and associated tick-borne diseases. The next is lodged by Jeanne Cringian and Lorraine Murray on behalf of tick-borne illness campaign Scotland. The petition calls on the Scottish Government to improve testing and treatment for line disease and associated tick-borne diseases by ensuring that medical professionals in Scotland are fully equipped to deal with the complexity of tick-borne infections, addressing the lack of reliability of tests, the full variety of species in Scotland, the presence of persister bacteria, which are difficult to eradicate, and the complexities caused by the presence of possibly multiple co-infections, and to complement that with a public awareness campaign. At the last consideration of this petition in February 2021, the session five committee took evidence from the then Minister for Public Health and Sport, Marie Gougeon, supported by Scottish Government officials Dr Jill Hawkins, the senior medical officer health protection and public health and Professor Tom Evans, CMO's speciality adviser in infectious diseases. During the session, the minister stated that the Scottish Government is committed to supporting people with line disease, finding new and better diagnostic and treatment tools and trying to prevent it in the first place. It was revealed that the Scottish Government would soon be holding around table event, which would bring together clinicians, patient representatives and public health experts to discuss testing, treatment and raising awareness. The minister confirmed that the Scottish Government is keen to develop an infectious diseases managed clinical network to include line disease in its work stream. The minister and officials also agreed that more research is needed to underpin the development of better treatment options, particularly for people who are suffering with longer term symptoms. Again, in discussing this petition, I ask colleagues whether they have any comments or suggestions that they would like to make. Thank you, convener. Some day in session five, when the evidence was given, I would like to ask the Scottish Government what the outcomes of around table event were and where they are in establishing infectious diseases managed clinical network and what they have done to promote a public campaign about it and the effects of the long term of Lyme's disease on people and what they have done to look into more research for it. Thank you. Do we know did the round table event take place? We don't actually know that, so I think we'll want to confirm if it has taken place and then I think sensibly establish any outcomes from it. Anybody else like to comment on this petition? Tess White. I would like to support my colleague Mr Torrance and say that we do need more research on this. Okay, thank you. That meets with the general agreement of the committee. Mr Sweeney? Sir, this has been raised in debates in other parliaments in relation to particularly ME, as a potential Lyme disease, as a contributory factor to long term chronic illness, which is defined as ME. It might be of interest to understand more about the interactions of research on that, because I think that it's another condition that people often feel it is not properly taken seriously by the medical profession, so it might be something worth considering as part of this petition. Okay, thank you. I mean, we did have a member's debate on this in session five, led by Alexander Burnett from memory. But yes, fine, thank you. Okay, we're clear. All right, anybody else any comment? Thank you. We now move on to PE1723, essential tremor treatment in Scotland, and we are joined this morning by Rhoda Grant MSP. Good morning to you. This is a petition lodged by Mary Ramsey. The petition calls on the Scottish Government to raise awareness of essential tremor and to support the introduction and use of a focus ultrasound scanner for treating people in Scotland who have this condition. The session five public petitions committee last considered this petition at its meeting on 10 March 2021. At that meeting, the committee agreed to continue the petition and include it in the legacy paper for their session six colleagues, successors, us, along with a suggestion to seek an update from the Cabinet Secretary for Health and Sport on the Scottish Government's plans to make an application to the National Specialist Services Committee for an MRGFUS service. Magnetic resonance guided focused ultrasound, which actually is easier to say than MRGFUS, is a relatively new treatment for essential tremor, which uses an MRI guide to powerful focus ultrasound to a small point in the body, causing an intense local heat which can destroy tissue. The Scottish Government highlighted guidelines that are published by the National Institute for Health and Care Excellence, commonly known as NICE. In June 2018, on the use of unilateral MRI guided, focused ultrasound thalamatomani for treatment-resistant essential tremor, this concludes that, while clinical evidence does not raise safety concerns, current evidence of efficacy is limited. Therefore, evidence of patient benefit is too limited for the NHS to currently adopt MRI guided ultrasound technology for treatment of essential tremor. The Scottish Government notes that this National Specialist Services Committee met in December 2018 to consider a stage 1 application for specialist treatment of patients with ET using magnetic resonance guided focused ultrasound. The committee was unable to endorse the application for funding as a nationally designated service. It was highlighted that NICE guidance is permissive and, while there is some evidence for use of magnetic resonance guided focused ultrasound in essential tremor, there is a clear statement that research is needed into its application for Parkinson's disease and MS tremor. NSE was clear that, should the evidence base be further developed and magnetic resonance guided focused ultrasound be recognised as a safe and effective intervention for treatment of tremor, the committee would be willing to consider a re-application in future. On 16 December 2020, the committee took evidence from Professor Dupankarnandi, consultant neurosynger and head of department chairing cross hospital and St Mary's hospital, and Professor Imperial College London. Our meeting papers summarised the evidence from that meeting. In her submission, the petitioner advised that her tremors and the lack of understanding surrounding them has impacted on her entire life. The petitioner does not believe that there is a need for further research and evidence into the effectiveness of magnetic resonance guided focused ultrasound before the Scottish Government backs it. Noting this treatment for essential tremor is currently available on Medicare in the United States of America, the NHS in Japan and in other countries around Europe. When referencing the progress made by NHS England, the petitioner concludes that while she believes that England is proceeding a pace with providing this treatment, unfortunately Scotland is falling behind as the costs for bringing it to Scotland are simultaneously increasing. Before we turn to colleagues, I think that I would like to invite Rhoda Grant to comment in support of the petition. Thank you for allowing me to speak. The petition was obviously a previous petition to the committee and some of the new members of the committee might not be totally aware. There are basically two treatments for essential tremor. An essential tremor is very disabling, because it means that people shake, so things that we all take for granted, like drinking, eating and public, even speaking, it can affect the way someone speaks. The people who suffer from it tend to become very isolated and tend not to mix socially. It is a very difficult illness to deal with. They tend also to a very late diagnosis. Mary Ramsey, my constituent and the petitioner, was not diagnosed until her forties and has had brain surgery to deal with it. The difficulty with the brain surgery is that it does work and it is a proven treatment, but you need to go back and move those electrodes. People who have brain surgery for essential tremor have a lifetime of procedures ahead of them, whereas focused ultrasound is non-invasive, so there is no brain surgery involved and is a one-off treatment. It is life changing for those involved. It absolutely is. Now, it is an approved treatment in NHS England fund this, and people from Scotland can be referred to NHS England for treatment, which to me is totally crazy, because we have this machine in Dundee and could be treating people here and now in Scotland at a much lower cost. What was the point about Dundee? I just missed that. When this petition started, Dundee, NHS Tayside University and Dundee were working together to fund and purchase a machine, they have now done that. The machine is available and is giving treatment here in Scotland, but only experimental treatment—I say that in inverted commas, because the treatment is not experimental—has been approved elsewhere, but it is under that locus that they can then treat people. A GP or consultant in Scotland cannot always, unless they are talking about experimental treatment, refer someone to Dundee. What they have to do is then refer someone to London to Professor Nandi and his colleagues. There is a huge waiting list, as you can imagine, and it seems just wasteful that we have this treatment available in Scotland, but Scottish people cannot really access it. Mary was speaking to me recently, and she sent me a video that I think will send on to clerks, and hopefully they can send that round to committee members of Ian Sharpe, who has received the treatment. Mary also told me this morning that herself and Ian Sharpe would be very willing to come to the Petitions Committee and give evidence of their experience of the two different treatments, and maybe committee members could get a better idea of that. I am urgent not to close this petition. I think that we have come a long, long way, and I think that the previous Petitions Committee was instrumental in getting this moved up, the political agenda, and probably instrumental in getting this technology into Scotland. It is a waste if we cannot actually use the technology for the good of patients in Scotland, so I would ask that you pursue Scottish Government on this and try and push that this treatment in Dundee becomes available to people in Scotland, but I also urge you to hear from Mary and Ian Sharpe, who would give you a first-hand view of what this condition means to them and how life-changing the treatment can actually be. Is that the only place in England where the treatment is offered, through Professor Nandi in London or other locations? There are two centres in London, I understand. For the invasive treatment, people in Scotland go to Glasgow or Newcastle. I am not sure if Newcastle is looking to develop this as well, but there is certainly the centre that is used by a lot of Scottish patients for the more invasive treatment. It is London at the moment that people need to go for this treatment. Okay, thank you. That was very interesting. Colleagues, does anybody like to comment on this bill, kid? Thank you very much and thanks to Rhoda Grant for giving us that really essential information. What I was most taken with is the report about Dundee being available to actually provide that sort of service, but it is not being taken up. It seems like a great deal of discomfort with people who have tremors and require treatment to have to travel all the way to London, and it also sounds as though it is a waste of money having to do all that when it is available in Dundee. I think that we should be in touch with the Cabinet Secretary for Health and Sport to raise that issue and ask why that facility here in Scotland is not being used for Scottish patients. Test-wide? I think that the very fact that there are over 4,000 people with essential tremors means that this does need looking at. It is very important for those 4,000 people. I agree with that. I think that we should write to the Cabinet Secretary to find out what stage they are at. I think that we should very specifically draw attention to the fact that the committee has been made aware of the Dundee facility. That may have arisen before, but none the less the fact that the facility exists and therefore it is clearly down to the approvals process within the health service as to whether or not this treatment should be offered. I think that the fact that it is offered elsewhere is a reasonably compelling testimony in support of that. I think that I would like to hear the response to that in the first instance, but I certainly do not rule out hearing from the petitioners themselves because I know from the petition that we started with today, whether it be mesh or petitions on other medical conditions, that that can very often give committee members a fairly unique insight into the condition itself. It would be well worth potentially hearing from that. Are we agreed to take that in two stages and keep the petition open? I was just looking at the submission from the University of Dundee. I wonder if we could get an update from them, because the last time was 18th of December 2020 that they gave us an update, and they were hoping to have an installation and not run by then. I wonder if you could write to them and ask for an update. That seems sensible as well, we could do that. We will keep the petition open, we will write to the cabinet secretary, we will write to the University of Dundee and we will reserve the option to bring the petitioners before us, depending on the progress that we subsequently make. We agree. I am pleased to say that Rhoda Grant has got a season ticket this morning to the Petitions Committee and is joining us along with Liam McArthur MSP for petition 1804, a halt Highlands and Islands airport's limited air traffic management strategy, a petition lodged by Alastair McKeehan, John Doig and Peter Henderson on behalf of the Bynbekula community council. The petition calls on the Scottish Government to halt Highlands and Islands airport limited air traffic management strategy project to conduct an independent assessment of the decisions and decision making process of the ATMS project. The clerks note summarises the actions taken in this petition during the previous session, including quite extensive three oral evidence sessions with the petitioners, representatives of Highlands and Islands air traffic management and the cabinet secretary for transport, infrastructure and connectivity. Since the petition was last considered, we have received four submissions, two from HIAL, one from the cabinet secretary and one from the petitioner. These have all been circulated within our meeting papers. Before coming to committee colleagues, I will turn to visiting MSP colleagues. Since he has been waiting for his moment in the sun, I will invite Liam McArthur to comment first. I also put on record my gratitude to your predecessor and predecessor committee for the work that they have done on this. It was pretty forensic. As you have outlined, they did some fairly detailed work, including a number of oral evidence sessions. Those were very helpful, not necessarily in getting to the sort of conclusion that I was looking for, but certainly exposing some of the fundamental issues involved in the whole project. I urge the committee to keep the petition open. I think that there has been a lack of willingness by HIAL's management to accept the deep, deep concerns that are across all the communities that are really served by the air traffic services that are to be centralised in Inverness. That goes across the political spectrum and those who have no political affiliation at all. I think that there is no question that modernisation of air traffic services is needed. That is not contested at all. What is fiercely contested is that the remote tower model is the only viable model that will achieve that modernisation, achieve the regulatory requirements that are coming down the track. Since the last committee took evidence, I think that the most substantive development has been the publication of the island impact assessment that was delayed, but it was carried out. Certainly, in the Orkney context, it identified no positive benefits, a range of negative and significant negative impacts of the centralisation proposals. Therefore, I think that there is a feeling certainly within the community that I represent that if the island's bill, the island's proofing concept is to mean anything, simply setting aside that island impact assessment is just not a sustainable position. In written questions, ministers have confirmed that they have had no engagement with HIAL's management on the outcome of that island impact assessment, which seems to me wholly unjustified and unsatisfactory. At the very least, I would hope that the committee might agree that that is something that needs to be addressed. I think that the other point to reinforce is that those proposals predate the pandemic and what we have seen in terms of the impact on air services generally. There is a real concern that the commitment of already millions of pounds of public money to the rolling out of this programme is going to be compounded by further investment before there is a proper due diligence and audit conducted on this expenditure. I think that we can all draw on examples of where that process has led to some fairly unpleasant and regrettable outcomes in other areas of public expenditure. Again, I would hope that the committee would agree that that auditory process needs to kick in earlier on rather than simply tell us that you really didn't want to do that some way down the line when the money is already being spent and we are well past the point in no return. I am not sure that there is much more that I can add at this stage, but, as I said, certainly in relation to the island's impact assessment, that has exposed many of the concerns that Rhoda, myself and former colleague Gail Ross were articulating at previous meetings and were shared by the committee colleagues at that stage. I think that the current committee might usefully follow-up with the cabinet secretary and, indeed, with Hyal. You made reference there to—was that a survey? Is that a new survey? Is this the island impact assessment? It is a provision of the island's act. The coming into force of the provisions was slightly delayed, so there was a question as to whether or not the proposals were legally bound to be subject to an island impact assessment, but given the nature of the programme, Hyal undertook this impact assessment at the conclusions of which— I am sorry, but when was that, sorry? Is that new or is that something that the committee was previously aware of? They were aware of it taking place. It came in—right, you're right—we've seen that. I just wasn't sure if that was something completely fresh, but we are aware of that. It was delayed in terms of its undertaking. I think that some of that may be due to Covid quite legitimately. The publication of it was then, I think, significantly delayed beyond when it was handed to Hyal's management and then shared more publicly, so obviously the committee—the predecessor committee—didn't have an opportunity, as far as I'm aware, to look at the detail of that in the context of the work that we're doing on this petition. Okay, thank you. I'm going to update me on that. I invite Rhoda Grant. Thank you, convener. I won't repeat what Liam McArthur has said, because I think that your time is short. I suppose that the petition is about two things. It's about the new air traffic management system, but it's also about the downgrading of Wiccan bimbicula, and I think that members will have seen in the petitioner's response some focus on downgrading of Wiccan bimbicula to aerodrome flight information service. That means that they can only take booked, unscheduled flights. Wiccan is in the process of developing a PSO to encourage more traffic through the airport, but it's important to note that, in the past, Wiccan has served as a base for North Sea oil, so it's very difficult to have booked unscheduled flights, especially helicopter traffic that can only land if booked in an emergency from oil rigs and the like. I don't think that Wiccan is suitable for AFIS, and neither is bimbicula, because bimbicula is home to an MOD range. We have traffic from all over the world coming in to test weapons on that range. Again, having only booked slots available at those two airports makes no sense to me, so I would urge the committee to look into that and see what impact that's going to have on the local economy, both oil and the MOD's work on bimbicula, because I'm concerned that the bimbicula facility was under threat from the MOD a few years ago and was almost closed and it was because of community intervention that it was kept open, but it's a facility of national importance. I don't think that the MOD has been properly consulted, although I'm having difficulty getting that information out of them. We need to look at the economic impact. One of the things Hyal is saying is now that they are exploding commuting for existing staff so that they're not forcing people out of work, but my early discussions with Hyal about commuting made it clear that HMRC would not allow that on a permanent basis. They would allow it as a transition, but not on a permanent basis. I would suggest that the committee look into the feasible ability, apart from, obviously, personally, that would be difficult for families to be away from home when they go home every night just now. I would ask the committee to look at that. I would also ask the committee to have a look at what's maybe happening in Inverness. I understand that one of the reasons for this process, as Hyal tells us, is recruitment, but the place that they've had issues with recruitment is in Inverness, where they intend to move everyone to. My understanding is that, at the moment, Inverness is suffering staff shortages to the point that the head of air navigation services is doing operational shifts to keep that going, so it seems to me crazy to be moving people to Inverness, where that is the most difficult place to recruit the recruitment in the islands. Hyal were actually really good at this. They recruited local people and trained them up, people who wanted to remain at home. What they had was something that could have been an exemplar for other areas, but because of a problem in one area, they seemed to be pushing that away. Digital Scotland has also passed the project as an amber or red risk, and I urge the committee to make contact with them to find out what their concerns are. I also contacted Audit Scotland, and they told me that Hyal's annual audit was out with their remit, but they have a responsibility for its use of resources. I wonder if the committee would contact Transport Scotland's auditors who are responsible for the annual audit of Hyal to see if they have any concerns about that. My understanding is that it is already delayed, it is already overpriced. It seems to me that this is just another vanity project that is going to have a detrimental effect on the very communities that are needed to work and need to work properly. Unlikely, nobody is saying that something does not have to change when you need radar in those airports. We need to make them more sustainable, but this is not the way to do it. I urge the committee to keep this alive and maybe probe in those areas to see if we can get a better understanding of the risks involved. Having heard from our two colleagues, I wonder whether, as we now consider what to do next, any colleagues have got any comments that they would like to make. I am tempted to come to you, David Torrance, simply because you obviously have been long engaged with this petition. Thank you for that. But not if you have a burning ambition for me not to. No, if somebody was taking several evidence sessions on this in session five, I would still like to keep the petition open because there are questions to be asked here, as my two colleagues have mentioned. I wonder if we could write to the different groups. I would like to write to Civil Aviation Authority just to find out how successful this has been in other areas. I know that we have been given the guarantees that it is on budget, but I would like to see that. The Highlands and Islands Impact Assessment, I would definitely like to see what that is in parts of the local economy and things like that. I would like to find that assessment and see what it is. I see that there are two issues here. One is employee relations issues in relation to Hyal, and that is for the leadership of Hyal. That is not for us. They have got to transition as they have been charged to do. However, Rhodogran actually does talk about safety issues, so if there are serious safety concerns, they need to be looked into as a matter of importance. Just my final point is about the residents. The residents of the Highlands and Islands are extremely concerned about the reliability of transport links. That is a completely separate matter to the employee relations issues at Hyal. In relation to the reliability of transport links for the Highlands and Islands, which is critical to their economy, we follow up with the Scottish Government. I think that it would be interesting to be able to judge where the costs involved in the project actually take us. Is it something that has been introduced, the idea of in order to save money and in order to provide Hyal with a better financial position? Other than that, one of the reasons for my concern over that is the fact that jobs locally could potentially be lost, good quality jobs for local people. I think that that is worth having a look at. The other thing is the safety of the system, the remote tower solution, which, because I am not technical, I really cannot grasp the idea about how this operates over such a large area. It is safety of passengers and crew and those on the ground, no doubt, who I think should be brought forward. I think that we need more information on the safety of the remote tower solution. Paul Sweeney. I thank the colleagues for their very enlightening submissions. In particular, I note that the budget for the project has been approved already by Transport Scotland, so I would like to know if that is just a general provision, whether the detailed specifications are locked in in terms of primary, secondary or preferred scheme for ADSB, whether that is conditional. Furthermore, I note that an escalation with action by the Prospect Trade Union, most recently a strike at the end of July, and perhaps what the latest situation is with the workforce and their representatives, whether they would be willing to make a submission in relation to that. I think that those are the key things that would be good to know at this point. Thank you. I think that I am minded to suggest on the basis that David Torrance wants to come back again. I am sorry, convener. I did not mention earlier on Digital Scotland, I know that my colleague Roder Grant mentioned it, about it being an amber or a red project. Can we write to them as well, please? Thank you. I think that we keep this petition open. I am mindful that there clearly has been a very extensive consideration of it by the previous committee, and that the reality is that the Scottish Government supports the initiative. They have confirmed that it is on budget and they have referred to the review independently through digital assurance office, but even so, like Mr Torrance, it is just assertions that it has been successfully deployed elsewhere in the world of things that I might just like to probe. I would quite like the Civil Aviation Authority to be very specific in telling us where it has been tested successfully elsewhere in the world and then for us to see whether that is the case. To pick up on the various suggestions that colleagues have made about writing to the Government just to find out the absolute status of the project at the present time, as everything they have previously said is still the case, is it still being reviewed and found to be on budget and to specification, and the issues that I think Mr Sweeney raised as well, I think that we could incorporate into that too. We are happy to do that. Content, thank you very much. Our next petition is PE1812, project Scotland's remaining ancient native and semi-native woodlands and woodland floors. This petition carries forward, having previously lodged by Audrey Baird and Fiona Baker on behalf of Help, Trees, Help Us. The petition calls on the Scottish Government to deliver world-leading legislation giving Scotland's remaining fragments of ancient native and semi-native woodlands and woodland floors full legal protection before COP26 in Glasgow in November 21. In its submission, the Scottish Government highlights that it is committed to maintaining or exceeding EU environmental standards where appropriate and practical to do so, through its environment strategy, vision and outcomes and in legislation through the continuity bill. It states that it will bring forward a draft policy statement regarding the use of the discretionary power to align with EU law for consultation early in this parliamentary session. The Scottish Government also intends to produce a new Scottish biodiversity strategy no later than 12 months after the convention on biological diversity's 15th conference of parties, COP15, and to increase the area protected for nature in Scotland to at least 30 per cent of land by 2030. In response, the petitioners described the Scottish Government's submission as a catalogue of failure, barely disguised by statements of intention on meaningful action to protect native woodland and stem biodiversity loss in the future, and they argue that most of their petition objectives have been ignored by the Scottish Government. With that ringing endorsement in our ears, colleagues whether anybody has any comments they would like to make at this time. I think that there is some work still to do. I would like to keep the petition open. I do not think that there is going to meet its aims of having the protection here before COP26, but I would like to seek an update from the Scottish Government on its response to independent deer working group that was suggested by the PPC in the last session, and to see where we are in the biodiversity protection of the woodlands. I agree that the current planning framework is not necessarily well defined enough in respect to ancient woodlands and that it could benefit from enhancement, as proposed by the petitioners, to the extent in which it is effectively enforced wilderness. That would be beneficial from a policy perspective. Therefore, there is a legitimate basis to maintain that the petition is open. Thank you for that. On that basis, I think that we are inclined to keep the petition open and to seek an update from the Scottish Government on its response to the deer working group. As our predecessor committee suggested, I think that that could bring forward some of the issues that Mr Sweeney has just raised. I agree. Petition 1837 provides clear direction and investment for autism support, lodged originally by Stephen Layton. The petition calls on the Scottish Government to clarify how autistic people who do not have a learning disability and or mental disorder can access support and allocate investment for autism support teams in every local authority or health and social care partnership in Scotland. That was last considered in February this year. At that meeting, the committee agreed to continue the petition, including it in the legacy paper that we have received, along with a suggestion to take evidence from the Cabinet Secretary for Health and Sport on the various concerns that have been raised in the written submissions that have been received on the petition. Since the committee last considered the petition, written submissions have been received from Autism Scotland and the Convention of Scottish Local Authorities. The petition has received 23 submissions to date and has been considered twice by the previous committee. The Scottish Government's submission of December 2, 2020 highlights that support for autistic people is available from a wide range of sources that provide a range of support, including social groups, one-to-one counselling and post-diagnostic support. The submission notes that the Scottish Government is working collaboratively with national autism charities and autistic-led organisations to deliver a national autism post-diagnostic support service. The pilot project ran from December 20 until May this year. A national autism implementation team was established in partnership between the Scottish Government and Queen Margaret University to support health and social care partnerships, to consider best practice and improve service in the redesigning of autism diagnostic services. It is supporting NHS boards to examine diagnostic pathways for autism and establish regional experts to assist with improving tiered autism specialisms across health boards. In its submission of March 11, 2021, Scottish Autism welcomes the petition's call for more resources from the Scottish Government at a local level to support Scottish autistic people and their families. Scottish Autism believes that there continues to be an absence of consistent and accessible support services available in Scotland. However, COSLA's submission stated that it currently does not support the call for a blanket approach to providing support teams or ring-fenced funding. This is due to the impact of ring-fenced funding and local authorities' ability to fund non-ring-fenced services. COSLA outlined that services are not provided to autistic people on the basis of the Mental Health Act, rather they are provided following a professional assessment of individual need and eligibility criteria. In its submission, the petitioner highlights that in the Child and Adolescent Mental Health Services rejected referrals report, the repeated issue raised was that services are declining to support autism needs on the grounds of this not being a mental health issue. The submission then suggested that if autism is to be considered a mental health disorder, investment from the mental health budget could be used to create autism support teams that would in turn reduce pressure on mental health and social work services. The petitioner concludes by stating their view that the status quo is not enough and that submissions to the petition made by autistic people and their families demonstrates that more still needs to be done. That is quite a comprehensive analysis of where we are at and I again wonder whether colleagues would like to contribute as we consider our next steps. I know that this has been a huge issue. I can remember colleagues in the last Parliament bringing forward debates and speaking regularly on it, and it is an issue about which a number of people feel quite passionately. We have a very specific legacy paper recommendation, which is to take evidence from the Cabinet Secretary for Health and Social Care on the issues raised. What do your colleagues feel about that proposal? Or is there an alternative course of action that they would like to advocate? David Torrance Thank you, convener. I think that the Scottish Government has made headway, but I still think that the recommendation from the Public Petitions Committee in session 5 to bring the Cabinet Secretary for Health and Social Care in, I think that we should do that and just see how much headway health and how much progress the Scottish Government has made and where it has been flagged up in the system. There are folks, how we can rectify that. I see nods of approval from colleagues, so we agreed on that as a course of action. I think that we are, and therefore we would like to follow that through. Just have a session where we are able to focus on these issues quite specifically with the Cabinet Secretary for Health and Social Care. Thank you. That brings us to petition number 1838, the regulation of non-statutory child advocacy services, and I'm delighted that we are being joined for this petition by Christine Grimm, MSP. Welcome to you, Christine. This petition is, again, a continuing petition originally lodged by Martin Baker and Catherine Bailey. The petition calls on the Scottish Government to ensure that non-statutory child advocacy services are properly regulated to ensure competence, transparency and accountability. The session 5 petitions committee last considered this petition at its meeting in 10 March 2021, and at that meeting the committee agreed to continue this petition included in the legacy paper which we have received, along with a suggestion to write to the relevant minister to seek a response on whether the Scottish Government will undertake the work necessary to introduce legislation to regulate non-statutory child advocacy services. Including its last consideration, the committee has considered this petition twice and has received 14 written submissions. In her written submission on 1 December 2020, the then minister of community safety stated that the regulation of child advocacy services would require a full consultation and primary legislation, in which the scope for and efficacy of regulation may be limited as child advocacy services are not only provided by organisations or persons acting in a professional capacity. In the event that regulation was implemented, consideration would be required as to how it is enforced with persons supporting in the capacity of a relative, for example. In response to the limitations of the scope and efficacy of regulation due to non-professional persons carrying out the role, the petitioner questioned whether the definition of services under any legislation could be outlined to cover paid employees or volunteer staff of organisations that offer such services. Before proceeding to colleagues, I would ask Christine Grahame if she would like to contribute to in support of the petition. Thank you very much, convener. Let me put on the line that I support advocacy services for children. That is not the issue. It is when we have, as you have already illustrated in the petition, very narrow, non-statutory child advocacy services in court proceedings to do particularly with contact and residence. I have looked at—what you have not read out and forgive me if this is something that you already know is that I came to this through a case that many of us do, but it broadened the whole issue. This was the experience that I am not going to anonymise and the devastation caused to the intervention of a child advocacy service in the lives of two of my constituents. The intervention started because of a series of unfounded allegations made against the man, but the advocacy service soon became the driver of events that multiplied the allegations without ever investigating their validity. Of course, once you have alienated children—I know that this is 20 years ago in practice as a family lawyer—it is practically impossible to undo. What is the backing for that? What happened was that my constituents went to proof and the sheriff in her judgment set out in detail the systematic creation by the child advocacy service of an entirely false narrative in the minds of the children, including practising with them emergency evacuation drills, as if the father would attack them, and refused to recognise its role in perpetuating and amplifying the falsehoods. There may not be that many cases, but one case is one case too many. I note what you have said about the cabinet—I think that it was a minister—Cash Denham's responses. I look through what you are doing, and I see the reference to the Children's Seeing Scotland Act 2011, children's advocacy services regulations 2020, which came into force in November last year. It only sets out requirements as to qualifications, training and fees. It does not set out anything requirement to do with regulation. I also note, as you already read out, the minister's response in saying that it would be difficult. It needs primary legislation, and I do not care about that. If something needs fixed, primary legislation is either here or there, but what it says is that it is not only provided by organisations or persons acting in a professional capacity—or quasi professional capacity, we might say. In the event that regulation was implemented, consideration would be required as to housing force with persons supporting the capacity of a relative. Relatives are a completely different species. They are not disinterested parties, and neither should they be in any proceedings regarding children with whom they are connected. What we are looking at is non-statutory advocacy services, which currently are not regulated. To get to the stage in court proceedings, after the damage that is done, pleadings and co-ordinates have all written out everything, and, by the way, the constituents did not see what had been said and only found out by the ways that were at the stage of proof that the damage is done. I think that the comments by the sheriff are very telling. I think that it is a very serious issue. You raised mesh and how serious that was, and how petitions have quite rightly moved us on. I would really like somebody like the cabinet secretary to answer to that. It is something that can be fixed. To say that relatives cause an issue in doing that, they do not. The constituents have already mentioned services. They have never talked about relative-providing services. The definition is all in that. That is my position on that. You can see that it is heartfelt, because I have been following this for two years with those constituents. I know the misery that is made of their lives and, in fact, the impacts on their children with whom they have no connection whatsoever now, and probably they will never have. I just think that that should not happen. Thank you for that. I will come to colleagues again, having heard from Christine Dreham and having read the submissions that we have received, if they would like to comment. I see that Tess White would like to comment. In your extensive experience, Christine, do you see any downsides to what you suggest? You have obviously balanced the two, or is everything an upside? Are you mindful of anything that has to be taken into consideration? Regulation is in the interests of all non-statutory advocacy services. Any service that is provided is non-statutory. I think that it makes people sure that they are certified in what they do, that they are regulated, and that what they say has weight and value, and is not as in this case. I do not think that it was deliberate, but it just so happened that a narrative was brought into the children that could never be undone. And alienation, parental alienation, is not a strange thing when spirits and passions are high in relation to contact and residency with children. The issue between the parents becomes something that spills over onto the children's children's children, but it does. So I think that regulation is in the interests of the non-statutory. I can't see what the problem is. You know, we all, we are regulated, we have to bear rules, and that's just as it should be. And I think that the same should happen with these non-statutory advocacy services. Thank you very much, and thank you to Christine Graham for providing us with depth of background. I find it difficult to actually believe, although it's true, that there are non-statutory child advocacy services. I think that's bizarre, and I can't see that any child advocacy service would have any particular logical reason for being against regulation of the services. I noticed that, referring back to the Minister for Community Safety at the time, Ash Denham, Christine Graham said, it would require full consultation and primary legislation, and I take Christine Graham's part. I don't know whether that was meant to be a disincentive to us to pursue the issue, or whether that was actually identifying the course of action, because I agree, and I think the committee from what I hear agree, if primary legislation is what is required because the case is compelling and correct, then that is what would have to follow. Therefore, I think that it would be, in the first instance, interesting to know whether the current Minister for Community Safety is prepared to commit to the Scottish Government undertaking that consultation that would be a precursor to any subsequent legislation in relation to the advocacy or regulation of non-statutory child services. And are we content with that? I think that that would be the first step in the pattern that was identified, and we will keep the petition open on that basis and see what response we receive. Thank you to the committee. Petition 1845, the agency to advocate for the healthcare needs of rural Scotland, and we are joined again by Emma Harper, MSP. This is the last of the petitions that we are considering on a continued basis this morning. Rhoda Grant is speaking to this one as well, my apologies. You are both competing with each other this morning to ensure that you are with us for the same number of petitions, but I am glad to have both. This was originally lodged by Gordon Baird in behalf of the Galloway community hospital action group, and the petition calls on the Scottish Government to create an agency to ensure that health boards offer fair and reasonable management of rural and remote healthcare issues. It was first considered in January this year, and the clerks note outlines that work that the session 5 committee carried out so far. Submissions received highlight some of the issues experienced by rural and remote communities as they try to access medical care. Those include patients being required to take long, often awkward journeys for not only critical care but also routine outpatient appointments. I think that we have all of us heard examples of that from colleagues in the chamber at various questions. Outreach clinics to rural communities being dependent on individual consultants rather than organised programmes, and a failure by key organisations to understand the importance of dispensing GPs to rural and remote communities. I will do it alphabetically, Rhoda Grant. The petition is not from people within my constituency, but you will have seen that Catherna's health action team also made a submission to the committee in support of the petition. Their concerns are very similar in that they have huge distances to travel to access medical treatment. While there is some funding available, it is not adequate to meet the financial disadvantage of that, but there is also a social disadvantage if people have caring responsibilities, looking after children when they are away, and all of that creates huge problems for people. That is consistent throughout the area that I represent, the islands and islands. It has been an on-going issue for me all the time that I have been in this Parliament. What I understand is that training for medics, nurses and all those involved in healthcare is geared towards teamwork, so that people can collaborate and work together to provide healthcare. In remote rural areas, we are asking people to work very much on their own without any backup and be dependent on their own skills and knowledge to do that. The training does not equip people for doing that. We also see that the NHS values specialisation. If you specialise in a subject, your grading goes up, and that is true for doctors and nurses. I spoke to nurses at one point who had a huge range of skills, because they needed to cope with anything that came through the door, and that was anything that was happening there and then. However, we are on a basic banding. The breadth of their knowledge was not recognised. It would only be the depth of their knowledge that was recognised. There is a huge disincentive for people who are generalists to become involved, one from a training point of view, and two from a financial career progression point of view. I agree with the petitioners that we need someone to take this and work with it, an agency that will look at this, training and remuneration to make sure that we have health services in those remote rural communities, because it gets to the point where people are not getting the health interventions that they need as quickly as they can, because it becomes very difficult for them. We do not need an A&E around every corner. We need services that provide those kinds of services to people without the same in-depth and specialisms elsewhere. They should have the same access to health services, regardless of where they live. I am aware of the petition. I know Dr Gordon Baird very well, and he has created it on behalf of himself and the Galway community hospital action group and another retired GP, Dr Angela Armstrong. The petition calls on the Scottish Parliament to urge the Scottish Government to create an agency to ensure that health boards offer fair and reasonable management of rural and remote health care issues. De Fries and Galloway is part of my South Scotland region, and Stranraer is the town where I was born and lived until I moved to the De Fries area when I was 12. I am very familiar with the rurality of the south-west part of my constituency, and I often hear from constituents that they feel forgotten, as many people automatically look to places north of the central belt and leave in the islands when providing examples of remote and rural places in Scotland. I have a couple of examples that I would like to share, and the convener has touched on one already. The NHS De Fries and Galloway is part of the South East Scotland cancer network. That means that people who live in Wigtonshire and De Fries can and be locker bay. They are included in cancer pathways and treatment plans mean that they sometimes have to go to Edinburgh for some types of cancer care such as radiotherapy. It is a 266-mile round trip for folk living in Stranraer. My understanding and response from questions raised to the previous health secretary about this cancer pathway issue has been that patients in D&G are offered a choice of place to attend as part of their treatment, meaning that, if the treatment choice was Glasgow, that would be the place to attend, but nowhere in De Fries and Galloway is close to Edinburgh by travel time than Glasgow beats in, for instance. A second example to highlight regarding fairness is that persons in other health boards, Ayrshire and Arran and Highlands and Islands, are offered travel reimbursement for journeys over 30 miles. That is not the case in D&G and people are means tested for any travel costs to be reimbursed. Those are two examples only. I understand that the Scottish National Party's manifesto proposes a centre of excellence for remote and rural health and social care, and I have already had a response from Cabinet Secretary, Humza Yousaf, regarding the initial progress of this. I welcome the Government's introduction of the SCOTGEM, Scottish Graduate Entry to Medicine programme. We passed the St Andrews Bill in the last session of Parliament. SCOTGEM does have a focus of increasing the number of graduate doctors with a rural focus. I would be grateful to the Petitions Committee to progress this petition. I would seek to be proactive and objective and have those proactive objective measures taken forward. We really do need to highlight the health challenges in remote and rural areas. I welcome the Petitions Committee to continue to progress this. I will ask colleagues on the basis of the evidence that we have heard. Thank you to my colleagues for giving evidence. I would like to keep the petition open. I think that we should write to the remote and rural general practice short-life working group, chaired by Sir Lewis Ritchie, and the rural NHS boards seeking their views on the action called in the petition. I would also like to write to the Scottish Government to request an update on the national centre for rural health to see what progress has been made there. Paul Sweeney. I think that the concerns raised by the petitioners are incredibly important. The submissions by colleagues today have been really enlightening as well. What I am curious about is the role of NHS health boards in those areas and how accountable they actually are. I think that that is the elephant in the room here, isn't it? That they are meant to be the democratic voice of stakeholders within those regions and clearly not performing that role effectively if that is the issue that is now rising from organic groups underneath. There needs to be a consideration of how effective those health boards are in representing the interests of their areas. Should the petition write to those health boards asking how they can respond to the concerns raised by the petitioners, how they can redesign their services in accordance with the issues raised by the petitioners? I would also argue that how transparent are the appointments to those boards? Is there elections to them that are well known? Should they not be considered as important as local council elections, for example, in terms of developing representation? I think that there is an element around that. How democratic are those health boards? How accountable are they? They are quite opaque. David Torrance? Oh, sorry, you are just waving your hand. Thank you. No, I am happy to support all those suggestions. I think that the issues raised in this are important. I would like to write to the health boards and to Sir Lewis Ritchie on the basis that it may well be that it would be useful for us subsequently to take evidence on the back of the submissions that we receive and to pursue those issues orally and in a little bit more detail as well. In the first instance, I want to hear how they would respond to some of the arguments that are made in the petition, but after that we could drill down a bit further. We will keep the petition open and proceed on that basis. I hope that meets everybody's approval. That concludes agenda item 1. We are glad that there are only two. Agenda item 2 is consideration of new petitions. I think that we are useful just for people who might be following proceedings to know that, as a standard working practice, the committee, whereas it historically used to meet and then agreed to ask the Scottish Government for its views on a petition, now is a matter of course rights to the Scottish Government asking its views on a petition and to some of the stakeholders as well in order that each of the sessions that we have in considering a petition is as informed as possible. I would not want anyone following our proceedings or any petitioner to think that that necessarily unduly influences the discussion that we subsequently have or the consideration that we subsequently have, but it does allow us to at least have a basic understanding of the reaction of the Government to the petition and also of other stakeholders who may have an interest. The first of our new petitions this morning, petition 1854, review the adult disability payment eligibility criteria for people with mobility needs. This is a petition lodged by Keith Park on behalf of MS Society and calls on the Scottish Government to remove the 20-metre rule from the proposed adult disability payment eligibility criteria or identify an alternative form of support for people with mobility needs. Adult disability payment ADP is due to replace personal independence payment PIP in Scotland from the summer of next year following a pilot in spring next year and under the principle of safe and secure transition the Scottish versions of DWP disability and carer benefits will at least in the short term have much the same rules as their DWP equivalence. In its submission the Scottish Government states that it consulted on the draft regulations for adult disability payment between 21 December 2020 and 15 March this year. The Scottish Government has advised that it will review the responses to the consultation and, if required, adjust the draft regulations in light of the feedback. The Scottish Government's submission highlights that the DWP has been clear that in order for ADP to be considered a comparable benefit to PIP, ensuring Scottish clients remain entitled to various reserve payments, it must be delivered on a like-for-like basis. The submission notes that any changes which widen eligibility risk DWP deciding that ADP is not a comparable benefit to PIP and withdrawing automatic entitlement to reserve payments for Scottish clients. As such it advises that, whilst the period of transition from PIP to ADP is on-going, it has decided not to make any significant changes to eligibility criteria before ADP is launched. The submission advises that the Scottish Government is focusing on the significant changes that it can make to how disabled people in Scotland experience accessing disability assistance, such as providing additional application channels and replacing assessments with person-centred consultations. The Scottish Government is committed to facilitating an independent review of ADP in 2023, one year after delivery has begun, which it believes will enable all of the eligibility criteria to be considered in the round rather than any changes being made in a piecemeal way. In its submission, the petitioner points to the Scottish Government's consultation and proposals for ADP, highlighting that people with disabilities and organisations working on their behalf identified the need to remove the 20-metre rule in their responses. The submission notes that the Scottish Government's proposals for ADP does not argue that the rule is an effective way to measure mobility. In response to the risk of ADP not being considered a comparable benefit to PIP, the petitioner argues that changing the 20-metre rule to a 50-metre rule would not impact unpassported benefits on the basis that an enhanced rate of mobility, compared with the standard rate, does not entitle individuals to any additional DWP benefits. Quite complicated but quite direct as well, and I wonder again whether any colleagues would like to comment as we consider what we might do with this new petition. I think that we could get in touch right to the Scottish Government to seek an update on the outcome of the consultation. The consultation is supposed to be an independent review of ADP in 2023, so we are all the way yet, but can we get an update on how progress is going just now on that consultation? What is being considered within that, which may answer some of the issues that we have from the petitioners? David Shawrns I would like to keep the petition open and back up the suggestions that he has made there, but I would really like to get a legal definition on this, that ADP must be delivered on a like-for-like basis. Any changes would widen the eligible risk to DWP deciding that ADP is not a compatible benefit to PIP, and we have drawn up matter of entitlement to reserve payments from Scottish clients. I would really like to get a legal definition. I would like to know if that is definite. Paul Sweeney I echo that challenge to the DWP on this matter of like-for-like basis. It is also important that we attest the provisions within the 2016 Scotland Act about where competence lies for devolved benefits and topping up or enhancing existing benefits. I think that this is quite an important issue that we need to really interrogate. The Parliament merits it should have a duty to explore that thoroughly. I think that there is a risk that there has been a risk averse approach by the civil service in trying to design this benefit that could end up causing significant harm to people in Scotland that we are trying to assist. Fundamentally, my personal view is that the entire system of arbitrary tick box exercises for assessing eligibility is absurd and it has no basis in any clinical evidence whatsoever. It is actually quite a bigoted policy against disabled people. From that point of view, from designing it from a policy perspective, moving away from it would be advantageous from my perspective, but also having this idea that we have to default to it in the Scottish Parliament is not reasonable. I think that we need to really test that issue. I think that there is an assumption there that perhaps having a chilling effect in this petition is therefore a valid way of actually using that to interrogate the provisions and actually has a wider constitutional element to it where it is saying, well, where does the threshold of the 2016 powers actually sit and what discretion is there? I think that it is important that we should not really treat the people who are probably suffering in quite significant hardship to wait 2023 for some sort of risk averse approach where we introduce it on a light flight basis and then it is tested thereafter. I think that we need to move more urgently on that. We can write to the DWP, can we? At the moment, it is the Scottish Government asserting that the DWP has taken a position. We do not actually know if that is the case. We do not know whether the DWP would regard a change from 20m to 50m as violating a light for light basis significantly as such. I simply see from the submissions that the Scottish Government suggests that that might be the case. I actually think that it would be worth testing that. The petitioner notes that it does not lead to any enhanced level of benefit as such. It just makes the access to the benefit slightly easier for the people who it is seeking to try and assist. I think that we should clarify that point at least in addition to the suggestion that came forward. I think that we maybe see in response to those representations to see where that takes us and then maybe pursue the discussion after that. Does that seem reasonable? Petition number 1865, suspend all surgical mesh and fixation devices. This is a new petition lodged by Rosanna Clarkin, Lauren McDougall and Graham Robertson. The petition calls on the Scottish Government to suspend the use of all surgical mesh and fixation devices, while a review of all surgical procedures that use polyester, polypropylene or titanium is carried out, and guidelines for the surgical use of mesh are established. In his submission, the Cabinet Secretary for Health and Social Care stresses the seriousness with which the Scottish Government takes all issues relating to mesh. He outlines the actions that the Scottish Government has taken in relation to the use of transvaginal mesh for the treatment of stress, urinary incontinence and pelvic organ prolapse, about which, obviously, we discussed earlier in the first petition this morning. He also highlights the high-vigilance scrutiny protocol, which was introduced for some other procedures, including abdominally inserted mesh for pelvic organ prolapse. The Cabinet Secretary also highlights research commissioned by the Scottish Government into the use of mesh in inducible hernia repair, which concluded that mesh resulted in lower rates of recurrence, fewer serious adverse events and similar or lower risk of chronic pain than non-mesh procedures. As a result, the Cabinet Secretary does not believe that there is evidence to justify a pause in the use of relevant devices. In response, the petition highlights the many personal testimonies that have been shared with the committee detailing the life-changing effects of having mesh procedures. The submission suggests that not all patients have been given sufficient information to be able to give fully informed consent. Neither does it seem that all surgeons are clear about when it is appropriate to use mesh. Since the publication of our papers, we have received two additional submissions from the petitioner. The first details key questions that the petitioner is seeking answers to. The second highlights the importance of the Cumberlage review and asks why more progress has not been made in delivering on its recommendations, which I believe the Scottish Government accepted in full from memory in response in the chamber. It is also important to emphasise for those who have followed mesh procedures historically that this is all mesh procedures across both men and women, and indeed children, and distinct from the petition that we considered previously, which relates very much to issues that affect exclusively women's health. This is a new petition, an important petition, and I wonder whether any colleagues of any proposals we might consider. Tess White. I would like to suggest that we do write to the cabinet secretary and ask for further information. When I read the petition, I empathised and sympathised. It is very upsetting to see what some people are having to go through. I am struck by the response from the cabinet secretary that says that fewer serious adverse events or lower risk of chronic pain than non-mesh procedures was exactly the same testimony that I think we received in relation to the original mesh petition at the first point of hearing. Until people knew that there was an issue to speak out about, it was not something that was much in the public domain. David Torrance. I am wondering if we just asked the cabinet secretary for us and we could ask questions and to give evidence to us, rather than write. Thoughts from others? Paul Sweeney. I think that, certainly from constituents that have contacted me, there is a wider issue that is definitely there that merits an investigation. The use of these products and the potential defects that result in significant chronic pain and other medical complications is not well understood, but there is clearly a significant level of anecdotal evidence that merits formal investigation. I do not think that there has been sufficient effort put in so far to achieve that, so I definitely think that it is a worthwhile petition. The provisions for initiating inquiry are reasonable, such as initiating it with the cabinet secretary in the first instance and inviting them to indicate how they will proceed with the formal investigation. I think that that is a reasonable way forward. I think that we are inclined to seek that request. I think that we might say that we would also like to raise progress on the Cumballage review and the recommendations that were made in that in relation to Mesh at the same time as we are pursuing these fresh issues as well. I think that that would be great. Petition 1866, to introduce legislation to improve bus travel for wheelchair users. This has been lodged by Daryl Cooper. The petition calls on the Scottish Government to introduce legislation so that wheelchair users are able to face front words when travelling on a bus. The Scottish Government explains that legislation governing bus travel for wheelchair users is reserved to Westminster, specifically the Public Sector of Vehicles Accessibility Regulations, PSVAR 2000. The submission highlights that is part of its recently published national bus strategy, Bus Back Better. The UK Government committed to complete a review of the PSVAR, the Public Sector of Vehicles Accessibility Regulations, by the end of 2023. The review is expected to be wide-ranging and consider the extent to which the regulations are currently effective in supporting access to respective services and how they could be improved in the future. In response, the petitioner highlights that the regulations are in place to enable disabled people to travel safely and in comfort. He argues that being forced to travel in a rear-facing space may not be comfortable for disabled people and that it should not be for bus operators to choose whether wheelchair spaces should be rear-facing. Colleagues, members, who would like to comment? David Torrance. Thank you, convener. I think that we have to close this petition understanding and rule 15.7 in order to consider that it is reserved to Westminster, but in doing so, I would ask a committee to petitioner to ask them to engage in the forthcoming review. It has been taken by the UK Government in 2023. I would resist closing this petition, although initially prima facie seems to be reserved. I think that there are significant provisions that are in fact devolved, particularly in terms of the 2019 Transport Act. For example, there are provisions in the 2019 Transport Act that can establish bus partnerships, which are probably the weakest provisions of regulation over a purely laissez-faire system. There are also franchising provisions, as well as direct public ownership, so I think that, in that context, there is significant regulatory capacity within the Scottish Government when defining, for example, a bus franchise to insist that certain provisions of service standards are achieved that are not dependent necessarily on legislation. They are simply dependent on how well-designed a franchise agreement is. Furthermore, I think that there are significant financial incentives. For example, around 45 per cent of all bus company turnover in Scotland is public money subsidy. Therefore, there could be provisions or conditionality attached to that public subsidy, which is from the Scottish Government, for example, for the procurement of new vehicles that specify a certain quality of specification of those vehicles to provide that capability within the service. On those factors alone, I think that there is significant provision for the Scottish Parliament as a legislature to design a better service standard that meets the petitioner's concerns. It is not solely relating to reserved powers. Furthermore, there is capacity within the petition committee to engage with the Scottish Office and to ask what efforts it might be able to make in mending legislation at Westminster that might help to back that up. There is a significant breadth of opportunity for us to pursue that. I certainly have long memories of the seatbelts in school buses petition, which eventually led to the minister, Mike Penning, agreeing to devolve competencies to the Scottish Parliament. I do not know whether that ever happened in the final analysis or not, but it did some time ago. David Torrance, having heard from Paul Swinney, would you be content for us to explore some of the issues further with the Scottish Government? I am very happy to do that and to keep the petition open on that basis. PE1867, to establish a new national qualification for British Sign Language. This is a new petition and it has been lodged by Scott McMillan. The petition calls on the Scottish Government to encourage the Scottish Qualifications Authority, which I will refer to as the SQA, to establish a national qualification in British Sign Language, which I will refer to as BSL, at Scottish SQF level 2. The petitioner is calling for the new qualification so that BSL can be eligible to be an L2 language, which would allow it to be taught from primary one. In our submission, the Cabinet Secretary for Education and Skills explains that the establishment of new qualifications is a matter for the SQA. She highlights, however, that children must be able to study an L2 language at secondary school to the level of a national qualification. There are currently no national qualifications in place for BSL, therefore, as matters stand, even with the creation of a national qualification in British Sign Language at SQF level 2, BSL would still not be eligible to be an L2 language, which is definitely a chicken and an egg. I have heard the definition of same. I wonder what members' thoughts and colleagues might have in response to that new petition. Bill Kidd, can we write to the SQA to invite their comments on the proposal? Personally, I think that the significant numbers of my constituents and everyone's who use BSL on a regular basis, including people who use BSL as part of their occupation, some of whom are signers, deserve the opportunity to be recognised in this manner. My own sympathies would be very much in support of that proposal. We have regularly, in Parliament, had people at organisations who have come to us and done their best to educate and train MSPs in the use of sign language. I remember thinking even then that it would have been quite useful if there was a professional qualification, an educational qualification that could be pursued in that regard. Let's go and see whether, in the first instance, the SQA can explain to us whether that could be introduced, what would be required in introducing it and what it sees as the obstacles to that proposal being progressed. The first instance will consider the petition afresh. That brings us to our final new petition this morning, which is petition number 1868, support for working single parents, lodged by Laura McCain. The petition calls on the Scottish Government to provide support to single parents by increasing the council tax discount available to single parents from 25 per cent to 50 per cent and lobbying the UK Government to create a working single parent tax allowance and a household income-based child benefit. In its submission, the Scottish Government highlights its commitment to reforming council tax. It also highlights measures that it has in place to support low-income households, including council tax reduction scheme, which provides relief to just under half a million low-income households. The Scottish child payment, which pays £40 per week per eligible child. The Scottish Government has also committed to extending the eligibility to under 16s by the end of 2022. The Scottish Government argues that this payment, alongside the best start grant and best start foods, could provide over £5,300 of financial support to families by the time their first child turns six years of age. I wonder, having had a chance to consider the submissions, what suggestions members might have as to how we would proceed. It is quite complicated, because there appears to be quite a determined course of action in place by the Scottish Government at the present time. They have committed to extending eligibility. They obviously do not have the competence to intervene in matters relating to UK income tax, unless and if they are beyond the responsibility of the Scottish Parliament, and they have indicated that they are supporting half a million low-income households. So important, as the issue is, I am not immediately clear what further course of action lies open to us having now sought and obtained the views of the Scottish Government. I do not know if other colleagues are minded to close the petition on that basis, or whether they feel that there is some further avenue that we could possibly explore. David Torrance, I agree with you. I think that it is very difficult to explore any other avenue, so under rule 15.7 of standing orders, I am happy to close the petition. I do not think that we do it with any great pleasure, but I think that our options are limited. If the committee is agreed, I think that that is the course of action that we follow. Thank you all very much for your contributions this morning. Thank you to our colleagues who joined us and I now close the meeting. Thank you.