 The Finlight with Business is a Members business debate on motion 1.5.475, in the name of Neil Findlay, on Scottish Government declines help of mesh expert. The debate will be concluded without any questions being put. Can I ask those members to speak in the debate to press their request and speak buttons now, please? I call Neil Findlay to open the debate. Mr Findlay, please. Thank you very much, Presiding Officer. I thank all members who signed my motion ac mae ein signog ni'n ym colleagues sydd wedi eu cypathaniau a chynigau i fyndeig u25 angen i ysch patreon. Y botredwg fyddwch wedi amser rydyn ni,�ong serfaihyrm ei wneud i ddewudiau eu hyp royne. Yr rhywbeth rydyn ni'n cael ei ddewydu eich lysteu iawn, yn girlfriendsêr, yn影片au ei bodf Nóshaweith Onnes, iawnau dda fel cadw i Gymhassaith Pl боb, fod yn dal,… And he'll live in constant chronic pain, affecting every aspect of their life." Some of these remarkable women are with us in the gallery tonight, and I salute their determination to be here today. Al opponents, that campaign has acted in the interests of others. They have tried to get meshabied so no other women would suffer like they have. have, but there was no real hope of any change or improvement for them, but there is now, and they are rightly calling for action. Many of those women have asked their GP or their consultant for help, and when they do, they can be referred to a consultant urogynoecologist based in Glasgow and Edinburgh, who are based at what has been described as Scotland's mesh centres of excellence. Those centres are often staffed by the very surgeons who implanted the mesh in the first place and who may be subject to litigation by the same patient, therefore they won't operate. For those who are accepted for remedial surgery, they want and expect full mesh removal, and many have been told that is what they would get. However, the reality is that despite Scottish Government press release that came out today, the reality is that full mesh removal is not available in Scotland. Instead, the mesh that is accessible to the surgeon when the operate is removed and the rest is left inside their body. Cabinet Secretary, I repeat that removal is not available for full mesh removal in Scotland. Unlike the rest of the UK, surgeons in Scotland favoured the type of mesh implant that has caused the most crippling of injuries because of where it was placed and the fact that it is so much bigger. In the US, Dr Dionseus Varonichus has developed new techniques and special medical instruments that allow him to carry out successful full mesh removal. His pioneer methods developed over a decade mean that the entire mesh implant is removed carefully and in one piece. He then photographs the mesh and measures it to ensure that it corresponds with what was put in on the medical records and ensures that it is corresponded. Therefore, he can confirm by photograph that the entire piece has been removed. Previously, the Scottish NHS was sending patients to see Dr El-Neill at University College London. Dr El-Neill carries out full mesh removal, but her list is closed and she has a huge backlog. Right now, we have a small window of opportunity to act, an opportunity that if we do not take it, it will be lost. That is to take up the very genuine offer from Dr Varonichus to come to Scotland, to work up to six days a week to carry out full mesh removal procedures, but critically also to train Scottish surgeons and his techniques. That is a serious and a genuine offer that I urge the cabinet secretary to take. In correspondence with me, the cabinet secretary has rightly said that Dr Varonichus must be, and I quote off, appropriate professional standing and recognised by the General Medical Council. None of us in this room, I am sure, would disagree with that sentiment, but this can be done. Dr Varonichus is a leading international expert in his field. Many surgeons want to learn from him, including Christopher Harden, the chairman of the British Association of Eurogynacologists, one of the UK's top specialists. Dr Varonichus has specialised in obstetrics in gynaecology since 2000 and female pelvic medicine and reconstructive surgery since 2013. He was awarded the Distinguished Surgeon Award from the US Society of Gynaecological Surgeons in 2018, and he has a hugely impressive CV. He could quickly be registered as what the GMC called a visiting eminent specialist. That would mean that he could complete the GMC registration process. Registration is not a barrier to him coming here. We would then need us for the NHS to cover his costs and provide an operating theatre for him to work in. It is my opinion that this could be financed using some of the additional £27 million that the cabinet secretary recently allocated to waiting times reduction, because, after all, mesh survivors have been waiting years—not weeks—years for such treatment. Those are exceptional circumstances and they require an exceptional response. If you are wondering what such an action would deliver, please look no further than the gallery of this Parliament. Here today is Dr Mary McLaughlin, a law lecturer from Ireland. Mary has flown over today because she wanted to be here to prove the impact of full mesh removal carried out by Dr Varonichas. On January 14, she paid £15,000 from her own savings to go to the US for surgery. She had all of the 20 centimetres of mesh that were implanted and removed from her body. Within a few days, she had much more mobility. Within a few weeks, she was walking again, and today she is so free of pain and suffering that she travelled to Edinburgh as living proof of what this procedure can mean. Compared with her previous condition, unable to carry on with her job, virtually bedridden and so much chronic pain, she could not even sit with her family to enjoy Christmas dinner. Just two months after her surgery with Dr Varonichas, she is well enough to travel here to be with us today. Compared with Lorna Farrell, who is in the gallery, or Claire Desley from Greenock and many others, who have ended up in even more pain and in wheelchairs following so-called full mesh removal in Scotland, they still have mesh inside them, despite being told that they would have full mesh removal. There are others who have been told that the mesh implant that they were given cannot be fully removed here. The reality is that Dr Varonichas can do it, and he is offering to come to Scotland to train our surgeons to do it. The decision to do this or not lies with the Cabinet Secretary and no one else. I do not beg Government Ministers ever, but I implore you today, Cabinet Secretary. I implore you. Please do the right thing and give these injured women the best treatment that is available. These women have lost so much. They should not, as some are, have to travel to the US and elsewhere, begging, borrowing, stealing, using their life savings or whatever to try and buy treatment. The Cabinet Secretary has the chance to act, has the opportunity to change lives. You have the chance to do the right thing. The alternative is that those women have left living a life of pain, a life of misery, careers and relationships lost, and a lifetime of medical costs, which I believe, if we take that collectively, will far outstrip the costs that would ever have to be made to bring this surgeon to Scotland. These women were implanted in Scotland. The recommendation for this procedure was given in Scotland. All they ask for is the realistic opportunity to have this dreadful material removed from them in Scotland. I say gently to members of the public in the galley. I understand why I am applauding, but it is not permitted in the Parliament. I have to say that I have many members wishing to speak, so from now on I would ask to be restricted to four minutes to allow us to get through everybody and to allow the Cabinet Secretary time to respond. I call Alex Neil to be followed by Miles Briggs, please. Thank you very much indeed, Presiding Officer. Can I congratulate Neil Findlay on obtaining the member's bill on this vital and serious issue? I start by saying that everybody in this chamber is absolutely united in the need to make sure that the national health service in Scotland does the right thing by those women whose lives have been so badly affected as a result of botched procedures in relation to mesh implants or botched devices, or in some cases both. It is estimated that there are about 1,000 women currently who are in a very bad place as a result of these mesh implants, and many of those women, most of those women, think that they are probably rightly the only way to deal with the problem is to remove the mesh. I think that a lot of clinicians agree with that. I know that I have a constituent who has suffered from this for the past 10 years and has been told that she cannot have the mesh removed because she cannot be sure and how and where the mesh is embedded into her system internally. That is a very serious issue indeed. The key point is that for women, for many women, removal of the mesh is the last chance alone to try to recover at least some of their health. The issue is how best we can address that. There are some women who have been and had mesh removed partially or even entirely within Scotland, but it appears that the new technology and the new techniques, pioneered by Dr Varonicus in St Louis in the United States, is on a level of its own, where the performance appears to be very consistent of a high quality and extremely effective. Clearly, we need to be sure that that all can happen for our people here in Scotland. He uses, as I understand it, micro-surgery. One of the important points is that he can use a particular type of ultrasound—translibrary ultrasound—that can locate the mesh before surgery. In the absence of this scan, mesh removal surgery is essentially happening blindly and only partially. There are major benefits to the new technology and the new technology. One of the important points is that the operation can be conducted through the groin in addition to the vagina, which allows for better access, in many cases, to full mesh removal in one operation. Why worry is that we will have so many women, so desperate, if we do not do something here in Scotland, we will end up with them having to spend their life savings, get into debt, to go to America to get this procedure done. I think that every avenue should be explored with our health boards, with our consultants, with the national health service to make sure that we can get access to the service in Scotland through Dr Varonicas. Whether he comes and does procedures or not, the really important point is that he comes to train people in Scotland in this new technology and using those new techniques, because that means that, after he goes home, we have the capacity to continue to provide full mesh removal through this technique for women in Scotland where it is appropriate and where they require it. I believe that we need to look at how we can achieve this, because we owe it to these women to try to improve the lives and, in many of those cases, that can only happen with full mesh removal. I thank my Lothian colleague Neil Findlay for bringing forward this debate this evening, and once again I commend Mr Findlay, Jackson Carlaw and, as we have heard, Alec Neill for their campaigning on going work to deliver justice for mesh survivors. I would also like to welcome to the public gallery many of the women and their families affected by the mesh scandal. As the co-chair of the Parliament's cross-party group on chronic pain, I have met with many women affected who have attended our meetings and shared their personal stories, and we should rightly pay tribute to each and every one of them. This debate is therefore a welcome opportunity to look at how the Scottish Government and our NHS should be working to meet the needs of mesh survivors and for those seeking full surgical removal, how that is being achieved in Scotland today and in the future. In preparing and researching for this evening's debate, I must admit that more and more questions seem to be arising when looking at the detail of what is being proposed in Scotland, the availability of operations to achieve full mesh removal today. We know that, in relation to TDT-O mesh implants, this was historically used twice as much in Scotland than anywhere else in the UK. The issues around its removal are well known and documented and present a number of issues. Therefore, in responding to the debate this evening, can I ask the cabinet secretary to confirm a number of key points? How many mesh removal operations have actually been undertaken in NHS Scotland to date? Have those operations been partial removal or full removal? How many of our health boards, as Neil Findlay has mentioned, are putting aside funds for this surgery? In addition, how many surgeons in Scotland today can undertake a full mesh removal? We need to make sure that our Scottish NHS can build the capacity now and in the future to deliver the surgery that will be needed to achieve full surgical mesh removal. I therefore fully understand and appreciate the disappointment and anger among mesh victims over the Scottish Government's decision to date to decline the offer made by Dr Veronica to travel to Scotland to work with NHS Scotland. As Neil Findlay has already outlined, Dr Veronica has developed techniques to carry out full mesh removal and the opportunity for NHS Scotland to learn from that. The development of new procedures around the complex removal of mesh is rapidly developing. In such a vital and important area that, at Neil's outline, we cannot allow to fall behind. We must not let Scottish patients to be at the back of the queue for mesh removal. Do you agree that part of the issue is about rebuilding trust and confidence in the health service? A lot of women feel very, very let down and in taking this procedure forward. The confidence in knowing that someone else who is an expert comes and supports the system is very, very important. I absolutely do. The fact that we are having this debate shows that we need to do more. Because we have had the debates around the whole scandal, what we need to be doing is making sure that we right those wrongs. Mr Findlay's motion specifically calls on the Scottish Government to reconsider the invitation and work to help to facilitate a genuine and positive offer that has been made. I hope that, in closing, the cabinet secretary will be able to respond to that positive offer. One very important issue that has been raised with me and has already been mentioned is the need for more translational ultrasound scans. That is also an area that we need to see progress. Deputy Presiding Officer, it is clear from on-going issues and this debate how the Scottish Government needs to develop a sustainable plan for surgical removal of mesh implants. We need to see significant improvements in how we provide that help to mesh victims and their families. I therefore hope that the cabinet secretary will rethink genuinely the offer that has been made to NHS Scotland. We must never lose sight of the fact that there are Scottish mesh survivors who are seeking solutions to address the life-changing injury and chronic pain that mesh implants have caused to them. I therefore believe that every offer of support and the extension of the hand of friendship that we have seen should be pursued and considered by SNP ministers to try to start the process now to right the wrongs of the mesh implants. I call Monica Lennon to call by Alison Johnson. I thank Neil Findlay for securing this important debate and for his tenacious campaigning alongside those courageous women. I pay tribute to all the women who have campaigned about mesh, many of whom are in the gallery today. I also thank colleagues Alex Neil and Jackson Carlaw for their cross-party commitment. I was at the press conference earlier today, and I am not embarrassed to say that I was moved to tears by those painful and harrowing stories. I would join others in pleading with the cabinet secretary to accept the help from the surgeon who is offering to treat those women. Scotland's mesh survivors are locked in a living nightmare. Despite their own pain and loss, those women have been campaigning for years so that other women do not suffer the same fate as a result of those barbaric mesh implants. Many have debilitating symptoms, including chronic pain and loss of mobility, but today, as Neil Findlay has said, after years of selflessly campaigning for other women, they are asking for something for themselves. There is a glimmer of hope, but it is galling that those women are even being put in a position where they have to ask for help, to beg for help. As one of the women in committee room 3 said today, they got these implants in Scotland, the damage was done in Scotland, so the damage should be repaired here in Scotland. Those women have been let down time and time again. They have had to become experts in their own condition where medical advice has failed and where Government interventions have been lacking. One campaigner today described her feelings of frustration, but even more upsetting that of having no self-worth. When her mesh symptoms were explained to a doctor, it was simply dismissed. She was told that she had mental health problems. Mental ill health can understandably occur as a result of chronic pain, but when it is blamed as the root cause of the pain, that is simply cruel. I am the convener of the cross-party group on women's health, so I have heard many women, including endometriosis and lipidema campaigners, say that they too have had their symptoms disregarded. If the mesh survivors have taught us anything, as a society we must start valuing women, believing women and listening to women. With Dr Veronica's offering to come to Scotland to treat women with complete removal of mesh, there is now our real chance to see their conditions improved and hope for the future. Alex Neil is absolutely right. It is not about simply coming to perform the operations. We have to take the learning from that and train our own staff, because it is not just an issue for Scotland. It is a global scandal, as we all know. The mesh women—not just the ones that are here tonight, but hundreds of women across Scotland—have been holding each other up. We have heard first hand from Dr Mary McLaughlin, who has come over from Northern Ireland. The transformative difference that treatment can make. Her story is one of hope to Scotland's mesh survivors. Like Neil Findlay, I am not too proud to stand here and beg the cabinet secretary to use her power to make this hope a reality for those women. In conclusion, I pay tribute to those women, campaigners and their families. I add my voice to Neil Findlay's and to other colleagues across the chamber. Those women deserve this treatment, and I hope that, in her remarks, the cabinet secretary will make that commitment tonight. I, too, would like to thank Neil Findlay for giving us the opportunity to debate the issue this evening. I would also like to thank Alex Neil and Jackson Carlaw for their long-standing commitment to the issue. I will never forget meeting the mesh survivors when they came to Parliament in 2017. A group of women who had undergone surgery to help address incontinence, who then found themselves requiring crutches in wheelchairs, no longer able to lift their beloved grandchildren. I met a woman and her husband who spoke openly of dealing with 24-hour-a-day incontinence. I spoke to women who had to resign from important work and important jobs, and I spoke to women who could no longer care for those they loved, caring for. Those very personal impacts and experiences shared openly with politicians and others. They cannot fall upon deaf ears. Today, Arish Mesh campaigner, Dr Mary McLaughlin, has come to the Scottish Parliament to share her story. As we have heard, Dr McLaughlin was operated on by Dr Varonicus, and the outcome has been transformative. As party spokespeople, as parliamentarians, as empathetic human beings, we need to act. When there is increased knowledge, experience and developments in techniques and instrumentation to remove those implants, we must use it. We cannot rely on individuals finding the money, a prohibitive sum for far too many individuals, but the Scottish Government must step in and help, because we can all appreciate how infuriating, how frustrating it must be to know that there is now a potential solution, that the excruciating pain that those women are living with might end, but I have to watch and wait and hope that somehow they too might be helped. It is clear that there is consensus across the chamber that we must do all that we can to help women whose lives have been destroyed by those implants. There seems to be some debate, too, about how comprehensive mesh removal is here in Scotland. In opening, Neil Findlay spoke about the fact that women who Dr Varonicus treats are given evidence of the full mesh removal, that it is measured that they see photos, and given how psychologically damaging it must feel to have something in sight that you just want removed, I can see why that is really important evidence. I would be grateful when the cabinet secretary speaks in closing if she could confirm whether or not full mesh removal is available in Scotland and how much evidence those having the procedure receive. I would be grateful, too, if she could confirm that any barriers that there might be to learning from Dr Varonicus can and will be removed. Surely, in this age of global knowledge exchange, we must strive to learn from experts in all fields. Mesh survivors have had to campaign too long and too hard to have mesh banned. I have absolutely no doubt that those inspirational and brave women and their families will campaign for access to full removal, but have we not already asked far too much of them? I thank Neil Findlay for giving me the chance to raise Bobby Dally's case. Bobby is a very brave woman who lives in the north of the Shetland. She has lived for 20 years with mesh inside her body. She has a son who is 32 years old with Down syndrome. She cares for him and she puts up with, as Alison Johnstone rightly has just said, excruciating pain every day of her life. I cannot be the only constituency member who, when someone like Bobby comes to see you, puts everything else into perspective. All the stuff that we deal with as politicians is but nothing compared to someone who goes through the hell of having this inside them and having had that go on for 20 years of their life. Bobby is an Aberdeen this week for an MRI scan and she has an appointment at the Greater Glasgow hospital later this month. She wants all that stuff out of her body, all of it out of her body. As she said the last time she came to see me, she, like thousands of other women, never gave consent for medical procedures involving mesh. She was never informed of the possible and actual consequences of mesh. She never gave consent to be in constant pain all her life and for her life to be made a misery. She never gave consent for lacerations of vessels, of nerves, of organs, including a bladder, the bowel, transitory, local irritation of the wound, mesh, extrusion and so it goes on and so it goes on. She could give me a list, a really tough list, that one could read through that. Sorry, Mr Finlay. If your constituent has even guesstimated how much all of her treatment has cost the NHS to date. Before you respond, Mr Scott, I am just mindful and I am not sure whether your constituent is one, but to ask members not to get into cases that may be subject to civil actions at the moment, I am not aware of whether that is in that case, but just to say to members to caution them that it might be some judici. You do not need to cost me on legal action on this one. That is fine, thank you. I take Neil Finlay's point, the answer is no. I think that Bobby Scott has better things to do than worry about how much it has all cost because of the, and just worry about how she cares for her son. Never mind dealing with all of that. Neil Finlay. The point that I was making is that the amount that this cost for the NHS could easily deal with the cost that they bring in this doctor to Scotland to carry out procedures. I take that point. I only want to make two other points. The first is the one that Neil Finlay also reflected in his remarks. That is about both the physical pain and the physical pressure on an individual, but also the psychological pressure. That is why I am really concerned in a set of circumstances where the NHS tries to force women to go to see the same clinician in the same hospital where they had the treatment that caused all this difficulty the first time around. Where someone going through this kind of pain in these circumstances asks for a different clinician and a different hospital, that is just what should happen. If the Cabinet Secretary can help people with that, that would be very important indeed. The final point that I want to make is the Government's statement today that Neil Finlay mentioned. I was pretty concerned and I quote when I read that we would be happy to discuss with both boards, health boards and professionals funding of additional education and training where a specific need is identified. I am a great admirer of Jean Freeman. I think that she is a very able politician and a great operator, which is badly needed in politics at the moment. I hope that she might want to reflect on where her sportsman put out a statement saying where a specific need is identified. I think that that is what this place has done. It has done it through the campaigning of Jackson Carlaw, Alec Neil and Neil Finlay. It has done it through colleagues from across the political benches. We need some leadership from the Government here. Bobby Dally deserves all that mesh out of her body. Can the Government please make sure that that now happens? I thank Neil Finlay for bringing this member's debate to the chamber today and to pay tribute to his passionate support of mesh victims, not just in Scotland but throughout the world. Tonight, we are debating an issue that will go down in history as one of the greatest medical injustices ever suffered by women. That is beyond dispute. There is cross-party consensus that has existed since the horrendous problems with mesh implants came to light, which resulted in the ill-fated moratorium on implants in 2014 instigated by the then health secretary, Alec Neil, who also continues to fight long and hard for justice for mesh victims. We now have a ban on implants brought in by current health secretary, Jean Freeman, which was warmly welcomed by campaigners, but now is not the time to dwell on the history of the scandalous issue. Neil Findlay's motion says that the Scottish Government is refusing to bring renowned mesh specialist Dr Vronicus to Scotland to train surgeons and perform mesh removal operations in Scotland. I look forward to hearing the cabinet secretary's response to that. Nothing should be off the table. It should not be a political issue, and I am glad that we have always had consensus across the chamber. The many women in the chamber today could not care less about politics. They just want respite from the daily struggle that they have endured since the operation was performed. Campaigning journalist Marion Scott did not get involved with the campaign because it was a good story. She got involved to get answers as to why a procedure that women were told would help them has ruined their lives. The women have been badly let down by health boards, the medical establishment and a disgraceful flawed review. In the past, I have called them brave and courageous for taking on this fight, which they are, but I do not think that that is any comfort, because I am sure that most days they do not feel brave or courageous. Last Friday, I had a meeting with directors at Greater Glasgow and Clyde health board regarding a constituency matter, and I took the opportunity to raise with them the issue of Dr Veronica's coming to Scotland. They told me that exchange training visits between surgeons happened regularly and were reciprocal with our top specialist going abroad to train surgeons in another country, and many coming here to do the same. They also told me that visits take place under direction from the chief medical officer and that there is a budget to do so, so I found that very encouraging. However, as Neil Findlay said, anyone providing assistance to health boards must have appropriate clearance from the GMC. Dr Veronica's is not registered with the GMC, but I really hope that a solution can be found to resolve this, and I was encouraged by what Neil Findlay said. I urge health boards to consent to finding a way to bring Dr Veronica's here for the sake of the sufferers and for the benefit of our surgeons who wish to expand their knowledge and skills, because the bottom line is that we should be performing those operations in Scotland. I think that what the member says is extremely interesting, but I wonder if she would agree with me that the chief medical officer should take an interest, particularly since she has set out her feelings on women's health inequality in Scotland just recently. I definitely agree with that. I think that that is an ideal opportunity to demonstrate what she meant when she said that there couldn't be a greater cause than that. I echo my colleague Alex Neil's earlier call for a global conference to be held here in Scotland, because I think that we can lead the way in this fight for justice. We have the best campaigners in the world in the mesh survivors group. Our country has a reputation for fairness and we must always stand united with mesh sufferers here and throughout the world. Before I call the next member to speak, I said that due to the number of members who still wish to speak in the debate, I am minded to accept a motion without notice under rule 8.14.3 to extend the debate by up to 30 minutes. I invite Neil Findlay to move a motion without notice. The question is that the debate be extended by up to 30 minutes. Are we all agreed? That is agreed. I now call Annie Wells to be followed by Elaine Smith. First, I put my thanks on record to Neil Findlay, Jackson Carlaw and Alex Neil for their commitment in campaigning for justice for those women. Of course, it goes without saying that all the tireless and passionate work of the campaigners who have fought passionately to get mesh victims the justice that they deserve. I also want to welcome them to the chamber this evening. As shown by the strength of feeling in the chamber, there is a great deal of disappointment amongst mesh victims over the Scottish Government's decision to decline the offer made by Dr Vironicus. One can only imagine the pain victims face on a daily basis and the worry of those yet to learn if the mesh will have the same life-altering impact on them as the women they have met and read about. I hope that today we can have a frank and honest discussion about the best way forward for mesh victims. If it is feasible for Dr Vironicus to make the journey to Scotland, then that option should be, of course, fully explored. No one wishes to see mesh victims suffering needlessly, and I have no doubt today that we are all in agreement on that. The journey that is getting to this stage when we are beginning to look at solutions has been a long and difficult one. The mesh that can be used in pelvic organ prolapses and incontinence women has been used in more than 20,000 women in Scotland over the past 20 years. Although there have been a number of high-profile cases in the media, the number of women affected is unfortunately still unknown, and the potential side effects of mesh are truly awful. They can range from chronic pain and loss of sexual function to major complications such as the implant intruding through the bladder or bowls, even necessitating the removal of organs. It can shrink or move inside the body, slicing through nerve endings, tissue and organs, and it is very difficult to sometimes are impossible to remove. The offer made by Dr Vironicus is therefore an appealing one, and I can completely understand why that would have no doubt given hope to those affected and those worried about the future. The Scottish Conservatives, led by Jackson Carlaw, have been on the side of the victims from the start. In 2017, 97 MSPs signed a pledge opposing any whitewashing of the mesh report. The Scottish Conservative MSPs have been calling for an end to the damaging mesh procedures in Scotland, and we welcome the hope to mesh procedures announced by the cabinet secretary last September. That support will continue, which is why we are calling on the Scottish Government to give full consideration of the offer and, if feasible, given the necessary checks to proceed. I attended Neil Findlay's press conference this afternoon, and it was truly heartbreaking to hear the stories of how mesh has completely ruined those women's lives. One lady told us that she was on the list to have both her bow and bladder removed. Another informed us that having been told that she would go back to work in university six weeks after the initial operation, 10 years later, she has never returned. Hearing the story of Dr Mary McLaughlin, a mesh victim from Belfast, who was paid for an operation by Dr Veronica herself, was eye-opening, and I can completely understand the frustration of the women who want the same. It is only right that we explore this option in full unless improperly to concerns of the women affected so that they do not feel that they are fighting a constant uphill battle in being heard. I thank the campaigners who fought hard on that issue. That is a really difficult situation, and whilst we are entering unchartered territory, it is so important that decisions are made with caution and care. We all in this chamber want the best possible course of action to be taken, which is why the Scottish Conservatives are calling for this offer to be fully explored. We owe that to the mesh victims, and hearing their stories again this afternoon reaffirmed that for me. I call Elaine Smith to be followed by Stuart McMillan, when Mr McMillan will be the last speaker in the open debate. Thank you, Presiding Officer. Like others, I commend Neil Findlayon for securing this debate and for his tireless work to uncover the women's health scandal and to get help and justice for the women victims. Of course, there are other MSPs, including Jackson Carlaw, Alec Neil and members of the Petitions Committee, who have also worked for justice on behalf of mesh survivors and campaigners. Those survivors have been fighting for others, and they now have hope for themselves. That is an important point that we need to make this evening, and it has already been made, but I will reiterate it. I also commend Marion Scott, who reported with her Sunday post on her fearless determination to expose the issues and to support the brave women involved in the mesh campaign. We know that the mesh is supposed to be banned from use following the lengthy campaign, but we still hear stories that it is being used even without the knowledge and consent of patients in some cases, and that is worrying. We also need to remind ourselves that the mesh that we are discussing can carry with it serious complications that include persistent chronic pain, sexual problems, mesh exposure through vaginal tissue and injury to nearby organs such as bladder and bowel. As mentioned by Miles Briggs, a few months ago, Marion Scott and some of the mesh campaigners spoke at the CPG on chronic pain, of which I am also a co-convener, to highlight the on-going problems that women are suffering and to seek help and support, which, for many women, must now mean having the mesh properly and fully removed. The Scottish Government said today that full mesh removal has already been provided by specialist staff working here in Scotland, but we really need clarification of that because that is strongly disputed. It seems that the only option that is currently available in Scotland for many women sufferers is partial removal, which often makes the situation worse and can cause autoimmune disorders. Sadly, we know how autoimmune disorders are treated with the thyroid scandal and other women's health scandal to add to the list that my colleague Monica Lennon put on the record. Removal did not go well for Lorna Farrell, whom we heard from at the press conference today, in whose story she was in last week's Sunday post. Lorna is now a wheelchair user following supposed removal of the mesh by surgeons in Scotland. Lorna says that her specialist admitted that she cannot fully remove the type of mesh implants that are most used in Scotland, and not only does Lorna now have increased pain, but she still has mesh left inside her. Clare Daily's story was also outlined in the Sunday post. Clare is also in a wheelchair after removal surgery and is now waiting to have her bowel and bladder removed. She is hoping that it might not be too late for her to have other options. Many women have been crippled with pain following the implants of the mesh, and we understand that some of it was not even thoroughly tested before it was first used on women. Now they are being further damaged by botched efforts to remove it. I think that the safe removal is the very least that our NHS should be providing, and it could be providing it, because Dr Varonicus, an eminent specialist in the United States, as we have heard from Neil Findlay and others, could not only perform life-changing surgery to reverse the damaging procedures performed in Scottish women, but importantly could train surgeons here to perform the procedure. There does not seem to be anything standing in the way of that, except that it seems that the Scottish Government's agreement to that. Mary McLaughlin, as we have heard from Northern Ireland, has had successful removal by Dr Varonicus. She has a life back, and at today's press conference, the mesh survivors said that they want to be Mary, but of course Mary had to pay herself, and that is a divide between those with personal funds who can actually get together the personal funds and those with none. Women have lost their livelihoods, depending on benefits, and cannot pay to go to America for surgery, and that surgery surely, surely must come to them. Mesh survivors have campaigned for seven years to have mesh banned. They cannot be expected to campaign for another seven years for life-changing surgery to remove the botched mesh. Dean Freeman can stop that scandal. She can give women the lives and their jobs back, and she surely, surely must do so. It is not only right for the individual women, but it will be much more cost effective in the long run for the NHS and for society as a whole. First of all, I congratulate Neil Findlay for securing the member's debate. In my near 12 years as an MSP, I have heard many difficult and challenging issues raised with me by constituents. However, I will certainly never forget what one constituent told me in 2017 about the pain that she loves with on a daily basis because of having a transvaginal mesh implant. The effect that it has had on my constituents day-to-day ability to do simple tasks—most of us were actually, to be granted—has become so, so problematic for her. She would not wish this pain on suffering on anyone. Other women in Inverclyde have also contacted me about the issue, and informed me of similar things that they have to deal with on a day-to-day basis. I very much acknowledge and also appreciate the devastating impact that mesh implants can have on a person's life. However, even in the most difficult of situations, politicians sometimes need to take a wee step back to try to have a balanced view, but there is a spice briefing for today's debate notes. It has been acknowledged that damage from transvaginal mesh is not inevitable and that, for some women, the procedure has been successful and that it continues to be pain-free. However, notwithstanding this, I very much highlight the suffering that I have mentioned before. One woman, negatively affected by mesh implants, is one woman too many. Clearly, the issue of mesh implants has affected far too many women in Scotland, and certainly something has got to be done to improve the situation. Jeane Freeman, the cabinet secretary, in September last year, took the bold decision to effectively ban use of transvaginal mesh in NHS Scotland for pelvic organ prolapse and stress urinating continents. Some women argue that the decision should have been taken earlier, but I am glad that the Government did listen to the recommendations made by the Petitions Committee as has been referred to already. I welcome the decision then, but we now have this new challenge. The issue of this motion in front of us and the issue that Neil Findlay has brought to us regarding Dr Veronica's coming to Scotland to support patients with mesh implants that need to be removed. With approximately 1,000 women potentially needing their implant removed, it would appear that there is merit for Dr Veronica's to certainly come to Scotland to help those women. I am not an expert and by any manner remains in this situation. Whether it is Dr Veronica's coming here or for Scottish Women going to America to get the assistance from Dr Veronica's, I am not going to take that decision, but I generally think that if Dr Veronica's came here, the idea of treating women but also educating our professionals so that NHS Scotland can deal with the situation going forward, as compared to having to rely upon bringing somebody in from America or elsewhere to deal with the situation going forward is a very strong argument. The idea of teaching and educating our professionals was so important in my opinion. I would like to see measures implemented to help not just my constituents but all the women in Scotland who need the assistance. I think that the contribution from colleagues across the chamber today has been extremely powerful in this particular regard. If there is a reason for Dr Veronica's not to come here to help my constituents and also help all the women in Scotland, I would like to be aware of what that particular is. I would also be keen for our NHS to obtain the assistance of this expert and to help to deliver the improved outcomes for many women in Scotland. In politics we sometimes talk about inputs and outcomes, inputs being the money but the outcomes being how that money is spent. For me it is a very simple situation here. The input is about getting an expert to come over to help but the outcome is for women to actually have a better life, a life free of pain. I think that that is an extremely strong message and I certainly encourage the cabinet secretary whether it is heard directly or getting the NHS boards to bring Dr Veronica's over here. I think that that would be extremely useful for all women in Scotland. Thank you very much. I am grateful for the opportunity to close this very important debate. I thank Mr Finlay for bringing it to the chamber. I recognise that very many women have suffered a significant amount and continue to suffer a significant amount of pain, of distress, of immobility, of deterioration in the quality of their life as a result of mesh complications. Like others, I express my sympathy to them but I know that that sympathy is of little use when your daily life is so marred by something that you thought would help you and actually has made your situation worse. I also want to recognise before I go any further the tireless work of the mesh survivors group and indeed colleagues across this chamber, many of whom have spoken tonight, in making sure that those issues are front of mind. I remain convinced that the decision that I took last year to halt the use of transvaginal mesh for pelvic organ prolapse and stress urinary incontinence was and remains the right one, but I am also convinced that a great deal of the evidence and the impetus to make that decision comes indeed from those women themselves. Now it is absolutely right to turn to the question of their situation and the complications that they face and the pain that they face. Let me repeat. Full mesh removal is available in Scotland and photographic evidence is used in that procedure, but it is clear that there is a dispute around that. Before I go any further, let me make this offer that I will discuss with Mr Finlay, with Mr Carson, with Mr Neil, the three prominent members in the chamber who have led the chamber's work in this. The evidence that I have to support that against the views of women that I know expressed earlier today and elsewhere, I know may well be expressed to me later when I meet some of them, that that is not the case. The analogy that I used today at the event today was that if full mesh can be removed, I could come along just now with a piece of twingum and stick it in your hair, I could then come along with a pair of scissors and very quickly chop that out, or I could come along with an instrument that one hair at a time would remove that piece of mesh. This is the difference that we are talking about, because if you do the former, then you damage people's tissue, their nerves and you leave them in chronic pain. If you take the approach that Dr Varonicus does, you have micro-surgery that removes it in a single piece with very little damage. Even if you provide us with the evidence, it is not comparing apples and apples. Mr Finlay, I have heard what you have said and I would like you to wait until I have finished to hear everything that I am going to say as well. I take the point that you make, although neither you nor I are clinicians. Let us proceed in as calm and reasonable a way as we possibly can. Our specialist centres offer a range of treatments and, importantly, those treatments are considered on a case-by-case basis. Importance in that is the shared decision making and the informed consent. Indeed, we touched on some of that when I took the decision last year to end the use of mesh in terms of those other conditions that I mentioned. In response to Mr Greg's questions, I do not have all of the detail that you asked, but I will make sure that that is provided to you and indeed to other members. However, the information that I have is that, after mesh removal procedures, photographic evidence is taken, there remain approximately 120 referals to the service per year and full-growing dissections are performed at the rate currently of 2 per month. The other information that you asked for, as I have said, I will make available to you. The clinicians involved in those two specialist centres are highly skilled and trained. Let me be clear, too, because that point has been raised that GMC guidelines are clear that no treatment should be refused to a patient because that patient has either complained or is engaged in litigation with the clinician involved. Should that be the case, I want to know that, because that is absolutely contrary to GMC guidelines. However, clinicians like clinicians across our national health service are engaged in continually developing their skills and practice, so there is, as Rona Mackay rightly said, a process by which that happens. It is commonplace across our health service to exchange clinicians between one country and another to learn new techniques, to study the research and the data that is gathered in order to improve skills and improve understanding. There is a process that is gone through in order to ensure that that happens. It need not be lengthy, it need not be complicated, but it is an important one nonetheless. It is not my decision as a cabinet secretary to decide what clinical practice or clinical learning should take place. That is for the clinical community in conjunction with their health boards, sometimes with the involvement of their Royal College. However, my job—I am really clear what my job is—is that, where that is considered by those clinicians to be the right thing to do, my job is to help to make that happen. Before I take your intervention, let me be absolutely clear for the record. I have not refused an invitation from Dr Veronicais. What I have said and Mr Finlay rightly made it clear in his opening is that there is a process to go through. If either the clinicians or the health board or a Royal College believe that that would be useful to them, my job is to help to make that happen where I can. Elaine Smith I would rather move on slightly, but I would certainly hope that the cabinet secretary might wish to make it clear to the health board so that it is something that she wants pursued. I wanted to ask the cabinet secretary that she took a clinical decision, because if she had not banned the use of this mesh, clinicians in Scotland would still be using it, so the clinical decision would still be to use it if the health secretary had not taken a decision to have it banned. I made that decision based on clinical advice and clinical evidence. My point is that none of us in the chamber are clinicians. Therefore, I am not arguing that you did say it, Mr Finlay. I am simply trying to take us through what is the right thing for me to do as a cabinet secretary and where I need to get advice from in that regard. I will take an intervention, of course. Neil Findlay So, when I wrote to you initially about this and have you initiated those discussions, what has been the outcome of those discussions, how much further have we moved this forward in the intervening time before we have come to today or is it today's parliamentary debate that will ensure that we begin those discussions? Cabinet secretary. No, today's parliamentary debate does not ensure that we begin those discussions. Indeed, on 22 February, our accountable officers, as members will remember, from the last statement that I made on mesh that I talked about accountable officers, they are in effect our medical directors and our individual health boards, met. They considered some of the follow-through from that exceptional circumstance protocol, from the halting of the use of mesh and those procedures that I talked about, about the high vigilance scrutiny, about the registry. There has also been discussions between myself and the chief medical officer about whether or not there are additional expertise and techniques that could be helpful to the specialist centres involved in Scotland. I will get to that point, but we will continue to see if that is possible for us to do. The other area of course that we have pursued, as I believe both Mr Finlay and others know, is with the MHRA, because mesh itself needs to be proven to be safe. We have pursued with the MHRA the evidence that they can offer us, that UK body, which is the body that approves the use of mesh and other such devices, what evidence they have of the procedures that they went through in order to be assured of the safety of that particular product, and we continue to pursue them on that. On that particular question, let me repeat. Nobody needs to implore me, nobody needs to beg me. I completely understand that the women involved rightly want to have the best possible response to the situation that they find themselves in, and for many of them that will require full mesh removal. What we need to do, what I need to do, is, with the clinicians involved, look at whether there is additional training, expertise, learning that can be provided by Dr Veronica's or others, what we need to do to ensure that that happens. I have heard what has been said. I respect absolutely what colleagues say. I remember being in the garden lobby myself the first time the women affected came to this Parliament, so with the chief medical officer I will look at what we can do with that clinical community to see what further learning and inquiry on techniques can be taken. Excuse me a minute, cabinet secretary. We are now at 11 minutes, and I can give you a little longer, but I think that we will have to conclude shortly. Okay. I appreciate that, Presiding Officer. I am almost finished. What I am saying to this chamber is that my mind is not close to this, it is not entirely my decision, it is what I need to do with the clinical community, with the chief medical officer, we will undertake further discussions in that regard. I have not refused Dr Veronica's offer, it is not for me to accept that offer, it is for me to discuss with the clinical community how their learning and techniques could, in their opinion, be improved and enhanced, and we will do that. Thank you very much. That concludes the debate, and I close this meeting of Parliament.