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I do not know whether any of the other members of the panel want to comment, but I will ask one final question of you, Professor Conway.

You mention

“slow recovery of training and support”

for the programmes. Why is that, and how urgent is it that programmes for adult oral health are reinvigorated?

I want to pursue the point about which aspects of oversight a board is responsible for, which Antony Visocchi touched on. Let me take the example of a scale and polish, which one would think is an aspect of front-line prevention work. Some 59 per cent of providers are operating at pre-pandemic level, so there is still a way to go to recover that service. Does your board have any oversight of such treatment? Is it happening in your areas? Can you take action, or does the problem belong to someone else? I put that first to our witness from Shetland.

Although I would always note that registrations are not activity, I absolutely agree with your concerns that, if people are not registered in the first place, it is very difficult to make an impact.

Can I take you back to before the pandemic? I do not know whether it was you or one of the other witnesses who, in their evidence to the committee, suggested that

“Prior to the pandemic, persistent inequalities in child oral health were recognised as an ongoing challenge for the programme.”

Why was that the case, given the effective community infrastructure that you have described? Was childsmile in need of reform? Did the pandemic expose its weaknesses?

Has it got back to the level at which it was prior to the pandemic?

That strikes me as a rather long answer to say that, until we resolve the existing problems, any question of abolishing charges is probably for the birds.

I see that Adelle McElrath is nodding. Would you like to add anything to that?

Can you tell us how the childsmile programme was impacted at the community and clinical levels? Professor Conway, I think that that is a question for you.

I am very proud of the childsmile programme. It was put in place by the previous Labour Government and has subsequently been continued by the SNP Government. It has transcended political parties as an excellent programme.

If we are not operating at the same level that we were before, what does the recovery programme for childsmile specifically look like?

I do not know whether anybody has anything to add.

Thank you very much, convener. I am very grateful for the opportunity to speak.

Gordon McPherson is, in fact, a world ambassador for world thrombosis day. He has been campaigning on this issue for 20 years, and I feel that I have known him for each and every one of those years. He is persistent, and rightly so, because he is asking the Scottish Government to raise greater awareness of deaths in Scotland that can be attributed to thrombosis, as you have outlined, and to show the risk factors, signs and symptoms to look for in order to reduce mortality and morbidity.

The petitioner lost his daughter, Katie, who was an occupational therapist, in 2003, when doctors at two hospitals failed to spot a blood clot in her leg and she was sent home with painkillers. Mr McPherson feels that if medical staff had been more aware of the risk factors, plus the signs and symptoms, Katie may not have died from untreated thrombosis.

The Scottish Government has not run an awareness campaign on the condition since 2011, and Mr McPherson feels that it is not treating the matter as seriously as is required. As a result of a lack of awareness on the part of both the public and medical professionals, he is concerned that there will be increased cases of thrombosis. He is keen that the Government does more than it is already doing. He is not looking for something that is hugely expensive—he has suggested practical stuff. For example, he has talked about blood clot alert cards, such as are available in Ireland. They inform patients of the risks and signs of clots and of the need to get medical attention fast in the event of a clot. That strikes me as something that the Scottish Government could do effectively without too much cost. He has raised issues such as that with the Scottish Government over the past 20 years and it has been particularly unhelpful in trying to progress the matter.

What makes the issue more significant—and is I think the reason why he has lodged a new petition—is that new research by the BMJ shows that, after a Covid-19 infection, there is an increased risk of DVT for up to 3 months, pulmonary embolism for up to 6 months and a bleeding event for up to 2 months after infection. The circumstances around thrombosis have changed since the Government’s last awareness campaign in 2011 when Covid-19 was not the health risk that it is now. In that light, I would be most grateful if the committee could consider whether it would be wise for the Government to take another look at public and medical professional awareness of thrombosis so that more lives such as Katie’s are not lost.

I acknowledge, convener, your own particular contribution to tackling the mesh scandal in Scotland, and I know that we will get a good hearing from all the committee.

I echo my colleague Katy Clark’s call for the committee to ask the Cabinet Secretary for NHS Recovery, Health and Social Care to give evidence on the issue and to give an update on all the promises that the Scottish Government made prior to the debate in January, as I have yet to understand whether those commitments have been fulfilled.

There is a need for a viable and safe alternative to mesh, and Maree Todd acknowledged as much in a previous committee meeting in June 2022, when she agreed that the skills gap between mesh and natural tissue repair needed to be bridged. I am keen to know what progress has been made on that.

Some patients have very recently had mesh inserted, and the petitioners have raised concerns that no discussion took place about the risks or the alternative treatments, if any, that could be offered. Patients in Scotland have the right to a choice and to make informed decisions about their healthcare, and medical professionals should be given the tools to answer patients’ questions about the risks and alternatives. It cannot be right that patients are relying on one another for information through support groups. Clear guidance needs to be in place and shared with all general practitioner practices across every health board.

I find it hard to believe, but the Scottish Government previously said that the mesh hernia repair used at the Shouldice hospital in Canada would not work for the Scottish demographic—I really do not understand why that would be the case. I believe that the opportunity remains to create a national treatment centre that properly offers alternatives and deals with the problems of mesh, and I wonder whether we can explore the matter.

We cannot continue to deprive those people who have had hernia mesh repairs of options for removal treatment. I would therefore be most grateful if the committee would do the petitioners and all of us a favour and press the Scottish Government in that regard.