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PE1952 is on instructing Scotland’s NHS to form specialist services for patients with automatic dysfunction—sorry, that should be autonomic dysfunction, which is quite different. The petition, which was lodged by Jane Clarke, calls on the Scottish Parliament to urge the Scottish Government to instruct Scotland’s NHS to form specialist services, training resources and a clinical pathway for the diagnosis and treatment of patients exhibiting symptoms of autonomic nervous system dysfunction.

PoTS UK’s recent submission disagrees with the Scottish Government, stating that many patients

“do not have access to the best possible care and support”,

and that PoTS, or postural tachycardia syndrome, is

“not well recognised within the cardiology profession”.

The submission highlights that there are no established pathways to diagnose and treat PoTS in adults across most health boards.

Chest Heart & Stroke Scotland’s written submission notes that

“Nearly 200,000 people in Scotland”

have long Covid and that 76 per cent of long Covid patients had symptoms of dys—gosh, how am I going to say this?—dysautonomia. However, it states that patients with dysautonomia

“struggle to access medical support ... and people ... with PoTS often wait years for a diagnosis”.

Chest Heart & Stroke Scotland calls for

“quicker and more co-ordinated diagnostic and treatment pathways”

for people with long Covid and for

“the creation of a clinical pathway that integrates with existing SIGN”—

or Scottish intercollegiate guidelines network—

“guidelines.”

It also supports training for general practitioners and

“further scoping to ascertain the size”

of the need for specialist support for people with dysautonomia.

The written response from NHS National Services Scotland states that it

“would not anticipate”

being

“invited to commission a national specialist service,”

devote “training resources” or develop “a clinical pathway”,

due to

“the broad range of local services and specialities”

around

“autonomic dysfunctions.”?

That was all quite technical, but important nonetheless. Do members have any comments or suggestions?

Dysautonomia.

Are members content to proceed with that request for further information?

Members indicated agreement.

Are we agreed on those actions?

Members indicated agreement.

I also suggest that we look at the possibility of arranging a visit for those members of the committee who might like to visit the area. It is quite a complicated issue and a physical appreciation of all that is being discussed would probably assist members.

That brings us to the end of item 2. Thank you, again, Ms Baillie, for your participation.

We move to the further consideration of continued petitions. PE1916, which was lodged by Councillors Douglas Philand and Donald Kelly, calls on the Scottish Parliament to urge the Scottish Government to instigate a public inquiry on the political and financial management of the A83 Rest and Be Thankful project, which is to provide a permanent solution for the route. It is a cause célèbre with which the committee is familiar, our having discussed it with regard to various petitions over a considerable period of time. No doubt Jackie Baillie, who joins the committee’s proceedings this morning, has done so, too. I welcome Ms Baillie to the meeting.

We last considered the petition on 9 November, when we again agreed to write to the Scottish Government. Since then, we have received a response from Transport Scotland, which indicates that

“potential route designs”

for a permanent solution

“are being progressed”,

with an expectation that a preferred route option will be announced “by Spring 2023”.

As an aside, I recently read a novel in which somebody said that Stockholm does spring very nicely, to which the riposte was yes, but in July. Now that we are getting nearer to July, the Scottish spring might well be what we used to call summer. However, here we are.

Transport Scotland’s response also notes

“the preferred medium term solution”

of improvements to the existing old military road, which was announced in December 2022. I remember visiting that with David Torrance a number of years ago for previous committee consideration of a petition.

We have also received a submission from the petitioners, highlighting concerns that improvements to the old military road might delay progress on a permanent solution as well as seeking information on Transport Scotland’s timetable for progressing a permanent solution. As I recall, when someone gets to the end of the old military road, they are confronted with quite a tricky topographical consideration. It is very steep and windy.

Before I open up the discussion to wider comments, I am delighted to ask Jackie Baillie whether she would like to contribute anything at this stage. She is probably as perplexed as I am by the definition of spring.

From what you have both said, it sounds as though there was a driving necessity to bring about a change in the arrangements that were in place. Every bit as much as clinicians and others thought that it was the right way forward, it sounds as though the previous arrangements were potentially dangerously unstable in terms of being able to provide a service.

On that basis, I am interested to know whether, to your knowledge, in the interim since 2016, the practice that you have evolved has been rolled out to other parts of the United Kingdom outside Scotland. In so far as you were able to establish a service, will you tell us what the main challenges were in trying to bring about what you have achieved, as a general introduction to the questions that will then follow? I do not know who will volunteer to speak.

That is very helpful. Thank you.

That is helpful. Scotland has a 62-day cancer treatment standard. For my understanding, is there similar pressure in your area in respect of that discipline?

Thank you for that.

Before I bring in my colleague Alexander Stewart, I am conscious, Ann Edwards, that you have been sitting patiently with us this morning, so might I bring you in to make any general reflections on the comments and evidence that we have heard so far?