Seòmar agus comataidhean

That is very helpful. Thank you.

I want to go back over some of that territory. You have spoken about the fact that it is felt that it is a “non-starter” to consider retraining pathologists and that the desire for that does not exist among that community. You have alluded to the shortage of radiologists. To be perfectly candid, it is not a public secret that Scotland is acutely short of radiologists. For example, the 62-day cancer standard is not being met by any of Scotland’s health boards. The waiting time for all the key diagnostic tests, including radiology, is not being met anywhere in Scotland. The statistics from December 2022 show that just 45.8 per cent of patients waited less than six weeks for their diagnostic test.

This is not necessarily a question that you can answer, but I wonder whether similar pressures were advanced in the arguments that took place when your service was set up. The Government might say in response to the petition, or to any initiative that we might subsequently seek to promote, that faced with an acute shortage of radiologists, its first priority should be the living and that any such proposal would divert and potentially further undermine our ability to satisfy or meet currents needs, or even to close the gap, as regards current provision. Was a similar sentiment advanced when you set up your service?

We do, in fact. I was getting ahead of myself by saying that I would bring in my colleague Alexander Stewart, because my colleague Fergus Ewing, who spoke a moment ago, has some questions directly on the finance side.

That is very helpful. Thank you very much. I bring in my colleague Alexander Stewart, who will ask some questions about tissue samples.

Thank you. Again, that is very helpful to our consideration.

That brings us to the end of the questions that we wanted to put to you. I am enormously grateful. You are all very busy professionals and clinicians, and the time that you have given us to hear your evidence this morning really will help the committee considerably as we consider the petition and how we might take forward some of the issues in it. Thank you all very much for your participation. I say on behalf of everybody here in the Scottish Parliament how very much it has been appreciated.

I will move now to Monica Lennon MSP, who is joining us this morning and has joined the committee on previous occasions when we have considered this petition. Before the committee reflects on what has been heard this morning, which I think that we can all say has been very interesting, is there anything you would like to reflect on and add, Monica?

PE1930, which was lodged by George Eckton, calls on the Scottish Parliament to urge the Scottish Government to ensure that a requirement of future rail contracts is for customers to be given information on the cheapest possible fare as a matter of course and to recognise the vital role of the existing ticket office estate in delivering on that aim.

We previously considered the petition on 23 November, when we agreed to write to the Scottish Government and Scottish Rail Holdings Ltd. Unfortunately, a response from Scottish Rail Holdings has not been forthcoming, but we have received a response from Transport Scotland on behalf of the Scottish Government, and members have a copy of that.

In its response, Transport Scotland highlights that the interaction of devolved and reserved matters

“will form part of the Scottish Government’s Consumer Duty scoping work”,

and that the Government is considering whether Scottish Rail Holdings will be covered by the consumer duty legislation.

Transport Scotland has also provided details of the on-going work to enhance smart ticketing across the public transport network, which includes the establishment of the National Smart Ticketing Advisory Board. The response also indicates that the fair fares review might shortly be concluding, if it has not already, to be followed by the launch of a public consultation on a draft vision for public transport.

We have also received a brief submission from the petitioner in which he welcomes the consideration of Scottish Rail Holdings being covered by the consumer duty legislation, while highlighting concerns about advertising of fares and the potential for the digital exclusion of certain groups or individuals.

Do members have any comments or suggestions for action?

The next petition, PE1967, is on protecting Loch Lomond’s Atlantic oak wood shoreline by implementing the high road option for the A82 upgrade between Tarbet and Inverarnan. A theme is developing here. The petition, which was lodged by John Urquhart on behalf of Helensburgh and District Access Trust and the Friends of Loch Lomond and the Trossachs, calls on the Parliament to urge the Scottish Government to reconsider the process for selecting the preferred option for the planned upgrade of the A82 between Tarbet and Inverarnan, and to replace the design manual for roads and bridges-based assessment with the more comprehensive Scottish transport appraisal guidance.

Jackie Baillie has remained with us in order to contribute to our deliberations on the petition again.

We previously considered the petition on 21 December 2022, when we agreed to write to Transport Scotland, Argyll and Bute Council, the Loch Lomond and the Trossachs National Park Authority and the Lochaber Chamber of Commerce. Since then, we have received responses from the national park authority, Transport Scotland and the council, which are included in the papers that are before us.

The response from the national park authority notes its concerns about the road design, with the caveat that a formal view will be provided once Transport Scotland finalises the proposal. It also highlights that, without further consideration of the details, it is not clear that the high road route would provide a more environmentally favourable option.

Transport Scotland has provided a lengthy and quite technical submission, which details its assessment process and the community engagement that has taken place on the A82 scheme to date. In particular, I draw members’ attention to comments on an Audit Scotland investigation into concerns relating to the application of the Scottish transport appraisal guidance.

We have also received a late submission from the petitioner, which was circulated to members. It outlines their response to the submissions that we have received.

Before I ask committee members for their thoughts on how we should proceed, I invite Jackie Baillie to contribute to our deliberations.

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.