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Thank you, Mr Sweeney. I think that you might have the same sense that I have that there is a lack of ownership of the actual direction of the pathway to a solution. That seems to be the point.

PE1865, by Roseanna Clarkin, Lauren McDougall and Graham Robertson, calls on the Scottish Parliament to urge the Scottish Government to suspend the use of all surgical mesh and fixation devices. I apologise for the fairly long preamble. The petition has had something of an airing in the Parliament in connection with the bill on compensation for transvaginal mesh surgery that was recently passed. The petition calls on the Parliament to suspend the use of 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.

The petition was last considered on 17 November 2021 and at that meeting the committee agreed to write to the Minister for Public Health, Women’s Health and Sport and to the Shouldice hospital in Canada. Responses have been received from the minister, the Shouldice hospital, Sling the Mesh campaign and the petitioners.

I am delighted that Jackie Baillie is still with us this morning and I welcome Carol Mochan MSP, who joins us online; both members wish to speak to the petition. Before I bring in my colleagues, I will provide a little bit more of the background, which I apologised for the length of a moment ago.

In 2019, the Scottish Health Technologies Group carried out a review into the use of mesh in primary inguinal hernia repair in men. The review concluded that, compared to non-mesh procedures, using mesh resulted in lower rates of recurrence, lower rates of serious adverse events, and similar or lower risk of chronic pain. The advice for NHS Scotland was, therefore, that surgical mesh should be used in elective repairs in inguinal hernia in adult males.

The SHTG review was subsequently expanded to include women, examining the outcome of mesh versus non-mesh surgery in a variety of groin or abdominal wall hernias. The Scottish Health Technologies Group concluded that current evidence supports the continued availability of surgical mesh for elective repair of primary ventral hernias, incisional hernias, and primary inguinal hernias in adults in Scotland. The group recommends, however, that consideration should be given to patient preference and that patients should also have access to alternative hernia treatment options such as non-mesh—suture and natural tissue—repair.

The chief medical officer has also undertaken a number of activities relevant to the petition, including: writing to the board chief executives and medical directors to draw their attention to the SHTG report’s findings; asking health boards to consider the availability of non-mesh surgery within their health board, and how any skills gaps can be addressed; asking health boards to consider the development of local clinical groups and broader clinical networks for the management of complex cases; and asking medical directors to remind clinicians of their obligations under the principle of realistic medicine, of informed consent and of the importance of recording both the content and outcome of such discussions.

With regard to the issues raised about the quality and authenticity of certain materials being used, the minister states that the Scottish Government contacted the Medicines and Healthcare Regulatory Agency in 2018, which confirmed that there was no new evidence to prompt regulatory action and that the products in question remained acceptably safe when used as intended.

The committee also wrote to the Shouldice hospital in Canada, as the leading experts in natural tissue repair. In what I thought was a fascinating submission, Shouldice states that in its own practice, surgical mesh is not used unless absolutely necessary and that has led to it being used in less than 2 per cent of cases. The hospital specialises exclusively in abdominal wall hernia repair. It states that where the body’s natural tissue is strong enough to support the surgical repair, natural tissue repair should always be used and where underlying patient tissue is poor, surgical mesh may be necessary in some femoral and large incisional hernia repairs. All the hospital’s surgeons are trained to do a natural tissue repair as their first choice; natural tissue repair should be the first choice for all primary inguinal hernias, most recurrent inguinal hernias, most femoral hernias, most epigastric and umbilical hernias, and small incisional hernias.

Shouldice also notes that since mesh was introduced in the 1980s, the recurrence rate for inguinal hernia repair—more than 85 per cent of most of its hernia repair—has not improved. There has been a staggering increase in post-operative complications not seen prior to mesh. Chronic and debilitating pain and other severe complications such as mesh shrinkage, mesh migration, and related nerve entrapment are widespread. There are no side effects of tissue repair if it is done correctly. Training for surgeons on the natural tissue technique ranges from three months for an experienced fellowship general surgeon to six to nine months for an inexperienced general surgeon.

The Sling the Mesh campaign shared the results of its recent survey of its 9,300 members with experience of vaginal, abdominal, pelvic, rectal, hernia mesh and mesh following mastectomy. It notes that one in four have considered taking their life,?six in 10 suffer depression, one third have been forced to give up their work, one in four now need a stick to walk, and one in 14 now need a mobility scooter or wheelchair.

In their submissions, the petitioners welcome the information contained in the Shouldice hospital submission and ask for further information to be sought on the use of protacks, which are devices used to fix mesh to soft tissue. The petitioners believe that there is evidence to suggest that a considerable sum of money has been spent recently procuring hernia mesh and other fixation devices and they feel that that money could have been spent on investigating and teaching natural tissue repair. The petitioners also query why mesh is still being bought and why clinicians are not yet accurately and systematically recording the effects of such material on patients.

We have gathered quite a lot of evidence since we last considered the petition. I invite both Jackie Baillie and Carol Mochan to contribute ahead of comments from committee members.

I suggest that the clerks liaise with the clerks of that committee to see what understanding they have of the issue. Maybe that committee can come back to us and we can decide how its work might fit with anything that we are doing.

Are we agreed on that approach?

Members indicated agreement.

Thank you all, and thank you, Mr Allan.

PE1864, on increasing the ability of communities to influence planning decisions for onshore wind farms, was lodged by Aileen Jackson on behalf of Scotland Against Spin. The petition calls on the Scottish Parliament to urge the Scottish Government to increase the ability of communities to influence planning decisions for onshore wind farms by adopting English planning legislation for the determination of onshore wind farm developments, empowering local authorities to ensure that local communities are given sufficient professional help to engage in the planning process, and appointing an independent advocate to ensure that local participants are not bullied and intimidated during public inquiries.

The petition was last considered by us on 1 September 2021. The committee agreed to write to a range of stakeholders. I am pleased to say that responses have now been received from Scottish Renewables, Planning Aid Scotland, the Royal Town Planning Institute and the petitioners. We also received a late submission from Finlay Carson MSP in support of the petition.

The submissions that we received were very detailed and comprehensive. I thank those who have taken the time to research the information, forward it to us and to submit their views on the petition. All of the submissions have been shared with members in the papers that they received in advance of the meeting, and for people following our proceedings, the submissions are all publicly available on the petition’s website.

Common themes across the submissions include: the role of local planning authorities as decision makers; ensuring that communities have access to professional help in navigating the planning process; ensuring that communities have early notification of section 36 applications; capacity issues for local authorities in meeting future net zero targets; potential learning from elsewhere in the UK, for example, local authorities applying English planning law; the use of inquiries and how communities can best contribute to them; and mechanisms to enable any issues with a developer’s conduct to be formally raised. Do members have any comments or suggestions for action?

There is a willingness for us to take evidence, but we want to be sure we are taking evidence from the right source. Are members happy to delegate to me the decision as to who that would be?

There is another group I am quite interested to hear from. There are repeated references to the powers that local authorities in England have in relation to wind farms. I wonder whether we could touch base with a representative organisation of local authorities in England to understand a little bit better the actual application of that process. I would like to know whether in practice that has worked in the way that is being suggested and whether there are any concerns or anxieties among English local authorities about the responsibility that has been devolved to them.

Are members content to proceed on that basis?

Members indicated agreement.

I am grateful for that. Do any members of the committee wish to comment?

I would like to write to those organisations and the Scottish Government to ascertain what qualifications must be in place, prefacing it by saying that the evidence the that committee has received so far seems to point to a lack of clarity about where the leadership for a resolution of this issue might lie. I would be interested in their comments on that because, from the evidence that we have received, the situation is not clear and therefore we are amassing evidence without it being clear what the trigger would be to give effect to progress. We will keep the petition open and proceed on that basis.

We took evidence from the minister prior to your joining the committee, but there is every reason to suggest that we might wish to have the minister back.

She stole your thunder.