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I was a member of the Public Petitions Committee back in 2014, when the issue of polypropylene mesh medical devices was brought to the committee’s attention by Scottish Mesh Survivors. To this day, I vividly recall the passion and the strength of feeling of all the women who gave their time to attend our meetings to give evidence and to recount their stories and personal experiences. It is thanks to the tenacity and bravery of those women that we are here today to discuss the introduction of the Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill and the significant steps that the Scottish Government has taken to offer assistance and to better help women who were harmed by vaginal mesh and the complications arising from it.

As a current member of the Health, Social Care and Sport Committee, I am delighted that a bill has been introduced that aims to give powers to the Scottish ministers to reimburse persons who entered into private arrangements to pay to have the transvaginal mesh removed from their body, and that the reimbursement will relate to the costs of removal surgery and reasonable connected expenses.

Before it was halted in 2018 by NHS Scotland, the use of polypropylene mesh medical implants to treat pelvic organ prolapse and stress urinary incontinence left many women with life-changing complications and facing multiple operations to remove it from inside their bodies. The Government’s recognition of the suffering and considerable harm that has been caused as a result of complications arising from the use of transvaginal mesh, and the Government’s determination to do everything within its powers to help those affected, are hugely encouraging. We have already taken decisive action on mesh and now Scotland will be the first UK country to reimburse people for private treatment that was previously sought.

Before I came to the chamber today, I spoke with a constituent who, for more than five years, has been dealing with the trauma that was caused by mesh implants. She was fitted with the implants following a front and back prolapse in November 2016. By February 2017, the mesh had come loose, resulting in her uterus hanging outside her body. That started a chain of visits back and forth to gynaecologists to attempt to find someone to help. Everyone recognised the impossible situation that she was in, but no one could offer a solution.

In her words, her life “effectively ended in 2017”. Because she was living with extensive daily bleeding, double incontinence, constant exhaustion and sizeable uterine tissue building outside her body, she had to give up work and lost contact with family and friends. She went from being an outgoing sociable woman to someone who physically could not leave the house. I do not think that any of us can truly appreciate the mental strain that that must have caused.

After many years of solitude, in a bid to live a normal life by attending a family function, she reports fasting for an entire day and night beforehand in the hope that she might be able to enjoy the occasion. Despite that, she lasted only one hour before having to call family and friends to assist her to leave discreetly for an incident of bowel incontinence. Needless to say, she did not attend any more events. She has recently found a surgeon who has offered her some hope and she is now on the first steps of a journey that she hopes will see her quality of life begin to improve.

It is clear to see why some women felt let down by the NHS and felt the need to seek private arrangements to have transvaginal mesh removed. The daily stress caused by unimaginable pain, accompanied by the difficulties posed by incontinence, have led many women to pay in the region of £20,000 to travel to private clinics for treatment. Although I highlighted someone’s story, it is easy to get lost in numbers. We must look past the data, statistics and costs to see the real people beneath—to see the personal experiences of mothers, daughters, sisters and families all across the country whose lives have been negatively affected by life-changing complications and pain. Many of them have ended up in wheelchairs and endured multiple-organ trauma or extensive nerve damage. All have a story to tell, many of them harrowing, but it is our duty to listen.

Earlier this year, a case record review began, which is looking into concerns raised by patients about their medical records. As we move forward, the continuing work of the review for women who have raised concerns about whether their case records accurately reflect the treatment that they have received, specifically in relation to full and partial removal of mesh, will be a vital tool in ensuring that affected women’s voices are heard. It will give women an opportunity to set out their concerns, have their records reviewed by clinicians and allow for discussion, explanation and mutual understanding. I truly hope that those women get the answers that they need about their situation.

I am delighted to see the bill introduced. I fully support the recommendations in the report and hope that the Government will take them on board—in particular, the recommendation that any scheme must include

“a flexible approach to reimbursement that takes account of individual circumstances”.

The women concerned have already been through so much and I believe that the time is long overdue for all women who need their mesh to be removed to have that done and for us to compensate affected women for the cost of private mesh removal surgery. I pay tribute to the hundreds of women who have come together and campaigned tirelessly to highlight the suffering caused by the effects of polypropylene mesh implant surgery. I look forward to the progress of the bill and to working alongside all colleagues to ensure that no other women will have to endure the dreadful experience that mesh survivors have endured.

I thank all my colleagues who signed the motion, enabling me to bring to the chamber this debate on mouth cancer action month 2021. I also say a heartfelt thank you to Barbara Boyd, who is a trustee of Let’s Talk About Mouth Cancer, which is a Scottish charity that was set up by a group of healthcare professionals with the aim of improving the prognosis for patients who are diagnosed with mouth cancer. The charity is dedicated to spreading awareness of the condition, and of the signs and symptoms and associated risk factors, and it aims to equip the public with the knowledge to facilitate self-examination and to encourage early presentation to healthcare professionals. Barbara is a patient champion for the charity, and a mouth cancer survivor. She is described by the rest of her team as a force to be reckoned with, and, having met her, I can confirm that that is true.

Shortly after moving into my constituency, Barbara came to see me, and I was privileged to hear her story and learn more about the charity’s work. She is a retired physical education teacher, and she told me that she did not know much about the condition until 2019, when she was diagnosed with tongue cancer. Thankfully, it was caught early and her treatment was successful, but she will require significant surgery and rehabilitation. Since her recovery, she has gone on tirelessly to campaign and educate others about the symptoms. Simple self-examination, and a basic knowledge of the symptoms that are associated with the condition, can mean the difference between life and death. Although anyone—even those with healthy lifestyles, like Barbara—can develop mouth cancer, nine out of 10 mouth cancers can be attributed to particular lifestyle factors that could potentially be prevented.

There is evidence to suggest that people who have certain habits or infections are at increased risk of developing the condition. Those include smoking, as around 65 per cent of mouth cancers are associated with smoking, and drinking alcohol, as around 30 per cent of mouth cancers are associated with alcohol intake. Drinking and smoking together can mean that mouth cancer is up to 30 times more likely to develop. A poor diet that is low in fruit and vegetables, poor oral hygiene and infection with human papillomavirus are all associated with mouth cancer. We also know that social deprivation and low socioeconomic position can play a role, and people from deprived communities in Scotland are twice as likely to die from oral cancer.

Dentists and their teams continue to have a vital role to play in ensuring that oral cancers are detected early, and we all have a duty to work together to ensure that the effects of the pandemic do not allow the inequalities gap to increase. The majority of deaths from mouth cancer occur because of late detection as a result of low public awareness of the signs, symptoms and risks. Early detection is key to improving survival rates for those who contract oral cancers, which means that dental attendance, and accessing dental treatment, is vitally important.

“The Scottish Health Survey: 2019 edition”, which was published last year, showed oral cancer to be

“the oral condition of greatest concern due to its seriousness and increasing incidence.”

It went on to say:

“Head and neck cancer, of which oral cancer and”

throat

“cancer are types, account for around 3% of total cases of cancer in the UK.”

In addition, it stated that somewhere in the region of

“530 people per year are diagnosed with oral cancer in Scotland”.

In September this year, the Health, Social Care and Sport Committee, of which I am a member, invited a number of witnesses representing national health service stakeholders to provide evidence to help inform what the committee’s agenda for the coming years will look like.

One of those witnesses was Donald Morrison of the British Dental Association, who gave evidence on behalf of the dental profession and outlined the challenges facing dentists and patients in Scotland. During the session, he talked about the knock-on effect that he believes the backlog across primary and secondary dental care, which has been caused by the pandemic, will have on oral health inequalities, as well as on early detection and survival rates for oral cancer. He stressed that, for health professionals,

“one of the most important things ... is that oral cancer is one of the cancers that is picked up asymptomatically”

or “through regular screening.” He went on to say that although

“The treatment of the cancer in its early stages is relatively simple”,

its after-effects can include

“disfigurement and quite drastic and difficult surgery.”—[Official Report, Health, Social Care and Sport Committee, 21 September 2021; c 41.]

The condition and its treatment can cause several complications, including changes to the appearance of the mouth, difficulty in swallowing and speech problems.

It cannot be denied that the pandemic has had a massive effect on the sector. It was reported that there were as many as 3.5 million missed dental appointments last year. We must help our dental services to recover and clear the patient care backlog, to which end I am pleased to see the Government’s commitment to moving forward with NHS dental recovery, and that it is supporting the sector to build back to pre-pandemic level activity. I believe that the additional funding of up to £12.5 million that has been made available to NHS dentists to enable them to remobilise services and see more patients, and help them to meet safety standards, alongside the removal of all dental charges for young people, represents a clear commitment in that regard. The Scottish Government is committed to scrapping NHS dental charges for everyone in Scotland, and removing them for everyone aged under 26 is the first step in that journey. The removal of those charges means that 600,000 young people now benefit from free dental care.

All those measures are important because mouth cancer does not discriminate—we are all at risk of being affected. We all know that early detection is key. By spotting the signs and symptoms early, we can prevent some cases from happening and improve early diagnosis rates. Self-checking for mouth cancer takes just two minutes, but it could save your life or the life of someone you know. If we all know what is normal for each of us, we are better placed to spot changes more quickly and seek early help. I urge everybody to join the British Dental Association, the Mouth Cancer Foundation, Let’s Talk About Mouth Cancer, the Oral Health Foundation, our dental professionals and all the Barbaras out there in helping us to raise awareness of the signs, symptoms and risks and encourage self-examination.

Does the cabinet secretary agree that City of Edinburgh Council’s consultation on a short-term let control area, which closed earlier this month and is currently being reviewed in the city chambers, is proof that local authorities have been empowered by the Scottish Government to find tailored solutions to their housing challenges?

To ask the Scottish Government what steps it is taking to emphasise the harmful effects of tobacco as part of its aim to reduce smoking and protect public health. (S6O-00400)

The number of smokers across the country has almost halved in the past 20 years. Despite that drop, smoking continues to kill 10,000 Scots and creates 35,000 hospital admissions a year. Those who live in deprived areas are three times more likely to be smokers.

Across my constituency and in wider Fife, the smoking rate is 13.6 per cent. What action can the Scottish Government take to further raise awareness of the harmful impact of smoking as we continue to work towards our target of a tobacco-free generation by 2034?

Does the minister agree that a straightforward—and the quickest—way of incorporating the United Nations Convention on the Rights of the Child would have been by means of a bill that the Parliament unanimously voted for receiving royal assent without objections from the United Kingdom Government’s law officers?

As homes and businesses across Scotland fall silent today in remembrance of the nation’s fallen, I am honoured to participate in this debate to reflect on and show my gratitude to all those who have served and sacrificed. Today, we come together to remember all those who, more than a century ago, sacrificed so much when the world changed forever; to remember the day that exhausted soldiers shook hands and the guns fell silent along the western front; to remember all the men and women who have served and suffered in conflicts in the 103 years that have followed; and to remember and respect all those who are involved in the armed forces and veterans community, including service personnel, veterans and their families and children.

Service life impacts on families in many ways. Postings take people away from their support networks and spouses away from employment, and children are uprooted from schools. Therefore, it is vital that we remain committed to providing the very best support for them. As a parent whose boys are both in the armed forces, I know that the point about families is really important. One of my sons is in the second battalion of the Royal Regiment of Scotland and, when he went on his first tour of Afghanistan when he was 18, I know the worry that that brought. My other son is in the Royal Electrical and Mechanical Engineers.

Veterans charities and third sector organisations play an essential role in delivering key support, but they have faced many challenges as a result of the pandemic. I am pleased that the Scottish Government not only recognises and addresses those challenges but has strengthened its financial support to allow those vital services to continue to provide help where it is needed. The £1 million armed forces third sector resilience fund is a clear commitment to Scotland’s former military personnel and builds on our proud track record of being there for our serving and military communities and their families.

In addition to setting up the national veterans care network—to ensure parity of access to specialist services and to support improved access to employment for spouses and partners of serving military personnel—the fund will allow Veterans First Point to continue its dynamic work. Developed by veterans for veterans and staffed by an alliance of clinicians and veterans, the service provides accessible, credible and co-ordinated services to veterans and the veteran community.

Veterans First Point has been providing support across the kingdom of Fife since 2016. Early this year, it moved to a new dedicated centre, which was opened by the Cabinet Secretary for Justice and Veterans. The new centre allows greater opportunities to improve the lives of the people of Fife and deliver the services, support and care that are needed in the right places and at the right time.

The centre is one of six Scottish centres that are jointly funded by the Scottish Government. The partnership between Veterans First Point, NHS Fife and Fife Council has had great success in delivering accessible, credible and co-ordinated services to ensure that veterans get the best possible care and support. The partnership was further strengthened in 2017 when Fife Council reaffirmed its support for Fife’s armed forces community with the appointment of an armed forces and veterans community champion. Acting as the elected representative link between the armed forces, veterans, the community and the council, the appointment of Councillor Rod Cavanagh, who works closely with the services, has brought a hugely positive impact locally.

One service user described the centre as

“A ‘haven’ for myself and others, providing a variety of welfare, social and mental health support, together with comradeship and most importantly a cuppa and a catch up, giving us a sense of wellbeing.”

Statistics that have been reported by the group that runs the centre show that 37 per cent of veterans who use the First Point Veterans service have experienced homelessness at some time in their lives, 31 per cent have addresses in the areas of the highest levels of social deprivation in Scotland, and 7.5 per cent are living with friends, are currently homeless or reside in homes of multiple occupancy. Those figures highlight the clear need for continued focus on the key transition areas, such as housing, health, education and families, and the importance of accessible practical and emotional support.

As we continue the work to ensure that all veterans and armed forces personnel have access to suitable and safe housing, to invest in programmes and strategies to aid mental health, to tackle issues of social isolation and loneliness, and to secure and improve employment opportunities so that veterans can access good jobs once their time in the military is over, it is important that we further develop our understanding and awareness of the needs of our veterans and armed forces communities. I am therefore delighted that Scotland’s census on 20 March 2022 will, for the first time, include a question on previous service in the UK armed forces. That information will give us a much better understanding of the veteran community in Scotland, including numbers, location, housing, employment status and other needs, such as healthcare and education.

In addition, the inclusion of a census question on veterans in the Scottish Government’s three primary surveys—the Scottish household survey, the Scottish health survey and the Scottish crime and justice survey—will vastly improve our understanding of the profile, circumstances and needs of veterans in Scotland. Those important steps will ensure that we have access to an increased quality and quantity of data that will best inform policy development and future strategy and enable targeted support.

I offer my thanks and gratitude to members of the armed forces community for their support throughout the pandemic and across every level of our Covid-19 response, from their work alongside the dedicated men and women of the Scottish Ambulance Service to the operation of mobile testing units to help to identify infections and break chains of transmission, as well as their support to ensure that more than 8 million first and second doses of vaccine have been delivered.

Today is a day of great emotion and rightly so. It is time to remember those who served and who are currently serving and to honour the memory of those whom we have lost. We must acknowledge the courage and sacrifice of those who have served our country to achieve the democracy that we enjoy today, and our responsibility to work for the peace that they fought hard to achieve.

I am slightly disappointed that renewables sector manufacturing jobs did not come to us. That is especially true for me because Burntisland Fabrications was in my constituency. The UK Government had a part to play in that.

The measures are also about training people for jobs around the globe. Several of my constituents work in maintenance in the renewables sector. They work in the international market, in places such as Turkey and Italy, and they bring back their income to spend in the local economy.

Opportunities such as those that are being delivered by Fife College, through the national transition training fund, are allowing tradesmen and tradeswomen to retrain in renewables technology installation and maintenance, and to develop the required skills for the transition into green jobs and a new future.

Although it is, of course, important to recognise that although progress has been made, work remains to be done. Efforts must, and will, continue to ensure that the ambition and early success of those programmes are improved on, with the addition of new and exciting opportunities.

The increased investment of £70 million will support local partnerships to provide training and employer recruitment incentives; colleges to deliver around 5,000 more short industry-focussed courses; the continued roll-out of new school co-ordinators through the developing the young workforce programme; a new graduate internship scheme; and increased volunteering capacity and third sector programmes. All those are extremely welcome. Also welcome is the £20 million that is being made available through the second phase of the national transition training fund in 2021-22.

We all know that our young people will have a key role to play as we deliver a better and fairer country and build on our ambition for Scotland. We must learn from what we have done so far and we must continue to work collaboratively to ensure that all young people can realise their full potential.

The global Covid-19 pandemic has had an unprecedented impact, the full scale of which has still to emerge. In 2020, we saw the largest disruption to education and employment in recent history. School closures and more general disruption to learning have impacted greatly on education and the development and wellbeing of children and young people—in particular, those who are vulnerable and marginalised.

That said, I have been privileged to witness some truly astounding displays of resilience, determination and flexibility from young people in my constituency in the past 18 months. I am sure that colleagues have also seen such examples in their constituencies the length and breadth of this country.

The introduction of the national transition training fund, along with the young persons guarantee, by the Scottish Government in 2020 in response to the economic impact of the coronavirus pandemic, was an important commitment to the future of employer-workforce development and to those who most need our support. By bringing together employers, partners and young people, the aim of the young persons guarantee is to connect 16 to 24-year-olds in Scotland to an opportunity, whether that be a job, an apprenticeship, further or higher education, a training programme or volunteering. That was ambitious, progressive and forward looking, so I am delighted that successful progression of that multifaceted programme has already created in excess of 18,000 opportunities for young people.

Alongside that, the national transition training fund seeks to tackle the rise in unemployment in adults aged 25-plus by offering short, sharp training opportunities for people to learn in-demand skills, and by providing adults with tailored support to identify relevant training and employment opportunities, followed by funded training to match their individual needs.

In Fife, I was pleased to see an initiative by Fife College in partnership with the Energy Skills Partnership being warmly received. The initiative is at the heart of delivering invaluable support. A series of fully funded training courses have been made available to individuals aged over 25 who have either faced redundancy or have been made redundant since last March, when the pandemic began.

Fifers who have been adversely affected by the pandemic can access a wide range of courses, including one on the most recent wiring regulation update, an upskilling qualification in electric vehicle charging that is aimed at qualified electricians, and training for tradespeople in the energy, engineering and construction sectors. Health and safety qualifications on offer include the National Examination Board in Occupational Safety and Health’s general certificate, and the Institution of Occupational Safety and Health’s managing safely course.

The purpose and design of the courses are to allow tradespeople to upskill and move into roles in sectors with better potential for future growth and job retention. The renewables industry in Scotland is growing and offers great employment prospects for those who have the required skills and knowledge.

As we promote and explore the potential of Scotland’s renewable energy sources, and renewable energy’s ability to meet our local and national heat, transport and electricity needs, it is clear that a highly skilled workforce will be fundamental to the success of our renewables industry.

Will the member give way?