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Hormone Replacement Therapy (Blood Tests) (PE2012)
Item 3 is consideration of new petitions. For those who might be joining us for the first time this morning to see the progress of a petition, I want to make clear, as I usually do, that, ahead of our consideration, we invite the Scottish Government to comment and the Parliament’s independent research body, SPICe, to look at the petition. That helps to inform the committee so that we can discuss matters in a meaningful way.
The first new petition, PE2012, which was lodged by Angela Hamilton, calls on the Scottish Parliament to urge the Scottish Government to remove the need for follicle-stimulating hormone blood tests in women aged 40 to 45 who are experiencing menopause symptoms before hormone replacement therapy can be prescribed to relieve their symptoms and replenish hormone levels. Angela tells us that she is aware of many women aged 40 to 45 who have all the symptoms of perimenopause, but, because their blood tests do not confirm that, they are dismissed by doctors and left to endure debilitating symptoms that affect all aspects of their lives.
In responding to the petition, the Minister for Public Health and Women’s Health highlights National Institute for Health and Care Excellence guidance that HRT can be offered without the need for a blood test when other symptoms are present but that a blood test may be required to rule out other illnesses. The minister also mentions that NHS Education for Scotland has been commissioned to create a bespoke training package focused on menopause, including perimenopause and menstrual health, and that there is now a specialist menopause service in every mainland national health service health board, with a buddy system in place for island health boards.
Angela has provided a submission that shares the experiences of women with perimenopause symptoms who have sought help from their general practitioners and been left feeling dismissed and let down. Colleagues will remember that that is a common theme in petitions. She also raises concerns about NICE guidelines not being consistently followed by local health boards and a specific concern about the prescription of antidepressants for women with menopause symptoms.
This is a different area of women’s healthcare. Unfortunately, there are similarities in the patient experience. There is an appeal to the committee to see what more we might be able to do about that. I suggest that we keep the petition open in the first instance and write to the Royal College of Obstetricians and Gynaecologists to seek its view on the action called for. Are there any other suggestions?
As you identify, convener, this would appear to be a major problem, and women are being let down. Over the past seven years, and even prior to that, I have had many letters in my mailbag on the issue, and it is fairly moving up the women’s health agenda.
In addition to your suggestions, I suggest that we write to NHS Education for Scotland to seek information on the development of the bespoke training that was mentioned, the framework focused on menopause and how the training is being rolled out to GPs and primary healthcare providers. It seems that the biggest problem that we have is that there is no consistency. Seemingly, women are being dismissed and having to endure and suffer for a number of years. Doing both those things will give us an opportunity to see where we are.
I agree with Mr Stewart. The training programme is not mandatory, but it should be—the issue affects half of our population.
Are we content to proceed with the suggestions that have been made?
Members indicated agreement.
Scottish Qualifications Authority Examinations (Appeals) (PE2014)
The second of the three new petitions that we are considering this morning is PE2014, on reverting to the appeals system used in 2022 for Scottish Qualifications Authority exams. The petition, which was lodged by Elliott Hepburn on behalf of Moffat academy students, calls on the Scottish Government to implement a revised SQA appeals process that takes into account evidence of pupils’ academic performance throughout the year, particularly prelim results.
The SPICe briefing states that the Scottish Government intends to replace the SQA and that it is expected that a bill will be introduced later this year for that purpose. The briefing outlines the appeals system used in 2022 and notes that the SQA described the 2022 appeals process as “an emergency response” to the Covid-19 disruption.
The SQA conducted a review of the certification and appeals processes, which included a consultation with learners, teachers, parents and others. The review found several issues, including increased workload for teachers and perceptions of unfairness in the process. All MSPs have probably received representations in relation to that.
Views on the approach for the 2023 appeals were mixed. The SQA appeals process for 2023 will involve a marking review by a senior marker that will focus on the correctness and consistency of the initial marking, and it will no longer consider alternative assessment evidence. The process is free, and individuals can appeal directly to the SQA.
The Cabinet Secretary for Education and Skills has responded to the petition. She has stated that the SQA is responsible for its operational decisions, including its approach to the appeals process for 2023. Her response highlights the examination exceptional circumstances consideration service, which supports pupils who are unable to attend their exams due to reasons that are outwith their control or whose performance may have been affected by personal circumstances.
I am struck by the fact that the appeals process now is simply that a senior marker focuses on the correctness and consistency of the initial marking and no longer considers alternative assessment evidence. I have to say that I thought that that was very often the principal thing that many schools submitted on behalf of pupils. It was a case of presenting evidence to suggest that the individual had done better than the process had shown. Notwithstanding that, that is what is happening in 2023.
I imagine that colleagues elsewhere who are intimately concerned with these issues will have debated them thoroughly. We are in a situation in which the Scottish Government is, I think, indicating that a forthcoming bill will alter the situation, so I am not sure that there is terribly much more that we can do at this stage.
I suppose that it is relatively early in the life of the petition. Given the point that you have made, convener, it seems that, on the ground of equity, in some cases, looking at other evidence, such as continuous assessment and the progress that a pupil has made over the course of the period to which the examinations relate, would be helpful. We are all conscious that, for every pupil, the results of their examinations for qualifications can determine their future. There is a lot at stake, and it is a huge moment for those children and their families.
I noticed that the Cabinet Secretary for Education and Skills stated:
“Alternative evidence will not be needed for the Appeals service this year.”
That is a statement and an assertion. I wonder whether we might invite her to flesh that out and state with a bit more detail why that view should now be the case whereas previously it was not. Are there not circumstances, particularly where there are elements of difficulty, problems or trouble in the life of a child, such as an interruption to their education through ill health or other issues of that ilk, that may well merit the consideration of alternative evidence?
It may be that the system provides for that separately—I do not know; I am not an expert on it at all. However, I am sure that, over the years, we have all had cases in which the outcome of an examination has been very much out of line with the prediction and that, in turn, has led to lots of soul searching and problems in individual cases.
Given the importance of the issue to children in general, I would not want to close the petition now. I hope that I am putting this clearly, but I would rather seek from the cabinet secretary a much greater explication of why it is that alternative evidence would not appear to be relevant this year when, in principle, prima facie, there are surely many circumstances in which the consideration of alternative evidence is not only appropriate but essential.
Yes, I am content that we should do that. I wonder whether we might also ask the SQA the very same question. We would be interested to know the basis on which it has concluded that simply the academic review of the correctness of the marking is sufficient.
The exams diet is coming to a conclusion, and results will be forthcoming in the next few months, so the issue will become a very live one for a considerable number of people. It would be interesting for us to take the petition forward at least to that extent, in order to have greater clarity on why that will be the case. We might ask the SQA what practical implication it believes the approach will have in relation to the outcome of appeals this year in comparison with previous years.
Are we content to do that?
Members indicated agreement.
The other question is whether the final report will be published.
I am sorry, Mr Choudhury, but what report is that?
On the independent reviews.
We will ask the Scottish Government about that.
Yes.
We will discern what that might lead to. We will check.
Prisoners’ Right to Vote (PE2015)
The final new petition that we will consider today is PE2015. The petition, which was lodged by Irene Krsmanovic, calls on the Scottish Parliament to urge the Scottish Government to extend the right to vote in Scottish local government and Scottish Parliament elections to all prisoners held in Scottish prisons.
On 4 May 2023, ministers laid a copy of the report on the review of the operation of section 5 of the Scottish Elections (Franchise and Representation) Act 2020. The report concludes by stating:
“The Scottish Government’s position remains that it is neither appropriate, nor necessary to ensure compliance with the European Convention on Human Rights, to enfranchise all prisoners, but that the correct balance is found in extending voting rights to those prisoners serving shorter sentences.”
It states clearly:
“The Scottish Government does not plan to revisit the 12-month threshold for prisoner voting.”
That is a fairly express direction.
Do colleagues have any suggestions on how we might proceed with the petition?
The Scottish Government has replied very clearly and at considerable length, and the issue has been looked at considerably before. It seems to me that there is very little, if any, prospect of any change.
From work that I have done over the years, some people take the view that those who are subject to long-term imprisonment by virtue of having committed crimes for which they are required to be incarcerated and have their liberty withdrawn should not enjoy the benefits of freedom, which include the right to vote. I make that comment for the record because many people have expressed that view to me very strongly over the years.
That has also been very much at the heart of the debate in Parliament.
Given the express direction that we have received that the Scottish Government has no plans to revisit the 12-month threshold, I propose that, under rule 15.7 of the standing orders, we close the petition on the basis that the Scottish Government’s position remains that
“it is neither appropriate, nor necessary to ensure compliance with the European Convention on Human Rights, to enfranchise all prisoners, but that the correct balance is found in extending voting rights to those prisoners serving shorter sentences.”
Are we content to do that?
Members indicated agreement.
I thank all of you very much.
The next meeting of the committee will be on Wednesday 14 June 2023, when we will take evidence from the Lord Advocate among others.
That concludes the public part of this morning’s meeting. We will now move into private session.
11:03 Meeting continued in private until 11:47.Previous
Continued Petitions