Vaginal Mesh Implants: Compensation
(3 months, 2 weeks ago)
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Baroness Cumberlege
To ask His Majesty’s Government what progress they have made in ensuring that those who have suffered complications following vaginal mesh implants receive financial compensation.
Baroness Cumberlege (Con)
My Lords, I am grateful to all noble Lords who have decided to speak in this short debate. I thank them for taking part and look forward to their contributions, as well as to the Minister’s reply. This is a subject that I feel very passionate about, and I welcome any support that your Lordships choose to give.
I was delighted to read that 140 mesh-harmed patients have received some redress, for it is long overdue. However, there are thousands of others harmed by mesh, still suffering, who are not included in the settlement. It is not just about mesh. In our report First Do No Harm, we recommended that those harmed by vaginal mesh, but also by the use of sodium valproate and by Primodos, should also receive redress.
It took me and my team two and half years to travel the country and gather the evidence, in the course of which we heard so many terrible stories of women who had been avoidably harmed. I have shared many of these stories with noble Lords during previous debates. Our report was published in July 2020, and I am sorry to say that I am still receiving emails today from women who are suffering so dreadfully, some of whom have now been diagnosed with post-traumatic stress disorder and are not being offered the support that they need. I have listened to women who have had to borrow money to have failed mesh implants removed privately and are now in considerable debt. Women who were prescribed sodium valproate and Primodos have children, many now adults, who will never be able to live independent lives after being exposed to the harm done by these drugs. These mothers bear great sadness from mis-prescribing. However, I am delighted to see that the current data indicates that there is almost no prescribing of sodium valproate during pregnancy. I hope that this means an end to ongoing harm, but there are so many who have been harmed and still need our help.
It is important to recognise that there was a failure on the part of the NHS to stop doctors prescribing sodium valproate immediately that the risks were known. I believe that the NHS must bear some of the responsibility for this. The same goes for those who were given Primodos.
The Hughes report, published in February 2024, had 10 recommendations, the first being that the Government had a responsibility to create an ex-gratia redress scheme. I believe that scheme needs to be put in place now, with interim payments being made as soon as possible. I was delighted to see how quickly the system was able to respond to the Infected Blood Inquiry. I therefore fail to see why these avoidably harmed people should be made to wait any longer.
Can the Minister say whether the Government have reflected on the role of the manufacturers of these medical interventions? The Government should shoulder the responsibility for redress and then pursue the manufacturers for their share of these catastrophes. I am pleased to see that the subject of redress is on the agenda of the noble Baroness, Lady Merron, and that she met the Patient Safety Commissioner at the beginning of August.
I am determined that all those affected by mesh, and the many others whose lives have been shattered by the effects of sodium valproate and Primodos, should receive the redress that they so richly deserve. These people have suffered enough; surely we should not be forcing them down such an adversarial route as taking action against the manufacturers when the damage done is so clear. The great majority of women cannot afford to bring lawsuits against the mighty drug companies; too many of them fail, and this was not their fault. They are not being offered the support they need.
Baroness Sugg (Con)
My Lords, I am grateful to my noble friend Lady Cumberlege for her significant work on highlighting the issues around vaginal mesh implants that have impacted at least 10,000 women, probably many more, and for her continued efforts to make some progress, in particular in tabling this Question for Short Debate. The evidence that your Lordships will have seen of women reporting severe complications from mesh implants, including chronic pain, infections, organ perforation and, in some cases, permanent disability, underlines how crucial it was that her work led to the pause on the use of vaginally inserted surgical mesh in 2018.
As my noble friend has set out, establishing a compensation scheme for women affected was recommended by her independent review First Do No Harm in 2020 and that was echoed by the Patient Safety Commissioner, Dr Henrietta Hughes, in her report in February this year. It has been a long-running concern and all the while many women are continuing to suffer the consequences of this treatment. I welcome the positive steps that were made by the previous Government, including the appointment of a Patient Safety Commissioner, but there remain many issues that, sadly, they were not able to resolve. I know that the Minister, as Minister for Patient Safety, Women’s Health and Mental Health, must have an overflowing in-tray, but I look forward to her response today in the hope that we will hear clear plans for progress.
As we heard, following a group claim, the financial settlement in August from three manufacturers of mesh implants was welcome news, but there is a clear argument that more needs to be done. Compensation is a tangible way to acknowledge the suffering of women and provide the support that they need to continue to live their lives. While that case in August was a success, and some women have pursued legal action individually, these cases have often been long, costly and emotionally draining. Many women do not have the financial resources or the legal knowledge to take on large medical corporations or hospitals.
In my research I was pleased to see that information on compensation was readily available on the NHS website, but it is clear that the existing approach is inconsistent and fragmented. Hundreds of women were prevented from making a claim due to the strict 10-year time limit that is in force from the date that the product was manufactured. I hope that the Government will consider looking at that. A national government-backed compensation fund would ensure a uniform and fair approach to dealing with claims, ensuring that all affected women have a fair chance of receiving the financial redress that they deserve without being forced into these lengthy legal battles.
I appreciate the complexities and the expense here and, of course, the importance of spending limited resources on improving health services. There are options for how compensation can be delivered and how it can be funded, and I know that other noble Lords will address that. Of course, financial compensation should go hand in hand with strengthening the regulation of medical devices and improving patient safety.
I pay tribute to the campaigners who have worked so hard to highlight this treatment over the years—the individuals, the women’s health organisations, and in particular the campaign group Sling The Mesh. I know that this work can be frustrating, exhausting and often thankless, but thanks to them, this issue, which can sometimes be seen as taboo, has been highlighted. We have seen some progress and will continue to push for more and I hope that they realise the difference that they are making.
In addition to the compensation scheme, Sling The Mesh is calling for a number of actions, from raising awareness of implant risk to tougher approval systems, regulations and oversight to protect public safety. In her response, I hope the Minister will also find time to comment on its calls for better databases to track the long-term harm of medical devices, which would help spot trends of harm, and for a sunshine payment Bill to improve transparency in the UK health sector by ensuring that the pharmaceutical and medical device industries declare all the money given to doctors, researchers, lobby groups, health charities, surgeon societies and teaching hospitals. That is not to stop that money being invested, just to be clear and transparent about what is happening.
I support my noble friend Lady Cumberlege’s call for action on implementing the recommendations in her First Do No Harm report and the more recent Hughes report. I look forward to the Minister’s response.
Baroness Berridge (Con)
My Lords, I too thank the noble Baroness for securing this debate and the panel for its review and tenacious follow-up of remaining recommendations, particularly recommendations 3 and 4 on financial compensation.
I am a member of your Lordships’ Select Committee on the Inquiries Act. With recent reports from statutory public inquiries on Grenfell and Covid-19, non-statutory inquiries such as this can be overlooked. While Grenfell and Covid-19 clearly needed the statutory model, it often comes with unhelpful TV images of banks of lawyers, looking like a courtroom. I do not want to pre-empt the publication of our report in the next few weeks, but it seems that both the noble Baroness and Bishop James Jones, who led the non-statutory Hillsborough review, managed to obtain the trust of victims’ groups, which is essential to that model. Along with my noble friend Lady Sugg, I too applaud those groups who were maturely able to see the advantages and merit of the non-statutory process and, I hope, found it less arduous than the courtroom-type hearings.
A number of recent inquiries—into the Post Office, Grenfell and infected blood—have led to the establishment of compensation schemes. Given the systemic failures outlined so clearly in this review and the avoidable harm caused, I would be grateful if the Minister could outline fully what distinguishes this request from those of the other schemes, if His Majesty’s Government’s position has changed since 4 July. Now that His Majesty’s Government are overseeing a number of these schemes, I hope there is co-ordination over the levels of compensation given, for instance over the costs of care in the home, so that there are comparable tariffs across the schemes. But the request for a redress agency, and the three separate schemes in advance of this, sits in a landscape of similar medical schemes—on variant CJD, vaccine damage and thalidomide, to name just a few. Why are these three schemes not just as worthy as those other medical schemes? I hope the Minister can justify this distinction.
In relation to vaginal mesh, will His Majesty’s Government not have had to consider how to justify on objective, reasonable grounds a decision that looks, prima facie, like indirect discrimination against women? I suspect that, more tellingly, the reason will be to do with the costs. As the review outlines, in other countries big pharmaceutical companies and the suppliers of devices contribute. Will the Minister undertake to meet these companies and ask them to bring a full assessment of the costs to them of litigation, both successful and unsuccessful? Could she also prepare a full assessment of the cost to the public purse of leaving this just to litigation?
By a full assessment I mean, inter alia, the legal costs and compensation paid out by NHS trusts in successful claims, the costs not recovered from the other side even in successful cases, the often unrecoverable lost time of medical staff having to attend court and prepare witness statements, and the costs of court time and of class actions being brought against the Secretary of State. Even if the HPT class action has been discontinued, what was the civil servant time, ministerial time, and Government Legal Department time involved in the case—and the cost to the public purse of debates and Questions in Parliament, including the private office time preparing the Minister and sitting in the Box? Could the companies and public purse assessments be compared to the costs of running a scheme similar to those I have outlined?
There are also non-financial costs borne by the victims and society. The awful testimonies of the debilitating effects of surgery are harrowing—I am so grateful that my loved ones have always had amazing NHS care. But perhaps there are women struggling with their disabilities who think, “If I had a bit extra to buy some help, I could get back to work, maybe just part-time”, or women who are managing their lives and thinking, “I could do some work, but now I have to take on litigation. That is really the final straw”.
The country needs as many people as possible in the workforce. Can the noble Baroness request any relevant information that the DWP holds in relation to these women? For instance, how many are in that situation? Would the noble Baroness be content for women who might be listening today to write to her to outline such situations—and, of course, add the civil servant cost of replying to that correspondence to the full assessment I outlined above?
Baroness Bennett of Manor Castle (GP)
My Lords, I join what I am sure will be a chorus of praise for the noble Baroness, Lady Cumberlege, both for securing this debate and for her brilliant work over many years on these issues, particularly that of vaginal mesh. I started working with the noble Baroness during the passage of the Medicines and Medical Devices Act. If we think back, many of the things the noble Baroness was pushing for have since been achieved. However, today we are addressing some of the things that still desperately need to be dealt with.
One of the noble Baroness’s achievements was the appointment of a Patient Safety Commissioner. Dr Henrietta Hughes is doing a brilliant job and, as has already been referred to, brought out a report in February urging that the compensation schemes for both sodium valproate and vaginal mesh be brought in as soon as possible. I will just do a little bit of advertising for Dr Hughes. She still has a consultation open on the principles of better patient safety and there is one more day for a chance to respond to that, if anyone would like to do so. It is such important work that it deserves to be highlighted.
I want to put this in the broader context of where we are now. We seem to be hearing weekly about a cascade of official and government failures: the Grenfell Tower tragedy, the Horizon scandal, the infected blood disaster and the Hillsborough tragedy. Obviously, we have a new Government and they do not bear direct responsibility for any of those circumstances, but it presents them with an enormous challenge: the challenge to respond sensitively, appropriately and at sufficient speed to do everything possible to ameliorate the circumstances of the victims.
These cases also throw up the challenge of acknowledging that the talk about “cutting red tape” that we have been hearing for so many years is a deeply dangerous approach. We need rules, regulations and controls to keep us safe. As the noble Baroness, Lady Sugg, drew attention to, we need to keep under control what those who make profits are doing to increase them.
We also need to listen to the people who are adversely affected when things start to go wrong. The reality is that so often—we know this is particularly the case with female patients—for years and years people said, “There’s a problem here”, and officialdom said, “No, nothing to see here; it’s all fine”, sometimes even saying that it was all in their head. The Government really need to stamp on that tendency.
I understand that it is early days for the new Government, but I have noticed—this is not directed at the Minister in particular, but at the Government more generally—that when I put down Written Questions and get the Answers, I seem to get essentially the same Answers as I got a few months ago under the previous Government. I urge Ministers, both individually and collectively, to please be curious and challenging. If an Answer was given six or 12 months, or two years, ago, ask if it is still the right one, if indeed it was the right one in the first place.
I have some specific points. A number of people referred to the recent settlement in the court case against the manufacturers. One of the issues that raised was the fact that hundreds of women were unable to make a claim due to a strict 10-year time limit from the date that the product was manufactured. Are the Government planning to do something about that?
I join the noble Baroness, Lady Sugg, in paying great tribute to Sling The Mesh and other similar campaigners. Is the Minister ensuring that her door is open not only to that group but to many other campaigning groups? It would be great to hear that that is the case.
A further point is that Dr Hughes recommended at least an interim payment scheme for vaginal mesh and sodium valproate. The question everyone is asking is, when are we going to hear about that?
The Independent reports that June Dunne, a 64 year-old, has been waiting for corrective surgery since 2019. What are the waiting lists now like?
Finally, the official government figures say that there are 127,000 mesh implants. The campaigners say there may have been many more. Are the Government looking into making sure that they have the proper records of all people affected?
Lord Mancroft (Con)
My Lords, I join other noble Lords in congratulating my noble friend Lady Cumberlege on securing this short debate on this important and increasingly troubling subject. I also want to take this opportunity to recognise the extraordinary work my noble friend has done, first in making her report and secondly, for following it up in so many ways.
One of the features of this terrible saga that has horrified me most is the way in which the health service has responded. Too many women, in seeking help, have been met not with sympathy and care but with indifference, denial, defensiveness and arrogance from those whom they believed would help them.
This is not my area of expertise, but I have been drawn into it by the experience of someone very close to my family who has suffered intolerably, has been treated appallingly when she should have been helped and has had to fight to have her health issues addressed. Following a referral in November 2014, she underwent an operation to insert mesh in December 2016. Subsequently, the mesh from her bowel travelled from her rectum to her fallopian tubes and ovaries. She has had countless infections and suffered ongoing severe discomfort and pain.
She has been pushed from pillar to post and seen four different specialists in four different hospitals. One urologist at the Royal United Hospital in Bath declined to examine her physically, as apparently, he could see simply by looking at her that she was fine. He categorically said that she did not have bad mesh. Had he taken the trouble to undertake even a cursory examination, he would have found that the mesh had perforated her vaginal wall, but he did not bother. She subsequently had to endure four operations to remove the mesh, ending with a stoma, which has recently been reversed.
Her current consultant has described hers as one of the worst cases of mesh damage she has ever seen. As far back as March 2021, this woman received a letter from the medical director of the North Bristol NHS Trust, in which he described her care and went on to write:
“I am very sorry to tell you these factors suggest the LVMR”,
the operation she underwent,
“was not clinically indicated at the time of the surgery in December 2016. … Undergoing an operation that may not have been required … is considered harmful”.
He went on to say:
“I sincerely apologise on behalf of the North Bristol NHS Trust that your surgery was not clinically indicated. This is unacceptable and we are taking this situation extremely seriously”.
Apart from the physical pain and suffering, there are practical consequences to consider. She was a fit, active, extremely competent and positive woman with a full family life and a thriving career at the top of her profession. Her condition was so debilitating that she was forced to give up her job. She lost her career and has been unable to work since 2016. The financial consequences are that she has lost her home, her savings, and now lives on disability benefits. She therefore has no credit rating, which means that the landlords she relies upon regard her as an undesirable tenant. She is unlikely ever again to have a partner or a personal relationship. That, I am sure your Lordships will agree, is a pretty horrific list of life-changing consequences.
As the trust conceded in its letter in March 2021, three years ago,
“This is unacceptable and we are taking this situation extremely seriously”.
I do not know exactly what “taking this situation extremely seriously” means, but after a period of legal wrangling, this woman has been offered compensation of £25,000, less costs of £2,500. That is compensation for pain, suffering, five operations over eight years, loss of home and career and substantial and catastrophic financial loss, leading to a life on benefits. No reasonable person could possibly conclude that this is adequate redress.
We spent the summer in this House debating the compensation to be paid to the victims of the infected blood scandal, and we are all familiar with the appalling injustices of the Post Office scandal and the levels of compensation those victims are rightly due to receive. The Government said they had no plans to set up a compensation scheme for the victims of mesh implants, but in light of the damage that has been caused to what could be as many as 25,000 women—it may be fewer, it may be more; we are going to hear from the Minister—and with the examples of the infected blood scandal and the Post Office scandal, I hope the Minister will tell us that the Government will revisit the decision not to set up a compensation scheme and will be able to tell us today how they plan to compensate these women, and within what timeframe.
Baroness Wyld (Con)
My Lords, in preparing for this debate, I went back to First Do No Harm, the original report from my noble friend Lady Cumberlege. I had read it before and I pushed the previous Government to up the pace on the appointment of the Patient Safety Commissioner because that dragged, but we got there in the end. I found the report’s contents no less shocking than they had been on the first reading. If anything, I found the testimonies of those living with harm from mesh even more upsetting this time, because these women and their families have been in limbo. I give my strong support to the call for redress from my noble friend Lady Cumberlege, and pay tribute to her work and that of the excellent Patient Safety Commissioner, Henrietta Hughes.
This was systemic failure, and we have heard a pattern of women not being listened to when they go for help, of being dismissed. Someone who gave evidence to the Hughes report said:
“I am a woman of a certain age, I’m slightly overweight, I’m a mum, not working, so I’m not given credibility”.
Let us remember exactly what happened. First Do No Harm describes women reporting excruciating chronic pain that feels like razors inside their body, damage to organs, the loss of mobility and sex life, and depression and suicidal thoughts. The report found:
“Some clinicians’ reactions ranged from ‘it’s all in your head’ to ‘these are women’s issues’ or ‘it’s that time of life’”.
Despite all this—or because of it—First Do No Harm sets out the burden of guilt felt by many women affected by mesh; risks they did not know about at the time they consented to their procedures; procedures they did not always need to have, given the degree of their incontinence or prolapse condition. As the report so sensitively said to the women at the time,
“it was not your fault”.
We should say that over and again to all the women who bravely came forward and exposed this scandal and had to talk about their most intimate and painful experiences. We should thank them.
There are three main things I want the Minister to comment on today. I would like her to set out, as others have said, the timetable for a response to the redress recommendations. I have witnessed her excellent command of her brief in opposition and now as a Minister—I will get told off for being too nice—and I have no doubt that she will put patients at the heart of her own work. Naturally, there has been some light-hearted banter in her first few weeks about timelines, and I am sure we have all been guilty of being creative with seasons and deciding when autumn might start and end, but in this context none of us can fall into that trap. It is perfectly correct for the new ministerial team to take the time properly to review this, but it is my job to push on behalf of the victims. I will not play politics, but I will push the Minister in that spirit. I have read the redress report in full, and while it acknowledges a range of complexities, it also has a range of very well-developed options, so I hope she will be able to set out a timetable.
I also want to talk about future services. The previous Government are to be commended for progress on the specialist vaginal mesh centres, but the Minister will want to focus on continuous improvement and will note that satisfaction levels are not consistent. Can she comment on what steps she will take to ensure that patient experience is captured? More widely, will she ensure that she pushes for the highest standards of maternity care for women, which, specifically relevant to this issue, must include postnatal pelvic floor rehabilitation? My noble friend’s report recommended the French model and access to specialist pelvic floor physiotherapy as soon as required. These are not niche healthcare issues; they go to the heart of how we as a society allow women to be treated at one of the most major events in their lives.
Lastly, I would like the Minister’s reflections on the experience of so many women being dismissed and not listened to. One quote in particular stuck with me:
“They would tell you there is nothing wrong with you and that you are just a hysterical woman”.
I was not surprised by that and many similar comments. Like many millions of women up and down the country, I have had excellent care in the NHS, but these testimonies reminded me powerfully of my own experience of injury as a result of childbirth. Luckily for me, it was nowhere near the scale of those suffered by these women—I would not pretend it was—and I recovered, but I was told that I could not be in any pain when I had never felt any pain like it. I was a fit and healthy young woman but I asked my husband if he could speak to someone and explain that I really was in pain because I thought they might listen to a man. I am sorry to resort to anecdote, but one hears this over and again.
I have run out of time, but I push the Minister to respond on these issues.
Baroness Brinton (LD)
My Lords, I thank the noble Baroness, Lady Cumberlege, for securing this debate and for her unstinting commitment to ensuring that victims of vaginal mesh, sodium valproate, Primodos and other medical problems and scandals continue to have their voices heard. Her report for the last Government, First Do No Harm, published five years ago now, was extraordinary and impossible to ignore, and those of its recommendations that have been implemented have started to change the way that support for patient victims is delivered. I hope—and I will come back to this later—that it is also starting the change in culture that we need to see inside the NHS. We all love our NHS and sometimes it can be hard to admit that some of the senior doctors within it are not the best people to support patients and ensure that patients feel they are getting the right help they need when things go wrong.
I am particularly pleased about the role of the Patient Safety Commissioner, which I remember us debating in 2020. Dr Henrietta Hughes is making a brilliant start, and I thank the noble Baroness, Lady Bennett, for the comments that she made about that. However, I repeat a question I asked when the post was first set up: is the office of the Patient Safety Commissioner getting enough resources to do the job that she so clearly has to? I have no doubt that she is a very able woman but I am concerned about the volume that her office is dealing with.
I pay tribute to the victims of not just vaginal mesh but sodium valproate and Primodos, who have continued to tell their stories. We know that repeatedly telling your story is painful too, but we need to hear them. I thank the noble Baronesses, Lady Sugg and Lady Wyld, and the noble Lord, Lord Mancroft, who told his friend’s personal story, all of whom reminded us of how dreadful the position is. While the difference between these problems and the infected blood scandal is that we are not seeing fatalities, we underestimate the long-term life changes that all these victims have faced, some of them the children of those who were fed medicines during pregnancy, not one of them at fault at all in any way.
There is one voice that we have not heard: that of the NHS whistleblowers. I shall mention one person of whom I had not been aware until there was an article about her in the British Medical Journal earlier this year. Sohier Elneil is a urogynaecological surgeon and an expert in women’s pain. She is the founder of the first NHS vaginal mesh removal centre and a tireless champion of supporting the victims and sorting out the problems. I was shocked to read that, after she started talking about this issue in 2005, she was excluded from events by doctors, then personally attacked and reported to the General Medical Council multiple times, mainly by fellow consultants—those who were the biggest implanters of mesh. She said:
“I was very upset. It felt like a war. They were saying I was removing mesh and harming patients unnecessarily”.
Professor Elneil continued with her campaign, and I have to say that her story did not stop there. She also uncovered some of the doctors being encouraged with financial incentives from the providers of vaginal mesh. It is good that both Henrietta Hughes’ report and that of the noble Baroness, Lady Cumberlege, said that things needed to become transparent. The last Government refused to allow those records to go on to the register at the GMC but they should be on that register, not kept elsewhere, because if a member of the public wants to find something out, the GMC will be the first place they go. Can the Minister say whether that will happen?
Others have already talked about the time limit. I shall make brief mention of the issue relayed by the noble Baroness, Lady Berridge, about the type of inquiry and the ability to make effective reports. In my portfolio I have covered virtually all these inquiries over the past 18 months, and I have heard every single group of victims say that another inquiry has provided the right response for them. None of the inquiries has yet been resolved—even those, such as the Post Office Horizon inquiry and the infected blood inquiry, which we think have been resolved. If the Government will not revisit the deadline, they will be dragged kicking and screaming into a higher level of inquiry as more cases are revealed. Please can the Government, preferably via the Cabinet Office, bring together the learning from all these inquiries about what goes wrong in government to make these things happen?
Lord Evans of Rainow (Con)
My Lords, this has been an excellent debate. I thank my noble friends Lady Sugg, Lady Berridge and Lady Wyld, the noble Baronesses, Lady Bennett and Lady Brinton, and my noble friend Lord Mancroft, who all made very powerful points in their speeches. I congratulate my noble friend Lady Cumberlege on securing this important debate. I pay tribute to her work on this issue over many years and her leadership on the First Do No Harm report of the Independent Medicines and Medical Devices Safety Review, as well as to her team of Sir Cyril Chantler, Simon Whale and Dr Valerie Brasse, and the patient groups.
Simply put, victims have suffered as a result of two medications and one medical device. The medications are: hormone pregnancy tests such as Primodos, which were later withdrawn due to concerns over birth defects and miscarriages; and sodium valproate, the anti-epileptic drug which was later found to cause physical malformations, autism and developmental delay in children after being taken by pregnant mothers. The medical device is the pelvic mesh implants which were used to repair pelvic organ prolapse and address urinary incontinence. Their use has been linked to crippling, life-changing complications.
My noble friend Lord Kamall tells me that when he was a Minister in the department he was horrified that progress for helping the poor women who had suffered from these two medications and one medical device was far too slow. Fortunately, the then Minister, Maria Caulfield, asked the Patient Safety Commissioner to explain what the Government should do to meet the needs of individual patients who had suffered these avoidable harms.
In government, we completed four of the initial recommendations in the report of my noble friend Lady Cumberlege, and another three were in progress in March 2024. The most important of these is the setting up of nine specialist centres which can provide the support needed in terms not just of redress surgically or treatment-wise but of the support that people need to help them cope with the issues. We expect the Government to deliver financial compensation for those affected by these treatments as soon as possible.
My noble friend Lady Cumberlege has said that after “first do no harm” should come
“and now do some good”.
As other noble Lords have referenced, the Patient Safety Commissioner’s report, published earlier this year, states that
“there is a clear case for redress based on the systemic healthcare and regulatory failures”
for women and children affected by the issues in England.
There is agreement across this House that Governments of all political colours have been too slow in delivering justice and financial compensation to victims of scandals in the past. We need mention only the Post Office Horizon scandal to remind ourselves of the importance of delivering justice to those who have been wronged. When these problems come to light, it is essential that we help the victims of these scandals as quickly as possible. Too many people suffered over the Horizon scandal and too many people and families suffered due to delays in helping victims of the infected blood scandal. Likewise, too many women, children and families have suffered as a result of women being prescribed Primodos, sodium valproate and pelvic mesh implants. The Government must act urgently to help those women who have suffered, so will the Minister give an undertaking today to make this a priority?
On 23 July, my noble friend Lord Kamall submitted a Written Question to the Minister asking when the Government intend to respond to the Hughes report and when they anticipate making the first payments under the recommended redress scheme. I thank the Minister for replying within three days, saying:
“The Government is considering the recommendations of The Hughes Report, and to prevent future harm, the Medicines and Healthcare products Regulatory Agency, NHS England, and others have taken action to strengthen oversight of valproate prescribing and mesh procedures”.
My noble friend Lord Kamall followed up on 29 July to ask the Government
“by which date they expect to issue a response to the Hughes Report, and whether they plan to offer compensation as the report recommends”.
Again, the Minister responded promptly with the Answer:
“The government is carefully considering the valuable work done by the Hughes Report and will respond in due course”.
We recognise that the Government are relatively new and need time to get up to speed, but can the Minister be more specific at this stage in answering the timescale question?
My noble friend Lord Kamall tells me that when he was a Minister there were two phrases in briefings that he was not fond of. One was “at pace” and the other was “in due course”. Can the Minister give noble Lords an approximate timescale for a decision—for example, by the end of 2024, mid-2025 or indeed the end of 2025? If not, can she enlighten noble Lords on when she will be able to give an estimate of the date by which she will know the date of the Government’s response? It is vital that they give some certainty to noble Lords—and, more importantly, to the many women and children who have suffered for far too long physically, mentally and economically. I know that the noble Baroness is a formidable operator as a Minister and, to speak personally, she has our full support on this side of the House.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron)
My Lords, I congratulate the noble Baroness, Lady Cumberlege, on securing this important debate. I compliment her on getting it early in the time of a new Government, which will help me to do the job that I will need to do. I also thank noble Lords for their powerful words on this important topic. To borrow some of the words used, anybody sitting here will understand that we are talking about something so harrowing, so shocking and so distressing that it would be hard not to be moved by what has been heard both today in the Chamber and, as the noble Baroness, Lady Wyld, said, when one reflects back on the report.
I give the assurance that after the debate I will reflect closely on all the points raised, and I will seek to cover a number of them as best I can now. The noble Lord, Lord Evans, obviously and rightly invites me to set out a timetable—as have many other noble Lords. I know that your Lordships’ House understands the newness of the Government and the need to get it right. While saying that, I also hope that noble Lords will appreciate that I understand that this has been going on for a very long time under the previous Government and that many individuals, and their families and friends, are looking for resolution.
As we have heard, lives have been irrevocably changed by vaginal mesh implants, and we have to ensure that lessons are learned. This Government will endeavour to build a system that listens—particularly, I might add, to women, whose voices have not been heard, which is why we find ourselves in many of the situations we are considering—and a system that hears properly and will act with speed, compassion and proportionality.
The noble Lord, Lord Mancroft, brought into the Chamber a very specific case, about which I was sorry to hear. I am sure that we are all sorry to know that the woman to whom the noble Lord referred is far from alone. I repeat to all those who have been affected that, as the report said,
“it was not your fault”.
We deliberately will put patient safety at the heart of improving our health and social care system. I convey my sympathy to everyone who has suffered complications following vaginal mesh implants. I am committed to ensuring that we learn from these tragic incidents. The Independent Medicines and Medical Devices Safety Review’s report, which was published in 2020 and chaired by the noble Baroness, Lady Cumberlege, was pioneering in its impact. The stories and realities are as deeply affecting today as they were when the noble Baroness commenced her work. I thank her, as many other noble Lords have done, for her work. She has been and is a key advocate for women’s health, but particularly for those who are experiencing complications and after-effects that they should not be enduring.
The Patient Safety Commissioner has continued this work. I thank her for the work she did on the Hughes report, published in February. Having met with Dr Hughes soon after my appointment, I very much look forward to working closely with her on a number of issues, including this one, to improve patient safety.
I hope that noble Lords will appreciate that in my comments I am reflecting on the situation as it stands. As we have heard, when used for pelvic organ prolapse and for stress urinary incontinence, vaginal mesh can be incredibly damaging for those suffering from complications, which is why it has been paused in these instances. NHS England has now established nine specialist mesh centres across England. The aim is to ensure that women in every region who have complications can get the right support and care. Each mesh centre is led by a multidisciplinary team to ensure that patients get access to the specialist care and treatment that they need, including pain management and psychological support as well as mesh removal surgery where that is appropriate.
The noble Baroness, Lady Sugg, and other noble Lords rightly raised the powerful Sling The Mesh campaign for an improved database. I associate myself with the comments of appreciation for that campaign group and many others who have campaigned in an area where others have feared to tread. I certainly share the desire of the noble Baroness, Lady Sugg, to ensure that there is proper data collection on device safety, which is why mesh centres will improve recording and monitoring of patient outcomes and experience by submitting procedural data to the pelvic floor registry. In this vein, through the National Institute for Health and Care Research a £1.56 million study has been commissioned to develop the patient-reported outcome measure for prolapse, incontinence and mesh complication surgery. In the longer term, this measure will be integrated into the pelvic floor registry.
The review by the noble Baroness, Lady Cumberlege, also looked into the matter of sodium valproate, and rightly so. I am glad to report that since then a number of actions have been taken or are under way to ensure that valproate is prescribed only when absolutely clinically appropriate. Alongside that, I am encouraged that the number of women who are still being prescribed it has reduced significantly following the MHRA’s introduction of the pregnancy prevention programme.
While significant progress may have been made in the areas I have outlined, the core question posed by this debate is about progress in ensuring that those suffering complications receive financial compensation for their suffering. This is an absolutely key question. This and the sodium valproate issue, which was reviewed in the Hughes report, are extremely complex and sensitive, as I know noble Lords appreciate. I want to reassure your Lordships’ House that I am considering this and the recommendations of the Hughes report.
As I mentioned at the outset, as a new Government, we need to carefully consider the report before coming to a decision. The recommendations will be discussed with colleagues across government, and lessons will be learned from other instances where patient safety has been impacted, as noble Lords have asked of me. As part of this, and in answer to some of the questions by the noble Baroness, Lady Bennett, and others, I will ensure that the number of those affected is reflected correctly. While I hope that noble Lords will understand, if not be happy, that I cannot provide a decision today, I commit to providing an update to the Patient Safety Commissioner’s report at the earliest opportunity and look forward to being able to update noble Lords further.
I have taken on board a point made by the noble Baroness, Lady Sugg, and throughout the debate, about the importance of transparency, trust and confidence. The department has worked with NHS England and healthcare providers to understand systems already in place for the collection and publication of information on doctors’ conflicts of interest and the work needed to implement updated guidance. That guidance will be published by NHS England. Again, I look forward to providing an update to your Lordships’ House on this. Furthermore, the department has held a public consultation on the disclosure of industry payments to the healthcare sector, and we will respond to that one shortly.
The noble Baroness, Lady Cumberlege, and other noble Lords raised the topic of imposing rules on manufacturers to pay compensation. This is a complex area and would potentially affect how products were developed, so it will need careful thought. Again, I will do that in conjunction with colleagues across government. Where a product causes injury, while it may be possible for an individual to pursue a claim for compensation directly against the manufacturer under existing legislation, I absolutely take the points made in the Chamber today that legal costs, practicalities, stress and the further distress that obviously goes alongside it often make this totally unrealistic.
I turn to some of the additional specific questions from noble Lords. The noble Baroness, Lady Bennett, was one of the noble Baronesses who raised the question on stopping manufacturers putting a 10-year time limit on redress. I will certainly raise this in discussions with colleagues at the Ministry of Justice, and I am happy to write to noble Lords further to update them on any progress. The noble Baroness, Lady Berridge, made a powerful and illustrative point that errors are not cost-free in any sense. I definitely echo her concerns about the extensive cost of this failure: some is seen and some unseen, but the costs are there. I will consider it such an exercise when I reflect on how we take this forward. The noble Baroness, Lady Wyld, also raised the point on maternity services, which, as she will be well aware, the Government recognise has serious issues. We are determined to improve this, and I assure noble Lords that my work is under way. Those areas failing in maternity care will be supported to make rapid improvements. The noble Baroness, Lady Brinton, clearly shares my appreciation, as do others, for the work of the Patient Safety Commissioner. I will ensure that she has the resources and support that she needs.
This subject rightly evokes great sympathy, but it also needs action. I must and will return to this again.