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.