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Justin Madders (Ellesmere Port and Bromborough) (Lab)
It is, as always, a pleasure to see you in the Chair, Dr Allin-Khan, but it is not a pleasure to be here marking two years since the publication of the Hughes report. Sadly, in that time, those recommendations seem to have been in a holding pattern somewhere in the Department for Health and Social Care.
Other Members have rightly spoken about the victims. Today, I think mostly about one of my constituents, who contacted me more than five years ago, raising concerns about the tragic loss of her son when he was 30. She believes that the sodium valproate medication that she took during his pregnancy was responsible for his learning difficulties and, ultimately, his early passing. Quite understandably, she feels let down by the state. She is also concerned about the profound effect that it may have had on her other children, and the fact that she was not alerted to the risks of this by the authorities.
What I find particularly disappointing, having contacted numerous Secretaries of State during that time, is that we have had no more than vague commitments and assurances that this issue will be addressed in due course. That does not cut it for my constituent; nor, sadly, does it do anything to assuage the guilt that she—wrongly, in my opinion—feels.
With other national scandals, such as infected blood and the Post Office Horizon system, the Government have eventually provided funding for mechanisms to compensate those affected, but they too had to wait decades. It is disappointing that the recognition that we all had at the time, that those systems were introduced that those delays had compounded the injustice, has not translated into any visible progress for those harmed by valproate and pelvic mesh.
I agree with the right hon. Member for New Forest East (Sir Julian Lewis) that, in those schemes, the interim payment system has been seen as a way to get at least some measure of redress. I am disappointed that we have not been able to learn from that experience and use a similar system for the people we are talking about today. I have sympathy for the view set out by the Secretary of State that redress must be considered alongside that for other patient groups, but that does not justify inaction.
Those harmed by valproate and pelvic mesh are frustrated by the delays and the obfuscation. The state has acknowledged and apologised for its failings. It has commissioned and published two reports on the matter, both of which have recommended that redress is provided to patients, but we have reached the point where reports and recommendations are not enough. It is time for the Government to act, and to provide the support that the many victims of this scandal deserve and need to manage their ongoing conditions. The can has been kicked down the road for too long; campaigners and those affected are understandably frustrated and anxious for change.
I would like to ask the Minister two things, echoing the questions raised by the hon. Member for Chesham and Amersham (Sarah Green). First, can the Minister confirm whether there has been an estimate of the total cost of providing redress? If so, can she share that today? That might, at least, give campaigners some hope that things are actually moving forward. Secondly, can she confirm whether she has discussed funding redress with the Treasury for inclusion in future fiscal events? I look forward to the Minister’s response—or, if she is unable to provide specific answers today, to a commitment that she or a colleague will do so in future, and a clear sense those who have suffered are now being listened to.
Several hon. Members rose—
The Minister for Secondary Care (Karin Smyth)
It is a pleasure to serve under you chairship, Dr Allin-Khan. I am grateful for the opportunity to address the House following the second anniversary of the report by the Patient Safety Commissioner, Dr Henrietta Hughes. I pay tribute to her work and, as others have, to Baroness Cumberlege for her work in the lead-up to that report. I also thank the hon. Member for Chesham and Amersham (Sarah Green) for securing this important debate. It has been a thoughtful and constructive debate on an issue that is highly sensitive for Members across the House, for campaigners and people who are here today, and for people watching online.
To answer the question from the hon. Member for Sleaford and North Hykeham (Dr Johnson), I am responding to this debate on behalf of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Glasgow South West (Dr Ahmed). He is the lead Minister for this area, but unfortunately cannot be here today—as Members will understand, that is often an issue, but I am happy to stand in. This is a matter of great interest to him personally. As colleagues know, he is a clinician, so has valuable insight into patient safety and how it works from a clinical perspective.
My hon. Friend wanted me to be clear that he is very happy to meet campaigners, as the hon. Member for Chesham and Amersham asked, to discuss our work in more detail. He met the Patient Safety Commissioner in December to discuss the Department’s ongoing work in relation to her report. Since then, he has continued his engagement with the commissioner on how we can do more to address the immediate needs of those affected by sodium valproate and pelvic mesh. As we have heard, and as many of us know from constituents—I know that many other Members have affected constituents but were not able to attend the debate—some of these women’s lives, as well as those of their families, have been changed forever because they were misled about the effects of sodium valproate and surgical mesh.
Many examples have been given in the debate, and constituents of mine have shared the most intimate details of the impact of sodium valproate and pelvic mesh. It has been truly harrowing for me and many other Members to listen to those details, as I am sure it was for those women who bravely shared them with a stranger, their Member of Parliament. That point was made well by many Members, including my hon. Friend the Member for Rushcliffe (James Naish), the hon. Member for Frome and East Somerset (Anna Sabine), and the Liberal Democrat spokesperson, the hon. Member for South Devon (Caroline Voaden), who spoke on behalf of her constituents.
We owe honesty, transparency and contrition to all the women affected, and we are determined to make sure that the lessons are learned and to keep patient safety at the heart of the reform. My hon. Friend the Member for Wolverhampton West (Warinder Juss) rightly highlighted the issue of trust in the system, which is so important as we go forwards. Our focus remains on building a system that listens and that acts with speed, compassion and proportionality. Everybody who has suffered complications from sodium valproate and pelvic mesh implants has my deepest sympathies. I express my gratitude to Dr Hughes and her team for the report that was published two years ago, and I am grateful, too, for her continued engagement with the Department as Patient Safety Commissioner.
Caroline Voaden
The Minister said that she supports a system that acts with speed. Could she give us an idea of when there might be a response to the report?
Karin Smyth
I want to address the main concerns and, as I said, the Under-Secretary of State is very keen to talk with Members and campaigners.
We remain committed to working alongside Dr Hughes and her team to better support patients and ensure that steps are taken to prevent similar harm in the future, both in this area and across the wider patient safety landscape. That is obviously crucial. Many Members mentioned the importance of women’s voices being heard in this area, and many of us were involved in the campaign in the previous Parliament. We must make sure that women’s voices are better heard in the health system. As my hon. Friend the Member for Morecambe and Lunesdale (Lizzi Collinge) said, the campaigners are doing that, and I pay tribute, as she did, to In-FACT, as well as Sling the Mesh and the very many other patient groups that have raised this on behalf of women. They should not have to, but I commend their work.
I assure Members and people listening to the debate that we remain committed to advancing this work across Government and to looking at lessons from any cases in which patient safety has been affected. I fully understand why colleagues are asking for an official response to the Hughes report here and now. It is important that we get it right, and we need to carefully consider all options and the associated costs before coming to a decision on the report’s specific recommendations. I am sure that many Members have seen the letter that my hon. Friend the Under-Secretary of State wrote to the Patient Safety Commissioner in November, and I reconfirm, as he wrote, that that work includes looking at the costs.
We must take forward the lessons learned from this work—including, as the right hon. Member for New Forest East (Sir Julian Lewis) and my hon. Friend the Member for Ellesmere Port and Bromborough (Justin Madders) highlighted, work on similar areas—and the Government are doing that. We must ensure that our approach provides meaningful, often ongoing support to those who have been so profoundly affected.
The Government have to consider options for financial redress collectively, with input from a number of Departments, and we started that work immediately. As was mentioned, the previous Government did not respond to the report when it was published, but we have picked up that work. Initially, Baroness Merron was the lead Minister, and it is now the Under-Secretary of State, my hon. Friend the Member for Glasgow South West.
I assure the hon. Members for Strangford (Jim Shannon) and for Aberdeenshire North and Moray East (Seamus Logan) that my hon. Friend recently met the devolved Government Health Ministers to discuss their respective positions further. He will continue to do so across all devolved Government areas; as Members have said, patients there are affected too. We have to proceed with care to ensure the correct approach. We are committed to providing updates at the earliest opportunity, once all relevant advice and implications are considered.
Karin Smyth
I will continue, if I may.
On non-financial redress, the Department is committed to meeting the needs of current patients with clinical requirements via three principal avenues. The first is improving clinical services and treatment to patients, and the second is commissioning further research and development programmes on sodium valproate and pelvic mesh to address the remaining knowledge gaps. I commend my hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) for sharing again his personal experiences and for laying bare the deep complexity and the need for more research and development, to which my hon. Friend the Under-Secretary of State is committed. The hon. Member for Leicester South (Shockat Adam), with his clinical knowledge, also added useful experience to the debate. That is absolutely what my hon. Friend will be taking forward. The third avenue is initiating longer-term preventive measures that will help ensure that the system can pick up on adverse trends in patient care and act more quickly in the future.
I will take each avenue in turn. On improvement of clinical services, although the number of women up to the age of 54 who have been prescribed sodium valproate has nearly halved since 2018, there is a significant group of patients already affected who have complex and varied needs, and the health system has to ensure that that cohort receives high-quality and tailored care. NHS England has committed to a pilot project on foetal exposure to medicine in the north of England, involving multiple clinical specialties and a wide range of clinical experts, that will undertake a comprehensive review of the service. Eighty patients have been seen as part of the pilot, representing 560 appointments and 650 clinical hours. We have received feedback from patients on the value for their quality of life of being seen by clinical experts and wider multidisciplinary teams. We are considering options to commission this service further nationwide.
NHS England has also completed an internal review of mesh centres across England. Mesh centres undoubtedly offer a valuable and impactful service, with nearly 3,000 patients now seen since their introduction. However, as a relatively new service, distinct areas for improvement remain, and we will look closely at the results of the internal review and promptly deliver the necessary improvements.
With regard to further research and development, the National Institute for Health and Care Research has been commissioned for a £1.56 million study to develop patient-reported outcome measures for prolapse, incontinence and mesh-complication surgery. In the longer term, those measures will be integrated into the pelvic floor registry, which monitors and improves the safety of mesh patients. Further research is also taking place in this area, and we will ensure that future work takes into account the recommendations of the pilot project and of the mesh centre audit.
On longer-term prevention work, recent discussions with NHS England and the Medicines and Healthcare products Regulatory Agency indicate that longer-term improvements in digitisation will help position the UK as a world leader in reducing valproate-exposed births and applying the insights to other teratogenic medicines. The Department will explore increasing centralisation and visibility of the annual risk acknowledgment form across care settings, as highlighted in the Hughes report, and may consider expanding the medicines and pregnancy registry to better link data with research outcomes.
Several hon. Members rose—
Karin Smyth
I will give way first to the hon. Member for Aberdeenshire North and Moray East.
Seamus Logan
I appreciate the complexities of the steps that the Minister is outlining. Nevertheless, in repeated contributions, Members have asked for a timescale, so will the Minister respond by the end of the Session? Will she respond by the autumn? Will she respond by the end of the calendar year? Can she give us some clarification, please?
Karin Smyth
I am happy to answer that at the end of my comments, but first I will take the intervention from the right hon. Member for New Forest East.
Sir Julian Lewis
I appreciate that the Minister does not have primary responsibility for this area, but it worries me that we are hearing an awful lot about process. What I fear is really going on is that Ministers have been told at the highest possible level, by the Chancellor or a Treasury Minister, that the money for redress will not be made available and they have to take that as their starting point. She may not be able to confirm this now, but I would like an answer as to whether a conversation of that sort has taken place.
Karin Smyth
I thank both Members for their comments. Experienced parliamentarians will know what I will be able to say. As my hon. Friend the Under-Secretary of State, the hon. Member for Glasgow South West, outlined in his letter, costs—I think that is what the hon. Member for Aberdeenshire North and Moray East was alluding to—are part of the overall consideration, along with the complexity, in the work that he is leading on behalf of the Department across all Government Departments.
Karin Smyth
I am going to close by emphasising again that we are profoundly sorry, of course, for the enduring harm experienced by women affected by sodium valproate and pelvic mesh. Their pain, which we keep in our minds at all times, and the life-altering consequences they have suffered are truly heartbreaking. We recognise the immense toll, much of which we have heard about again today, that this has taken on them and their families. We have listened closely to calls for clarity, speed and decisive action on the report’s recommendations. To be very clear, we are committed to setting out our response at the earliest credible opportunity while ensuring that it is both robust and deliverable. I think that, as we have heard again today, Members here and people listening recognise the complexity of that. I assure those listening that my hon. Friend the Under-Secretary of State is determined to progress this matter, and he is willing to meet campaigners and discuss that in more detail, as Members have asked us to do today.