Cumberlege Review: Pelvic Mesh

Alec Shelbrooke Excerpts

Thursday 5th December 2024 Westminster Hall

[Chris Vince (Harlow) (Lab/Co-op)]

I beg to move,

That this House has considered pelvic mesh and the Cumberlege Review.

Thank you, Mr Stringer, for your chairmanship. I sincerely thank all Members who have come to contribute to this debate. I thank the Minister, my hon. Friend the Member for Gorton and Denton (Andrew Gwynne), and the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), for attending. I also particularly thank Baroness Cumberlege for coming along to the debate.

In my first MP constituency surgery I met Debbie— I am delighted that Debbie and her husband Ian are here today. Debbie was active. She was into keeping fit and socialising with friends and family but, following her operation to have pelvic mesh inserted, she was forced to give up work. She now suffers from chronic pain in her hips, pelvis, groin and legs. She often suffers from fatigue. She is unable to exercise. She suffers from incontinence, post-traumatic stress disorder, severe depression and autoimmune disease. She later found out that the operation to have the mesh inserted was not even necessary.

When Debbie had her first operation to have the mesh removed, she was told that it was removed completely, but later found out that was not in fact true. She was forced to have a second operation, where, again, not all the mesh was removed.

Despite winning subsequent court proceedings, she has received no compensation, in part due to the surgeon not being covered by insurance. Debbie’s case shows the barriers for victims of medical negligence. It took seven years for Debbie’s case to get to court. Part of her concern is that the surgeons operating to remove the mesh are the same doctors who did the initial operation to insert it.

[Sir Alec Shelbrooke (Wetherby and Easingwold) (Con)]

This is such an important debate, and many of us in this room have been working on this issue for a very long time. I point the hon. Gentleman to the Government’s review of the NHS. We only have nine centres. We have to emphasise how important it is that the review addresses the need for more surgeons in these areas. The issues that he is outlining are so common, yet we only have nine centres.

[Chris Vince]

I thank the right hon. Gentleman for that useful intervention. Following my meeting with Debbie, two further Harlow residents have come forward who have also been part of this scandal. I have spoken to Members across the House who have constituents with the same issue. More than 600 women came forward to be part of the Cumberlege review and the subsequent Hughes review. This is a huge issue that affects many people.

As many Members will be aware, on 21 February 2018, the then Secretary of State, the right hon. Member for Godalming and Ash (Jeremy Hunt), called for an inquiry. The independent medicines and medical devices safety review, chaired by Baroness Julia Cumberlege, who I am delighted to see here today and whose support I am delighted to have, published the “First Do No Harm” report in July 2020. The report considered two medications and one medical device, but I will focus on pelvic mesh implants, which were used in the surgical repair of pelvic organ prolapse and to manage stress urinary incontinence. It was hugely emotional to hear Debbie’s story—to hear at first hand the huge impact that this issue has had on her life.

In her report, Baroness Cumberlege described the accounts of women who had been affected by this issue as “harrowing”. I think we can all agree that that is absolutely the case. I will not go through the whole review, because that would take too long, but I will just highlight a couple of things said by women who came forward and spoke about the impact that the procedure had had on them.

The women said that there was a

“lack of awareness of who to complain to and how to report adverse events”

and reported

“breakdown of family life; loss of jobs, financial support and sometimes housing”.

However, the situation is even worse than that. The women also spoke about a

“loss of identity and self-worth”.

Sometimes, we fail to recognise the massive connection between physical health, including a physical procedure such as this one, and people’s mental health and wellbeing. The women also reported

“a persistent feeling of guilt”.

Nobody who is a victim of medical negligence should feel guilty about that fact.

--- Later in debate ---

[Sir Alec Shelbrooke (Wetherby and Easingwold) (Con)]

It is a pleasure to serve under your chairmanship, Mr Stringer. I congratulate the hon. Member for Harlow (Chris Vince); it is encouraging that new-intake MPs are already raising this issue. As he said in his opening remarks, constituents have been to see their Members of Parliament because of the pain, suffering and injustice that they have gone through, and they are still not getting anywhere. I am not sure who the lady is, but it is very nice to see her in the Gallery because it is an exceptionally important issue for women.

Can we get back to one very important fact about this? We are dealing with people who have had their lives destroyed in the prime of life because of something they were recommended by the NHS. In all honesty, if we were at, say, the dentist’s and they said, “We need to do this to your tooth”, we would say, “Okay.” We would not say, “Can I come back tomorrow?” and then google for any issues. We trust the clinicians and listen to what they say.

Let us flip that coin and give the other side: at the time, a lot of those clinicians genuinely thought that vaginal mesh was, for want of a better description, a bit of a miracle cure. As time has gone on, it has become apparent that it was one of the worst procedures that could ever have taken place, and it is the time lag that has created the problem.

I have spoken about this topic many times. I have described some of the things that have happened to some of my constituents, including people who were once extremely active now not being able to stand up. When my constituent came to see me, she had to do the entire surgery stood up and leant over the table because she could not sit. She was younger than I am now. She eventually managed to take out private loans and have the mesh removed. There lies one of the big injustices: this was something done by the NHS, and the NHS has run away from its responsibility to solve the problem.

I accept that it is difficult for someone who has had the procedure to accept that the surgeon who put the mesh in might be the person who will remove it. But we do not have enough experts in this area, which goes back to the intervention I made on the hon. Member for Harlow: as the review of the NHS comes forward, resourcing must be considered. I have said it before and I will say it again: I believe the NHS to be a misogynistic and sexist institution that was too quick to pat women on the head and say, “Oh well, it’s just what women go through,” in so many aspects of gynaecological health, as well as other things.

I have known the Minister for a long time. I consider him to be a friend, and I know that he is in the job because he fundamentally believes in people’s rights. He has a hard task ahead of him. That hard task is not because of what the Minister wants to drive into place; it is because of the pushback that he is going to get from the NHS and the Treasury, which will say that it cannot be done. He is going to have a tough time, but we can already see that this is not a party political issue in the House. Many of us on the Conservative side criticised our own Government in debates on this subject, because they were getting the pushback from the Department of Health and Social Care and the Treasury—and we said that it was not good enough.

Removing mesh is like taking hair out of chewing gum. It is not a simple operation. It is not just that it breaks up and starts to infect other organs in the body, which is what can cause the incontinence, as it makes its way into the gut; it has now been shown that there are low-level infections within the mesh.

My constituent who finally had mesh removed had a period for the first time in 10 years. Think about that for a moment—being told, “Well, we’re not quite sure what is wrong,” and then, when the mesh is removed, suddenly having periods again after a decade. That shows how much the issue has not been taken as seriously as it should have been. The shadow Minister, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), and I were speaking only last week about a constituent who has a similar issue. Where could she find the mesh centres? There are nine mesh centres, but the issue affects the entire country.

The hon. Member for Shipley (Anna Dixon) mentioned the NHS compensation scheme. We moved on from that because it simply was not working. People were not getting the compensation from the scheme because it was not really accessible, and it was confrontational. That comes back to the point of the NHS doing something but not wanting to take responsibility for it. I am afraid that the Minister will be under pressure from people saying, “You must defend the NHS. That is your job. You represent the NHS. When people criticise the NHS, they are criticising you and the Government.” But that is not true: the Minister will have our full support for pushing back in that way.

This is the Thalidomide situation again—it is as controversial and, frankly, as scandalous as Thalidomide. We are talking about the “miracle drug” that women took in pregnancy to stop them from getting morning sickness, and it took years before it was banned; in some countries, it was used for several years after that. We pay compensation to victims of Thalidomide for the rest of their lives. I am proud to have been the Member of Parliament who in 2012 got the health grant extended for another 10 years. It is now a lifetime health grant. I am proud of that; it is something we did in this House. People turn around and say, “Redress is something we have to assess because there are so many people,” but why is that? There are so many people because the procedure was done willy-nilly and now those involved do not want to take responsibility.

Many other Members want to speak, and I will let them have their say. The Minister has my full support and, I am sure, the full support of many Members here—and he is going to need it. I ask him to stay strong, to keep in mind why we are doing this and to remember the victims who have had their lives destroyed in every single aspect. They must have the redress and the ability through the NHS to have the situation rectified so that they are not borrowing £25,000 to go privately to the same surgeon they would see on the NHS.

--- Later in debate ---

[Sir Julian Lewis (New Forest East) (Con)]

Listening to the heartfelt contributions of so many new colleagues, I get the impression that most if not all of them had, like me, never heard of this problem until a constituent walked into their surgery and told them of the terrible experience that they had had.

I have a practical suggestion: at the end of this debate, which will no doubt follow in the footsteps of several previous debates that were equally well informed, passionate and horrifying, we should perhaps put our names to a joint letter to a man called Nick Wallis. He is a freelance journalist who did a wonderful thing: he researched the Post Office Horizon system disaster and wrote a book called “The Great Post Office Scandal”. If I remember correctly, it was serialised for a week on Radio 4, and subsequently he was the consultant to the remarkable production, “Mr Bates vs. The Post Office”. We can have these debates regularly, as we have been doing, and we can upset and horrify each other by recounting our constituents’ pain and the appalling negligence that led to these terrible outcomes, but until the issue grasps the public imagination, I do not think people will get anywhere.

Interestingly, one point that has not been mentioned is the possible responsibility and liability of the large pharmaceutical company that manufactured the mesh in the first place. What research did it undertake? What responsibility does it have? What help can the Government give people who have been irreparably harmed to go after that company for compensation?

There has been one great positive development, which has been referred to several times, and that is the magnificent work of Baroness Cumberlege, who certainly did the whole community of damaged women the best possible service in conducting that excellent review. The question is to what extent will her recommendations be implemented?

I pay tribute in particular to my right hon. Friend the Member for Wetherby and Easingwold (Sir Alec Shelbrooke), who spoke earlier, and the hon. Member for Washington and Gateshead South (Mrs Hodgson), from whom we are about to hear, for their exemplary leadership of the all-party parliamentary group on this terrible disaster and for keeping the flame burning all these years. I say “all these years” because it has been a long time. Looking back on my own website to check my contributions, I see that this is now the fourth full- scale debate in which my colleagues and I have gone over the same ground. If anybody is interested, the dates of the previous three debates, which were packed with testimony and interesting information, were 19 April 2018 —slightly longer ago from now than the entire duration of the second world war—8 July 2021 and 3 February 2022. It would not be appropriate for me to go over in detail what has been said previously, as it is all there on the record, but it is important to recognise that we are talking about thousands and thousands of damaged women—10,000 at the very least, and as we have heard, some estimates put the number as high as 40,000.

Treatment centres have been mentioned, but there is a particular question about who has the skill to practise in the treatment centres. Who will put themselves forward as being appropriately skilled? It will be the very people who inserted the mesh in the first place.

In one of the earlier debates, I cited a constituent who was 35 when she was given what was described to her as “routine surgery”, 16 years before the debate in question took place. I said then:

“She was initially told that it was her fault that her body was rejecting the two mesh implants. She then went through a cycle of implants, the removal of protrusions and eroded segments and seven bouts of surgery. Three TVTs—trans-vaginal tapes—are still inside her, she suffers chronic pain from orbital nerve damage, constantly needs painkillers and has had constant side effects, indifferent treatment and a refusal to admit fault or to refer her to an out-of-area specialist in mesh removal.”—[Official Report, 19 April 2018; Vol. 639, c. 508.]

[Sir Alec Shelbrooke]

My right hon. Friend has just made an important point. He spoke about the removal of protrusions and seven surgeries. That almost puts a gloss on what has happened. We have all heard from women who have had the surgery and the experience of many of them is that they have been butchered. It is important to make that clear in this debate, especially for new Members, because we have discussed this in Parliament before: when we think of surgery, we think of any other normal surgery, but this surgery leaves huge amounts of scar tissue and has butchered women in ways that I will not go into now. That must be recognised when we describe some of the remedials that have happened, mainly because those carrying them out do not really know what they are doing at this stage.

[Sir Julian Lewis]

Exactly right. That is why my constituent said at the time, “I do not want anyone from the hospital coming near me ever again. I have lost complete faith in them. I have been lied to and told repeatedly that it was my body rejecting the mesh. But unbelievably they kept putting more in.”

Over this period of six or more years I have probably tabled about 12 or 15 questions for written answer, obviously to a previous Government. I will quote three, which were all in the aftermath of the Cumberlege report. In June 2021—for the benefit of Hansard it was question 16777—I asked the Secretary of State for Health and Social Care

“what checks his Department carried out to ensure that surgeons awarded NHS contracts for the removal of failed vaginal mesh implants had not previously been responsible for (a) originally implanting them, and subsequently (b) denying that anything had gone wrong with them; and whether any personnel awarded NHS contracts to work at mesh remediation specialist centres are known by his Department to be currently facing legal proceedings for implanting mesh which injured women who are now seeking its removal at such centres.”

The answer, which came from the then Minister of State, read:

“It is the responsibility of the employing organisations”—

presumably the NHS—

“to ensure that the staff undertaking mesh implantation and/or dealing with mesh complications are qualified and competent to do so. NHS England’s procurement process to identify the specialist centres to deal with the complications of mesh considered a range of clinical and service quality issues. No assessment was undertaken regarding National Health Service contracts or staff facing legal proceedings.”

Somebody in the process of suing a surgeon but still needing ongoing care may have no other option but to go to a mesh centre headed up by—guess who?—the surgeon who she is suing because he damaged her in the first place.

The second written question I will refer to was in July 2021—question No. 31274—which read:

“To ask the Secretary of State for Health and Social Care, with reference to the debate on the Independent Medicines and Medical Devices Safety Review on 8 July 2021…what steps he plans to take to research new and improved techniques for removal of eroded surgical mesh implants.”

As we have heard, it is intolerably difficult to remove this stuff. One would think that the very least the NHS could do would be to make a dedicated effort to develop new techniques for doing it. The description of it being like removing hair from chewing gum is vivid. I have sometimes speculated—I am not in any way qualified to do so—that maybe the answer to this might be to develop some sort of technique that could harmlessly dissolve the material and let it be gradually flushed away, rather than physically trying to disentangle it with the risk of doing more damage. That may be completely and utterly impracticable, but my point is that we do not know because no proper national effort is being made to find a way in which this disaster can be, to some extent, effectively rectified without harming the victims further.