Cumberlege Review: Pelvic Mesh

Anna Dixon Excerpts

Thursday 5th December 2024 Westminster Hall

[Chris Vince]

I thank the right hon. Gentleman for his intervention and I could not agree more. In the case of Debbie, who I have spoken about, she did not even need the procedure in the first place, but clearly that information was not provided correctly to her. Many women absolutely would not have gone through with the procedure if they had known about the dangers—and, as I say, in Debbie’s case she did not need to go through with it.

The Cumberlege review made a number of recommendations. First, it recommended establishing a separate redress scheme to meet the cost of care and support for people who have experienced avoidable harm caused by the pelvic mesh. It also recommended:

“Networks of specialist centres should be set up to provide comprehensive treatment, care and advice for those affected by implanted mesh”,

and that a database should be created of all patients who received an implant of medical devices, including the pelvic mesh.

The previous Government published their response to those recommendations in July 2021. They did not accept the report’s recommendations about redress. However, in December 2022 they announced that they had asked the Patient Safety Commissioner to explore options for redress, and that project began in the summer of 2023.

On 7 February 2024, the Hughes report was published, setting out recommendations for redress for those harmed by sodium valproate—a medicine used to treat epilepsy—and pelvic mesh. The report calls for the establishment of an independent, two-stage redress scheme to provide both financial and non-financial redress for affected patients.

I realise that I have been talking for quite a long time, Mr Stringer, but I think you appreciate the importance of this subject. I will quickly go through the recommendations of the Hughes report, so the Minister is aware of them. There are quite a few recommendations and they are as follows:

“The government has a responsibility to create an ex-gratia redress scheme providing financial and non-financial redress for those harmed by…pelvic mesh. This scheme should be based on the principles of restorative practice and be co-designed with harmed patients.”

We have seen that throughout this process patients have not had a voice and it is hugely important that they have a voice in finding the solution.

The Hughes report’s recommendations also said:

“Redress should provide all those harmed by pelvic mesh or valproate”—

the other medicine I mentioned—

“with access to non-financial redress. To deliver this, the government should work with other government departments, the healthcare system and local authorities to measurably improve harmed patients’ access to, and experience of, public services.”

Another recommendation was:

“The government should create a two-stage financial redress scheme comprising an Interim Scheme and a Main Scheme… The Interim Scheme should award directly harmed patients a fixed sum by way of financial redress… The Interim Scheme should be followed by a Main Scheme. This would offer more bespoke financial support to directly harmed patients based on their individual circumstances and…those indirectly harmed”.

[Anna Dixon (Shipley) (Lab)]

I thank my hon. Friend for securing this important debate. The NHS has a clinical negligence scheme and it spends a lot of money on lawyers. Does my hon. Friend agree that victims of this particular scandal should, like many others, get no-fault compensation? And does he think the NHS should look at its clinical negligence scheme and move towards no-fault in order to reduce the spend on lawyers?

[Chris Vince]

I thank my hon. Friend for the question. I broadly agree with her. Over the last year we have seen some terrible scandals, the Post Office scandal and the infected blood scandal. When we have debates on those in this House, we recognise that things should have been done much more quickly and that we should have been much more open to providing financial support to the people affected. We should look at this case in those terms.

To continue the recommendations, the report states:

“Patients who received relevant treatment through either the NHS or independent sector should be eligible for the Interim Scheme and Main Scheme…”

and adds that patients should find the application process for both schemes “straightforward”. Again, that speaks about accessibility and making the process non-adversarial, which is really important. It comes across in both reports that victims of the pelvic mesh scandal were made to feel guilty and that it was their fault, which is absolutely not the case.

The report states that both schemes

“should be administered by an independent body which commands the confidence of patients.”

We want those patients to feel confidence in the scheme. Both schemes

“should effectively signpost harmed patients to services which can provide them with free emotional support.”

I reiterate the importance of that emotional support. Finally, the report states:

“The government must ensure that the launch of the Interim Scheme and the Main Scheme is accompanied”—

this goes back to the point made by the right hon. Member for New Forest East (Sir Julian Lewis)—

“by an awareness raising campaign to ensure that all potentially eligible patients are made aware of it.”

As I mentioned earlier, 617 people directly harmed by the pelvic mesh implants contributed to the Cumberlege report, and 471 people directly harmed by the pelvic mesh implants provided evidence to the Hughes report. That shows the huge number of women affected by the scandal. I am delighted to see how many Members from across the House have been contacted, as I was by Debbie, by constituents who have been impacted by this. In August this year more than 100 women who experienced pain and complications from transvaginal mesh implants received payouts from three manufacturers of the product, but there was no admission of liability.

I thank the Minister for his time and for giving consideration to the recommendations. I truly thank everybody from across the House for contributing to this debate and I look forward to hearing from them. I finish with a quote from the Hughes report, from a patient harmed by pelvic mesh:

“It always comes back to we innocently trusted that we were having something that was going to fix our embarrassing health condition and then from that we have had our lives shattered. This is not our fault.”

--- Later in debate ---

[Anna Dixon (Shipley) (Lab)]

It is an honour to speak under your chairmanship, Mr Stringer. I again congratulate my hon. Friend the Member for Harlow (Chris Vince) on securing this important debate and highlighting the trauma caused to many women, such as his constituent Debbie, by the pelvic mesh scandal.

Before entering Parliament I spent 20 years in the health and care sector, including at the Department of Health and Social Care as a senior civil servant. Patient safety and quality were part of my responsibilities. I was involved with some of the inquiries into tragedies of maternal and infant deaths, such as at Morecambe Bay; with the Government response to the Francis inquiry into the tragic deaths at Stafford hospital; and with subsequent reviews by Sir Bruce Keogh. That is more than a decade ago.

As my hon. Friend was saying, the NHS is fantastic at its best; it is there to heal and cure. But it is a tragedy that there continue to be patients who suffer harm as a result of medical care and treatment. The pelvic mesh scandal, I am afraid, follows a long line of other scandals—not least the infected blood scandal. I am obviously pleased that the Government have recognised the harm caused by that scandal and are committed to a full and fair compensation scheme. Obviously, here we are seeking redress for the women who have been harmed. It is important that we learn from the past as well as prevent scandals such as this from happening again in future.

As has been the case with many other Members, a constituent approached me about this issue. I am pleased with the male allyship on show today. The voices of women are often not heard; there are power issues when it comes to surgeons, who are often male. This follows other scandals involving unnecessary hysterectomies, for example. We need to remember some of the horrific consequences for women such as Julie, who lives in Baildon in my constituency. Her story is similar to some of those that have already been shared. The details are pretty harrowing. Her life has been torn apart as a result of both the mental and physical consequences. I will not go into the details of her case, which are similar to those already mentioned. We must look for redress for the unnecessary suffering and seek to put the issue right.

Like other Members, I pay tribute to Baroness Cumberlege for her work on the review. I have admired her from afar for a long time; in the 1990s, she was Health Minister when I was early in my health career and she did fantastic work on maternity services in 2015. That resulted in recommendations and the setting-up of networks; we have seen progress on that as well as care and advice, and obviously I welcome that. For women who had mesh inserted, particularly for urinary incontinence and vaginal prolapse, it is vital that such services are accessible in every region, as my hon. Friend the Member for Harlow said.

More needs to be done. In particular, under the Consumer Rights Act 2015 the statute of limitation for faulty medical devices is just 10 years. That is obviously too short a timeframe for pelvic mesh, because it can easily take longer than 10 years for the most serious negative effects to come to light. I have written to the Secretary of State for Business and Trade, seeking an amendment to that Act to increase the statute of limitation to 20 years for faulty medical devices and products. I am pleased to say that a review is under way. Will the Minister follow up on that and ensure that the representations made are followed through on behalf of people affected in the future and seek justice?

Drawing on my professional background, I want to address the points made about the products. There are significant clinical trials for drugs and pharmaceuticals, but we do not gather sufficient evidence before products such as mesh go into widespread use. I again urge the Minister and others, including the National Institute for Health and Care Excellence and the National Institute for Health and Care Research, to ensure that all devices and products—particularly implants—go through a proper clinical trial process before they are licensed. That relates to the point about device licensing. Drug licensing is very strict and takes place over many years, but do we have sufficient device regulation for these sorts of implants?

On professional regulation, we obviously give the surgeons the benefit of the doubt and hope that they were using best practice at the time, but we have to recognise that in some cases surgeons and doctors do not operate in the best interests of the patient, and that full informed consent may not be given. We have seen examples of that, even after the problems with pelvic mesh came to light. I urge the Government to look at whether the professional regulation is strong enough.

Since my early work in this area, I have maintained an interest in patient safety. As the newly elected vice-chair for the all-party parliamentary group on patient safety, I look forward to continuing to work with the chair, the right hon. Member for Godalming and Ash (Jeremy Hunt); I worked with him when he was Secretary of State for Health and Social Care. Hopefully, we will work with other Members across the House to improve safety in the NHS and address the pelvic mesh scandal and other issues. I hope that no one suffers in the way that women such as Debbie and my constituent Julie have in the past. We must protect patients for the future.

--- Later in debate ---

[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.

[Anna Dixon]

I think the right hon. Gentleman makes a very valid point. Obviously, from my professional background, I see myself as fairly well-informed, but the scale of the damage done by this particular implant—the pelvic mesh—is also a shock to me. It is really timely that new Members are made aware of this issue. Hopefully, we can support any efforts to continue to raise it, and I commend Members who have been in this place for longer on their work to date.

I hope that the Minister will reflect on the specific point about research. As someone with a research background, I absolutely agree with you—I am sorry, Mr Stringer; I meant the right hon. Gentleman—that more effort needs to be put into research, not only on how we might treat such cases in future, but on the remedial effect.

[Graham Stringer (in the Chair)]

I thank the hon. Lady for correcting herself and acknowledging that “you” refers to the Chair. I also remind all hon. Members that interventions should be brief and to the point.