Surgical Mesh

Bambos Charalambous Excerpts

Thursday 19th April 2018 Commons Chamber

[Owen Smith (Pontypridd) (Lab)]

I congratulate my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) on securing today’s debate. This is the first occasion on which we have debated this issue on the Floor of the House—in the main Chamber—and it is a very important moment in the campaign.

I thank and congratulate all the women who have been campaigning on this issue, long before it was raised by any of us in Parliament—particularly the indefatigable Kath Samson, who has led the Sling the Mesh campaign quite brilliantly in recent years and made this such a salient issue in the media, and now in Parliament. From a personal perspective, I very much thank my own constituent, Carolyn Churchill, who came to see me about this issue several years ago and revealed to me the scale of the suffering and trauma—life-changing trauma—that she had experienced as a result of having mesh implanted. We campaigned to have her mesh removed, and that has been life-changing for her. I am delighted to see her with us today in the Gallery.

It would be easy to be extremely angry and passionate about this, but I do not want to do that today, nor do I want to list the many life-changing, debilitating ways in which people have been affected. I am sure that many other Members will speak about that. I want to speak a little more dispassionately about how we have got to where we are, the history of mesh, and some of the wider lessons. While this is a tragedy for individuals, it is clear, as the hon. Member for Totnes (Dr Wollaston) highlighted, that it also speaks to deep, substantive issues not just about mesh but about licensing, monitoring and the diffusion of devices into the health marketplace more generally.

So what is the history of mesh? Mesh was introduced in the 1970s, and withdrawn because it was not felt to be an effective way of addressing issues and because many doctors felt that there were too many side effects associated with it. Like many devices, it was then improved marginally, and it was reintroduced in the late ’90s and early 2000s. As my hon. Friend the Member for Kingston upon Hull West and Hessle said, it was marketed incredibly aggressively among doctors because it was perceived as being quick and easy—day case keyhole surgery as opposed to much more invasive, difficult and costly means of treating stress-related urinary incontinence, in particular, through colposuspension and autologous sling, using individuals’ own tissue to raise the bladder to deal with incontinence.

One understands why, in that set of circumstances where mesh was seen as safe and effective, doctors picked it up in huge numbers. In 2008-09, 14,000 women had an implant—the high point, as it were, of the usage of mesh. As my hon. Friend said, we have seen a general decline in usage over a period. Throughout that period, the Medicines and Healthcare Products Regulatory Agency, the National Institute for Health and Care Excellence, the royal colleges and Ministers in this place and elsewhere have said, in effect, that it is safe, with side effects in only 1% to 3% of patients—perhaps 3% to 5%, they have conceded on occasion, but still relatively small numbers and arguably, they say, within the bounds of acceptability for surgery.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

Does my hon. Friend agree that had doctors not sold mesh aggressively to women, many women may not have chosen it as a way of solving their problems and may not have had the problems and complications they have now?

[Owen Smith]

Yes. The long and the short of it is that this has become such a widespread problem because younger women, in particular, were told by their doctor that there was a quick and easy way in which a minor inconvenience for many women—although a major inconvenience for some—could be dealt with.

Clearly, the scale of the side-effects was not apparent, for all the reasons my hon. Friend the Member for Kingston upon Hull West and Hessle listed, but notably because there is no long-term trials data in respect of devices. The sorts of complications that we now see emerge over a long period. That is why, in our country and across the world, such widespread concern about mesh has been emerging in every health market.

--- Later in debate ---

[Bambos Charalambous (Enfield, Southgate) (Lab)]

I congratulate my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) on securing this important and timely debate. Excellent points have been made by all Members who have spoken, so I will be brief to allow time for the Front-Bench responses. We have heard about some harrowing cases involving people’s constituents, most recently from the hon. Members for Torbay (Kevin Foster), for Glasgow North West (Carol Monaghan) and for Thirsk and Malton (Kevin Hollinrake). There has been cross-party support for the motion and the demands on the Government to act. I think that everybody who has spoken today thinks that mesh should no longer be used in surgical procedures until the inquiry reports back.

On 6 February, I had the pleasure of meeting some of the remarkable women from the Sling the Mesh campaign, many of whom are in the Public Gallery looking down at us. These women have been left debilitated and in agony following mesh implants. I was shocked as each one told me about their own personal and horrific ordeal. They told me how they were in unbearable pain when they sat down or stood up, how they had gone from being active, energetic women in the prime of their lives to being left housebound, in some cases unable to work, with a complete loss of their sex life. I can only imagine the mental suffering that these brave women and other victims have had to go through.

One thing that I found particularly striking was how many of these women said that they almost did not have the mesh implants but were swayed by the casualness with which they were sold to them when they were weighing up their options on how best to resolve their medical conditions relating to prolapse or incontinence. None was told of the risks of vaginal mesh, and I am sure that if they had been they would have considered other, less risky, alternatives. No one goes to hospital expecting to be cured of one problem only to be given another a thousand times worse. There are serious questions that need to be answered about the mis-selling and promotion of mesh, and we have not had much of a response on that despite many requests.

I find it staggering that, despite the potential risks being known, mesh is still being used today. Surely its use should be stopped and women warned of the dangers. Even by the NHS’s own figures, 1% to 3% of vaginal mesh implants result in complications. The figure is far too high. Other studies have the figure as high as 10%, and it could be higher—we do not know. It is worrying that we have such cases at all. Whether the figure is 1%, 3% or 10%, even a one in 100 chance of being maimed by an implant is a price not worth paying.

The Government should follow the example of New Zealand, which has managed to stop using mesh. Is it really acceptable for the Government knowingly to allow women to be injured by the state in this way? How many more women need to suffer while they wait for NICE to complete its review?

The Government’s retrospective review of surgery for vaginal prolapse and stress urinary incontinence using tape or mesh is a welcome start to finding out how many women have been affected, but the scope of the review is too narrow and there is a real fear that women will be missed. Why cannot women from Wales, Scotland and Northern Ireland be included in the review, and what about men affected by surgical mesh?

I call on the Government to ban mesh implants immediately and to widen the scope of their retrospective review. NICE should bring forward its review and the Government should introduce pelvic floor physiotherapy on the NHS as standard for all new mothers. We need to find out what has gone wrong, and why. The victims of the mesh scandal have suffered enough. We need action now.