Surgical Mesh

Debate between Chris Elmore and Fiona Bruce

Thursday 19th April 2018 Commons Chamber

[Chris Elmore (Ogmore) (Lab)]

On the hon. Lady’s comments about justice being done, I have been approached by two constituents who have been greatly affected by vaginal mesh. One of them is unable to work. She has to be lifted up to walk as she cannot stand by herself, so she needs carers. Does the hon. Lady agree that in many cases it is not only justice that is needed, but compensation? As the Chair of the Health Committee said, we need to start looking at compensation for some women. My constituent is in her early 50s and can no longer work.

[Fiona Bruce]

That is something that I have said not only about this issue, but about the use of valproate. It is important that we pay close attention to the experiences and difficulties that patients have endured. We need to be more open to learning what we can from their experiences, making changes where necessary and—as the hon. Gentleman says—examining where compensation should be sought for them.

Baroness Cumberlege has been instructed to look comprehensively at the whole issue. The Government want to listen. We have all seen examples in which people have appeared to listen to concerns, nodded their heads and then gone away and done nothing. That is not what is happening here. I believe that the Secretary of State and Ministers not only want to listen carefully to concerns on this issue, but stand ready to act appropriately. For that reason, I think the proposal in the motion for a full public inquiry is inappropriate at this stage. We need to give time for Baroness Cumberlege to report. We need to urge that that be done urgently, and we need to ask Ministers questions.

I have some questions of my own for the Minister. What is the timescale for the review and what progress has been made already? Does the Minister agree that introducing an outright ban would be inappropriate before the review? Can she assure the House that the new NICE guidelines which recommend against first use of the surgical mesh to treat pelvic organ prolapse are being carefully followed throughout the NHS? Is it correct that in the vast majority of instances the use of surgical mesh has proven to be an effective intervention that has enabled many women to live happily and independently after surgery? I believe that some 1,500 women receive vaginal mesh implants each year and the majority respond well. If that is correct, it is important to balance that against the distressing individual cases that we have heard about today. I also understand that the high rate of success for the use of surgical mesh to treat hernias suggests that an outright ban would be rash at this stage, and certainly premature before the Cumberlege review reports.

What information can the Minister provide on the recent development of a new material for surgical mesh implants? What more information do we have about how that is expected to reduce discomfort because of its greater likeness to human tissue? Can the Minister update the House on what progress is being made to improve GPs’ awareness of SUI and POP and how best to treat those conditions, so that women are given the most appropriate treatment for their circumstances? Will the Cumberlege review take into account international research on this issue? We have heard some mention of it today, but I understand that no other jurisdiction has imposed an outright ban on the use of mesh.

In conclusion, the Secretary of State has made it clear that we are building on substantial work from over the past few years—the Cumberlege report comes on the back of a lot of other work, and I hope the Minister will confirm that that will all be taken into account. I ask Members to await that report before we make any final decision. Professor Keith Willett brought forward the 2017 Mesh Oversight Group report, which followed the Mesh Working Group interim report in 2015. He said that

“there has been significant progress since this work began. Information available to women and clinicians is now better and more consistent, data recording has been improved, including of complications, and women can now be referred to multi-disciplinary teams of health professionals with the experience necessary to advise women who are experiencing complications from mesh surgery on their treatment options.”

John Wilkinson, Director of Devices at the Medicines and Healthcare Products Regulatory Agency, stated:

“We continue to see that evidence supports the use of these devices in the UK for treatment of the distressing conditions of incontinence and organ prolapse in appropriate circumstances.”

We must ensure through this review that every circumstance in which these devices are used is appropriate, and that the women involved feel confident of that.

Prisoners: Parental Rights

Debate between Chris Elmore and Fiona Bruce

Wednesday 13th December 2017 Westminster Hall

[Fiona Bruce (Congleton) (Con)]

I listened carefully to the hon. Member for Swansea East (Carolyn Harris). I am pleased that she said that, in a healthy situation, it is vital for a child to have contact with their parent who is in prison. I will speak about that with particular reference to the excellent recent Farmer review about the importance of strengthening prisoners’ family relationships, where appropriate, to aid rehabilitation.

The Farmer review calls that a “golden thread” that needs to run through the prison system, along with the threads of employment and education, as a priority for prison governors. It says that that third strand is essential if we are to

“put a crowbar into the revolving door of repeat reoffending and tackle the intergenerational transmission of crime.”

I therefore urge Ministers to consider adding a new deputy director for families to the existing deputy director roles in the prison system. Before I highlight two ways in which prisoners’ family ties and, importantly, parental ties could be strengthened, I pay tribute to Dr Samantha Callan, Lord Farmer’s adviser, whose intelligent, thoughtful and dedicated contribution to the production of the review was invaluable.

First, I encourage Ministers to consider providing Skype or other face-to-face digital platforms where family visits may be difficult. BT’s slogan, “It’s good to talk”, might be a cliché, but it is incredibly important for people to keep relationships with their families or other significant individuals alive while they are in prison. Men who can ring their children every evening have a reason to stay out of trouble throughout the day. One prisoner told the Farmer review:

“If part of your prison routine is to do homework with your child or ring home regularly to hold a quality conversation with her, this is a strong deterrent to taking a substance that would mean you were unable to do that because you were ‘off your head’.”

The high cost of phone calls is frequently raised by external prison organisations such as the Prison Reform Trust as a cause of considerable resentment across the prison estate. I understand that costs should fall when the contract with BT is renegotiated in April 2018, and plans to digitise the entire prison estate with cable networks and to put a phone in every cell will further reduce call costs. However, that system will not be fully installed and functioning until 2021, and a prison service that values relationships needs to do more to help people stay in touch with their families and particularly their children.

Although phone calls are highly valued, the prison service should consider adapting to new forms of communication that are becoming commonplace in the community. That is not about giving every prisoner an iPad, although I have been told that women in some high-security prisons in the US have access to iPads in the interests of staying in touch with their children. Virtual video visiting is gradually being made available in prisons in Northern Ireland, such as Magilligan Prison. Although I would be concerned if we got to the point where that replaced face-to-face visits, Skype-type technology can enable prisoners to “visit” their own homes and see their family members in that context, and remind them of what they have to gain by settling into their sentences, getting out as soon as possible and not returning.

[Chris Elmore (Ogmore) (Lab)]

I am sure the hon. Lady is aware that children whose mothers are in prison are, on average, 64 miles away from them. I agree wholeheartedly with what she says, particularly about electronic interaction. Does she agree that, if we are to overcome the sheer distances, particularly for Welsh prisoners—there are no women’s prisons in Wales, although I am not advocating for one—we must find new technologies to enable mothers to interact with their children?

[Fiona Bruce]

I absolutely do. Although keeping prisoners close to home has to be the goal wherever possible, the challenges of the prison population make that hard, so it is not unusual for prisoners to be some distance from home—so far that families may even have to stay overnight if they visit. I wholeheartedly concur with the hon. Gentleman.

Technology that is being put into prisons to facilitate virtual court appearances could be adapted to improve contact for families on the outside who may otherwise have to make a superhuman effort to come into prison. Foreign nationals are unlikely to get visitors. In his report, Lord Farmer mentions meeting a man in prison who had been in local authority care since he was a child and whose only relative was his 93-year-old grandmother. It is impossible for her to visit, but if someone helped her with Skype she would at least be able to see him again. Imagine an A-level student close to her exams who was unable to visit her dad in prison but could communicate with him using a tablet, or a mother with a child with a health problem who would otherwise have to choose between visiting her partner in prison or keeping a vigil by that child’s bedside.

Of course there have to be safeguards. The Farmer review recommends that, in the interim period before full digitisation, empowered governors should be able to make Skype-type communication available to the small percentage of prisoners whose families cannot visit them due to infirmity, distance or other factors. A booking system and application process would mean that prisoners’ requests to access video calling technology had to be cleared by the governor. Alternatively, tablets could be made available in visiting halls, as apparently happens on the juvenile estate in Tasmania. Family members might need help to access video calling technology. Funds from the assisted prison visits scheme could be made available to people who needed to travel to a local voluntary organisation for help to make a call, for example. Will the Minister consider what can be done between today and full digitisation to ensure that families can maintain contact through these innovative means?

The second point I will make—more briefly—relates to the use of ROTL: release on temporary licence. The latest, up-to-date policy on ROTL procedures is unpublished and awaited by governors. I urge Ministers to ensure that it is published as soon as possible. Research indicates that the use of ROTL to maintain and develop family ties contributes to reducing reoffending. Respondents to the Farmer review—prisoners, families, organisations and academics—considered that it should be used more. They told Lord Farmer that that would give prisoners the opportunity to adjust gradually to family life outside of prison and to spend more time in responsible roles such as parent or partner.