Surgical Mesh

Fiona Bruce Excerpts

Thursday 19th April 2018 Commons Chamber

[Fiona Bruce (Congleton) (Con)]

I echo the comments of many hon. Members and express my deep concern for all women who have experienced debilitating and sometimes severe pain and discomfort following the use of vaginal mesh. In all our considerations of the use of such devices, their health, safety and wellbeing must be our first concern.

I welcome the Government’s recent announcements of Baroness Cumberlege’s review of the use of vaginal mesh and two other areas of medical safety—the use of valproate and Primodos. I was in the Chamber when the Secretary of State for Health announced that review on 21 February and I could tell from the tone of his announcement, not just the content, that he personally cares very greatly about the women affected by this issue. He wants to ensure that lessons are learned wherever possible, so that care can improve to ensure that each woman gets the treatment that is right for her—the best that can be provided for her as an individual. I am sure that the Minister shares that view.

The Secretary of State said:

“It is an essential principle of patient safety that the regulatory environment gives sufficient voice to legitimate concerns reported by patients, families and campaigners, works alongside them and responds in a rapid, open and compassionate way to resolve issues when these are raised.”—[Official Report, 21 February 2018; Vol. 636, c. 166.]

Ministers want to ensure that we do better in future where necessary, and to ensure that patient voices are brought to the table. I support the review and I want to ensure that justice is done for all women who have concerns about the use of vaginal mesh. We need to ensure that we maintain public confidence.

[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.