Cumberlege Review: Pelvic Mesh

Debate between Graham Stringer and Julian Lewis

Thursday 5th December 2024 Westminster Hall

[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.

[Sir Julian Lewis]

That being said, Mr Stringer, I am absolutely delighted that the hon. Lady made that intervention. When someone of her expertise and experience says that even she had not realised the scale of this issue, it shows the magnitude of the task that faces us. This is every bit as bad as we heard in the excellent introduction from the hon. Member for Harlow (Chris Vince)—I apologise for not paying tribute to him earlier. He has done us all a great service by bringing this debate to Westminster Hall. This is on a level with the infected blood disaster, and it deserves the same level of treatment and remediation in so far as that is possible.

Reverting to the written question I asked, the Minister of the State at the time answered:

“There are no current studies specifically relating to new and improved techniques for the removal of eroded surgical mesh. However, there are five studies ongoing on surgical mesh implants and the National Institute for Health Research welcomes funding applications for research into any aspect of human health, including on the removal or implantation of vaginal mesh. There are currently no plans to establish a unit in order to train mesh removal specialists.”

I want to quote a third and final written question of those 15. Question 124936, from February 2022, stated:

“To ask the Secretary of State for Health and Social Care, what recent progress has been made in establishing the South East Regional specialist centre for the treatment of women damaged by mesh implants; and whether checks will be carried out to ensure that such women, when seeking remedial treatment from that specialist centre, are not placed in the hands of surgeons who were responsible for (a) implanting the mesh originally, (b) denying that anything had gone wrong with the implants and (c) claiming that women reporting extreme physical pain from the implants were imagining it.”

After a fairly long paragraph in reply, the answer concluded:

“Patients can discuss their choice of surgeon with the multi-disciplinary team if they have concerns regarding a specific clinician and can also discuss a referral to a surgeon in another specialist mesh centre.”

Think of the conversation that would require. A patient would have to explain to the person who had—to quote my right hon. Friend the Member for Wetherby and Easingwold—“butchered” them that, because they did not want to have his or her ministrations any further, they wanted to be referred to somebody else a long way away. Good luck with all that.

I will briefly touch on some points raised by people in the community of damaged women. I have been told about difficulties regarding personal independence payment applications. It has been suggested that staff managing PIP applications and renewals need better training and understanding of mesh injury. There has been some progress, apparently, in the gradual acceptance that many women had not given informed consent at the beginning, and this is perhaps beginning to make itself felt in relation to the legal actions that some people are undertaking. Just imagine being in constant pain and having the burden of undertaking those legal actions.

There is concern that mesh removal centres do not seem to have the same approach across the board for treatment or surgery. There are also very lengthy waiting lists if someone opts for a second opinion, for the reason I have already explained or any other reason. Mental health support and counselling is not readily available, which is another gap. We have already heard an excellent contribution by the hon. Member for Shipley (Anna Dixon) noting that the 10-year limitation for legal action on medical devices needs to be reviewed, because by the time some women have confirmation that the mesh is the problem, the 10 years could well have passed.

I have already mentioned that the Government ought to be looking to assist the legal cases against the pharmaceutical company or companies. It would be interesting to know whether the Government are making any progress on the subject of interim payments, which I believe the Cumberlege report recommended prior to any more bespoke payments based on individual circumstances. Will the Government encourage the yellow card Medicines and Healthcare products Regulatory Agency reporting to be made mandatory? If people are not reporting in when these things go wrong, how can we be sure of the scale of the problem? Finally, it is noted that there is a clear need for transparency for the public to be aware of exactly what payments medical professionals in the health sector receive from the pharmaceutical industry when they recommend these “routine procedures” that so often go wrong.

I conclude with a case that I have deliberately anonymised. Nothing should be drawn from where I happen to represent as to which surgeon in which mesh centre I might be referring to. This is what one victim has said about someone I will call surgeon X. He

“operated on me in 2009 to insert the mesh, which was described as a simple procedure that would solve my problems. Mesh was eroding through the vaginal wall immediately, and I had seven further ‘repair’ surgeries, which did not solve the erosion problem. In 2016, he advised me he could remove the mesh, so I paid privately for the surgery. During the surgery, nerves were damaged, causing severe pain and limitations, and the mesh was not all removed. I am left with the pain and limitations permanently, and have been told by another surgeon that full removal is now not possible. This surgeon is the clinical lead of the mesh centre”

local to her. She concludes:

“No surgeon should ever be allowed to cause damage to multiple patients, yet not only continue to perform the same surgeries, but to be head of the very centre which should be helping women. I feel sick at the thought of passing him in the street, let alone needing to see him as a health professional. I am sure we all feel the same.”

House of Lords Reform

Debate between Graham Stringer and Julian Lewis

Tuesday 10th January 2023 Westminster Hall

[Sir Julian Lewis]

If we were having a debate about Scottish independence, I would be happy to engage with that. Our Scottish colleagues have quite rightly chosen to participate in the UK national constitutional debate, and that is what we are considering this afternoon. I have a firm view that if the House of Lords had to go, it would be far better to have a single elected Chamber, rather than two elected Chambers that would perpetually be either deadlocking or rubber-stamping each other.

[Graham Stringer]

I agree with the thrust of the right hon. Gentleman’s arguments. Does he agree that there is a fallacy in the comparison with other countries that have two different systems and an upper House? They rely on a written constitution and the courts interpreting it. That fallacy is deep within the Brown report—somehow, constitutionally, we will limit one House when we do not have a written constitution. Is that not a nonsense?

[Sir Julian Lewis]

The hon. Gentleman is an independent thinker on his party’s Benches. Not for the first time, I find myself in total agreement with him. The hon. Member for Ellesmere Port and Neston (Justin Madders) said that the system of two elected Houses works well in other democracies. I am not sure that the citizens of the United States would entirely endorse that opinion, great though their democracy is.

Combat Air Strategy

Debate between Graham Stringer and Julian Lewis

Thursday 27th June 2019 Westminster Hall

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

It is a pleasure to make a brief contribution to this debate under your chairmanship, Mr Stringer. All three previous speakers have shown absolute mastery of the detail, which I cannot hope to match in this context, so I intend to draw out some of the broader issues and seize a particular current opportunity: the forthcoming election of a new leader of the Conservative party and Prime Minister.

Occasionally in politics, a window of opportunity opens, usually when aspiring leaders of the nation wish to generate support from those whom they presume to lead. We on the Select Committee on Defence met on Tuesday and decided that we would write to both of the final candidates in the leadership election. I have in front of me the text of the similar letters sent to each, picking up on the Foreign Secretary’s bid for the support of defence-minded MPs. In those letters, we spell out the fact that the Defence Committee, whose members represent four different parties, has for several years been absolutely united about the fact that we need to be spending more on defence.

In particular, the Committee believes that we ought to have as our target figure not the bare 2% of GDP that we currently just about manage to spend, but a figure approaching 3% of GDP, the proportion of gross domestic product that used to be spent by the United Kingdom—not during the cold war, when that figure was 4.5% to 5%, but as late as the mid-1990s, several years after the cold war had come to an end.

The complexity of weapons systems in any of the dimensions that we might care to identify—land, sea, air, cyber-space, or space itself—is increasing. If we do not have an adequate financial base for defence, it is difficult to see how any of those projects can hope to be brought to fruition. That applies as much to what from this moment onwards I will call “the Tempest strategy” as it does to every other system.

In a few moments, I will come back to the terms of the letter that I sent. However. I want to emphasise what my hon. Friend the Member for Berwick-upon-Tweed (Anne-Marie Trevelyan) has just said by noting that as these advanced weapons systems get more complex, their numbers get fewer, and they have to be planned longer and longer in advance. Needless to say, they also cost a great deal more. I am a little more familiar with the cycle involving warships than I am with aircraft, but we can see the same pattern. For example, there are two types of submarines: nuclear-powered attack submarines and ballistic missile submarines. No sooner have we completed the construction of a class of one of those vessels than we have to construct a class of the other.

[Graham Stringer (in the Chair)]

Order. I do not wish to interrupt the right hon. Gentleman, who is making some interesting points, but the question is “That this House has considered Combat Air Strategy progress and next steps.” I hope the right hon. Gentleman will focus his remarks on the objective of the debate.

[Dr Lewis]

All will become clear very soon, Mr Stringer; you have my assurance.

Just as we must not interrupt that cycle, whether it be for a nuclear-powered submarine that is an attack submarine or a nuclear-armed submarine that is a ballistic missile submarine, we must not interrupt it for frigate or destroyer construction. We face exactly the same problem with aircraft strategies: we have gone from the Typhoon to the F-35, and even as we are introducing the F-35—the fifth-generation aircraft—we must already be planning for the sixth. That is despite the fact that, as has been pointed out, one of the existing aircraft still has at least 20 years to go in its lifespan, and the other has only just begun a period in service with the Royal Air Force lasting probably twice that. The question that arises, therefore, is how the new generation of aircraft can be financed.

With that, we come back to the issue of what we are being promised. Whenever Prime Ministers or Defence Secretaries are in place, we are told constantly that all is fine and everything in the garden is rosy and flourishing, yet when Defence Secretaries leave their position, they immediately call for increases. Recently, one brave Defence Minister even said at the Dispatch Box that we are not spending enough on defence. Now, we find that the Foreign Secretary is saying that within the next five years we ought to increase defence spending by a quarter, and he even made a speech at Mansion House suggesting that over 10 years, the rate of increase should be that much greater.

Looking at the Tempest strategy, we have to ask ourselves how an aircraft of that degree of complexity, requiring so long to be designed and brought into service and demanding so much in the way of our resources, will be financed. The sole issue that I wish colleagues to consider today is that, if it takes 30 years to conceive and build the sixth generation of our air power, we will have to invest a great deal of money in it. We on the Defence Committee have worked across party lines to try to change the terms of the debate on funding aircraft, land systems and naval systems, as well as dealing with the issues that arise from what are commonly called the 21st-century threats in space and cyber-space.

It is a matter of concern that there have been indications that the permanent part of defence and security machinery has been advocating that we move away from our traditional profile and stance: of investing in such systems as those aircraft to a greater degree than the rest of our NATO European allies. Normally, as we know, the overall burden of NATO’s expenditure has been borne by the US superpower; the continental allies have put forth something below the minimum guideline and we have been somewhere in between.

It has been disturbing to see arguments being put behind the scenes that we should come to terms with the fact that we should not in future seek to outdo our continental European allies and should lower our expenditure to the level they invest. Personally, I feel that would be a disastrous mistake—it would mean that we would no longer be able to rely on retaining an industrial base that could produce and develop weapons systems of a complexity to keep us at the cutting edge of air power, sea power and land power, let alone protect ourselves in space and cyber-space.