Independent Medicines and Medical Devices Safety Review

Julian Lewis Excerpts

Thursday 8th July 2021 Commons Chamber

[Emma Hardy]

I completely agree and thank the right hon. Gentleman for bringing this debate forward and championing it from the other side of the House. He correctly says that we need to have all that evidence so that people can give that informed consent.

Finally, the report recommends establishing specialist treatment centres

“to provide comprehensive treatment, care and advice”.

Some of these care centres are being established, which is good news, but again there are concerns about the data collection on patient outcomes after mesh removal and not all women are having all their mesh removed—some of this is only a partial removal. Again, what questions are being asked and what data is being collected? I have submitted numerous written parliamentary questions to the Department but have yet to receive a clear answer on exactly what data will be collected.

There are also important questions to be answered on the competence of surgeons to undertake removals. I know that my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) has a very difficult story on this issue. The Department says that it is for individual trusts to decide which surgeons to use for removals, but I do not share that view. How can it be fair to ask a woman to return to the same surgeon who put the mesh in, causing her all that harm, in order to have it removed? I really think we need to look at this issue again.

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

The situation is even worse than the hon. Lady suggests, because in some cases these surgeons, who have now been appointed as lead figures in the mesh centres, are the people who not only put the mesh in but then persisted in denying that the mesh was the cause of any of the terrible problems their victims had suffered.

[Emma Hardy]

I thank the right hon. Gentleman and completely agree with his point.

We are now one year on from publication of the Cumberlege review. Of course I accept that there has been a pandemic, but there is nothing to stop the Government accepting the recommendations. We would all be quite realistic and understand that the Government can accept the recommendations but that there would have to be a delay in implementing them, because of the pandemic. That would be fine, but they have not. They have implemented only two recommendations, on an apology and on the appointment of a patient safety commissioner.

Given the lack of progress and the concerns that I have outlined, to which I know colleagues here will add further, I urge the Government to reconsider the implementation taskforce. The problems identified by the review are systemic and of long standing and, if unaddressed, will condemn more to a lifetime of suffering. It is essential that they are brought to an end, and to do so the review’s recommendations must all be implemented in full.

--- Later in debate ---

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

I must say it is quite hard to speak unemotionally after hearing the tragic story that the hon. Member for Ayr, Carrick and Cumnock (Allan Dorans) has relayed to the House. How much more difficult must it have been for Baroness Cumberlege to hear dozens, if not hundreds, of such stories of individual human suffering? She came up with a truly magnificent report and the House of Commons had what I thought was one of its best days for a long time when we discussed it, in no small measure due to the Minister for Patient Safety, Suicide Prevention and Mental Health, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries) and her response to the report. We would all have felt quite justified in thinking that, at last, there was real light at the end of this horrible, terrible, awful tunnel, but it does not seem that we have got to the end of it yet.

I took from Baroness Cumberlege’s report one particular area of hope, and that was the establishment of the specialised mesh centres, and I wish to focus in my contribution on three questions. First, are the mesh centres truly dedicated and comprehensive one-stop shops offering all the types of treatment likely to be needed and all the types of investigation likely to be required, if not under one roof, then at least within a single footprint, or are they merely specialists hubs in name only?

Secondly, there is another problem related to the centres. Are we seeing a situation in which surgeons who could have been described as mesh problem deniers are now reinventing themselves as mesh problem remediators? I do not think they are qualified to hold that role. I fear that there is an attitude of mind that says, “Well, it’s not that easy to find people who specialise in this area, and therefore, even though these are the people who put the mesh in, maybe they are the people who are best qualified to take the mesh out.” I absolutely refute that. Not only did those people put the mesh in, but when the patients came along time and again to say what terrible problems they were suffering, those were the people who refused to listen to them. They were the people who, in some cases, insisted on putting more mesh in, and they were the people who, in other cases, refused to let the patients have a referral to figures such as Miss Sohier Elneil in London or Professor Hashim Hashim in Bristol, who are—or were at that time—the true, and possibly the only, specialists in mesh removal.

When I was thinking about what to say in the light of what had gone before, I was debating whether I should use the word “butchered”, but my right hon. Friend the Member for Elmet and Rothwell (Alec Shelbrooke) did use it in his most powerful speech and I will use it as well. The idea that someone who has butchered your body is an appropriate person for you to go back to, after all that, and that they could then say they are going to take the mesh out, when that person may well have stood in the way of your perhaps going to see Miss Elneil or Professor Hashim, who could have done something for you, is unconscionable.

My third question is: what research is being undertaken on new methods of safe removal? If indeed it is the case that an argument is going to be made that there might be some future use for mesh in safer ways, what research is being done to see whether or not something could be developed that would not run the risks of this disaster?

I shall say something very fanciful now, and it is probably nonsense, but the thought occurs to me, hearing about the way in which the flesh grows around the mesh, the mesh fractures and it becomes so very difficult to remove: has anybody ever thought that it might be possible to develop a future type of mesh, if this is not possible with the mesh that has already been put inside people, that might conceivably be harmlessly dissolved within the body if something went wrong, by the addition some sort of chemical? That may be absolute nonsense, but the point is that unless specialist research is carried out, this sort of botching and butchery is going to continue.

As a result of the three constituency cases that I originally cited in a debate on—it is hard to believe that it is more than three years ago—19 April 2018, I have received certain amounts of information and concerns from Kath Sansom, who does such wonderful work with the Sling the Mesh group. I conveyed a message to her and basically said, “If you were standing up in this place today, what points would you like to put over?” She said:

“The debate is calling for all Cumberlege recommendations to be implemented without further delay, including financial redress for women and sweeping reform of the healthcare and regulation framework. Women are losing hope that they have been properly listened to. They need urgent financial redress for the many losses they have suffered. They want to know also when they go to a specialist centre that it is not a postcode lottery of care. To date the specialist centres are special in name only.”

In other words, is there really a new centre, or are people being sent from pillar to post for all the different parts of the investigations and having to wait months between each particular appointment for each particular type of investigation?

Kath also said:

“There has been no national training programme and no agreed way to measure success—they haven’t even agreed on outcome logging measures to standardise the data capture.”

She also made the point, which I think I have made strongly enough, about some of the centres

“being run by pro mesh surgeons who have denied mesh is a problem”.

[Alec Shelbrooke]

I said this in my speech, but it is worth emphasising again. We are talking about what needs to be done and what is happening, but we must also come back to people; as my right hon. Friend says, people are very important. Women are killing themselves. They are killing themselves. Look at the suicide rates for women with mesh problems and endometriosis. Women go through crippling pain, and dozens a year are taking their own lives. Does that not make the point that my right hon. Friend is making—that we have to move more quickly on this?

[Dr Lewis]

It totally does. I shall share a little something with the House. Although it does not compare with the agony of what these women are going through, I lost a year and a half of my life when I was given some inappropriate treatment that resulted in my being unable to read for a year and a half during my early 20s. What really made it worse was the knowledge that, if I had not asked for a particular treatment to try to improve my tired eyes because I was studying, none of it need have happened. How much worse must it be for these women, many of whom are not only undergoing all this suffering, but are undergoing it because they were told it was a minor procedure and they thought, “Oh, well—maybe I will have it, then.” If only they had known, they would never have gone within a mile of it. They must be saying that, over and over again. To expect them to go back to the same surgeons who did not tell them what the consequences could be is inhumane and totally unrealistic.

The issue of some people having a financial interest in promoting certain products has been touched on. We are obliged to declare our interests in this House and perhaps something like the Physician Payments Sunshine Act would be the equivalent for people in this context.

Finally, Kath draws attention to what she calls a black hole in official statistics. She says, for example, that according to hospital statistics, in the year 2008-09, 1,038 women were readmitted to hospital with problems within 30 days of a mesh sling having been implanted. In comparison, data derived from surgeons says that only 104 women were admitted to hospital—that is something like 10% of the total. Some 934 women have somehow gone missing from the surgeons’ data.

These are strange and disturbing features. This House has shown itself at its best in condemning what happened. The Government need to build on that and put in place the measures recommended by the report to make it far less likely that it could happen again.