Surgical Mesh

Kevin Hollinrake Excerpts

Thursday 19th April 2018 Commons Chamber

[Dr Lewis]

Indeed. I would be surprised at that, because if that is what Dame Sally believes she ought to be making different recommendations.

I have been given a particular study, which is described as the largest study of surgical mesh insertions for stress urinary incontinence. Over 92,000 women were surveyed in this particular examination, including all NHS patients in England over an eight-year period. The conclusion states:

“We estimate that 9.8% of patients undergoing surgical mesh insertion for SUI experienced a complication peri-procedurally within 30 days or within five years of the initial mesh insertion procedure. This is likely a lower estimate of the true incidence.”

I reiterate my point about acceptable and unacceptable percentages. When we are talking about these very large numbers, even relatively low percentages make the procedure too risky to be used in anything other than last-resort circumstances similar to those described by the hon. Member for Glasgow North.

In the past decade, my constituent Emma has undergone X-ray-guided injections, ultrasound scans, MRI scans, in-patient stays, tests galore, more and more scans, and, eventually, a biopsy. She has been refused referral to a mesh specialist centre. It seems highly likely that she should never have been given a mesh implant in the first place after the trauma of such a difficult birth, which leads me to the next point about inadequate warnings. I understand from my constituents that they were given little warning, and in many cases no warning at all, about the potential dangers.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

My right hon. Friend is making some very important points. Does he agree that prevention is better than cure? If physiotherapy were offered to women after childbirth, that might obviate the need for any surgery at all as a result of these kinds of complication.

[Dr Lewis]

Indeed. The problem with this issue, as it has been impressed on me at any rate, is that this has been put forward as a quick-fix alternative to other procedures, whether surgical or not, which would take much longer.

Having paid thousands of pounds for private specialist assessment, in the end Emma eventually managed to get the sort of referral she wanted. I have been given the following clinical summary of her condition:

“Vaginal mesh; foreign body giant cell reaction, chronic inflammation and fibrosis.”

I have a page here that lists some 50 different symptoms related to implant illness and foreign body giant cell reaction. I venture to suggest that if this ghastly catalogue of things that could go wrong had been shown in advance to those 100,000-plus women who have had a mesh implant, more than 90% of them at least would have turned it down.

This is what my constituent Eileen wrote to me:

“The effect that this has had and is still having on my life is massive. I can no longer carry out basic tasks at home or do things with my children due to the pain. I need to take medication every day from my GP to try and ease the pain. I cannot go to work at present due to the pain and I am currently on sickness absence leave from my job. The mesh implant that I have had has and is continuing to destroy my life. I need an operation to remove the mesh implant, but the operation is very complex and unfortunately there are limited amounts of surgeons who are experts in the full removal of these mesh implants. Due to my financial situation, I am not in a position to be able to afford to have the full removal of the mesh implant done privately and therefore I am having to wait for this to be done on the NHS which is taking far too long.”

I turn now to Helen, who probably has the most horrifying story of the lot. She was 35 when given what was described to her as routine surgery 16 tortured years ago. She was initially told that it was her fault that her body was rejecting the two mesh implants. She then went through a cycle of implants, the removal of protrusions and eroded segments and seven bouts of surgery. Three TVTs—trans-vaginal tapes—are still inside her, she suffers chronic pain from orbital nerve damage, constantly needs painkillers and has had constant side effects, indifferent treatment and a refusal to admit fault or to refer her to an out-of-area specialist in mesh removal. She writes:

“I do not want anyone from the hospital coming near me ever again. I have lost complete faith in them. I have been lied to and told repeatedly it was my body rejecting the mesh; but, unbelievably, they kept putting more in.”

She suffers from truly terrible bowel problems, some no doubt caused by the side effects of the painkillers and the sleep aids she has to take. Consequently, she suffers from depression, loss of confidence and lack of self-esteem. She further writes:

“I feel let down by professionals who were supposed to treat me to the best of their ability. There has been information about the adverse effects of mesh around for years, yet these doctors are still happily inserting them into thousands of women.”

She is desperate to be referred to one of the few doctors who specialise in mesh removal and feels trapped under the control of the very people who have let her down. She continues:

“I want these devices out of my body.”

Who can blame her?

Let me conclude by quoting, from an article in The Daily Telegraph of 23 October last year, a lady who suffered for eight years:

“I just wish I had never, ever had it done. I would rather have coped with that very minor problem of stress incontinence than this. If I had known even one of the possible risks of the surgery there is no way I would have had it done. I am furious that I was never told that this could happen.”

--- Later in debate ---

[Kevin Hollinrake (Thirsk and Malton) (Con)]

I thank and congratulate the hon. Members for Kingston upon Hull West and Hessle (Emma Hardy) and for Pontypridd (Owen Smith), as is customary and also entirely justified on this occasion. This issue must be kept in the public eye.

One of the great privileges of being an MP is being able to give people a voice—to represent people in our constituencies who have been wronged, often in terrible circumstances through no fault of their own. In this case, for me that person is here today in the Gallery: Jacqui Cheetham. I am delighted to be able to represent her story, and her words are far more powerful than mine could ever be. When she visited me at my surgery what came across was the scale of the problem and also its traumatic consequences given the relatively minor condition that Jacqui suffered from before the operation took place.

I would like to use Jacqui’s words rather than my own, because, as I have said, they are far more powerful than mine could ever be. She explained that she had two surgeries using mesh, in 2005 and 2006:

“Within a few days of surgery I had severe pain in my groin and bladder. I was referred back to York Hospital on many occasions. The surgeon said he could find nothing wrong with me and eventually recommended I saw a psychiatrist, as he believed it was all in my head. As a teenager I had a history of mental health problems when my parents went through a nasty divorce. I was left to bring up my younger sister and take my main, secondary school exams. I simply could not cope but because this is on my medical records, even though the mesh operation was many years later they still referred back to that time and thought this must also be psychological. My GP spoke up for me and told them I was not depressed and demanded they find a solution. Eventually I was given a MRI scan and the mesh was found sticking into my bladder. I was then operated on to partially remove the mesh. After the operation, the surgeon described the pain of the mesh sticking into me as being like barbed wire as the raw edges of the material had hardened. It’s intended that your body should mould itself into it and removal would be like extracting it from concrete…

Since 2006 I have lived my life in constant pain. I take concentrated Oramorph and wear…Buprenorphine patches. I also take codeine for ‘break-through’ pain.

I was a fit young mother in my late 30s when I had this done, suffering mild incontinence. My ambition was to run the London Marathon and I found the incontinence merely a nuisance. How I wish I could go back to those days! I would never have had this operation, had I known this possible outcome. I was not warned of any such dangers.

I now cannot walk far. I can’t stand or sit for extended periods of time. I struggle with simple tasks that require my concentration. Both my drugs and my pain affect my sleep. I am now 50, though I feel much older.

Quite simply, this operation has ruined my life and has had a massive impact on my family. My children are now grown-up but they were young at that time and I was unable to be a proper mum to them; unable to run and play with them as a parent should. There seems to be a misconception that the mesh which causes the greatest problems is “prolapse mesh” but this simply is not the case. All mesh can cause problems.”

I know that the ministerial team is very concerned about, and aware of, these issues, in part due to the fine work of parliamentarians. Ministers rightly point out that no healthcare system in the world has yet banned this treatment, and they set about the review in February 2018, which has provided much of the information that we now have to address these points.

As my right hon. Friend the Member for New Forest East (Dr Lewis) pointed out, the scale of the problem is becoming clearer, but I do not believe we understand the true scale yet. The recent Guardian report said that out of 100,000 operations there were 6,000 removals, so there is an issue with at least 6%, and that is just the ones that have been removed, so we know the scale is greater than is currently acknowledged.

Something needs to be done now. It is heart-warming that the people who come to our surgeries to tell their stories want most of all to prevent this from happening to others, and we must pay credit to the people from the Sling the Mesh campaign for what they have done to benefit others as well as trying to redress some of the difficulties they experience themselves.

The hon. Member for Kingston upon Hull West and Hessle raised the issue of physiotherapy, and she is absolutely right: prevention is better than cure. She mentioned that this problem has cost the healthcare system £245 million; it would be a true economy, not a false economy, to implement what she suggests as a simple first step for new mothers.

We also need to get to the bottom of the issue by having a true audit, including of, for example, private patients, to make sure we know the true scale of the problem; I support those calls. It must also be sensible when there are alternatives to look at a suspension of this treatment today. Burch colposuspension and autologous sling are alternative treatments, and it makes sense to me and certainly my constituent to suspend this treatment and look at other treatments in the meantime while we find an alternative. Perhaps the new Sheffield University treatment will prove effective, but, as the Chair of the Health and Social Care Committee said, it needs to go through a clinical trial rather than women effectively being used as human guinea pigs. I support the extension of that until clinical trials can show that we have a solution without the traumatic consequences that affected so many women.