NHS Hysteroscopy Treatment

Debate between Lyn Brown and Barbara Keeley

Tuesday 31st January 2023 Westminster Hall

[Ms Lyn Brown (West Ham) (Lab)]

I beg to move,

That this House has considered the matter of NHS hysteroscopy treatment.

It is an absolute pleasure to serve under your chairship, Sir Mark. I am particularly glad to be joined in this debate by hon. Friends and by the hon. Member for Thurrock (Jackie Doyle-Price). When she was responsible for women’s health, she took this issue seriously. We had a number of highly productive meetings about it, so it is welcome that we have the benefit of her ministerial experience in the debate.

This is the 10th time that I have spoken in this House about the completely unnecessary pain and trauma that women are subject to when they undergo hysteroscopies. Women who need pain relief are simply not being given it. They are being patronised, belittled and, frankly, betrayed. Effectively, they are bullied into accepting treatment so painful and damaging that they would never have agreed to it had they known what was coming.

I first spoke about how this issue needed to be resolved 10 years ago, at the behest of a constituent who came to my surgery to talk to me about her experience. Frankly, I am horrified that precious little seems to have changed since then. I will share a few of the recent stories that women have sent me since the last time I spoke about hysteroscopies in this place. I have had to choose very carefully: the number of women who have written to me is large, but my time this afternoon is short.

Julie had a hysteroscopy in July last year. She is 71 years old and wears hearing aids. Julie thought she was going in to see a gynaecologist and perhaps to have an ultrasound to investigate unexpected bleeding. She had been given no additional information, despite having waited for that emergency appointment for six long months. I can imagine how frightened she was. As expected, Julie’s appointment started with an ultrasound; unfortunately, the scan showed some thickening in the lining of her womb. Julie had removed her hearing aids to avoid losing them, which had happened before, so she could not clearly hear what was being suggested, but she was told that another procedure was necessary. A different nurse came in, and that was the very first time that Julie heard the word “hysteroscopy.”

Julie was, of course, a little confused about what was happening, because she could not hear properly, but she managed to make out that she might feel some mild cramping as the fluid and the scope were inserted. However, she describes the pain as utterly excruciating. The nurse tried to talk her through it and take her through breathing exercises, but they did no good—how could they? Julie was in a clammy sweat; she was worried that she would pass out. She was asked whether they could continue, and she was so worried about the ultrasound findings, and the last six months’ wait, that she said they could. A second attempt was made. Julie simply could not hold back her tears, or even breathe, through the terrible pain. Thankfully, the nurse asked again whether the procedure could stop, and Julie could say nothing but yes.

Afterwards, Julie was terribly woozy. She was wobbly, and scared that she would faint and fall. She was well cared for at that point—given pads for the bleeding and hot packs to help with the severe abdominal cramping. She lay in the recovery suite for about an hour, crying. Even after that, she was disassociated, trembling and struggling to walk. I remind hon. Members that she is 71 years old. She is truly lucky that she did not fall and break something.

Another woman who wrote to me was so overwhelmed by the pain of her hysteroscopy without pain relief that she fainted and fell from the full height of the operating bench to the floor. After that, she was left with not just serious bruises but lasting dizziness that has led to repeated falls and broken bones. It has physically affected her so badly that she has found it hard to stay in work for the very first time in her life.

In some ways, Julie was lucky, but the lasting impact on her was still significant. She vomited, and when she got home she continued to bleed for more than a week afterwards. She describes herself as stoic. She has had several surgeries before, and she lives with serious arthritis, so she is no stranger to pain. In her words, what she went through was “a brutal, torturous experience”.

The shameful truth is that at no point was Julie offered any form of pain relief at all. She only heard that a hysteroscopy was even a possibility while lying on the examination table with her legs up in stirrups. It is frankly a miracle that she was not so traumatised as to lose trust completely in the NHS, but she has since been back. She has had another hysteroscopy under general anaesthetic and found it an utterly different experience. All the procedures and risks were explained beforehand, and she had outstanding care throughout.

While Julie was in the waiting room for the second, successful hysteroscopy—this points to how commonplace this experience is—she met another woman whose experience was just like hers. The other patient was just as upset, but said she would not make a complaint because she felt she would just be ignored, and that would make her even more stressed. Sadly and understandably, most people who have had similar terrible experiences with the procedure are like the woman Julie met. We never hear their stories.

Let me offer some more testimonies to give voice to those whose pain and distress were completely ignored. Martha was seriously injured during her hysteroscopy last August. She went in for a check-up after she had bleeding for several days after starting hormone replacement therapy. Her GP referred her for the hysteroscopy, but although he explained some of what the procedure would involve, he was, in Martha’s words, “blasé”. He showed absolutely no understanding that Martha’s medical history and conditions made extreme pain and damage much more likely. When the procedure began, Martha described the pain as “excruciating”—exactly the same word that Julie used.

Martha screamed out, “No, no, stop,” repeatedly, yet when the doctor looked at her, he looked very unimpressed. He asked her whether she would rather he stopped so she could come back and have it under general anaesthetic. She said yes, but instead of listening, he insisted that he have more time—just 30 seconds. He went in again with a smaller scope, but again it caused searing pain.

After the procedure, Martha understandably felt violated, but sadly that was far from the end of her ordeal. She had burning pain for weeks, mixed with a loss of feeling in her groin. She developed repeated bladder infections and double incontinence, and her muscles started wasting. She had difficulty standing and walking. Eventually, Martha was told that she had post-operative nerve damage. To put the cherry on the cake, I understand that the doctor who did this to Martha recorded her pain score as just one out of 10. To me, this sounds very much like fraud—on top of sheer callousness, absolute incompetence and indifference.

Martha describes herself as a fiercely independent woman who does not suffer fools, but she told me she had the overwhelming feeling she had been duped and made a fool of. She says she has always trusted professionals, but never, ever again. She is reeling because the NHS that she supported for decades

“managed to injure me and cripple my life, take my self-respect and my confidence in under 15 minutes.”

Martha tells me—I think she might be right—that the next great women’s health scandal after mesh implants will be this.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I am really appalled, and I want to raise a point with my hon. Friend. The situation Martha found herself in is happening up and down the country. A constituent who was due to have a hysteroscopy examination at our local hospital in Salford was told the same thing as in the stories my hon. Friend is telling: “Local anaesthesia can be given if necessary” and “Take paracetamol one hour before.” However, this constituent had a family member who had had a hysteroscopy in a private hospital and was offered a general anaesthetic because the procedure was “too painful” to be performed in any other way. So the NHS patient in a private hospital is offered a general anaesthetic, but the one in an NHS hospital is not. When I wrote to the hospital on my constituent’s behalf, I was told:

“a general anaesthetic can be requested, though the medical team advise against it.”

There is a key question that I want to put to my hon. Friend. It is all right to say that the procedure can be stopped or carried out later, but does she believe that the information given to patients is wrong and that that is not acceptable care?

[Sir Mark Hendrick (in the Chair)]

Order. Can I ask that, when hon. Members intervene, they make it short?