Cumberlege Review: Pelvic Mesh

Sharon Hodgson Excerpts

Thursday 5th December 2024 Westminster Hall

[Mrs Sharon Hodgson (Washington and Gateshead South) (Lab)]

Do you want to give some guidance on how long is left, Mr Stringer, so I can cut my speech accordingly?

[Graham Stringer (in the Chair)]

I intend to call the spokesperson for the Liberal Democrats at 2.30 pm.

[Mrs Hodgson]

In the short time I have available, I will try to make some important points. It is a pleasure to serve under your chairmanship, Mr Stringer. As co-chair of the all-party parliamentary group for first do no harm—along with Baroness Cumberlege, who it is a pleasure to see in the Public Gallery—it is a pleasure to speak in this important debate. I also point out how many officers of the all-party group are here in the Chamber, on a Thursday and on a one-line Whip. That speaks for itself as to how important the issue is to the House and to all of us. I thank my hon. Friend the Member for Harlow (Chris Vince) for securing this important debate to shed further light on this still under-discussed scandal.

Members present, campaigners watching at home, and especially patients, will all be aware of the extent of the injustice. I have had the privilege of working with wonderful campaigners over many years, and I take this opportunity to pay tribute to Kath Sansom from Sling the Mesh, who is a key campaigner for mesh victims and has been a great support to me and to colleagues over the years. I am glad that she is in the Public Gallery to watch the debate, alongside Debbie, who is the constituent of my hon. Friend the Member for Harlow, and who brought this scandal to his attention.

My first contribution in this House on surgical mesh was in 2017, during my time as shadow Minister for Public Health, and I am glad to see the actual Minister for Public Health and Prevention in his place to hear this debate. I have continued to campaign tirelessly on the issue through debates and my work with the all-party group ever since.

The issue is not only of political importance to me; it matters to me on a profoundly personal level. As I am sure some in the Chamber will know, among the thousands of women affected by mesh complications is my mam, who was one of the 617 mesh-damaged women who met, or made submissions to, Baroness Cumberlege for her review. I took my mam along to an evidence session in Gateshead, and she was able to meet Baroness Cumberlege and tell her story personally. She still talks about that to this day—she is very grateful.

After suffering mild stress incontinence, as we have heard from a number of people who went through the procedure, my mam had SUI surgery to have some tension-free vaginal tape inserted, which was a quick and common treatment offered to women for incontinence. However, had she known the life-limiting complications she was about to suffer as a result, dealing with slight stress incontinence would not have seemed very bad at all.

Two to three years post-surgery, my mam had one health complication after another. She suffered all sorts of autoimmune reactions, recurrent urinary tract infections, and was in constant pain in her groin, arms and legs. She became a shadow of her former self, and it took us quite a few years to work out what was causing the symptoms and pain. It was only through my research for that debate back in 2017 as the shadow Minister that I was able to join the dots together, and from that moment on we both wished constantly that she had never had the operation.

My mam will be 80 in January, and she would say that she is one of the lucky ones. Since I first spoke on the topic, she has been able to get the mesh surgically removed. It was a long delicate operation, thankfully carried out by the amazing Suzy Elneil, which she had to undertake in London in order to avoid the surgeon who put it in her in the first place—something that the right hon. Member for New Forest East (Sir Julian Lewis) and others have spoken about. That is something that many mesh-damaged women will understand. With the removal of the mesh, many of her health complications vanished immediately. The road to recovery is far from smooth for many mesh-damage victims, however, and my mam is no exception. She is still recovering to this day and, in her words,

“will never be the same again.”

I sat next to my mam at her local hospital and watched her be gaslit and undermined by her original surgeon when she first sought help with her pain and symptoms. Our doctors, surgeons and healthcare providers are meant to protect us, not harm us. Hence, “first do no harm”—an unwritten contract between patients and healthcare providers that rightly makes us feel that when we seek medical help, we trust that we will be made better, not worse. Surely the least we can expect in cases where harm does happen is accountability and for wrongs to be righted. Instead, we see a culture of defensiveness and a lack of accountability. It is therefore shocking that the surgeons responsible for the implantation of this life-shattering mesh are the very same people tasked with removing it.

I was going to talk about Baroness Cumberlege’s recommendations—which we have had success with and which we have not—but sadly the right hon. Member for New Forest East used up all the time, so I cannot.

[Sarah Green (Chesham and Amersham) (LD)]

It is a pleasure to serve under your chairmanship, Mr Stringer. I thank the hon. Member for Harlow (Chris Vince) for securing today’s debate. We are here because four years after being published, the Cumberlege review has not been implemented and there is still no redress scheme. I will turn in more detail to the progress made on those recommendations, but first I pay tribute to the many individuals who have campaigned so hard for so long to be heard, for their experiences to be taken seriously, to receive some sort of justice, and to know that the same harm will not be done to others. Some of them are in the Public Gallery today and I thank them for their tireless campaigning.

I also pay tribute to the right hon. Member for Godalming and Ash (Jeremy Hunt), when he was Health and Social Care Secretary, and to the former Member for Maidenhead, when she was Prime Minister, for commissioning the review in the first place in February 2018. Baroness Cumberlege has never stopped giving voice to those she encountered during the two years she led that review. She has gone to great lengths to keep this issue on the agenda. She is due to retire shortly and we will miss her. I would like to say how grateful I am, as I know others will be, not just for her advocacy on this issue but for her encouragement and support of hon. Members in this place to do the same. If I may be so bold, Baroness Cumberlege has played her part. It is now up to us in this place to hold this new Government to account and to ensure that her recommendations are implemented in full.

Let us not forget that the Cumberlege review was called “First Do No Harm”, because at its centre are people who suffered avoidable harm—harm done to them by our health system. I was first introduced to this issue by my constituent Carol. I have shared her story before and remain in awe of her dignity and desire to help others despite having experienced the most devastating medical trauma. She needed her MP to help her get a visa for the United States for urgent medical treatment during the pandemic because of the travel restrictions that hon. Members will remember. She had undergone a hysteropexy and a rectopexy using surgical mesh.

Instead of resolving Carol’s pelvic organ prolapse, the procedures left her with a serious autoimmune disease, struggling to walk and unable to continue her normal daily life. She had to take long-term sick leave from her job as a doctor and could not remember a day without pain. When she contacted me for help with her visa, she was seriously unwell and had been told that she urgently needed her mesh removed or her prognosis was not good. We managed to get her the visa she needed. She is now mesh-free following a successful removal, and she is the first person in England to have undergone successful rectal mesh removal. She is still suffering, but is no longer in the same danger that she was. She is clear that she was able to look outside the NHS and the UK only because her medical training and personal resources enabled her to find Dr Veronikis, who treated her successfully. I should say at this point that there needs to be more awareness of rectopexy mesh, which affects men, women and children.

Carol and others like her were given hope when the Cumberlege review was initiated, and again when it was published in July 2020 with its nine recommendations. I am sorry that to say that not enough progress has been made on those recommendations since. The reality is that only two of the nine recommendations have been implemented in full. The first was an apology, which was given as soon as the report was published. The second was to establish the office of the Patient Safety Commissioner.

Beyond that, things have stalled. Recommendations 3 and 4 called for an independent redress agency, and for redress schemes to be established for all three interventions. After originally rejecting those two recommendations, the Health Minister at the time asked the Patient Safety Commissioner in late 2022 to look at the options for providing redress for those who had been harmed by mesh and valproate. The commissioner’s report—the Hughes report—was published in February. I was present at its launch, and it really felt like a milestone; it felt as though progress had been made. Surely the Department would not commission that work if it had no intention of following through on a redress scheme.

That was in February this year. By the summer, when the election was called, the previous Government were still saying that they would respond to the report, so they never gave a formal response. To date, there has been no official response from the new Government to the Hughes report. In the words of the Patient Safety Commissioner:

“it is now urgent for the government to give those families some clarity. Many of them live with pressing financial hardship, as well as physical pain and disability…we must not compound the physical and mental harms experienced by these families by setting and raising false expectations if there is no intention to deliver on redress.”

[Mrs Hodgson]

I am grateful to the hon. Lady for covering the recommendations, which I was not able to do. That has relieved me somewhat. We have at last seen some compensation for the victims of Windrush, the infected blood scandal and the Horizon scandal. Does she agree that it is incumbent on the Government to treat this scandal with the same seriousness, fully accept recommendation 4 and put the redress scheme in place?

[Sarah Green]

I could not agree more. This is where I must pick up Carol’s story again. She tried to pursue her claim against her original surgeons through the courts, and she hit on an unexpected problem. She approached multiple legal firms who would not take her case because one or both of the surgeons were advising them on other cases and, as such, it would have been a conflict of interest. Indeed, the same surgeon who caused Carol life-changing injuries acted as an expert witness in an unrelated surgical mesh negligence case. The judge in that case said:

“he had cherry-picked those parts of the evidence which were supportive of the Defendant’s case and did not comment on those parts which were consistent to the Claimant’s. That is not the correct approach to be taken by an independent expert, whose duty is to the court. His evidence lacked balance and was unpersuasive.”

On this occasion, the judge called it out, but that is not the only instance of the medical profession closing ranks—it is not a unique occurrence. Such clear bias and conflicts of interest are a huge barrier to justice for mesh victims around the country.

The point of recommendation 3 in the Cumberlege review was to establish a non-adversarial avenue for redress after someone has been harmed in a healthcare setting. Both the Hughes report and, more recently, the Darzi report found that the current clinical negligence system is difficult for patients to navigate and prevents the healthcare system from learning from its mistakes. It is also eye-wateringly expensive for the taxpayer. If it is the dead hand of the Treasury blocking a redress scheme, Ministers would do well to reflect on that. As the Patient Safety Commissioner points out, the clinical negligence system is behind only nuclear disarmament and pensions on the list of liabilities on the Government’s balance sheet. I must ask the Minister when the Department will respond to the options outlined in the Hughes report, and when families can expect to see redress schemes up and running.

Recommendation 5 relates to the establishment of mesh centres around the country, and while such centres have been established, they get mixed reports from patients. My question on the mesh centres is about their outcomes. How is the Department ensuring a consistent service across them all, and how are outcomes being measured? With so many people reporting dissatisfaction with the centres, it is not enough that they exist; they need to be working well for the patients they are there to serve. Recommendation 6 relates to the MHRA, and it is clear that we still need the yellow card reporting system to improve. I would also welcome the Minister’s thoughts on progress against recommendation 7, which is about creating a central patient-identifiable database. To my understanding, it is still a work in progress.

The previous Government’s decision not to take forward the eighth recommendation, which is for a mandatory register, is disappointing. The recommendation called for

“Transparency of payments made to clinicians”

and

“mandatory reporting for pharmaceutical and medical device industries of payments made to teaching hospitals, research institutions and individual clinicians.”

I fail to understand why more progress has not been made on that. I know that campaigners have written to the Department asking it to consider a sunset Act that speaks to that recommendation, and I urge the Minister to chase a response to them.

Preventable Baby Loss

Sharon Hodgson Excerpts

Wednesday 4th September 2024 Westminster Hall

[Mrs Sharon Hodgson (Washington and Gateshead South) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I thank the hon. Member for Ashfield (Lee Anderson) for securing this important debate and for his moving opening speech. My thanks also go to Bliss for the briefing that it provided.

This is an incredibly important debate for me and, I have no doubt, for all of us here today. As some Members will know, I—like many others here today, sadly—have experienced the devastation of baby loss. Having not spoken about my experience of baby loss until 2016, 11 years after I became an MP, I know how difficult this can be to talk about openly. I want to thank all colleagues for being here, some of whom have personal motivations, as we have heard.

I want to tell you a little bit about my daughter Lucy and about my experience of baby loss. My daughter Lucy was born at 23 and a half weeks, and sadly she was stillborn. Her heart beat throughout my labour until just minutes before she was born. The experience of giving birth to a stillborn child is incredibly traumatic, as we have heard and as I have spoken about previously. It feels weird that the world around you is not responding as it would if you had given birth to a live baby. I felt that I made everyone around me, or anyone I met, feel very uncomfortable: it is one of the last taboos, as the hon. Member for Clacton (Nigel Farage) spoke about. No one knows what to say to you when you have lost a baby or given birth to a stillborn baby—it is everyone’s worst nightmare—so I did not talk about it, and I certainly did not tell anyone new to my life who had not known me before I lost Lucy. When I became an MP in 2005, it took me until 2016 to actually talk about it in this place, or to anyone from my post-baby-loss life.

What compounded this grief was the fact that Lucy did not receive a birth or death certificate. Even more upsettingly, in my records it was not recorded as a stillbirth; it was recorded as a miscarriage. Because she was just days away from being 24 weeks, she was three or four days short of the required legal age to be eligible for a death certificate. Because of that, she does not officially exist in any official records other than our own family records.

We did name Lucy during a blessing in a private room, which I was moved to after she was born, when I had to give birth in the maternity ward among all the live babies. She was then taken to the chapel of rest and we held a very small funeral service for her, organised by the chaplain at the hospital and the Co-op, which funded everything. I will be forever grateful for that: it meant a lot at the time and still does. The acknowledgment of Lucy’s existence that they provided us with was truly invaluable, particularly when it had been denied to us by the lack of a death or a birth certificate.

After my experience, I knew things had to change, even though I could not talk about it for a long time. Alongside the former Members Will Quince, Antoinette Sandbach and Victoria Prentis—some of us here will remember Victoria, who left the House at the last election—I became one of the founding members of the all-party parliamentary group on baby loss in 2016. I am pleased that the APPG is still going; I hope it gets reformed. It has become a vehicle for making great progress with regard to baby loss, in particular for securing bereavement suites across the country, improved patient pathways and better recording of data, among many more improvements. Still more are needed, sadly.

I then became one of only two MPs on the pregnancy loss review, alongside our former colleague Tim Loughton, following his private Member’s Bill. The review’s work resulted in significant changes—not least the decision, announced just earlier this year, that parents who lose a baby before 24 weeks of pregnancy in England can now receive a certificate in recognition of their loss. I know that this has been a great source of comfort for many who now feel they can finally get a formal recognition and acknowledgment that their baby existed. I am certain that it would have made a huge difference to me and my family.

[Carla Lockhart]

I thank the hon. Member for the moving real-life story that she has told. I commend her and her colleagues for their efforts on baby loss certificates. Does she agree that a greater effort needs to be made in the devolved regions—I am thinking of Northern Ireland—to replicate what is happening here in England with baby loss certificates, such is the importance of the issue for families?

[Mrs Hodgson]

I absolutely agree. I only realised that the certificates were just for England when we were pulling together my remarks for today. That is remiss; I encourage the devolved nations to follow the example of England and bring the certificates in, because they really make a massive difference to parents suffering early baby loss.

Despite these improvements, we still have a long way to go to provide the care and respect that all families need during such a difficult time, as well as to ensure that we take steps to reduce stillbirth rates. As expressed by Bliss, an organisation that campaigns for change for babies born premature or sick, there has been a concerning increase in the neonatal mortality rate and the pre-term birth rate. It points to a high variation in care as a factor that can be addressed to reduce that worrying increase.

As the MP for Washington and Gateshead South in the north-east, I know just how damaging the impact of inequality can be as we experience the acute end of regional inequality, which can manifest itself through less investment and less access to the resources we need. In relation to baby loss, inequality prevails and, as Bliss highlights, the number of babies lost to mothers from the most deprived areas has increased at a rate twice that of babies lost to mothers living in the least deprived areas.

It would be remiss of me not to mention that neonatal mortality rates are much higher for babies from an ethnic minority. Babies of black ethnicity are twice as likely to be stillborn as babies of white ethnicity. It is a failure of our healthcare system that babies of black and Asian ethnicity continue to have much higher rates of neonatal mortality. Disgracefully, that disparity is also seen in maternal healthcare. Maternal mortality for black women is currently almost four times higher than for white women. As some Members may have heard, the tennis star Serena Williams has spoken in great detail about her awful experience in that regard. I encourage Members to read her article in Elle magazine, which is still available online. Even as a very wealthy and globally recognised figure, Serena’s voice was dismissed during pregnancy and childbirth.

We must ensure that there is the right training and support for healthcare professionals to ensure that all those terrible disparities are addressed. The cases that we have heard today are so traumatic. Crucially, we must centre the voices of patients—usually mothers, but sometimes their partners as well—and listen to what they are saying about their own bodies and experiences. As we have seen with the high level of disparity in neonatal healthcare outcomes, we will fail to achieve change if we are not listening to those at the heart of this crisis.

If we are to effect change, we must also increase our midwifery workforce, as well as increasing the capacity in our NHS to allow the necessary training to be delivered. I am pleased that Labour is taking strong action to get our NHS back on its feet. In our manifesto, we committed to training thousands more midwives as part of the NHS workforce plan. It is also significant that Labour has said that we will ensure that trusts failing on maternity care are robustly supported into rapid improvement, and we will set an explicit target to close the black and Asian maternal mortality gap.

[Mr Gregory Campbell (East Londonderry) (DUP)]

Does the hon. Member agree that two points that have emerged from this important debate are that greater resources are required to deal with the problem, and that a greater understanding is needed of the individualistic nature of the problem? No two mothers or families will react to baby loss in exactly the same way, as she and other hon. Members have so passionately outlined. Those are two of the most important issues arising from the debate, and hopefully we can learn from them.

[Mrs Hodgson]

I absolutely agree. The hon. Member makes a very valuable point: resources matter, but it is also about how they are implemented. Human interaction and professional training is so important.

I am hopeful for the future and proud of the change that has been made so far. Looking at all colleagues in the Chamber today, I know that together we are a powerful voice that can make such a difference to families during that terrible time and can help to improve outcomes for others, so that fewer people experience this most dreadful loss in future.