Meeting of the Parliament (Hybrid) 08 September 2020
I begin by pointing members to my register of interests, specifically my interest in healthcare technologies.
I am pleased to have the opportunity to speak in the debate on Baroness Cumberlege’s report. This is not the first time that the Parliament has debated polypropylene mesh implants and the devastating impact that their use has had on so many patients. My remarks will be focused on that.
I was a member of the Public Petitions Committee and it will be hard for me to forget the harrowing evidence that that committee took, along with the Cabinet Secretary for Health and Sport and the chief medical officer. That session will not leave me, not even long after I have left the Parliament. I can still vividly picture the discomfort of those who were giving evidence. So many of the sufferers—many in wheelchairs—were sitting behind the witnesses and reacting to every question and answer. The discomfort of those giving evidence was because there was little that could have been said to justify why more had not been done to alleviate the suffering, or to prevent future suffering, of so many. Actions that could and should have been taken swiftly had just not been implemented. The reality was that there were no excuses.
I pay tribute to those who have campaigned and lobbied so passionately. Others have mentioned Elaine Holmes and Olive McIlroy for bringing the petition to Parliament in 2014.
As members said, MSPs of all parties have been instrumental in keeping this travesty on the agenda. Jackson Carlaw, Neil Findlay and Alex Neil joined members of the Public Petitions Committee for every evidence session on the mesh petition and were vociferous in cross-examining the witnesses.
There has been undoubted progress, but the journey is far from over, which is why I ask the Parliament to support the Scottish Conservative amendment in the name of Jackson Carlaw, which calls for mesh removal surgery to be undertaken
“by surgeons who enjoy the full confidence of the women affected, fully funded by the NHS.”
Alex Neil spoke well to that point, which, surely is the least that the women can expect. The Scottish Government must try to secure the services of the mesh removal specialist Dr Veronikis. It is baffling to the campaigners that that has not already been done.
Let us remember that the petition was brought to the Parliament in 2014, six years ago. We have heard how the then Cabinet Secretary for Health and Wellbeing, Alex Neil, called for a moratorium on the use of mesh in Scotland’s health boards, in the belief that that would halt the use of the procedure while further evidence was taken. I know that he was as shocked as we were to find out that the moratorium was not binding and several health boards had continued with the procedure regardless. There is a lesson for the Parliament there. A cabinet secretary can make what is undeniably the right decision to protect public health, unaware that his decision can be overruled without his knowledge.
It is poignant that the report that we are debating is entitled “First Do No Harm”, considering how mesh surgery and other treatments that are mentioned in it have been deployed. As my colleague Donald Cameron said, the report falls short of recommending an outright ban on the use of mesh implants but suggests that such implants should be used as a last resort and only after other treatments have been fully explored.
Just as important is how patients are engaged in adverse event reviews, which has to change. I have raised the issue in this Parliament many times in the context of other events, such as childbirth mortality. The appointment of a patient safety commissioner seems to be a logical way to promote the importance of listening to and learning from patients’ experiences, and it is good to hear the Scottish Government’s commitment to the approach.
The report highlights the need for a substantial review of the Medicines and Healthcare products Regulatory Agency. I have to say that the MHRA’s engagement with the Public Petitions Committee was far from satisfactory. I look forward to the review.
Another recommendation of the report is:
“A central patient-identifiable database should be created by collecting key details of the implantation of all devices at the time of the operation.”
Members have called for accessible data in healthcare on many occasions. The development of an IT platform that enables the use of accessible data in healthcare is necessary if we are to make significant progress. We are behind the curve, which makes mistakes such as we are considering harder to identify and they then take longer to investigate. Accessible data is a prerequisite in so many issues that face our healthcare system.
In many ways, Scotland has been at the forefront of the drive to change how mesh is presented as a solution for patients—and the petitioners have been at the forefront, too. However, it is fair to say that the Scottish Government has been a little lethargic at best. It is worth pointing out that we have had three health secretaries in those six years. Since Alex Neil took what looked like decisive action and called for a moratorium on the procedure, the Scottish Government seems to have been reluctant to respond with urgency.