Meeting of the Parliament (Hybrid) 24 November 2021
As a member of the Health, Social Care and Sport Committee, I am pleased to speak in support of the bill at stage 1.
I thank all the women who came to give evidence at the committee and all those who have campaigned tirelessly for justice. I cannot imagine the impact that it has had on their lives and those of their families, and I am in awe of their continued determination.
I also thank the MSPs and former MSPs who supported the women in the previous session of the Parliament, including those who are affectionately known by mesh survivors as the meshkateers: Alex Neil, Neil Findlay and Jackson Carlaw.
As I am sure many members are, I am keen that we get a reimbursement system that is flexible enough to ensure that no one is unfairly penalised. Many of the women who paid for their own mesh removal did not anticipate being reimbursed, which means that many of them will no longer have food receipts or proof of taxi journeys, for example. The committee also raised concerns about the potential restrictiveness of the proposed cut-off date of the scheme and the residency requirements. I was pleased to hear the cabinet secretary’s commitment on the residency element.
We heard at committee that Covid has delayed some of the women going to America for surgery. I hope that there is a contingency in place to ensure that no one falls through the gap between the cut-off date for the reimbursement scheme and the start date of the new private surgery contracts. That point was well made at committee by Jackie Baillie. Some of the so-called in-betweeners may not be able to wait for the new contracts to begin if the mesh is compromising organs or causing unbearable pain.
If the legislation is to achieve its intended purpose, we must not let women fall through the cracks. As the committee’s report notes,
“the Bill documentation does not address the question raised by the Law Society of whether cases where private removal surgery has not been fully or partially successful will be reimbursed.”
Survivors should not be penalised for not having had a successful surgery. For some women, full mesh removal will not have been possible. Emma Harper made the excellent point at committee that it would be difficult to measure success—is it 40 per cent, 60 per cent or 90 per cent mesh removal? Some may have had private exploratory surgery only to be told that the mesh could not be removed, and I believe that they, too, should have their costs reimbursed.
We must ensure that women are not excluded from the scheme due to circumstances that are outwith their control. We have to take account of the fact that some women could not afford the cost of private removal surgery and did not expect to be reimbursed, so they did not pursue private treatment. As the committee’s report notes, those women
“may have experienced the same breakdown in trust in NHS Scotland”
and may understandably be upset that they have been further disadvantaged by their inability to pay up front.
We must ensure that trust is rebuilt between them and the health services. Some women have borrowed money from family and friends to pay for their surgery, and I strongly feel that they should not be excluded from any reimbursement scheme. Some women had to leave employment due to the debilitating effects of mesh implantation, and some of their partners have become full-time carers. They may not have been able to secure a loan and should not be penalised for having had to turn to family and friends for help. I appreciate that there may be difficulty in securing evidence for informal donations as opposed to a bank loan, and I would appreciate comment from the minister on how those issues could be worked through.
In committee, I raised the importance of supporting mesh survivors’ mental health and asked whether consideration had been given to reimbursing private medical costs related to mental health treatment. Mesh survivors might have lost confidence in NHS Scotland and might want to seek private treatment for what has been a traumatising event for many of them. If the bill aims to right a wrong, we need to consider the other forms of treatment and support that women who have been affected have had to seek as a result of their mesh surgery.
I have concerns about the residency requirement. Women who received their original mesh surgery when they were resident in Scotland should qualify for reimbursement under the scheme. Some women may have moved away from Scotland after their original surgery due to a breakdown in trust between them and NHS Scotland, and they should not be penalised for that. As the committee’s report notes, “greater clarity is needed” around that if the bill is to
“adhere to the principles of fairness and equity.”
I will close by saying that I look forward to working with members across the Parliament as the bill progresses. We have all heard about the devastating impact that mesh implantation has had on many women. It is vital that the bill establishes a comprehensive and fair scheme that does not result in mesh survivors falling through the cracks. We owe them that, at least.
16:09