Chamber
Meeting of the Parliament 14 June 2012
14 Jun 2012 · S4 · Meeting of the Parliament
Item of business
PIP Silicone Breast Implants
Thank you, Presiding Officer.
It has been a useful debate. I think that, on reflection, most members would recognise that this is an issue that goes beyond party politics and is about trying to ensure that we do the right thing in addressing the concerns that have been raised. Unfortunately, Mary Fee’s suggestion that there has been inaction by the Scottish Government in that regard is not only not reflective of the facts, but is simply wrong. It is important that, in contributing to a debate on an issue of such importance around women’s health, members reflect on what action is being taken.
The experience of one of Malcolm Chisholm’s constituents demonstrates the type of response that we have asked NHS Scotland to make. I recognise that members may have different views on what that response should be, but it is simply wrong to suggest that no action has been taken.
It is right, when a matter such as this arises and when the regulatory regime that we have in place has not protected individuals from the alleged fraudulent activity of the company that produced the breast implants, that we look at whether there are ways in which we can ensure that the regulatory system is more effective in addressing the concerns. Nanette Milne is correct to say that it is not possible to get a 100 per cent fail-safe regulatory system, but we clearly have to ensure that we learn lessons in order to ensure that the system is sufficiently robust, which is what the Earl Howe review was intended to do. I acknowledge Malcolm Chisholm’s view about the content of that review, but it is important to recognise that the review will be supplemented by the wider review by Sir Bruce Keogh that is being undertaken at present and which will report next year on whether further measures need to be taken beyond the recommendations of the Earl Howe review.
I recognise that despite the review, people—including members of the PIP implants Scotland campaign—continue to have concerns about the regulatory regime. However, it is important that we ensure that the reviews that are taking place address those concerns and the concerns that the PIP implants Scotland campaign believes the MHRA, the Department of Health and others have to address. As a Government, we are open to considering the matters and to making the necessary representations where that is appropriate.
Concerns have been expressed about the content of PIP breast implants—Malcolm Chisholm made a specific point on that in relation to his constituent. I understand that the MHRA has carried out further tests on PIP implants and that, as part of Sir Bruce Keogh’s work, the data and the toxicology findings are being looked at. I am informed that there are difficulties in carrying out toxicology tests on breast implants that have ruptured, which leads to difficulties in offering certainty on what may be in those particular breast implants. That is the scientific expert advice that has been provided, but I understand that further tests have been taken as part of the Sir Bruce Keogh review.
Maureen Watt raised the issue of how breast implants are chosen by different clinicians. NHS Scotland does not routinely provide cosmetic surgery, and the number of breast implants is limited. The guidelines and criteria on their use are clear—they are largely for breast augmentation for women who have undergone a mastectomy. The choice of breast implant is largely decided by clinicians, who work with patients to establish what is most appropriate to that individual. That is why we allow boards to procure breast implants that their clinicians believe are best suited to their individual patients, rather than controlling procurement nationally. I am sure that Maureen Watt will recognise the benefit that is gained from that approach.
It has been a useful debate. I think that, on reflection, most members would recognise that this is an issue that goes beyond party politics and is about trying to ensure that we do the right thing in addressing the concerns that have been raised. Unfortunately, Mary Fee’s suggestion that there has been inaction by the Scottish Government in that regard is not only not reflective of the facts, but is simply wrong. It is important that, in contributing to a debate on an issue of such importance around women’s health, members reflect on what action is being taken.
The experience of one of Malcolm Chisholm’s constituents demonstrates the type of response that we have asked NHS Scotland to make. I recognise that members may have different views on what that response should be, but it is simply wrong to suggest that no action has been taken.
It is right, when a matter such as this arises and when the regulatory regime that we have in place has not protected individuals from the alleged fraudulent activity of the company that produced the breast implants, that we look at whether there are ways in which we can ensure that the regulatory system is more effective in addressing the concerns. Nanette Milne is correct to say that it is not possible to get a 100 per cent fail-safe regulatory system, but we clearly have to ensure that we learn lessons in order to ensure that the system is sufficiently robust, which is what the Earl Howe review was intended to do. I acknowledge Malcolm Chisholm’s view about the content of that review, but it is important to recognise that the review will be supplemented by the wider review by Sir Bruce Keogh that is being undertaken at present and which will report next year on whether further measures need to be taken beyond the recommendations of the Earl Howe review.
I recognise that despite the review, people—including members of the PIP implants Scotland campaign—continue to have concerns about the regulatory regime. However, it is important that we ensure that the reviews that are taking place address those concerns and the concerns that the PIP implants Scotland campaign believes the MHRA, the Department of Health and others have to address. As a Government, we are open to considering the matters and to making the necessary representations where that is appropriate.
Concerns have been expressed about the content of PIP breast implants—Malcolm Chisholm made a specific point on that in relation to his constituent. I understand that the MHRA has carried out further tests on PIP implants and that, as part of Sir Bruce Keogh’s work, the data and the toxicology findings are being looked at. I am informed that there are difficulties in carrying out toxicology tests on breast implants that have ruptured, which leads to difficulties in offering certainty on what may be in those particular breast implants. That is the scientific expert advice that has been provided, but I understand that further tests have been taken as part of the Sir Bruce Keogh review.
Maureen Watt raised the issue of how breast implants are chosen by different clinicians. NHS Scotland does not routinely provide cosmetic surgery, and the number of breast implants is limited. The guidelines and criteria on their use are clear—they are largely for breast augmentation for women who have undergone a mastectomy. The choice of breast implant is largely decided by clinicians, who work with patients to establish what is most appropriate to that individual. That is why we allow boards to procure breast implants that their clinicians believe are best suited to their individual patients, rather than controlling procurement nationally. I am sure that Maureen Watt will recognise the benefit that is gained from that approach.
In the same item of business
The Deputy Presiding Officer (John Scott)
Con
The next item of business is a debate on motion S4M-03294, in the name of Jackie Baillie, on women’s health.10:27
Jackie Baillie (Dumbarton) (Lab)
Lab
I welcome the opportunity to debate the PIP breast implant scandal.I welcome some of the women who have been caught up in the scandal, who are here today cam...
The Minister for Public Health (Michael Matheson)
SNP
I welcome the opportunity to have the debate. I also welcome those from the Scottish campaign group who have joined us for the debate. They have been at the ...
Dr Richard Simpson (Mid Scotland and Fife) (Lab)
Lab
One of our concerns is that the second Bruce Keogh review—not the toxicology review—is on cosmetic procedures only. There are many other procedures, such as ...
Michael Matheson
SNP
The review is dealing specifically with the issues that arise from the PIP implant matter, and we should give the review group the opportunity to consider th...
Nanette Milne (North East Scotland) (Con)
Con
I thank Jackie Baillie for bringing forward the debate, because although we do not agree with her conclusions on the issue we think that it is important that...
Jackie Baillie
Lab
In recognising the scale of the problem, does the member support a public inquiry being held at UK level?
Nanette Milne
Con
I will give the member my reasons for not doing so later.We must remember that silicone implants carry an inherent risk to an individual’s health. No such im...
Fiona McLeod (Strathkelvin and Bearsden) (SNP)
SNP
We are in a serious and worrying situation, so I am glad that we are having this debate. We should take the opportunity to reassure the many women out there ...
Jackie Baillie
Lab
I was quoting the cabinet secretary, who has consistently said that we would perhaps be safer using the upper limit, which is 4,000 women.
Fiona McLeod
SNP
Thank you, Ms Baillie. I confess that I was not at the Health and Sport Committee meeting that day—I was in hospital getting my gallbladder removed. However,...
The Deputy Presiding Officer (Elaine Smith)
Lab
Come to a conclusion, please.
Fiona McLeod
SNP
I contend that the EU and the UK have swung too far towards self-regulation and self-policing. Given that Scotland has no voice in Europe and only a small vo...
Mary Fee (West Scotland) (Lab)
Lab
When I first heard about the PIP silicone scandal, I was shocked. I still cannot comprehend the feelings of anguish and worry that must have been—and still a...
Margaret Burgess (Cunninghame South) (SNP)
SNP
I can only imagine the stress and anxiety that are felt by women who have PIP breast implants. For some time, they have lived with that worry day and daily. ...
Dennis Robertson (Aberdeenshire West) (SNP)
SNP
I, too, welcome members of the campaign to the chamber. However, although I have a great deal of sympathy for their situation, I am not sure that a public in...
Jackie Baillie
Lab
I did not invent the 4,000 figure; it actually came from the member’s own Cabinet Secretary for Health, Wellbeing and Cities Strategy. Nevertheless, the poin...
Dennis Robertson
SNP
As I said, the 4,000 figure came from the UK Government and relates to the purchase of implants. The cabinet secretary was quite right to highlight the upper...
Malcolm Chisholm (Edinburgh Northern and Leith) (Lab)
Lab
I first became very concerned about the issue a few weeks ago when a constituent came to one of my surgeries and showed me photographs of two breast implants...
Maureen Watt (Aberdeen South and North Kincardine) (SNP)
SNP
There has been much debate about exactly how many women in Scotland, the UK and across Europe might be affected. Those numbers remain unclear, but we can be ...
The Deputy Presiding Officer
Lab
We turn to the closing speeches. I call Nanette Milne. You have up to five minutes.11:17
Nanette Milne
Con
This has been a worthwhile, interesting and considered debate with good speeches from members in all parts of the chamber. As I said previously, it is import...
Jackie Baillie
Lab
This is not about apportioning blame, but about learning lessons of responsibility for the after-care of the women so that the same mistakes do not happen in...
Nanette Milne
Con
I appreciate that, but I still think that the on-going work and its conclusions will satisfy.It is certainly true that we can continue to improve regulation ...
The Deputy Presiding Officer
Lab
I call Michael Matheson. I can give you around seven minutes, minister.11:22
Michael Matheson
SNP
Thank you, Presiding Officer.It has been a useful debate. I think that, on reflection, most members would recognise that this is an issue that goes beyond pa...
Jackie Baillie
Lab
Will the minister take an intervention?
Michael Matheson
SNP
I am very short of time and I want to cover as many points as I can.A number of members mentioned the introduction of a register. Some members may be aware t...
Dr Richard Simpson (Mid Scotland and Fife) (Lab)
Lab
As all members have acknowledged, this has been a useful debate, but some questions remain unanswered.Why should there be an inquiry? Why should we not just ...