Hansard

The motion to which I speak is on the impact of transvaginal mesh on women’s health, which the Parliament has rightly debated on a number of occasions in this session and previous sessions.

The fact that our Parliament has addressed the issue regularly underlines the seriousness of the harm experienced by women who continue to suffer painful complications after having mesh implanted. I will not be alone in hearing from women who have described how their lives have been blighted personally and professionally by complications after mesh surgery. What is worse, for some of them, their suffering was added to when they felt that their pain was downplayed, dismissed or ignored altogether.

However, members of this Parliament listened to women. They believed them, raised their experiences and pressed their concerns. The Government has listened, too. It is fair to say that, by working with the Parliament and committed professionals in the national health service, enduring improvements have been made to the care that is offered to women affected by mesh.

One of the ways in which the Government sought to respond to affected women was the establishment of the transvaginal mesh case record review. The review was led by Professor Alison Britton with the assistance of an expert panel and conducted entirely independently of the Scottish Government. We had no contact with the participants as part of the review nor sight of any records. The review was established to examine the medical records of women who feared that their treatment had been recorded inaccurately. Women considered that they had been informed that their mesh had been fully removed but subsequently discovered that it had been removed only in part.

I thank Professor Britton for her meticulous work and echo her thanks to the women who shared their experiences and insights. Professor Britton notes that, despite the personal and emotional cost to them, women engaged in the review not only or even mostly for themselves but to make a difference to other women’s quality of life.

The review’s approach was not to seek to establish blame or necessarily to find fault but to allow women an opportunity to discuss and better understand their health records with an expert panel. Forty-seven women who had been involved in a meeting in 2019 with the then First Minister and Cabinet Secretary for Health and Sport were invited to take part. Eighteen women, six of whom had had mesh removal surgery, took up the offer of a report on their records. Each of the women received a bespoke report about their circumstances and their records. Women were offered an opportunity to talk to the panel about their report. Time was allowed for them to talk again after reflecting on the report and their first discussion.

It will be for the individual women involved to judge the benefit of the process to them, but the panel noted that there was a general appreciation of not being rushed and being able to define their journey in their way. From the Government’s perspective, we were grateful to Professor Britton, the panel and their staff for fulfilling their remit so thoroughly and in a way that has respected women’s experiences.

The report is not easy to read and we note with concern the following observation:

“Every patient is entitled to expect and receive accurate information both before any treatment is chosen and to be advised on the effectiveness and consequences of any intervention. Most of the cases that we reviewed did not meet these standards.”

That is a critical point to which I will return.

The review’s remit also sought a wider report, which Professor Britton published in June with 21 recommendations. As was only reasonable, most of the recommendations were about the care that is now available to women affected by mesh. They addressed communication between clinicians and patients and between different parts of the NHS; information and support made available before and after removal surgery; and collaboration across the United Kingdom and the establishment of a register of surgery.

The Government endorses all the recommendations. Moreover, we believe that the NHS in general and the complex mesh surgical service in Glasgow in particular are acting now to make substantial progress towards achieving the objectives that the recommendations pursue, as well as responding to comments from women.

As I noted in my letter of 22 August to the Health, Social Care and Sport Committee, it is accepted by all that there remains a need for continuing improvement in the Glasgow service. However, at the same time, we know from patient feedback, which is gathered annually, that changes in the service that were made in response to previous feedback are already better matching women’s needs.

The complex mesh surgical service in Glasgow is centred on a published national clinical pathway.