Hansard

I refer members to my entry in the register of members’ interests. I am a practising NHS GP.

In the past two decades, some 20,000 women in Scotland underwent transvaginal mesh implant surgery. They were advised to do so in order to treat conditions such as incontinence and prolapse, often as a result of trauma at childbirth. Tragically, some 600 women who underwent implant surgery have suffered painful and life-changing side effects. There have been complications from surgery because of erosion of the mesh inside the body, causing nerve damage, chronic pain and vaginal scarring. There have been cases of organ perforation, with synthetic propylene mesh actually becoming exposed inside the vagina.

In the Health, Social Care and Sport Committee, we have heard from women who have had to endure harrowing experiences following mesh surgery: pain, infections, reduced mobility, difficulties with intimacy and psychological strain. Many of those women were simply not believed when they were crying out for help. It was nightmarish. Despite their pleas, those suffering women were forced to wait and wait before remedial intervention was offered. Having lost all confidence in our NHS, those with the means turned to the private sector, including travelling to the United States. They sought out specialists who believed them and had the expertise to correct our health service’s mistakes.

We have come a long way since 2014, when sufferers brought a petition to the Scottish Parliament calling for action: the implant procedure was halted in 2018; in July 2021, the Scottish Government agreed to meet the costs of private treatment to remove transvaginal mesh; and in January 2022, Parliament passed a bill to reimburse women who had already paid for private healthcare. We now also have specialist clinics in NHS Greater Glasgow and Clyde to support women experiencing complications from mesh implant surgery. There has been cross-party support since Parliament began trying to right the wrongs of failed transvaginal mesh implants and support those who are suffering. However, have we done enough?

In her motion, the Minister for Public Health and Women’s Health, Jenny Minto, highlighted the continuing improvement in the support offered by NHS Scotland and notes that it is well aligned with the recommendations of a major case review of records. The motion also notes the assurance that affected women are able to access the national mesh removal referral pathway and that the Scottish Government is committed to offering women a choice of surgeon. However, are the processes that are in place today robust? Do women still find themselves at the mercy of an absurd, Kafkaesque bureaucracy?

There is still a long way to go to rectify the injustices of Scotland’s implant mesh failures and still further to posit Scotland as an example for others to follow. Waiting times to access specialist surgical services for mesh-injured women are still unacceptably high. The referral pathway is still lengthy and complex, especially when patients seek care outwith the NHS. Complex mesh surgical services are hosted by NHS Greater Glasgow and Clyde. Despite agreements being in place with private providers, there are real concerns that bureaucratic gatekeepers at the Glasgow service may obstruct the signing off of patients’ preferred plans to seek treatment outwith Scotland. Patients who return from abroad are left with no follow-up.

There is a reason why some patients may want to look elsewhere. Professor Britton’s review found that trust in the complex mesh surgical service was all but completely depleted. The review found evidence that women had been repeatedly misled and told that they had undergone full mesh removal when, in fact, just small amounts of plastic had been surgically excised—with no groin incisions, full removal was impossible.

The Health, Social Care and Sport Committee also found that many women faced long waits for treatment from the NHS service, with one woman saying that she had waited nearly two years between appointments. There is more. GPs cannot refer patients directly to the complex mesh surgical service. Patients have to first see a local urogynaecologist in their local health board before being referred on, which means another layer of bureaucracy, significantly more time waiting and significantly more time in unnecessary pain. That is unacceptable.

We must make it easier for patients to get the help that they deserve. This SNP Government talks the talk but, having not implemented any of Professor Britton’s 46 recommendations or thought about other changes, it does not walk the walk. There has been a complete failure of implementation, despite cross-party support.

The minister must do better and perhaps show some contrition for those women who are suffering.