Meeting of the Parliament 24 October 2023
As we have heard, complications relating to the use of vaginal mesh have caused widespread and severe symptoms in thousands of women. Those patients have been failed once and, as it stands, the complex mesh surgical service, or CMSS, which is a service designed to remedy the pain and suffering of those patients, continues to fail some of them.
In its scrutiny of the CMSS, the Health, Social Care and Sport Committee took a variety of evidence. Some reported positive experiences, which is to be welcomed, but others reported barriers to accessing long-term holistic care and support that they feel that they need and should be entitled to expect. Evidence that we heard demonstrates a lack of urgency. Without intervention, the service could exacerbate the trauma of some patients. I am pleased to hear that the minister acknowledges that and to have the opportunity to highlight some of the key issues that the committee heard evidence on.
Uncertainty around referral pathways is rife, with variation between different NHS boards and confusion among medical professionals. If people working in the sector are not clear on how this works, what hope is there for patients? The minister has set out plans to remedy that, including a letter to GPs clarifying the referral pathway. I seek detail on how the Government will ensure that those measures are effective.
Once referred, patients report
“‘living in limbo’ and ‘treading water’ whilst waiting for a mesh complications consultation, ‘pushed from pillar to post’: an ‘endless conveyor belt’ of ‘humiliating tests’ and ‘red tape’ with no one really knowing what to do.”
Patients told us that during that uncertain time it was difficult to contact the CMSS. Poor communication is an on-going theme, with limited information provided to patients. Waiting well initiatives could help, and I eagerly await an update and detail on how the Government will ensure that information is accessible to patients for whom English is not their first language.
On top of years of life-changing symptoms, these patients face difficult decisions and a complicated procedure, which participants described in a study as like
“taking fish bones out of chewing gum.”
It is clear that emotional support is much needed. Demand for proposed peer support groups was limited, but is that surprising when peer support groups put the onus on patients to support each other? That lack of uptake should absolutely not be taken for a lack of need for emotional support. That is very much needed by those women. The minister has acknowledged the struggles of patients who face doubt from medical professionals.
Indeed, academic research has found that patients have felt that the medical community has denied that symptoms were caused by mesh. Some felt treated as if they were hysterical. Some report months—if not years—of trying to be heard. Studies from University College London show that healthcare staff routinely underestimate women’s pain and that not everyone who will have a complication from surgical mesh has started to have symptoms. That issue is on-going, and we have a chance to learn from previous mistakes.
Bias creates shame and taboo around women’s health. That makes it difficult for women to communicate their pain and the issues that they have. When they have finally found the words and the courage to talk about this, they have not been listened to. I seek assurance from the Government that it will tackle the bias that is present in the healthcare system so that we do not fail another wave of patients who are adversely affected by transvaginal mesh or any other healthcare issue.
We must also grant attention to prevention. Many do not know about stress urinary incontinence until they give birth. Open and frank conversations about the importance of pelvic floor strength are required. I am pleased to see that the Government has accepted the Health, Social Care and Sport Committee’s recommendation on that matter.
On-going monitoring of the success of the initiatives and changes that have been made accordingly will be vital. Reducing stigma is an important factor in prevention.
I thank those who shared evidence with us. There can be no doubt that we have failed those patients and that they, quite rightly, expect more.
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