SURGICAL MESH – 19 April 2018
Dr Julian Lewis: I start by saying that I think the steps taken in Scotland, as described by the hon. Member for Glasgow North (Patrick Grady), sound extremely sensible as interim measures until final decisions can be taken. I echo the thanks due to the hon. Members for Kingston upon Hull West and Hessle (Emma Hardy) and for Pontypridd (Owen Smith), their associates in the all-party group, and Sling the Mesh campaigners. I also thank my three constituents, Emma, Eileen and Helen, who have all shared with me their harrowing experiences of the procedure.
There is no doubt that when vaginal mesh procedures go wrong, the results can be truly catastrophic. A letter from the Minister states clearly that
“women have suffered atrocious and debilitating complications”
from these implants. Her counterpart in the Upper House, Lord O’Shaughnessy, has conceded this:
“While these treatments can be effective, in a small minority of cases meshes can cause serious long-term injury and disability, and prevent or reduce the ability of affected women to work.”
According to a letter from the Health Secretary to parliamentary colleagues in February:
“Clinical experts here and abroad agree that, when used appropriately, many women gain benefit from this intervention, and hence a full ban is not the right answer.”
I find it difficult to follow that logic. There might be an acceptable argument if we were talking about a procedure in which the numbers of interventions were in the hundreds, but, as I said in an intervention and as the hon. Member for Pontypridd (Owen Smith) endorsed, we are talking here about over 100,000 people. When we are talking about over 100,000 people, if even the Government’s low figures of 1% to 3% going badly wrong are right, that is still 1,000 to 3,000 people. I have been given, by my constituent Emma, a leaflet from Sling the Mesh that says that its estimate is that at least 15% of people are seriously and badly affected. On that scale, we are talking about over 15,000 people being seriously damaged by this procedure.
Owen Smith: I thank the right hon. Gentleman for giving way and for his kind remarks. Would he be surprised to learn that the chief medical officer, Dame Sally Davies, speaking alongside the Health Secretary in a Facebook Live broadcast just a few months ago, said that she thought the serious complication rate was between 15% and 20%? I have written to her asking where she got those numbers, although as far as I am aware she has not replied to me, because that is at odds with all the previous comments by Ministers and officials.
Dr Lewis: Indeed. I would be surprised at that, because if that is what Dame Sally believes she ought to be making different recommendations.
I have been given a particular study, which is described as the largest study of surgical mesh insertions for stress urinary incontinence. Over 92,000 women were surveyed in this particular examination, including all NHS patients in England over an eight-year period. The conclusion states:
“We estimate that 9.8% of patients undergoing surgical mesh insertion for SUI experienced a complication peri-procedurally within 30 days or within five years of the initial mesh insertion procedure. This is likely a lower estimate of the true incidence.”
I reiterate my point about acceptable and unacceptable percentages. When we are talking about these very large numbers, even relatively low percentages make the procedure too risky to be used in anything other than last-resort circumstances similar to those described by the hon. Member for Glasgow North.
In the past decade, my constituent Emma has undergone X-ray-guided injections, ultrasound scans, MRI scans, in-patient stays, tests galore, more and more scans, and, eventually, a biopsy. She has been refused referral to a mesh specialist centre. It seems highly likely that she should never have been given a mesh implant in the first place after the trauma of such a difficult birth, which leads me to the next point about inadequate warnings. I understand from my constituents that they were given little warning, and in many cases no warning at all, about the potential dangers.
Kevin Hollinrake: My right hon. Friend is making some very important points. Does he agree that prevention is better than cure? If physiotherapy was offered to women after childbirth, that might obviate the need for any surgery at all as a result of these kinds of complication.
Dr Lewis: Indeed. The problem with this issue, as it has been impressed on me at any rate, is that this has been put forward as a quick-fix alternative to other procedures, whether surgical or not, which would take much longer.
Having paid thousands of pounds for private specialist assessment, in the end Emma eventually managed to get the sort of referral she wanted. I have been given the following clinical summary of her condition:
“Vaginal mesh; foreign body giant cell reaction, chronic inflammation and fibrosis.”
I have a page here that lists some 50 different symptoms related to implant illness and foreign body giant cell reaction. I venture to suggest that if this ghastly catalogue of things that could go wrong had been shown in advance to those 100,000-plus women who have had a mesh implant, more than 90% of them at least would have turned it down.
This is what my constituent Eileen wrote to me:
“The effect that this has had and is still having on my life is massive. I can no longer carry out basic tasks at home or do things with my children due to the pain. I need to take medication every day from my GP to try and ease the pain. I cannot go to work at present due to the pain and I am currently on sickness absence leave from my job. The mesh implant that I have had has and is continuing to destroy my life. I need an operation to remove the mesh implant, but the operation is very complex and unfortunately there are limited amounts of surgeons who are experts in the full removal of these mesh implants. Due to my financial situation, I am not in a position to be able to afford to have the full removal of the mesh implant done privately and therefore I am having to wait for this to be done on the NHS which is taking far too long.”
I turn now to Helen, who probably has the most horrifying story of the lot. She was 35 when given what was described to her as routine surgery 16 tortured years ago. She was initially told that it was her fault that her body was rejecting the two mesh implants. She then went through a cycle of implants, the removal of protrusions and eroded segments and seven bouts of surgery. Three TVTs – trans-vaginal tapes – are still inside her, she suffers chronic pain from orbital nerve damage, constantly needs painkillers and has had constant side effects, indifferent treatment and a refusal to admit fault or to refer her to an out-of-area specialist in mesh removal. She writes:
“I do not want anyone from the hospital coming near me ever again. I have lost complete faith in them. I have been lied to and told repeatedly it was my body rejecting the mesh; but, unbelievably, they kept putting more in.”
She suffers from truly terrible bowel problems, some no doubt caused by the side effects of the painkillers and the sleep aids she has to take. Consequently, she suffers from depression, loss of confidence and lack of self-esteem. She further writes:
“I feel let down by professionals who were supposed to treat me to the best of their ability. There has been information about the adverse effects of mesh around for years, yet these doctors are still happily inserting them into thousands of women.”
She is desperate to be referred to one of the few doctors who specialise in mesh removal and feels trapped under the control of the very people who have let her down. She continues:
“I want these devices out of my body.”
Who can blame her?
Let me conclude by quoting, from an article in the Daily Telegraph of 23 October last year, a lady who suffered for eight years:
“I just wish I had never, ever had it done. I would rather have coped with that very minor problem of stress incontinence than this. If I had known even one of the possible risks of the surgery there is no way I would have had it done. I am furious that I was never told that this could happen.”