UK government finally recognises the mesh scandal

^{The government’s recent debate over the vaginal mesh scandal was a welcome step towards recognising the debilitating effects that women have faced from these devices.}

Yesterday (19 April), MPs met in parliament to debate what is commonly being referred to as the biggest health scandal since thalidomide – vaginal mesh.

Led by Labour MP Emma Hardy, the debate referenced the recent NHS Digital audit that looked into the women adversely affected by mesh devices.

Opening the debate, Hardy gave a harrowing account of one of her constituents “who, after having incontinence following the birth of her twins and a hysterectomy, was advised to have this mesh operation. She is now unable to work, in constant pain and suffering, cannot take part in sports and has problems sleeping. I remember listening to what she said to me and feeling horrified that this had happened to her. As I have learned, she is most definitely not alone.” She said.

Hardy used the debate to call for NICE guidelines for mesh used in stress urinary incontinence (SUI) to be brought forward from 2019 to this year. She also asked for pelvic floor physiotherapy to be offered on the NHS to all new mothers as a way to offset the need for vaginal mesh devices.

Contrary to last year’s debate - in which calls to suspend the mesh were rejected alongside the need for a public inquiry, politicians agreed on a need for action.

For years now, women have campaigned against the side-effects of vaginal mesh devices, stating that the devices have caused life-changing effects such as chronic pain, organ erosion, nerve damage, psychological harm and more.

NHS Digital’s recent audit showed that at least 500 removal operations for vaginal mesh devices have been carried out by the NHS every year since 2008.

At the debate, Owen Smith, MP and chairman for the All Party Parliamentary Group for Surgical Mesh, spoke about the problem with these removals.

“Some women are left with pieces of mesh inside them, even after surgery. Those sorts of complications are clearly very worrying. They ought to have been explained properly to women, but obviously were not, in very many cases.” Smith argued.

A major point of the debate regarded how women have not been properly informed about the potential benefits and dangers of these devices. Clinical evidence on the efficacy of mesh devices has been lacking and the Medicines and Healthcare Product Regulatory Agency “has only a fraction of the knowledge of the adverse effects associated with mesh” according to Hardy.

Unfortunately the regulatory process, in which manufacturers only have to supply a small amount of evidence into the efficacy of their devices, has led to a high number of products being available on the market. The lack of data into these devices has resulted in women (and indeed clinicians) not knowing about the dangerous side-effects and the potentially devastating consequences on their health and wellbeing.

At the debate, Conservative MP Dr Sarah Wollaston stated that consent for women has to be “based on high-quality, balanced and evidence-based information, and that has been lacking”.

Perhaps most importantly, government finally started to recognise that issues stem not just from clinical practice, but from the devices themselves. In January, campaign group Sling the Mesh released a survey of over 500 women that detailed the impact that mesh was having on their lives. The survey showed that over half of the women suffer from constant urinary infections, eight out of 10 suffer pain when walking, over half suffer from incontinence and three in 10 are unable to urinate.

At last year’s debate, Jackie Doyle-Price, the Parliamentary Under-Secretary of State for Health believed that issues surrounding vaginal mesh implants were related to clinical practice instead of to the devices themselves.

Yesterday however, Doyle-Price acknowledged that the product itself has issues but noted that it was important to consider why the devices were being used, and for what reasons.

“If we are talking about some new mums, the level of risk clearly would not be outweighed by the benefits, but if we are looking at women suffering from horrendous conditions of incontinence, that is a very different debate. Again, we need to think about the broader issues. It all comes down to making sure that the guidance is properly applied and that clinicians who are recommending the use of mesh are properly making that assessment in discussion with their patients.” Doyle-Price said.

The debate highlights the true problem that are being caused by vaginal mesh devices. And whilst it may be dangerous to suggest that the devices haven’t benefitted women, the diligent campaigning done by groups such as Sling the Mesh shows that it is an issue that urgently needs addressing.

Thankfully steps are being done, and NICE is set to publish draft guidance on the use of mesh devices this year before the official guidance is published in 2019.

Ending the debate, Hardy gave thanks to the women who have campaigned to bring this issue to light.

“I end by thanking again all the fantastic women up there in the Gallery right now watching this debate. We are only talking about this now because of your bravery in coming forward and speaking out, and I thank each and every single one of you. We cannot undo the suffering you have experienced, but by speaking out and being so incredibly brave, you will stop women in the future going through what you have gone through. I and every Member who has spoken today thank you.”

In response to the debate, Kath Sansom, said: 

“Finally the UK Government are waking up to the fact that mesh implants are causing mayhem for women. They cannot keep burying their heads in the sand trying to justify their use.

“The sad fact is nobody can reassure women that a mesh implant will be Ok for her lifetime, because there are no long term human trials. We are the human trials and we are saying they can cause devastating complications years down the line.

“Hernia mesh is also causing life changing complications and the numbers of men and women suffering pain from hernia mesh, who are joining Sling The Mesh is growing.

“There is no NICE guideline on hernia mesh use and this is something we are told is being looked into. We say this must be done as a matter or urgency. Even clinical pathways of care in mental health have a NICE guideline so the fact that hernia mesh, a permanently implanted device does not, is shocking.”