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27 September 2017, 14:19
A clinician who resigned from a review group looking at the safety of mesh implants has said he did not feel the report achieved the "reduction of harm" he expected.
Dr Wael Agur said the report left the door "slightly open" for some mesh implant procedures to be performed, which he does not believe should have happened.
The review, published in March, concluded mesh implant procedures must not be offered routinely to women with pelvic organ prolapse, that patients should be offered a range of treatments - mesh and non-mesh - and they must be given the information to make ''informed choices''.
Thousands of women in Scotland have been treated using the implants but some have suffered painful and debilitating complications.
Dr Agur, a consultant urogynaecologist, said key data he believed was crucial to inform the recommendations was removed from the body of the report into an appendix and an annexe.
He told the BBC: "I stood down as I didn't feel comfortable that the report has achieved the reduction of harm that I expected it to achieve.
"It was so important that we got this right. Not just for the women in Scotland but for the women around the world. It's important also to remember that Scotland is leading on this matter.
"Scotland is the only country where an independent review was running and looking in full detail at the benefits and risks of these procedures and promising women in Scotland, the UK and around the world that we are going to come up with independent recommendations that reduce harm to women."
Mesh survivors Olive McIlroy and Elaine Holmes also resigned from the review panel, claiming the final report had been ''diluted''.
Dr Agur told the broadcaster: "I do believe that in some points Scotland is still in the lead but I expected more reduction of harm. From my own experience and my own interpretation of evidence I do believe that the report could have done more to reduce harm without losing value.
"I believe that the report has left the door slightly open for some procedures to be performed and I do not believe that that should have happened."
He concluded the procedure should either not be performed at all or restricted to clearly defined situations where a group of surgeons, and not just a single surgeon, should decide.
Dr Agur will give evidence to the Petitions Committee at the Scottish Parliament on Thursday.
Synthetic transvaginal tapes and meshes are used in the treatment of pelvic organ prolapse (POP) and stress urinary incontinence (SUI).
In June 2014, then health secretary Alex Neil asked health boards to suspend the use of the implants after a campaign by women who have suffered serious side effects.
Scotland's Chief Medical Officer, Dr Catherine Calderwood, said she had "fully accepted" the recommendations made by the independent review and had been clear that the suspension of the use of mesh implants should remain in place until she was satisfied they had been implemented.
She added: "The cabinet secretary met with the chair of the independent review, who informed us that some evidence has been presented in a different format to that of the interim report, but that no evidence has been deleted or hidden.
"The interim report is available to read on the independent review's website and the final report builds on that.
"The clinician who resigned from the review group drafted an alternative version of one chapter which was not agreed by the rest of the group, but in the interests of transparency was published on the Scottish government website."
She said a review is being carried out into the process of the independent review.
She added: "We are ensuring that all women who wish treatment for urinary incontinence and pelvic organ prolapse receive the appropriate treatment for their symptoms by offering the full range of options available and that they are fully informed of the risks and benefits for them."