Mesh implant procedures should end in Scotland, report finds

21 August 2018, 06:35


The use of mesh implants in the Scottish health service should stop, a parliamentary report has concluded.

Holyrood's Public Petitions Committee has urged the Scottish Government to halt the use of such procedures, used in the treatment of pelvic organ prolapse (POP) and stress urinary incontinence (SUI).

Thousands of women in Scotland have been treated using the implants but some have suffered painful and debilitating complications.

The committee said they had "serious concerns" about the final report of an independent review into the use of mesh, which last year concluded that mesh must not be offered "routinely" to women with pelvic organ prolapse.

The review was announced by the Scottish Government in 2014, with health boards requested to stop the procedure until its conclusion.

Its final report was branded a "whitewash" by campaigners, including Elaine Holmes and Olive McIlroy, who lodged the original petition with the parliament on behalf of the Scottish Mesh Survivors campaign.

They resigned from the review amid the controversy, as did expert clinician Dr Wael Agur.

Professor Alison Britton has been commissioned to conduct a review of the review, which is due to report later this year.

After considering evidence taken on the issue, the committee said its preference was for "the use of mesh devices to treat SUI and POP to cease in Scotland".

The report criticised the continued use of the procedure in Scotland despite the request for a moratorium.

"We have serious concerns about the credibility of the final report as a basis for informing both clinicians and patients to make fully-informed decisions," the report said.

MSPs said they shared the concerns raised by mesh survivors "about the transparency and true independence" of the review and warned of the potential for the final report to be used "to justify the lifting of bans on mesh in other jurisdictions".

The committee said that if Prof Britton's review revealed significant flaws, the final report "must be regarded as lacking credibility to the extent that it requires to be revisited".

Convener Johann Lamont praised the "courage and commitment" of Ms Holmes and Ms McIlroy and urged the Socttish Government to respond to the concerns.

"Seeing and hearing the experiences of the many women we have heard from during our consideration of this petition was incredibly emotional, with the physical and mental impact plain to see," she said.

"One of the most important things to come out of this report was the extent to which women were not believed when they were highlighting their concerns to the medical profession, ultimately resulting in there being no record of their concerns."

Deputy convener Angus MacDonald said the report had cross-party support.

He said: "The committee expects a positive response from the Scottish Government, particularly given we're awaiting the review of the review from Professor Alison Britton which will hopefully shed some more light on this extremely upsetting saga."

Scottish Labour MSP and mesh campaigner Neil Findlay said: "Mesh survivors, and myself, said the review was a whitewash. The committee's damning report confirms it as such.

"It is now time for those MSPs and the Scottish Government to ensure these mesh survivors are not failed again."

A Scottish Government spokesman said "serious consideration" would be given to the findings and health boards were expected to implement its recommendations.

The Chief Medical Officer would develop designated centres able to treat the "very few" women who have no choice but procedures using a mesh, while also overseeing an audit of all procedures in Scotland in future, he added.

But he said: "The MHRA is the regulator of medical devices across the UK, and responsibility for the agency is reserved to Westminster. The Scottish Government cannot therefore ban mesh.

"We have, however, repeatedly raised concerns about mesh with the MHRA when they have been brought to our attention and, were the agency to issue a medical device alert in relation to it, health boards would be fully expected to act on it."