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Petitioner submission of 2 September 2021

PE1517/YYYY: Polypropylene Mesh Medical Devices

We are heartened the Scottish Government’s Women’s Health Plan for 2021 – 2024 highlighted the importance of learning from the mesh crisis.

The report said, “We have taken decisive action in relation to mesh, including halting its use in 2018, and we will pursue the outcomes set out in the Mesh Survivors' Charter”.

The Cabinet Secretary’s categoric assurance there will be no reintroduction of transvaginal mesh procedures in Scotland is a vital milestone in our campaign.

All focus is now rightly on the treatment of mesh complications in women.

While there have been significant advances, there is still room for essential improvements.

As a matter of priority, we urge the Scottish Government to publish a Patient Referral Pathway which will give clarity to both patients and clinicians – we all need to know how the Pathway will work. Treatment outside Scotland must not involve an onerous referral process.

There are grave concerns that appointment waiting times for the National Mesh Complication Centre in Glasgow may extend beyond one year. Fears are justified that this will exclude patients wishing treatment outside Scotland if the government continues this scheme for only one year.

When do commissioned contracts for outside of Scotland mesh removal treatments commence? And how many women will be treated by each provider annually?

A private provider in England (Bristol’s Spire Hospital) received a commissioned contract from the Scottish Government to treat women. A few days ago, NHS Bristol, where the same experts in mesh removal work, have been recognised by NHS England as an official National Mesh Complication Centre. Will it save tax-payers money if Scottish patients are referred to NHS Bristol, which also has the benefit of full intensive care facilities, and women can still be treated by the same expert surgeons as opposed to referral to the privately-owned Spire Hospital?

Despite cross party support for our Charter, we continue to find ourselves in limbo, as the Mesh Complication Centre in Glasgow has repeatedly failed to respond to our request to improve service quality by:

•  Publishing their training and qualification with regard to mesh removal surgery.
•  Publishing their declarations of interests with mesh manufacturers past and ongoing.
•  Providing pre-operative assessment and full after-care for patients who choose mesh removal surgery outside Scotland – if patients wish it.
•  Providing women with a Patient Decision Aid before surgery to allow an independent decision to be made free from pressure.
•  Providing women with detailed photographic evidence of their mesh removal after surgery.
•  Providing care and treatment for all complex mesh cases.

Commissioned surgeons from outside Scotland must be invited to participate in the Multi-Disciplinary Team (MDT) meeting so they have first-hand clinical information for patients they are going to operate on.

The Scottish Government’s Realistic Medicine initiative supports shared decision between clinicians and patients – we agree. It is essential that women considering mesh removal surgery are invited to attend the part of the MDT meeting that discusses their case. MDT members will then obtain first-hand information of the mesh complications the patient suffers, the impact this has on their quality of life, their treatment wishes, treatment provider choice, and their expectations from any such treatment.

Progress on appointment of a Patient Safety Commissioner appears to have gone quiet. We urge the Scottish Government to expedite this important role.