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As I understand it, it is the Medicines and Healthcare products Regulatory Agency that grants licences for those products on a United Kingdom-wide basis. David Bishop might want to come in on this but, as I understand it, the transvaginal mesh situation prompted a review of all those processes. I think that on-going work is still being done on that.

Our feeling in the Scottish Government is that the MHRA’s procedures should be absolutely robust and that there were lessons to be learned from that situation. We are keen to ensure that those lessons are learned.

I invite David Bishop to give some more information on that front.

That would be a challenging undertaking retrospectively. However, on the use of mesh in other sites for gynaecological procedures that was not subject to the halt, the high-vigilance protocol has a number of procedures in place that ensure that that is perfectly possible. There is documentation of all the procedures and complications and on the reporting of complications on an agreed database. Crucially, documentation is given to every single patient who is treated with mesh that details their procedure and the mesh product used, along with the name of the patient. Therefore, in future, the precise situation that you have outlined will be less likely to arise in gynaecological procedures in which mesh is used.

I am not sure how that would happen, given the scale of the procedures, with 5,000 to 6,000 per year being carried out since the 1980s. However, as Mr O’Kelly outlined, patients should first present at their GP.

People must be listened to, because the key point that has come out through all the testimonies is that people do not feel listened to. We must learn from the transvaginal mesh incident—people’s concerns have to be taken seriously and acted on appropriately. In many areas, there will be a multidisciplinary team in place, as Mr O’Kelly outlined. There is a complexity in dealing with mesh complications, and the multidisciplinary team and clinical networks will together look at each individual case. However, it must be straightforward for patients to access that level of expertise when they find themselves in the situation that Mr Kidd describes.

Thank you. I am grateful to the committee for having me here today. At the outset, I want to acknowledge the efforts of those who have brought forward the petition; I commend them for doing so.

As members know, we have taken decisive action on transvaginal mesh. That action is well documented elsewhere, so it is important today to focus on the use of mesh in other situations.

We are acutely aware that there is concern about the use of mesh in other sites, not least from those who are experiencing complications. I am very sorry to read of the impact that those have had on individuals and their families. I was sorry to read in a submission on this petition that people felt that their symptoms were “dismissed” when they presented for help. Some people did not feel that they were informed of the risks of the procedure that they underwent, and it is only natural to feel let down in those circumstances.

If I may, I will for a moment focus on the use of mesh in hernia repair, which is a very common procedure in NHS Scotland. The Scottish Government asked the Scottish health technologies group to review available evidence on the use of mesh in hernia repair, first in adult inguinal hernia and secondly in abdominal wall hernia more generally. The group published a report on adult inguinal hernia in January 2020 that concluded that, compared with non-mesh procedures, using mesh resulted in lower rates of recurrence, fewer serious adverse events and similar or lower risk of chronic pain. We await the publication of the second piece of work, which considered the more general use of mesh in hernia repair and is expected imminently.

There are, of course, other gynaecology procedures for which the use of mesh has not been halted. In those circumstances, a high-vigilance protocol is in place across the whole of NHS Scotland. It is important to remember that some of those procedures are complex and long established, with few—if any—viable alternatives. To suspend their use would leave a cohort of people with limited or no treatment options.

I know that this is a very difficult and emotive subject. I welcome being questioned on it and I want to reassure the committee and anyone watching that the Government is absolutely committed to ensuring that everyone with mesh complications gets the care and treatment that they deserve.