MPs call for urgent ban on surgical mesh

MPs have called on the government to urgently suspend all mesh implant operations and for the National Institute for Health and Care Excellence (NICE) to bring forward guidelines on using mesh in stress related urinary incontinence from 2019 to 2018.

Leading the debate in the House of Commons on 19 April, Emma Hardy, MP for Kingston upon Hull West and Hessle, also called for pelvic floor physiotherapy to be offered to all new mothers as standard on the NHS, as happens in France.

She said, “Mesh was given to lots of young women following childbirth—many women still in their 30s—and it has left them feeling disabled. These women were injured. These women were ignored. These women are the victims of a scandal.”

Earlier in the week NHS Digital published an audit of surgical mesh.12 Hardy commented, “The audit is not perfect. For example, it looks only at NHS hospital figures and misses off private patients and outpatients; does not include men; does not include ventral rectopexy mesh sufferers; does not cover visits to GPs; and does not indicate how many times someone has to visit their GP before being referred for outpatient treatment.

“However, it seems broadly to agree with what we have been saying all along: that the government’s claim that only 1% to 3% of women suffered serious complications is just not accurate.”

She told MPs that the cost to the NHS of outpatient appointments for women suffering mesh problems could be as high a £245m (€279m; $344m) in nine years, according to an analysis of the audit figures by Carl Heneghan, professor of evidence based medicine at the University of Oxford.

“His analysis of the trend in outpatient appointments also shows that more are required by women as each year passes after their surgery, which is completely the opposite of what you would expect after a successful surgery,” she said.

Sarah Wollaston, a former GP who now chairs the health select committee, said that the scandal highlighted the importance of rigorous clinical trials for devices as well as medicines and of long term monitoring of complications.

She said, “If we are to have informed consent for women, it has to be based on high quality, balanced, and evidence based information, and that has been lacking. We also need to be clear that, if a medical device is altered in any way, it must be part of a clinical trial. That was entirely lacking in this situation.”

Philippa Whitford, MP for Central Ayrshire, said, “There was simply not enough trial work and research done at the beginning, and follow-up was far too short. The mesh problems emerge only after time goes on.”

NICE recently recommended against using surgical mesh for pelvic organ prolapse, but guidelines on mesh in stress related urinary incontinence were not due to be published until 2019.3 However, responding to the debate, Jackie Doyle-Price, health minister, said that NICE guidance on mesh for urinary incontinence would now be published for consultation later this year and completed next year.

She told the Commons, “Ultimately, the tragedy of this case is that women have put their trust in the medical establishment to look after them and to make them well, and they have come out with the most debilitating, life changing injuries.

“It is very clear from the clinical guidance on these products that they should not be used as a first intervention, and should be used only in very extreme cases.”