Transvaginal Mesh Implants (Removal)

– in the Scottish Parliament on 10th October 2019.

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Photo of Jackson Carlaw Jackson Carlaw Conservative

1. Does the First Minister agree that, in Scotland and beyond, mesh has become the greatest medical scandal of modern times?

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

In general terms, yes, I share the concern that Jackson Carlaw has articulated today and on previous occasions.

There have been two on-going priorities for the Scottish Government, which I hope have the support of members across the chamber. The first was to ensure that there was a halt to new mesh procedures. Earlier this week, we saw statistics that show that there have been no such procedures in Scotland since the Cabinet Secretary for Health and Sport took action to draw a halt to them.

The second priority, which is certainly on-going, is to ensure that women who have suffered complications from mesh procedures that were done in the past get the care and treatment that they need and to which they are entitled. The Scottish Government takes that extremely seriously, and will continue to take the appropriate steps.

The wider matters around mesh that we have discussed in the chamber previously—approval of the particular procedures and of what is used in those procedures—are governed by the Medicines and Healthcare products Regulatory Agency. They are not within the responsibilities of the Scottish Government. However, with the support of members from across the chamber—including, I think, Jackson Carlaw—we have urged action at United Kingdom Government level.

Photo of Jackson Carlaw Jackson Carlaw Conservative

The First Minister is right. There has been an heroic and successful effort by Scottish mesh survivors to secure a moratorium on the practice. We were delighted by the action of the Cabinet Secretary for Health and Sport, and by the fact that statistics this week show that there no further procedures have been done.

We had hoped that Scotland would, for the women who are in desperate need of mesh removal surgery, welcome the pioneering American surgeon Dr Dionysios Veronikis to undertake mesh removal, which would change hundreds of lives. We now learn, however, that Dr Veronikis has called off—mostly, it seems, due to a co-ordinated attempt to block him by powerful people within the national health service and the medical hierarchy.

My constituent Lorna Farrell raised thousands of pounds to travel to the United States to be operated on privately to have her mesh successfully removed by Dr Veronikis. Surely the First Minister will agree that it is unacceptable that women who have been harmed, however inadvertently, by our Scottish NHS, should have to raise thousands of pounds to undergo a horrendous journey, while enduring severe pain and difficulty, in order to have that wrong righted privately in the United States.

The First Minister:

I have enormous sympathy with the sentiments that Jackson Carlow expressed on behalf of his constituent. Of course, those sentiments could be expressed on behalf of any woman who has suffered complications, and who is suffering from a mesh procedure.

Let me address very directly the issue of the specialist from the United States, Dr Veronikis. It remains the case that the Scottish Government wants him to come here. However, if he is to be able to treat patients here, certain General Medical Council requirements must be met, which the Scottish Government has no discretion to waive.

One of those requirements is the need for a contract of employment from the national health service, which necessitates clinicians from here going to see him in the United States. Although we had hoped that that would happen in August, it had to be postponed because of the clinical commitments of clinicians here. Clinicians will visit the United States in November—next month—and remain willing to meet Dr Veronikis, if he agrees to reconsider his position. I respectfully concede that that is entirely a matter for him.

Jackson Carlaw talked about efforts by senior influential people. Let me make it very clear that I am not aware of any such efforts. It would not be acceptable for anybody in the medical community here to seek to block Dr Veronikis. My understanding is that that is not the case; indeed, the chief medical officer personally invited Dr Veronikis to come to Scotland. As I said at the outset of my answer, it remains our wish that that will happen.

Photo of Jackson Carlaw Jackson Carlaw Conservative

The clear suspicion of many people is that there is a professional and institutional campaign to frustrate Dr Veronikis’s involvement. It is the view of many people that establishment figures in the NHS are trying to protect their own backs. I exclude from any blame or suggestion of it the Cabinet Secretary for Health and Sport.

Last night, I contacted Dr Wael Agur, who is the leading mesh expert in Scotland, and one of my constituents. This is what he had to say about Dr Veronikis’s visit:

“I can confirm that surgeons here felt deeply threatened by Dr Veronikis’ offer to visit Scotland. No doubt there is a professional conspiracy against his visit. The surgeons suggested another US surgeon instead: Howard Goldman—who is one of the most prominent proponent of the continuing use of mesh. In addition, he promotes partial (rather than total) mesh removal, the complete opposite of Dr Veronikis. Inviting Dr Goldman would undoubtedly support the local surgeons in their efforts to reintroduce mesh procedures in Scotland.”

If that is true, it is an outrage. Will the First Minister now personally intervene?

The First Minister:

As Jackson Carlaw and others would expect, I have already looked very closely at the matter. If there is the suspicion that Jackson Carlaw described, I will not stand here and second-guess it. If that is what people feel, it is a suspicion that requires to be addressed.

However, I say genuinely to Jackson Carlaw that I am not aware of evidence that backs that up. If there is evidence, I certainly want to see it, and to be in a position to take action on it.

I have set out—I have tried to do so very clearly and calmly—the requirements that need to be met before somebody from outside the UK can treat and practice in the UK. They are set not by the Scottish Government but by the General Medical Council. Those requirements require clinicians from here to go the States. It is regrettable that the visit that was planned for August had to be postponed. However, a visit will take place, and if Dr Veronikis is prepared to reconsider his position, it will be an opportunity for that requirement to be fulfilled.

I want—as everybody wants—patients to have the treatment that they need. Let me make the point very clearly that that means treatment that is considered to be clinically right for them, in which they have confidence, and of whose efficacy they can be assured. As First Minister, I am prepared to consider all options to make sure that women get that treatment. We will continue to do that, because I do not underestimate in any way, shape or form the suffering, stress, pain and anxiety that many women have suffered as a result of mesh.

Photo of Jackson Carlaw Jackson Carlaw Conservative

I thank the First Minister for that. I can say that the women have complete confidence in Dr Agur, who is acting in the Scottish Government’s review group. The women also have complete confidence in Dr Veronikis—especially my constituent, who is a living example of the success of his mesh-removal procedures. Her life has been transformed, and it is hugely emotional to meet her and see that.

My principal concern remains firmly the women who have been affected. The moment for a public inquiry might, depending on events, be coming. However, during this decade-long scandal, many of the affected women feel that they have been unable to meet and discuss their experience directly with the First Minister. They feel that the urgency of their situation now needs the direct support and engagement of the head of their Government. So, will the First Minister agree today to meet, together with MSPs from across the chamber, the affected women directly in early course, to listen to them and to give them the personal commitment, leadership and attention of the First Minister to get their lives sorted?

The First Minister:

Yes, I will. However, in doing that, I also want to make it very clear to the women who have been affected that the matter has my personal attention and the close personal attention of the health secretary. That has been demonstrated by the actions that have been taken; it will continue to be demonstrated by actions that will be taken.

I obviously understand the deep emotion that many people feel about the issue. Obviously, the women who have been affected do, but so do people who have been in direct contact with the women.

I also understand the scepticism and concerns about how it is perceived that elements within the medical community in Scotland are addressing the issue. We must tackle that and take action systematically to ensure that that perception is not the case.

I want any patient who considers it best—and where there is a clinical view that it is best—to be treated by somebody like Dr Veronikis to have that available. I obviously cannot stipulate that he agree to come here, but if he is willing to reconsider his position, steps are in progress to fulfil the requirements that would allow that.

Beyond that, we will openly consider any other options to ensure that women get access to the care and treatment that they need. That is a commitment that the health secretary and I have given previously, and which I have no hesitation in giving again today.