It is a pleasure to serve under your chairmanship, Mr Owen. I will be as brief as I can, because we are all very keen to hear from the Minister.
A lot of the key points have been extremely well made by all the Members who have spoken. I particularly congratulate Emma Hardy on securing the debate and opening it for us. I also want to pay tribute to the chair of the all-party parliamentary group, Owen Smith, for the work that he has done.
Like many Members, the issue was brought to my attention by a constituent and the very powerful and emotional meeting held in one of the Committee Rooms before the formal founding of the APPG, where we heard testimony from a range of constituents and campaigners. Many of those testimonies have been echoed and repeated today, notably, but not exclusively, by the hon. Members for St Ives (Derek Thomas), for Gower (Tonia Antoniazzi), for Strangford (Jim Shannon), for Elmet and Rothwell (Alec Shelbrooke) and for Manchester, Withington (Jeff Smith). They are painful enough to listen to—we saw the reactions of Members in the room as we heard those testimonies—so how much more painful and traumatic it must be for people to have to live in those terrible situations.
Paul Masterton raised the situation in Scotland, and I want to dwell on that for a moment. He must be one of the first opposition politicians—as he is in Scotland—ever to say the words, “I am disappointed that the results of the independent review were implemented in full.” Normally, Governments get criticised for not implementing the outcomes of an independent review.
In 2014, the Scottish Government requested a suspension in the use of vaginal medical mesh by the NHS in Scotland. In 2015, the Cabinet Secretary for Health apologised to women who had been left in severe pain by these operations. Since that suspension was introduced, the use of mesh has fallen dramatically. Between 2009 and 2016, the number of women receiving mesh surgery in Scotland has fallen from 2,267 to 135.
I understand from what was said by Dr Wollaston, who probably knows far more about these issues than many of us in the room, that it would be very difficult to get that figure right down to zero, because there may be occasions when the surgery is appropriate. However, it has to be under very specific conditions and absolutely with the fully informed consent of which she spoke. That comes out clearly in “The Scottish Independent Review of the Use, Safety and Efficacy of Transvaginal Mesh Implants in the Treatment of Stress Urinary Incontinence and Pelvic Organ Prolapse in Women”.
The hon. Member for East Renfrewshire is right to say that transabdominal mesh is not yet under suspension, but that remains, and should remain, under constant review by the chief medical officer in Scotland. All the evidence that was submitted to the review are available on the website, along with the different drafts. It is important that we make it clear that the evidence has been fully published, and that the recommendations were made independently by the review and have been accepted in full by the chief medical officer in Scotland, who has been clear that the requested suspension of the use of mesh implants should remain in place until she is satisfied that the recommendations have been implemented.
An oversight group will oversee the recommendations and will be expected to put the patient at the heart of everything it does. Professor Alison Britton has been asked to examine the review process itself, to listen to and take on board some of the concerns that the hon. Gentleman raised. I would be interested to hear from the Minister what discussions she has had with colleagues in Scotland about what lessons can be learned from some of the questions that have been asked there.
The Scottish Government have no power to ban the use of mesh, because the matter remains reserved to the Westminster Parliament and, in particular, to the Medicines and Healthcare Products Regulatory Agency. The Sling the Mesh campaign, as we have heard from a number of Members, has asked for some clarity from the MHRA and a stronger, more stringent system of auditing the efficacy of mesh and other medical practices.
One of the most important things that has come through clearly in the debate is the collection and analysis of data, so that a full picture of the situation can be brought up. We have heard so many times of individual cases where people are told, “This is just you; this is an isolated case,” when it very clearly is not. The evidence has to be gathered, and full investigations have to take place and continue.
There is a clear expectation that the MHRA must continue to review the use of medical mesh implants. That should include considering all available evidence and taking lessons from the use of such implants further afield, such as in the United States and Europe. That is important to ensure not only that the best healthcare options are provided, but that women can be confident that the services they have received have been shown to be effective under robust and effective clinical trials—an important point, which was stressed by the hon. Member for Totnes. One of the key things I have learned from this debate is the difference between the testing regime for medicines and the testing regime for implants and other medical devices. There is clearly a cross-party consensus on that, and I hope the APPG will continue to look at the issue.
I welcome the conclusions and recommendations of the Scottish and English reviews of the use of this procedure. We must ensure that surgical mesh implants are used only after all other appropriate alternatives have been exhausted and, crucially, only when women give their fully informed consent.
Once again, I pay tribute to the campaigners for their bravery and courage and for bringing this issue to our attention. I hope it is not a totally inappropriate comparison, but this reminds me of the Women Against State Pension Inequality campaign, during which individual, isolated cases started to snowball, and the issue got on to the agenda. That campaign for justice made progress and is now being heard loud and clear. There is a parallel with this campaign, although it is not exactly the same. I hope the Government listen. We have to thank those campaigners for the small and belated progress that has been made. They will rightly hold us to account to ensure we make progress.