Women suffering from the complications of surgical mesh implants could be sent to England, the private sector or abroad for treatment.

The Scottish government says it is looking at treatment possibilities “outwith NHS Scotland,” including abroad, after MSPs said any service should have the confidence of women affected.

However women and campaigners have told healthandcare.scot they would not trust any solution that involves any surgeons who advocated for the implants in the first instance.

In a joint statement, the committee of a mesh patient support group called for the NHS to fund treatment abroad.

A single service for mesh complication patients across Scotland was launched in August last year, after a Scottish government report found there had been variations in the treatment offered by different NHS boards.

The Health Secretary has now said further treatment options are being considered.

It follows MSPs voting for the ‘early prospect of full transvaginal mesh removal surgery being undertaken by surgeons who enjoy the full confidence of the women affected, fully funded by the NHS’.

A parliamentary answer published this week states referral to England, where three specialist surgical removal centres are being launched in April, will be a ‘further choice‘ where required and clinically appropriate. 

In the answer, Ms Freeman adds: ‘In addition, I have asked NHS National Services Scotland to actively consider whether options are available for the commissioning of mesh removal services outside of the NHS.

‘It is important to note, however, that the referral of patients for treatment outwith NHS Scotland, particularly where it involves foreign travel, is a complex issue. This is particularly so in terms of ensuring the safety and wellbeing of patients.

‘We must be assured regarding the quality and safety of care available. Treatment must also take account and be integrated with pre- and post-operative care. There are also obvious concerns around women travelling long distances during the present pandemic.’

There is continuing controversy over treatment for women affected by the procedures, often used to treat incontinence following childbirth, which have been linked to painful, often permanent complications after the implant disintegrated or shifted.

An offer from leading American surgeon Dr Dionysios Veronikis to come to Scotland to train doctors in full mesh removal procedures he had pioneered fell through after discussions with NHS Scotland broke down.

Some patients who underwent a procedure to have the mesh taken out later learnt this had been only a partial removal.

Use of vaginal mesh in Scotland was banned in all but exceptional circumstances in 2014 and halted entirely in 2018.

A report by Baroness Cumberlege looking at the use of mesh and two other treatments called for wide-ranging changes across the whole of the UK, including a register of doctors’ conflicts of interests and changes to regulation.

In the wake of the report the Scottish government committed to bringing in a patient safety commissioner.

The national service, which is hosted by NHS Greater Glasgow & Clyde, launched in August and offers ‘comprehensive assessments’ and vaginal mesh removal surgery for women over the age of 16 who have complications from mesh insertion (vaginally or abdominally) for urinary incontinence and prolapse.

Asked about the proposals, an online support group for mesh survivors in Scotland said they had little confidence in treatment in Scotland or England.

In the statement issued to healthandcare.scot, the group said: “When is a choice not a choice? When the Health Secretary says we can be funded to attend new NHS mesh centres in England run by the same kind of surgeons we have here.

“If desperate women are willing to travel thousands of miles to get to a surgeon who can remove mesh in full, then NHS Scotland should be instructed to expedite it. After all, they damaged us and have covered up for decades the true numbers of disabled and dead.

“As for our well-being and safety, when hundreds if not thousands are receiving next to no proper care within the mesh system in Scotland then the Health Secretary is simply using words to delay until the inhouse mesh centre is operational.

“Three health secretaries, three different governments since patients started campaigning, but still the same surgeons in situ. It stinks and mesh damaged women are not being helped.

Scottish Labour MSP Neil Findlay, who has campaigned on behalf of patients, said:

“Scottish women have no confidence in the mesh removal centre being established here since they will be staffed by the same surgeons who recommended their mesh implants.

“What we need is Jeane Freeman to either bring pioneering US surgeon Dr Veronikis here or commit to covering the cost of mesh injured women traveling to the US for his specialist services. That is the bottom line.”

 

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