Parliamentary Questions and Reports
A sample of some of the parliamentary questions, answers, reports and debates relating to Sling The Mesh are below.
Further questions and written answers can be found on TheyWorkForYou. The majority of questions have been asked by:
- Emma Hardy
- Sharon Hodgson
- Owen Smith
- Alec Shelbrooke
- Julian Lewis
- Sarah Green
- Sara Britcliffe
- Lord Philip Hunt
- Baroness Julia Cumberlege
- Sarah Wollaston
- Jim Shannon
- Kevin Hollinrake
2026
Pelvic mesh and sodium valproate compensation / financial redress Research Briefing
2025
Debate on the first anniversary of the Hughes report on valproate and pelvic mesh
2024
Mesh implants: Compensation House of Lords debate What progress has the government made in ensuring that those who have suffered complications following pelvic mesh implants receive financial compensation.
2023
The Health and Social Care Committee has welcomed a decision by the Government to boost resources for the Patient Safety Commissioner to examine redress for those harmed by sodium valproate and pelvic mesh.
Sling The Mesh has more than 9,300 members with vaginal, abdominal, pelvic, rectal, hernia and mesh following mastectomy.
Our latest survey shows 1 in 4 have considered taking their life owing to life changing, irreversible pain and 6 in 10 suffer depression. A third have been forced to give up work and 1 in 5 reduce their hours in order to cope. There are 1 in 4 who now need a stick to walk and almost 1 in 14 who need a mobility scooter or wheelchair.
Six in 10 suffer recurring urinary tract infections and 1 in 14 are becoming antibiotic resistant so are at risk of sepsis.
These complications are unacceptable.
Read the full Sling The Mesh statement and further submissions.
2021
Q: With reference to the Answer of 22 July 2021 to Question 33177, on Medicines and Medical Devices Safety Review, has a decision been made on the mandatory reporting of adverse events?
A: A decision has not yet been made. The Medicines and Healthcare products Regulatory Agency continues to investigate the matter with the intention of making proposals by the end of the 2021-22 financial year.
- In 2023 it is still NOT mandatory and the MHRA has no intention of changing this.
Q: Will it be made mandatory for doctors to report complications of healthcare treatments to the MHRA Yellow Card scheme?
A: The MHRA is reviewing the issue of making reporting of adverse events mandatory for healthcare professionals and will be discussing this with other partners in the healthcare system with a view to making firm proposals in quarter 4 of 2021/22.
- In 2023 it is still NOT mandatory and the MHRA has no intention of changing this.
2020
Rectopexy
Q: What is the evidential basis for the omission of rectopexy mesh from the specialist removal guidelines for the proposed specialised mesh removal centres?
A: The NHS England specialised mesh removal centres were introduced in response to the recommendations set out in the Mesh Oversight Group Report, published in 2017. The centres are for women with complications resulting from mesh inserted for urinary incontinence and vaginal prolapse. These services are specifically linked to specialised gynaecological treatment.
The main reason to perform a rectopexy is to correct and repair a rectal prolapse, which is, therefore, outside the scope of the services that the specialised mesh removal centres can offer.
View on the UK Parliament website
GPs
Q: What steps are planned following the Cumberlege Report to ensure that GPs are informed of (a) the effects of faulty mesh surgery on the patient, and (b) all support and treatment options that are available for those patients?
A: All recommendations of the Independent Medicines and Medical Devices Safety Review are being considered carefully and the Government will provide an update in due course.
If a woman has previously had vaginal mesh inserted and is having complications, she should speak to her general practitioner (GP) or surgeon in the first instance. NHS England is also working with providers to set up specialist centres for mesh inserted for urinary incontinence and vaginal prolapse.
GPs will be able to refer patients to these specialist centres to ensure patients can get the treatment and support they require.
View on the UK Parliament website
Pain management
Q: What plans are in place to support the creation of a holistic pain management service as part of the proposed NHS mesh specialist centres.
A: There are currently no plans to create a separate holistic pain management service as part of the proposed NHS mesh specialist centres.
Women who are referred to the mesh specialist centres will be able to discuss their treatment with the Mesh Service’s Multi-Disciplinary Team. The team will include a specialist in pain management with an expertise in pelvic pain who will support patients in managing their pain.
View on the UK Parliament website
Mesh centre teamwork
Q: What plans are in place to ensure the proposed NHS mesh specialist centres function as a network?
A: The proposed NHS mesh specialist centres will function within a clinical network arrangement. Centres within a region will have jointly agreed guidelines, pathways, referral guidelines and protocols for patient follow-up.
View on the UK Parliament website
Data registry
Q: What are the plans for establishing a data registry to log every complication resulting from mesh surgery?
A: NHS Digital has put together a programme of work to establish an information system to collect surgical implants and devices data from all NHS and private provider organisations starting with mesh-related procedures.
It is currently in the pilot stage and, once completed, will be followed by establishing a Medical Device Information System (MDIS). MDIS will be used to support surveillance of all medical devices, including mesh-related procedures, and will enable patients to be identified and contacted where safety concerns are identified. NHS Digital hopes to move to full roll-out in January 2021.
View on the UK Parliament website
Conflicts of interest
Q: Have steps been taken as a result of the disclosure that a 2012 study published in European Urology, which concluded that no patients were suffering thigh pain three years after their transobturator mesh procedures?
A: We cannot comment on individual cases and neither can the General Medical Council.
Q: Why is NICE suggesting taking away pain medication for those with no clear cut reason for their pain and why is abdominal prolapse mesh still routinely used when vaginal prolapse mesh is banned and incontinence mesh is suspended?
A: Departmental officials have been working with NHS England and NHS Improvement to establish means of specialist support for those women requiring it. While NHS England and NHS Improvement complete the process of commissioning mesh removal centres, there are hospitals in England where this type of treatment is available. Both the British Association of Urological Surgeons and the British Society of Urogynaecology have information on their respective websites about the hospitals and surgeons that will provide the specialist support required.
On managing chronic pain, the National Institute for Health and Care Excellence (NICE) advises that the draft guideline is still out for consultation in line with their standard processes. This will close on Monday 14 September after which their guideline committee will meet to consider comments received.
On pain specifically experienced as a result of mesh insertion, NICE advises that its specific guideline is ‘Urinary incontinence and pelvic organ prolapse in in women: management’, which includes advice on managing complications.
On the use of mesh to treat hernias (abdominal wall reinforcement), the Medicines and Healthcare products Regulatory Agency has not had any evidence which would lead it to change its position on use of surgical mesh for hernia repairs.
Q: With reference to the vaginal mesh implants scandal, what steps are being taken to require (a) medical personnel who are consultants to firms making medical products that they propose to use for their patients (i) declare their interest and (ii) draw their patients’ attention to such a declaration when recommending the use of those products?
A: The General Medical Council already has guidance covering financial and commercial arrangements and conflicts of interest, which all medical practitioners must adhere to and which came into effect on 22 April 2013. We will consider whether these arrangements should be strengthened.
National Health service prescription charge exemptions are in place to help those with greatest need.
The Government will consider the recommendations in the First Do No Harm report published on 8 July very carefully.
Q: What is the Government doing about a surgeon who failed to declare £100,000 from makers of a mesh he was trialling, from which, he said, no patients were suffering thigh pain three years later?
A: We cannot comment on individual cases and neither can the General Medical Council.
2019
Q: Will the Government expand the scope of the Independent Medicines and Medical Devices Safety Review to include hernia mesh?
A: No, but the department expects that the conclusions of the review will contain lessons for organisations across the health system.
View on the UK Parliament website
Q: Will the Government ask NICE to produce guidance on all hernia mesh?
A: No.
View on the UK Parliament website
Q: What assurances have the Government received that surgeons in England continue to maintain their skills in non-mesh hernia repair treatments?
A: Surgeons follow NICE guidelines. (Hang on a minute, you just told us there are no plans to draw up a full set of guidelines!)
View on the UK Parliament website
Q: Will the Government commission research on the number of patients who have been adversely affected by hernia mesh operations?
A: No.
View on the UK Parliament website
Q: Do NHS Digital statistics tell us the number of patients adversely affected by hernia mesh operations.?
A: No.
Owen Smith writes in Politics Home that regulations need toughening up for medical devices. Read the full article
2018
Q: Which arm’s length bodies is the Government in dialogue with to assess how it can continue to build on the evidence base for surgical mesh?
A: Following publication of NHS Digital’s ‘Retrospective Review of Surgery for Urogynaecological Prolapse and Stress Urinary Incontinence using Tape or Mesh’, at the request of the Parliamentary Under Secretary of State for Health (Lord O’Shaughnessy), the Chief Medical Officer sought views on what the data tells us and what further questions it raises from arm’s length bodies, professional groups/societies, academics and campaign groups.
The arm’s length bodies and professional groups/societies approached were NHS England, National Institute for Health and Care Excellence (NICE), Medicines and Healthcare products Regulatory Agency (MHRA), Royal College of Obstetricians and Gynaecologists, Royal College of Surgeons, Royal College of General Practitioners, the British Association of Urological Surgeons and the British Society of Urogynaecology.
The Department is also in dialogue with NHS England, NICE, MHRA and NHS Digital on the matter.
Q: When will there be rectopecxy coding?
A: There will not be a specific hospital code for ventral mesh rectopexy until 2020.
Q: What are the plans to extend the time allowed for cases of clinical negligence to be brought on behalf of women harmed by pelvic mesh, and what assessment has been made of the number of women so affected and of their exposure to debilitating side effects?
A: There is currently no plan to extend the limit in medical negligence cases specifically for mesh-injured patients.
Under section 11 of the Limitation Act 1980 a patient is able to bring a claim for damages for clinical negligence against a trust or any other healthcare provider within three years from the date of injury. However, this can be longer if the patient is a child, when the three year period only begins on his/her eighteenth birthday; the patient has a mental disorder within the meaning of the Mental Health Act 1983 so as to be incapable of managing his/ her own affairs, when the three year period is suspended; or there was an interval before the patient realised or could reasonably have found out that he/she had suffered a significant injury possibly related to his/her treatment.
The ‘date of knowledge’ of an injury could be a number of years after the treatment. In recognition that there may be some cases where the prescribed period is inadequate, the Limitation Act 1980 also gives the court discretion to disapply the limitation period in respect of claims for personal injuries when it considers it just and equitable to do so.
NHS Digital’s Retrospective Review of Surgery for Urogynaecological Prolapse and Stress Urinary Incontinence using Tape or Mesh, found for mesh insertion procedures for urogynaecological prolapse, between 2008/09 to 2016/17, 27,016 patients had a reported mesh insertion procedure for urogynaecological prolapse. There were only three reported readmissions for a removal procedure within 30 days of the identified insertion procedure. For patients who had a removal procedure more than 30 days after their initial insertion, the highest rate of readmissions occurs in the reporting year following the insertion. Patients who had an insertion in 2008/09 had a removal rate of 3.9 patients per 1,000 in 2009/10, but for patients who had an insertion in 2015/16, their removal rate was lower at 1.8 patients per 1,000 in 2016/17. The rate fluctuates for patients who had an insertion in the intervening reporting years. A summary of the report is attached.
The questions focus on hernia mesh, a pelvic mesh suspension, whether regulatory processes will be improved, how the Government can assure patients get full information on risks, and action being taken to ensure mesh is not offered as the first line of treatment for SUI or prolapse. Also, Lord James O’Shaugnessy replies that translabial scans will not be offered at specialist hospitals to diagnose mesh complications.
Q: To ask Her Majesty‘s Government whether they plan to commission new guidelines from NICE in relation to hernia mesh.
Q: In the light of the publication on 17 April of the national audit of patients, will the Government suspend the use of pelvic mesh?
Q: In the light of issues experienced by patients with mesh, does the Government plan to improve the regulatory system for medical devices.
Q: Is the Government satisfied that patients are getting full information about the risks of mesh; and that the use of terms such as tape, ribbon or sling are not misleading patients in seeking to avoid the term mesh?
Q: To ask Her Majesty’s Government what action they are taking to prevent mesh from being offered routinely to patients as a first intervention.
Q: Will the Government ensure translabial scans are available at every acute hospital where urogynecologists and gynaecologists are seeing women for pain and complications after the implantation of pelvic mesh?
Q: Will the Government bring forward the NICE guidelines for mesh in stress-related urinary incontinence from 2019 to 2018?
Q: To ask the Secretary of State for Health and Social Care, whether specific Hospital Episode Statistics codes are planned to be assigned to ventral mesh rectopexy procedures to allow clear identification and monitoring of the number of such procedures conducted.
A: Hospital Episode Statistics (HES) is a database containing details of all admissions, accident and emergency attendances and outpatient appointments at National Health Service hospitals in England. Procedural codes are not dictated by HES.
The OPCS Classification of Interventions and Procedures (OPCS-4) is a Fundamental Information Standard which is used by clinical coders within the NHS. There is not one single code for ventral rectopexy in OPCS-4 and therefore the procedure cannot currently be identified through a single code. However, this procedure would be assigned a code based on whether it was for internal or external rectal prolapse, rectocele, obstructive defecation or faecal incontinence.
Any member of the public can submit change requests to request changes to OPCS-4 using the NHS Digital Request Submission Portal. A request has been submitted through an NHS trust for the addition of ventral mesh rectopexy; the removal of the mesh inserted during ventral rectopexy will also be considered as part of this submission.
View on the UK Parliament website
Q: To ask the Secretary of State for Health and Social Care, whether specific Hospital Episode Statistics removal codes are planned to be assigned to ventral mesh rectopexy as they are at present for TVT and TOT surgical mesh procedures.
A: Hospital Episode Statistics (HES) is a database containing details of all admissions, accident and emergency attendances and outpatient appointments at National Health Service hospitals in England. Procedural codes are not dictated by HES.
The OPCS Classification of Interventions and Procedures (OPCS-4) is a Fundamental Information Standard which is used by clinical coders within the NHS.
The OPCS-4 codes are categorised to provide a summary of a consultant episode of patient care for reporting and counting purposes. As such not every procedure has a unique code.
The codes assigned are based on the information documented by the responsible consultant and classification business rules and standards for consistent coding. A combination of OPCS-4 codes may be used for coding ‘ventral mesh rectopexy’ dependent on how and why it was performed.
Any member of the public can submit change requests to request changes to OPCS-4 using the NHS Digital Request Submission Portal. A request has been submitted through an NHS Trust for the addition of ventral mesh rectopexy; the removal of the mesh inserted during ventral rectopexy will also be considered as part of this submission.
View on the UK Parliament website
Q: To ask the Secretary of State for Health and Social Care, if he will make an assessment of the potential merits of conducting a retrospective audit of ventral mesh rectopexy to take account of its omission from the Government’s audit into recovery after vaginal mesh surgery.
A: NHS Digital published an audit on 17 April 2018, titled ‘Retrospective Review of Surgery for Urogynaecological Prolapse and Stress Urinary Incontinence using Tape or Mesh’. An executive summary of the report is attached.
The audit reviews Hospital Episode Statistics (HES) data. HES data contains details of all admissions, outpatient appointments and accident and emergency attendances at National Health Service hospitals in England. It includes private patients treated in NHS hospitals, patients who were resident outside of England and care delivered by treatment centres, including those in the independent sector, funded by the NHS.
The Department is engaged in ongoing dialogue with arm’s length bodies to assess how it can continue to build on the evidence base for surgical mesh. This includes discussion of areas of concern beyond urogynaecological mesh – i.e. mesh used in surgical procedures to treat rectal prolapse.
Q: To ask the Secretary of State for Health and Social Care, if he will immediately suspend the use of medical procedures involving vaginal mesh implants.
A: The Government does not support a suspension or ban of the use of surgical mesh devices. The view of the Medicines and Healthcare products Regulatory Agency (MHRA) is that surgical mesh devices are acceptably safe when used as intended and as part of an appropriate treatment pathway where the associated risk and benefits are considered, and where surgical mesh devices conform to the requirements of the current legislation in the European Union.
As a Department we are committed to improving the outcomes for all patients involved. We continue to work closely with MHRA, NHS England, the National Institute for Health and Care Excellence and professional bodies. MHRA continue to review available evidence to ensure our regulatory position is up to date, liaising with EU partners and non-EU regulators.
2017
Lord Porter of Spalding asks how many women have had surgical mesh implants since the introduction of the operation.
Scottish MP Paul Masterson asks what discussion have taken place with the Medicines and Healthcare products Regulatory Agency (MHRA) in relation to transvaginal mesh products.
