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Chamber and committees

Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 5 May 2021
  6. Current session: 12 May 2021 to 7 June 2025
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Displaying 2800 contributions

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Health, Social Care and Sport Committee

Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill: Stage 1

Meeting date: 2 November 2021

Sue Webber

I have two questions: one about the reimbursement process and one on service commissioning for the future. We will deal with the reimbursement element first. Mr Hornby has spoken about it being a case-by-case process. We have heard from many of the witnesses about how complicated the issue of what we call wraparound costs is—we already know that the surgery is complicated, that no two cases are the same and that unexpected costs occur.

The administration of the reimbursement scheme sounds like it might be quite complex. At the same time, the payment will not be made until everything is concluded, but women will want to be reimbursed as quickly as possible. What extra resources has NSS put in to administer the scheme successfully to tie it all in for the women at the end of a traumatic period of their lives?

Health, Social Care and Sport Committee

Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill: Stage 1

Meeting date: 2 November 2021

Sue Webber

NHS National Services Scotland has expressed concern that the bill might set a precedent for other groups in a similar position. What have you and your team learned from the experience to ensure that we will not have to consider similar provision for other procedures in the future?

Health, Social Care and Sport Committee

Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill: Stage 1

Meeting date: 2 November 2021

Sue Webber

I have a quick question for Dr Jamieson. What is the time period between the first and second consultations? That will have a big impact when you are planning your service.

Health, Social Care and Sport Committee

Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill: Stage 1

Meeting date: 2 November 2021

Sue Webber

Thank you for coming along, cabinet secretary. You mentioned the cross-party support for the bill, but given that the NHS has always had the ability to refer patients for services between Scotland and England, can you see any reasons why you might not need to establish the reimbursement scheme?

Health, Social Care and Sport Committee

Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill: Stage 1

Meeting date: 2 November 2021

Sue Webber

Our papers say that, when we called for views on the bill from the health boards, we received responses only from NHS Highland and NHS Greater Glasgow and Clyde. That is an indicator that the health boards are perhaps not aware of what is going on despite the publicity that the matter has had. What work is under way to publicise the service to the various NHS boards throughout Scotland? What is the timeline for them to receive guidance on the referral routes to make the process as clear as possible for women who will access the service via their local health boards?

Health, Social Care and Sport Committee

Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill: Stage 1

Meeting date: 2 November 2021

Sue Webber

Thank you for those answers. However, going back to what Jackie Baillie said earlier on and the correspondence that we received last night, that trust and confidence are still not there. That binary choice, and the one route into referral via Glasgow, will be an issue.

Although the choice of surgeon is significant, another factor is that, for whatever reason, the Glasgow service has a bad reputation among mesh survivors. What, specifically, are we doing to give women the confidence to come into the service, knowing that they will get a good outcome, wherever it might be, for whatever treatment and whatever the approach might be needed at the other end?

Health, Social Care and Sport Committee

Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill: Stage 1

Meeting date: 2 November 2021

Sue Webber

Thank you; that answers my specific question.

Can you clarify whether all women will still have to refer in via NHS GGC, whether the commissioned service be the Glasgow mesh service, the site in NHS England, the potential site at Spire Healthcare, or overseas? With regard to the hierarchy—that word might not be correct but you will understand it—is there a preferred route? If the women do not want to go to Glasgow, will we encourage them to take up the service in NHS England because it is an NHS service and the wraparound care might be more definable there, or are those choices patient driven? The matter is complicated.

Health, Social Care and Sport Committee

Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill: Stage 1

Meeting date: 2 November 2021

Sue Webber

You have spoken at length, and we have heard much, about the complexity of the wraparound care that the women need. Are you satisfied that the bill and the provision for procurement of services from the private sector will not undermine the NHS in any way?

Health, Social Care and Sport Committee

Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill: Stage 1

Meeting date: 2 November 2021

Sue Webber

Thank you for that answer. We know that the first point of call is often with the woman and her GP, but there are many GPs across the country. What wider publicity and training are being provided about the national mesh service, and particularly about the GPs linking into it and understanding the complications that arise from the surgery, so that they can refer women quickly and effectively into the service?

Health, Social Care and Sport Committee

Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill: Stage 1

Meeting date: 26 October 2021

Sue Webber

Is that the realistic medicine that you referred to earlier in the discussion today?