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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 3582 contributions

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Citizen Participation and Public Petitions Committee

Continued Petition

Meeting date: 12 May 2022

Jackson Carlaw

I know that you are not seeking to draw parallels, but, from our experience, I think that the use of mesh in the transvaginal example was underpinned by issues of cost and the fact that it was a much simpler procedure than the alternative.

You referred to the European Hernia Society. The British Hernia Society, in expressing its scepticism and its justification for mesh as the principal and preferred route, says that the sutures that are required for the alternative—the tension-based repair procedure that you pioneer—are not resilient enough. How do you respond to that? How do you deal with that?

Citizen Participation and Public Petitions Committee

Continued Petition

Meeting date: 12 May 2022

Jackson Carlaw

Following on from that, I invite Paul Sweeney to reflect on what has been said so far and then to ask our next set of questions, as well as any question that might have occurred to him.

Citizen Participation and Public Petitions Committee

Continued Petition

Meeting date: 12 May 2022

Jackson Carlaw

One of the issues that we faced in Scotland in relation to the removal of mesh in the transvaginal area was that that operational procedure required a huge amount of skill. The glib view, before all this was examined properly, was that it might be possible for some clinicians from Scotland to simply sit in on a few procedures to gain the necessary skills. However, that did not prove to be the case, which is what led to the legislation in Scotland that is facilitating the transfer of women to wherever the skills exist.

In due course, we will have a meeting with the Scottish Government minister with responsibility for this issue. For the moment, though, Alexander Stewart will explore the potential transferability to Scotland of the skills and experience of the staff of the Shouldice hospital, and of its preferred model.

Citizen Participation and Public Petitions Committee

Continued Petition

Meeting date: 12 May 2022

Jackson Carlaw

You just referred to the situation in which the use of mesh might still be appropriate. It occurs to me that the reason that mesh has been relied on by some is that the nature of the hernia suggests that the tissue walls are not sufficiently strong to withstand the subsequent pressure.

You have explained the preparatory criteria that you have for people you think it would be appropriate to operate on, but when it comes to—how can I put this?—what you find internally, are there times when you look at what is there and think, even though the patient has taken all the necessary action, the tissue wall might not be sufficiently strong to withstand the procedure? Does that happen from time to time, with the result that you have to fall back on an alternative?

Citizen Participation and Public Petitions Committee

Continued Petition

Meeting date: 12 May 2022

Jackson Carlaw

With regard to that rather uncomfortable thought that you had in relation to men, does that happen from time to time?

Citizen Participation and Public Petitions Committee

Continued Petition

Meeting date: 12 May 2022

Jackson Carlaw

I want to understand one final thing. How is the procedure financed in the healthcare system in Canada? Obviously, we have a national health service here, so everything is part of a national healthcare plan, but in relation to the patients who present to you, what is the financial underpinning of the procedure that is undertaken?

Citizen Participation and Public Petitions Committee

Continued Petition

Meeting date: 12 May 2022

Jackson Carlaw

Is that a public plan?

Citizen Participation and Public Petitions Committee

Continued Petition

Meeting date: 12 May 2022

Jackson Carlaw

That is helpful.

Citizen Participation and Public Petitions Committee

Continued Petition

Meeting date: 12 May 2022

Jackson Carlaw

That is a considerable complement.

As colleagues have no further questions to ask, I thank you very much for a fascinating opportunity. It is amazing what the world’s worst pandemic has led us to being able to explore across the world more easily, as we have become familiar with this virtual technology. Otherwise, it is not a conversation that we would have thought to have or been used to having.

On behalf of the committee, I am incredibly grateful to you for the time that you have given us and the evidence that you have presented.

Is there anything that you would like to say that we have not touched on?

Citizen Participation and Public Petitions Committee

Continued Petition

Meeting date: 12 May 2022

Jackson Carlaw

Thank you; that is very helpful.

My colleague, David Torrance, will ask our fourth question, which explores the controlled trials and the low recurrence rates. He will ask a couple of questions that follow on from what you have just said.