Chamber and committees

Thank you for your statement, minister.

How do you intend to evaluate and monitor the impact of the payment reform?

We move on to our final theme, with questions from Paul Sweeney.

Thank you.

Agenda item 4 is an evidence session on the National Care Service (Scotland) Bill. We will hear from representatives of local government and integration joint boards. I welcome to the meeting Eddie Follan, who is the chief officer in health and social care at the Convention of Scottish Local Authorities; Eddie Fraser, who is the chief executive of East Ayrshire Council and is representing the Society of Local Authority Chief Executives and Senior Managers Scotland; and Professor Soumen Sengupta, who is the director of health and social care in South Lanarkshire health and social care partnership and is representing the Health and Social Care Scotland chief officers group. We move straight to questions.

Paul Sweeney has some questions.

Good morning, and welcome to the 30th meeting of the Health, Social Care and Sport Committee in 2023. I have received apologies from Emma Harper. James Dornan joins us as her substitute.

Our first agenda item is to make a decision on taking business in private. Do members agree to take items 5 to 8 in private?

Members indicated agreement.

Of course.

You are straying from my question, which was about such organisations being on a governance board. Can you offer an opinion on whether they should be involved? I have heard about the importance and regard that you give them, but I do not know whether you think that they should be in the room.

I thank the minister and her officials for attending today.

Like many, if not all, members, I have heard from constituents over the years whose lives were devastated as a result of mesh implants. As we know, mesh was implanted in patients to support weakened or damaged tissue, and was used to treat conditions that some women suffer after childbirth, such as incontinence and prolapse. Over 20 years, more than 100,000 women across the UK, including more than 20,000 in Scotland, had transvaginal mesh implants. However, in 2018, the use of mesh was halted in Scotland, after hundreds of women were left with painful and life-changing side effects.

The physical symptoms and trauma that some women have endured are unimaginable and unacceptable. The situation was often made worse because they felt that their experiences were not taken seriously when they sought help. I have constituents who travelled to the USA and paid privately to be treated because they had, understandably, lost trust in those who would treat them here in Scotland.

One of my constituents sought help from Dr Veronikis in the period between the Scottish Government procuring an NHS referral route to private removal surgery and the Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Act 2022 coming into force. Initially, she would have missed out on being reimbursed, due to the cut-off date for reimbursement. I am sincerely grateful to the then health secretary—the current First Minister—for accepting an amendment at stage 2 of the Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill process to adjust the date to ensure that my constituent and many other affected women would benefit from that support. Rightly, the Scottish Government listened to the women impacted and ensured that no one was penalised for using their own funds to seek mesh removal surgery privately.

People turn to our NHS at times of need and expect our health service to do what it can to alleviate their health problems. Sadly, for too many women, the medical procedures only exacerbated the pain and suffering that they felt. The complications of transvaginal mesh surgery can have long-lasting effects, even after the mesh has been fully or partially removed, all of which contributed to a breakdown in trust for many.

I know that the Scottish Government is working hard, as is our health service, to rebuild that trust. The Scottish Government has taken decisive action on mesh and has already taken many steps that address a number of Professor Britton’s findings in the transvaginal mesh case record review. Scotland is also the first country in the UK to reimburse people for private treatment previously sought. Rightly, the Scottish Government has agreed with the principle that women should be supported and empowered to make decisions about their treatment.

A range of other measures are being undertaken to improve the services for people with complications arising from a result of mesh surgery, whether that is through the reimbursement of costs that I mentioned, the procurement of private providers in Bristol and Missouri or the specialist service in Scotland. It is that latter service that I want to speak about, particularly through the lens of the work of the Health, Social Care and Sport Committee. Members will be aware that, throughout this year, the committee has been taking evidence on the complex mesh surgical service, and that is on top of the previous scrutiny of the cost reimbursement bill, which took place before I became committee convener.

The committee’s primary purpose in carrying out its scrutiny of the CMSS has been to highlight the issues that have been raised through the consultation process to those who are responsible for delivering the service, and to explore what is being done and what further can be done to improve the service so that it properly meets the needs of its patients. As convener, I have written a number of times to the Minister for Public Health and Women’s Health to share concerns that have been raised with the committee in evidence. Those include concerns about the referral pathways, which other contributors have mentioned this afternoon, waiting times for CMSS, perceived inconsistent information being provided and the need, among other things, for an integrated system that provides holistic support to women.

In the minister’s most recent response, she acknowledged that there is scope for further improvement in the service. I know that the Scottish Government wants to ensure that the satisfaction levels of women attending the NHS specialist service in Glasgow continue to grow and that waiting times fall.

I also note the minister’s comments on the progress that is being made regarding a training pathway for mesh removal credentials as well as the recruitment of a specialist consultant to work with the core urogynaecology team in the Queen Elizabeth university hospital campus. Additionally, I welcome the action by the chief medical officer, who has written to all GPs to raise awareness of the referral pathway and to encourage them to access a mesh learning package that has been made available on NHS Scotland’s online learning service.

Those actions will continue to improve the support that is on offer to the women who are impacted. I know that all members are united in our determination that everything be done to help those whose lives have been impacted by mesh complications, whether women opt into or out of surgery.

It is only the courage of the women affected that has brought us to this point. Of course, it should not have taken their retelling of their experiences for them to be listened to. As the First Minister has recognised, they were badly let down by the initial service responses that doubted their lived experiences. We owe it to all the women affected and their families to continue listening to their concerns and acting on them.