My profession should have been the first to apologise not last. We must learn to listen
BY DR WAEL AGUR MESH SURGEON AND MEMBER OF SCOTTISH GOVERNMENT ADVISORY COMMITTEE
When I first heard about mesh, like other surgeons I knew, I believed it was something that would help my patients so I welcomed its introduction.
I changed my mind when I began to see the lifechanging complications and injuries these devices were causing, and became one of the few surgeons to speak out about the risks of using mesh.
While I welcome the recommendations in the Cumberlege Report, I believe it did not go quite far enough in seeking an outright ban on the use of mesh implants such as the TVT-O devices and vaginal mesh for prolapse which have caused most harm. I believe this was a missed opportunity to finally draw a line under the use of these mesh implants to treat the bladder conditions and pelvic organ prolapse which can happen after childbirth.
The report has left the door open for the use of certain kinds of mesh if the current suspension is lifted. It concerns me that at some time in the future when the furore has died down, mesh manufacturers will find a way to bring their products back into the operating theatre.
It saddens me that professional bodies representing surgeons who implanted so many women who ended up with life-changing complications have not apologised, despite the harrowing stories in the report and despite its invitation to apologise.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists issued an immediate apology following the independent parliamentary inquiry there, however UK clinical societies and royal colleges dragged their feet. Despite the very clear first recommendation in the report to apologise, they finally made that apology on Friday afternoon, and only that after apparently being prompted by The Sunday Post.
It seemed grudging, dragged out and, it pains me to say, their actions will leave patients wondering whether there is a desire that lessons will be learned, and whether their suffering continues to be disregarded by the people they trusted to care for them.
As a profession, we must listen to the patients.
The report has been critical of these professional bodies for staying silent and of the regulatory system which allowed generations of women to be injured.
Despite the thousands of women who had been injured, and despite knowing the report was due to be published, just days later, medical watchdog the Medicines and Healthcare products Regulatory Agency (MHRA) published guidance stating they still considered the benefits of using mesh outweighed the risks. The organisation was continuing to display its lack of consideration of mesh victims, lack of understanding on patient safety in relation to mesh devices and lack of empathy for those whose lives have been destroyed. The subsequent correction of this mistake, by removing the MHRA view only few days after its publication, does not build confidence in our device watchdog. Serious damage had already been done.
For those overwhelming reasons, I wholeheartedly support the call for a Patient’s Commissioner and for Scotland to have its own regulatory equivalent of the MHRA, and for an open system where declaration of interests of surgeons and researchers are made readily available to patients and the public.
Scotland led the way across the world by becoming the first country to suspend the use of mesh implants. I believe we can continue to lead the way, and can build on that by putting in place structures which will protect patients in future from a repeat of the mistakes of the past.