Health | Support for patients requiring treatment for post-mesh conditions
To ask the Minister for Health the degree to which patients requiring treatment for post-mesh conditions continue to receive support and recognition in the scale required at the earliest possible juncture; and if he will make a statement on the matter.
I understand that complications from a mesh implant are very distressing and painful for those women involved and since the emergence of this matter, the ongoing priority focus for the Department of Health has been to ensure that all women experiencing mesh related complications receive high quality, multi-disciplinary and patient-centred care. Women’s health remains a key priority for the Government and the Department of Health continue to focus on prioritising the care needs of women affected by mesh related complications.
Uro-Gynaecological (Transvaginal) mesh is used in the surgical treatment of Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP) in women and such mesh devices have been widely used for this over the past two decades. However, in late 2017, in line with emerging international evidence, concerns were raised at national level regarding the frequency and severity of complications associated with the use of transvaginal mesh devices. The then Minister for Health requested the Chief Medical Officer (CMO) to prepare a report on the clinical and technical issues involved.
In November 2018, the CMO’s Report on The Use of Uro-Gynaecological Mesh in Surgical Procedures was published. The Report contains a number of recommendations regarding the safe and effective provision of mesh procedures in urogynaecology and an appropriate response to women who suffer complications as a result of undergoing such procedures. In July 2018, the CMO had asked the HSE to pause all mesh procedures where clinically safe to do so, pending confirmation of the implementation of specific recommendations in the CMO’s Report. This pause remains in place.
In April 2019 the HSE published a detailed Implementation Plan to progress the recommendations detailed in this report and the National Women and Infants Health Programme continue to lead on this work for the HSE.
In relation to the service provisions and supports in place to support women experiencing mesh related complications, multidisciplinary specialist services for women suffering from mesh complications are available via the HSE National Mesh Complications Service, based at Cork University Hospital (CUMH) and the National Maternity Hospital (NMH) Dublin. This service has been operational since 1st September 2021. There are designated HSE contact points and associated care pathways to ensure that service needs can be identified and provided for and all persons affected by mesh are strongly encouraged to access these services via their clinical consultant.
Trans-labial and transvaginal education and training was carried out in November 2021 by a Consultant Uro-Gynaecologist from Croydon University Hospital in the UK, on site in CUMH. The Mesh Complications Service will have a lead Consultant for this service at the two centres (NMH and CUMH) to facilitate trans-labial scanning.
The HSE has advised the Department of Health of a Treatment Abroad Scheme protocol for mesh removal, for women with certain defined clinical complexities. This protocol aims to ensure timely access to care under the Treatment Abroad Scheme for this patient group where clinically appropriate.
A key priority is that all women affected by mesh are offered care. Consequently, women affected by mesh have been strongly encouraged to engage with the relevant HSE contact points and the associated care pathways, to ensure that their service needs can be identified and provided for. Information on this, and a list of contact points, are available on the HSE website.
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