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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 2 August 2025
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Displaying 775 contributions

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Citizen Participation and Public Petitions Committee

Continued Petitions

Meeting date: 6 October 2021

Maree Todd

No. That was perfect.

Citizen Participation and Public Petitions Committee

Continued Petitions

Meeting date: 6 October 2021

Maree Todd

As I understand it, it is the Medicines and Healthcare products Regulatory Agency that grants licences for those products on a United Kingdom-wide basis. David Bishop might want to come in on this but, as I understand it, the transvaginal mesh situation prompted a review of all those processes. I think that on-going work is still being done on that.

Our feeling in the Scottish Government is that the MHRA’s procedures should be absolutely robust and that there were lessons to be learned from that situation. We are keen to ensure that those lessons are learned.

I invite David Bishop to give some more information on that front.

Citizen Participation and Public Petitions Committee

Continued Petitions

Meeting date: 6 October 2021

Maree Todd

That would be a challenging undertaking retrospectively. However, on the use of mesh in other sites for gynaecological procedures that was not subject to the halt, the high-vigilance protocol has a number of procedures in place that ensure that that is perfectly possible. There is documentation of all the procedures and complications and on the reporting of complications on an agreed database. Crucially, documentation is given to every single patient who is treated with mesh that details their procedure and the mesh product used, along with the name of the patient. Therefore, in future, the precise situation that you have outlined will be less likely to arise in gynaecological procedures in which mesh is used.

Citizen Participation and Public Petitions Committee

Continued Petitions

Meeting date: 6 October 2021

Maree Todd

I am not sure how that would happen, given the scale of the procedures, with 5,000 to 6,000 per year being carried out since the 1980s. However, as Mr O’Kelly outlined, patients should first present at their GP.

People must be listened to, because the key point that has come out through all the testimonies is that people do not feel listened to. We must learn from the transvaginal mesh incident—people’s concerns have to be taken seriously and acted on appropriately. In many areas, there will be a multidisciplinary team in place, as Mr O’Kelly outlined. There is a complexity in dealing with mesh complications, and the multidisciplinary team and clinical networks will together look at each individual case. However, it must be straightforward for patients to access that level of expertise when they find themselves in the situation that Mr Kidd describes.

Citizen Participation and Public Petitions Committee

Continued Petitions

Meeting date: 6 October 2021

Maree Todd

To be absolutely clear, the process of informed decision making is about the patient and the clinician sitting down together, understanding the condition that the patient presents with and talking over the options. It involves consideration of the elements of the acronym that is gaining popularity in realistic medicine circles, which is BRAN—the benefits, the risks, the alternatives and the effect of doing nothing. Alternatives are absolutely part of that process. That approach is becoming ingrained in medical practice—for example, the acronym appears in advertising campaigns in the virtual waiting room for NHS services in my area. The intention is to normalise that process.

The clinician should be sitting with someone and discussing alternatives. They should say, “Here’s what you’ve got and this is my understanding of the factors that are significant for you as an individual. What do you need me to understand about you as an individual? Let’s see what alternatives are on the table and make a decision together.” That is how it should be. The onus should not be on the patient to ask questions. We intend to create an atmosphere in which it is normal for the patient to ask questions. It is their body that is the subject of the process, and it is altogether more satisfactory if the patient is empowered to make a decision in such situations.