MPs have stopped short of recommending a pause on the use of surgical mesh for a common birth injury.
A petition by Sally Walker and Charlotte Korte had asked Parliament’s Health Committee to suspend mesh implants for some operations until surgeons could be upskilled.
In its just-published response, the committee said there was no consensus among surgeons on whether a pause was necessary, and deferred to the Ministry of Health.
The women behind the petition said mesh-injured patients would be “mortified” at the committee’s response and said it had simply “passed the buck”.
“We are extremely disappointed,” Walker and Korte, who had both been severely injured in botched mesh operations, said in a joint statement.
“We do not feel this report reflects that level of harm that is occurring, and we want the voices of mesh harmed to be heard. We want mesh injured to know we will not give up.”
Sally Walker led the petition to suspend the use of mesh in the treatment of stress urinary incontinence, a common birth injury. Walker's insides were so badly damaged by the medical device that her bladder had to be removed. Photo / Dean Purcell
The Green Party was also upset with the committee’s report. Spokeswoman Jan Logie said that by leaving any decision to the ministry, it “essentially gets the same body which has procrastinated for so long to make the final decision”.
The petition’s primary focus was the suspension of mesh implants for the treatment of stress urinary continence, a common injury which causes urine leakage after coughing or other exertions.
Parliament’s Health Committee, after holding public hearings, concluded that submitters had differing views on whether a pause was necessary, and that such a move could reduce access to a treatment that worked for many women.
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The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) said the benefits of mesh operations to the population as a whole outweighed the risks. Those benefits included less pain, shorter hospitalisations, a faster return to activities, and reduced cost, when compared to historical treatments for severe incontinence.
A ban on mesh implants would remove the most commonly-used procedure worldwide for this condition, the college said. It also noted that mesh implants were the only option for some women.
The Royal Australasian College of Surgeons (RACS) said it was neither for nor against the suspension of mesh procedures to treat stress urinary incontinence.
The RACS instead proposed a partial pause until the end of 2023 at the latest, during which implants could only be performed at specialist mesh centres by credentialled surgeons. This would “buy time” for improvements to the system, including a national register of mesh and pelvic surgeries.
MPs on the committee noted that the ministry was already considering a halt to the procedure.
They concluded: “We recommend to the Government that the Ministry of Health work with the relevant colleges and the Medical Council of New Zealand to investigate how it could effect a pause. We agree with [the RACS] that any pause should be time-limited.”
In May, the ministry’s chief medical officer Jo Bourne confirmed the ministry was investigating a pause, but said officials had not yet worked out a mechanism for doing so.
The Health Committee said that some of Walker’s other requests, including the credentialling of surgeons, a national register of mesh implants, and improvements to informed consent, were already being worked on by the ministry.
Green Party MP Jan Logie questioned the speed at which the ministry was implementing measures to reduce the harm from surgical mesh. Photo / Mark Mitchell
However, the co-petitioners and the Green Party were concerned about the slow implementation of these initiatives.
The first round of credentialling has taken place, but that only covers the most complicated operations and the ministry has said further credentialling - such as for implanting mesh - will be “some way off yet”.
A national registry is being developed in conjunction with Monash University, but this was not expected to be ready until the end of the year at the earliest.
While those measures were being considered, patients were still being harmed, without a comprehensive record of their injuries, advocates said.
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