Scottish Health Secretary Alex Neil requests mesh implant suspension

Alex Neil Health Secretary Alex Neil outlined a series of measures when he appeared before MSPs

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Scottish Health Secretary Alex Neil has requested a suspension in the use of mesh implants by the NHS in Scotland, pending safety investigations.

Some of the women who received the procedure, which is used to ease incontinence, have suffered painful and debilitating complications.

Mr Neil told MSPs he was "deeply troubled" by the issue and was setting up an independent review.

Campaigners said his decision was unexpected, but welcome.

Several of Scotland's 14 regional health boards said they would agree to the health secretary's request, while others explained that they had not used the procedure in some time.

The Scottish government said it would hand a dossier of Scottish cases to the Medicines and Healthcare products Regulatory Agency (MHRA), which would have the final say on the use of mesh implants on a UK-wide basis.

A MHRA spokesman said its research showed that while a small number of women had experienced distressing effects, the benefits of these tapes and meshes outweighed the risks and could help in dealing with upsetting conditions such as urinary stress incontinence and pelvic organ prolapse.

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EXPLAINER - Mesh implants
Woman in pain
  • Health Secretary Alex Neil has called for the suspension of mesh implant operations. But why? Find out how the procedure has blighted the lives of some women.
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About 1,850 women have the procedure in Scotland every year.

The health secretary said he had asked Scotland's acting chief medical officer, Dr Frances Elliot, to write to health boards with a request to immediately suspend the procedures until further evidence from both the Scottish government review, and a European Commission investigation into mesh implants, became available next year.

Harrowing evidence

"I believe that is the right thing to do, and that we should base any future decisions on the evidence as presented by these two reports," said Mr Neil.

The health secretary said his suspension request extended to both tension free vaginal tape (TVT) and pelvic organ prolapse (POP) procedures.

From Democracy Live: MSPs heard harrowing evidence about the side effects of mesh implants

Mr Neil's decision came after the Scottish Parliament's petitions committee previously heard harrowing evidence about women who suffered life-changing side effects after undergoing the procedure.

Some have been left in constant pain after the implants hardened, and told they could never have sex again.

Appearing before the committee on Tuesday, Mr Neil said: "We should all be very concerned to hear how these implants have affected the lives of some women in Scotland and elsewhere.

"I've personally met with women who've been adversely affected, and I was deeply troubled to hear how women affected have suffered, and they have my full sympathy and support and we'll certainly do everything we can to improve the situation.

"No one should have to experience the level of suffering that some of these women have had."

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How health authorities have responded to the Scottish government request
  • NHS Highland said it had received Dr Elliot's letter and would act on the advice given.NHS Greater Glasgow and Clyde said it had not yet received the letter, but would comply with any guidance on mesh implants.
  • NHS Ayrshire & Arran said it would act on the Scottish government guidance.
  • NHS Forth Valley said it stopped using vaginal mesh implants in 2011, adding: "We continue to use tension free vaginal tape which research has shown to be safe and very effective."
  • NHS Dumfries and Galloway, said: "NHS Dumfries and Galloway has not carried out mesh procedures for pelvic floor reconstruction for some time and we do not plan to undertake this surgery in the foreseeable future."
  • NHS Fife associate medical director Dr Gordon Birnie, said: "NHS Fife has not used mesh for the treatment of pelvic organ prolapsed for a number of months, although the material has still been used for tension free vaginal tape procedures. However, in light of the publicity surrounding the health secretary's announcement, we have taken a decision to postpone all such procedures until further notice."
  • NHS Tayside said it had not yet received the letter, although the authority added that it got an email from Dr Elliot, sent to all health boards, asking whether there had been discussions on suspending mesh implant procedures.
  • NHS Lothian said they had not received the letter.
  • NHS Borders Medical Director, Dr Sheena MacDonald, said: "We understand that further communication will be forthcoming from the Scottish government, which will be considered with appropriate action taken as required."
  • NHS Western Isles said it was addressing the action noted in the letter
  • NHS Grampian said they had not received the letter but had been told it would arrive this week at some point. They said they would normally comply with this type of guidance. "We have noted the announcement by the Cabinet Secretary and will give the most urgent consideration to the letter from the Acting Chief Medical Officer."
  • NHS Shetland said its gynaecology services were provided by NHS Grampian and it would be following their policy and procedures.
  • NHS Orkney are thought to be in same position as Shetland
  • NHS Lanarkshire said they were aware of the chief medical officer's letter, but had not received it yet. They will review the contents of the letter when they do.
  • NHS Greater Glasgow and Clyde said they had not received the letter. They say they await it and would comply with any guidance it offered on mesh implants.
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Transvaginal mesh implants are usually used to treat a prolapsed bladder and relieve incontinence, often as a result of childbirth.

Hundreds of mesh implant-related claims are due before the Scottish courts within the next year, with cases already under way in the US and Canada, where the authorities have issued warnings to hospitals.

The Scottish Mesh Survivors campaign group had previously called for a suspension, pending an inquiry.

Mr Neil said estimates over the success of the procedure indicated that most women, about 1,450, did not appear to suffer complications, but he warned the figure was "not entirely reliable", because of the under and non-reporting of problems.

Olive McIlroy and Elaine Holmes at the Scottish Parliament Olive McIlroy, centre, and Elaine Holmes, who have both received surgical mesh implants, previously raised the issue in parliament

One Scottish health authority, Dumfries and Galloway, has already suspended the use of mesh implants, saying it had not used them for some time and had no plans to in the foreseeable future.

The health secretary said a series of other measures were being taken, including:

  • A working group involving clinicians and patient representatives had produced a patient information booklet on the risks an alternatives to mesh implants.
  • New patient guidance was being developed to help with women who come forward with complications.
  • The Scottish government will hand a dossier of Scottish cases to the Medicines and Healthcare products Regulatory Agency (MHRA), which would have the final say on the use of mesh implants on a UK-wide basis.
  • In the last year, Scotland's chief medical officer wrote to GPs three times, alerting them to possible risks.
  • Scottish ministers will take part in a UK working group on mesh implants.

An MHRA spokesman said it had asked the Scottish government to provide any new evidence it had for assessment.

He said: "We have listened to and understand the concerns that many women have about vaginal tapes and meshes.

"That's why we commissioned and published independent research in 2012 that reviewed the available evidence about the safety and adverse effects associated with vaginal tapes and meshes.

"The findings showed that while a small number of women have experienced distressing effects, the benefits of these tapes and meshes outweigh the risks and can help in dealing with upsetting conditions such as urinary stress incontinence and pelvic organ prolapse."

Campaigner Olive McIlroy, who brought the matter to the attention of the petitions committee after suffering from mesh implant complications, said: "I just didn't expect that decision today.

"It was the decision that we were hoping for and we're very glad that the minister made it, but he could have made it a year ago."

From Democracy Live: Alex Neil outlined his plan at the Scottish Parliament petitions committee

The 57-year-old described MHRA regulations as "completely flawed", adding: "We welcome that there is going to be an independent review and there will be no manufacturers or anyone with a vested interest involved.

"It has been too long. Our alternative evidence has been there for all to see, but nobody has listened."

Mr Neil said he hoped to announce the chair and remit of the Scottish government inquiry before the Holyrood summer recess.

Decision 'delay'

Lindsay Bruce, from Thompsons Solicitors, who represents many of the women who have been harmed by surgical mesh implants, welcomed the government's action, adding: "We hope the Scottish government will make sure that, in future, any surgical implant like mesh is subject to the same kind of rigorous testing that new medicines go through before they're given to the public."

The Conservatives and Liberal Democrats welcomed the health secretary's decision.

Labour health spokesman Neil Findlay, added: "My Scottish Labour colleagues and I joined with the many women affected by mesh implants to call for suspension 12 months ago, so why has it taken so long for the cabinet secretary to act?

"His delay means that approximately 1,800 more women have been fitted with a product that many people believe is causing severe injury and life-changing side effects to women in Scotland."

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    Scottish Borders Council has agreed to reintroduce a scrutiny group with the ability to challenge decisions made by its executive committee.

    SBC

    It is part of wider moves to create a new committee structure.

    The scrutiny committee will be able to use a "call-in procedure" to review executive committee decisions.

    The executive committee is taking on greater powers as it is taking over the remit of the education and social work and housing committees.

     
  47.  
    10:51: Day the German fleet surrendered

    Armistice Day is remembered as the day World War One ended. But for naval historians, Britain's greatest victory came 10 days later. Operation ZZ was the code name for the surrender of Germany's mighty navy.

    Painting of the German surrender by Charles Pears

    In the Firth of Forth 96 years ago today, the mighty dreadnoughts of the Royal Navy's Grand Fleet began to raise steam and one by one let slip their moorings.

    The mightiest fleet ever to sail from Britain's shores was heading for a final rendezvous with its mortal enemy - the German High Seas Fleet.

     
  48.  
    10:44: Woman hurt in blaze jump

    A woman has been injured while jumping from a window after fire broke out at flats in South Lanarkshire.

    Flats in Morgan Street, Hamilton

    Emergency services were called to the three-storey block in Morgan Street, Hamilton, at about 03:30.

    The woman was treated at the scene for leg injuries by paramedics before being taken to hospital as a precaution.

    No-one else was injured. Firefighters in breathing apparatus searched the building and extinguish the fire. They left the scene just after 07:00.

     
  49.  
    10:38: Quit and miss for McCall BBC Sport Scotland

    Stuart McCall admits he misses management but has "nothing imminent" lined up following his recent departure from Motherwell.

    Stuart McCall

    The former Scotland midfielder, who has continued his coaching role with the national team, ended a near four-year spell at Fir Park earlier this month.

    The 50-year-old told BBC Radio Scotland he had "enjoyed every minute" of his time at Fir Park.

    "I love being on the coaching field," he said. "It's something I miss."

     
  50.  
    10:32: Your views

    What do you think about Nicola Sturgeon's cabinet reshuffle? Who would be your choice for politician of the year?

    Care to share your thoughts on the rarely-seen Nessie?

    Get in touch via email, tweet using #ScotlandLive or visit the BBC Scotland News Facebook page.

     
  51.  
    10:27: Deaf school governors resign

    Nearly half of the governors at the national school for deaf children have quit it has emerged.

    Donaldson's school

    The resignations come after government ministers ordered Donaldson's School in Linlithgow to come up with a plan for urgent improvements within seven days.

    Concerns have been expressed by inspectors about leadership at the school and a new principal has been appointed.

    Meanwhile, police are still assessing claims that sexual offences may have been carried out at the school.

     
  52.  
    10:18: Brown on new powers

    Gordon Brown will set out a programme for "jobs, economic growth and tackling poverty" using the new powers of the Scottish Parliament when he addresses business leaders in Glasgow today.

    gordon brown

    The former prime minister will detail specific proposals, including 17 new powers for Holyrood, which he is calling on the Smith Commission to endorse.

    The commission is tasked with brokering further devolution in Scotland following the independence referendum.

     
  53.  
    10:11: High class meals

    The number of pupils having school meals in Dumfries and Galloway has reached a record high level.

    School dinner

    The latest figures are outlined in a report to the local authority's education committee.

    They show that uptake in both the primary and secondary sectors is continuing to increase.

    According to the report, the number of school meals served up in schools across the region has risen in each of the past five years.

     
  54.  
    10:03: Dounreay radiation release

    A fire in part of Dounreay's Prototype Fast Reactor (PFR) facility last month led to an "unauthorised release" of radioactivity.

    Dounreay

    Dounreay Site Restoration Limited said "procedural non-compliances and behavioural practices" by staff led to the incident on 7 October.

    The Caithness site's fire brigade extinguished the blaze in the PFR's sodium tank farm within 30 minutes.

    DSRL said no-one was hurt in the incident.

     
  55.  
    09:55: Dad's hope for Clare's Law

    The Aberdeen father of a woman murdered by her ex-boyfriend has said he hopes a new law to be piloted in Scotland will save women from a similar fate.

    Clare Wood

    Clare Wood, 36, who was murdered in 2009 in Salford, was unaware of George Appleton's history of violence against women.

    Clare's Law allows people to access information on the offending history of their new partner.

    The law will be piloted from next week in Aberdeen and Ayrshire.

    The victim's father, Michael Brown, said he was "absolutely delighted" that the scheme had come into force.

     
  56.  
    09:48: Suspended surgeon 'back' The Press and Journal

    tweets: Aberdeen Royal Infirmary breast-blunder doctor could return to wards

    Read the full story here.

     
  57.  
    09:35: Christmas loneliness

    Childline say an increasing number of children are calling them for help on Christmas Day.

    Girl sitting on steps The report comes against a backdrop of allegations over organised child abuse and exploitation

    The charity has seen a year on year increase - with loneliness one of the most reported problems.

    ChildLine Scotland area manager Elaine Chalmers said: "We've seen examples of children being left alone in a room whilst mum and dad were in another room and they hadn't been spoken to all day.

    "They felt very isolated and although they don't like school very much, the Christmas holidays can be a difficult time for them."

     
  58.  
    09:27: Young voters survey

    Scots aged 16 and 17 who voted in the independence referendum have been asked to tell a Scottish Parliament committee about their experiences.

    The Devolution (Further Powers) Committee has developed an online survey which asks young people their views on their experience of voting in the referendum and the extent to which the referendum has led them to be more engaged in politics.

    Polling card for Scottish referendum

    They are also asking schools, colleges and youth groups to submit video clips so they can gather more information about the views of young people.

    Committee Convener Bruce Crawford said: "We are particularly keen to hear from young people across Scotland about their experience of voting for the first time in this year's referendum.

    "We saw an unprecedented level of interest and democratic engagement around the referendum and we are determined to ensure young people continue to be engaged in Scotland's democratic and political processes."

     
  59.  
    09:15: Mother tongue

    Researchers at Aberdeen University say women could hold the key to preserving regional dialects.

    A six-year study of language in east coast fishing communities showed that the use of traditional words - such as scurrie for seagull - is in decline.

    But it revealed young women have a stronger knowledge of them than men.

     
  60.  
    @NicolaSturgeon First Minister Nicola Sturgeon 09:10: Political move

    First Minister Nicola Sturgeon tweets: Delighted to announce that @JohnSwinney is the new Deputy First Minister of @scotgov

    Nicola Sturgeon and John Swinney
     
  61.  
    09:03: High note John Beattie BBC Scotland

    Here's a test: go to 41 mins in its first take and live: who do you recognise?

    Children in Need
     
  62.  
    08:59: Dundee apes Hollywood

    Research at Abertay University in Dundee is applying computer games technology to the film industry.

    The software is being used to help movie-makers cut the costs of planning action sequences.

    games software

    The technique has already been used to "pre-visualise" scenes that were later filmed for the blockbuster Dawn of the Planet of the Apes.

    The team at Abertay believe it could significantly reduce the costs of preparatory work in the film business.

     
  63.  
    08:55: Your Views

    What do you think about Nicola Sturgeon's cabinet reshuffle? Who would be your choice for politician of the year?

    Care to share your thoughts on the rarely-seen Nessie?

    Get in touch via email, tweet using #ScotlandLive or visit the BBC Scotland News Facebook page.

     
  64.  
    08:48: Political shake-up Glenn Campbell BBC Scotland news

    Scottish cabinet reshuffle by @NicolaSturgeon expected to begin at 9am. We should know new line up by about midday.

     
  65.  
    08:45: Lottery cash for honour abuse charity

    A project supporting victims of honour abuse in Edinburgh has been awarded almost £800,000 in lottery cash amid a rise in the number of reported cases.

    It follows a survey that suggests the offence is accepted by a significant number of families in Edinburgh's black and ethnic minority communities.

    Asian women

    So-called honour crime is when a family member abuses a relative they believe has shamed the family or community.

    The Bright Choices project was given £786,814 from the Big Lottery Fund.

     
  66.  
    08:41: Celtic vote on living wage

    Celtic shareholders will vote later today at the club's AGM on whether its employees should be paid the living wage.

    celtic park

    The proposal, which would see all staff earn a minimum of £7.85 and hour, was thrown out at last year's meeting.

    But Hearts's adoption of the living wage puts pressure on the Glasgow club which has always prided itself on its charitable history.

     
  67.  
    08:39: Weather update BBC Scotland Weather Latest

    A largely dry day to come with some bright spells, the best of the sunshine across the far north, the northwest and the Northern Isles.

    One or two showers this morning over Angus, the northeast and the Northern Isles, they will become more isolated as the day progresses.

    Outbreaks of rain will spread into the southwest by the end of the afternoon.

    South-easterly winds will start to pick up, strengthening in coastal areas later this afternoon. Temperatures will reach around nine or 10C.

     
  68.  
    08:33: What's on the back pages?

    Celtic captain Scott Brown has expressed delight at signing a new four-year contract with the Scottish champions.

    Scott Brown

    Dundee United manager Jackie McNamara says Scottish fooball will "end up like the league of Ireland" if more clubs lay synthetic pitches.

    Ally McCoist insists his side's meeting with Championship leaders Hearts tomorrow is even bigger than the League Cup semi-final date with Celtic in the new year.

    It's another day of Scottish football gossip and you can read it all here.

     
  69.  
    08:29: Cabinet reshuffle - Brian's View Brian Taylor Political editor, Scotland

    I think we're looking at promotion for Shona Robson within government - she's currently been in cabinet as Commonwealth Games Secretary - and doing other elements of governmental work.

    Shona Robison

    I wouldn't be at all surprised to see her become health secretary in place of Alex Neil and wouldn't be at all surprised to see him moving back to an economic remit within cabinet.

     
  70.  
    08:25: And the award goes to...

    Nicola Sturgeon has been named Scotland's Politician of the Year the day after becoming the country's first female leader.

    Nicola Sturgeon speaking at rally during the independence referendum campaign

    First Minister Ms Sturgeon was awarded the honour by The Herald newspaper.

    The new SNP leader played a high-profile and influential role during the independence referendum campaign.

    She saw off competition from Scottish Conservative leader Ruth Davidson and Green party co-convener Patrick Harvie to win the title for a third time.

     
  71.  
    08:17: Cabinet reshuffle Brian Taylor Political editor, Scotland

    The reshuffle is under way and it does appear that it's going to be a big reshuffle with big changes.

    My information at this stage is that the Justice Secretary Kenny MacAskill and the Education Secretary Mike Russell will be leaving the government. Those in themselves are big changes and they've been ministers from the outset; in the case of Kenny MacAskill in the cabinet in that post from the outset.

    Kenny MacAskill (left) and Mike Russell

    Those are the two we have at this stage.

    Labour had called for the departure of Kenny MacAskill, Mike Russell and Alex Neil.

    It's my understanding that Alex Neil will be remaining in government. I believe, though, that he may be shifted to a new post.

     
  72.  
    08:12: Return of the Mack

    One of Charles Rennie Mackintosh's earliest works has been recreated on the walls of the Glasgow Art Club.

    Glasgow Art Club The Glasgow Art Club has been subject to a £1.2m refurbishment

    In 1893, when the architect was 25, he stencilled the wall frieze.

    As the years passed by, the work became unfashionable and was damaged by water so it was covered up by plaster.

    The recreated mural will now be the showpiece of the club following a three-year refurbishment at a cost of £1.2m.

     
  73.  
    08:06: Nessie, is that you?

    Fallen trees and branches from a woodland could be a cause for recent sightings of the Loch Ness Monster, a conservation charity suggests.

    The Woodland Trust said deadfall washed out by rivers from Urquhart Bay Wood could explain a recent report of something emerging from the loch.

    The Woodland Trust suggests fallen trees and branches are behind new Nessie sightings

    The trust said the lochside wood was a "Nessie spawning ground".

    Previous explanations for the monster have included circus elephants being exercised in the waters.

    Several reported sightings of Nessie have been made recently. Another image of an object in the loch was thought to be the wake of a boat.

     
  74.  
    08:03: What the papers say

    Justice Secretary Kenny MacAskill is expected to be the most high-profile casualty when Nicola Sturgeon reshuffles her SNP cabinet, writes The Scotsman.

    Daily Record, The Herald. The Scotsman

    The Daily Record has a story about vandals who spray-painted on the car of a rape victim who waived her anonymity to criticise the justice system.

    A poll reported in The Herald says more than 40 of Britain's top economic experts have come out against the full devolution of income tax to Scotland.

    Read our full review of today's Scottish papers here.

     
  75.  
    08:02: Cabinet reshuffle?

    Scotland's new First Minister Nicola Sturgeon is expected to announce a ministerial reshuffle later.

    Ms Sturgeon's post-Alex Salmond team is expected to have a strong female presence but opposition parties are calling for more drastic changes.

    Nicola Sturgeon

    While there are no firm signs as to who may be in the cabinet, Ms Sturgeon's close ally Shona Robison, married to SNP deputy leader Stewart Hosie, has been tipped for a senior post.

    Humza Yousaf is also tipped for a role.

    Meanwhile, Ms Sturgeon has been named Scotland's Politician of the Year the day after becoming the country's first female leader.

    She was awarded the honour by The Herald newspaper.

     
  76.  
    08:00: Welcome Thomas McGuigan BBC Scotland News

    Good morning. It's Friday and another bumper edition of Scotland Live as we offer the top news and sporting headlines across the country between now and 18:00.

     

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