Jerry Buttimer (Cork South-Central, Fine Gael) | Oireachtas source

I am taking this matter on behalf of the Minister for Health. I congratulate Deputy Ward on his appointment as Chair of the European affairs committee and wish him well in the role.

He has raised a very important matter regarding women's health and the healthcare provided to them. The urogynaecological transvaginal mesh is used in the surgical treatment of stress urinary incontinence and pelvic organ prolapse in women. Such mesh devices have been widely used to treat those conditions over the past two decades. For many women suffering the distressing symptoms of stress urinary incontinence and pelvic organ prolapse, surgical procedures using synthetic mesh devices have provided a more effective and less invasive form of treatment than traditional surgical procedures.

However, as the Deputy noted, concerns about the safety of mesh devices have arisen in many countries because of the frequency and severity of complications associated with their use. In November 2017, in response to public and patient concern about the ongoing safety of mesh devices, the then Minister for Health, Deputy Harris, requested the Chief Medical Officer to prepare a report for him on the clinical and technical issues involved in ensuring both the safe and effective provision of mesh procedures in urogynaecology and an appropriate response to women who suffer mesh complications.

In July 2018, the CMO 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. In November 2018, the CMO's report on the use of urogynaecological mesh in surgical procedures was published. It 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. The CMO's report included 19 recommendations across four key areas, namely, patient information and consent, aftercare for women suffering complications, clinical and professional recommendations, and information systems.

In 2018, the HSE commissioned a review of the CMO's recommendations. In 2019, it began work on the recommendations, providing regular progress updates. The Covid-19 pandemic subsequently delayed that work. Implementation of the report's recommendations will provide significant assurance that all patients presenting for treatment for stress urinary incontinence and pelvic organ prolapse, and all women who develop mesh-related complications, receive high-quality, patient-centred care in accordance with accepted evidence and supported by robust clinical governance mechanisms.

In 2023, the HSE established a national vaginal mesh implant oversight group to oversee vaginal mesh implants in HSE acute hospitals in terms of both primary implant surgery and tertiary complications services. The focus of the group was to review and assess implementation of the recommendations as set out in the CMO's report and assess the appropriateness of resuming urogynaecological mesh procedures, cognisant of international developments and approaches in this complex area. I have noted the Deputy's comments regarding services in other jurisdictions. The Department recently received a report from the HSE's national vaginal mesh implant oversight group. Officials are actively liaising with the HSE on all aspects of this work to ensure comprehensive implementation of the CMO's recommendations.

I again thank the Deputy for raising this very important matter. I will convey the points he raised to the Minister for Health.

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