David Cullinane (Waterford, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

231. To ask the Minister for Health the reason for removing the treatment abroad scheme funding for mesh-injured persons; the reason for removing funding for travel abroad for translabial scans; if his attention has been drawn to the fact that this is interrupting patients' treatment; and if he will make a statement on the matter. [27528/20]

Stephen Donnelly (Wicklow, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I am aware that in response to concerns raised in Ireland regarding complications associated with the use of mesh devices in late 2017, the then Minister for Health requested the Chief Medical Officer (CMO) to prepare a report on the matter. The report was informed by the available national and international evidence and the personal experiences of women who have suffered complications following mesh surgery. 

In July 2018, in advance of publication of the full report, the CMO requested the HSE to pause all mesh procedures where clinically safe to do so. This pause was instigated pending implementation of initial recommendations regarding (i) professional training requirements, (ii) patient information and consent and (iii) the development and maintenance of a national data set for all mesh procedures carried out in HSE funded hospitals. 

The CMO report was published in November 2018. Four of the 19 recommendations relate to data gathering to support the development of information resources to permit long-term research and audit of practice, ensuring the reporting of mesh related complications, and ensuring timely, appropriate arrangements for the management of women with complications.

The HSE published a detailed Implementation Plan for the recommendations in the report in April 2019.  The National Women and Infants Health Programme is leading on this work.

The pathways for women experiencing mesh complications, established by the HSE, have been in place for over a year.  All appointments offered to women through these pathways have been to the public system.  I would strongly encourage all women affected by mesh to engage with the relevant HSE contact points provided, to ensure that their service needs can be identified and provided for.

The Treatment Abroad Scheme (TAS) is not available for patients wishing to have mesh related surgery for Stress Urinary Incontinence (SUI) or Pelvic Organ Prolapse (POP) as there is currently a pause on mesh surgeries for these specific ailments.  The TAS scheme is not available for mesh removal, full or partial, as the treatment is available publicly in Irish hospitals.  

I wish to advise that Translabial Scanning has been made available on an interim basis under the TAS until the two scanners which have been purchased by the HSE are operational in the two Mesh Complications Centres.  As Translabial scanning is a diagnostic tool and not a "treatment" it does not normally qualify for this scheme. However, having listened to the requests from women for this specific type of scanning to be made available this interim measure was taken.  

I would assure the Deputy that considerable work has been done to date in this country and continues to progress on patient safety in relation to mesh implants; and the patient voice is central to our understanding of these, and similar, issues.  As part of the ongoing policy response, my department officials are examining options to establish a process for an independent, compassionate engagement for women affected by mesh to have their voices heard; and will make proposals to me in this regard.  Any engagement process will need to take account of the wider context relating to the COVID-19 pandemic.