I have met with the Mesh Survivors group on a number of occasions, most recently on 11 November, and I have listened to their personal stories.
I am fully committed to ensuring that all women who develop mesh-related complications receive high quality, multi-disciplinary and patient-centred care.
Since this issue came to my attention in late 2017, an ongoing priority focus for my Department and the HSE is to put in place the necessary structures for, and the provision of, care of women who have been affected by the use of mesh implants and progress has been made across a number of areas.
Firstly, to understand the clinical and technical issues involved, I requested the Chief Medical Officer to thoroughly examine the issue and prepare a report for me. This report was published in November 2018 and includes recommendations across a number of key areas including care pathways for the management of women with complications.
The HSE has advised that a package of care is now available for women who have been identified with urgent or immediate needs. In addition, the HSE’s National Service Plan 2020 identifies the continued implementation of the CMO’s report on transvaginal mesh as a priority action.
I am informed that an ongoing work programme for the clarification and development of treatment pathways and appropriate referral services for women suffering from mesh-related complications is being progressed through the HSE, led by the National Women and Infants Health Programme. In terms of broader service provision going forward, I am informed that the HSE’s proposals include the development of multidisciplinary specialist services for women suffering from mesh complications at Cork University Hospital and National Maternity Hospital Dublin
The HSE has published a dedicated webpage about vaginal mesh implants, including contact information for women suffering complications, which I hope is a useful resource. This can be found on the HSE website.
The HSE has advised that sixty contacts have been received from women through the established mesh pathways, which includes women suffering from post-mesh surgery complications. The HSE has also indicated that a number of these are women who have travelled to the UK for mesh removal and are now in need of complex aftercare.
Funding has been identified within the HSE in 2019 to provide a package of care, including non-surgical supports procured through the private system, for women already identified with urgent or immediate needs.
I am informed that translabial scanners have been procured by the HSE for the mesh centres at Cork University Hospital and the National Maternity Hospital Dublin and the two sites are awaiting delivery in the coming weeks. Access pathways to the translabial scanning service will be via the mesh pathways and on a consultant to consultant basis. Training for personnel in the use of the scanners has been arranged with a specialist mesh centre in the UK and it is expected that the service will commence early in the New Year.
At my recent meeting with the Mesh Survivors Ireland group in November 2019, I made a commitment to have my officials examine the potential for medical cards to be provided as a possible support for women affected by transvaginal mesh implants.
Under the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. The HSE's Expert Group on Medical Need and Medical Card Eligibility has previously examined the issue of awarding medical cards and concluded that a person’s means should remain the main qualifier for a medical card. However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines.
In relation to individual applicants, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds his or her income threshold, where he or she faces difficult financial circumstances, such as extra costs arising from an illness.
The HSE National Medical Card Unit is responsible for determining medical card eligibility. Every effort is made by the HSE, within the framework of the legislation, to provide a medical card application system that is responsive and sensitive to people’s needs. If the HSE is made aware that persons have particular requirements, assistance will be afforded to help that person to complete their application. This assistance can be availed of through a person's local health office or by calling LoCall 1890 252 919.
I strongly encourage all women affected by this issue to engage with the relevant HSE contact points - provided on the HSE website - and the associated care pathways being provided, to ensure that their service needs can be identified and provided for as early as possible.
Having met with the women affected recently, I have also made a commitment to consider the establishment of an independent, compassionate process for women affected by mesh to have their voices heard. My Department is currently developing proposals on how to establish this process.