Summary

  • The Public Petitions Committee takes evidence on mesh implants.

  • Nicola Sturgeon is quizzed during first minister's questions

  • Labour MSP Richard Leonard leads a member's debate on the importance of workers ownership

  • SNP MSP Ruth Maguire leads a debate on flexible working, maximising talent and driving inclusive growth

  • MSPs debate the Domestic Abuse Bill before voting on its general principles at decision time

  1. 'We were duped, used'published at 10:44 British Summer Time 28 September 2017

    Elaine Holmes

    Elaine Holmes says the final report exposed women to risk and had no resemblance to the original report.

    Ms Holmes says Health Secretary Shona Robison accepted the final report and did not listen to the mesh survivors fears.

    She says any hope for change was dashed.

    "We were duped, used," she says.

    Ms Holmes says the former health secretary was right and that "we should be the only evidence needed."

  2. 'Justice was not done, our voices were drowned out stifled by the pro-mesh lobby'published at 10:42 British Summer Time 28 September 2017

    Elaine Holmes says the adversity and pressure the petitioners endured in the review group came flooding back.

    Ms Holmes says she agrees with nearly everything Dr Agur has said as it highlights how they were all marginalised.

    She says the promises made by then Health Secretary Alex Neil were to no avail, through no fault of Mr Neil.

    Ms Holmes says: "Justice was not done, our voices were drowned out stifled by the pro-mesh lobby."

  3. 'This is a growing global scandal'published at 10:40 British Summer Time 28 September 2017

    Elaine Holmes

    Elaine Holmes thanks Scottish Mesh Survivors family and friends present in the gallery and also pays tribute to those too ill to be here.

    Ms Holmes says "this is a growing global scandal"

    She pays tribute to Dr Wael Agur who gave evidence regarding the "whitewash report".

  4. Background: Mesh sufferers quit expert group over 'diluted' reportpublished at 10:37 British Summer Time 28 September 2017

    Olive McIlroy and Elaine Holmes said they could no longer trust the expert group on mesh implantsImage source, bbc
    Image caption,

    Olive McIlroy and Elaine Holmes said they could no longer trust the expert group on mesh implants

    In March two patient representatives quit the independent review group looking at the safety of mesh implants.

    Olive McIlroy and Elaine Holmes, who both suffered severe complications following mesh implant surgery, claimed the final report had been watered down.

    It followed claims that an entire chapter has been removed from the report ahead of its publication.

    Scotland's Health Secretary Shona Robison has said she will meet with the women to discuss their concerns.

    Read more here.

  5. The petitioners are next ................published at 10:31 British Summer Time 28 September 2017

    Petitioners Olive Mcllroy and Elaine HolmesImage source, bbc
    Image caption,

    Petitioners Olive Mcllroy and Elaine Holmes

    The Public Petitions Committee will now continue taking evidence on PE1517, external by Elaine Holmes and Olive McIIRoy on behalf of Scottish Mesh Survivors - "Hear Our Voice" campaign on polypropylene mesh medical devices.

    The committee will then hear from the petitioners:

    • Elaine Holmes
    • Olive McIlroy
  6. Call to open the report to a public consultation processpublished at 10:31 British Summer Time 28 September 2017

    Dr Wael Agur says he is hear today to open the report to a public consultation process.

    Dr Agur says people would declare their interests and give evidence to the government as has been done in Europe.

    Dr Wael Agur

    He says his request is on the content and outcome of the process.

    Labour MSP Neil Findlay asks how many who have read the form containing the risks have decided to go ahead with the procedure.

    Dr Agur says 22 people have completed the form in the past year and only one decided to go ahead with the procedure and research has shown that person did not read the form fully.

  7. Clinician praises Shared Decision Toolpublished at 10:29 British Summer Time 28 September 2017

    SNP MSP Angus Macdonald raises the issue of the Shared Decision Tool.

    Dr Wael Agur says the Shared Decision Tool has been an eye-opener and was the idea of the chairman of the review group.

    Dr Agur says the patient reads all the information and then requests the treatment they desire.

    The clinician says he has gained a lot of insight about patients simply by what they write on the form.

  8. No analysis on individual healthboards or surgeonspublished at 10:27 British Summer Time 28 September 2017

    Tory MSP John Scott says this must be an enormously skilled procedure if it is a "15cm blind procedure".

    Mr Scott asks if there has been an analysis of different healthboards and surgeons on how successful the procedure has been.

    Dr Wael Agur

    Dr Wael Agur says there has been no analysis of individual healthboards or surgeons but there has been analysis of national outcomes on the procedure.

    Dr Agur says regardless of the surgeons skill, there will be patients that will sustain injury.

    He says the risk is small at 1% but, for some, it is too close to the nerve.

    Dr Agur says surgeon training is important but it will only reduce the risk to those who will not have long term damage and not the 1%.

  9. The risks outweigh the benefitspublished at 10:22 British Summer Time 28 September 2017

    Tory MSP Michelle Ballantyne asks if there are a lot of women out there who have low level pain who are not reporting this and she asks if this is why he backs a ban.

    Dr Agur says the risks outweighing the benefits.

    The clinician says these procedures have significantly dropped so the peak of the adverse events have already been reached in2014-15,

  10. 'I do believe the MHRA could have done a lot more'published at 10:21 British Summer Time 28 September 2017

    Dr Wael Agur

    Tory MSP Jackson Carlaw asks if there is an argument for a review into how the MHRA test medical devices.

    "I do believe the MHRA could have done a lot more," says Dr Wael Agur.

    Dr Agur says the MHRA were going to publish a table of adverse effects caused by the device and this would be similar for Australia.

    "It can be a lot more transparent," he says.

  11. Review report would be much safer if the word 'routinely' is taken outpublished at 10:18 British Summer Time 28 September 2017

    Tory MSP Jackson Carlaw asks if the final wording in the review group report is safe.

    Dr Agur says it would be much safer if we take the word "routinely" out of chapter eight.

  12. 'I was lucky'published at 10:17 British Summer Time 28 September 2017

    Dr Wael Agur

    Labour MSP Neil Findlay says he is not sure whether a review will look at any relevant interests people had going back beyond a year or if it will tighten rules on this for the future.

    Mr Findlay asks if having people declare their past interests from over a year ago would make it more transparent.

    Dr Wael Agur says he believes it would and that is not currently on the interest form.

    Dr Agur says "I was lucky", because his healthboard banned the procedure and adds that he invested and received funding from mesh manufacturers.

    He says he does not believe that the people who have not declared extra interests on the form have done anything wrong because they were not asked.

  13. Labour MSP asks if members of the review group were compromisedpublished at 10:14 British Summer Time 28 September 2017

    Labour MSP Neil FindlayImage source, bbc
    Image caption,

    Labour MSP Neil Findlay

    Mr Findlay says the issue of declaration of interests in the review group is critical.

    The Labour MSP says the government insisted only one year of interests was required and he asked if some of the people were compromised.

    Dr Agur says he does not believe any member has failed to declare their interests.

    Mr Findlay says but it only went back one year.

    The clinician agrees the forms could have been better.

  14. Frustrating that medical devices are not put through more rigorous testingpublished at 10:11 British Summer Time 28 September 2017

    Dr Wael Agur

    Dr Wael Agur says chronic pain is the most disturbing effect particularly when the patient is being intimate with their partner.

    Dr Agur says the risks of this are small but has a significant impact on a persons life when it happens.

    He says it is important to fully inform patients of the risk and that nerve damage cannot be reversed.

    Dr Agur says it is frustrating that the manufacturers do not put the medical devices through more rigorous testing.

  15. Non-mesh procedures have less risk of bladder damagepublished at 10:08 British Summer Time 28 September 2017

    Labour MSP Neil Findlay asks about the complications of mesh and non-mesh implants.

    Dr Wael Agur says the advantages of the mesh tape procedure area all related to recovery as it is minimally intrusive.

    Dr Agur says there is a quicker recovery and it is cheaper for the NHS.

    OperationImage source, Getty Images

    He says the mesh implant disadvantages are immediate with a higher risk of bladder damage during the operation.

    The clinician says this is due to it being a blind procedure.

    He says the non-mesh procedures have less risk of bladder damage.

  16. Chapter 6 presented as a table so it was easier to understandpublished at 10:06 British Summer Time 28 September 2017

    Dr Wael Agur

    Dr Wael Agur says when presented with facts that contradicts beliefs then people react differently.

    Dr Agur says his view is that any new evidence should be fully researched and considered.

    He says chapter 5 was written by a public health specialist and he is impressed by the amount of work that went into it but it is difficult for some, even for him, to understand.

    Dr Agur says this is why chapter 6 was presented as a table.

  17. Important table removedpublished at 10:01 British Summer Time 28 September 2017

    Dr Wael Agur says the health secretary has asked health boards to suspend mesh implants but not all have.

    Dr Agur says the important table that made a huge difference in expressing concerns has been moved to an appendix in the report.

    He says other evidence has been moved from the report to an online annex.

  18. 'It is all about safety'published at 10:01 British Summer Time 28 September 2017

    Dr Wael Agur says use of the vertical tape should be restricted to patients who do not want the non-mesh procedures.

    The consultant gynaecologist and obstetrician says it is not only about the incidence of adverse results it is all about safety.

    Dr Agur asks the patient must consider if it is worth being in constant pain and losing intimacy with their partner for life to spend a few days less in hospitals.

  19. Prolapse and horizontal mesh implants should be bannedpublished at 09:59 British Summer Time 28 September 2017

    Dr Wael Agur

    SNP MSP Alex Neil asks if Dr Agur supports a full ban.

    Dr Agur says this has been a learning procedure for him and many of his colleagues.

    He says he stopped doing the procedure for prolapse before the suspension.

    Dr Agur says he was still convinced that the vertical tape was still the gold standard and best procedure available, but having reviewed the evidence that view is not there anymore

    He says the procedure for prolapse should be banned and he believes the horizontal tape should be banned apart from in certain circumstances.

    The gallery applaud, including mesh implant campaigners.

  20. Background: Mesh implants still used in Scotland despite suspension callpublished at 09:58 British Summer Time 28 September 2017

    Media caption,

    Mesh implant woman says life changed and is 'a nightmare'

    Last December BBC Scotland found that hundreds of mesh implant operations had been performed in Scotland despite ministers recommending their suspension.

    Figures obtained by the BBC show that 404 women had received mesh and tape implants since the health secretary called for the suspension in June 2014.

    The Scottish government said the position had been made clear.

    Those boards still using mesh implants said they discussed all the potential risks with patients before surgery.

    The procedure is used to ease incontinence and pelvic prolapse.

    Over the past 20 years, more than 20,000 women in Scotland have had mesh or tape implants. But some have suffered painful and debilitating complications.

    In 2014 a number of campaigners gave evidence to the Holyrood Petitions Committee. Several of them were in wheelchairs - unable to walk because of surgical complications.

    As a result, the then Health Secretary Alex Neil wrote to health boards requesting a suspension in the use of mesh implants by the NHS in Scotland pending an investigation into their safety.

    Read more here.