New Zealand’s laboured response to problems with surgical mesh implantations is under the spotlight in Australia.
Representatives from patient advocate group Mesh Down Under (MDU) gave evidence at a public hearing for the Australian senate inquiry into transvaginal mesh implants on Friday.
In New Zealand, of the mesh-related claims lodged with ACC so far, 810 have been “decided on”, with a treatment bill of at least $12.8 million to the taxpayer. About 55 percent of those claims – and a similar proportion of costs – relate to vaginal repair procedures.
Surgical mesh, made from polypropylene, is implanted to strengthen weakened tissue and muscle areas. In addition to pelvic organ prolapse repair, it is also used in hernia repairs.
Due to serious complications from the use of the mesh – which has led to several class-action lawsuits in Australia and other overseas jurisdictions – a series of medical bodies, including the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, patient advocates and various health organisations have participated in the Australian senate inquiry since it began in February.
Currently, the inquiry is mid-way through four scheduled public hearings. Charlotte Korte and Patricia Sullivan of MDU gave evidence and answered questions via teleconference link for the Perth hearing.
“New Zealand mesh victims are relieved that the Australian Government is undertaking such a robust inquiry which includes the patient voice,” Korte told the committee.
“[Our] Government did not implement a full inquiry after our petition in 2014, and has not bothered to listen to the mesh victims of New Zealand.”
Korte and Sullivan, who both have serious injuries from surgical mesh implantation, have campaigned relentlessly for stricter regulations and higher safety standards governing the use of mesh in New Zealand.
New Zealand-born Australian senator Derryn Hinch, who has compared the devastation caused by surgical mesh to the Thalidomide scandal of the 1950s and 1960s, asked Korte specifically about the implementation of a surgical mesh register in New Zealand – one of seven recommendations made by the Health Select Committee at the conclusion of its inquiry into surgical mesh last June.
“The problem is, there is absolutely no understanding of how big this problem is.”
Korte, whose advocate group MDU have criticised the Government for its lack of action in implementing those recommendations, informed Hinch and his fellow senators that a surgical mesh register was unlikely to become a reality in New Zealand in the near-future.
“We have met with the [Health Select] Committee, we presented to Parliament, they undertook some of the suggestions we made from the Health Select Committee, but none of this is mandatory,” Korte said.
Health Minister Jonathan Coleman, who took up the portfolio six months after the Health Select Committee began in 2014, has repeatedly stated a surgical mesh registry was being considered as part of a wider review of all therapeutic products legislation.
Most recently, he said in a letter to MDU – dated August 23 – that “medical device registries are being considered within the Therapeutics Products Bill”.
Public consultation of the bill was expected in “late 2017 or early 2018”, he said.
However, as surgical mesh operations continued, and the number of people injured from complications grew, implementation of select committee recommendations – including the development of a register specific to surgical mesh devices – was needed immediately, Korte and Sullivan said.
“The problem is, there is absolutely no understanding of how big this problem is,” Korte told the senate inquiry.
“Unless coding [for mesh surgeries and injuries] is introduced, and a register, there will be no understanding.”
Meanwhile, Labour health spokesman David Clark said if elected, his party would “start the work programme on a surgical mesh registry” immediately. However, he would not clarify the amount of funding a Labour Government planned to spend on this.
Clark also gave an ambiguous answer regarding how a registry would be created, declining to specify whether it would be considered separate to the Therapeutics Products bill – the approach chosen by the current National government.
Furthermore, while ACC figures showed how many injury claims related to surgical mesh were being assessed, it did not provide an overall outlook on the total number of people who had been adversely affected by mesh.
MDU also believed mandatory reporting of adverse events by health professionals, particularly in regards to surgical mesh implants, was another key step in gaining a more comprehensive assessment of complications.
At the moment, often surgical mesh patients had to report injuries themselves by filling out an online form on the Medsafe site.
Despite this, Coleman – who has previously stated he is completely satisfied with his handling of surgical mesh problems in New Zealand – has refused to declare his stance on a mandatory adverse events reporting system for health professionals.
While he did not answer the question in email communications with Newsroom, he outlined to MDU in his August 23 letter that there was “no evidence that mandatory reporting by healthcare professionals increases reporting rates of adverse events”.
Coleman also referred to “the issue” as being previously addressed “at the time of select committee hearing”.