NHS Hysteroscopy Treatment — House of Commons, 2020-09-24
Topic: Health
Lyn Carol Brown (Labour, Centre-left): The reason I am here tonight is to continue the campaign, because it has been going on for some years. I first spoke about this in an Adjournment debate, and an hon. Gentleman I know who sat on the Front Bench took it back to the Department of Health. This campaign has gone on for quite a long time Let me tell the House about Vidya. Vidya had a terrible experience with hysteroscopy earlier this year. Vidya has had a vaginal birth. She has experienced that pain, but when the camera was inserted into her womb, Vidya felt such agony that she was not even able to tell the doctor to stop. Like Rebecca, she simply could not scream out. Vidya had not been asked to sign an informed consent form. She was not asked about the level of pain she was experiencing at any time. She said: "I can’t eat, I can’t go out, I cannot stop reliving the agony in my mind. If I sleep I wake up with terrifying nightmares. I can’t stop crying." Like so many of the women who have had to go through this, Vidya has lost trust in healthcare professionals and in our NHS, and I think she is likely to have post-traumatic stress disorder I would also like to talk about Alison. She was completely unaware that she was going to have a hysteroscopy until she arrived at the hospital. She had not been sent a leaflet or told anything to prepare her. She had not even had a paracetamol. She said: "The pain was like I had been thrown into full-on labour contractions. I was crying and screaming out…panting…my heart was racing. The pain was off the scale. After I left the hospital crying in my sister’s arms, she had to help me to the car. I cried solid for 14 hours. This will stay with me the rest of my life." Alison’s hysteroscopy took place last Wednesday. These violations of patient dignity and rights are still happening regularly, seven years on. They have to be stopped. I would be happy to send the survey to the Minister, as I have done with previous Ministers, and I hope she will find the time to read through the accounts herself Personal experiences are the most important thing here, but there is also new scientific evidence. On 14 September this year, the British Journal of Anaesthesia published an analysis of eight years of data on hysteroscopy outpatients. It found that 18% of patients reported pain at a level of seven or more out of 10, and only 8% reported no pain. Almost 40% of patients were given no pain relief and only 2% were given a local anaesthetic. The doctors and their patients reported back. The clinicians’ judgments about pain seemed to be the very opposite of what their patients actually felt. The doctors who had given an anaesthetic, even a low dose, reported observing very little pain. Sadly, they were not seeing the reality of their patients’ experience. Their patients reported feeling pain when the doctors said there was none. The study suggests that the doctors are, frankly, terrible at judging the extent of the pain of the women in front of them. It also suggests that local anaesthetics are not enough for many women We know that our NHS is overwhelmed by covid. We all understand the pressure that the NHS and the Department of Health and Social Care are under. I also understand the pressure that Ministers must be under, but I hope that the Minister will commit, like the last Minister, to taking forward this issue quickly to ensure that the necessary change happens. In January, I asked if pain during hysteroscopy could be included on the agenda of the women’s health taskforce of England. I was told that the taskforce would be open to it, but then came covid. So can the Minister tell me whether the taskforce has met since January? Has it discussed the issue of suffering during hysteroscopy? If not, will she commit to including it when the taskforce next meets Also in January, I followed up the most fundamental changes that I think we need to see. The NHS is currently actively encouraging hospitals to perform hysteroscopies as outpatient procedures, with no possibility of a general anaesthetic or other sedation, through the ironically named NHS best practice tariff. Due to the tariff, an NHS manager’s trust will lose money if it provides a general anaesthetic. I have raised the problem of the best practice tariff several times now. Last year, I sent submissions to the utterly opaque and unaccountable consultation conducted by NHS Improvement—also ironic. Like many women of the campaign, I did not even receive a proper response. That is simply a disgrace. Women must not be ignored. We must see the change we seek In my last debate in December 2018, I had four straightforward asks. Sadly, they are still relevant today. I want to see: better information to enable informed consent; improved training, especially on the risk factors and forms of pain relief that doctors are trained to offer; every trust properly funded for the most effective and necessary forms of anaesthetic appropriate to hysteroscopy patients; and, finally, permanent removal of the perverse financial incentive that puts more women at risk of trauma. I hope the Minister will tell us about what action the Government might take on each of those Every time I have raised the experiences of the many women who have suffered as a result of hysteroscopy, I have had a genuinely sympathetic response. I genuinely believed that the former Minister, the hon. Member for Thurrock (Jackie Doyle-Price), was taking forward our case within Government, but the work she started did not seem to be allowed to come to fruition. I have to ask why If women’s health, informed consent and patient safety are genuine priorities for the Government, I hope to leave today with genuine optimism and renewed confidence that, with the new Minister, our campaign will finally have its success. We cannot be satisfied with sympathy—it is not enough. We need action. The Government must finally bring this sorry state of affairs to a conclusion so that women can be assured that, if they need a hysteroscopy on the NHS, they will be in safe, caring and sensitive hands.