NHS Hysteroscopy Treatment — House of Commons, 2022-01-31
Topic: Health
Maria Colette Caulfield (Conservative, Centre-right): I congratulate the hon. Member for West Ham (Ms Brown) on securing this debate. I thank her for all her hard work. I am very sorry that she has been speaking about this issue for nine years and is still having to share some of the stories and experiences of women who have contacted her, whether that is Jane, who was unaware of the potential for pain when having such a procedure—women being investigated for endometriosis often wait eight to 10 years to get a diagnosis, so if there is an offer of a procedure to find the cause of their problems, of course they will grab it and not necessarily ask questions about what is involved; or Sandy, who got no information on pain relief at all, or Penny. Penny was warned by the nurse—often nurses are attuned to these things—and was worried about what the outcomes were, but went ahead with the procedure. These are shocking tales that should not be happening in this day and age. I appreciate everything that the hon. Lady says, and I offer that I will be happy to work with her on this issue As Members will be aware, hysteroscopy is an essential tool to get to the bottom of many complaints. Whether that is cancer, endometriosis, vaginal bleeding or pelvic pain, it is a necessary test. While other tests can be used, they do not necessarily get to the level of clinical detail that a hysteroscopy can provide for clinicians. It is therefore important that the test is available for women, but in a way that does not create the problems we have heard about this evening Many women can have the procedure as out-patients in 10 to 15 minutes and it can be relatively painless, but many women, as we have heard today, experience great pain, which puts them off from coming back if they need further procedures, as the hon. Lady has said. If they share that story with other women they know, it can put them off from coming forward, too Unfortunately the NHS does not collect data on the number of women who experience pain during a hysteroscopy or the women who fail to have the hysteroscopy and then need to have either a general anaesthetic or further anaesthetic later on. I am aware that the Campaign Against Painful Hysteroscopy estimates that between 5% and 25% of women are affected and have reported severe pain, and frankly that is not good enough. I welcome that NHS England will be meeting the campaign group on 4 February. I look forward to hearing the outcome of that meeting, and I will be following up any recommendations after that The hon. Lady is right that for many procedures a man would undertake, anaesthetic is probably routinely provided or offered. We need to ensure that the same applies to those procedures that women have to go through There are guidelines in place, and I spoke only last week to the president of the Royal College of Obstetricians and Gynaecologists, because I knew this debate was coming up. Those guidelines were published back in 2011, and they need updating. The guidelines focus on minimising pain and optimising the woman’s experience, as well as making specific recommendations on how to reduce pain, but as the hon. Lady said, we do not have the information to know who is and is not following those guidelines. We are therefore not in a position to say whether, if those guidelines were followed, many women would not experience pain, and that is the difficulty we have. The data is therefore crucial In the last debate that the hon. Lady secured on this issue, which I think was in September 2020, my predecessor, the right hon. Member for Mid Bedfordshire (Ms Dorries), informed the House that to ensure the recommendations were robust and up to date, the royal college would be producing a second edition, in which it will assess whether the current guidelines are effective and are being used. The second edition is being jointly developed with the British Society for Gynaecological Endoscopy, and I am assured that patients’ voices will be at the heart of its development. The royal college has informed me that good progress is being made, and that it will have the updated guidelines by next year.