argyrotsipi/train-dataset huggingface dataset:
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Robert William Henry Seely (Conservative, Centre-right): I congratulate the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) on calling this important debate. Are the figures accurate? I have been told that some of the figures do not include people who are treated abroad and come here having developed complications, or people who have been to private clinics. The numbers that we have may therefore not be accurate, perhaps underestimating the true total.
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Sarah James (Wollaston) (Conservative, Centre-right): I was about to come to that very point. Crucially, many of the women I have met have been treated in the private sector. In this House, we should be concerned about all our constituents, not only those who are treated in the NHS. Of course, it is the NHS that often then bears the burden of managing complications, but we must have a much more accurate picture I support the call from the Royal College of Obstetricians and Gynaecologists and from the British Society of Urogynaecology for mandatory prospective data collection, using the BSU’s database. That is a well-established method of collecting outcome data. Retrospective snapshots are no substitute for collecting data as we go forward or, most importantly, for being able to track it in the long term. Although the majority of complications that happen after 30 days happen in the first year, many of the women I have met developed complications far later than that. I particularly want to emphasise to the Minister how important it is that we have access to shared databases not just here in the UK, but across Europe. Will the Minister tell us whether the Government will be seeking for us to remain part of the European Database on Medical Devices—EUDAMED—so that we not only get an accurate picture of what is happening here in the UK, where our population is smaller, but can compare our data with the whole European Union That brings me to the wider point about Brexit that is highlighted in the report of the Select Committee on Health on the implications of Brexit for medicines, devices and substances of human origin: the issue of access to clinical trials. It is encouraging that the Government have stated that they wish to remain a part of the European Medicines Agency or to have associate membership, but there are all sorts of aspects to forward clinical research on which it is essential that the Government campaign. They must campaign not just to maintain regulatory alignment and harmonisation, but to ensure that we can remain part of all research mechanisms and mechanisms for ensuring that we have the earliest possible awareness of any complications—not just from drugs but, as this situation has shown, from medical devices. I hope that the Minister will further outline the Government’s intention in that regard.
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Oliver Heald (Conservative, Centre-right): My hon. Friend will remember that I spoke about my constituents in Letchworth during the debate in Westminster Hall. I am delighted that the audit has been done, but another constituent from Letchworth has been in touch with me since then. She has had ventral mesh rectopexy surgery and posterior mesh rectopexy surgery, which I understand are subsets of the mesh cases. Does my hon. Friend agree that if we were to look at a smaller group of people such as her across Europe, we would actually get quite a good picture of what is happening, given that we would be looking at data across a bigger area?
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Sarah James (Wollaston) (Conservative, Centre-right): My right hon. and learned Friend is absolutely right, and his point applies not only to medical devices. When it comes to relatively rare conditions, we need to look at the widest possible population base in order to detect any complications. It is also important to use the widest possible population base when detecting rare complications. I thank him for highlighting that If we are to have informed consent for women, it has to be based on high-quality, balanced and evidence-based information, and that has been lacking. We also need to be clear that if a medical device is altered in any way, it must be part of a clinical trial. That was entirely lacking in this situation. The types of device, including the size and thickness, were changed without anyone properly recording or following up on those changes. That has to be the key lesson for the future.
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Sarah James (Wollaston) (Conservative, Centre-right): I absolutely agree. It strikes me that there has been a kind of wild west out there, with representatives saying, "Why don’t you try this one? This is probably going to be better", without organisations setting up clinical trials from the start so that we could compare different devices, and without women giving properly informed consent that a different kind of device would be used. Lessons have to be learned not just for mesh surgery, but for other medical devices. Just because something sounds like it might be better, it does not mean to say that there will not be serious complications. Those complications may also happen at a late stage. We need databases such as EUDAMED so that we have access to the widest possible population base and clear device tracking.
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Sarah James (Wollaston) (Conservative, Centre-right): I do agree As I say, informed consent is essential, and that was lacking in very many cases. There are cavalier attitudes and assumptions that medical devices are somehow safer than medicines, but we know that that is simply not the case. We have to rigorously make sure that devices are all part of clinical trials, with long-term follow-up and tracking. Perhaps the Minister could update us on how we are getting on with the barcoding of devices, which clearly makes them over time. One of the tragedies is that many women are completely unaware that they have even had mesh inserted at all. That, again, has to be a lesson that we learn for the future about accurate documentation I hope that the Minister will comment on whether there are plans to introduce compensation for victims. As I said, many of the women I have met have had profound, life-changing injuries, and many are entitled to compensation.
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Sarah James (Wollaston) (Conservative, Centre-right): I thank the hon. Lady for making that point. Yes, absolutely: the scars have been profound not only in physical terms but in the impact on how people feel about themselves. There is a great impact not only on them but on their families and their relationships On access to services, while we all welcome a tertiary service being set up for victims of urogynaecological mesh, there is concern about current waiting times for those who wish to have a referral to a tertiary centre, and about access to investigations, which need to be timely. When women come forward to report deeply personal and distressing experiences, it is important that they can be seen as rapidly as possible. I hope that the Minister will comment on that.
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Fiona Claire Bruce (Conservative, Centre-right): I echo the comments of many hon. Members and express my deep concern for all women who have experienced debilitating and sometimes severe pain and discomfort following the use of vaginal mesh. In all our considerations of the use of such devices, their health, safety and wellbeing must be our first concern I welcome the Government’s recent announcements of Baroness Cumberlege’s review of the use of vaginal mesh and two other areas of medical safety—the use of valproate and Primodos. I was in the Chamber when the Secretary of State for Health announced that review on 21 February and I could tell from the tone of his announcement, not just the content, that he personally cares very greatly about the women affected by this issue. He wants to ensure that lessons are learned wherever possible, so that care can improve to ensure that each woman gets the treatment that is right for her—the best that can be provided for her as an individual. I am sure that the Minister shares that view The Secretary of State said: "It is an essential principle of patient safety that the regulatory environment gives sufficient voice to legitimate concerns reported by patients, families and campaigners, works alongside them and responds in a rapid, open and compassionate way to resolve issues when these are raised."—[Official Report, 21 February 2018; Vol. 636, c. 166.] Ministers want to ensure that we do better in future where necessary, and to ensure that patient voices are brought to the table. I support the review and I want to ensure that justice is done for all women who have concerns about the use of vaginal mesh. We need to ensure that we maintain public confidence.
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Julian Murray Lewis (Conservative, Centre-right): I start by saying that I think the steps taken in Scotland, as described by the hon. Member for Glasgow North (Patrick Grady), sound extremely sensible as interim measures until final decisions can be taken. I echo the thanks due to the hon. Members for Kingston upon Hull West and Hessle (Emma Hardy) and for Pontypridd (Owen Smith), their associates in the all-party group, and Sling the Mesh campaigners. I also thank my three constituents, Emma, Eileen and Helen, who have all shared with me their harrowing experiences of the procedure There is no doubt that when vaginal mesh procedures go wrong, the results can be truly catastrophic. A letter from the Minister states clearly that "women have suffered atrocious and debilitating complications" from these implants. Her counterpart in the Upper House, Lord O’Shaughnessy, has conceded this: "While these treatments can be effective, in a small minority of cases meshes can cause serious long-term injury and disability, and prevent or reduce the ability of affected women to work." According to a letter from the Health Secretary to parliamentary colleagues in February: "Clinical experts here and abroad agree that, when used appropriately, many women gain benefit from this intervention, and hence a full ban is not the right answer." I find it difficult to follow that logic. There might be an acceptable argument if we were talking about a procedure in which the numbers of interventions were in the hundreds, but, as I said in an intervention and as the hon. Member for Pontypridd (Owen Smith) endorsed, we are talking here about over 100,000 people. When we are talking about over 100,000 people, if even the Government’s low figures of 1% to 3% going badly wrong are right, that is still 1,000 to 3,000 people. I have been given, by my constituent Emma, a leaflet from Sling the Mesh that says that its estimate is that at least 15% of people are seriously and badly affected. On that scale, we are talking about over 15,000 people being seriously damaged by this procedure.
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Julian Murray Lewis (Conservative, Centre-right): Indeed. I would be surprised at that, because if that is what Dame Sally believes she ought to be making different recommendations I have been given a particular study, which is described as the largest study of surgical mesh insertions for stress urinary incontinence. Over 92,000 women were surveyed in this particular examination, including all NHS patients in England over an eight-year period. The conclusion states: "We estimate that 9.8% of patients undergoing surgical mesh insertion for SUI experienced a complication peri-procedurally within 30 days or within five years of the initial mesh insertion procedure. This is likely a lower estimate of the true incidence." I reiterate my point about acceptable and unacceptable percentages. When we are talking about these very large numbers, even relatively low percentages make the procedure too risky to be used in anything other than last-resort circumstances similar to those described by the hon. Member for Glasgow North In the past decade, my constituent Emma has undergone X-ray-guided injections, ultrasound scans, MRI scans, in-patient stays, tests galore, more and more scans, and, eventually, a biopsy. She has been refused referral to a mesh specialist centre. It seems highly likely that she should never have been given a mesh implant in the first place after the trauma of such a difficult birth, which leads me to the next point about inadequate warnings. I understand from my constituents that they were given little warning, and in many cases no warning at all, about the potential dangers.
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Kevin Paul Hollinrake (Conservative, Centre-right): My right hon. Friend is making some very important points. Does he agree that prevention is better than cure? If physiotherapy were offered to women after childbirth, that might obviate the need for any surgery at all as a result of these kinds of complication.
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Kevin John Foster (Conservative, Centre-right): It is a pleasure to be called to speak in this debate, and I congratulate the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) on securing it. It has been quite something to listen to the many stories that have been repeated here this afternoon. My involvement in this issue was prompted not only by conversations with my former colleague in the Ministry of Housing, Communities and Local Government, my hon. Friend the Member for Eastleigh (Mims Davies), but by the case of my constituent, Mrs Beverley Jelfs, who had mesh inserted for a prolapse. When she emailed me, she said: "My life has changed so much since having this device inserted in me in 2011. I can no longer work due to pain, fatigue, not able to sit or stand for long. The mesh eroded through my vaginal wall, which 7 weeks later had to have part removal. I have no intimate relationship with my husband, due to the mesh damaging me…I have gone from a very busy and socially active life, to being a depressed lady." That sums up the impact that the issue has on her. Although her work was done at a local private hospital, I also asked my local Torbay Hospital—the main NHS hospital serving my constituency—for details of the approach it adopted Given the age demographics of Torbay, I had expected slightly more cases to be raised with me. Those that have been raised involve people who have been treated at a particular private hospital. Given that this is a wider issue, I do not think that it is constructive to bring the name of the hospital into the debate, but it is interesting to note that that is where these queries come from I was pleased to get a detailed response from Julian Barrington, the consultant in obstetrics and gynaecology at the hospital, giving me some of the figures for the work he has done. I am pleased to note that the failure rates reported back on some of his cases have been a lot lower than some of the averages, but in his letter he makes the point that none of the patients in Torbay has been treated with Ethicon meshes, over which most of the concerns and complications have arisen. His other comment is welcome: given some of the issues being raised, since October 2017 he has suspended all vaginal surgery using synthetic mesh until the results of the NICE recommendations are published and until professional medical bodies make a decision.
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Jacqueline Doyle-Price (Conservative, Centre-right): It is actually an issue of rigorous process. We need to make sure that NICE guidance has clinical integrity. The guidance to which the hon. Gentleman refers comes at the end of a longer process of other guidance that is going through the system. None the less, that intelligence is shared throughout—it is an entirely consultative process. The issues that we need to settle are all part of the public debate. Essentially, the publication of the NICE guidance comes at the end of that. The important thing is that everyone knows the issues and that we are very clear about the context in which this is an appropriate treatment. The guidance is very clear: this treatment should not be offered as a routine first intervention.
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
Julian Murray Lewis (Conservative, Centre-right): Before those interventions, the Minister said that if people are still not getting adequate treatment, it should be brought to her attention. As I mentioned, I have been contacted by constituents saying they felt trapped because the people who did the procedures were refusing to refer them elsewhere for a second opinion and for possible help from the very small number of people who specialise in the rectification and reversal of these procedures. What advice can she give my constituents about how to break out of this restriction on being referred to people in whom they can have more confidence?
Surgical Mesh — House of Commons, 2018-04-19
Topic: Health
John Simon Bercow (Conservative, Centre-right): I thank the hon. Lady and everybody who has joined us today. I hope that they have felt uplifted by the debate We now come, colleagues, to the Back-Bench motion on cancer treatment. [Interruption.] Apparently, before we move on I should put the question on the debate on surgical mesh. I thank the specialist Clerk for his help and for rescuing me. We will now be entirely orderly Question put and agreed to. Resolved, That this House commends the recent announcement of a retrospective audit into surgical mesh for pelvic organ prolapse and stress urinary incontinence; notes that vaginal mesh has been banned in other jurisdictions such as New Zealand; further notes that NICE guidance recommends against the use of surgical mesh for pelvic organ prolapse and that no NICE recommendations have been made for stress urinary incontinence; notes that Sheffield University recently announced the development of a new mesh material; and calls on the Government to suspend prolapse and incontinence mesh operations while the audit is being carried out, to bring forward the NICE guidelines for mesh in stress related urinary incontinence from 2019 to 2018, and to commit to a full public inquiry into mesh if the audit suggests that this is the best course of action.
Cancer Treatment — House of Commons, 2018-04-19
Topic: Health
James Peter Brokenshire (Conservative, Centre-right): I am very grateful to the Backbench Business Committee for enabling the House to debate these important issues this afternoon. It is a pleasure to follow the hon. Member for Croydon Central (Sarah Jones), who introduced the debate in such a powerful and effective way I do not think that anyone who watched Baroness Tessa Jowell’s speech could have been anything but moved by her powerful and poignant words. I know it moved me, having got to know, like and respect Tessa over many years for her work in Government and in the House, and for the way she is able to bring people together from across politics with a very constructive, focused and tenacious approach just to get things done. The timing of Tessa’s speech also touched a particular chord with me, coming as it did just a week or so after my own surgery to remove a tumour from my lung. It was a brave, humbling and inspiring speech in equal measure, with her very personal description of her brain tumour and the impact it has had on her, her call to action to secure more funding for brain tumour research, and her stressing the need for more effective clinical trials and the joining up of analysis and data. But fundamentally, what shone through in Tessa’s words was a profound message of hope—hope for the future; hope in the face of her own physical adversity—and her unstinting passion to secure positive change for the benefit of others. So many debates in this House or in the Lords, while passionate and important, can sometimes appear sterile, perhaps a little arcane, with discussions of statistics, policy or implementation of points of law. Tessa’s speech cut through all that to focus on the human condition: the life well led, what gives it meaning and purpose, and the overriding power of human kindness, compassion and love Tessa’s campaign has already made a difference. I warmly welcome the positive response from the Government by the Prime Minister, the Health Secretary and Members across Government to make change happen.
Cancer Treatment — House of Commons, 2018-04-19
Topic: Health
Jeremy Richard Streynsham Hunt (Conservative, Centre-right): I am most grateful to my right hon. Friend. I wonder whether, on behalf of the Prime Minister and the Cabinet, I could follow the shadow Health Secretary in commending Tessa’s campaigning. Most people come to this place hoping to leave a legacy, but she has left not just one legacy, but two—her amazing achievements with London 2012 and her amazing campaigning on cancer. It is our privilege to take part in this debate and our duty to act on what she says.
Cancer Treatment — House of Commons, 2018-04-19
Topic: Health
George William Freeman (Conservative, Centre-right): That is very kind. I take the hint from my hon. Friend The assets that we have in our health system are phenomenal assets to drive this research model, and I think it is our challenge to release them, but in order to do so, we need patient consent. However interventionist we are as Ministers, we as a system will not and cannot release data on tissues and genetics without patient voice. This research model requires us to empower patients and the charities that speak to and for them. I would like us to think about setting up disease portals in which patients can slide the consent bar on their phones, share their records, and help the charities to drive research Finally, we need to accelerate the uptake of innovative medicines in the system, which is what the accelerated access reform that I put together with my right hon. Friend the Secretary of State was all about. I dream of—I think we are within touching distance—a model in this country enabling the NHS to use its genomics and data to drive research. If we reform NICE to drive accelerated access, we give Tessa and the people for whom she spoke the legacy that they really want. We will make this country the leader not just of research, but of accelerated uptake of new treatments.
NHS and Adult Social Care: Multi-year Funding Plan — House of Commons, 2018-05-22
Topic: Health
Elizabeth Mary Truss (Conservative, Centre-right): We will come forward with a new long-term plan for the NHS and provide a new multi-year funding settlement in support of that plan. What is also important is that we are developing policies on artificial intelligence and digital services to make sure that our NHS delivers better outcomes for patients.
Transport Emissions: Urban Areas — House of Commons, 2018-05-22
Topic: Health
Michael Andrew Gove (Conservative, Centre-right): One thing we have done is to work with the academic community. Indeed, I met some of its members yesterday at Imperial College, one of our best universities, to look at the impact of the steps we are already taking to improve public health and to save money for the Exchequer. By definition, that work is publicly available to all. I take on board the hon. Lady’s point. We are bringing forward primary legislation. We can use the model that has been constructed to see how different impacts could be generated by different policies, and I look forward to sharing those results with her.