Vaginal mesh implant – national apology from Australian government.

Mesh implants: Government issues national apology over ‘agony and pain’ caused by device

Health Minister Greg Hunt has issued a national apology to the many women whose lives have been ruined by the debilitating effects of pelvic mesh implants.

Key points:

  • Health Minister issues national apology to mesh patients
  • Action follows patient horror stories
  • New register to be set up to track mesh devices

Speaking as he released details of the Government’s response to a Senate inquiry into vaginal mesh, Mr Hunt said he wanted to acknowledge the pain and suffering of those at the centre of the medical scandal.

“On behalf of the Australian Government, I say sorry to all of those women with the historic agony and pain that has come from mesh implantation which have led to horrific outcomes,” he said.

“My message to them is your voice has been heard, and not just heard but acted upon.”

The ABC has obtained details of the Government’s response to the inquiry, which is expected to be tabled today.

Mr Hunt said the Government would work with states and territories on setting up a voluntary national register of women who have had mesh devices and anything that went wrong.

“I would like to see it (the register) set up by the end of 2019, if not the middle of the year,” he said.

Patient groups had wanted it to be made compulsory for all health practitioners to report side-effects of any implantable device.

Mr Hunt said while his Government supported such a move, it was outside federal powers to do so.

“We will encourage the states and territories to adopt mandatory standards,” he said.

Do you know more about this story? Email Specialist.Team@abc.net.au

There’s been a mixed response from women and consumer health groups who continue to lobby for all mesh products to banned.

At the moment many items have been pulled from shelves and only select products can be used by qualified surgeons.

Mother of two Joanne Villani said she had witnessed some reforms by regulators, but many problems she experienced more than a decade ago still persisted.

“Women are still not being believed by their doctors,” she said.

“Doctors are still implanting mesh and telling women it’s new mesh and it is the same mesh.

“I would like mesh to be banned until it’s been shown to be safe. If it’s not shown to be safe, then it should never be used again.”

Senator Derryn Hinch pushed for the Senate inquiry, calling mesh “one of the biggest medical scandals” in Australian history.

Among the other actions the Federal Government will take are:

  • Permanent Medicare payment items for the removal and treatment of pelvic mesh
  • Asking states and territories to conduct an audit of pelvic mesh

Mr Hunt said he would raise the issues with his counterparts at the next health COAG meeting.

“I would be surprised if any state or territory resisted the steps that we have taken,” he said.

“Too many women have suffered too much for too long.”

‘I’ve friends who probably won’t make it’: patient

For Ms Villani it was not that pelvic mesh stopped her being able to have intercourse with her husband, it was the broader impact it had on their relationship.

“We actually split up for quite some time. It’s nothing my husband did or thought,” she said.

“It was very hard when he felt guilty and I felt guilty. It caused strain.”

The mother-of-two left the family home for some time because of the problems mesh caused in her relationship.

She has now returned to her partner because they “just want to be together”, but said their partnership would never be the same.

It is just one way Ms Villani said mesh has “totally altered my life” after her doctor suggested it to treat prolapse and incontinence following the birth of her son.

She recalled her surgeon seemed quite excited about the product at the time and believed he was on the “cutting edge” of new techniques.

“It didn’t quite work the way they expected,” she said.

“I went back to the surgeon on a number of occasions to discuss problems I was having and I was basically told it was in my head.”

Eleven years on, she said her situation had improved little.

“I have pain all the time,” she said.

“I’ll have to give up my job eventually. My financial future is also affected. I’ve been extremely depressed and anxious.”

Ms Villani said the worst part was that she was “not the only one”.

“Some women are expecting to die from their complications,” she said.

“I’ve friends who probably won’t make it.”

Patient advocates call for regulation of devices

And while Ms Villani welcomed the Government’s reforms to regulation and reporting, she said it did very little to help women who were continuing to struggle with debilitating side-effects from the product.

“I have friends who are talking about suicide. So we all need help,” she said.

“I would like to believe the Federal Government is serious about reform but what I see is a lot of this comes down to money.

“Money isn’t the issue, we are the issue.”

Patient advocates had been hoping for much tighter regulations of implantable devices, so that a scandal like pelvic mesh could not happen to other patients in the future.

Health Issues Centre chief Danny Vadasz said the Minister’s apology would provide much-needed validation to women who had long been told their problems were in their heads.

He welcomed the push for mandatory reporting, but said it relied on doctors listening to their patients.

“What we found in a lot of cases [was] women believed they had an adverse outcome but their practitioners didn’t,” Mr Vadasz said.

“You can only effectively mandate something if there’s an agreement on what constitutes an adverse result.”

He said the states and territories, to date, had not made an audit of past mesh cases a priority, but “hopefully with the Minister’s encouragement they will put this on the front burner”.

Mr Hunt said discussions were also underway to include implantable devices on the My Health record, if a patient chose.

But he said it would not be mandatory and the Government wanted to make sure that the My Health record system “was an entirely voluntary system”.

Mr Vadasz did not think the My Health record was an adequate avenue for a registry of devices because it had “sufficient problems of its own”.

“Complicating one problem by introducing the problems of another isn’t a way of coming up with an overall solution,” he said.

The Health Issues Centre was also hoping to see stricter credentialing around which surgeons were allowed to implant mesh.

“I haven’t heard anything yet that suggests there’s going to be tighter control of clinical trials that would enable a high degree of confidence in products that find their way to market,” Mr Vadasz said.

“I think people still need an explanation about why the various regulatory systems that are supposed to protect the public failed.”

(Source: ABC News Australia)

Mental health help in Australia is a joke

GPs struggle in a system ill-equipped to deal with mental health

I sat in the waiting room staring at my hands, willing them to stop shaking. Anxiety was a fighter jet, roaring through my cells, dropping grenades from head to toe.

When the doctor called my name I shuffled after her, a shrunken version of a self I no longer recognised. Fixing her eyes on a computer screen, she hammered the keys and asked me to explain why I was there.

Our complex emotional pain is being treated with six-minute medicine by time-poor GPs, says Jill Stark.
Our complex emotional pain is being treated with six-minute medicine by time-poor GPs, says Jill Stark.

Photo: Christopher Nielsen

When I told her I was experiencing what felt like an acute recurrence of the depression and anxiety I’d grappled with since I was a teenager she pushed a sheet of paper across the desk and I began to tick boxes.

During the last 30 days, how often did you feel hopeless? … During the last 30 days, how often did you feel so nervous that nothing could calm you down? … How often did you feel so sad nothing could cheer you up?

Ten questions, scored from one to five, with one being ‘none of the time’ and five ‘all of the time’. Under 20 is well. Over 30 is a severe mental-health disorder.

“You got 25, which means you’re only mild to moderately depressed, so there’s not much to worry about,” she said, reaching for the prescription pad before asking if I was suicidal.

I thought about it for a while and said no. “Good. These ones aren’t prescribed very often these days because they’re much easier to overdose on. But you’re not suicidal, so that’s fine.”

Less than fifteen minutes after I sat down I stood on the street weeping. I had no support, no plan for how I was going to make it through the day, armed only with the knowledge that should I want my kill myself the drugs I’d been prescribed were well-equipped for the job.

Journalist Jill Stark.

I wish this was an isolated experience. But since documenting my mental health battles in my recent memoir Happy Never After, I’ve been inundated with messages from people across Australia telling similar stories.

Our complex emotional pain is being treated with six-minute medicine by time-poor GPs struggling to meet demand in a system woefully ill-equipped to deal with the mental health challenges of modern life.

It was revealed in recent days that GP waiting rooms are crammed full of patients with psychological problems.

Research released by the Royal Australian College of General Practitioners found that 62 per cent of people visiting a doctor are presenting with mental health problems – significantly more than any other medical condition.

College president-elect Dr Harry Nespolon said doctors are in an impossible situation, forced to either charge patients for more time to manage these complex problems or wear the out-of-pocket costs themselves.

“As access to psychologists and psychiatrists can be restrictive, to say the least, GPs must not only work as the frontline of support – but as the entire support model, something which is currently not supported by patient Medicare rebates,” he said.

How much longer can we continue like this? When will we stop treating emotional health as the poor cousin to physical health?

We are in the grip of a mental health crisis. We have the highest Australian youth suicide rate in a decade. More people are depressed, anxious and medicated than at any other time in our history. If trends continue, clinical depression will be the second most disabling condition behind heart disease by 2020.

Raising awareness is not enough. The time for wristbands and hashtags has passed. We have learned to ask R U OK but when the answer is ‘no’, too often there is nowhere to go.

Our Medicare system needs to better reflect the times we live in and the health problems we face. Doctors need the financial support to offer longer consultations for patients with complex psychological needs.

And as a matter of urgency, we must stop rationing psychological services to ten subsidised sessions per year.

When I was at my lowest point, I saw my psychologist twice week just to keep my head above water. I raced through my Medicare sessions in five weeks.

At almost $200 per hour, I then had to raise almost $400 a week just to stay in therapy and out of hospital.

There are few other areas of healthcare where we place such arbitrary limits on a patient’s ability to recover.

Through life’s lottery I was fortunate enough to have a supportive employer, and family who could afford to fund my therapy. Without their assistance I honestly don’t think I’d be alive.

Not everyone is so lucky. Many people are no longer here because they couldn’t afford their mental illness. It’s a devastating indictment on a system that is fundamentally broken.

We must demand better. The chances of surviving our emotional pain should not be determined by the balance of our bank accounts.

Lifeline: 13 11 14

Jill Stark is a Melbourne journalist and author of Happy Never After

(c) Fairfax Media Australia.