Response to NZ Herald article – 26 June 2023
RANZCOG acknowledges the pain and distress suffered by many Aotearoa wāhine who have experienced complications arising from pelvic mesh implants.
The NZ Herald published an article on Monday 26 June titled ‘Surgical mesh: Half of surgeons assessed for using mesh did not meet minimum standards’.
The College’s full statement to the NZ Herald, attributed to to Dr Susan Fleming, Chair of Te Kāhui Oranga ō Nuku (RANZCOG’s New Zealand Committee), is below.
You can watch RANZCOG’s appearance at the Health Select Committee’s inquiry here: https://www.facebook.com/hescnz/videos/858770008559823
RANZCOG was represented by:
– Dr Susan Fleming, Chair of Te Kāhui Oranga ō Nuku
– Dr Sarah Machin, NZ Training and Accreditation Chair
– Dr Tim Dawson, Urogynaecology subspecialist
– The principle focus of the first round of credentialing was on mesh removal.
– Mesh removal credentialing was assessed at different levels of difficulty – partial and complete removal.
– Applicants applied for the level best suited to their experience and skills.
– As well as being assessed for removal of mesh, surgeons were also assessed for mesh insertion.
– All gynaecologist who applied to be credentialed were deemed competent to implant mesh for stress urinary incontinence and to manage the more common complications related to this surgery.
– All surgeons, including gynaecologists, should be credentialed by Te Whatu Ora for the work that they do.
– For transvaginal mesh procedures, if not certified by the new Credentialling framework, surgeons should be certified against the Australian Commission for Safety and Quality in Health Care (ACSQHC) framework- https://www.safetyandquality.gov.au/sites/default/files/migrated/Credentialing-of-Senior-Medical-Practitioners-to-Undertake-Transvaginal-Mesh-Implant-Surgery-forStress-Urinary-Incontinence.pdf
– Read RANZCOG Position Statement on mid-urethral slings – https://ranzcog.edu.au/wp-content/uploads/2022/05/Position-statement-on-midurethral-slings.pdf
Statement provided to the NZ Herald on Thursday 22 June
– RANZCOG supports the idea of setting broad credentialing standards at a national level. Ideally, the credentialing approach should be consistent across all areas of clinical and surgical practice.
– Our approach, and ongoing education, was outlined in our submission to the Petition of Sally Walker: Suspend the implantation of mesh sling for stress urinary incontinence. Read it here: https://www.parliament.nz/resource/en-NZ/53SCPET_EVI_125675_PET3637/51bc9ced5e85373e659983cf9d2f421b49bda31f
– RANZCOG acknowledges that mesh removal requires special skills and training. We are in support of the newly launched specialist mesh centres (https://www.tewhatuora.govt.nz/keeping-well/the-new-zealand-female-pelvic-mesh-service/) where there is expertise in how to treat mesh complications and in the most appropriate techniques for mesh removals.
– More broadly, we have worked with the Ministry of Health to stress the need for adequate communication with all stakeholders, and that the framework and its roll out needs to be embedded in a supportive and learning culture.
– As the credentialing framework is rolled out it will be important to monitor the process to ensure the needs of women are being safely met.
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