Healing after harm: An evaluation of a restorative approach for addressing harm from surgical mesh (5 May 2022)

Summary

Thousands of patients worldwide have experienced extreme pain and life-altering side effects as a result of surgical mesh implants. This report was commissioned by the New Zealand Ministry of Health to evaluate the project  ‘Hearing and responding to the stories of survivors of surgical mesh: Ngā korero a ngā mōrehu – he urupare’, which addressed issues raised by people injured by mesh in New Zealand. 

A restorative approach to addressing harm in healthcare seeks to provide a collaborative, non-adversarial approach to resolving disputes. It recognises the need for relational interaction and conversation to support healing.  The project's restorative process was co-designed in 2019 by the Ministry of Health, advocacy group Mesh Down Under, and researchers and facilitators from Te Ngāpara Centre for Restorative Practice at Te Herenga Waka, Victoria University of Wellington.

The evaluation was led by a team at the Te Ngāpara Centre, who evaluated the experiences of 230 people who took part in the restorative process. They aimed to find out if the project objectives were met and whether a restorative approach could be used in other health contexts.

Content

The evaluation found that:

• a restorative approach met substantive, psychological, and procedural needs during the Listening and Understanding phase of the project. Most participants said their dignity was preserved, their experience was validated, and their communications were respectful.
• the massive extent of harm and injury after surgical mesh procedures was powerfully communicated. This inspired the responsible parties to collaborate and undertake actions for repair and prevention.
• many consumers were largely unaware of progress on the 19 actions that resulted from the Planning and Acting phase of the project and were unsure if their needs would be met in the future.

The report concludes that healing after harm is possible when approached within a relational framework and that restorative approaches could potentially be transferred to other health contexts. Restorative justice approaches should be embedded alongside existing regulatory structures, policies and procedural responses.