On 23 August 2023 the Director-General of Health endorsed a pause in the use of surgical mesh to treat female stress urinary incontinence (SUI), following a recommendation from the Surgical Mesh Round Table (SMRT). This precautionary measure was taken to reduce harm and ensure patient safety.
The Ministry of Health and Health New Zealand acknowledge those who have suffered significant avoidable harm through surgical procedures involving mesh.
Four safety conditions must be met before the pause can be reconsidered: mandatory credentialling of clinicians; structured informed consent supported by a patient decision aid; patient case discussion at dedicated stress urinary incontinence multidisciplinary meetings; and establishment of a registry for female pelvic floor procedures.
Three conditions have been implemented, while work to establish the Australasian Pelvic Floor Procedure Registry - New Zealand is continuing.
Meeting all four conditions is necessary but not sufficient alone to trigger the Surgical Mesh Roundtable (SMRT) to advise the Director-General of Health on the status of the pause; it would not automatically result in the pause being lifted.
Since the pause was introduced, the Ministry of Health and Health New Zealand have continued work across the health system to strengthen safeguards, improve transparency, support informed decision-making and respond to recommendations from previous reviews and engagement with women affected by surgical mesh.
This includes an independent review of the National Credentialling Framework and work to establish the registry. The review and registry are separate parts of the wider programme to strengthen safety, quality and transparency in pelvic floor care.
National Credentialling Framework
A key focus has been the National Credentialling Framework for pelvic floor reconstructive and urogynaecological procedures, which supports consistent expectations for clinicians undertaking these procedures.
The Ministry of Health has commissioned external reviewers to independently assess whether the National Credentialling Framework remains fit for purpose and is being implemented effectively. The independent quality and safety review will consider both the design of the framework and how it works in practice, including whether it supports safe, consistent and transparent credentialling.
The review will not decide whether the current pause on the use of surgical mesh should be lifted. Independent reviewers will engage with a range of stakeholders, including professional bodies, surgeons, clinical team members, private providers and consumers. Findings are expected to be published in the first half of 2027.
Progressing the Female Pelvic Floor Procedure Registry
Health New Zealand is continuing work on New Zealand's first registry for female pelvic floor procedures, including procedures that use surgical mesh. The registry is intended to improve oversight, monitoring and learning over time, and is one part of the wider work programme to strengthen safety, quality and transparency in care.
Late last year, Health New Zealand signed an agreement with Melbourne's Monash University to implement the Australasian Pelvic Floor Procedure Register in New Zealand. Health New Zealand has also partnered with the Centre for Health Outcome Measures New Zealand, a charitable trust experienced in managing health registries, to support a rollout.
Work is now focused on adapting the Australasian register for the New Zealand context before a pilot study trials registry processes. The pilot is expected to begin late this year and aims to test the processes, procedures and resources for a small cohort of surgeons and patients. The pilot outcomes will help inform planning for rollout across New Zealand.
The registry is an important safeguard for future oversight and is the remaining condition still being progressed.
Improving transparency and consumer information
The SMRT continues to provide independent advice and oversight for the ongoing work programme. Improvements have also been made to increase transparency, including proactive publication of SMRT meeting minutes (from April 2026 onward) and work to improve publicly available information and resources for consumers.
Maintaining focus on women's health and wellbeing
The experiences of women harmed by surgical mesh remain central to this work. Their insights have helped shape improvements in governance, consumer engagement, credentialling and transparency, and continue to inform how agencies approach safety, consent and access to care.
Health agencies also recognise that urinary incontinence can have a significant impact on quality of life for many women. Ongoing work remains focused on supporting access to appropriate treatment options and ensuring women have the information they need to make decisions about their care. The SMRT has highlighted the importance of a whole-system approach, including access to conservative and non-surgical treatment options.
The Ministry of Health and Health New Zealand remain committed to keeping the safety, wellbeing and experiences of women central to decisions about surgical mesh care.
