We have released information held by the Department of Health under the FOIA about correspondence regarding metal and metal hip implants. The original request is below. The information we are releasing relates to concerns about a possible cancer risk associated with MoM hips by a surgeon in Wales, which at the time was unproven. The information was not released immediately as there were further needs for redactions and agreement from the Welsh Assembly Government (WAG).

A Department of Health spokesperson said:

“Concerns that people with metal on metal hip implants might have an increased risk of cancer have been investigated several times internationally and we take such concerns seriously in theUK. These investigations have not found any evidence that those who have these implants have an increased risk of cancer.

“The MHRA, NICE and the British Orthopaedic Association are working with responsible manufacturers of hip implants to ensure that patients can be confident they will receive the highest quality of devices when they need them.

“If patients have any questions, they should speak to their orthopaedic surgeon or doctor.”

 The original request was as follows:

The applicant made a request to the DoH under the FOIA about (metal on metal) hip implants on 18  April 2012 as follows:

“My request relates to hip implants and is as follows: 

“Please disclose all correspondence, including emails, between the Chief  Medical Officer – or officials acting on her behalf – and the NHS Medical  Director – or officials acting on his behalf – in relation to hip implants  between January 29-Feb 1 and on February 29 and March 5, including replies.

“Please disclose all correspondence, including emails, between the Chief  Medical Officer – or officials acting on her behalf – and officials at the  MHRA, including Dr Susanne Ludgate, in relation to hip implants from January 29-Feb 1 and on February 29 and March 5, including replies.

“Please disclose all correspondence, including emails, between the NHS Medical Director – or officials acting on his behalf – and officials at the MHRA,  including Dr Susanne Ludgate, in relation to hip implants from January 29-Feb 1 and on February 29 and March 5, including replies.

To clarify: I’m requesting correspondence from January 29 to February 1, and on February 29, and on March 5.”

The DoH had initially provided some redacted information (personal data) and to prevent any prejudice to international relations with the Welsh Assembly Government (WAG) on a full release of that information.

The applicant subsequently challenged the redacted information with the Information Commissioner’s Office (ICO). The DoH is now content to release the information to the applicant without significant redactions, given the passage of time since the original request was made and with the agreement of the Welsh Government.

Commentary

The study in question was instigated because of a seeming correlation between metal on metal hip replacements and incidence of cancer (in fewer than 150 patients) at one site inWales.  However, the findings, when looked at within a larger, more statistically valid sample, suggested no link.  There was a concern at the time that release of this information, particularly without sufficient context, would cause undue alarm in the population, and damage to the relationship between the Welsh Assembly Government (WAG) and the English Department of Health (DoH), with whom the information was shared in good faith. The passage of time since the study was undertaken now means that the issue is less sensitive to share with the general public at this much later stage.

There was also a concern that patient information could be identifiable from the information redacted. This is now presented in a more general form, making reference only to “a site inWales” rather than the specific location, which has allayed concerns from the Welsh Assembly Government on this front.

In light of these minor changes to the presentation of the information and the passage of time, we are now content for the information to be released in line with the applicant’s request.

Q & A

Why has it taken so long to release this information?

The delay only applied to redacted material, which was subject to investigation so as not to cause unnecessary public alarm. The information released now is no longer considered to be sensitive.

This is further evidence that metal on metal implants are linked to cancer?

No such evidence was found. The investigation found no positive correlation between metal on metal hip replacements and cancer when local findings were examined within a statistically valid sample.

Released Information:

M-o-M FOI