One of the infamous implants.
Just before Christmas, the French government caused widespread concern throughout the UK by recommending the removal of implants produced by French firm Poly Implant Prothese (PIP) which were found to be made from industrial rather than medical grade silicone, citing an increased risk of rupture. Despite the UK insisting that they had not found any increased risk of rupture, nor any link with cancer, they later decided to advise that any woman who had received PIP implants could get them removed for free, if they wanted, through the NHS.
It was also confirmed that women who had received PIP implants during a privately paid operation would also get them removed for free, after private clinics stated that it wasn’t their problem. This will raise a few eyebrows from the taxpayer, as 95% of the PIP implants used in the UK were within the private sector, and removing these implants will have an estimated cost of £11million. However, this is only the tip of the iceberg. It brings to the forefront a poorly regulated private plastic surgery sector, which may be costing the NHS millions of pounds each year*.
It has been revealed that cosmetic chains are employing surgeons for cosmetic plastic surgery when they would not be qualified as consultants on the NHS. Under the NHS, a surgeon is still in training and must be supervised during operations until they become consultants. While those employed by the major private health groups are NHS consultants doing part-time private work, those working under cosmetic chains, such as the Hospital Group and Transform, are not on the special register. Sometimes they may be no more than GPs or retired dentists, a frankly terrifying concept.
These private clinics claim that they are perfectly entitled to do so, and that their surgeons are more than qualified due to the amount of experience they have performing the operations. They also point to the fact that their clinics meet the standards of the Care Quality Commission. Despite these feeble attempts at justification, it is surely worrying that those performing operations have not received the same training as NHS consultants.
Another confounding factor is the increasing number of surgeons who qualified in Europe who come to the UK to work as plastic surgeons. Due to EU regulations, they are automatically put on the specialist register, despite the fact that sometimes their training is not deemed to be the equivalent of that required for a UK trained surgeon to be put on the register. Fazal Fatah of BAAPS (The British Association of Aesthetic and Plastic Surgeons) recognised this problem stating “The EU regulations are a problem… We have lost autonomy on this health issue”. More definitively, a Government-funded report on cosmetic surgery in 2010 stated that inclusion on the specialist register itself did not assure quality.
It may be easy to think that cosmetic surgery could not possibly have the same risks as other surgical specialities, such as general, cardiothoracic or neurosurgery, but the consequences of unsuccessful cosmetic surgery can be life changing. A face lift may result in the paralysis of a nerve (Accessory nerve) responsible for muscles in the neck, meaning the person could find that their head will face over one shoulder almost permanently. Bad ‘boob jobs’ can lead to a winged scapula. Skin death, or necrosis, can also occur around the area of incision. I could go on…
The new Health and Social Care Bill will further open the NHS to private sector providers. This can only be worrying for patients due to the lack of power the UK government holds over private health providers. With 95% of those who received the PIP implants in the UK being from the private sector, the best the Health Secretary, Andrew Lansley, could do was to request the private sector to take similar action to the NHS. Even regardless of such a bill, it is clear that greater regulation is required to ensure high quality of healthcare throughout the UK, be it through the NHS or private sector. Doctors and surgeons should have the same training to ensure they are of the highest standard. Unfortunately, all too often, after botched private cosmetic surgery the NHS are left to pick up the bill and to try and minimize the damage to the patient. With the decreasing NHS budget already causing problems, with cries of decreasing quality of health care, it is clear that greater regulation should be introduced to help appease an already burdened NHS.
*The cost for botched private plastic surgery both in the UK and overseas.
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