Announcing a review of cosmetic surgery
“Cosmetic surgery: review to stamp out grubby practices” was the BBC’s headline announcing the review by NHS Medical director Sir Bruce Keogh of what he refers to as “the cosmetic surgery industry”.
In the accompanying video piece (http://www.bbc.co.uk/news/health-19264798) Sir Bruce starts with a denouncement of the PIP implant fiasco, lamenting that the regulation of the devices was inadequate and that there was no central register of women who had had these devices, so slowing the process of recalling or contacting them. It is worth pointing out that neither of these lapses was a failure of the so-called “industry”, but each were a failure of the arm of government responsible.
And to be fair to the MHRA (the body responsible for supervising the safety of devices such as breast implants) none of the processes were designed to deal with what appears to have been a deliberate fraudulent flouting of the manufacturing standards in another sovereign European country (France). Perhaps now, when counterfeiting designer brands is so common, the regulators will be more vigilant. But because of the free trade within the EU this will require some fairly tough European standards and can’t be left to individual countries: in other words it will be a federal issue and require European legislation. That will never happen quickly.
Sir Bruce’s second point about a register is an important one. I used to sit on the MRAs Committee for the Safety of Devices, and I have seen the uphill task that committee faces in terms of the sheer volume of medical devices of all sorts that require expert regulation. It is impossible to make such a system watertight.
We used to have a voluntary breast implant register in the UK but many women did not want their details entered onto it, nor to be contacted again, preferring discretion. I am in favour of ALL devices from breast implants to heart valves, hips to lenses being registered and I would like to see that register held centrally by the MHRA ad updatable remotely and anonymously. This could be done by implanting a chip at the same time as the device (either incorporate din the device or close by) so that simple information about the history of the implant can be retrieved by a simple scan (similar to the scan on a supermarket check out) and the information updated via the web.
As to grubby practices: here I think Sir Bruce refers to some of the high pressure sales employed by some clinics, the discounted surgery, the two-for-one deals, or even the untrained surgeons unsupervised and often not monitored or only visiting the UK briefly (making regulation very difficult). There is a lot to clean up there and Sir Bruce will have to recognise that there are faults in many areas, not just with the doctors and nurses, but also with some government agencies.
Patients can be assured hospitals like Spire and BMI are well regulated, exact high standards from their surgical teams and conform to all the guidance and standards of the Care Quality Commission, the General Medical Council and other overseeing bodies. We are proud to offer cosmetic surgery in proper hospitals where al the facilities you might possibly need to be safe and secure are on hand. I, my colleagues and our hospitals, have nothing to fear from this review and we are all delighted that at last some of the outrageous claims of much less competent clinics and surgeons will be exposed as misleading, unethical or as the BBC puts it “grubby”. The sooner the better, so that the true high quality of the care we offer can be established.