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The silicone hits the fan: Marge Berer of Reproductive Health Matters says the breast implant fiasco is what we can expect from private medicine

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London, 25 January 2012

The editor of Reproductive Health Matters (RHM), a leading academic journal about sexual and reproductive health and rights, has said that the scandal surrounding faulty breast implants highlights many problems with private health care which will intensify if governmental proposals come into force.

"[T]he rapidly expanding private sector provision of breast implants for cosmetic reasons, by an "industry" that has been permitted to remain self-regulating in spite of evidence of its shortcomings and the risks involved, was a public health problem waiting to happen," Berer writes in a blog for the British Medical Journal.

She points out several ways in which the private cosmetic surgery industry has been dogged by unresolved criticism:

• Clinics have been criticised for not adhering to minimum standards, not monitoring quality of care and failing to record adverse events systematically.
  
  
• Cosmetic surgery providers have been accused of failing to provide potential patients with written guidance on clinic procedures, of publishing misleading advertisements, of selling procedures under the guise of counselling, of having no formal complaints procedures, of not documenting complaints and their outcomes and of having inadequate registration of surgeons.
  
  
• Private clinics are not obliged to keep records and, if they do, it appears that they can cite "commercial confidentiality" to avoid revealing data.

Labour MP Ann Clywd has been calling for an independent umbrella body to govern the cosmetic surgery profession since 1997, most recently in 2008. Her warnings went unheeded. Yet Nigel Mercer, president of the British Association of Aesthetic Plastic Surgeons, said in 2009: "In no other area of medicine is there such an unregulated mess. What is worse is that national governments would not allow it to happen in other areas of medicine. Imagine a '2-for-1' advert for general surgery? That way lies madness!"

What is more, says Berer, Health Secretary Andrew Lansley is planning to open the door to privatisation of health care on a much wider scale than anything we have yet experienced. His Health and Social Care Bill is scheduled for report stage - where MPs discuss possible amendments - on 6 February. The Bill could result in many more private health corporations getting control of health care provision currently dealt with by the NHS. With some private companies refusing to remove faulty breast implants because of the cost implications, Berer suggests that we're already getting a taste of the problems to come in a new "US-style health system."