guardian.co.uk,
Sarah Boseley, health editor, Wednesday 11 January 2012
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| Andrew Lansley, the health secretary, told the Commons he did not think the NHS should foot the bill for the removal of breast implants. Photograph: PA |
Andrew Lansley, the health secretary, intends to pursue through the courts the
cosmetic industry companies that are refusing free operations to women wanting
substandard breast implants removed.
Lansley is
prepared for a full-scale confrontation with the recalcitrant elements of the
industry after the declaration of the Harley Medical Group that it will not pay for removal of the PIP implants that have triggered great anxiety in women in
the UK and in France. Transform and the Hospital Group have also said that
women will have to pay.
The health
secretary is inviting women refused free help to go to their GP, who will refer
them to an NHS hospital for removal – although not replacement – if that is
what they want. But Lansley says the taxpayer should not be expected to foot
the bill and the government will actively seek to recover the cost from the
private chains.
"We
will pursue them extremely aggressively through the courts," a source
close to Lansley said. "We will go after them."
Lansley
believes the clinics are turning their backs on their patients.
"For
them to abdicate responsibility we think is immoral," said the source.
On Friday
Lansley said the NHS would remove and replace implants for free, where women
wanted it, if their operation had originally been on the NHS. This would
normally have been breast reconstruction after cancer surgery. The big
providers of private healthcare who also perform some cosmetic surgery,
including Nuffield Health, BMI and Spire, have all said they will follow suit.
Lansley is
now urging Harley to rethink. "Eight private companies are offering to
replace implants for their patients – Harley Medical Group should follow
suit," he said. "Today the professional bodies for cosmetic surgery
have sent out a letter to all surgeons calling on them not to charge for their
time when they remove these implants. That should significantly reduce the
costs for all companies and I would urge Harley to rethink its decision in
light of this. All providers have a duty of care to their patients. It is
unacceptable for wrangling over liabilities to get in the way of this. These
providers should offer help to women who need it and deal with liabilities
later."
The Harley
Medical Group was by far the biggest buyer of the cut-price and, as it turned
out, substandard implants from Poly Implants Prosthese in France, which used
silicone gel filler of industrial grade intended for mattresses. Its surgeons
operated on 13,900 women between 2001 and 2010, while Transform did around
4,000 implants. Transform says it will charge £2,800 for removal. A third
chain, the Hospital Group, says it will only replace those that have ruptured.
Lansley's
offer to women is intended to end the anxiety of the 40,000 or more who have
received PIP implants. An expert group, chaired by the NHS medical director,
Sir Bruce Keogh, said on Friday that it could find no evidence that the
implants were dangerous or more likely to rupture - but the clinics had not
kept good enough data on the operations to be sure.
The private
chains say they will go out of business if they have to pay for all the
operations and blame authorities such as the Medicines and Healthcare products
Regulatory Agency for allowing the implants into the country.
The lines
are now drawn for a major confrontation between the government and the private
cosmetic clinics.Lansley told the Commons that Keogh's group would now
investigate safety and regulation in the industry as a whole, including other
types of cosmetic surgery and the use of dermal fillers. His review will look
at whether the products are properly regulated, whether the people who carry
out procedures have the necessary skills and whether the clinics themselves are
fit for purpose. There will also be a swift immediate review of standards in the
private clinics by the Care Quality Commission.
The
European Union is reviewing the EU Medical Devices Directive to see whether
tightening of the rules would prevent another PIP scandal. Lansley said there
will also be an investigation into what happened to allow the implants into the
UK.
The Harley
Medical Group's chairman, Mel Braham, told the BBC the firm did not have the
resources, the surgeons, or the operating facilities needed to do the surgery.
He said the government had a moral responsibility to replace the PIP implants,
because of what he called the failure of regulation by the MHRA.
"We're
only sitting here today because the Medicines and Healthcare products
Regulatory Agency (MHRA), their own regulatory authority, has approved these
implants and obviously hasn't done their proper checking.
"We're
an innocent victim like everyone else, we're attempting to do our best for our
patients ... We can't take on this whole thing on our own, especially when it
wasn't our fault."
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