The recent controversy and public alarm in women having had cosmetic surgery for breast enlargement involving PIP (Poly Implant Prostheses) silicone implants has highlighted more than any other in recent times the stark attitude shift in natural beauty and health perspectives. As a medical herbalist, and holistic healthcare practitioner, I always advocate natural approaches to healthcare especially conventional medical treatments including drugs especially if I know there are equally effective and perhaps safer natural alternatives. The notion that injecting and inserting synthetic substances voluntarily and electing to have a surgical procedure (where there is no medical need and always presenting an element of risk) seems absurd at the very least. However, it does highlight society's skewed ideas of beauty, confidence, visual presentation and a tenuous link to the acquisition of wealth, expectations, individual's rights and responsibilities and of course the very idea of 'health' itself. Right now, the debate is at the point of play where is it the blame game and 'passing the buck' syndrome. The Government (and NHS) want the private clinics to offer free removal and replacement of implants emphasising the duty of care that they should have for all their patients. For patients who had their surgery at clinics that have gone out of business or those that simply refuse to redeem their actions are being offered free removal only on the NHS, at a cost to the taxpayer. To give an idea of the scale of the costs being discussed (not necessarily all being on the NHS), we are talking about approx £3000 for each removal and replacement for a total of about 40,000 women (this does not include men who had testicular implants, carried out more likely for cancer but this may only be a fraction of this total and most likely be under the NHS). Understandably, this has generated much debate, discussion and anger in so many sections of our society, not least of which is the humble taxpayer who will eventually foot the bill for women who have, ostensibly undergone non-medical emergency surgery for the sake of vanity. I don't refer to the small percentage of individuals who had PIP implants under reconstructive surgery for cancer, trauma and other medical causes such as congenital deformities or in rare instances, body dysmorphia which may require psychological assessment and/or psychiatric treatment.
Many things are shocking in this story:
- a regulatory failure not just by the UK (MHRA - the Medicines and Healthcare products Regulatory Authority) but also by the EU who authorised PIP as safe in 2000
- a failure of the MHRA to investigate the concerns of the surgeons who reported clinical problems directly to them as far back as 2005
- a lack of a cohesive and united framework of information delivery and communication between key government bodies and authorities of the UK and the EU, leading to misinformation and inconsistencies in the evidential data of rupture rates between the UK clinics and other EU countries. It is on this basis that the NHS are refusing to replace implants for private patients for free
- a failure of the professional bodies to inform and disseminate news to their members
- a failure of surgeons to keep updated on developments in their own field by reading the appropriate literature in peer-reviewed medical journals
- private clinics too eager to make money and for their sheer greed which has gone unheeded for far too long and possibly a failure to seek redress through their indemnity insurance
- the assumption by women that the more costly (allegedly 'safe') implants are somehow going to miraculously eliminate any element of risk in having a synthetic product in their body or indeed any long-term complications (such as leakage)
- no punitive measures taken against the MHRA or indeed the EU regulatory authorities for failing to offer protection - this will (or has done already) diminish public confidence in the healthcare system as safe and robust
Given the relaxed attitude that the MHRA have demonstrated when they were first alerted to this potential national health scare, it seems all the more deplorable that they scrutinise and over-regulate the herbal medicines profession and have removed incredibly useful herbal medicines from the market based on incorrect information and partial data without carrying out a comprehensive review, further research and investigative study. Whilst it is difficult to sympathise with the many women who are in this plight and are justifiably worried, I can't help but think that the regulatory authorities have some responsibility in putting things right.
As far as the public are concerned, including and particularly those women who underwent the surgery, they see this as a simple issue of consumer rights not understanding that medical devices (such as breast implants) are not subject to the same principles as purchasing a faulty toaster or television where you can legitimately ask for your money back or demand a replacement. The arguments they present are as ludicrous, limited in logic and lacking in intelligence as much as their decision to undergo elective surgery in the first place whatever their reasons and motivations for doing so.
However, it is evident that something needs to be done because doing nothing is not an option. The necessary representatives of key organisations, the Department of Health and the medical profession must engage in useful dialogue to avert a potential clinical disaster which may happen if no action is taken now. Waiting for a medical emergency will impact on the NHS and may end up costing the taxpayer even more money. This PIP breast implant scandal has also highlighted the real cost of private health and if the current proposals for NHS reform under the Health & Social Care bill is to be motioned, this failure and and worry could be a real concern for all of us but for entirely different health reasons. More important is a need for a focus on why women feel the need to mutilate their bodies in the extreme in the quest for beauty which is beyond mere vanity. A false competitive market and a society that does not embrace women in all shapes and sizes, nor indeed empower them to accept their own bodies in all its natural forms. Sadly, it is women who set up these idiotic notions of the perfect body shape and encourage unhealthy competition, be it for jobs, a mate, money or status.... yet another indictment on this society.