NHS in Wales spent £3m plastic surgery

NHS Plastic Surgery
NHS Plastic Surgery

THOUSANDS of Welsh hospital patients are getting free plastic surgery on the NHS, we can reveal today.

Welsh surgeons are performing the ops on patients’ noses, ears, breasts and stomachs with the costs now spiralling to more than £3m a year, figures obtained by Wales on Sunday show.

Last year alone, more than 2,000 patients unhappy with their looks went under the knife for everything from tummy tucks and nose jobs to facelifts and ear-pinning. Welsh hospitals insist very few of the procedures would be done only for cosmetic reasons and patients get the green light on clinical grounds.

But recent research suggests growing numbers of surgeons are carrying out work for cosmetic reasons in the face of intense pressure from patients, particularly young women, ready to fake distress in return for a free procedure.

Campaign director of the Taxpayers’ Alliance Emma Boon voiced concerns some young women milked the system for vanity treatments.

The rising demands for plastic surgery come against a backdrop of savage NHS cuts, with John Appleby, chief economist at the King’s Fund, saying Wales faces an 11% drop in funding over the next three years. Miss Boon said: “The NHS is there for the treatment of those people who are ill and need medical attention and help. “That’s what taxpayers think of when they think of the NHS – they don’t imagine their money is being spent on cosmetic surgery that in some cases simply isn’t justifiable.”

The figures obtained by Wales on Sunday through a Freedom of Information request show in 2010 plastic surgery cost the Welsh NHS around £3.25m. Since 2008, 617 patients in Wales have had “pinnaplasty” – the surgical term for pinning back the ears. Based on 2009 figures the cost of the surgery is around £2,000 per patient.

Staff at Swansea’s Abertawe Bro Morgannwg Health Board, where there were 463 pinnaplasties between 2008 and 2010, say children going through the procedure have often suffered bullying and physical abuse. Over the same two-year period, 777 women have had their breasts enlarged, reduced or lifted on the Welsh NHS. Medics say ops to enlarge or lift the breasts are “usually” carried out for greater symmetry after surgery or where there’s been a complete failure of development due to an illness.

It is estimated over half the ops are for reductions. Surgeons say patients must have back or neck pain or severe infections beneath the breasts to get these. In other cases the breasts are also reduced to make them more even after surgery. A small number of the 777 cases have involved using a prosthesis for reconstruction after breast cancer.

Between 2008 and 2010 just under 200 nose jobs were completed on the Welsh NHS. The number of ops overall was around 1,400, but many of these included “septal surgery” to relieve a blocked nose.

In other cases medics say the procedures might have been carried out to treat a deformity. The figures also show around 59 patients have had facelifts or genioplasty ops to correct the profile of the chin while 130 have had tummy tucks. Medics again insist the surgeries are carried out for legitimate reasons – for example, tummy tucks where there has been “severe functional disturbance” after massive weight loss.

But research led by Professor Peter Salmon of the University of Liverpool shows women use a range of underhand tactics to con doctors into operating on them.  The study, published in the British Journal of Plastic Surgery, found women would dress down in unflattering make-up.  Medics told the study many patients are placing doctors in an impossible position by refusing to accept they cannot have free surgery.

It says surgeons are ignoring guidance from the National Institute for Clinical Excellence (NICE) that patients should only end up on the operating table on strict clinical grounds. In more and more cases they agree to the surgeries to avoid the time and misery that inevitably follows when insistent patients are told “no”. In a typical NHS clinic studied, nearly half of requests for nose jobs and a quarter of demands for tummy tucks were granted. About half the patients who asked for a breast reduction were successful, and slightly less than a fifth of those who wanted breast enlargements.

The report said a 37-year-old woman who demanded breast implants was referred to a psychologist and a psychiatrist, who both concluded she did not need them. Despite this, the surgery went ahead.  Mark Scriven, medical director and consultant surgeon with the Betsi Cadwaladr University Health Board – where 76 pinnaplasties and 18 facelifts were carried out on the NHS between 2008 and 2010 – insisted ops are carried out for sound medical reasons. He said: “The facts are that we do not provide surgery for people wishing to change their body in some way for aesthetic reasons. “The operations listed are in the vast majority of cases for problems – for instance, breast reconstruction following mastectomy and operations on the nasal septum to improve breathing.”

A spokesman for the Welsh Government said all NHS treatments must improve the health and “quality of life” for patients. He added: “Cosmetic surgery – surgery undertaken exclusively to improve appearance – will not normally be funded in the absence of previous trauma, disease, congenital deformity or psychological distress.

“The Welsh Health Specialised Services Committee has clear guidance for consultants considering cosmetic surgery not usually available on the NHS.”  The new figures further highlight some of the difficult treatment funding decisions facing health professionals and NHS managers in Wales. In February, Wales on Sunday revealed how hundreds of overweight patients are being refused life-saving obesity operations on the NHS because they aren’t fat enough

Up to 1,000 people are being referred for the last-chance weight-loss operations every year, but the NHS in Wales paid for just 59 operations last year. A leading expert said people in Wales are dying because the operations – known as bariatric surgery – are not being funded. The lack of NHS funding will leave many patients struggling to manage their weight and related health problems on their own.

If you aren’t lucky enough to secure funding for plastic surgery or bariatric surgery or would like more information then please contactangela@secretsurgery.co.uk or visit www.secretsurgery.co.uk or call 0843 289 4 982.

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