Pick up the pieces

December 3, 2008

breast implantThis story by Nick Triggle, a health reporter at BBC News, makes me cross.

To my mind, it’s lazy journalism, riddled with assumptions and sweeping generalisations.

Briefly, it seems the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) is whining about patients who travel abroad for their surgery, and who, should they develop post-op complications, then turn to the NHS for help.

NHS pays to rectify cosmetic ops

The NHS is having to pick up the tab for cosmetic surgery performed abroad that has gone wrong, doctors say.

To me, the use of the term ‘cosmetic surgery’ implies something superficial, frivolous. And the term “gone wrong”? – What kind of subtext is there in that? That Johnny Foreigner is somehow not as good a surgeon as Our Brave Boys? “It’s gone wrong” = “He didn’t know what he was doing”. Is that what you’re really saying, Mr Triggle?

My surgery – genital reaffirmative surgery and breast implants – was carried out by a ‘cosmetic surgeon’ – but, to me, it was neither superficial nor frivolous. It was part of a process which had taken me from attempting suicide to beginning a life which is truly mine.

Also, since these unspecified “doctors” (lazy journalism, Mr Triggle) raise the subject of money, correct me if I’m wrong, but isn’t it the taxes paid by those same patients which fund state-provided healthcare in the first place? Or are these “doctors” suggesting that a two tier system is in order? And can’t we just guess who’d get to decide which person’s life is more valuable?

The British Association of Plastic, Reconstructive and Aesthetic Surgeons said many patients were turning to the health service for follow-up care.

Yeah, and…? I was lucky – I had no post-op complications, but if I had, then yes, I too would have gone to the NHS for assistance. And why not? What else is the NHS for, if not to treat sick people?

The government […] urged those thinking about going abroad for operations to be careful.

It is estimated that up to 100,000 people a year are heading abroad for cheap cosmetic surgery such as breast enlargements, tummy tucks and face-lifts.

BAPRAS said the growing demand was being fuelled by the availability of cheap flights, but warned that the trend was leading to problems.

Well obviously people contemplating major surgery are careful. You don’t just wake up one sunny morning and think, “I know, I’ll just hop on a plane to Poland, quick tummy-tuck, bit of shopping, pick up some duty free and be home by bedtime”. You do your research. You make sure that the clinic you choose is of as high a standard as you can afford – and that they’re expecting you and are prepared to operate on you. It’s not a fast food drive-by.

And as for “the growing demand […] being fuelled by the availability of cheap flights” – one of those sweeping generalisations – I say no; it’s just one factor. My view is that it has far more to do with the gatekeeper attitude of the NHS. Even body dysmorphia can cause major psychological distress for people, let alone the gender dysphoria with which I was diagnosed.

So why then, Mr Triggle, are you not asking about a healthcare system which only admits those it deems suitable, instead of facilitating people’s wish to ease their distress? Or do you not think that’s a health issue worthy of consideration?

[BAPRAS] said its members had seen a range of complications including blood poisoning, wound infections and blood clots, as well as patients who were not happy with the results of the surgery.

And, of course, none of those things ever happen in good old Blighty, now, do they? Xenophobic, much?

And the association warned that the extra work being caused by having to see these patients could end up delaying other NHS work.

Another sweeping generalisation – and emotional blackmail to boot.

I’m beginning to think that – even if I had been able to have my surgery in the UK, in a timely manner and at a reasonable cost, I’d still have gone to Thailand. Because if that’s the attitude of the professional association who represent the surgeons who carry out the work, well, quite frankly I’d rather take my chances abroad.

It said patients should be made to pay for rectifying treatment except where there was a life life-threatening situation or if the patient was suffering from acute pain.


BAPRAS spokesman Hamish Laing said the NHS should not be expected to “pick up the pieces” unless the complications were life-threatening.

And you wouldn’t go to a hospital if you weren’t suffering from acute pain or life-threatening complications? Oh please

“There are patients who are having operations they couldn’t normally have had on the NHS and we don’t think it’s right that we should be having to take up resources that should be used for reconstructive plastic surgery in the NHS to sort out these problems,” [Hamish Laing] said.

Mr Laing, ask yourself why people aren’t having these operations carried out by the NHS. and I believe you will find that the gatekeeper v. facilitator argument is at the back of it. Stop trying to blame the patients, please. Go and talk to the NHS, ask it why these operations aren’t carried out here in an affordable manner for people who need the psychological and physical benefits this work brings.

Did I hear the word “funding”? And that isn’t the patients’ problem, either.

Thankfully, there is a small voice of reason in this frankly unhinged outburst – the Patients Association has responded:

Katherine Murphy, of the Patients Association, agreed it would be wrong to withhold treatment.

She said patients needed better information about treatment available abroad.

And this is what it comes down to, really. Because, if we in the UK are stuck with a system which makes it difficult to receive medical care when we need it; if the system consistently refuses to listen to the voices of those who are asking for help; if the system decides that the only help it will make available is that which it sees fit, in its own sweet time and it has to be said, paid exorbitant fees for – then what on earth do you expect people to do?

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