Concern over cosmetic surgery clinics

Cosmetic surgery is gaining in popularity

A damning report has found poor standards at private clinics offering plastic surgery in the UK.

The Consumers' Association found clinics agreeing to unsuitable surgery and failing to provide adequate information about the risks involved.

The implication of this report is that the commercial drive is influencing clinical decisions, and that is not good medicine

Mr Norman Waterhouse

It is estimated around 65,000 to 75,000 cosmetic surgery procedures are carried out each year in the UK.

However, there are concerns that the service is not properly regulated - despite a new government system of regulation for private health care.

The CA publication for Health Which? sent two actors with hidden recording equipment to 21 appointments at private cosmetic surgery clinics.

Three highly experienced surgeons gave their verdicts on the visits.

They found:

• Discounts offered if patients agree to more than one procedure
• Surgeons were often vague about their expertise
• Unqualified "patient co-ordinators" conducting consultations
• Poor standards of medical history taking by many surgeons
• Some surgeons skirting over the potential risks of surgery
• Wrong information being given out by a number of clinics

The CA investigators also found surgeons who were prepared to perform unsuitable cosmetic procedures.

For example, one actor inquired about surgery to reduce the size of his nose (rhinoplasty).

One of the expert panel of surgeons, with 30 years experience in rhinoplasty, confirmed the actor's nose was well proportioned with his face and he did not need cosmetic surgery.

Only two of the clinics investigated turned our actor away as unsuitable.

The other eight found different reasons why surgery was appropriate.

Foreign surgery

The British Association of Aesthetic Plastic Surgeons, together with other surgical organisations, says the public is still at risk from unqualified practitioners.

No recognised standard of training for cosmetic surgery exist, though it is hoped with the establishment of the Cosmetic Surgery Interspeciality Committee this will change.

Health Which? also examined the trend of companies offering surgery abroad. Researchers examined deals offering surgery in Poland, South Africa and Cyprus.

They identified a range of problems, including:

• Not meeting the surgeon until arrival
• "Exclusion of liability" clauses
• Lack of comprehensive aftercare

Health Which? is calling for a single register of approved cosmetic surgeons and for the role of "patient co-ordinators" to be restricted - they should not be providing explanations of procedures, the risks or taking medical histories.

Sue Freeman, Managing Editor of Health Which?, said: "Cosmetic surgery remains a bit of a lottery.

"Patients need clear information about the risks involved and the qualifications of those carrying out operations.

"Our investigation showed this was severely lacking in many cases"

Doctor's concern

Mr Norman Waterhouse, secretary of the British Association of Aesthetic Plastic Surgeons, told BBC News Online he was very concerned about the current situation.

He said: "The implication of this report is that the commercial drive is influencing clinical decisions, and that is not good medicine.

"Once you think of cosmetic medicine as a market place, then market techniques start coming into play, and that is not appropriate."

Mr Waterhouse said that at present it was possible for somebody who had failed to complete their training as a cosmetic surgeon could simply set themselves up in private practice anyway.

Similarly, people who had spent years specialising in a particular type of cosmetic surgery could carry out private work in another field in which they might have had no experience.

"It should be made clear how is and who isn't a plastic surgeon," said Mr Waterhouse.

Training

"The government would act very quickly if somebody was offering cut-price brain surgery without the necessary certification.

"I do not understand why the same force is not evoked for aesthetic surgery."

We will take action against individuals and organisations in order to eradicate poor practice within this sector

Ros Gray

Mr Waterhouse said the Commons Select Committee had failed to recommend regulation with sufficient teeth to tackle the problem.

His association is now insisting that its members submit details of their work for audit as a condition of continuing membership.

Plastic surgeon Barry Jones told BBC Breakfast that without an approved register, people should first see their GP and try to use surgeons who worked in the NHS.

'Action will be taken'

Ros Gray, of the National Care Standards Commission (NCSC) set up to regulate private medicine, said that new national standards would help to tackle the problem.

She said: "The NCSC will use its powers to stamp out sloppy practice. Our inspectors have powers to enter a clinic at any time - including unannounced spot checks.

"We also have powers to investigate complaints against clinics and their staff.

"The NCSC will not tolerate the abuse of people who place themselves under the care of others and we will take action against individuals and organisations in order to eradicate poor practice within this sector."