Breast reconstruction after mastectomy is one issue, breast augmentation is a totally different issue. The former is repairing the effects of a clinical procedure, and the later is best described as cosmetic surgery: it is healthcare consumerism. This blog is about women who have demanded to have breast augmentation.
The NHS is care according to clinical need and is not healthcare consumerism.
Should the NHS remove the substandard PIP implants? Go back to the basic principle I mentioned above: care according to clinical need. Is there a clinical need to remove the implant? If it has ruptured then yes, there is a clinical need. However, the French study implies that there is a 3% chance of rupture, so that means there is a very good chance that the implants will not rupture and there is no immediate need for intervention. Since the implant was inserted through healthcare consumerism, the woman should use her consumer rights and demand redress from her surgeon. That is, return to the cosmetic surgery company assert her consumer rights and demand that the surgeon addresses the issue. The implant was not fit for purpose, she had a contract with the surgeon who provided the implants, and her consumer rights are that he addresses the issue and replaces the implant with an implant that was fit for purpose.
There is an issue of the psychological effects on a woman who has these implants. Should the NHS treat that? Of course it should: mental health is a vital part of the work that the NHS does. This is care according to clinical need, the mental health needs of the woman with PIP implants. The NHS has a range of treatments for anxiety and the most easily available is to seek the advice and re-assurance of her GP.
To anyone saying that we should pander to the demands of the worried well who have PIP implants, I would ask them why those women should be a priority over the worried sick, the women who are right now being denied hip replacements because under the Croydon List they are deemed to be in not enough pain to justify the NHS paying for the operation.
If Lansley caves into the demand that the NHS removes all PIP implants then this will be the death of the NHS ethos of care according to clinical need. He will have accepted that the NHS is a demand-based system, like the healthcare system in the United States.