to think that it's not for the nhs to pick up the bill to remove potentially faulty breast implants?

[wannaBe]

There are calls today for women who have had the faulty French breast implants to have them removed on the NHS. Apparently 40000 women have these implants, and to remove all of them would cost the NHS £150 million.

Now, if a woman has had these implants as part of reconstructive surgery following mastectomy then I agree that she should be able to have them removed. But other than that, if you choose to buy yourself bigger breasts (and let's be honest, leaking implants are not a new thing), then it isn't the nhs's responsibility to pick up the tab if there might be a problem.

If your life is in immediate danger then you would obviously need to have surgery on the NHS, but just on the off-chance? I think the company responsible should be the ones picking up the bill and don't see why the taxpayer should shoulder the responsibility for other peoples' vanity.

They should, except legal representation is expensive and i doubt that all of the women could afford it. If they got legal aid or the NHS persued the private company, once again it would probably cost more.

LF - mandatory insurance before private ops is a sensible idea IMO. My German friend says that everyone there has to have insurance (there is a cheapie state option too) and whilst I wouldn't want to see that here, I think to access private services it should be necessary.

but we do live in a society that discriminates and decides things like this on personal/local/post code lottery judgement
working in nhs commissioning i see it everyday

YABU. The woman may have chosen to have the implants for cosmetic reasons but if the implants are a health risk they should be treated on the NHS.

People go skiing, break their leg and get treated on the NHS I don't see how this is any different.

Hedge - I think it was a discretionary procedure and so it is at the patient's discretion how they choose to ditribute their finances and what decisions they now make. I don't think the NHS should pay for a remedy in any of the cases you outline although I would question why the cancer patient had to go private in the first place as reconstruction should surely be offered as part of her treatment?

Fiona- could you give me an example of what is decided on a personal level (not clinical). I don't see it as a SW, lots of money to spare, not a judgement in sight.

Alt - these women were always going to have to pay to have these implants replaced because they will not in any case last life long. Implants don't last. It's a still evolving technology, the risks of which are not fully understood - even if you don't have crap ones. I absolutely do not see why the NHS should pay for these women to have them replaced.

I don't think the NHS should pay to have them replaced.

Just to have them removed.

If the implants were fitted by a clinic which is still there and operated by the same company, then that company should remove / replace! Of course, if the original business is no longer there, the NHS should step in. The Dept of Health should be talking to the private clinics to plan the way forward.

"I did find myself getting wound up with the woman on the BBC yesterday as she seemed to expect to be helped. Not quite sure what it was that irked me."

Possibly whatever it was she'd also had done to her lips?!

NL Not all the women will have the money to have the implants removed. In an ideal world you don't have a medical procedure unless you can afford the upkeep but life doesn't work that way does it?

If the NHS put them in, then they should remove and replace them.

If they were put in privately, but a remedy cannot be found from the clinic, then the NHS should check them and unless they are an immediate problem, give the woman a choice of having them removed (but not replaced) or leaving them in.

nhs is free at point of need,there are significant risk and contraindication as result of sub-medical grade silicone use. those affected have a clinical need eg removal of suboptimal product,regardless of reason the implant was inserted

the nhs routinely undertakes interventions and surgery that are lifestyle related in cause eg diet,smoking. some, not all of the implants are cosmetic reason.but nonetheless they now pose a risk and need removed

I agree there may be a class action and sue the company for misdescription and inadequate product and perhaps recoup costs

I hope someone will have inherited the liabilities of the companies that carried out the original operations, or the one that manufactured the implants (gather it has gone bust).

There's also an issue about the regulators here - apparently the Americans were raising the alarm about the manufacturer back in 2002. And the surgeons - how far did they check the reliability and suitability of the implants they were using?

Birds--seen (and heard) of stuff going to non-clinical panels consisting of about two people making exceptional circumstances funding judgments on all sorts..eating disorder treatment, prosthetic limbs/mobility equipment,lazer (sp?)hair removal etc etc. and on a more macro level I'm seeing the commissioners making bigger organisational funding decisions because they want to be popular with GPs so that they stay in their favour and have a function when GPs take more control. compared with slightly more accountable local authorities NHS commissioners seem to have carte blanche to do what the hell they want.

Should smokers pick up the bill for lung cancer treatment?

"we are all at risk of cancer. It's just that some of us are more so because of lifestyle choices we make."

Actually, WannaBe, some of us are at markedly higher risk of cancer because of inherited genetic faults. I got my first lot at the age of 30.

If those of you demanding taxpayer-funded removal had actually experienced the hell that is NHS cancer treatment I suspect you would be less inclined to encourage the NHS to spunk £150 million on this.

It has been widely known for yonks that implants are problematic - my cousin had a product recall on her plastic tits in 2002. Anybody who seriously thinks you can insert a lump of silicone into living flesh without consequences (including cancer) is an imbecile. Zero sympathy.

Haziedoll 'Not all the women will have the money to have the implants removed. In an ideal world you don't have a medical procedure unless you can afford the upkeep but life doesn't work that way does it?'
No apparently the way life works is you make a decision to embark on an unnecessary medical procedure for breast augmentation - that will require further ops in years to come - and are all outraged and surprised when you find that the newly developed technology in your boobs is crap - but nevermind the NHS will fix it!

I had cosmetic dentistry 14 years ago. The work was done for vanity reasons, however the appearance of my teeth had a huge impact on my confidence and someone once said to me that I was a dead ringer for the bloke from The Pogues. Nice.

When I had them done I assumed I would be able to have them replaced at the end of their lifespan and set up an ISA to fund it. Unfortunately after kids and redundancy my ISA was used elsewhere.

After my second pregnancy it all went a bit wrong and a couple of my veneers fell out. I was amazed that I could have the replacements on the NHS and fortunately for me I didn't have to pay as I had just had a baby. When I was talking to my dentist I was saying I was surprised that cosmetic treatment was included on the NHS and he said the initial treatment may have been carried out for cosmetic reasons but now I had a genuine dental need so it was only fair that that I should receive treatment under the NHS. He also said that if I had seen a half decent dentist as a child I would have been referred for orthodontic treatment and wouldn't have needed to go down the cosmetic route so I don't lose any sleep over it.

As I understand it the government have not yet stated that they are of the opinion that these inplants need to be removed.

If they had the money to pay for private implants then they also have to pay to get them removed privately IMO, as most of them have chosen to have them through vanity alone.
Anyone that got them through the NHS should get them replaced by the NHS.
I have a saline implant due to a mastectomy, it is not perfect but a damn sight better than using a prosthesis which I did for about a year, and which made me utterly miserable.
As far as I know these are safe, but I would expect the NHS to replace it if there was ever a problem.

The thing about the NHS is that you can't start saying "we will treat you, but not you". The only time that's feasible is if there is an organ and more than one person who needs it.

Obviously the ideal would be that if you get implants, you save enough money to have them removed if things go wrong but not everyone does that.

I just don't think you can draw a line and say "no, we're not treating you".

And I say this fully in the knowledge that my health problems go untreated due to lack of resources.

No, of course lung cancer patients shouldn't have to pay for treatment! The difference is that where breast implants were provided by a provided by a private sector company, that company must be obligated to provide the remedy.