Private surgery going wrong - NHS stepping in

[Garysmum]

I’m aware of lots and lots of people going abroad for surgery cosmetic and non-cosmetic and dentistry etc.

In some cases that surgery is going wrong. Patients return to the UK and then have to turn to the NHS for help.

For example there is a very unwell lady on TikTok who paid for her gastric sleeve in Turkey and she’s now been in hospital in the UK for days with complications. Poor woman is very unwell.

She received a lot of hate filled comments about her use of the NHS having paid for private surgery. It’s impossible to know the details - for example was she just speeding up a process that she would have had on the NHS or perhaps she wouldn’t have qualified for NHS surgery - we don’t know.

She had rightly pointed out if the surgery had been successful, she would have saved the NHS not only the cost of the operation itself but also costs associated conditions she had from being overweight.

i certainly would consider necessary non-cosmetic surgery overseas if I could afford it, it would make an appreciable difference to my quality of life and if I felt there was a backstop if things go wrong. As it stands that backstop does exist as we have the NHS. And I do agree that having private operations whether in the UK or abroad does take the strain off the NHS - e.g. knee replacement (my dad), hip replacement (friends aunt), tonsillectomy (godson) can speed up the process by years in many cases.

But I then wondered if there are any circumstances where the NHS could or should refuse to pay for after care? Some surgery might not be carried out to UK standards overseas or after care might be compromised by having only a week abroad etc?
Does it matter if it is cosmetic?

It makes no difference that they are going abroad. Paid for surgery in the UK falls to the NHS when it goes wrong as well. Private hospitals do not do acute/emergency/high dependency care.

Don't fall for the headlines.

The same people could pay for the same surgery in this country. If they suffered the same complications they would be treated by the same NHS service as they are being now. It is all smoke and mirrors designed to give someone to "blame" (other than the government) for the state things are in.

They remove your stomach, Jesus Christ 🙈

Well like PP above says, if you don’t treat someone when they’re suffering major complications post surgery then they will die.
So are you comfortable with leaving someone to die because they chose to get their tits done in turkey? I’m personally not comfortable with that.

NHS isn’t here to make moral decisions on whether someone deserves treatment based on WHY they got ill.

We could extend that to include alcoholics, drug addicts, racing drivers, DIY enthusiasts….

An insurance situation would certainly be better - to qualify for surgery abroad it should be regulation to have an insurance policy. This can then be claimed on and paid to NHS directly.

The NHS does not get to pick and choose who it helps. There's a description in the book "This going to hurt" of a patient who got drunk, stood on top of a bus shelter, then slid down a telephone pole, the anti-vandal paint on which caused a degloved penis. Was that patient more or less deserving of NHS care than people who've sought medical help abroad?

The NHS is there to fix what's broken, to the extent they reasonably can. If the level of stupidity or other culpability of the patient in becoming broken would not normally be an obstacle to them being treated, I don't see why a decision to seek medical care abroad should treated differently.

So what are your views on people needing surgery and care after skiing accidents abroad?

The only cases where I have known this to happen, the surgery has happened abroad and paid for by travel insurance. Of course any further complications sometimes years down the line are treated by the NHS. A lot of this cant be anticipated.
I don’t necessarily agree or disagree with the NHS being a backstop as a PP said nobody would leave people to die of complications from private surgery.
To my mind, the greyest area is purely cosmetic surgery and procedures where a patient wouldn’t meet the criteria for good reason. E.g I read an article about people being accepted for gastric bypasses abroad with bmis sub 30.
I can’t see a solution though. Unless legally you have to purchase insurance for private surgery. But can you imagine the bureaucracy? The cost of administration would surely outweigh the benefit?

Im looking into weight loss surgery but am too scared to go abroad, I need some where that will allow follow ups or fixing things if it goes wrong

What I dont understand is, why the NHS doesnt allow a semi private route whereby I pay what might be a discounted private rate, but I pay into the NHS so am saving them money by getting rid of obesity related issues but equally paying them money

Imagine how much they could make if everyone who had gone abroad had paid that same money to teh NHS to get it done

I was to be put on an nhs waiting list for gall bladder removal, I took private through my work, I have ended up.with a complication (1% risk and due to the fact I really needed the surgery). If I had waited on the nhs - considering the mess my consultant had to deal with - and I had needed an urgent removal then I suspect my outcome would have been much worse. I have also freed up a space on the nhs wait list.

I am having nhs treatment to fix the complication. I don't feel that it is wrong for me to do so.

The day the NHS starts allowing patients to jump the queue for cash will be the day the NHS becomes just another private provider

You would be paying to bump other, poorer patients further down the waiting list. That goes against the whole way the NHS works.

Well in lots of peoples cases it wouldnt be jumping the queue because they would be things not offered on the NHS or in my case, I dont meet the criteria for weight loss surgery by all accounts

What I mean is that in the same way a private provider has a company, the NHS could set up an arm which provides services for payment, it wouldnt interfere with the current provision

Most NHS doctors or surgeons work privately anyway

But that surgical slot would still come at the expense of other, poorer patients.

You wouldn't be magically creating a new surgery slot (because that would cost the same as a private op, which you don't want to pay). You'd be using an existing slot, and bumping poorer patients who are waiting for other operations down the queue.

Most NHS doctors or surgeons work privately anyway

Yes, of course they do. But they charge privately for it, and don't use spaces on NHS surgical lists.

But complications can happen through surgery abroad, and accidents abroad. Neither intend to need assistance from the NHS

If I go back to my skiing accident, they'll probably need physio

It's not clear cut I've had private surgery in the UK and was referred to the NHS for complications. Private hospitals don't have the specialist equipment or staff in the UK for many complications. I would have been happy to pay a fee.

Perhaps people who opt for private cosmetic procedures should be billed if they need NHS corrective surgery? It’s hardly fair to use an over stretched service to patch up surgery that you elected to have for non life threatening reasons

Get the private hospitals to have high dependency , equipment and staff. If they do it will be the end of the NHS as staff will leave to work in the privates for better pay.

I totally agree. I got mine abroad when I was living abroad (so operated in the country I lived in). It was absolutely life changing.

I can say there's a certain point where large breasts can be debilitating. If men grew breasts do large they couldn't participate properly in sport, had disfigured shoulders and chronic back/neck/shoulder pain, breast reduction would be automatically available from age 18 for anybody above a certain size.

No it's not it's because labour costs , buildings are cheaper. Cost of living is much cheaper in some countries. UK isn't even the best for top notch surgeries to be honest.

This. Only a few private health care facilities have emergency services. They are dependent on the NHS in cases of haemorrhage, heart failure etc.

The problem is that gastric sleeves/bypass surgeries have something like a 50% complication rate within 5 years because it is essentially forced anorexia. A friend who is a teacher had it in the summer holidays, and while she has lost lots of weight, she is also pale, tired, lacking in energy and still can't eat solids 12 weeks later. I wouldn't be surprised if she is anaemic and ends up tube fed. She just doesn't look healthy and admits that she never really tried to lose weight because she has never eaten any vegetables and hates all exercise.

The problem with private health care is that it gives the public a false sense of security so they approve the decimation of the NHS.

I agree. I'd add that patients should have to stay in the country of surgery for longer than they do. It's pretty impossible for a dr in Turkey or Belgium to correct anything that's gone wrong if the patient is back in the U.K. This also means the dr/clinic doesn't have the costs involved with that.

To the people saying it would be a bureaucratic nightmare. Not really. Insurance companies have global networks. If you're in holiday in Turkey, have an accident and phone the insurance to ask which hospital you should go to, they'll usually be able to tell you. It may cost something to set up a network in cosmetic surgery initially, but without a doubt they could make it work. Additionally, if insurance companies were involved, they'd be able to impose requirements on any surgeon/clinic in their network (because there'd be some kind of requirements anyway to become a linked dr/clinic) and likely insure that drs/clinics had to conduct longer in-person follow up. It's possible there'd be two tiers where those who come back to the U.K. earlier, paid more insurance then those who stay longer.

I agree for home treatment.

But for cosmetic surgery abroad, I reckon making people pay insurance in case they need NHS surgery as a result of the overseas surgery, it can actually help promote how good and valuable the NHS is.

@SydneySage accident physio is going to have to be nhs unless you have decent travel health insurance that will pay for extended costs.
How would you deal with the situation - do you think travel and private surgery overseas type insurance should be mandatory or that the NHS should try to continue seeing all patients?

HNRTT but you might want to think beyond the 'NHS putting things right' and your 'correction' mindset. Not to say things don't go wrong for NHS treatment but some of the patients I've seen who have overseas elective surgery will never have botched operations 'put right', just had their lives saved, and for surgery botched in ways I've never seen in the UK.