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?

There are frequent cases of ladies choosing to give birth privately. Then complications occur and the private hospital is not equipped to deal with it.

They are then transferred to the NHS.

Bariatric surgery frequently IS life-saving, yet despite whatever % of the population is obese class II/III+ - my health board offer just 2 NHS surgeries per year. that’s a lot of people not being helped.

I know a lot of people that have been to Turkey for gastric surgery. I'm in groups on fb as well. I don't know any that have had serious side effects /infections that have had to be treated here. I think with reputable surgeons etc the rate of failure is quite low, both in the uk and in Turkey. But in Turkey there may possibly be more opportunists, and customers that don't research thoroughly and simply go for the cheapest etc instead of actually shopping around, reading reviews etc.

But

If 100 people go to Turkey for essential surgery and 1-2 have complications, the NHS has still saved £££££ from not having to operate on those other 98 Patients.

I do quite like the idea of having a verified range of surgeons and hospitals that are approved by both Turkish and Uk health experts. With a good range of insurance policies to cover for any issues. I can even imagine a future where is easier for the NHS to shop patients over to Turkey and outsource the treatment and care for 1/3 of the price of it being in the uk.

My dad and his wife lived in Turkey for 11 years. She was diagnosed with a terminal illness within 3 days of going to see the Dr. They couldn't fault the system over there, they raged about it. How easy it was, how quick. Hardly any waiting lists and low prices.

What I am saying is that there's not much difference between someone having surgery abroad and someone skiing abroad

the risk level is similar, but why would we not be ok with someone returning from surgery, but we are ok with someone returning from skiing

Or smokers illnesses, alcohol accidents, mostly self inflicted to a degree

I disagree with part of that statement. You'll find a lot of private hospitals have very knowledgeable and experienced staff. A lot were once in the NHS at various points in their careers. They often do have better equipment and instruments too it just depends where you go. In terms of hdu and icu's my feeling is its just not profitable to have potentially long term patients in there.

@bellac11 perhaps have a look at Semaglutide. Worth considering trying that privately if you can’t get on the NHS before weight loss surgery.

the risk level is similar, but why would we not be ok with someone returning from surgery, but we are ok with someone returning from skiing

Skiing accidents fall in a different category for me than cosmetic surgery, some of which may be to solve a genuine medical issue (such as a breast reduction) but others are for vanity purposes. In which case you've actively chosen elective surgery, a skier hasn't.

I'm not entirely sure the NHS should fund excessive skin removal due to weight loss either. The challenge is that there isn't enough money to fund everything so something has to give. Is it non-essential cosmetic surgery or cancer drugs? My father is on essential heart medication which the NHS is reviewing the funding of due to their need to reduce expenditure. Where do you draw the line of necessary v nice to have?

most people have paid into the system through the years, and if things go wrong, they deserve to have help from the NHS. They are not queue jumping, they are ill.

This happens constantly within the UK. Private hospitals are set up for fit and well people without social concerns to elect to have a surgery. If something goes wrong some have an HDU but it's not like NHS HDU, there is no ICU. If there is any complications they will be transferred to the NHS hospital often under the same surgeon who has completed the op, especially in small cities. Its a nice environment, lovely food, comfier linens and private rooms and there is obviously the massive benefit of having the op done within a reasonable time frame. However that scene at the end of this is going to hurt is worryingly possible, thankfully doesn't happen often because people have preops and mostly fit and well with few comorbidies and they have a low threshold to transfer. But that means that the staff are potentially less ready to deal with the more complex situations that can arise.

The patient presenting with surgical complications is unwell and requires treatment, just as anyone who has weight related comorbidities would be treated, non compliant with meds would be treated, patients who use IV drugs would be treated etc etc etc.

@SydneySage you make a good point. I don’t pretend to have any answers but I personally think it’s a conversation that we should be having.
I do think the NHS cannot continue finding what it is supposed to be funding unless the Government increases the spend on this as the health and social care levy has been withdrawn.
There have to be lines, the question is where? IVF? Smokers? Etc. should everybody be on the cheapest version (generic) of drugs? Do patients on more expensive drugs get switched to similar drugs - there are lots of different drugs for hypotension, asthma etc so not just switching between branded and generic. GPs used to do this periodically.
I am more worried about possible NHS cuts - budget is a week away.

So, yet another one of the considerations people fail to consider when demanding the abolition of the NHS.

At the moment the private hospitals seem to be able to say 'not our problem' if somebodies knee replacement gets infected, or their hip dislocated a week post op, likewise can reject you if you carry MRSA or need an HDU bed post op due to comorbidities or being too high risk.

The NHS picks up the pieces for all this, and guess what? It costs a fuckton of money to resource for complex and unplanned care compared to routine elective.

If the NHS was gone, I reckon the cost of private would double or triple in order to provide the care they shirk at the moment.

In answer to the OPs question, yes the NHS should pick up the cost for complications from abroad, because they already do for the private hospitals in the UK and there's no moral or ethical difference if the surgery was done in the Spire, or in Spain.

Do patients on more expensive drugs get switched to similar drugs - there are lots of different drugs for hypotension, asthma etc so not just switching between branded and generic. GPs used to do this periodically.

They still do.

My daughter has to argue at least once a year (backed up by her specialist) when her narcolepsy prescription is changed to a generic, which inevitably means she gets a different one to her usual and it simply doesn’t work for her.

She’s pointed out numerous times the issue (it’s common with lots of narcoleptics), but it still happens repeatedly.

There’s no balancing of the overall costs. When she was changed originally we didn’t realise that was the issue. She went from being a full time student with a part time job and a fair bit of independence to struggling to even deal with her studies.

Currently she’s full time Uni, works part time and has been so stable that the DVLA would (if she applied) give her a driving license. If the change is ever made and she can’t get it back she fears she’ll end up on benefits barely able to function.

Is this provigil ? My doctor still prescribes that every month they haven't moved me to a generic. I drive and have a full time job there's hope !!! To be honest if they ever took it off me I would pay private as losing everything would definitely justify the cost.

I'm due to have a tummy tuck and lipo soon in the UK with a reputable surgeon at a private hospital. Cost £8500. Shop around. Don't go to Turkey!

Many are paying for private healthcare. Think physiotherapist, osteopath, chiropractor. Without this private service being available we'd have a lot more people with health complications.

Perhaps because of exchange rates . . . salaries in Turkey are not as high as the UK . . . everything is a lot less expensive there. Doesn't mean it's crap

If you didn't have to wait a decade for a gastric sleeve on the NHS - then . . .

There are lots of people who have OPs, procedures, treatment everyday privately so we can be grateful that it means the NHS queues are shorter and the NHS isn't more burdened.

A lot of these people pay taxes - why should they be denied treatment in the event that the OP didn't go well? And if it went well, then would we thank them?

Well in many cases the NHS is more burdened by botched surgeries done abroad. There was an article about a woman who got a gastric sleeve privately in Turkey and it was so botched that she ended up almost dying and spent 5 months in the ICU.

Any NHS savings from her getting her gastric sleeve surgery privately abroad was wiped out within the first 48hrs of ICU care!

I’m not sure the probability of a poor outcome is the same when comparing skiing to surgery abroad. I think a higher % of operations abroad result in near death or injury than skiing does tbh.

In addition surgery abroad is an unnecessary risk in the sense that the patient would avoid it if they knew about it. No one deliberately books a quack doctor who has killed patients. They’re taken in by unrealistically low prices and slick marketing. There is some safety and qualifications regulation urgently needed for these pop up clinics marketing surgery to foreign tourists from the UK and elsewhere.

Surely the number of women having to use the NHS to save their lives after surgery in Turkey gives you a good indication of why it’s cheaper there, no?

i've been abroad 3 times to have surgery, once to Belgium for a gastric band, once to the USA for a breast uplift and once to turkey to have my band removed and replaced with a gastric sleeve.

I did my research, the facilities were world class, no complications and i have been happy with the outcome especially form my op in Turkey. a year later and they are still in touch with me checking i'm fine. the aftercare has been amazing.

Turkey insisted i stay 5 days after my op to ensure as much as possible there were no complications and tbh with enough research you should be able to find a excellent surgeon and hospital. I am now considering a tummy tuck and would NEVER go to a UK surgeon

I went to turkey for bariatric surgery, it was £3500 compared to £10,000-£12,000 here in the uk. I did my research properly and i have lost a huge amount of weight with absolutely no complications. I don't know why people think that Turkey is some primitive country, the hospital was as well equipped, clean and luxurious as any private hospital in this country. The surgeon was a professor of bariatrics and lectures all over the world and I actually had more pre op tests done than would be done in the uk. I was sent home with extensive notes ( written in Turkish and English) to give to my gp and extensive aftercare instructions. My gp was actually really impressed with how through they were and happily agreed to do my 3 monthly bloods on the NHS because i had saved the NHS so much money on the surgery and future health problems caused by being overweight. I will definitely be going back there for plastics when i can afford it. I would say that the only downside is the pretty uncomfortable plane journey home after surgery!

There already is insurance for this www.medicaltravelshield.com

I’m really torn on this one. A Turkish surgeon (I’ve researched REALLY well) has quoted me a touch under £3k. Spire want £12.7.

I don’t WANT to be rushing home after surgery - but that £9k will buy me a LOT of extra nights in turkey.

I’ve had all my surgeries abroad simply because I was living there. American hospitals are NOT operating out of mud huts… and if other countries are SO shite (🙄) - why do we keep nicking their staff?

Most private hospitals in UK transfer patients who become unwell to NHS, particularly when critical care is needed.
Most private hospitals are set up for low risk elective surgery on well patients.

Bariatric surgery is high risk and not necessarily cosmetic - indeed live saving for some people. Generally high risk bariatric is done in NHS because of need for critical care and specialist anaesthetic support.