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?

Ours in the NHS hospital board disappear too at this time.

The crash team does not disappear overnight in my experience. And there are doctors on site 24hrs a day in A&E, as a minimum.

No that's a sleeve where half the stomach is removed.. I've had a bypass and my stomach is still there, albeit redundant 😊

If they sued tobacco companies, they'd probably also have to sue organisations like the (nationalised) Coal Board (as it was back then) over miner's lung.

Exactly. Asurgeon who isn't after your money will give honest and safe advice on this.

Whereas a surgeon who knows that they won't get your money unless they clear you to fly a week or so after an op... well they have a significant conflict of interest!

Obesity is a risk factor for DVT on its own. If you are having bariatric surgery, your risk of DVT is even more elevated over the following weeks than it would be a non-bariatric patient.

Skiers, definitely! That's what winter sports insurance is for! I think you'd be mad not to get it.

My friend ski injury Three years was her recovery time you need damned good insurance for that

www.hcahealthcare.co.uk/our-services/specialties/intensive-care-medicine

these hospitals amongst others have private ICU so it’s nonsense to say that none of them have it

www.circlehealthgroup.co.uk/hospitals/the-clementine-churchill-hospital/private-critical-care-harrow

clevelandcliniclondon.uk/clinical-institutes/critical-care-anaesthesia/critical-care

stanthonys.org.uk/our-services/critical-care-services

www.spirehealthcare.com/spire-manchester-hospital/patient-information/critical-care-unit/

www.nuffieldhealth.com/hospitals/leeds/about-us

plus Bristol Spire

a range across the country and there are more. Not loads but not a blanket none.

I don’t believe that in an acute NHS hospital you have no doctors and no crash team overnight.

Board members and managers? Sure. They do 9-5 (ish) but clinicians? Nah. Consultants may not be on duty overnight except maybe in ED, CCU and ITU but there will be a fair covering of doctors.

When I worked private it was literally just a handful of nurses overnight.

I travelled to Turkey for extensive surgery very recently
The work I had done would have been 30k ish in the UK 9k in Turkey
I lost around 8st by myself, no NHS weight loss surgery.
The care I received in Turkey was excellent.
I stayed longer than needed in Turkey incase of serious complications.
On my return to the UK I picked up an infection in one of the wounds, I had antibiotics prescribed by the Turkish surgeon ready to take.
This infection wasn't caught in turkey, it was just one of those things that happened
My practice nurse had to apply a dressing 2/3 times
She said that the cost to the NHS would have been more if I'd cut myself cooking ( the wound needing stitches etc) and needed antibiotics prescribing by the NHS.

I have a long term illness which if it was diabetes or epilepsy would entitle me to free prescriptions for life,my illness doesn't and it requires a lot of medication and a lot of prescription charges which I pay.
My mental health has improved massively which is another saving to the NHS.
The cost to the NHS of the surgery i had done in Turkey is minimal but I would be classed as a surgery tourist.
I did feel guilty about going to my GP surgery but I weighed it up in my head and I've saved the NHS money by paying privately in Turkey

I have no idea where you worked privately, but I wouldn’t say it is representative of the private hospital system? Ours has ICU, HDU a crash team and doctors available 24/7. Is be surprised at a hospital being able to do surgery of any complexity without it?

Large hospital in the south. Did lots of elective surgery. No HDU let alone ITU. No docs after about 5 or 6. I was gobsmacked to discover I was effectively alone with a number of post op patients overnight.

As I said though this was a long time ago, I’d hope it’s better now.

Care to back that up w some stats @Ylvamoon?

Skiers and other travellers should have insurance anyway, wouldn’t be too hard to say that insurance also has to cover medical care, say up to a maximum of £50, 000, that they might need after repatriation following an accident abroad. It would cover most injuries and would mitigate some of the cost of injuries needing longer care.

An ACL injury (ski injury) will be patched up abroad and enough aid given to get on a plane. But you won’t be getting your repair in Zurich with your travel insurance. That’ll be on the NHS.

How does that work for going abroad for surgery? Surely someone doesnt stay out there for 6 weeks?

How does that work for going abroad for surgery? Surely someone doesnt stay out there for 6 weeks?

That's what I was wondering. And I had to wear compression socks and take blood thinners for a month, even without the flying part.

Because after a hip replacement you are not very mobile and therefore at even greater risk of DVT.

I feel similar.

I've recently had upper limb surgery (so I was mobile afterwards) and my surgeon still strongly advised me to cancel a flight I had planned (which I did).

He said that even though I'm very low risk for DVT to start with (lifestyle, weight, general good health etc.) general anaesthetic substantially increases the DVT risk for 4-6 weeks. He also said that he was the least conservative of his surgical colleagues in terms of the amount of time he advises to wait before flying.

A bariatric patient will be higher risk for DVT by virtue of their weight, and yet overseas clinics are happy to take their money in the knowledge that they'll be flying a week or so later.

A lot of overseas clinics say on their website that flying is fine shortly after the op.

Of course, they have a financial interest in saying that, don't they?

Very, very few of our private hospitals have critical care facilities. A few nearly have a level 2 HDU but it's not whatvthd NHS would recognise as HDU.
Most have an SLA for transfer in case of any incident - it's enacted by dialling 999.
Most have one foreign trained (often South African or NZ) junior doctor covering the hospital for all patients for all reactive care. They generally work one week on, one week off.
A few bigger cities do have bigger private hospitals with critical care but they are not the norm. Most critical cares in the private sector lack the expertise of the NHS critical care teams because they are tiny.

The ethos of the NHS is that the care is free at the point of delivery regardless of who you are and what your circumstances. We do not question why you are ill be it botched surgery abroad, a smoking related illness age or sheer bad luck. This is how it should be, it doesn’t matter what we might be thinking privately, if we stop treating people on presentation without question, then I’m out of it I’m pretty sure the vast majority of my colleagues would feel the same. We are not employed to play judge and jury over he individual we can of course advise at a later date.

Just commenting on the lady who wrote about breast reduction - completely agree, I tried to get the surgery done by NHS but impossible, G cup, breasts only got bigger after menopause and more unmanageable.

I’ve now had a reduction for which I paid 7, 500 euros for in Spain.

perhaps if the nhs was more thorough when vetting people who come on holiday to the uk and use our nhs service and pay nothing many with serious existing health conditions and having expensive surgery which the fees are just written off - when any person from abroad enters the country it should be compulsory for them to take out heath insurance.l i think students from abroad do pay a fee of about £100 or less if they need health care (about the price of 2 blood tests)
per annum.

the nhs cannot realistically fund all this free health care. the nhs do not feel that they should have any part of the financial recovery

as for going abroad for surgery why does everyone think the uk is the only place where there is good health care. americans and canadians together with the irish flock to lithuania for joint replacements - they have top doctors and state of the art hospitals - the same all over europe - in fact some of these hospitals have far superior standards. further afield bangalore in india has the top professors and state of the art hospitals which cannot be bettered. ok if there are any problems when you get home mistakes are made here with the nhs and you have paid your taxes and in fact are paying twice - once privately and then again in the uk and are entitled to be treated.

lh