Breast implant scandal exposes private healthcare

Keep private vultures out of our NHS!

March to save the NHS 17 May 2011, photo Paul Mattsson (Click to enlarge)

The Health and Social Care Bill, currently working its way through Parliament, is a huge threat to our NHS. The government is trying to sneak through privatisation under the guise of 'reform'. All the big business parties agree that 'the market' can help run our public services efficiently. But we've seen countless examples of the devastating effect of handing these services over to private companies who only care about making profit. The latest is the scandal over PIP breast implants.

Sue Powell

One blog on the PIP breast implant scandal read: "How many people realise, when you entrust your health to a private clinic you have less consumer protection than if you bought a used car?"

Some people think women should pay for their 'bad lifestyle choice' but the NHS should not discriminate - this is how private medical insurance works - denying help to alcoholics, smokers, drug addicts, the obese, people who engage in 'dangerous' activities (which potentially could include occupational risks) or have health problems.

The scandal over PIP breast implants has wide implications and affects a staggering 300,000-400,000 women in 65 countries. The Con-Dem government has shown callous disregard towards the 40,000 British women who have PIP breast implants (Poly Implant Prothese).

Last week, some of them, carrying placards reading "Health Before Wealth" and "Toxic Time Bombs", protested outside the Harley Medical Group (HMG). HMG, like other clinics, refuses to pay for the routine removal of PIP implants.

Women were told to approach their clinics but many calls were unanswered. Some clinics declared bankruptcy (opening later under another name). HMG's chair, Mel Braham, who advised the Labour government on industry regulation and standards, even thinks the whole thing is a conspiracy engineered by competitors.

The four biggest clinics, including HMG and Transform (turnover last year of £36.2m) are implicated in the majority of the 40,000 operations using PIP implants. Scandalously, HMG claims its clinics do not have the resources or time to cope with the 'panic' of its patients. It wants the NHS to do the ops, while HMG would pay for new implants - but demands a government loan to do so.

UK health secretary Lansley, after issuing several conflicting statements, agrees with the clinics that routine removal of implants is not medically indicated, but now says the NHS would pay to remove, but not replace, implants (although the Welsh Government has promised to do so in Wales). Replacing implants is not a cosmetic exercise: there are health implications and this policy will cause further distress and expense to the NHS.

But it is not all bad news for business: Now PIP is bankrupt, no-win, no-fee lawyers are eagerly touting for clients online. MyBreast, MyFace, MyBody has identified an opportunity, stating it has never used the French implants, will offer free consultation and can help women with PIP implants.

The case for fighting Lansley's NHS reforms and the need for public ownership and control of all areas of medical practice, including the pharmaceutical and medical device industries, has surely never been stronger.

PIP scandal

How could PIP get away with selling implants made from industrial grade silicone used in mattresses and computers? The company already had a bad name - its products were banned by US authorities (the FDA) in 2000. UK patients sued successfully after the Medicines and Healthcare products Regulatory Agency (MHRA) identified inadequacies in the biological safety of its production of hydrogel implants (although the insurance companies have not paid up).

Warnings about PIP silicone implants began circulating in France and Britain three years ago. PIP implants were the cheapest available: they had no protective coating and the silicone used was ten times cheaper than medical grade silicone.

This is not the first scandal involving private practice and the next "toxic time bomb" - artificial face implants - is already ticking. With over 60,000 people receiving cosmetic surgery in Britain every year, cosmetic surgery is big business.

But cosmetic surgery is not just about vanity: its development as a major branch of medicine began with pioneering treatment of horrific and debilitating injuries sustained by soldiers and airmen during the two world wars.

Reconstructive surgery is vital to cancer patients, burns and trauma victims, but this work is mainly confined to the NHS.

The proliferation of private practice reflects a media-driven obsession with body image. Massive industry expansion did not lead to more stringent licensing and control - quite the opposite. Clinics do not even have adequate insurance. As increasing numbers of teenagers opt for cosmetic surgery, some clinics are offering underage clients payment plans. It is unlikely they will they be as eager to help when the estimated 20% of their clients need corrective surgery.

The whole story reveals some ugly aspects of private medicine and the medical devices industry. With worldwide sales exceeding $300 billion in 2011, competition in the medical devices industry is fierce. There are 18,000 companies in Europe alone, hence the massive pressure to 'cut costs'.

Last year, artificial hip joints sold by Johnson & Johnson were withdrawn because metal, rather than plastic and metal had been used in their manufacture. Patients experienced severe pain and toxic metal deposits in the blood - many thousands will have to undergo corrective surgery. In 1983 one US study found that 20% of pacemakers implanted were medically unnecessary. One patient endured six ops and paid $60,000 only to be told her heart was healthy. This is what marketisation of health care means.

Medical devices such as breast implants, artificial hip joints, facial fillers and pacemakers are not subject to the same stringent controls as apply to drugs.

Manufacturers do not have to prove safety on the basis of clinical trials. GPs and surgeons are required to report problems, but the lack of a national register of implants makes it difficult to track problems. Ruptures are often due to accidents which might not be linked to product quality and leaking implants do not always cause immediate symptoms. UK clinics were not obliged to divulge information on sourcing and many still refuse to do so.

None of this explains why no action was taken. Back in 2010 the Hospital Group and Healthcare UK were offering free consultations to concerned patients with PIP implants. Even after PIP products were banned, they were sold in Holland under a different name. Private practice makes a mockery of the physician's oath "to do no harm" and replaces it with "greed is good".

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