UK Health Secretary Andrew Lansley has been walking a tightrope in dealing with the scare over breast implants. The medical evidence on the dangers of the PIP implants is ambiguous, and Lansley is justifiably anxious to avoid spending scarce NHS resources on unnecessary removal of the prostheses. At the same time, he dare not put lives at risk by refusing NHS treatment to those who need it: the health service is, after all, not judgemental about treating smokers, who put their lives at risk despite unequivocal medical evidence as to the dangers of their habit.
Lansley's current stance is that the NHS will remove implants free of charge from any woman who received them from the state in the first place, in most cases as part of reconstructive surgery. He is urging private providers to do the same thing, and a gratifying number have already agreed to do so. Still, some of the less scrupulous clinics are likely to refuse, and there appears to be a good number that have vanished without trace. It seems inevitable that the NHS will have to offer removal to anxious women who are left high and dry in this way.
That won't please everyone. Step forward, for example, Cristina Odone, who took a very tough line in her blog in the Daily Telegraph. Ms Odone trumpets her Catholic faith loudly to all who will listen -- she used to edit the Catholic Herald -- but it seems to have gone AWOL on this occasion. Judge not lest ye be judged yourself, Cristina: are you quite sure there's nothing in your own lifestyle that some fastidious doctor might, some day, see as a reason to deny you treatment?
And yet....some of the women appearing on TV to demand the removal of cosmetic implants on the NHS are not doing themselves any favours. Most of them are claiming they cannot afford to pay for the procedure, or would have to take out a loan in order to do so. So how did they pay for the implants in the first place? And if they were willing to take out a loan, or to scrimp and save, in order to satisfy their vanity by getting the wretched things inserted, why are they not prepared to do the same thing in order to safeguard their health by having them removed?
The question that Andrew Lansley and his civil servants have to answer for the longer term is how to prevent this sort of thing from happening again. A number of media columnists, mostly women, are expressing the hope that this scare will deter future generations of women from messing with nature, whether through implants or botox treatments or whatever. Good luck with that. Others are suggesting that the Government needs to impose standards on the industry, and maybe even make it mandatory for women who have frivolous cosmetic procedures such as implants to take out insurance against the cost of their removal. Good luck with that too.
What we should really hope is that this whole sorry tale will make the government think again about whether and how it gets more private money into the NHS. Private money will always gravitate towards the more expensive, luxury end of the business, because that's where the money is to be made. You don't see many ads in the tabloids for private procedures to deal with haemorrhoids or ingrowing toenails. And as we are all now discovering, the private practitioners are quick to scoop the profits, but rather less prompt to step up when things go wrong.
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