Where can I find NHS spending on cosmetic surgery details?

[Silent1]

I'm currently watching the hospital from the other night and it strikes me that none of these people should be given surgery for free.
It's not a disease or life threatening and it's not really a quality of life thing, if it's so bad why don't they pay?

[SuBo Wrestler]

What about psychological reasons?

[parakitaMol.]

I'll see if I can dig out the link I found for last 3 years spending.

If I remember correctly two of most significant costs were non-UK born births (labour ward tourism) and people who didn't turn up to appointments.

[parakitaMol.]

I can't find it as quick as I thought - but this gives a broad spend breakdown by area


Kings Fund Report - Breakdown

[Silent1]

parakitaMol. said:

I can't find it as quick as I thought - but this gives a broad spend breakdown by area


Kings Fund Report - Breakdown

Thanks very much

[TVR1]

saw this programme last night myself.....although I ended up having to switch over when 'Kylie?' was talking about how desperate she was to have an enhancement....something along the lines of...

'I'm so desperate to have the operation that I would do anything! Anything! When I talk to other people like,who want the operation I ask how much like, and what like, would they do? They wouldn't go as far as me so don't want it as much! Me like, I woul go so far as.............EATING A SPIDER!!!! No! I'd even eat a thousand, if it came to it!'

And also the classic line of 'They even give boob jobs to child killers like Maxin Carr' ermm....IIRC Maxine Carr wasn't.

Edited by TVR1 on Tuesday 10th August 19:03

[davepoth]

The NHS should only be funding cosmetic surgery when a psychologist has decided that the defect is causing the patient such a bad body image issue that it is making them ill. This would cover things like sex change operations, which are a very good example of the process.

[Tiggsy]

On was on a cosmetic surgery web site/forum doing some research for the other half - it was staggering how many young(ish) girls regarded the option of going to the GP and turning on the waterworks as a fairly standard first step in the "how do you, like, finance this stuff init"

[parakitaMol.]

I don't think it should be handed out to everyone on request but I do think that these emotive NHS spending stories have the power to divert people from other less overtly contentious but significantly larger drains on the resource.

I'd be interested to know the ratio of non-value cosmetic surgery to reasonable cosmetic surgery (birth deformity, reconstructive surgery after accidents or disease). And then how that entire area relates to other treatment costs - like obesity or alcohol. In order to get some real perspective on the matter.

I find myself more irritated at the widespread abuse of casualty departments as walk-in centres for minor ailments than what I would suspect is only a relatavely few people having needless cosmetic surgery.

[Silent1]

parakitaMol. said:

I find myself more irritated at the widespread abuse of casualty departments as walk-in centres for minor ailments than what I would suspect is only a relatavely few people having needless cosmetic surgery.

I'm annoyed equally by all of it, people who are born severely deformed deserve plastic surgery, cosmetic surgery for aesthetic reasons when there's really no need isn't something the NHS should fund. You don't see appeals for charities to go to china/india/a.n.other 3rd world country to perform breast augmentations do you, whereas they do for cleft palates etc.

It's far quicker to solve the cosmetic surgery cost than it is to retrain the mouthbreathers that an A&E isn't a doctors surgery,

[parakitaMol.]

Silent1 said:

parakitaMol. said:

I find myself more irritated at the widespread abuse of casualty departments as walk-in centres for minor ailments than what I would suspect is only a relatavely few people having needless cosmetic surgery.

I'm annoyed equally by all of it, people who are born severely deformed deserve plastic surgery, cosmetic surgery for aesthetic reasons when there's really no need isn't something the NHS should fund. You don't see appeals for charities to go to china/india/a.n.other 3rd world country to perform breast augmentations do you, whereas they do for cleft palates etc.

It's far quicker to solve the cosmetic surgery cost than it is to retrain the mouthbreathers that an A&E isn't a doctors surgery,

No, and I do agree with you, and its an apalling waste of resource, but I also think it's a bit of a red herring - because its such an obvious scandal, that's why I'd be interested to know the true extent - how many GPs really support a referral with no substance and how many consultants actually then agree - in relation to the genuine cases. That's the problem, even if you could find an accurate figure for reconstructive surgery on the NHS it won't be broken down into 'worthwhile' and 'non-worthwhile' cases. It seems if they can scrape a few 'shock' stories together for a TV show or Daily Mail article then we perceive it to be more widespread than it is.

P.S. I had my broken jaw and broken nose fixed on the NHS after a motorcycle accident and I'm glad it is available.

[Silent1]

parakitaMol. said:

P.S. I had my broken jaw and broken nose fixed on the NHS after a motorcycle accident and I'm glad it is available.

That's a valid use of resources though, you didn't walk in and say "my nose has a bump right here and it's making me want to kill myself, fix it now"

I know what you mean about the spending though, i'll be very suprised if there's a breakdown of reasons of why the surgery was given, as a best hope maybe they'll split cancer/disease reconstruction and psychological reasons.

[GordonL]

I had a chat with a couple of consultant plastic surgeons about this a few years ago.

They reckoned that a lot of the NHS cosmetic surgery was basically a very good teaching exercise for their junior staff. Basically a bit of practice for the junior staff doing (for example) a minor nose job was an ideal way to prepare them for a more complicated reconstruction for say a cancer patient.

Food for thought

[Silent1]

GordonL said:

I had a chat with a couple of consultant plastic surgeons about this a few years ago.

They reckoned that a lot of the NHS cosmetic surgery was basically a very good teaching exercise for their junior staff. Basically a bit of practice for the junior staff doing (for example) a minor nose job was an ideal way to prepare them for a more complicated reconstruction for say a cancer patient.

Food for thought

It's not being done by junior surgeons or surgeons in training, it's being done by senior surgeons and competing for theatre time with more deserving operations.

[mph1977]

Silent1 said:

It's not being done by junior surgeons or surgeons in training, it's being done by senior surgeons and competing for theatre time with more deserving operations.

theatre lists are use or lose - wasted theatre time costs money

as for 'not being done by juniors' surely that depends on how the 'firm' is run ...

[GordonL]

Interested how you would know that "senior" staff are doing the work?

My theatre lists for example, the theatre is booked in my name, I'm the named person on the patient logs etc but the bulk of the work on my list is nearly always done by my junior staff. I'm there but I don't usually get my hands dirty for the simpler stuff. So simply looking at the theatre logs you'd think that I was doing everything myself and I'm not...

[parakitaMol.]

Numerous procedures are carried out by junior doctors. That's how they learn.

My OH is a Doctor and I've heard lots of shocking stories from his time in hospital medicine, before and after qualifying.

Many many things are subjective. I guarantee if you saw a full list of treatments and procedures and also NHS support in other ways you'd find 1000 things that *you* deemed unneccessary. But others' don't, things that cost more and are more frequent.

I suspect this particular issue is no more than a handful of cases a year. Most GPs won't refer for no reason, then most consultants won't progress for no reason. As for those GPs and Doctors who do collude to 'waste' resources, they are the ones who should be held accountable?


Charles Tannock

BBC

Times

Standard

Standard said:

Health trusts have written off around £5 million a year of unpaid bills run up by overseas residents. In one case, a patient had 18 unpaid invoices for at least five treatments.

Telegraph

Telegraph 2010 said:

Patients who miss hospital appointments are costing the NHS more than £600 million a year.

Whilst I don't applaud any 'waste', I really think this particular issue is a drop in the ocean as the numbers are miniscule compared to all the other abuse of the system that goes on - Health tourism and missed appointments being only two - don't get me started on the tossers who turn up at A&E departments so they don't have to take time off work in the week to see their GP.

Did that TV show give any figures?

[mph1977]

GordonL said:

Interested how you would know that "senior" staff are doing the work?

My theatre lists for example, the theatre is booked in my name, I'm the named person on the patient logs etc but the bulk of the work on my list is nearly always done by my junior staff. I'm there but I don't usually get my hands dirty for the simpler stuff. So simply looking at the theatre logs you'd think that I was doing everything myself and I'm not...

when i worked in theatres we'd joke about the position of 'circulating surgeon' for a Consultant who was present in the theatre but not scrubbed because the Reg and and the SHO/ HO were actually operating ...

we did also have 'Reg lists' which were nominally the 'property' of a Consultant but were only listed with cases that the more competent/ senior SpRs could do with either a junior doc or ASP as an assistant...

[thepeoplespal]

BY A LEAST TWO PHers said:

I suspect this particular issue is no more than a handful of cases a year. Most GPs won't refer for no reason, then most consultants won't progress for no reason. As for those GPs and Doctors who do collude to 'waste' resources, they are the ones who should be held accountable?


Telegraph

Telegraph 2010 said:

Patients who miss hospital appointments are costing the NHS more than £600 million a year.

Whilst I don't applaud any 'waste', I really think this particular issue is a drop in the ocean as the numbers are miniscule compared to all the other abuse of the system that goes on - Health tourism and missed appointments being only two - don't get me started on the tossers who turn up at A&E departments so they don't have to take time off work in the week to see their GP.

If anyone knew the ballache required to get funding for a "cosmetic procedure" it is not a process that is undertaken lightly by any GP. The only cosmetic procedure we have asked for funding recently was a nose job to fix damage from a previous RTA a few years ago, I'd say it was more than justified, but it is still classed as cosmetic.

As for missed appointments I'd definitely introduce charges as resources have been wasted and I'd introduce a system of more through eligibility checks for patients without a NHS number, as practices get conflicting information as to eligibility. I've known Practices get bked for rejecting a patient without valid documentation, which makes it logical to get disheartened and just accept people who may not be eligible for NHS care.