Volume 1

The regulation of private and other independent healthcare : fifth report / Health Committee.

  • Great Britain. Parliament. House of Commons. Health Committee.
Date:
1999
Catalogue details

Licence: Open Government Licence

Credit: The regulation of private and other independent healthcare : fifth report / Health Committee. Source: Wellcome Collection.

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    Information to consumers 56. Advertising clearly plays a considerable part in persuading men and women to consider undergoing cosmetic surgery and other similar treatments. Those individuals are then placed in environments which lack many of the safeguards patients might find elsewhere in the NHS and in the independent sector. They are nearly always self-funded so there is no medical insurer offering some degree of oversight of activities. They are often self-referred, so there is no GP advising them on where to go for treatment, or indeed on the appropriateness of treatment. On arrival at the clinic, or in preliminary telephone discussions, they are often interviewed by medically-unqualified sales consultants, who may be acting on commission. 57. It is standard practice for those seeking cosmetic surgery to pay in full for their treatment in advance. According to Mr Braham of Harley Medical Group this is because the procedures are elective and the results are “very subjective”.'” Elsewhere the British Association of Cosmetic Surgeons (BACS), in a different context, describes the outcomes of cosmetic surgery as “highly predictable”.'“ This apparent contradiction can be explained. The BACS memorandum describes the operation in terms of the pathology it generates; the Harley Medical Group refer to the operation from the viewpoint of the client who has undergone an operation designed to boost their self-esteem by changing their appearance. Nevertheless in many cases there does appear to be a gap between patients’ expectations of what surgery can achieve and the final outcome of the surgery. 58. We believe that it is important that this gap is bridged. The issue boils down to one of informed choice and informed consent. The Consumers’ Association point out that “the vulnerability of patients using independent and private health care services is heightened by the dual ‘clinical and commercial’ function of the provider and the lack of independent and objective information available”.'” The Report of the Independent Review Group established by the Government to investigate the application of UK law in respect of consent to medical treatment by women undergoing surgery for breast augmentation similarly concluded: “some women are placed under considerable sales pressure especially at cosmetic clinics. It appears that frequently too little time is devoted to counselling of patients and that advice is inadequate as a basis for consent ... [we] heard that some women do not even tell their families that they are intending to have breast augmentation surgery, and prefer not to seek referral through General Practitioners. This makes such women particularly vulnerable to high pressure sales techniques ... It is essential that women have the opportunity to make informed decisions about their treatment to enable them to assess the risks and benefits of silicone gel breast implants in the light of realistic information which is factually accurate about the operation and about the implants themselves.”!° 59. One of the measures that the Independent Review Group suggested to improve consumer awareness was the provision of information to consumers in the form of standard leaflets, uniform throughout the NHS and independent sector.'*’ It is our view that much of the information on cosmetic surgery being provided to consumers by clinics is subjective and compromised by the commercial imperative underlying its production. It is time the balance was redressed. We recommend that the Government requires providers of cosmetic surgery and similar related disciplines to provide information as to the efficacy and effectiveness of treatments offered following guidelines set out by the Department. The regulator of the independent sector should assess the accuracy of this information in determining whether or not to grant a licence. We recommend that it be mandatory that providers of such services should distribute such information. We suggest that these information packs should strongly urge consumers to contact their General Practitioner before undergoing medical and surgical treatment and should suggest questions for consumers to ask when 103 104 105 106 107 Q698. Ev., p433. Ev., p33. Silicone Gel Breast Implants: the Report of the Independent Review Group, 1998, para 5.2.5. Ibid, para 5.2.7. The Government have not yet responded to this proposal.