Earlier today, the UK government issued its formal response to Sir Bruce Keogh’s recommendations, made as part of an investigation into practices of both surgical and non-surgical cosmetics procedures.
While much of what is written attempts to be positive and a tiny step in the right direction, judging by the response across social media, news outlets and professional bodies, I’m not the only one who feels underwhelmed by what has been published.
Having referred to the cosmetic surgery industry — particularly with regard to the use of dermal filler products — as a ‘crisis waiting to happen’, Sir Keogh had argued for tougher regulation of the industry to prevent a world in which so-called ‘cowboys’ were free to roam.
However, the government’s response is weak in comparison and, as the British Association of Aesthetic Plastic Surgeons (BAAPS) says, allows a situation in which ‘business as usual’ continues.
‘Frankly, we are no less than appalled at the lack of action taken — this review, not the first one conducted into the sector — represents yet another thoroughly wasted opportunity to ensure patient safety,’ said Rajiv Grover, BAAPS President and consultant plastic surgeon.
Much of the outrage at the response lies with the decision not to reclassify dermal fillers as medicines, not to set up a compulsory register, and that there is no requirement for the surgeon involved to provide consent for the procedure.
While injectable anti-ageing treatments will no longer be allowed to be administered by untrained workers, and that those wishing to provide such treatments will have to undergo specific training, there is no detail as to what this specific training should be or encompass, or indeed, what the prerequisites for training would be.
Essentially, therefore, could anyone access a course without the necessary prior medical knowledge of human anatomy and be ‘qualified’ to administer such treatments? The Health Education England’s review of training and qualifications is due to be published in April.
Could anyone still be able to purchase, and administer, a dermal filler product? They haven’t been reclassified, as the UK government awaits an EU-level decision on this (proposals were published in September 2012).
And without the relevant consent structures in place, what else is there to protect both patients and practitioners?
‘The fact that there is no requirement for the actual surgeon involved to provide consent for the procedure makes a mockery of the entire process. It’s business as usual in the Wild West and the message from the Government is clear: roll up and feel free to have a stab,’ said Mr Grover.
It seems that the entire response of the government has been an after-thought and tantamount to lip service.
While Dr Dan Poulton, UK Parliamentary Under-Secretary of State for Health, introduces the report with bold facts that the industry is estimated to be worth £3.6 billion in 2015 (€4.4 billion); that cosmetic interventions are now the norm and available on many high streets; and that non-surgical procedures account for 75% of the total market, what we’ve been given is a response which provides no real objectives for change and improvement.
We’ve been told to ‘wait and see’ while the government passes the buck to other bodies to deal with. If the entire exercise has been in response to the PIP breast implant crisis — which technically started in 2006 when surgeons raised concerns with the UK Medicines and Healthcare products Regulatory Agency (MHRA) — I suspect we will still be waiting for a very long time before any real, positive change is affected.
We’d love to hear your thoughts on the government’s response to the Keogh Review — add them below!