DUNCAN BARKES Should taxpayers shell out for failed boob jobs?

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Some 40,000 women in Britain have had faulty breast implants. These implants contain silicon better suited to double-glazing seals and patients have been advised to have them removed. Most private clinics have agreed to do this at no cost, but some are refusing or are no longer in business. In these cases the NHS has said it will carry out the procedure, but should it?

The NHS is marvellous, but can it still afford to be an all-encompassing safety valve? I am not suggesting it should be privatised, but we need a rational conversation about what it should cover.

In the case of these dodgy breast implants, an argument can be made that the private patient should pick up the tab for their removal. Although there are of course the cases of reconstructive surgery following mastectomy, which is a different matter, most breast enlargement procedures are vanity surgery.

But if someone has paid several thousand pounds for a ‘boob-job’ and the silicon was iffy and their clinic has gone bankrupt, or is refusing to carry out the removal operation for free then, as tough as it is, I don’t think it unreasonable to expect the patient to pay. Why should the taxpayer pick up the tab?

The role of the NHS may already be changing. GPs in Hertfordshire are now refusing to sanction joint operations for obese patients unless they lose weight.

If you follow this line of thinking then one could ask why the NHS should treat people with conditions or diseases caused by excessive smoking and drinking.

Aneurin Bevan set up the NHS in 1948 on some solid socialist principles. But our country is a very different place now.

We have a bigger population than ever before. Thanks to some significant medical advances that have led to the development of some amazing (but often costly) drugs and treatments, people are living for longer. I cannot see how the NHS can continue to provide the level of service that it does.

Why should it treat someone who has cirrhosis of the liver because they have drunk to excess every day for 20 years, despite repeated warnings? Why should it fund an operation to pin back somebody’s ears when the condition is hardly life-threatening?

I am a great supporter of the NHS and I want it to still be around long after I have popped my clogs. But as with any brilliant idea, it has to evolve.

If Bevan’s brilliant institution is to survive, then some difficult decisions need to be made.

I’m very sorry for any lady who has these implants, but the cost of their removal should not fall to anyone other than the clinic responsible.

If the clinic can’t or won’t, then regrettably the lady herself must foot the bill.