The current news about PIP, the now-defunct silicone breast implant manufacturer who came up with the brilliant wheeze to use cheap industrial silicone in its implants, raises interesting questions about the relationship between private and NHS medicine.
30,000 French women will have their balloons removed, but the DoH is reassuring UK recipients that there is nothing to worry about, even though it seems the PIP device is more prone to rupture, which will present the immune system with a challenge.
There is an association of 7-8 cancer cases with the PIP , including one rare Anaplastic Large Cell Lymphoma. It will take many more cases of cancer and illness to develop before the probabilities of a causative relationship becomes accepted by the academics. Studies of the carcinogenic potential of the contaminants will be needed, and all studies will cost much money. They should be funded by the insurance services of the private cosmetic surgery industry - but it would be naive to expect that will happen.
The French are using the precautionary principle, and the UK is using the HITS (Head in the Sand) principle.
In the end, I predict that it will be advised that all the PIP prostheses will be ordered to be removed.
But who will pick up the bill?
Removal costs are about £2000, and replacement £5000. Most were put in at private expense. Removal and replacement should therefore be at private expense. But one woman said: "I was constantly unwell and the implants lost shape," she said. "They looked deformed. I went back to the clinic but they told me I would have to get the NHS to clean up the mess."
This is clearly the line that the cosmetic surgery industry and their insurers will be lobbying for. The Tories, when they have finished being in denial, will probably agree to the NHS doing the remediation work free of charge, in line with their policy of dumping on the NHS while promoting and supporting private medicine.
See also: My book Bills of Health, which showed that about 20% of NHS clinical work is devoted to treating illness caused by unemployment, poverty, bad housing and pollution.