Mary Dejevsky: Removing faulty breast implants is imperative – but not at our expense

Notebook

It's going to happen; just a question of when. I give it a week. Breast implants (or rather the removal thereof) will stop being an issue, and become a feminist issue. We'll hear about the inalienable right of every woman not just to improve herself in whatever way she sees fit, but to have the enhancement undone and the "procedure" underwritten by you, me, patients everywhere deprived of the latest drugs because the budget has run out, and the housebound forced to wait for new hips because the operating theatres are clogged.

Of course women with implants are worried; of course they want to know whether their implants came from PIP. Of course they want them out. But 90 per cent – that is nine zero, nine out of 10 – of implant operations in the UK are entered into voluntarily and privately, not for post-cancer reconstruction. You can be puritanical and condemn the number of such operations as reflecting vanity and social pressure. Or you can be sympathetic and argue that aesthetic enhancement has always been the way of the world and women should be free to spend their own money in whatever way they wish.

Whatever your view, though, it does not, and should not, follow that the rest of us have to pick up the tab when something goes wrong. The obvious recourse is probably closed. The company no longer exists, and the claims against it will be so high as to make it unrealistic to expect any recompense. Next stop: the surgeons who were using PIP implants because they were so much cheaper than other people's. If their clinics kept records and discovered, or could have discovered, that the failure rate was worse than with other brands, they have a case to answer.

If not, however, you can choose to blame inadequate regulation – always remembering that the opposite is the "nanny state" – the "cowboys" who flourish in this sector, or the women's heedlessness of the risks. And if it's regulatory failure you plump for, you should know that it wasn't the supposedly anti-women bias of the Coalition's cuts, but the last Labour government that halted funding for a national breast implant register.

I offer two suggestions, aside from – obviously – compulsory registration of all clinics. Legitimate cosmetic surgeons should set up a fund to help women pay for the removal of PIP implants; the NHS should not have to pay. And all those who go under the knife voluntarily, as well as their surgeons, should have to be privately insured. If you can afford £4,000 for implants, you can afford another £100 or so to insure against any risk that comes along. And if you don't, well, you're on your own.

A parting gift from 'The Iron Lady'

As – so it seems to me – the only woman newspaper writer not invited either to meet Meryl Streep in someone's kitchen or even to see a preview of The Iron Lady, I'm feeling a bit left out. But at least no one can accuse me of being suborned into plugging a film before the paying public has seen it. In fact, my advance response has little to do either with the supposedly "stellar" performance of Streep or the much-lauded directing of Phyllida Lloyd. (I'll judge that, thank you very much.) It is rather: what a damnably fortunate politician David Cameron is.

The soft-leftishness of many reviews so far means that compliments are generally coupled with fearsome warnings against romanticising the Thatcher years and ignoring the suffering – as though she was some sort of Eastern-Bloc dictator. I'm betting that what this film will unleash is a wave of nostalgia – for the lady herself, for strong leadership, for saying it like it is, for sticking to your principles, for not having your policies watered down by focus groups, for tough love and the best of British. All this gives Cameron the chance of his premiership. All he needs now is a worthy vision, quick.

m.dejevsky@independent.co.uk