E Jane Dickson: Fake breasts and public health – a perfect storm

The breasts muddle is just a snapshot of what we can expect with the Health Bill and its muddle of provision

Related Topics

What is it about breasts that stop us thinking straight? We could go down the earnest Freudian route or we could cut to the wisdom of Hedy Lamarr. "Men," said the fabulously upholstered Hollywood siren, "have only two interests, money and breasts." Viewed in this light, the current political imbroglio over the financing of bigger breasts is pretty much the perfect storm.

This week, the Department of Health ruled that while the NHS will remove the dodgy PIP implants from patients who had their breasts enlarged privately, it will not provide replacement implants in the course of the same operation. The decision rests on the founding principle of the NHS that private and public medicine should remain separate. The fact that, for years, private procedures have been carried out in NHS hospitals rather knocks the stuffing out of the principle. But it remains the case that patients cannot usually have a pick'n'mix package of privately and publicly-funded treatment for the same condition, at the same time.

Some 35,000 privately-enhanced women, frustrated in their hopes of a one-stop re-fit, are joined in their criticism of the DoH ruling by the Commons Health Committee, chaired by former Conservative Health Secretary Stephen Dorrell. In a burst of chivalry Dorrell recommended that "we should start looking after the interest of the woman, rather than the small print of the rules". Putting women through unnecessary medical procedures, he went on, "is bad medicine". Meanwhile, enlarged and aggrieved women stare soulfully from the pages of every magazine sharing their personal fears, with no trace of irony, about "invasive and unnecessary operations".

Pressed as to why they elected to stuff their breasts with silicone in the first place, most revert to the mantra of the "empowered woman": "I did it for me."(And if this empowerment happens to chime with gonzo porn sensibilities, well, that's another matter.) I guess their reasons are more various than they appear – I suspect that in generations to come, the artificially-distended bosoms of the early 21st century will be an anthropological curiosity on a par with bound feet or stretched necks – and I dislike the "serves them right" vindictiveness served out on these women. Anger and frustration at the "can't pay, won't pay" attitude of the private health care providers responsible for the dodgy implants is entirely reasonable.

Nonetheless, "I did it for me" is not a compelling political reason to reinflate privately-purchased bosoms at the taxpayers' expense. Indeed, the presentation of such demands to a health service already stretched beyond capacity, borders on the obscene.

There are sound practical reasons for keeping private and public health provision separate. If privately-purchased implants were fitted as part of an NHS procedure and, in 10 years' time, the replacement implants were found to be faulty, who would pick up the tab for compensation? Sympathy and financial support is due to the small minority of PIP victims who have undergone reconstructive surgery after a mastectomy and now find themselves worrying about defective implants. Beyond that, I'd say it's a case of "let the buyer beware". And I mistrust the political animus whipped up by Dorrell and his colleagues against the NHS on a high-visibility issue which affects a relatively small proportion of the population.

Let's say that patients who have undergone private treatment on knees or hips – the choice of many in an era of NHS queues stretching to the end of doom – discover that they have been fitted with defective prostheses. Would the Government be so quick to cry "scandal" and insist the NHS does something about it, quick-smart? Would pictures of pained pensioners jutting their dicky hips at the camera be all over the press like a rash? I doubt it. But the words "breast" and "scandal" just fit so snugly together.

Meanwhile, the real public health scandal – the systematic dismantling of the NHS as we know it – proceeds on its stately course, with smooth talk of "improved choice and accountability". Interesting to note, too, that Spire Healthcare and BMI Hospitals, two of the major providers of PIP implants, were reported as being among the private companies consulting with David Cameron on his plans for a "devolved" health service.

The confusion over breast implants is just a snapshot of what we can expect with the new Health Bill and its muddle of private and public health provision. But it serves as a timely illustration. Do we really want "free-market" health, where in any sudden or systematic crisis, local authorities can act independently in offering remedies for "knock-down" prices? Can complicated issues of compliance and compensation, issues which, year on year, loom larger in public health, easily be resolved in Cameron's vision of "devolved" health care? If we're all to be buyers, we'd better all beware.

React Now

  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

Ashdown Group: Marketing Manager (B2B) - Romford - £40,000 + car

£35000 - £40000 per annum + car and benefits: Ashdown Group: Marketing Manager...

Ashdown Group: Helpdesk Analyst - Devon - £20,000

£18000 - £20000 per annum: Ashdown Group: Helpdesk Analyst - Devon - £20,000 ...

Ashdown Group: Data Scientist - London - £50,000 + bonus

£35000 - £50000 per annum + generous bonus: Ashdown Group: Business Analytics ...

Ashdown Group: IT Project Coordinator (Software Development) - Kingston

£45000 - £50000 per annum: Ashdown Group: IT Project Coordinator (Software Dev...

Day In a Page

Read Next
File: David Cameron offers a toast during a State Dinner in his honour March 14, 2012  

Vote Tory and you’re voting for the rich to get richer and the poor to get poorer

Mark Steel

If I were Prime Minister: I'd end the war on drugs

Patrick Hennessey
General Election 2015: Ed Miliband's unlikely journey from hapless geek to heart-throb

Miliband's unlikely journey from hapless geek to heart-throb

He was meant to be Labour's biggest handicap - but has become almost an asset
General Election 2015: A guide to the smaller parties, from the the National Health Action Party to the Church of the Militant Elvis Party

On the margins

From Militant Elvis to Women's Equality: a guide to the underdogs standing in the election
Amr Darrag: Ex-Muslim Brotherhood minister in exile still believes Egypt's military regime can be replaced with 'moderate' Islamic rule

'This is the battle of young Egypt for the future of our country'

Ex-Muslim Brotherhood minister Amr Darrag still believes the opposition can rid Egypt of its military regime and replace it with 'moderate' Islamic rule, he tells Robert Fisk
Why patients must rely less on doctors: Improving our own health is the 'blockbuster drug of the century'

Why patients must rely less on doctors

Improving our own health is the 'blockbuster drug of the century'
Sarah Lucas is the perfect artist to represent Britain at the Venice Biennale

Flesh in Venice

Sarah Lucas has filled the British pavilion at the Venice Biennale with slinky cats and casts of her female friends' private parts. It makes you proud to be a woman, says Karen Wright
11 best anti-ageing day creams

11 best anti-ageing day creams

Slow down the ageing process with one of these high-performance, hardworking anti-agers
Juventus 2 Real Madrid 1: Five things we learnt, including Iker Casillas is past it and Carlos Tevez remains effective

Juventus vs Real Madrid

Five things we learnt from the Italian's Champions League first leg win over the Spanish giants
Ashes 2015: Test series looks a lost cause for England... whoever takes over as ECB director of cricket

Ashes series looks a lost cause for England...

Whoever takes over as ECB director of cricket, says Stephen Brenkley
Fishing for votes with Nigel Farage: The Ukip leader shows how he can work an audience as he casts his line to the disaffected of Grimsby

Fishing is on Nigel Farage's mind

Ukip leader casts a line to the disaffected
Who is bombing whom in the Middle East? It's amazing they don't all hit each other

Who is bombing whom in the Middle East?

Robert Fisk untangles the countries and factions
China's influence on fashion: At the top of the game both creatively and commercially

China's influence on fashion

At the top of the game both creatively and commercially
Lord O’Donnell: Former cabinet secretary on the election and life away from the levers of power

The man known as GOD has a reputation for getting the job done

Lord O'Donnell's three principles of rule
Rainbow shades: It's all bright on the night

Rainbow shades

It's all bright on the night
'It was first time I had ever tasted chocolate. I kept a piece, and when Amsterdam was liberated, I gave it to the first Allied soldier I saw'

Bread from heaven

Dutch survivors thank RAF for World War II drop that saved millions
Britain will be 'run for the wealthy and powerful' if Tories retain power - Labour

How 'the Axe' helped Labour

UK will be 'run for the wealthy and powerful' if Tories retain power