30/01/2012 17:23 GMT | Updated 22/05/2015 10:12 BST

Who Should Pay For Faulty Breast Implants?

Last week Health Secretary Andrew Lansley told the 40,000 British women who have been fitted with PIP breast implants that there's no medical evidence to suggest that that they should be removed.

So far, Britain is the only country to give this advice: French, German and Dutch authorities have all recommended routine removal of the implants, which were filled with industrial-grade silicone intended for mattresses.

breast-implant-debate-lauren-pope Photo: Getty

Although there is no established link between the faulty implants and cancer, experts fear that there is a risk of inflammation and scarring if they rupture or tear. And anecdotal evidence suggests that rupture rates of these implants are much higher than they should be, with some doctors warning that that pressure from tight bras, rough sex or intense workouts could be enough to cause them to burst.

So it's no surprise that many women, including TOWIE's Lauren Pope, have been shocked and frightened to discover that they have PIP implants while many others, like glamour model-turned-body builder Jodie Marsh, are anxiously waiting to find out if they are affected.

If they have been fitted with the faulty implants they will then have to decide whether they should take the precaution of having more surgery to have the implants removed or replaced.

Andrew Lansley has pledged that all women who had the implants fitted on the NHS (including those who had reconstructive surgery following treatment for breast cancer) can have them removed and replaced for free.

He doesn't think it's fair to the taxpayer for the NHS to "foot the bill" for patients who had private PIP implants, but believes that private clinics have a "duty of care" towards their patients and believes that they should offer their patients the same deal.

However, if the clinic that originally fitted them no longer exists or refuses to remove them for free, he said that the NHS will fund the removal subject to a doctor's recommendation.

The British Association of Aesthetic Plastic Surgeons (BAAPS) has already called on its members to waive surgery fees for corrective surgery, saying that it gives the private sector "a real opportunity to demonstrate their commitment to duty of care."

So far, eight private healthcare companies, including BMI Healthcare, Nuffield Health and Spire, have said that they will remove and replace PIP implants for free. But, in total, these firms only performed between 3,000 and 4,000 operations in the first place.

Now it has emerged that the Harley Medical Group, which carried out 13,900 PIP implant operations between 2001 and 2010, says that it doesn't have the resources to offer free replacements to patients.

Despite having a turnover of £25 million last year, the company's Chairman, Mel Braham, said that the firm made an operating loss.

And Transform Cosmetic Surgery, estimated to have fitted around 4,000 PIP implants, has also said that it will not fund removal and replacement, but it will do the surgery at cost price - up to £3,000.

According to the Telegraph, this means that around 90% of women who had the surgery performed privately will end up getting their implants removed courtesy of the NHS.

Mel Braham argues that this is how it should be. He claims that the the Government should ultimately bear the responsibility - and the cost - because the medical regulator (the MHRA) failed to ensure that PIP implants were safe.

But should the buck really stop with the Government?

The Welsh Government has already announced that all women who had PIP implants fitted privately can not only have them removed, but also have them replaced, on the NHS in Wales.

But then Wales also provides free prescriptions to all, and has done since 2007, so has a different approach to managing its budget.

Given that the government's drive to make £20 billion of efficiency savings across the NHS in England by 2015 is already having a huge impact on frontline services, it seems unreasonable to now allocate an estimated £150 million just to fix botched boob jobs.

Yes, we've all heard the argument that people who smoke, drink or become obese aren't denied access to the NHS to treat conditions that they arguably brought on themselves.

But by pledging to remove the substandard implants the NHS is, to all intents and purposes, already treating the problem.

The health of the nation won't be adversely affected if women who opt to have their implants removed can't afford to have them replaced.

M&S might sell fewer bras in its DD-G range - and the Britain's bustline might start to look a little deflated - but that's nothing that a push-up bra and a set of chicken fillets can't sort out.

No surgery is risk free, but if there's a sound medical reason to go under the knife, most make an informed decision to do so.

But while many argue that the psychological benefits of cosmetic surgery shouldn't be underestimated, I've yet to hear that a boob job, a tummy tuck or a face lift can confer measurable benefits to health.

When you sign the consent form for a cosmetic procedure at a private clinic, you do so with the knowledge that things can and do go wrong - and the ailing NHS shouldn't be held accountable if that decision backfires.

More than 270 women in the UK now intend to sue the clinics where they were fitted with PIP implants and this, along with a proposed Europe-wide review, should mean that the cosmetic surgery industry will become subject to tighter regulations, which is undoubtedly a good thing.

But the bottom line is that the NHS isn't there to buy us bigger, firmer or perkier boobs.

And while I sympathise with women who have found out that they have been fitted with PIP implants and can't afford to pay to get them replaced, hopefully the PIP scandal will remind us that bigger isn't always better, and perhaps we should take a more cautious approach to cosmetic surgery in the first place.

By Ceri Roberts