Measures to tighten regulation of Plastic Surgeons announced – Do they go far enough?

Consumer Protection and safeguarding potentially vulnerable consumers of Plastic Surgery is in the headlines again today with new guidelines being published by the General Medical Council (GMC) to regulate doctors who undertake Plastic Surgery.

In June 2015 we reported on the consultation that was taking place in the light of concern about patients in this area and draft guidance that had been prepared. That guidance has now been approved and will take effect in June 2016. We ask though whether the guidance goes far enough in protecting purchasers of Plastic Surgery.

Doctors must now:

  • Advertise and market services responsibly
  • Give patients time for reflection
  • Seek a patient’s consent themselves rather than delegate this task
  • Provide continuity of care
  • Support patient safety

It is recognised within the new measures that patients consulting with doctors for treatment are not only often highly vulnerable but also may have been, in the past, induced to have a surgical procedure while under some financial pressure to take advantage of a special offer. Advertising has permitted ‘two for one’ offers, surgery offered as a prize and incentives for referring friends. These are now banned and doctors must also ensure that others do not misrepresent their services.

The introduction of a ‘cooling off’ period following a consultation will enable patients to properly consider the risks that have been explained to them at a face to face meeting.

In the past, consent has often been delegated by the operating surgeon to a junior colleague but tightening up this step enables a patient to have the opportunity of a full explanation from the doctor but also the opportunity to ask questions about the risk of surgery from the person undertaking the procedure. For patients who have a Psychiatric history, this may influence their decision to undergo a procedure and as part of the consent process the doctor must now consider any pre-exisiting condition and whether the surgery is right for this patient.

Continuity of care is important to ensure that if complications arise, the patient knows who to contact and how care will be managed.

Support for patient safety requires full and accurate records of consultations, using systems to identify and act on patient safety concerns and contributing to programmes to monitor quality and outcomes.

Do these measures go far enough?

As Medical Negligence solicitors, we see cases where, when something goes wrong with Plastic Surgery there remains a lack of accountability.

All too often the injured and vulnerable patient is met with resistance in reporting concerns and it can take months to identify whether the clinic or the doctor will take responsibility for rectifying and addressing medical concerns. As Plastic Surgery is often funded as a package of care, responsibility for the operation itself may lie with the surgeon but wrapped up in a package of care, part of which is offered by the hospital itself. Surgeons sometimes are willing to waive a fee for re-operation but the clinic is not willing to do so for in-patient treatment if they are not responsible for sub standard care.

We also have experience of clinics employing Plastic Surgeons who live overseas. Currently there is no easy way of accessing professional indemnity insurance held by foreign doctors overseas and if the doctor returns to their native country after delivering sub- standard care, it can be very difficult for them to be brought to account or to pay out damages even if a case is upheld against them.

At the outset of treatment, it is very difficult for a lay patient to understand the potential pitfalls if something goes wrong and it is only when this situation arises, that it may become apparent that a contract signed is not fully covered by the insurers of a hospital as liability generally lies with the individual doctor who is employed on a sub contracting basis.

What Next?

The guidance is a step in the right direction but it will only fully benefit consumers if they are also able to make a ‘purchase’ in the full knowledge of who are the reputable practitioners in this area of medicine.

Help with this might come later in the year and the Royal College of Surgeons has called on the Government to introduce legislation in the next Queen’s Speech to provide further safeguards. Central is the proposal of a certification scheme to enable members of the public to see which surgeons have been approved to carry out cosmetic surgery.

Mr Stephen Cannon, Chair of the Cosmetic Surgery Interspecialty Committee and Vice President of the Royal College of Surgeons, said:

Cosmetic surgery is a booming industry, but the law currently allows any doctor – surgeon or otherwise – to perform cosmetic surgery in the private sector. This can make it difficult for patients to identify an experienced, highly trained surgeon from someone who should not be practising.

To correct this, we will launch a new system of certification later this year which will help patients to find a certified surgeon, who has the appropriate training, experience and insurance to carry out a procedure – such as a tummy tuck or nose job.”

If you or a family member has been affected by Plastic Surgery treatment which you think may have been sub- standard, please do not hesitate to contact a member of our Clinical Negligence Team on 0800 316 8892 for further advice.