Surgery blitz no hospital solution

Jessica Newman, with her mother Jacqui, will benefit from more funding of the Monash Children's Hospital. Picture: Tony Gough Source: Herald Sun

AN elective surgery blitz that could spark an extra 20,000 surgeries a year will not be the panacea for soaring demand, warn doctors, nurses and the State Opposition.

The $421 million over four years to reduce the 55,000 strong waiting list has also been criticised for forcing public hospitals, which have faced bed and theatre closures, to compete against private hospitals for funding.

Shadow Health Minister Gavin Jennings said the move smacked of privatisation by stealth.

"When service provision is based on who can do it cheapest, Victorians can't be guaranteed they'll be able to access the best care, no matter where they live."

But Treasurer Michael O'Brien said it would drive competition and make sure more people are treated sooner.

"I don't think most people waiting for an operation are worrying about whether it is done in a public hospital or a private hospital . . . they want to get better sooner," Mr O'Brien said.

Boost for hospital projects

Australian Nursing Federation secretary Lisa Fitzpatrick hit out at the $210 million health cuts over four years.

She said the State Government wanted hospitals to treat an extra 49,000 emergency patients, but only provided an extra $2.5 million in funding.

"What the government is signalling is hospitals need to save in order to do more, but there is no fat in the system," she said.

AMA Victoria president Stephen Parnis welcomed the budget as a step in the right direction, in particular the additional money for medical interns.

Patients will benefit from $400 million to fund the Monash Children's Hospital and the Royal Victorian Eye and Ear Hospital. Only $30 million will flow next year, despite projects due for completion in 2016 and 2017 respectively.

Jacqui Newman, who has a daughter, Jessica, 9, in the Monash Children's Hospital for the past seven weeks fighting cancer, said she was pleased to hear the hospital would get funding because the rooms were small, needed upgrading and the hospital lacked stimulation for ill children.

The budget had $18 million for Numurkah health services, $35 million for mental health at Werribee Mercy Hospital, $238 million for training doctors and nurses, $29 million Northern Hospital expansion and $50 million towards a new public hospital in Geelong.

Health Minister David Davis said its $14 billion record investment would ease pressure on the system.

Opposition Leader Daniel Andrews accused the Government of cutting $826 million from health during its rein and contributing just $3.8 million to $176.3 million of Federal funds to treat more patients.

with Stephen  Drill and Grant McArthur

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Surgery bug hits desperate and dateless

PROCEDURES: Cosmetic injections are high on the complaints list. Source: Supplied

A BOOM in cosmetic surgery has left many patients disfigured, with accusations those seeking treatments were not sufficiently cautioned about the risks.

A report tabled in Parliament warned that some patients were left permanently deformed and suffering agonising side effects.

Increasing numbers of patients say they were mutilated and their lives destroyed.

A total of 14 doctors and nurses are under investigation for dozens of allegedly botched procedures dating back to 2006.

The shock report by the Health Quality and Complaints Commission said cosmetic surgery in Queensland had left patients with "severe infection, temporary paralysis, blood clots, the need for repeat procedures, (and) significant psychological distress".

And it questioned the training of the doctors and nurses to perform often complex surgeries.

The HQCC listed "major and minor permanent harm" as "significant scarring, leaking and burst breast implants, repeat procedure with further complications, nerve damage, cut muscle/organ, excessive skin removal, and gross deformity".

There were complaints about tummy tucks, face lifts, eye surgeries involving lids and brows, and surgeries to necks, chins, ears and buttocks.

There were complaints about liposuction and varicose vein removals.

Most complaints came from women although there was one complaint of a botched penis enlargement. Mercifully, the report spared us the details.

As if by way of consolation, the report added: "There were no reports of patient deaths."

The Gold Coast, the Sunshine Coast and Cairns were over-represented in the number of complaints, no doubt reflecting the pitiful body-beautiful beach culture enslaving many of the locals.

There were few, if any, complaints in more sensible cities such as Toowoomba, Hervey Bay and Rockhampton.

After reading the report, it is hard not to conclude that Queensland has a serious body image issue.

It is a modern disease that strikes desperate and dateless middle-aged women and men attempting to recapture their lost youth.

And there are girls as young as 12 with such poor self-esteem that they are demanding cosmetic surgery, a psychologist friend says.

There are teenagers requesting dangerous cosmetic procedures with the full knowledge - and approval - of their mothers.

Shamefully, one 16-year-old was offered a breast enlargement as her Christmas present by her mother thrilled with her own boob job.

The risks of surgeries and procedures are grossly understated, according to the report to Parliament.

The HQCC said more than half of the complainants stated they received inadequate or inappropriate treatment, while nearly 40 per cent complained of complications and "unexpected outcomes".

Unexpected outcomes? What were they thinking? Did they expect to walk out of surgery looking like Scarlett Johansson or Tom Cruise?

The report added: "Permanent harm reported in cosmetic surgery complaints was related to breast enhancement (implants and lifts), followed by abdominal surgery, face and neck surgery and breast reduction surgery.

"Permanent harm reported in cosmetic medical procedure complaints was related to laser treatment, followed by cosmetic injections.

"While cosmetic surgical procedures clearly carry greater risks, medical cosmetic procedures also carry risks."

It said "temporary minor harm" included bruising, pain, minor infection, and allergic reactions.

There were also complaints about costs, prompting this warning: "Unlike many other areas of medicine, doctors and nurses practising cosmetic procedures operate in a commercial market where they are seeking financial profit and their patients are seeking procedures as a matter of choice to boost self-esteem or make them feel better about their bodies rather than for medical need to treat trauma or disease.

"The roles of patient and customer are blurred. This blurring can compromise a patient's capacity to identify when the practitioner is their best advocate in ensuring their health needs are met and when the practitioner is a commercial services provider with a vested interest in the procedures and products being considered."

The HQCC looked at 245 complaints about cosmetic surgical and medical procedures.

In all, 82 per cent of cosmetic procedure complaints were about cosmetic surgery and 16 per cent were about cosmetic medical procedures.

"Breast enhancement was the most frequently complained about cosmetic surgical procedure," the report said. "Cosmetic injections and laser treatment were the most frequently complained about cosmetic medical procedures, followed by chemical peels.

"The number of complaints about cosmetic medical procedures more than doubled between 2006 and 2012.

"The most frequently reported concern in complaints about cosmetic procedures was treatment (accounting for 82 per cent of complaints), followed by fees, costs and rebates."

The HQCC said there was various "harm types" identified.

These included "additional surgery or operation required to fix problems, post-procedure complications, such as significant pain and discomfort, bleeding, vomiting, infection, scarring, significant psychological distress or dissatisfaction with outcomes and complications from inadequate follow-up care by the healthcare practitioner".

It said unavoidable harm and surgical complications did occur.

"However, there are times when harm could have been avoided."

And it said advertising for cosmetic procedures "often focuses on the benefits, while 'downplaying' or not always mentioning the risks".

"It is critically important that people thinking about having a cosmetic procedure are made fully aware of any risks and possible complications.

"This information should be available to consumers in advertisements, at the pre-operative counselling stage and as part of post-operative follow-up information and care."

HQCC chief Cheryl Herbert told Parliament the community often perceived cosmetic procedures to be "low risk" when, in fact, they were often complex, required a high degree of skill and had a number of potential risks.

"We analysed cosmetic surgery and medical procedure complaints because consumers generally underestimate the risks associated with such procedures, and there is less regulation and few safeguards compared to other areas of medicine," Herbert said.

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'More Aussies going abroad for surgery'

More Australians are heading overseas for surgery. Picture: Getty Source: National Features

AN increasing number of Australians are presenting at hospitals with complications from cosmetic surgery performed overseas, a leading surgeon says.

Australian Society of Plastic Surgeons president Geoff Lyons says the issue of medical tourism has only emerged in Australia in the past five or six years but it is a growing problem.

It is difficult to know the exact number of people who are travelling overseas for cheap surgery, but the number is definitely rising, he says.

"There are a number of thousands of people doing it each year and the indication is those figures are increasing and they're increasing dramatically," Dr Lyons told AAP.

He said the major driving factor was cost.

The most popular procedure for Australians engaging in "medical tourism" is breast augmentation.

But breast reductions and abdominoplasty - or tummy tuck - procedures are also common.

Patients who develop complications once home face the extra hurdle of being treated by a doctor who did not perform the original procedure.

The cost of treating the complications has to be absorbed by Australia's public health system, unless the patient opts for private treatment which can be difficult, Dr Lyons said.

"They have to double dip into their costings.

"That's often difficult for them and distressing."

Australians mostly choose Asia, particularly Singapore and Thailand, when heading overseas for surgery.

But the market is global.

Speaking at the Plastic Surgery Congress in Melbourne on Wednesday, experts from the US and the UK said Mexico, Eastern Europe and Africa also attracted large numbers of "medical tourists".

British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) president Graeme Perks said a recent survey found 16 per cent of people in the UK would travel overseas for surgical procedures.

He said it was estimated 43 per cent of Britons who travel overseas for surgery do so for cosmetic procedures.

Research published by BAPRAS found that of 215 patients who travelled overseas for procedures, 74 per cent had complications, 26 per cent were unhappy with the appearance and 26 per cent required emergency surgery.

He estimated cleaning-up botched surgeries performed overseas cost the UK anywhere between STG500,000 ($A747,000) and STG5 million ($A7.47 million).

"It shows how much we know about what's going on," Mr Perks said.

Dr Lyons said medical tourism is an increasingly big area because cosmetic surgery is an increasing area.

"It's an area that generates a lot of money," he said.

"So you get people trying to target that industry."

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