Visualised: Breast implants funded by the NHS more often than breast reductions

Following on from yesterday's case study, the chart below compares the number of breast implants with the number of breast reductions funded by the NHS in England between 2007-2009. These are operations taken in NHS hospitals or commissioned for the independent sector.



More up to date data is yet to be available, although the NHS Information Centre for Health and Social Care said in a Freedom of Information request that hospital incidents of such procedures were published on HES Online here, here and here.

According to the NHS Information Centre, "breast reconstruction may be carried out following an injury, or for medical reasons or for cosmetic reasons." But as procedures get logged in by codes and since within one surgical operation more than one procedure may be carried out, the NHS said extracting this information from HES Online might bring up duplicates. Still with the various types of codes it uses to log operations, which have also been changing several times over the years, this information is rather hidden from our view, at least for the time being.

Click here for the Google spreadsheet (draft). 

Visualised: Cosmetic procedures at Barnsley PCT 2011-2012

Barnsley PCT spent over £1m on cosmetic procedures between the financial year 2003/04 and the time they replied to my FoI enquiry on February 7 2012. 

They write: "The earliest data held on our records are from 2003 up to the end of the financial year 2011.

Procedures are carried out at Sheffield Teaching Hospital."

Below is a visualisation of the latest data received from Barnsley PCT completed in Many Eyes. For the full data set click here.

Case study: “I was 5ft 1in and had 32FF boobs.”

Even with some Primary Care Trusts spending as much as £1m a year on cosmetic surgery patients like 25-year-old, hairstylist, Lydia Buist, still choose to take the private route.

Lydia started having severe back problems due to her large breasts when she was still in school. “When I was 14 I was big,” she says. “I was 5ft 1in and I had 32FF boobs. Nothing fitted me and I was always self-conscious.” 

When she turned 18, Lydia asked her GP about breast reduction but was told she had to wait. “My doctor said to me: ‘You will be accepted, but they want you to become an adult and get comfortable with being an adult before that happens.’”  

Lydia did wait for five more years only for her back problems to get worse: “It was a long stressful few years. It really ruins your back. I used to wear a bra all the time, except for when I would take a shower. I was so depressed about it too. It’s crazy to me why people get implants. I have no idea why they do it.”

The NHS gives the example of breast reduction procedures conducted due to severe back pain, depression and confidence issues on their website when explaining why they fund cosmetic surgery in the first place. It reads: “In rare cases, cosmetic surgery may be provided on the NHS if it’s required to protect a person’s health, for example, a breast reduction operation, if the weight of a woman’s breasts is causing her back problems.”

Still the waiting times and budget cuts put Lydia off asking her doctor about funding again. “I have a friend who is a 30HH and got refused on the NHS because of the budget cuts. She is struggling to raise money for her reduction now,” says Lydia.  

“Knowing her made me feel really bad when I had my operation,” she explains, “because I was not near the case she was. But I feel so much better now. It’s like I’m free.” 

“I also didn’t go on the NHS because it takes so long and it was only thanks to my parents that I got to have it when I did. Plus private hospitals are so much better and the medication and aftercare is great,” adds Lydia.

FoI Data Mapped: Primary Care Trusts delay response to cosmetic surgery query

How much does the NHS spend on cosmetic surgery? Which procedures are financed more often? Which are the most expensive? Which body parts get "adjusted" on the NHS the most?

Eight in ten Primary Care Trusts (PCTs) in England failed to share such cosmetic surgery data requested under the Freedom of Information (FoI) Act. Just 15.33% of the PCTs in the country  have responded fully* and in a timely manner to an FoI asking for the number and cost of cosmetic operations they fund.

Over 150 NHS individual PCTs and clusters were asked in January for any "information" held on "hospital episodes of cosmetic surgery" including, but not restricted to, the following:

•  types of cosmetic operations that were conducted;
•  details of reasons for carrying out the operations;
•  any details on the operations;
•  a breakdown of costs;
•  a list of hospitals they were carried out in. 

Five months on, most failed to provide this data.

According to the NHS website, cosmetic procedures are rarely funded. Coupled with the "clinical reasons" requirement (that any individual seeking such an operation would need to fulfil) it made for the most common explanation provided by PCTs in their replies.

As such, since cosmetic surgery is funded only in exceptional circumstances and for clinical reasons (never cosmetic), the FoIs came back saying that the NHS doesn't "routinely" pay for such procedures and in some instances an additional internal policy outlining the conditions needed to get such a procedure on the NHS was attached.

The map below shows which PCTs did provide the required data, in a reasonably accessible format and in a timely manner. You can access the Fusion Table behind it here. Please note that a few PCTs are not represented on the map as no kml files were found for their boundaries. If you come across these, please contact me so we can update the map. The full record of complete (Y) and incomplete (N) responses can be viewed in this spreadsheet (draft).

Further posts will outline more results from this data.
As always ideas, feedback and comments are much appreciated.





*i.e. Provided reasonably acessible figures (data)