25 August 2007

Cosmetic surgery under the NHS

Dr Grumble has rarely been to a doctor. He hasn't even met his GP though he did know the previous one who used to be his house physician. It's a very long time since Dr Grumble's blood pressure was measured. The last time was as part of the protocol for an experiment Dr Grumble was a volunteer for. Doctors are not very good at looking after themselves. But Dr Grumble has had cosmetic surgery. And it was carried out under the NHS. Dr Grumble is not really much of an advocate for cosmetic surgery. He thinks that the masked elderly American women look worse than if they had been allowed to grow old gracefully. But it's up to them. If they want to pay to have their skin stretched that's their affair.

There was never any question about whether or not Dr Grumble could have his cosmetic surgery done under the NHS. The top plastic surgeon in the Wales even offered to fix his stick out ears at the same time. But this was a long time ago when the NHS had only been going for about 7 years. What was the cosmetic problem? Dr Grumble had a mole the size of a man's thumbnail bang in the middle of his forehead. It looked peculiar. If he had lived in Tibet at the right time it would have been seen as a sign and he would surely by now be the Dalai Lama. But being in the UK at a time of the wonderful new NHS, the view was taken that the young Grumble should have the mole removed lest he was picked on when he went to school. And so the mole was duly removed. It was the worst experience of Dr Grumble's life - after deaths in the family. In those days, you see, children were kept locked in a strange ward and families were not allowed to visit because it 'upset the children'. It's very very frightening if you are just four. Especially when they drag you under force to remove your stitches. Dr Grumble still has flashbacks.

Lou and her breasts.

But when does cosmetic surgery become something that the NHS should take on. Who decides? Not doctors it seems. Take the case of Lou in the picture above. You could argue about the rights and wrongs of the state paying for her surgery to deal with the intertrigo and other problems related to her large appendages. But surely managers should not just have a blanket ban - easy though that is? The same applies to moles. Surely a child with a large mole right in the middle of his forehead still merits NHS treatment - or does he? But what about a child with a smaller mole on a cheek? Who decides?