Stephen Dorrell, chairman of the House of Commons' Health Select Committee, said it was "neither good medicine nor common sense" to expect women to undergo one NHS operation to remove sub-standard implanrs and then another one - paid for privately - to replace them. At the moment the NHS will only remove implants containing industrial-grade silicone, that were fitted by private clinics, if those companies are unwilling or unable to do so. Andrew Lansley, the Health Secretary, has said that the NHS does not carry out cosmetic procedures. But the policy has resulted in many of those fitted with faulty implants simply not having the NHS operation, or resorting to paying private clinics again for removal and replacement procedures. They usually have to fork out about £3,000. So far only 298 women fitted privately with the implants, made by the French firm Poly Implant Prothèse (PIP), have decided to have them removed on the NHS, a tiny proportion of the 47,000 who received them. Now the Health Select Committee has criticised the Government's policy as not being in the women's best medical interests. Mr Dorrell, the Conservative MP and a former health secretary, said it would be "more economical and better medicine" if removal and replacement were combined in one NHS operation. He was speaking as the committee published a report into the Government's handling of the PIP scandal. The committee has asked the Department of Health to "propose a framework that would allow women in certain circumstances to combine NHS removal of implants with paid-for private surgery to insert replacements". Mr Dorrell said women would be asked to pay for the replacement component of the operation, and the new implants themselves, up-front. They should then seek to recoup the costs from the private clinic which fitted them originally, the surgeon, or the firm's insurer, he suggested. However, even if women paid for the replacement element of surgery - and the new implants themselves - the move could still lead to large increases in the costs of dealing with PIPs to the taxpayer. That is because it would be very likely to drive up demand for the NHS 'offer'. Despite the small number of procedures so far, the bill to taxpayers is already thought to have exceeded £1 million when GP, consultant, surgeon and operating theatre costs are taken into account. However, the Government has signalled it is unlikely to adopt the proposal due to the general rule banning co-payment in the NHS. Earl Howe, the Health Minister, said: "I understand that the prospect of two operations is difficult and distressing for women but it is a founding principle of the NHS that people don't pay the NHS for treatment. "If we allowed patients to pay for treatment in this case it would set a precedent for other treatments and cosmetic surgery. The responsibility for this sits squarely with private providers."
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