National Health Service: 75th Anniversary

Lord Cashman Excerpts

Thursday 30th November 2023 Lords Chamber

[Lord Cashman (Lab)]

My Lords, it is a real pleasure to follow the right reverend Prelate the Bishop of London, particularly given her experience in the NHS—and, may I say, her recent intervention in Synod on the issue of same-sex unions. It is also good to look around the House and see Members wearing the red AIDS ribbon, a powerful reminder that tomorrow is World AIDS Day and of what research, awareness-raising and the saving of lives can bring about when we work together. I particularly congratulate the Government on the Secretary of State’s announcement yesterday on increasing opt-out testing for HIV/AIDS and hepatitis C. That brings me to my first point, which is that it is vital that we do not forget the lessons learned from the recent Covid pandemic and the importance of simple but effective preventive public health measures in helping to protect the NHS against the financial and logistical burden of seasonal and other infectious diseases.

Ministers will recall that a targeted hygiene approach was applied to control transmission of Covid-19 and other infections in public areas, at COP 26 in Glasgow, and at the 2022 Commonwealth Games in Birmingham. The approach was extremely successful. If the Government were actively to promote targeted hygiene among the public and with owners and operators of public spaces, it could deliver a threefold benefit: building public confidence in using communal spaces and, by preventing illness, reducing pressure on the NHS and boosting productivity in the workforce.

This brings me to my second concern: the complications following aesthetic surgery procedures abroad, a service now widely advertised in the United Kingdom. Demand for cosmetic surgery is increasing year on year. Recently in the United Kingdom, the British Association of Aesthetic Plastic Surgeons, or BAAPS, in its 2022 national audit, reported a 102% increase in cosmetic procedures performed nationally, accompanied by a growing trend in patients seeking cosmetic surgery abroad, resulting in an increase in complications on their return. The BAAPS 2022 audit found a 44% increase in complications following cosmetic surgery abroad, including life-threatening concerns necessitating emergency surgical debridement and intensive care admission for sepsis.

This national concern is twofold: first, the increased burden placed on the NHS; and secondly, the physical and psychological burden placed on the patient. The true burden on a young working female demographic has seen increased incidence of lost workdays, significant side-effects of renal impairment, hearing loss from antibiotics, repeat theatre visits to valuable emergency theatres, and A&E visits. There is also a real concern about the true cost to the nation and the NHS arising from multi-resistant bacteria. This is in addition to cosmetic deformity and psychological issues from permanent scarring.

There are many factors influencing patients’ choosing cosmetic surgery abroad, but there is little public awareness of the incidence of complications following such surgery abroad and the additional financial burden incurred on seeking treatment and corrective procedures, both privately and in the NHS. Study proposals are being drawn up by the British Association of Plastic, Reconstructive and Aesthetic Surgeons. The aim of this service evaluation, as the Minister may know, is to obtain retrospective and prospective data from all plastic surgery units in the United Kingdom relating to recent NHS and private clinic admissions for complications following cosmetic surgery abroad, the management of surgical and non-surgical treatment, and the country in which the primary surgery was performed. Therefore, I urge the Minister and his department to engage with BAPRAS on that proposal, and I look forward to his response.

Finally, I end with a quote from a senior aesthetic consultant:

“Problems remain: bad days, loss of workdays, side effects of drugs to hearing, kidney and liver function, loss of life and scarring and psychological effects of cosmetic surgery that has gone wrong. The real worry will be the introduction of multi-resistant bacteria to many specialist parts of our NHS, A&E, infectious diseases, plastic surgery, ENT and general medical longer-term needs. Our NHS lacks direction and leadership, due to the political football that is the NHS and the transient nature of the managers who run it and who are responsible for the spend in it”.


That is as damning as it is concerning, and it is clearly time for urgent intervention—and I have not even touched on the deeply worrying proposal for physician assistants. Yes, let us celebrate this amazing 75th anniversary. I have much to thank the NHS for, not least the love and care of my late husband in his 50th year, at the end of his life. But while congratulating the NHS, let us also take the necessary action and decisions to assure its continuation.