Getting plastic surgery may be a logical decision. It could include situations like seeking reconstructive surgery following an accident or skin grafting after a serious burn. It could also be a decision based on more cosmetic reasons in cases where the patient’s sole aim is to improve their aesthetic appearance. When making that decision in Ireland, however, a potential patient must also consider the fact that the field of plastic surgery is unregulated.

Currently there is no legislation or regulation on plastic surgery in Ireland. While this does not necessarily take away from the legal and professional work carried out by many qualified doctors, it also leaves room for a potentially dangerous grey area of unregulated plastic surgery clinics and doctors.

Medical professionals registered with the Irish Medical Council are, of course, held to their professional standards [1]. In addition, there is the Irish Association of Plastic Surgeons (IAPS), which is the only Irish body charged with the training of new doctors who seek to pursue a career in plastic surgery [2]. All members of the IAPS are listed on the Specialist Register at the Irish Medical Council and the majority have dual public and private hospital affiliations [3]. The issue at hand, however, is with the unregistered plastic surgeons operating in an unregulated market.

In 2008, the IAPS produced a document, approved by the Royal College of Surgeons in Ireland (RCSI) that called on the Department of Health to introduce strict regulation of plastic surgery, particularly in the area of advertising [4]. The IAPS noted the significant increase in advertising for plastic surgery over the past decade, coupled with the proliferation of television programmes with “makeover” segments that feature plastic surgery, has resulted in an increased demand for plastic surgery procedures [5].

Among the recommendations in the document submitted by the IAPS are a new code of practice to be introduced stating that it should be illegal for payment to be made to a clinic before a consultation with a surgeon; that the qualifications and relevant experience of a surgeon should be made clear to the patient; that initial consultations should not be done by a nurse or lay counsellor; that a recognised specialist training programme in cosmetic surgery be established; and that surgeons suspended for clinical reasons should not be allowed work in the private sector [6].

It also recommends that a new body be established to regulate the private healthcare sector, which would ideally be funded by the private healthcare sector and should be responsible for overseeing all regulatory matters related to the private healthcare sector [7].

In February 2010, a spokesman for the Department of Health said the department was “developing legislative proposals for a mandatory licensing system covering both public and private facilities, including private cosmetic surgery clinics” in line with the recommendations of the Commission on Patient Safety and Quality Assurance, which reported in 2008 [8]. “The Minister intends to bring these proposals to Government by the end of the year,” he said [9].

Until that time comes, the field will remain unregulated. At this stage, it would be helpful to have any level of regulation – no matter how basic – that, at the very least, establishes a licensing system for plastic surgeons and private plastic surgery clinics. Through the lack of regulation, the Government is potentially leaving the door wide open to unqualified doctors setting up a private practice in Ireland, which compromises the safety of the patients.

References

1 See http://www.medicalcouncil.ie/Professional-Standards/Professional-Conduct-Ethics/The-Guide-to-Professional-Conduct-and-Ethics-for-Registered-Medical-Practitioners-7th-Edition-2009-.pdf.

2 http://www.plasticsurgery.ie/

3 http://www.plasticsurgery.ie/

4 http://www.imt.ie/news/2008/03/cosmetic_surgery_to_carry_heal.html. 18 March 2008.

5 http://www.imt.ie/news/2008/03/cosmetic_surgery_to_carry_heal.html. 18 March 2008.

6  http://www.imt.ie/news/2008/03/cosmetic_surgery_to_carry_heal.html. 18 March 2008.

7 http://www.imt.ie/news/2008/03/cosmetic_surgery_to_carry_heal.html. 18 March 2008.

8 http://www.irishtimes.com/newspaper/health/2010/0209/1224264026543.html. 9 February 2010.

9 http://www.irishtimes.com/newspaper/health/2010/0209/1224264026543.html. 9 February 2010.

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