The Hospital

The Hospital examines the demands for cosmetic surgery on the NHS and how they are affecting resources otherwise allocated to treating seriously ill patients. As well as curing the unwell, doctors are now expected to correct our perceived imperfections. Broomfield Hospital in Essex is home to one of the NHS's busiest plastic surgery units and the majority of their requests for cosmetic surgery are for breasts. According to national guidelines none of the cases can be purely 'cosmetic', but many of the cosmetic operations at the hospital are carried out due to non-cosmetic reasons. Popular culture is often cited as influencing teenage girls in favour of bigger breasts and the NHS is now continually being asked to draw the line between normal and abnormal sizes. But as consultant surgeon Venkat Ramakrishnan says, 'everything is subjective.' Local Primary Care Trust panels decide who qualifies for cosmetic surgery, and while national guidelines remain the same for PCTs, the interpretation of them can vary across the country, leading to a post code lottery for eligibility. 'When we see a patient who is denied an operation and a very similar patient who receives the operation it is very frustrating for us,' says consultant surgeon Venkat Ramakrishnan. 'It is very difficult for us to explain to the patient who didn't get the operation, why.' Venkat and his team perform around 40 cosmetic procedures every year and have to fit anything cosmetic that is approved into a tightly packed operating schedule.