Companies that provide surgery abroad should foot NHS bill, nurses say

Nurses have warned that surgical procedures abroad are too easily being sold as “holiday packages”, as they called for companies providing the operations to foot the NHS bill when things go wrong.

So-called surgical tourism could also be driving a deadly resistance to antibiotics.

The trend of people travelling overseas for the likes of weight loss surgery, dental care and cosmetic procedures is “likely to grow”, nurses said, despite some patients dying from complications.

Speaking to delegates at the Royal College of Nursing’s annual congress in Liverpool, Nicola Smith, who works in district nursing, said she has been “really shocked” by some cases.

“Over the last two years, I’ve seen some horrendous, horrendous wounds coming back from people that have had surgery abroad,” she said.

She spoke of one woman whose wound from skin removal surgery – which is usually performed after weight loss – turned necrotic.

Ms Smith added: “I think she thought she would come home, have a quick recovery and go back to work. I ended up sending her in with sepsis.

“It’s really sad – this procedure was sold to her as like a holiday package.

“A lot of young people are very exposed to social media. You know, ‘you can have a holiday, six grand’.

“All she told me about was how fantastic the hotel was after she had her surgery. There was no blood pressure tested. There was no aftercare for this woman at all.

“In fact, to be fair, I’m surprised she made it back on the flight. It’s really scary.

“We need to educate our young people … we need to educate people on the dangers of having surgery abroad.”

Infection control nurse Nykoma Hamilton, of the RCN Fife branch, suggested companies that provide packages which include hotels, surgery and transfers to appointments should pay insurance for the NHS to seek financial compensation when complications arise.

“We’re all getting told to tighten our budget,” Ms Hamilton told delegates.

“So if people have decided that the wait list is too long, they’re in too much pain, for whatever reason, they’ve decided to have that option of surgery abroad, that company that they went with, they should pay an insurance, so if you do have to be cared for by the NHS for – and we’ve seen some horrid complications – the NHS should then be able to seek financial compensation from that company.”

She also issued a warning over the “granddaddy” of antibiotic resistance.

“Our concerns relate to the fact that a lot of people are colonised with a lot of extensively drug resistant organisms,” Ms Hamilton said.

“Now, that is a global health problem that affects us here in the UK, as well as abroad, but the infection control teams are getting slightly worried.

“So we’ve had a near 30% increase in the detection of carbapenemase resistance – now that’s your absolute granddaddy of resistance ones.”

Carbapenems are among the most powerful antibiotics, while carbapenemases are chemicals made by some strains of bacteria.

These chemicals allow the bacteria to destroy carbapenems and become resistant to the antibiotic.

Ms Hamilton said patients can be colonised with this bacteria and live with it for a while without harm, unless it gets into the bloodstream when they will be resistant to most of the antibiotics available.

Elsewhere, Samantha Spence, who tabled the debate at the RCN congress, claimed about 5,000 people from the UK travelled abroad for weight loss surgery alone last year.

“That was almost equal to the number treated within the NHS in 2021/22,” she added.

“Now within the UK, private care is costly. NHS waiting lists long. This trend looks likely to grow.

“While some return with positive life-changing outcomes, others come back with complications requiring urgent care, adding strains to NHS resources.

“With variations in infection control, differing medical standards, lack of follow up, coordination, tragically, some patients have died from such complications.”