If thousands of UK patients head overseas for knee or hip replacement surgery every year, why shouldn’t you? Alex Dodds shares his view.
*photo courtesy of pathdoc via Shutterstock
Not long ago, I saw a patient at my clinic who needed ACL revision surgery. In case you’ve never heard that phrase before, a revision is an operation to try and ‘fix’ a failed ACL reconstruction. These aren’t wholly uncommon – it’s a frustrating truth that 5%-10% of ACL reconstructions fail. The issue with this ACL reconstruction, however, was that it hadn’t been performed by me or any UK consultant. It had been carried out in Turkey by a patient who had gone overseas for treatment.
It’s a free country, of course. You can do that if you choose. But in this case, it meant that the NHS was picking up the tab (and the time and resource burden) of fixing a problem that had been created elsewhere.
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The problem with travelling overseas for surgery
I’m sure you’ll have heard/read the accounts of people who head overseas for private knee and hip surgery. I don’t encounter many complications from overseas treatment in my Gloucestershire surgery – suggesting it’s not an option that’s widely adopted in Cheltenham, Gloucester and the Cotswolds – but the ONS estimates around a quarter of a million UK patients travel overseas for surgery every year.
It’s easy to cynically throw around accusations of ‘medical tourism’ but the issue of long NHS waiting lists and expensive private treatment is very real. I can entirely understand why patients would consider travelling to get private treatment faster and cheaper than they would receive in the UK. But I’d also offer the following counterpoints.
Cost: While it’s true that the basic cost of surgery overseas may sometimes be less than in the UK, you will incur many supplementary costs. In addition to the flights, the biggest of these is accommodation. Advice varies, but most reputable sources suggest you shouldn’t fly within six weeks of surgery because of the increased risk of blood clots. Some sources double that, especially for long haul flights.
If we take the most conservative of those figures, six weeks in a hotel or Airbnb is going to be pretty costly.
Treatment: Let’s not pretend the UK is a glowing beacon of practice and the rest of the world isn’t. You can find excellence anywhere – but it’s only through rigorous regulation that you’re able to distinguish the qualified, the experienced and the trustworthy from, well, the others.
In the UK, surgeons must be registered to practice on the medical register, controlled by the General Medical Council. You can search their performance on the National Joint Register. These quality measures give patients lots of reassurance. They’re a guarantee of competence.
Not every country has similar systems in place, and while I might be perfectly happy buying clothing or an electric toothbrush online based on the Google reviews, I’m not sure I’d want to rely on them for my hip or knee surgery.
Aftercare: It’s a rarity, but if you have your knee replacement in the UK and, post recovery, it’s too stiff, you can do something about it by seeing the surgeon who performed the procedure. The same would be true if you dislocated your hip post replacement. Access to the people who treated you in the first place is important, because they are the ones most familiar with you and your hip/knee.
When you have your surgery abroad, revisiting your surgeon gets much more complicated. Not only is it expensive, depending on the problem, you may not be able to fly. In that situation, the NHS inevitably becomes your backup, but they’ll be trying to address the problem without access to the relevant medical records.
These aren’t conversations I have with many patients. But I’m sure some prospective hip and knee replacement patients in Cheltenham, Gloucester and the Cotswolds are thinking about it. If that’s you, then the choice is, of course, yours. I’d just urge you to think carefully not just about the procedure itself, but what might happen afterwards.
If you’d like to explore options for your private knee and hip surgery, please get in touch or call 01242 246549
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