Ms Margaret O'Donnell:

I note that no member of the Irish Association of Plastic Surgeons used PIP implants and that they were never used in any of the public hospitals for breast reconstruction after a mastectomy or in any of the mainstream private hospitals. Their use was confined to commercial clinics and the biggest user has gone out of business. I have seen patients with this problem find their way to me. I have other patients who do not know what implants they received, only that they were operated on in that clinic. It is a big concern and a registry would have been useful in tracking down the type of implant used in these cases. The Australians have set up a database which they are willing to share with other countries; therefore, there is a model offered free of charge which is something that could be looked into here.

Two members asked about deaths. A women died in Dublin in 2007 after gastric banding surgery. That was despite her GP having recommended that she not undergo the procedure owing to other health problems. We do not know if there have been other deaths; that one was highly publicised. As there are no statistics, we cannot tell the joint committee how many breast implants are provided in the country. There is no registry and no database indicating the amount of cosmetic surgeries or other procedures undertaken. The evidence from other countries is that the number of non-surgical cases is rising massively and that such procedures are being performed across the board by all sorts of practitioner. It is correct to say services are being provided beyond the competence of the people providing them. People can set up with any kind of machine or device without restriction. That is where a register of practitioners would help to clarify matters, as one would know if one was seeing a beauty therapist or a plastic surgeon trained to treat X, Y or Z condition. An ophthalmologist should not be providing breast implants but performing eye surgery. This has been done in other countries. In France and Denmark legislation has been enacted to identify the procedures that can be undertaken by each category of practitioner.