BMJ 1996;313:1479 (7 December)

Letters

Interventions requested for psychological reasons should be studied

EDITOR,--We were interested to note that Anne Klassen and colleagues chose to look at breast reduction as an example of a cosmetic surgery procedure that is not being provided by the NHS.1 They comment that common reasons for referral were physical problems (for example, pain, discomfort, and skin irritation); psychological and social reasons were less common. They conclude that breast reduction is an effective treatment for these women. We question the relevance of this study to the debate on rationing, and particularly whether the findings can be taken to indicate the benefits likely to come from other cosmetic surgery procedures.

South and West Devon Health Authority has operated a policy of restricted access to certain cosmetic surgery procedures, including breast reduction, for over a year. Under this policy requests for breast reduction because of physical symptoms have invariably been approved; such requests constitute a small proportion of the requests for . . . [Full text of this article]


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Relevant Article

Should breast reduction surgery be rationed? A comparison of the health status of patients before and after treatment: postal questionnaire survey
Anne Klassen, Ray Fitzpatrick, Crispin Jenkinson, and Tim Goodacre
BMJ 1996 313: 454-457. [Abstract] [Full Text]

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