Cosmetic cowboys can still operate as key plank of cosmetic surgery reform deferred



3 July, 2023

The national medical regulator’s flagship reform to prevent major cosmetic surgery taking place in backyard facilities has hit a snag after plans that all cosmetic surgery must take place in an accredited facility were abruptly suspended.

On the eve of the commencement of cosmetic surgery reforms sparked by revelations that cowboy operators were carrying out major surgery in unhygienic facilities without actually being surgeons trained to recognised standards, the Australian Health Practitioner Regulation Agency quietly delayed the requirement that operations must take place at a facility accredited by the Australian Commission on Safety and Quality in Healthcare.

It was intended as a major plank of AHPRA’s cosmetic reforms that came into effect on July 1 but the Medical Board of Australia advised surgeons and medical colleges on June 29 that it was deferring requirements that medical practitioners perform cosmetic surgery only in accredited facilities or in facilities registered for accreditation, with no revised date for the reform to take effect.

In a published communication, the board said “the ACSQHC has alerted the board that there may be some difficulties with implementing the staged approach”.

The deferral has dismayed many surgeons, who saw it as the key regulation to prevent patient harm from cowboy operators amid widespread anger over the rest of the reforms, which are seen as fundamentally flawed.

The deferral followed a process of consultation in which doctors raised issues of widespread confusion, particularly among plastic surgeons, who questioned how the guidelines for facilities would impact on doing minor procedures in their rooms.

Specialist plastic and reconstructive surgeon Tim Edwards, from the Australasian Society of Aesthetic Plastic Surgeons, said the deferral was necessary because of “unintended consequences” to patients of requiring all procedures to be carried out in accredited facilities, which would add thousands of dollars to the cost of some minor procedures.

“I think in fairness to the Medical Board, what they’re dealing with is a very small number of people who are prepared to flout rules and regulations and standards,” Dr Edwards said.

“But after all these many months of committees and inquiries and new regulations, the end result is that cosmetic cowboys can still operate. There’s nothing that can stop them. So one could argue that this whole process so far has failed to achieve what it set out to achieve.”

AHPRA insists its reforms instituted as of July 1 will protect patients undergoing cosmetic surgery. The agency hailed its crackdown on cosmetic surgery advertising, including on social media, as ensuring doctors could not make misleading claims about the benefits of cosmetic surgery, or downplay its risks.

Medical Board chair Anne Tonkin said the suite of reforms, which also provide for an “area of practice endorsement for cosmetic surgery” that sets new training and accreditation standards for the industry, would stamp out unsafe practices. There is

also legislation before Queensland parliament, that if passed will be followed as national law in other states to protect the title ‘surgeon’.

“Doctors are committed to patient safety, but too many people have been left emotionally and physically scarred after cosmetic surgery,’’ Dr Tonkin said.

AHPRA CEO Martin Fletcher said any practitioners ignoring the new rules would face tough action.


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