Anxious women given PIP breast implants on the NHS will be able to have them removed for free, with private firms expected to offer the same deal, the Government said today.
While experts concluded there is no evidence to recommend routine removal of the implants, they said they could not entirely rule out that some are toxic.
Around 40,000 women in the UK received the implants, manufactured by a now-closed French company Poly Implant Prostheses (PIP), which were filled with non-medical grade silicone intended for use in mattresses.
The Government said those patients who had their implants on the NHS as part of breast reconstruction surgery - believed to be around 5% of the total - will be able to have them removed and replaced if they are concerned.
The Government expects private firms to give the same offer to anxious women who paid for their implants privately and also wish to have them taken out.
All women who have received an implant on the NHS will be contacted and offered a consultation with their GP or their original surgical team.
They could be offered scans to see if there is any evidence that their implant has ruptured.
With the support of their doctor, women who still have concerns will be able to have them removed and replaced free of charge on the NHS.
The Department of Health said it expected private firms to match the NHS offer.
It said: "Private providers have legal obligations to their patients. The NHS will offer a package of care for its patients, and we expect the private sector to do the same."
If the private clinic that provided PIP implants has closed down, the NHS will pay for removing the implants if the patient is entitled to NHS care.
But it will not pay for replacements in these patients.
The Government also intends to pursue private clinics to avoid the taxpayer picking up the bill.
Some private firms have already come forward to say they will offer women free removal of their implants.
The expert group behind the review concluded there is no link between the implants and cancer, as reported in one French case.
But it said it was "undeniably the case" that the implants are made up of non-medical grade silicone and should not have been implanted in women in the first place.
The expert group was unable to establish if the rupture rate is higher for PIP implants than for others.
But it could not be confident that PIP did not change the silicone in the implants, so could not rule out the possibility that some are toxic.
Health Secretary Andrew Lansley said his main concern has been for the safety of women who have had PIP implants.
"It has been a worrying time for these women," he added.
"We have at every stage sought to offer them as much advice and evidence as is available to us.
"Our advice remains the same, that there is not sufficient evidence to recommend routine removal.
"We have always recommended that women who are concerned should speak to their surgeon or GP.
"The NHS will support removal of PIP implants if, after this consultation, the patient still has concerns and with her doctor she decides that it is right to do so.
"We believe that private healthcare providers have a moral duty to offer the same service to their patients that we will offer to NHS patients - free information, consultations, scans and removal if necessary."
Mr Lansley said data from the industry has not been good enough to enable them to give a clear recommendation on the risk posed by PIP implants.
"We will therefore support women, including removal of the implant, if needed."
In France, the government has told 30,000 women they should have the implants removed while the Czech and German authorities have recommended that women should also have them taken out.
The boss of PIP has reportedly told police the victims are money-grabbers and he had "nothing to say" to them.
In the UK, the expert group will now examine wider issues around quality of data, surveillance and regulation of the cosmetic industry sector.
The Care Quality Commission is also reviewing whether clinics comply with registration requirements and is considering fuller inspections.
Fazel Fatah, president of the British Association of Aesthetic Plastic Surgeons, said women should be reassured that removal is a precautionary measure.
But he added: "It is accepted that these implants are sub-standard and not of a high medical grade.
"When they rupture, they cause significant disruption and it is not acceptable.
"This is a sensible decision, taken after intense deliberation and we support that."
Tim Goodacre, from the British Association of Plastic, Reconstructive and Aesthetic Surgery, said: "Our advice remains the same: the implants should be removed and women need to return to their implanting clinic which has primary responsibility for helping them, as emphasised in the report."
Mark Harvey, a partner at Hugh James solicitors, which is representing more than 250 women, said the Government seemed to have made a tacit admission that it has no power to compel private clinics but he expected clinics to follow the NHS's lead.
"If they do not, then we will be asking the courts later this year to compel them to do that."
PA 2012
PA 2012
