Turkey defends medical tourism standards amid UK criticism after deaths

Turkey has defended its healthcare system after Britain accused it of putting patients’ safety at risk following a rise in deaths of medical tourists.

The Turkish embassy told The National that health tourism is an important part of the country's relationship with the UK and would play a role in closer ties.

The UK’s Foreign Office took the unusual step earlier this year of issuing a warning to Britons travelling to Turkey for treatment after 24 deaths were recorded in the past few years.

In one case mother-of-three Abimbola Ajoke Bamgbose, 38, died in Turkey after cosmetic surgery left her with perforations to her bowel and she suffered multiple organ failure.

Another saw 25-year-old Joe Thornley lose his life after suffering internal bleeding after weight loss surgery.

The British Association of Aesthetic Plastic Surgeons (BAAPS) and the British Obesity and Metabolic Surgery Society (BOMSS) said 100 per cent of all surgical complications member physicians had dealt with from procedures carried out abroad had originated in Turkey.

Incidents included the case of Angela Perkins, 57, who travelled to Turkey in 2021, and was left disfigured after an £8,000 operation on her face went wrong.

The Turkish embassy has defended the services on offer and says they are regulated to meet the “highest standards of quality and safety”.

Already in the first quarter of this year, Turkey has welcomed 412,000 foreign patients this year, and last year the figure hit 1.3 million.

“Turkey is a leading destination for health tourism, offering high-quality healthcare services,” it told The National.

“Patient safety is a top priority in the Turkish healthcare system. Patients are provided with detailed information about the services offered, and they can report any complaints they have.

“This helps to ensure that patients receive the best possible care.

“Healthcare services in Turkey are provided by authorised institutions and surgeons in accordance with international standards. These institutions are regularly audited by the Turkish authorities to ensure that they meet the highest standards of quality and safety.

“These annual assessments are obligatory for health institutions.”

Long NHS waiting lists make surgery abroad more tempting

As part of a new series on global health care, The National spent months speaking to doctors, hospital managers and patients from the UK and overseas to track changes in how people are treated.

There are more than seven million people on NHS waiting lists, with many waiting years for surgery.

A series of NHS strikes in recent months have affected waiting times, as well as hospital, emergency and intensive care services. In March, a British Social Attitudes survey revealed that a little more than half (51 per cent) of people are unhappy with the NHS – a record level of dissatisfaction in its 75-year history.

It has led to a surge in patients choosing private care, however the costs are beyond many people.

For example, prices with HCA Healthcare, the group of central London hospitals to have done the most hip and knee operations in the capital in 2022, start from £13,900 for the procedure and hospital stay, and consultant fees start at £1,400.

Going abroad has become an attractive alternative.

Countries such as Turkey offer surgery at less than half the price of the UK, leading to a boom in medical tourism.

The Foreign Office said the most popular procedures tempting travellers to Turkey are cosmetic surgery, dental procedures and cardiac surgery.

Cassie Dridge, 47, took to a crowdfunding site to try to raise funds to go to Turkey for gall stone surgery after facing a two-year wait in the UK.

She was quoted £8,000 privately in the UK but was able to gain access to the treatment for less than £3,000 in Turkey.

Others have used the same sites for dental and weight loss surgery in Turkey.

The popularity of Turkey led to the Foreign Office taking the unusual step of issuing a warning about the dangers of medical tourism in April.

“The standard of medical facilities and available treatments vary widely around the world. As such, British nationals considering undertaking medical treatment in Turkey should carry out their own research; it is unwise to rely upon private companies that have a financial interest in arranging your medical treatment abroad,” it said.

“We are aware of 24 British nationals who have died in Turkey since January 2019 following medical tourism visits. There are reports of an outbreak of botulism cases linked to weight loss treatments performed in Istanbul and Izmir in February 2023.”

BAAPS told The National that last year it saw a 35 per cent rise in the number of patients suffering serious complications.

Since 2018, more than 300 patients have required surgery after returning to the UK, it said, costing the NHS £15,000 per patient on average.

It said that in 2021, 75 people were treated for complications, including life-threatening problems such as the emergency surgical removal of dead skin tissue and admission to intensive care for life support following systemic infection.

“These complications, despite treatment, would still leave permanent life changing physical deformities along with the psychological effects of these injuries,” BAAPS said.

NHS has to pick up the bill of botched surgery

Mary O’Brien, president of BAAPS, said the NHS is left to pick up the bill of botched surgery.

“When patients go abroad for cosmetic surgery, they usually have no knowledge of the competence and experience of the surgeon, and there is very little prospect of follow-up care and advice,” she said.

“Best practice is compromised by the fact that patients are only meeting their surgeon immediately before a procedure – at which point, generally, they are committed to and have paid for the surgery. Patients then return to the UK without adequate medical records, if any – follow-up is difficult.

“Complications do occur and are usually left to the British system to pick up. The surgeons involved in these schemes do not have a work permit nor are registered in the UK, and it is unlikely there will be any possibility of seeking revisional surgery.”

BOMSS has strongly advised patients not to go abroad for weight loss surgery.

“We understand that accessing bariatric [weight loss] surgery on the NHS can be a frustrating experience and BOMSS is working hard to improve this situation,” it said.

“One consequence of the current lack of NHS provision of this treatment is that people decide to self-fund their care, either in the UK or abroad.

“BOMSS strongly advises UK residents to be cautious when considering bariatric surgery abroad. Care in the UK is tightly regulated with all providers regularly monitored and inspected.

“As a professional society, we are increasingly concerned by the number of patients presenting with the complications of surgical procedures performed outside the UK.

“There is often an assumption that the NHS will sort out any issues once the patient returns home, but this is not always straightforward and has resulted in severely ill patients being repatriated to the UK and presenting themselves to their local A&E department.

“Less than half of NHS hospitals trusts have access to a bariatric service and the specialist advice that is likely needed in these cases.”

“Standards of healthcare regulation overseas often differ from the UK, which means the quality of surgical care can vary significantly. In the event of a problem, legal redress is much more difficult leaving people exposed and unprotected.

“Weight loss surgery is an effective, but complex intervention requiring at least two years of support from a specialist team with dietetic, nursing, psychological and surgical expertise and lifelong annual reviews.

“We believe this is best delivered in a UK setting where surgical standards are high and rapid access to expert help after surgery is more straightforward.”

The Turkish embassy says patients need to ensure they are seeking accredited institutions and it is committed to growing its relationship with the UK.

“It is of utmost importance that the patients seek accreditation of the health institution they would like to apply,” it told The National.

“Turkey is committed to developing its bilateral ties with the UK in the field of tourism. Health tourism is an important part of this relationship, and British tourists who visit Turkey for healthcare services consistently appreciate the quality of care they receive.”