Leading UK doctors are warning that the National Health Service is being left to “pick up the pieces” from complications linked to a rise in surgical tourism.
There are also fears that people of normal weight are buying slimming drugs, such as Ozempic and Wegovy, online without proper “wraparound” care.
A rising number of people are travelling abroad for procedures including weight-loss surgery and hair implants, but may not be getting the same standard of care that they would expect in the UK, said Prof David Strain, a professor of cardiometabolic health.
Prof Strain, chairman of the British Medical Association’s board of science, said medics in the UK are seeing an increasing number of patients with complications, including infections, from operations.
Foreign Office travel advice says that the standard of medical centres and available treatments can “vary widely globally”, and tells of six British nationals who died in Turkey in 2023 after medical procedures.
Medics at the the BMA’s national annual meeting in Belfast heard that there has been a “boom” in surgical tourism, which is “leading to a rise in serious post-surgery complications and deaths”.
Delegates passed a motion expressing concern about patients who need emergency surgery when they return to the UK.
The motion also called for an increase in weight-management services “partially” funded by a rise in the sugar tax.
Lose weight the healthy way - in pictures
“Several overseas clinics provide bariatric surgery far cheaper than the cost of disposable instruments used in the NHS. Follow-up is typically non-existent," said Dr Samuel Parker from the BMA, presenting the motion.
“[There are] reports of shortcuts, inappropriate use of disposable instruments and patients suffering serious complications necessitating emergency NHS treatment.”
On the sugar tax, Dr Parker said: “The sugary drinks tax in England was followed by a drop in a number of cases of obesity among older primary school children.
"It is estimated that 5,000 cases of obesity per year may be prevented in Year 6 girls alone.”
Prof Strain told journalists: “Surgical tourism has been a problem for some time.
"People disappear off to notably South Africa and Turkey, but there’s many other places to disappear to.
“And complications can arise late from any procedure, not just obesity surgery, even just something as simple as hair implants that people travel for.
“You can get infections and the problem is people come back and they are asking the NHS to pick up the pieces of procedures that were done with less standards that we would normally apply in the UK.
“Health tourism is on the rise as people are slightly more affluent. International travel is easier than it was. Organising these things are easier thanks to the internet.”
He said that the increase in anaesthetic procedures abroad have been spurred on by a “social media nation” where people feel the need to present themselves in a certain way.
“What we can never guarantee is the surgical standards in different countries, and even the equipment that may be used, and that’s where the risk comes,” Prof Strain said.
He said that someone who has returned from abroad and needs urgent treatment after a botched operation is taking a bed that could be used for an elective procedure, adding to delays.
“In an already overburdened health service then, health tourism can cause significant issues,” Prof Strain said.
On weight-loss drugs, he said: “One of the big worries about using these agents without a full wraparound service is that if you just give a drug that makes people lose weight, without the proper wrapround care that goes with it – talks about the changes in diet required and exercise that is absolutely required.
"Then people will lose fat and muscle and other tissues, and we end up with a condition called sarcopenic obesity, where basically the muscles are being lost at the same rate that the fat is being lost, and you see that so-called Wegovy face, which is very gaunt.
“In all of the trials for weight-loss drugs, every single one of them, it was drug-plus-lifestyle intervention and dietary advice.
"And the worry is that if you just buy these drugs off the internet without that … support, you end up jabbing yourself, and we don’t know the health benefits will be the same in those settings.”
Prof Strain said one of the problems with weight-loss pills was that tests had not been conducted on people of normal weight, so the effects were unknown.
“There’s always concerns about online drugs that have side-effects, that have interactions, and that can have an undesired effect if given to the wrong person.
“And any drug if it’s given to the wrong person can potentially do harm.
“Once you are living with obesity the brain chemistry changes, and these drugs are all about correcting the brain chemistry, so you start to feel satiated from food, you start to eat normal amounts.
“If you are a completely normal weight and you don’t have these alterations in brain chemistry, it’s entirely possible the drugs do absolutely nothing.
"Or it’s entirely possible that they even muck up the brain chemistry.
“They’ve never been tested in those populations. These are drugs that have been tested and they have got amazing results in people living with obesity, have amazing results from people with diabetes – we’re starting to see results in kidney disease and other disease states.
“But throughout the trials, nobody has been using these drugs in people who have normal weight without diabetes, because it made no sense.
“So if you’re asking me what the effects are, I don’t know.”
Killing of Qassem Suleimani
The burning issue
The internal combustion engine is facing a watershed moment – major manufacturer Volvo is to stop producing petroleum-powered vehicles by 2021 and countries in Europe, including the UK, have vowed to ban their sale before 2040. The National takes a look at the story of one of the most successful technologies of the last 100 years and how it has impacted life in the UAE.
Read part four: an affection for classic cars lives on
Read part three: the age of the electric vehicle begins
Read part one: how cars came to the UAE
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Starring: Nayanthara, Vignesh Shivan, Radhika Sarathkumar, Nagarjuna Akkineni
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Ziina users can donate to relief efforts in Beirut
Ziina users will be able to use the app to help relief efforts in Beirut, which has been left reeling after an August blast caused an estimated $15 billion in damage and left thousands homeless. Ziina has partnered with the United Nations High Commissioner for Refugees to raise money for the Lebanese capital, co-founder Faisal Toukan says. “As of October 1, the UNHCR has the first certified badge on Ziina and is automatically part of user's top friends' list during this campaign. Users can now donate any amount to the Beirut relief with two clicks. The money raised will go towards rebuilding houses for the families that were impacted by the explosion.”
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How to play the stock market recovery in 2021?
If you are looking to build your long-term wealth in 2021 and beyond, the stock market is still the best place to do it as equities powered on despite the pandemic.
Investing in individual stocks is not for everyone and most private investors should stick to mutual funds and ETFs, but there are some thrilling opportunities for those who understand the risks.
Peter Garnry, head of equity strategy at Saxo Bank, says the 20 best-performing US and European stocks have delivered an average return year-to-date of 148 per cent, measured in local currency terms.
Online marketplace Etsy was the best performer with a return of 330.6 per cent, followed by communications software company Sinch (315.4 per cent), online supermarket HelloFresh (232.8 per cent) and fuel cells specialist NEL (191.7 per cent).
Mr Garnry says digital companies benefited from the lockdown, while green energy firms flew as efforts to combat climate change were ramped up, helped in part by the European Union’s green deal.
Electric car company Tesla would be on the list if it had been part of the S&P 500 Index, but it only joined on December 21. “Tesla has become one of the most valuable companies in the world this year as demand for electric vehicles has grown dramatically,” Mr Garnry says.
By contrast, the 20 worst-performing European stocks fell 54 per cent on average, with European banks hit by the economic fallout from the pandemic, while cruise liners and airline stocks suffered due to travel restrictions.
As demand for energy fell, the oil and gas industry had a tough year, too.
Mr Garnry says the biggest story this year was the “absolute crunch” in so-called value stocks, companies that trade at low valuations compared to their earnings and growth potential.
He says they are “heavily tilted towards financials, miners, energy, utilities and industrials, which have all been hit hard by the Covid-19 pandemic”. “The last year saw these cheap stocks become cheaper and expensive stocks have become more expensive.”
This has triggered excited talk about the “great value rotation” but Mr Garnry remains sceptical. “We need to see a breakout of interest rates combined with higher inflation before we join the crowd.”
Always remember that past performance is not a guarantee of future returns. Last year’s winners often turn out to be this year’s losers, and vice-versa.
Karwaan
Producer: Ronnie Screwvala
Director: Akarsh Khurana
Starring: Irrfan Khan, Dulquer Salmaan, Mithila Palkar
Rating: 4/5
Results
2.15pm: Maiden (PA) Dh40,000 1,200m
Winner: Maqam, Fabrice Veron (jockey), Eric Lemartinel (trainer).
2.45pm: Maiden (PA) Dh40,000 1,200m
Winner: Mamia Al Reef, Szczepan Mazur, Ibrahim Al Hadhrami.
3.15pm: Handicap (PA) Dh40,000 2,000m
Winner: Jaahiz, Fabrice Veron, Eric Lemartinel.
3.45pm: Handicap (PA) Dh40,000 1,000m
Winner: Qanoon, Szczepan Mazur, Irfan Ellahi.
4.15pm: Sheikh Hamdan bin Rashid Cup Handicap (TB) Dh200,000 1,700m.
Winner: Philosopher, Tadhg O’Shea, Salem bin Ghadayer.
54.45pm: Handicap (PA) Dh40,000 1,700m
Winner: Jap Al Yassoob, Fernando Jara, Irfan Ellahi.
KILLING OF QASSEM SULEIMANI
KILLING OF QASSEM SULEIMANI
Dengue%20fever%20symptoms
%3Cp%3EHigh%20fever%20(40%C2%B0C%2F104%C2%B0F)%3Cbr%3ESevere%20headache%3Cbr%3EPain%20behind%20the%20eyes%3Cbr%3EMuscle%20and%20joint%20pains%3Cbr%3ENausea%3Cbr%3EVomiting%3Cbr%3ESwollen%20glands%3Cbr%3ERash%26nbsp%3B%3C%2Fp%3E%0A
ABU DHABI CARD
5pm: UAE Martyrs Cup (TB) Conditions; Dh90,000; 2,200m
5.30pm: Wathba Stallions Cup (PA) Handicap; Dh70,000; 1,400m
6pm: UAE Matyrs Trophy (PA) Maiden; Dh80,000; 1,600m
6.30pm: Sheikha Fatima bint Mubarak (IFAHR) Apprentice Championship (PA) Prestige; Dh100,000; 1,600m
7pm: Sheikha Fatima bint Mubarak (IFAHR) Ladies World Championship (PA) Prestige; Dh125,000; 1,600m
8pm: Sheikh Zayed bin Sultan Al Nahyan Jewel Crown (PA) Group 1; Dh5,000,000; 1,600m
MOUNTAINHEAD REVIEW
Starring: Ramy Youssef, Steve Carell, Jason Schwartzman
Director: Jesse Armstrong
Rating: 3.5/5
Zayed Sustainability Prize
UAE currency: the story behind the money in your pockets
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Killing of Qassem Suleimani
Specs
Price, base: Dhs850,000
Engine: 3.9-litre twin-turbo V8
Transmission: Seven-speed automatic
Power: 591bhp @ 7,500rpm
Torque: 760Nm @ 3,000rpm
Fuel economy, combined: 11.3L / 100km
KILLING OF QASSEM SULEIMANI
UK-EU trade at a glance
EU fishing vessels guaranteed access to UK waters for 12 years
Co-operation on security initiatives and procurement of defence products
Youth experience scheme to work, study or volunteer in UK and EU countries
Smoother border management with use of e-gates
Cutting red tape on import and export of food
ONCE UPON A TIME IN GAZA
Starring: Nader Abd Alhay, Majd Eid, Ramzi Maqdisi
Directors: Tarzan and Arab Nasser
Rating: 4.5/5
