The Irish Association of Plastic Surgeons (IAPS) has been calling for uniform regulation of the private and public sector for many years and the issue now seems to have finally been put on the political agenda. The IAPS and the Royal College of Surgeons in Ireland (RCSI) separately wrote to the Medical Council last week outlining their concerns about the lack of regulation of cosmetic surgery clinics in the state.

What prompted those moves?

A French surgeon at an Advanced Cosmetic Surgery (ACS) clinic in Dublin, who split his time between Ireland and France, has been suspended from the Medical Council's register on foot of a High Court order pending a full fitness-to-practise inquiry. The IAPS and RCSI told the Medical Council complicated procedures such as gastric banding (complex anti-obesity surgery) should not be carried out at facilities other than major hospitals. They also voiced concern about aftercare for patients at some private clinics.

Last Sunday, a national newspaper published an article stating that a woman died after she underwent gastric banding by the French surgeon at an Advanced Cosmetic Surgery clinic. This claim has been strongly denied by the clinic, which told the Sunday Tribune it was now taking legal action against the newspaper that initially published the story.

"What has been said about that surgeon is completely untrue. That patient had blood tests and an investigation with a camera to see if she was suitable for the procedure. The surgeon found cancer cells, so she would not have been suitable and the clinic informed her GP. Unfortunately, 12 hours later she died from sleep apnoea, which was unrelated to the investigation by the surgeon, " said ACS managing director Halina Ashdown Sheils. "His suspension had nothing to do with his work, but was a minor issue over documentation. He's one of the most experienced gastric-banding surgeons worldwide. He'll come and give evidence at the inquiry and most likely be given his licence back."

What problems have been identified due to lack of regulation?

Some cosmetic surgery patients are at serious risk because of the lack of regulation, according to Dr Jack Kelly, a Galway-based member of the IAPS. "There is very little regulation in the cosmetic surgery industry in terms of qualification of doctors, training and ongoing professional development, " he told the Sunday Tribune. "There is an issue with auditing of activity in some clinics and a major problem at some clinics with aftercare service."

Kelly said there were few members of his association who had not seen some complications arising out of treatments provided in cosmetic surgery clinics. "Just 10 days ago, a woman came into the A&E at Galway University Hospital with significant complications from abdominal plastic surgery [tummy tuck]. She had an infection;

it was a very serious post-operative complication. She had the procedure at a private clinic but she couldn't get anyone there to see her after the operation. I'm not trying to damn the whole private sector;

some of them deliver a well-delivered service. But some of them don't and it can have very serious consequences."

The RCSI also has serious concerns, according to its director of consumer affairs, Arthur Tanner. "The surgeon in question was performing major surgery and then leaving the country, and thus left the patient unattended on the same day as the surgery had been carried out. The concerns were relayed to RCSI by certain surgeons who were forced to deal with urgent surgical complications relating to the surgery that had been carried out as the patients were unable to contact the surgeon who had carried out their original surgery, " he said.

Meanwhile, Ireland's cosmetic surgery magazine, Rejuvenate, will call for "urgent regulation" of the industry in its next edition after being "inundated" with calls from people who've had bad experiences.

According to Ashdown Sheils, her clinic provides an excellent aftercare service, but she faced criticism last week that the French surgeon could not provide adequate care as he was not permanently based in Ireland. She said she had full confidence in the surgeon's abilities and that she herself had a gastric band fitted by the surgeon last April before introducing the procedure at the clinic.

She suggested Irish plastic surgeons had a vested interest in keeping foreign plastic surgeons out of the market. "All of the doctors who work at my clinic are on the Medical Council's register. This call for regulation is something I would welcome and agree with. But it's really about some plastic surgeons here not wanting surgeons from outside this jurisdiction to come into this country and work."

But this assertion was strongly rejected by the IAPS's Kelly. "That's not true, " he said. "Everyone in our association is busy with our jobs in the public and private sector. We've more than enough work to do.

Our concern is for the standard of care for the patients, these are serious medical procedures. As cosmetic surgery procedures become more complex and frequent, this is leading to more problems."

Has anyone ever died in Ireland from a botched cosmetic procedure?

No. But a Limerick mother-of-two died last year after flying to the US to undergo cosmetic surgery. Kay Cregan (42) from Skagh, Croom, suffered complications after undergoing surgery for a facelift. She had travelled to New York for the surgery in a Manhattan clinic hoping to surprise her husband Liam on her return. He believed his wife was in Dublin on a business trip and only learned she had been taken to hospital in New York when he was contacted by the Department of Foreign Affairs.

How has the government reacted?

Minister for Health Mary Harney said the Commission on Patient Safety, which is due to report next summer, is looking at the licensing of all healthcare facilities, including cosmetic clinics. "It's not good enough that there is no accreditation in Ireland of hospital facilities, both in the public and private sector, and it's a major deficiency as far as patients are concerned and patient safety issues are concerned, " she said.

"Obviously, I can't talk about any individual case. I would urge patients, however, to be vigilant when they go forward for unnecessary surgery."

Kelly said the IAPS welcomed the development on the commission's report but stressed it was a long time coming and was not by any means imminent. "We have been calling for regulation for years, " he said. "This news is better than nothing.

We hope it will be effective and it won't just be another government report that sits on a shelf."