British patients who have cheap surgery abroad are bringing dangerous superbugs back to the UK, nurses have warned.

Some NHS hospitals have seen a 30 per cent spike in cases of antibiotic-resistant bacteria–which can be fatal if it enters the blood stream–triggered by patients returning from operations overseas.

NHS nurses said they had seen a surge in cases of ‘horrific wounds’, infection, sepsis and patients dying over the past two years from complications after having overseas surgery-and suggested foreign clinics should pay the NHS compensation when things go wrong.

Growing numbers of British patients who face lengthy NHS waiting lists and high costs for private surgery in the UK are travelling abroad for cheap surgery, most often to Turkey and Eastern European nations.

Around 5,000 patients had weight-loss procedures abroad in 2024-more than the 4,500 people who had the procedure on the NHS in 2021-22, according to a BMJ report. 

Waiting times for weight-loss surgery on the NHS can be up to four years.

Some UK patients are enticed abroad by social media marketing which promotes major surgery-like gastric bypass operations or cosmetic procedures – as part of ‘luxury package holidays’, the Royal College of Nursing annual conference heard this week.

But infection control measures in countries outside the EU can be significantly less rigorous than those in the UK. 

Around 5,000 patients had weight-loss procedures abroad in 2024 - more than the 4,500 people who had the procedure on the NHS in 2021-22, according to a BMJ report

Around 5,000 patients had weight-loss procedures abroad in 2024 – more than the 4,500 people who had the procedure on the NHS in 2021-22, according to a BMJ report

Various procedures which are not offered in the UK are carried out by surgeons in Turkey

Various procedures which are not offered in the UK are carried out by surgeons in Turkey  

Here, strict rules ensure operating theatres have regular inspections, are well-ventilated and surgeons use new or sterilised equipment for each patient.

Nykoma Hamilton, an infection control nurse from Fife, in Scotland, said patients returning from treatment abroad were increasingly infected with bacteria resistant to the strongest antibiotics used to treat the most severe infections – a group of drugs called carbapenems.

She told the conference: ‘Our concerns relate to the fact that a lot of people are colonised with a lot of extensively drug-resistant organisms.’

NHS hospitals and clinics in her area had recorded a ‘near 30 per cent’ increase in detection of carbapenem-resistant bacteria, she said, describing the superbug as the ‘absolute granddaddy of resistance’.

District nurse Nicola Smith, from Slough, said she had been ‘really shocked’ by some of the ‘horrendous wounds’ and infections she had seen in people who had come back from surgery abroad.

WHAT IS ANTIBIOTIC RESISTANCE? 

Antibiotics have been doled out unnecessarily by GPs and hospital staff for decades, fueling once harmless bacteria to become superbugs.

The World Health Organization (WHO) has previously warned if nothing is done the world is heading for a ‘post-antibiotic’ era.

It claimed common infections, such as chlamydia, will become killers without immediate solutions to the growing crisis.

Bacteria can become drug resistant when people take incorrect doses of antibiotics or if they are given out unnecessarily. 

Former chief medical officer Dame Sally Davies claimed in 2016 that the threat of antibiotic resistance is as severe as terrorism.

Figures estimate that superbugs will kill 10 million people each year by 2050, with patients succumbing to once harmless bugs.

Around 700,000 people already die yearly due to drug-resistant infections including tuberculosis (TB), HIV and malaria across the world. 

Concerns have repeatedly been raised that medicine will be taken back to the ‘dark ages’ if antibiotics are rendered ineffective in the coming years.

In addition to existing drugs becoming less effective, there have only been one or two new antibiotics developed in the last 30 years.

In 2019, the WHO warned antibiotics are ‘running out’ as a report found a ‘serious lack’ of new drugs in the development pipeline.

Without antibiotics, C-sections, cancer treatments and hip replacements will become incredibly ‘risky’, it was said at the time.

In one case, she treated a young woman who surgery abroad for skin removal after weight loss. 

Two week’s later, patient’s large thigh wound was only loosely held together with stitches, the tissue was dying and she had developed sepsis.

‘It’s really sad as this procedure was sold to her like a holiday package – all she told me about was how fantastic the hotel was after she’d had her surgery and that they took her back to a posh car,’ she said. 

‘A hotel is lovely but it’s no place to be when you’re in pain, when there’s an infection, when you’ve got serious complications.

‘There was no blood pressure testing, no aftercare for this woman at all. In fact, I’m surprised she made it back on the flight. It’s really scary.’

The British Association of Aesthetic Plastic Surgeons (BAAPS) has issued a warning about the infection risk of surgery abroad, saying: ‘Some people are returning with multi-resistant bacteria that are hard to treat and may infect other people’.

The number of antibiotic-resistant infections across the UK has grown by 7 per cent before the pandemic, up from around 62,000 in 2019 to nearly 67,000 in 2023, figures from the UK Health Security Agency show.

Nurses told the RCN debate patients should be free to choose where to have treatment but needed better information about how to check clinics were safe and what aftercare would be provided.

And they suggested the NHS should not have to shoulder the burden for mistakes made abroad.

Ms Hamilton said foreign clinics should have to cover patients with an insurance policy, so that the NHS could claim compensation if it had to treat complications later.

An investigation published by the BBC last year found NHS hospitals were spending more treating complications from people having cheap surgery abroad than they were on providing the treatment to NHS patients. 

Complications included infections, sepsis, excessive bleeding and severe malnutrition.

Speaking after the debate, RCN head of nursing Carli Whittaker said: ‘The trend of patients travelling to other countries for treatment can pose difficulties, including adequate aftercare once home and the risk of infection post-operation.

‘Very high waiting lists are a prominent factor, with some deciding to pursue treatment overseas rather than be forced to wait months, sometimes years, in the UK. Nursing staff will always provide the best care for those suffering from the complications of surgery abroad, but the issue must be tackled at its root.’

Wes Streeting, the health secretary, has urged people to ‘think very carefully’ before going overseas for surgery — warning that the NHS is left to ‘pick up the pieces’.

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