Material World: Cosmetic tourism (2024)

The Material World Column from the November 2024 issue of the Socialist Standard

A recent Daily Mirror headline ran ‘Mum of five dies after butt-lift treatment’. It explained how Alice Delsie Preet Webb failed to recover from an operation by an unregistered practitioner which involved injecting hyaluronic acid and dermal fillers into the backside (a so-called ‘Brazilian butt-lift’). This apparently was the first time anyone in the UK had died from this procedure. But, as confirmed in a recent article about ‘cosmetic tourism’ in the Times by Sarah Ditum, such outcomes are far more common when people (largely women) decide to take a holiday abroad and at the same time have cheap surgery done on various parts of their body they consider need improvement. She referred to a website which asks the question: ‘Why not take full advantage of the charming beaches and sunshine while sparing some time for dental treatment?’

The trouble is that it sometimes goes wrong and people end up with wonky teeth, a lopsided smile, uneven size breasts, tummy folds rather than tucks, and even worse. In fact, since 2019, as the article tells us, ‘at least 28 British medical tourists have died following treatment in Turkey’. And that’s not counting the much larger number who return home with complications which they then need to try and get fixed by the NHS. Of course, many of the thousands who do this each year are lucky and for them it works out as they would want. But it’s definitely a gamble and, according to the article, the reason women are prepared to take that gamble is that they want to be, as the article puts it ‘the best version of themselves’ and not ‘substandard’. And, given the prohibitive cost of such surgery in the UK by regulated medical professionals, they see no alternative but to seek it out more cheaply in less regulated countries – Thailand, Mexico, Slovakia or – the most common destination – Turkey.

Society of the spectacle

But why is it that people want to look different from the way they are in reality? In the late 1960s the French writer Guy Debord published The Society of the Spectacle, which presented the idea that ‘all that once was directly lived has become mere representation’. His point was that, because of the atomised and consumerist nature of capitalist society, an obsession with outward appearance (ie ‘the spectacle’) had taken the place of the authentic reality of social life and relationships. People’s lives were mediated by images of perfection which they were made to feel they had to live up to. This led them to focus on the superficial and become alienated from their fellow humans and from socially beneficial interaction.

Though this was theorised more than 50 years ago, it is surely more relevant than ever today. While it is true that, in any kind of society, people may find certain aspects of their physical being less than satisfactory, they are more likely to focus on that if other aspects of their life fail to offer them satisfaction and the ability to fulfil their natural talents and capacities.

This is precisely the case in modern capitalism where the vast majority of us are obliged to expend most of our energies working for an employer in activities we are unlikely to have chosen freely but are dictated by the needs of the market on the employer’s side and the need to keep the wolf from the door on the worker’s side. And this work, including the conditions in which it is carried out, is unlikely to represent any kind of real fulfilment of the individual’s personal needs or aptitudes. So is it any wonder if, outside working hours, workers’ minds are occupied with superficialities – sporting spectacles, stars of entertainment, the lives of royalty and other ‘celebs’, and also perceived flaws in their own physical appearance?

Life blood

Capitalism’s need to constantly find ways of supplying its life blood – profit – means that it can only seek to relentlessly sell things, to provide the means for workers to cultivate and spend money on those superficialities. So it’s no surprise that, for example, music concerts starring people’s ‘idols’ are promoted with ticket prices as high as they are likely to be able to scrape together money or credit for. Nor is it any surprise that, held back as they are from fulfilling their real talents or needs by lives dominated by wage and salary work, the feelings of powerlessness and inferiority this engenders make them easy prey to the cult, to the idol, to the hero, to the conspiracy theory, and to the cheap cosmetic procedures promised by potentially dubious practitioners.

In the society of the ‘quick buck’ we live in, tainted as it is by money and the profit system, should we therefore be surprised if the products we are offered for purchase do not serve the purpose they claim to but upset our expectations, and even – in the case of botched cosmetic procedures – make our life even more uncomfortable than we perceived it as in the first place? It’s time we got rid of the false value system that puts appearance before substance, that puts ‘looking good’ over being truly human.

Howard Moss

Toothache? Pay private fees or do it yourself (2023)

From the August 2023 issue of the Socialist Standard

Many will know that, while most people have to pay something for NHS dental treatment, it is still free to a certain section of the community: children and pregnant women and new mothers. But, as George Monbiot pointed out in his column in the Guardian on 2 March:

‘Every child in the UK is entitled to free treatment by a non-existent dentist. Some people on benefits, pregnant women and those who have recently given birth also have free and full access to an imaginary service. Your rights are guaranteed, up to the point at which you seek to exercise them’ (tinyurl.com/s7epuzad).

Dental practices, being profit-seeking businesses, consider that what they are paid for treating NHS patients is not enough – they claim that in some cases it doesn’t even cover their costs – and so are increasingly reluctant to offer it and have not been using up all their NHS funding. In February it was reported that ‘Around £400million allocated for dental care went unspent this year because of a shortage of dentists willing to do NHS work’ (tinyurl.com/yrrpakv2).

What this ultimately means is that any patient requiring urgent treatment is forced to make a choice between suffering or paying privately for the treatment there and then.

With private dental treatment running into the hundreds, sometimes thousands of pounds, it is obvious that those on lower incomes are really faced with no choice at all.

The system does appear to offer an alternative. Since 2006 the necessity to ‘register’ with a particular dentist has been abolished. What this means is that a patient whose regular dentist is unable or unwilling to provide NHS-funded treatment can shop around for another dentist prepared to treat them under the NHS.

The reason this only ‘appears’ to be an alternative is because it is another of Monbiot’s rights to a non-existent service. You won’t find another dentist prepared to treat you as they won’t find it profitable. So, when you look at those same low-income families and elderly people who can’t afford to ‘go private’, you see that really this is not much of an alternative at all.

In any event, going to another dentist obviously can involve increased travel costs if the dentist is out of the area. While merely inconvenient for some it could mean the difference between having the treatment and not for others such as the very low-waged who do not have access to personal transport or the rurally housed elderly who rely on poor public transport coverage. When you add the psychological factor of forcing people to see a dentist they are unfamiliar with which, as we know, can have a particular impact on older members of our community, you can see why so many people elect to wait for their own dentist to be able to do the work or forgo the treatment altogether.

There is another option – DIY dentistry – which, apparently, some have been taking. As Monbiot noted:

‘The result, in one of the richest nations on Earth, is that people are extracting their own teeth, making their own fillings, improvising dentures and sticking them to their gums with superglue, and overdosing on painkillers’.

We continue to be forced into a situation where, when we need treatment which is vital to our health and well-being, we either pay extortionate private fees, are forced to seek out another dentist at our own cost or, if none of the above are possible for us because of our financial situation, simply wait, with our condition worsening.

In socialism dental treatment would be provided freely to anyone who needed it. Unshackled from the financial pressures of the capitalist system, freed from the necessity of eking out an inadequate funding budget, the health services would be able to treat all those in a timely fashion to the best possible standard.

The fact is that no-one should be forced to make such dire choices when it comes to this or any other area of their health. The NHS was originally intended to implement the admirable principle: ‘Treatment free at the point of need’. Where our dental treatment is concerned, this principle has long had a thread tied between it and the door handle, and the door slammed shut.