It is a long standing principle of the NHS that it should treat patients without making value judgments about the lifestyle choices that may have been responsible for their condition, writes Totnes MP Dr Sarah Wollaston.

If that were to change as a result of the calls for the NHS not to treat women who have had cosmetic breast implants, I think that would be a great shame.

After all, where and who would draw the lines? Should we refuse to treat those who take part in high-risk sports such as hang gliding or even riding? Would we decline to treat smokers or the person who contracts hepatitis from a dodgy tattoo?

Of course, private clinics should be held accountable; they have an ethical duty to treat their former customers free of charge should their use of low-cost French breast implants be shown to have an unacceptably high risk of rupture.

But if those clinics, along with manufacturers PIP, have gone into liquidation, then where women are at risk the NHS should not, in my view, leave them stranded if they are unable to afford to have faulty implants removed.

The final advice on the need for removal will depend on an expert review panel convened by the Department of Health, but the news that some private clinics are admitting to much higher rupture rates does add to the concern for the thousands of women who have implants.

Many have had these fitted following reconstructive surgery for cancer or other serious conditions and several women have contacted me to tell of the worry they face while waiting for confirmation of the type of implant they themselves have in place.

At present there is no national register for implants, as there is for some other types of prosthesis, which makes it more difficult to track which device any individual may have in place. It also makes it more difficult to follow up the true rate of long-term complications. The current system involves voluntary reporting to the Medicines and Healthcare Regulatory Agency, but private clinics may have little interest in long-term follow up.

In my view, the private cosmetic surgery industry needs to be held to account for this avoidable scandal.

If they have been concealing data of reported harm from former patients and not then sharing this with prospective clients, then both the courts and the General Medical Council should take action.

In future perhaps all women opting for cosmetic implants should pay a compulsory insurance premium to cover the costs of replacement should the implants fail or cause problems so that the NHS would not have to pick up the tab on behalf of the multi-million-pound cosmetic industry.

Such a premium could also cover the cost of maintaining a register.

The two professional bodies representing aesthetic or “plastic” surgeons should reappraise the ethics of cosmetic implants, particularly where these are promoting a dysmorphic “plastic” image of women. After all there is a long history of implants failing and anecdotal reports for years from women who claim that they have damaged their health.

There are those who argue that cosmetic surgery is just an extension of the right to make any decision about one’s appearance and that it is no-one else’s business to interfere. That may be the case, except that this industry does impact on wider society by encouraging and colluding with an artificial and damaging stereotype of women.

Of course it is ultimately the responsibility of individuals to make decisions about their health and live with the consequences, but I can’t help feeling that those decisions may have been based on inaccurate follow-up data and therefore false reassurance about the safety of implants.

I hope the GMC will take action if surgeons and their clinics are shown to have failed to pass on reports of pain or leaking from PIP implants because this should surely have been an ethical responsibility, even if not a legal duty, in order to fulfil their duty of care to future patients.

For all those women facing the agonising wait for news about whether their surgeon fitted cheap PIP implants filled with industrial-grade rather than medical-grade silicone, this will be a nerve-wracking few weeks.

Ultimately, whatever anyone’s views about cosmetic surgery, I feel we should all support the principle of the NHS being there to support us, free at the point of need and regardless of our ability to pay ... and without feeling that its staff will be making judgments about us.

Thousands of women have had breast implants for cosmetic, rather than medical, reasons, but have their decisions been based on accurate safety data?