Most cleft lip and palate operations are less than completely successful, a damning report has revealed. Less than half the children could speak clearly after the operation, two out of five had poor dental bite and less than a third had good lip appearance.

The specialist units performing this delicate operation were also criticised. Of the 57 such units in the UK, only six to eight provided good to excellent care, and the overall results were five to 12 times poorer than in the six European centres examined.

The study, by the government funded Clinical Standards Advisory Group, discovered rivalry between plastic surgeons and maxillofacial specialists about who should carry out the operations. The result was that the surgeon was usually poorly trained, with very little experience (BMJ, 1998; 316: 723).

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Written by What Doctors Don't Tell You

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