Breast implant scandal: 9 in 10 women will use NHS Firms that used large numbers of PIP implants are refusing to fund surgery costs for removal and replacement. On Wednesday, Harley Medical Group (HMG), which supplied 13,900 women with PIP implants, said it did not have the financial or surgical capacity to fund or carry out the operations. That followed the announcement at the weekend by Transform Cosmetic Surgery, estimated to have fitted some 4,000 women with PIPs, that it would not be funding removal and replacement. The Hospital Group, thought to have been Britain's second-biggest user of PIP implants after HMG, has maintained silence on the issue, refusing even to return calls or emails for requests for information from the media. A statement on its website implied it too was refusing to pay up for surgery. The statement chose to highlight the advice of a group of experts to the Department of Health that "there is no evidence to suggest routine removal." However, it neglected to mention pleas by Andrew Lansley, the Health Secretary, that private firms had "a duty of care" towards their patients - and that he expected them to offer free removal and replacement. The firms that have agreed to offer removal and replacement are as follows: Nuffield Healthcare The first company to say it would fund removal (on Wednesday January 4) it used PIPs on about 150 women. The firm said it would meet all costs of investigation, further surgical treatment and removal, if needed, for all of them. Spire Healthcare Agreed on Friday January 6 to fund removal and replacement for the 1,500 women who had received PIPs through the company. Linia Said at the weekend it would remove and replace implants for some 1,540 women who had received them at the firm's clinics, but only "when appropriate" and on a "case-by-case" basis. BMI Healthcare Has announced it will remove and replace implants for women who received PIPs at BMI's clinics "at no cost," and will also remove and replace implants for women who originally received them elsewhere for "a guaranteed fixed price package." In total, the two categories include some 1,311 women, although a spokesman refused to say how many had originally received them at BMI. Ramsay Healthcare Has agreed to fund removal and replacement after consultation with a clinician for some 150 former clients. Will remove and replace PIP implants for the 46 clients who received them there in the past, free of charge. Aspen Has agreed to fund removal and replacement after consultation with a clinician for "just over" 150 former clients. Has stated HCA will "meet the cost incurred" for those former patients who received PIPs and "require clinical investigation or further surgical support, including the removal of the PIP implant due to clinical need," including the distress of having them.