Baroness Wyld (Con)
My Lords, I first congratulate Laura Trott MP on her success in skilfully navigating her Bill through the other place, and in particular on its arrival in this House unamended. I am afraid the beginning of my speech may be a bit of an Oscars speech, because so many people have campaigned on this issue to date. I want to mention Alberto Costa MP, who has campaigned for so many years following the high-profile case of one of his constituents who suffered a terrible injury following a botched lip filler administered by an unregulated and unqualified beautician, and Carolyn Harris MP and Judith Cummins MP, who are co-chairs of the All-Party Group on Beauty, Aesthetics and Wellbeing. I also pay tribute to the fantastic work of Save Face, which is a national register of accredited practitioners who provide non-surgical cosmetic treatments.
I was delighted when Laura Trott approached me to sponsor this Bill in this House and I hope, with the help of noble Lords, to steer it on to the statute book in the remaining weeks of this Session. I am sure we will have a very wide-ranging discussion about children and young people; for good order, I declare my interests as a non-executive member of the boards of Ofsted and DCMS.
The purpose of the Botulinum Toxin and Cosmetic Fillers (Children) Bill—which is very hard to say—is to prohibit specific cosmetic procedures being performed on people under the age of 18 in England, except under the direction of a doctor, thus safeguarding children from the potential health risks of Botox and cosmetic fillers. The Bill has cross-party and government support; we are very grateful for the collaboration from both Opposition Benches and the time that noble Lords have given me. I hope that will help its progress.
I still find it quite shocking that this Bill is needed at all. To be clear, I have no problem whatever with an individual’s right to alter their appearance, should they so wish. However, children are still developing, physically and emotionally, and without this legislation we are leaving them exposed to completely unacceptable risk. Laura Trott commented in the other place:
“The most frequent reaction I have received in response to my Bill is, ‘Surely, that is illegal already.’”—[Official Report, Commons, 16/10/20; col. 652.]
Today we have the chance to ensure we put this right.
In recent years we have seen a growing prevalence and normalisation of non-surgical cosmetic procedures; they are increasingly accessible and affordable on the high street because technologies and products in this field have advanced. Cosmetic fillers and botulinum toxin—which I will refer to as Botox, which is actually a brand name—have been identified as the two procedures most appropriate to be brought under the scope of the Bill, as they are two of the most accessible and invasive procedures available on the high street.
For those who do not know, I will quickly say what Botox and cosmetic fillers are. Fillers are gel-like substances commonly injected into the lips or face to add volume and plump the injected area; they may also be used in the hands and feet, or for non-surgical nose jobs. There are temporary fillers and less common permanent fillers, which have an increased risk of serious complications. Although some filler products are regulated as medicines, they are usually classified as general products. As a result, there is a vast range of products available for purchase, and the specification and assurance of the product is limited.
Botulinum toxin is a medicine injected into the skin to smooth lines and wrinkles—I considered making a joke about Botox in your Lordships’ House, but I thought we ought to play it safe today. As prescription-only medicines, they are regulated by the MHRA in the UK. Regulated healthcare professionals with prescribing responsibilities, such as doctors, may delegate responsibility for the administration of the medicine to a secondary practitioner who does not have to be medically qualified.
I will now explain why children are at risk. In England, cosmetic surgery can be performed only by doctors registered with the GMC, and providers of cosmetic surgery are required to register with the Care Quality Commission. As non-surgical procedures, the administration of botulinum toxin and cosmetic fillers is not a regulated activity. The procedures can be performed by clinicians, beauty therapists or lay people in both clinical and high street venues.
Although these procedures are offered on the high street, there are risks and complications. Risks from Botox include blurred or double vision, breathing difficulties, if the neck area is injected, and infections. For fillers, complications include the substance moving away from the intended treatment area, infection, scarring and blocked blood vessels in the face, which can cause tissue death and permanent blindness. People—mainly women—have been left with rotting tissues, lip amputations and lumps.
Currently, children, in the same way as adults, may access Botox and cosmetic filler procedures on the commercial market without a medical or psychological assessment. A 2018 survey showed that 100,000 under-16s had undergone cosmetic enhancements, the most common of which were fillers.
This Bill’s focus is intentionally narrow. It will create a new offence in England of administering botulinum toxin and cosmetic fillers to persons under 18, except where their use has been approved by a medical practitioner. The procedures will still be available to under-18s from doctors and a limited range of registered health professionals—dentists, pharmacists and nurses who are acting under the direction of a doctor—as there are cases where medical conditions would require such a treatment, for example with migraines. It also places a duty on businesses to ensure that they do not arrange or perform the procedure on under-18s unless it is administered by an approved person—a doctor, nurse, pharmacist or dentist.
The Bill creates no new enforcement mechanisms. Local authorities will be able to use the powers already accorded to them under the Consumer Rights Act 2015. As they would be criminal offences, the police can use their existing powers in relation to the powers in the Bill. The legislation would bring these specific invasive cosmetic procedures in line with age restrictions on tattoos, teeth-whitening and sunbed use.
The Bill is both short and straightforward—in many ways that is its strength—but its effect in introducing an important protection for young people is crucial. It is not about attacking the cosmetic treatment industry; indeed, the industry supports the purpose of the Bill. It is about ensuring that young people cannot access cosmetic procedures until they are able to make a genuine, informed choice.
Like many others speaking today, I speak a fair bit in this House and in my other work outside it about policy affecting children and young people. I spend most of the rest of my life, when not at work, worrying about my three young daughters and whether I am being overprotective or not protective enough, given that, after all, life is full of risk and we should prepare children for that. But there are situations when we have an absolute responsibility to step in and remove danger. I strongly believe that this is one of them. I beg to move.