Body Image and Mental Health

Ruth Jones Excerpts

Tuesday 23rd July 2019 Commons Chamber

[Mr Kevan Jones (North Durham) (Lab)]

I begin by agreeing totally with the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron): the debate is important. Last week we had a debate on mental health; we have two this week, one here today and one in Westminster Hall on Thursday afternoon on the Mental Health Act 1983. That is good because the more we talk about mental health issues, the more we normalise them. The hon. Lady is right. I have been a Member of the House for more than 18 years, and it has changed. The more we talk, the better. She makes a very good point.

Ministers are going into the twilight zone at the moment; seeing whether they are going to come out of the reshuffle. I add my thanks to the Minister to those of my hon. Friend the Member for Dewsbury (Paula Sherriff). The Minister has been a passionate advocate for mental health and she deeply cares about it. We know when a Minister gets it, and she does. I hope that she survives whatever happens over the next few days. The other thing that is unusual and does not get a great deal of publicity is the fact that she is prepared to work across party and across the House, and to listen to alternative viewpoints. I wish to put that on the record.

I pay tribute to the Mental Health Foundation for its excellent report. I know that the Minister was at the launch. I think it was the first time that body image and mental health had been brought together. The hon. Member for East Kilbride, Strathaven and Lesmahagow talked about eating disorders, and the stark facts that come out of the report should concern us all.

It is important to say that it is not just young people who are affected. As my hon. Friend the Member for Dewsbury said, 20% of the adult population in the UK feel ashamed of their body image and 34% feel down about it. In some cases, that will not lead to mental health problems, but in a lot of them it will. If people have anxiety about their body image, it leads to related conditions.

According to the report, 34% of young people feel upset about their body image and 31% feel ashamed of it. We cannot insulate young people from society—we should not even attempt to do so. Living in society can be difficult and challenging at times, and young people face the added pressure of social media.

[Ruth Jones (Newport West) (Lab)]

I thank my right hon. Friend for making such a positive speech in this important debate. Does he believe that social media and advertising have a significant impact on young people, and does he agree that the Government need to take more vigorous steps to ensure that young people are protected from images that can lead them to form negative views of their own body?

[Mr Kevan Jones]

I completely agree with my hon. Friend. I will go on to speak about the role of advertising because, as she will know, it has changed. When we were growing up, adverts were in magazines or on television. Now, they are accessible to young people 24 hours a day, seven days a week on smartphones and tablets. That has changed the pressure on young people, as is highlighted in the Mental Health Foundation’s excellent report.

Before I come on to advertising, I will touch on the issue of cosmetic surgery, which the Minister raised. Members may want to know why I am interested in the subject. It is down to a force of nature, my constituent Dawn Knight, whom the Minister has met. Unfortunately, several years ago a cosmetic procedure on her eyes led to the horrific situation that she can no longer close her eyelids. As the hon. Member for East Kilbride, Strathaven and Lesmahagow said, such procedures are not easily reversible. It is not like someone changing their hair colour and not liking it. The procedure has had a devastating effect on Dawn’s life. I pay credit to her, because she has been determined to campaign on this issue. I know that she has met the Minister on a number of occasions to highlight the dangers of cosmetic surgery.

The Minister referred to regulation. I have been calling for regulation in this area for five years. I do not think there is a lack of political will, and certainly not from this Minister, but I am told that the Department of Health and Social Care is so scarred by the Health and Social Care Act 2012 that it does not want to bring forward any more health-related legislation. I say to Ministers that they must. This is the wild west because there is no regulation.

The Minister rightly warned people not to go abroad for such procedures, because standards are not high. Sadly, I have to say that they are not very high in this country either. Dawn’s case and the cases of numerous women that Dawn has documented over the years show that surgery that takes place in this country is sold like a commodity. It is not sold as something that could threaten or change people’s lives; it is sold like any other product. I am sorry, but it is not like any other product. Some of these procedures are very dangerous and can result in death.

The problem is the way the industry is structured. There are groups that give the impression that they employ surgeons and that they are hospitals. One that I have spoken about on behalf of Dawn and other victims—that is what I call them—is the Hospital Group. One would think that it is a hospital that employs surgeons and nurses, but it is not. It is a sort of marketing facility company that has a hospital and flies in surgeons from Europe, sometimes on a daily basis. They fly in, operate and fly out again. The aftercare treatment is non-existent in some cases. As Dawn’s case shows, when people try to sue the individual, they find that their indemnity insurance does not cover the resulting legal case.

What we need is a properly regulated system. The fly-in, fly-out surgeons need to be banned. I am sorry, but it is not acceptable. People say, “We have the General Medical Council,” but that is another of my hobby-horses. It is an organisation that is ripe for reform. The Government have promised reform of how the GMC operates, but they have not brought legislation forward. We need legislation to reform it because, as I will say in respect of another organisation in a minute, I am never a great fan of self-regulation. I was one of those who campaigned to take regulation away from the Law Society. Self-regulation has clearly failed. Nearly five years on from her complaint against the doctor, Dawn Knight is still fighting. It is not a user-friendly process for anyone to get redress for their complaint and we need to address that as a matter of urgency.

Cosmetic surgery is advertised and sold like any other commodity. There used to be two for one offers on Facebook and elsewhere—buy one procedure and get another procedure free. There were time-limited offers. Those should all be banned; they should not be allowed at all, because some of those procedures are very dangerous and people are often not aware of the dangers. I would argue that such a ban is part of the regulation we need. This is not a multimillion-pound industry, but a multibillion-pound industry and it is exploiting people’s poor body image.

Before anyone had any type of cosmetic surgery, I would insist that they had a mental health assessment. Not only should the risks of the surgery be explained, but we should question whether people actually want the procedure.

Advertisers use “Love Island” to promote the idea of young women having procedures to enhance their appearance. That reinforces the image that somehow there is a perfect body to be had, but also the idea that these procedures are risk free. Having spoken to Dawn and other victims of cosmetic surgery, I know that these are not risk-free procedures. In many cases, they lead to mental health problems afterwards during the recovery process.

As the Minister rightly said, the ones who pick up the tab are us—the taxpayers. Not only do we pick up the bill for the correction of the surgery when these organisations fold themselves into new companies and go into bankruptcy, meaning that people cannot get any redress; we also pay for the mental health services for those individuals afterwards.

I say again that we need more regulation of advertising. The Advertising Standards Authority is a toothless tiger. The Mental Health Foundation’s report says that last year the ASA upheld a complaint against the producers of “Love Island” for promoting cosmetic surgery as part of the advertising package around the show. But anyone who has dealt with the ASA will know that it is slow and that it is not proactive. One of the report’s recommendations is that it should be proactive in looking at adverts in advance to ensure that they are pre-screened before they go out. Again, though, that involves self-regulation, and it does not work.

I accept that we have a Government at the moment who do not like regulation and who want to strip it out. We are possibly going to get more of that nonsense over the coming months from the new Prime Minister, but I take the clear view that the state needs to protect people when they are being exploited. On cosmetic surgery, I take the clear view that people who want to have cosmetic surgery have the right to choose what to do with their money, but they should have a fully informed choice rather than being pressured by glossy advertising.

Online advertising and body image have already been raised in the debate. We have heard about the way in which adverts and other images are photoshopped and that this is somehow a positive thing that every young person should look forward to. The Minister also mentioned Botox and fillers. Those procedures are not cosmetic surgery in the sense of people going under the scalpel, but I would argue that they are equally in need of regulation because of the appalling effects when things go wrong. According to some adverts, people can simply go along in their lunch hour and have a Botox or filler treatment and then walk away in the afternoon, but those are medical procedures. They are advertised on social media and elsewhere, but Botox is a prescription drug, and it is interesting that people seem to have access to it even though they have no qualifications at all. No qualifications are needed for injecting someone. Madam Deputy Speaker, I could inject you with Botox this afternoon—not that you need it—without any qualifications or training whatsoever. The Minister was right to say that the problem with the way in which social media algorithms work is that anyone who enters the term “Botox” into a Facebook search, for example, will then be bombarded by adverts not only for Botox and fillers but for training courses on how to administer them. People can actually sign up for those courses in order to earn money.

The only regulation around this is Facebook. Dawn Knight has raised the matter directly with Facebook, but I understand that the only thing anyone can do is to say to Facebook that they no longer want this on their feed and take it down. I have written to Sir Nick Clegg, who has now gone off to live with the beautiful people in California, to ask him why Facebook is carrying those kinds of adverts and bombarding vulnerable people with adverts for Botox and other fillers. Those adverts have no disclaimers about risk, and there is no quality control over the individuals offering the services. As the Minister said, they could be people in hairdressers and other such places. Well, I am sorry, I know Facebook is earning money from those adverts, but it should ban them. I know that the vulnerability of young people is a matter of concern for the Minister, for Dawn Knight and for me. They could be getting access to these procedures without knowing the risks, and they are being targeted by the social media companies. I am waiting to see what response I get from Sir Nick Clegg and the beautiful people in California. Hopefully, they will take some action against this.

This is a serious issue, not just in terms of the way people are personally affected; it costs the taxpayer money when cosmetic surgery goes wrong and when people need mental health support. We also need regulation. We are all focused on Brexit at the moment, and perhaps this is another area that will not be addressed over the next few months. I hope that that is not the case, and I know that the Minister will continue to argue for this reform, as she has already done in Government. I also know that my constituent, Dawn Knight, will not leave this issue alone. I will not do so either, because people are putting themselves at risk and it is the duty of the Government to take action in Parliament to protect individuals when they need it. There is a lot of pressure on young people when it comes to body image. All I would say to those young people today is this: think positively, and be kind to yourself.

Acquired Brain Injury

Ruth Jones Excerpts

Tuesday 2nd July 2019 Westminster Hall

[Ruth Jones (Newport West) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Rosindell, and I commend my hon. Friend the Member for Rhondda (Chris Bryant) for securing this important debate. I know that many Members have been involved in these debates before, so bear with me: as the newbie, I may be making points that they have made many times over, but I think they bear repeating.

There have been many debates about what the definition of acquired brain injury is. I do not think it helps to focus on little details; it is important to be inclusive and generic, and make sure those people who need services, help and support get them. That is why I believe the definition of acquired brain injury should be wide and far-reaching. It is important that we remember that when we look at the various options.

Our national health service is a fantastic service. My constituency of Newport West is very close to Aneurin Bevan’s, so obviously I am going to say the NHS is brilliant—of course it is. It is great at the life-saving stuff, but it is not so great at the long-term rehabilitation needed by people with long-term conditions. With cardiac arrests, lives are saved, but the aftermath and the quality of life afterwards are so important.

Acquired brain injury may be the result of one incident or acquired over a period of time, but its effects are always lifelong and often permanent. As a physiotherapist, I have worked with patients with acquired brain injury at various stages of their journey, from intensive care—when it is very much life or death what is going to happen next—to the sub-acute, high-dependency and in-patient settings. At those stages, there is thankfulness that the person is going to survive, but the reality is beginning to set in that this will not change back any time soon; this is a permanent change, and the family has to deal with it. That is a very hard time for people.

There is then the long-term effect, when people might be back in their homes but are struggling to deal with their adjusted circumstances. That is often a time when people feel neglected, left and lost, and it is important that we focus on that area as well. Acquired brain injury does not just affect one person, but their families, friends and work colleagues; as my hon. Friend the Member for Rhondda has said, this predominantly affects younger people, so work colleagues are also involved. People always express their wish to provide help and support, but they need advice and guidance on how best to do so, and it is important that we recognise that.

The effects of acquired brain injury are also far-reaching, and might be physical, mental, or even spiritual. Others speak far more eloquently about that, and how it impacts on people’s working and daily lives, but I would like to emphasise the long-term needs of people with acquired brain injury. Research in the field of neuro-plasticity clearly indicates that recovery can go on for weeks, months and even years after an insult or trauma. It is therefore vital that our rehabilitation services can match that, so they must be available for weeks, months and years after the incident. In the later stages, somebody may not require treatment, advice and support every day, but it should be available for them to access when they need it.

I am delighted that the Health Minister is here today, and I would like to make a plea to her for additional resources for the vital services that people with acquired brain injury require in the long term. Obviously as a physiotherapist I am biased, so I am going to say we need more physios, but we also need occupational therapists, speech and language therapists, and providers of other therapies. Psychological input and support is also vital, and people often overlook that important aspect of rehab. The right hon. Member for South Holland and The Deepings (Sir John Hayes) has also mentioned diagnostics, because if we do not know what we are dealing with, we cannot treat it effectively.

It is really important that we have those additional resources when we need them; they should be accessible through time, over months and years. It is important to remember that this is not an event, but a process.

NHS Pensions

Ruth Jones Excerpts

Wednesday 26th June 2019 Westminster Hall

[Ruth Jones (Newport West) (Lab)]

I commend the hon. Member for Poole (Sir Robert Syms) for bringing this important debate to the Chamber. I did not intend to speak, but I feel obliged to do so now. I understand why this scheme was brought forward. It is not the scheme that I have problems with but its implementation and the unintended consequences, which have already been raised.

The situation in the NHS is complex. We have three NHS pension schemes, and it is really difficult to work out; I am part of two of them and I struggle to work out what I am supposed to be doing. We understand that it is difficult. The taper comes in at £110,000. The Chancellor told me in the Chamber that it is £150,000, but it is not. This is important, because although these wages seem a lot to some people, they are not that high compared with those of senior businesspeople. The taper will affect people such as consultants, GPs and medical academics. These are our leaders, and we need to ensure that there is succession planning. If these people leave abruptly because they realise the tax implications, there is no chance for succession planning.

[Alex Chalk]

The hon. Lady is making a good speech. It is true that senior consultants are often relatively well paid, but they cannot afford sometimes four, five or six-figure tax bills suddenly arriving on their doormats, which provide the most profound disincentive to their doing what they want to do: care for patients.

[Ruth Jones]

Absolutely. The hon. Gentleman makes an excellent point, and much more eloquently than I could. These things are coming in at the end of people’s working lives, and it is difficult for people to budget for them when they do not know what will land on the doormat. When we enter working life and take on board pensions, we know what we are signing up to. These changes are being made in the latter stages of people’s working lives, so it is really difficult to budget and plan for them.

Several constituents who work at the Aneurin Bevan University Health Board in my constituency have written to me to say that they will finish work early or cut down on the number of sessions because of these punitive tax bills. Although obviously the health service in Wales is devolved, pensions are not, so it is important that we look at this issue in the round and across the UK. We need to make sure that we retain these doctors across the board.

I commend the hon. Member for Poole for introducing the debate. I ask the Government to look again at this situation.