Medical Aesthetics Industry: Regulation

Ian C. Lucas Excerpts

Tuesday 14th May 2019 Westminster Hall

[Alberto Costa]

My hon. Friend, in his time as the relevant Minister in this area, contributed enormously to this field, and I pay tribute to the work he has done in pushing for regulation of the industry.

I am not sure how to answer my hon. Friend’s point, because regulation takes many different forms. I think we would all argue that we want a healthy, thriving, competitive beauty industry. We do not want to strangle it or place an unnecessary obstacle before the business. We seek to achieve a safe beauty industry, where our constituents can approach any beautician of their choice, safe in the knowledge that these individuals have been properly trained and are qualified and regulated. I am certainly up for having the debate on whether they should be regulated by the General Medical Council, the overarching regulator of healthcare professionals or some other regulatory body, but regulation is the key.

I would also like to highlight the distinct difference between Botox and dermal fillers. Botox is a prescription-only medicine that can be prescribed only by a regulated healthcare professional, such as somebody regulated by the GMC. However, there is a loophole. At present, the prescriber is able to delegate the administration of the injections to another person, which unfortunately creates a way for people who are perhaps not regulated at all to administer the product. On the point my hon. Friend made a moment ago, if we were to have a regulatory body that somehow was able to delegate to others, we would have to ensure that those to whom the administration of the procedure was delegated were suitably trained to administer the procedures.

It is evident that these procedures are becoming more popular, and social media has an influence: so many young people are having procedures such as dermal fillers and Botox that that is almost normalising them. Given that the procedures are so widely seen on social media, they are being viewed by young people as equivalent to, for example, having one’s hair cut, as they are just as accessible. I have heard that people will say, “I’m just going out to have my lips done,” just as we might say, “I’m just popping out to have my hair done.” The normalisation of a procedure that can result in trauma should be looked at carefully.

[Ian C. Lucas (Wrexham) (Lab)]

Freyja Medical, in my constituency, provides an excellent service, but it also pointed out to me the important role that it sees Parliament performing in highlighting the impact and consequences of some of the very poor work that is carried out on individuals. I would certainly like to join the all-party parliamentary group, and I think one of the most important things we must do is get the message out to people on how dangerous the administration of these products can be.

[Alberto Costa]

I agree entirely, and I encourage the hon. Gentleman to join both the excellent APPG of the hon. Member for Falkirk (John Mc Nally), and that set up by the hon. Members for Swansea East and for Bradford South (Judith Cummins) and me. They are complementary APPGs and we would welcome the hon. Gentleman’s interest and expertise.

I mentioned a moment ago that this debate should not centre on the conversation about medics or non-medics carrying out these procedures; I believe it is fine for properly qualified and regulated beauticians to be able to offer them. I also highlight the fact that people who receive botched fillers often end up having to go to our national health service to pick up the pieces, as my hon. Friend the Member for Ribble Valley mentioned a moment ago, so that ultimately the taxpayer has to foot the bill.

As the Keogh review concluded:

“Dermal fillers are a particular cause for concern as anyone can set themselves up as a practitioner, with no requirement for knowledge, training or previous experience.”

In February 2014, it was made illegal to offer dermal fillers without training, but the training has not been clearly defined, and some of those who may be qualified to give lip fillers may not have the necessary training to be able to dissolve them or identify when something has gone wrong. We have met or heard from beauticians who would argue that they are properly trained or qualified, but in some instances they can be trained or qualified only for one part of the procedure, and not necessarily for when things go wrong. Surely, anyone carrying out these procedures should be able to identify when things have gone wrong and remedy them immediately.

The British Association of Aesthetic Plastic Surgeons would like to see the development of clinical guidelines on the use of dermal fillers. The Royal College of Surgeons has also expressed that it would like to see dermal fillers classified as a prescription-only medicine. Serious complications of cosmetic procedures can include infection, nerve damage, blindness, blood clots and scarring. That links to what the Government have helpfully announced today, as the campaign will help to inform consumers of those risks. They are also recommending that consumers go to a regulated healthcare professional.

The medical director at NHS England, Professor Stephen Powis, has said that professionals who provide procedures such as fillers should be encouraged to join the new Joint Council for Cosmetic Practitioners. That is very sensible, as it has been set up to assist members of the public, although it is not obligatory. We also face the surrounding issue of body dysmorphia and mental health. Professor Powis has also argued that practitioners should be officially registered and trained to identify people who may be suffering from a body image or other mental health-related issue.

Social media is a powerful tool for young people to look at and to share their experiences. Platforms such as Instagram and Facebook are often used as a principal source of information when people are researching fillers and Botox. I argue that that should not be the case: education on those matters should ideally be face to face when someone is having the procedures, with a trained and regulated practitioner.

Rather surprisingly, there is no age restriction on cosmetic procedures, and I argue that we should have one. The Nuffield Council on Bioethics recommended that children under 18 should not be able to have these procedures unless there was an overriding medical reason for them to do so. As a comparison, the law as it stands in England is that if someone wants to use a sunbed, they must be over 18. I mentioned unregulated vets earlier; we would not consider taking a valued pet to an unregulated vet to have an injection, so why would anyone let, for example, their 16-year-old daughter have someone unregulated inject something potentially poisonous into her face? I invite the Government to consider age restrictions.

The other point I will make is about the content of many dermal fillers. There is a total lack of regulation on the content—that is, the chemical ingredients. According to the British College of Aesthetic Medicine, there are more than 60 dermal fillers available in the UK market alone. It should shock us that we often do not know the content of those fillers and what poisons they may well contain that might have a negative impact on someone’s body.

I believe that urgent regulation is required to protect consumers—our constituents. The steps that the Minister and her Department have taken today are very welcome indeed, but we must do more. I look forward to the Minister’s comments, because I am confident that she is looking into this.