Medical Aesthetics Industry: Regulation

John McNally Excerpts

Tuesday 14th May 2019 Westminster Hall

[Alberto Costa]

The hon. Lady is correct. I pay tribute to her and to the hon. Member for Swansea East (Carolyn Harris) for setting up the new all-party parliamentary group on beauty, wellbeing and aesthetics, along with me. I look forward to her interventions at meetings of that all-party group; I know she has a great deal of knowledge of this area. I agree that we do not want to stifle the beauty industry—we want it to grow and be successful—but we all want to protect our constituents.

[John Mc Nally (Falkirk) (SNP)]

I congratulate the hon. Gentleman on setting up the APPG. I am the chair of the APPG on the hair industry and I am keenly interested in this development. A possible solution to the problem has been put forward by the British Association of Beauty Therapy and Cosmetology. It appreciates the concerns about mandatory registration, but thinks that a regulatory framework, led by the Government, would be difficult to implement and that the voluntary self-regulatory framework is not working either. BABTAC believes that the time has come for the Government to institute a mandatory regulatory framework that would be self-governing and would include BABTAC and the Royal College of Surgeons. Does the hon. Gentleman agree with that?

[Alberto Costa]

I agree. The hon. Gentleman has been doing sterling work on behalf of his constituents in related matters with his sister-APPG, and we wish him every success with that. He is right that we have to look at the issue in the round and include professionals who are experts in the field, who contribute to our economy and who themselves want a properly regulated beauty industry.

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[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.

[John Mc Nally]

People who put their life savings into investing in their businesses need reassurance that their investment is protected and not undermined by poorly-trained practitioners, because we all make assumptions—seemingly unfounded ones—that those businesses all operate legally and above board. I must bring to the attention of hon. Members the fact that I have met with the insurance companies, which are deeply concerned about the lack of regulation in this particular business. I wonder whether the Minister will comment on how businesses could be better insured and how we could make this a viable business that would not be undermined by other people.

[Alberto Costa]

The hon. Gentleman makes an important point, because this goes to the heart of what professional indemnity insurance is. One of the principal points of regulation is that a consumer knows that, if the professional is negligent, as people often are—people make mistakes—they will not be suing a man or woman of straw; that professional will have professional indemnity insurance behind them. That is the right form of protection in our society, in addition to qualifications and training.

I am pleased to champion this issue, along with the hon. Members present. I once again encourage the Government to continue doing the right thing, and to lead us to a situation in which we have a properly functioning and regulated beauty industry.

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[Jackie Doyle-Price]

I accept that invitation most gratefully, and I look forward to hearing the conclusions. The time is right for us to take action on this, and I am grateful for the support of Members from across the House in wanting to do that and to do the right thing, with the intention of protecting consumers, which is obviously central to us, but also ensuring a system of regulation that is proportionate for the industry. We need to make sure that we balance both of those.

We have not really given the industry enough attention, given the speed with which it has grown. We increasingly see examples of consumers receiving poor treatment; my hon. Friend the Member for South Leicestershire referred to his constituent, to whom I am grateful for sharing her story. We need to make everyone much more aware of the risk because, as he says, people think it is just like having a haircut; it is becoming extremely normal to have what are poisons injected into the face. We need to make sure that everyone is aware of the risk before they undertake such a procedure, so that they can make an informed judgment.

[John Mc Nally]

I am not taking exception to the idea of it being just like having a haircut, but I have been involved in the business of hair salons for more than 50 years and have run salons, and it is not just like having a haircut. There is a similarity in terms of the investment put into any business, which is long term in some cases. When somebody comes along who has not properly trained and has little knowledge, there will be consequences of what they practise. In my all-party parliamentary group’s inquiries, we have come across modern-day slavery, trafficking, money laundering and all sorts of things, which just builds the case for a mandatory regulatory framework.

[Jackie Doyle-Price]

The hon. Gentleman makes a good point, because when we talk about these examples, there is a danger that people can apply that prejudice to the entire industry. It is in the interests of everyone involved in this industry to welcome regulation, not least to celebrate the professionalism of what they do. There are some very reputable practitioners out there who are not actually in the medical industry. For example, semi-permanent make-up—a surgical procedure that does not involve any invasion—clearly does not require as strident regulation as what we are talking about with injectables, but it is the same industry, and we need to ensure an adequate registration system.