Botulinum Toxin and Cosmetic Fillers (Children) Bill

Judith Cummins Excerpts

Committee stage & Committee Debate: House of Commons
Wednesday 25th November 2020 Public Bill Committees

[Carolyn Harris]

I welcome the comments from both the Minister and the hon. Member for Sevenoaks. We would welcome the opportunity to work with the hon. Lady to ensure that we strengthen the Bill. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Judith Cummins (Bradford South) (Lab)]

I beg to move amendment 3, in clause 1, page 1, line 23, after “age,” insert “including by requiring and recording proof of this information,”.

It is a pleasure to serve under your chairmanship, Ms Rees. First, I thank the hon. Member for Sevenoaks for introducing this Bill and successfully bringing it to Committee. It is long overdue. I thank her from the bottom of my heart.

I stand in support of the Bill’s principles and I want to reiterate a point made by my hon. Friend the Member for Swansea East. My amendments seek to enhance the Bill and close the gaps in the wording. This amendment is a probing amendment and it deals with ensuring that a framework for age identification is present when practitioners are assessing a client for a non-surgical cosmetic procedure.

I am concerned that, as currently worded, the Bill leaves open to interpretation what reasonable steps a practitioner must make to establish the age of the person receiving the procedure. I want the Bill to make it clear that practitioners must request proof of age before any procedure is undertaken, verify the authenticity of that document and ensure that it is recorded, to ensure that there is no doubt about a client’s age. We need clear and explicit guidelines to ensure that vulnerable young people do not fall through the net.

My hon. Friend the Member for Swansea East and I established and became the co-chairs of the all-party parliamentary group on beauty, aesthetics and wellbeing. I am worried about how few protections there are for children under 18 years of age when it comes to non-surgical cosmetic procedures.

I was also in attendance at our inquiry into ethics and mental health. It will be no surprise that all our expert witnesses agreed that young people are at their most vulnerable in their teenage years. They are faced with many pressures, including societal pressures, which make ideal beauty standards the norm, especially in this age of social media. We must ensure we put safeguards in place to protect our young people.

I ask the hon. Member for Sevenoaks and the Government to consider this amendment to ensure that proper mechanisms are in place to strengthen the process of age verification for non-surgical cosmetic procedures and to improve the accountability of all practitioners. The amendment requires the practitioner to formally log and prove a client’s age.

Like my hon. Friend the Member for Swansea East, I welcome the opportunity to adapt the wording of the amendment should the hon. Member for Sevenoaks be unable to accept it. I ask that this amendment be considered.

[Ms Dorries]

Again, I thank the hon. Lady for moving the amendment. I understand that it will not be pressed to a Division, but I give her my absolute assurance that all comments made in the Committee today will be taken away and reviewed by my hon. Friend the Member for Sevenoaks and me before we move forward on to the next stage of the Bill. I thank all hon. Members for their contributions today.

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[Judith Cummins]

I am happy with the assurances that we will be listened to and that our words will be considered throughout the passage of the Bill. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Question proposed, That the clause stand part of the Bill.

[Laura Trott]

Clause 1 of the Bill creates a new criminal offence of administering in England botulinum toxin injections and cosmetic fillers to persons under 18. Currently, children and young people can access invasive cosmetic procedures on the commercial market without the requirement for any medical or psychological assessment. As the hon. Member for Bradford South said, that cannot be right.

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[Judith Cummins]

Would my right hon. Friend’s amendment cover the eventuality that I described? That was related to me by the APPG’s most in-touch consultant, my daughter, who told us about her friend who, for her 16th birthday, had a lip filler injected by her cousin.

[Mr Jones]

That is the point. Part of this is about a process of education to teach people what the dangers are. These products are marketed and sold to people—especially young people—as if they are just like make-up.

Well, they are not make-up—this is a medical procedure that can have life-threatening consequences if it goes wrong. It is clear that some of the advertising on Facebook and other sites is directed at under-18s. The Minister mentioned body image, and the Mental Health Foundation’s report from last year on that issue shows that the marketing is for young people.

This is a probing amendment to get this issue on the record. We need to look at ways to ensure that young people are protected from advertising. It is not newspaper advertising; that is for old-fashioned people like me. It is advertising on Facebook, Instagram and elsewhere. I have raised this issue with Facebook. Of course, we get the usual guff from Facebook: “Oh well, we take them down.” I have even written to Sir Nick Clegg asking whether he will do anything about it. Getting an audience with or response from the Pope would be easier than getting a response from him. Those platforms are making money out of this, and they are targeting their adverts at young people, not older people.

Do not get me started on the Advertising Standards Authority, which is a completely toothless, useless tiger, frankly. It takes down some adverts, but they keep proliferating. The social media companies need to do something about it, because young people are being put at risk and because there is a market. Botox is supposed to be a medically controlled substance, but it is not; it is advertised. The way the companies get around that is that, although they cannot advertise botox, they can advertise a consultation, which just happens to be for botox. Facebook, Instagram and others could take down those adverts overnight and just stop them, but they are not doing that because there is clearly money to be made in this sector. Some of those issues will come out in the private Member’s Bill of the hon. Member for Bosworth on body image, but if we do not tackle them, this Bill could be enacted and the Facebooks of this world could still make money on the back of this sector.

The purpose of new clause 1 is to ensure some oversight over the effectiveness of the Bill. It calls for a report when it is under way so that we can assess whether it is effective. It also relates to advertising and promotion. By raising this issue with the Minister, I want to put on the record that there is an issue. I accept that advertising is not directly within her remit as Public Health Minister, but I want to see what more can we do not just on the targeting of under-18s, but on the broader issue of the way in which big business is trying to circumvent the law—advertising botox is supposed to be illegal.

There are two ways of doing that. The first is to stop the supply of botox from prescribers, and the second is to crack down on it very heavily. The Mental Health Foundation’s report on body image shows that, in this age of the internet and the internet of things, young people are in a terrible situation and are suffering due to their body image. That is reinforced by advertising. Botox is seen as a quick fix, but it is potentially dangerous. We need to try to stop this danger to our young people.

Dementia: Covid-19

Judith Cummins Excerpts

Thursday 12th November 2020 Westminster Hall

[Judith Cummins (Bradford South) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Graham. I thank my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) and the hon. Member for Strangford (Jim Shannon) for securing this important debate, and I am pleased to follow the hon. Member for Eastbourne (Caroline Ansell).

I want to start by talking about my constituent Tracy Gothard. Tracy released a video of what happened when she visited her mum Doreen, who has dementia, in a nursing home in Bradford. In the clip, we see what so many of our families are currently going through. Hon. Members might have seen the footage. In it, Tracy and her sisters stand outside and speak to their mum in the car park through a closed window. Doreen asks Tracy to come inside and motions with her hand, to which her daughter replies “I can’t come in. We are not allowed yet because of that nasty bug.” Doreen’s face crumples, and she breaks into tears. It is a heartbreaking video, and I do not think that anybody can watch it and not be moved to tears.

The window meeting between Tracy and her mum was the first one that they had since August, when Bradford was placed under local restrictions. I asked Tracy what she would like me to say to the Minister on her behalf in this debate. She said:

“I’m begging from the bottom of my heart to give key worker status to just one family member, to help us see loved ones in care homes. This has now been ongoing for too long, and in my 51 years of life, I have never not seen my mum, especially at Christmas. I appeal to your better nature, on behalf of myself and thousands more, to not let this continue.”

Tracy speaks on behalf of everyone who has a loved one with dementia in a care home. Anyone who has cared for someone living with dementia knows that regular contact with family members keeps that spark inside alight. Digital visits are simply not appropriate, as people with dementia view the world differently. Memory clinics must reopen, and they need to be in person. As virtual memory clinics, they cannot simply replicate the quality and appropriateness of a face-to-face appointment for anybody living with dementia.

The Government need to recognise that family carers play an essential part in caring for people with dementia who live in care homes. When family carers are unable to visit and provide that care, the health and wellbeing of people with dementia can seriously decline at a rapid pace. I fully support the call by the Alzheimer’s Society and others to designate at least one informal carer per care home resident as a key worker, with access to testing, training, PPE and, when they come, vaccinations. The Government must urgently speed up their action on this issue, as time is not on our side. Will the Minister clarify whether an adult caring for an adult with dementia can form a support bubble with another household? The regulations are not explicit on that, and our carers need that support.

Finally, I want to quote from the hard-hitting report by the Equality and Human Rights Commission. It states:

“There is evidence that human rights standards may have not been upheld in the response to the pandemic, including in key decisions about hospital discharges, care home admissions, visits, access to critical care and prioritisation of testing, putting people with dementia and other care home residents at greater risk of harm.”

That should be a wake-up call to us all: inaction is not an option.

Public Health

Judith Cummins Excerpts

Wednesday 7th October 2020 Commons Chamber

[Judith Cummins (Bradford South) (Lab)]

I am pleased that we now have the opportunity to debate these regulations, but it is extremely disappointing that we have not had the opportunity to debate on the Floor of this House, since they were introduced, the original regulations that put Bradford under local restrictions.

Bradford has now been under local restrictions since July, and during that time my constituents have faced considerable restrictions on their freedoms, unable to meet relatives at home, in their gardens, in pubs or in restaurants, and restricted from visiting care homes. Many face real risks to their jobs and livelihoods. Despite these restrictions, the infection rate across Bradford South has continued to rise, from 35.8 to 187.5 per 100,000. Something is not working, and the Government must set out why they think this is and what they are planning to do next.

Since the local restrictions were introduced, I have had severe concerns about the way in which the Government have handled them. Throughout this period, decisions have repeatedly been announced on days when the House is not sitting, which means that we are unable to question Ministers about them on behalf of our constituents. They have often been announced late in the day through Twitter or by press release, which has added to a sense of outrage and confusion as people seek to understand increasingly complex rules. Moreover, the Government have repeatedly failed to make public the data and criteria that are driving these decisions. This lack of accountability by the Government cuts to the heart of our democracy, and has added to the feeling that decisions on imposing or lifting local restrictions are being taken inconsistently or for reasons other than scientific evidence.

Bradford South was at 35.8 cases per 100,000 when it was put into local restrictions, yet areas that now have much higher numbers of cases have not been subject to such restrictions. The Government need to explain why. We need clarity and consistency in decision-making processes. My constituents have been living with these local restrictions for months now. The least they deserve from the Government is honesty and transparency about whether the local restrictions are working, and a clear plan to review the Government’s strategy if they are not.

Oral Answers to Questions

Judith Cummins Excerpts

Tuesday 6th October 2020 Commons Chamber

[Owen Thompson (Midlothian) (SNP)]

What assessment he has made of the effectiveness of lockdown restrictions on limiting the second wave of covid-19.

[Judith Cummins (Bradford South) (Lab)]

What assessment he has made of the effectiveness of local restrictions on reducing the transmission of covid-19.

[The Secretary of State for Health and Social Care (Matt Hancock)]

I chair the Government’s local action gold committee, which considers the latest data and advice from experts, including epidemiologists and the chief medical officer, and the Joint Biosecurity Centre. Through this process, we consult local leaders and directors of public health. We have seen local actions in some parts of the country bring the case rate right down and we need to make sure that we are constantly vigilant to what needs to happen to suppress this virus.

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[Matt Hancock]

I discuss these matters with the Cabinet Secretary and other colleagues across government all the time, and I also speak regularly to the Mayor of London. We maintain vigilance over the transmission of the virus right across the country.

[Judith Cummins]

Can the Secretary of State answer a very simple question: what rate of infection means that a local authority needs to go into local restrictions and what rate means that it can leave them? Of course I accept that there will sometimes be very specific circumstances, such as workplace outbreaks, that would need to be considered, but surely it is not beyond his level of competence to do both, because my constituents deserve to know when they can see their families.

[Matt Hancock]

Of course the hon. Member’s constituents and all those who are under local action restrictions yearn to see their families. We all yearn to be able to get back to the normal socialising that makes life worth living, but I am afraid that the answer to her question is in the question: because of specific local circumstances, such as outbreaks in a workplace or a halls of residence, it is not possible to put a specific number on the point at which a judgment is made to put in place local restrictions, which we do in consultation with the council, or to take an area out of them.

Covid-19

Judith Cummins Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

Yes, of course, the further advice will go out for social care. We put updated advice out at the end of last week knowing that that was a likely step, and there will be further advice precisely to help people to address exactly that question.

[Judith Cummins (Bradford South) (Lab)]

Given the anxiety in schools, colleges and universities about exams, will the Minister reassure students and staff alike that there is provision in place for exams to take place within the cycle of this academic year? Will he also reassure the House that, in the event of school closures, there is provision in place to feed those children who are currently in receipt of free school meals?

[Matt Hancock]

Those are both very important points. Children who receive free school meals often receive their best or, in some cases, their only meal at lunch time at school, and it is an issue that I discussed with the Education Secretary over the weekend.

Health Inequalities

Judith Cummins Excerpts

Wednesday 4th March 2020 Commons Chamber

[Judith Cummins (Bradford South) (Lab)]

It is a pleasure to follow the hon. Member for Eddisbury (Edward Timpson). I would like to focus on one particular area of health inequality: the lack of access to NHS dentistry and the damaging effect that this is having on people’s health. I fundamentally believe that we cannot continue to treat dentistry as the Cinderella service of the NHS. It is underfunded, undervalued and in need of reform. There is a crisis in access to NHS dentists, and significant inequality in the availability of access. This is having an adverse effect on the health and wellbeing of our children, in particular, with tooth decay remaining the biggest cause of admission to hospital for five to nine-year-olds.

Unfortunately, there is a regional and socioeconomic divide in both the availability of NHS dentistry and in good dental health outcomes. Nearly 50% of children in the worst performing local authority area have tooth decay; in the best performing area the figure is just 4%. In Bradford, the figure is far too high at 40%. We also see wide regional inequalities of access. In Bradford, 88% of people who tried to do so got an NHS dental appointment, compared with 95% nationally.

Locally, I have had some success in campaigning for more investment in local NHS dental services. An access pilot scheme that ran in 2017 provided an extra 4,200 appointments. The scheme significantly cut waiting times for dental care in Bradford. More than half of those extra patients had not seen a dentist for more than two years. The “Stop the Rot” campaign with the Bradford Telegraph & Argus resulted in over £600,000 of clawback funding being reinvested in Bradford over three years. May I thank two former Ministers, the hon. Member for Winchester (Steve Brine) and Alistair Burt, for their help with this?

Will the current Minister take the hint and please confirm that, given the proven need, this reinvestment will continue into Bradford South? However, it is clear that this is not the long-term fundamental solution that is needed. First, we need to see reform of the dental contract, which is simply not fit for purpose. Secondly, the Government must get a grip on dental recruitment, which threatens to make access even harder. Thirdly, the Government must roll out the starting well programme across the country. Currently, it is limited to a handful of wards across 13 local authorities.

Finally, the Government must commit to fully funding NHS dentistry. It is operating on a budget that has remained essentially static since 2010. The scale of oral health inequalities in this country, in particular among our children, requires significant investment. The Government need to step up, never mind level up, and stop the crisis in NHS dentistry.

Coronavirus

Judith Cummins Excerpts

Tuesday 3rd March 2020 Commons Chamber

[Matt Hancock]

We do not want people who suspect they have coronavirus to go to their GP; we want them to do this via NHS 111. Further to my earlier point about being able to self-validate for sick pay for seven days, they can of course then do that by phone and get an email confirmation, should they need to, to extend that to the full 14 days. Of course, as well as tackling coronavirus, the NHS must do business as usual. We are increasing the amount that people can do over the phone, Skype and other forms of telemedicine. That could be increasingly important if there is widespread concern about communicable diseases.

[Judith Cummins (Bradford South) (Lab)]

What steps is the Secretary of State taking to ensure continuity of social care, both in care homes and for care given at home, given the problems and workforce implications arising from coronavirus?

[Matt Hancock]

We have a huge amount of work under way, including looking at what we can do to ensure that people can get support in care homes. It is not just about the staff, of course; elderly people in care homes are, according to the data, among those most vulnerable to the disease. The care home element of our plan is incredibly important and we will be providing more details in the coming days.

Living with Dementia

Judith Cummins Excerpts

Tuesday 25th June 2019 Westminster Hall

[Judith Cummins (Bradford South) (Lab)]

Thank you, Mr Paisley, for allowing me to speak in this important debate. It is a pleasure to serve under your chairmanship. I congratulate my hon. Friends the Members for Oldham East and Saddleworth (Debbie Abrahams) and for Cambridge (Daniel Zeichner) on securing this important debate, and commend their work on the all-party parliamentary group on dementia.

The scale of the challenge of dementia is well known, but it bears repeating. In the UK, some 850,000 people live with dementia. That is set to double by 2040. Of course, the figures do not capture the great many other people whose lives are touched by dementia, most obviously family, friends and carers. With so many people affected by dementia, we need a comprehensive and joined-up approach that supports people and their families as soon as they are diagnosed. This must involve health, social care, local government and voluntary organisations.

There is a great deal of innovation and good practice. We must do all we can to ensure that it is shared as widely as possible, which is why I entirely agree with the Alzheimer’s Society that we need a national strategy on dementia. Of course, it is hugely important that the strategy is fully funded. I urge the Government to consider that in the upcoming spending review.

When thinking about a joined-up approach, we should look at the lessons from the integrated personal commissioning pilots. IPC, a partnership between the Local Government Association and NHS England, aims to integrate healthcare and education services around people rather than organisations. It focuses on an individual’s needs, along with the available community and peer support, to build their confidence and skills for self-managing long-term conditions such as dementia. It seeks to offer choice and control to patients by widening access to integrated personal budgets and developing more options to help people to achieve their goals.

An important point that the Alzheimer’s Society has raised is the need to ensure that people with dementia understand the information that they receive. What is told to people with dementia is not always the same as what they receive and understand. Given the nature of the condition, it is vital that medical professionals and others continually ensure that people are empowered by what they are told.

That point leads me on to the need for improved education about Alzheimer’s and dementia. I pay tribute to the Alzheimer’s Society’s Dementia Friends initiative, which has spread awareness and has seen 2.75 million people—including me and others in my office—become Dementia Friends. However, there is still poor knowledge among much of the public and some medical and care professionals about Alzheimer’s, dementia and what can be done to help people with the disease.

The Department of Health and Social Care should consider implementing a dementia awareness campaign to increase understanding of the symptoms of dementia and the interventions and treatments that can slow the progress of the disease, and to support people with dementia and their carers to lead independent lives for as long as is appropriate. The Government must do more to improve standards within the social care workforce to meet the needs of people with dementia, including by funding training to tier 2 of the dementia training standards framework for everyone who works in adult social care or interacts with people with dementia.

Finally, I turn to the support that we must provide for carers. I pay heartfelt tribute to the many thousands in this country who care for people with dementia and a whole range of other conditions. Out of love, they provide selfless care and deserve our utmost respect. Much more help must be given to those who care for people living with dementia. Carers need a wide range of practical, emotional and financial support. For instance, in its recent report on dementia and disability, the APPG on dementia found that carers need more support to know exactly what financial help they are entitled to, as well as how to make a successful claim. Carers are also time-poor and have little energy and—dare I say it?—headspace left after meeting the demands of caring for someone 24/7. The agencies involved need to take a more proactive approach to ensure that carers can claim the financial help they need, because they are entitled to support for the care they give their loved ones.

As we have heard, the Government’s aspiration to make the UK the best country in the world for dementia care and support is welcome, but it must be met with action and funding to make it a reality. I hope the Minister makes those commitments today.

Oral Answers to Questions

Judith Cummins Excerpts

Tuesday 18th June 2019 Commons Chamber

[Stephen Hammond]

I thank my right hon. Friend for his comments on saving the hospital department—that is very important. He is right to raise the important role of the nursing associates, who deliver hands-on care in a range of complex settings. Thousands of nursing associates began training in 2017 and in 2018. Health Education England is leading a programme to recruit more than 7,500 into training in 2019, and I am sure that some of them will benefit his constituency.

[Judith Cummins (Bradford South) (Lab)]

15. Bradford NHS Trust is pressing ahead with plans to set up a wholly-owned subsidiary company. Last week, 97% of Unison members voted for strike action. Given that the trust is currently run by a temporary chair and a temporary chief executive, and is acting on guidance from a now-defunct body, will the Minister, to improve retention, call on the trust to drop these plans and keep the NHS family as one?

[Stephen Hammond]

The hon. Lady knows that a wholly-owned subsidiary is created as a legal entity. It is 100% owned by NHS organisations. It is also the case that local trust board members sit on the boards of those subsidiary entities. It is therefore appropriate that the local organisation takes that decision.

Medical Aesthetics Industry: Regulation

Judith Cummins Excerpts

Tuesday 14th May 2019 Westminster Hall

[Alberto Costa]

The hon. Gentleman is correct. We need to ensure that we have appropriate regulation with these procedures, or similar types of procedure. He is right to raise this issue on behalf of his constituents.

[Judith Cummins (Bradford South) (Lab)]

I thank the hon. Gentleman for securing this important debate. He will be aware of its importance as he is a vice-chair—along with my hon. Friend the Member for Swansea East (Carolyn Harris) and me—of the all-party parliamentary group on beauty, wellbeing and aesthetics. Does he agree that any new regulations that come forward need to consider non-medical regulation? We need to ensure we have properly qualified beauticians, with recognised qualifications, to carry out these procedures.

[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.

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[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.

[Judith Cummins]

I very much welcome the Minister’s announcement today. On training and regulation for beauticians—non-medical people who constitute around 50,000 jobs in the UK economy—there is huge appetite and support within the industry for proper and appropriate regulation, and there is recognition of the urgent need for that. However, there are no regulated qualifications available for non-medical practitioners for injectables at the moment. Going forward, does the Minister think there will be some kind of progression route for beauticians to go into this kind of industry, so that we can guarantee proper standards for the consumer?

[Jackie Doyle-Price]

The hon. Lady is right, and I am grateful for the spirit in which she makes her comments. Anyone who establishes themselves in business as a beautician wants to deliver a good service, has pride in what they do and would not want to be accused of doing anything unsafe.

My first focus of activity is those organisations that train people in these procedures, because I can see a situation in which a beautician will have paid thousands of pounds to go on a course and will then think that they are qualified, but they might not be. That is where we need to bring the focus of regulation in the first instance, so that when somebody proudly displays their certificates, consumers can have some guarantee that they are legitimate. I welcome the opportunity to air these issues with the all-party parliamentary group as we move this system of regulation forward.

Sadly, we only have 30 minutes for this debate, so I doubt whether I will be able to get through as much as I would wish, but I will do my best. I am grateful for the interest of all Members here. We will continue this discussion. It is worth saying that Botox treatments and dermal fillers are increasing and, along with laser hair removal, now represent nine out of 10 non-surgical treatments performed in the UK. This is a major area of risk.

Hon. Members have referenced the campaign that we launched today. Clearly, consumers will be the best defenders of their own interest, but we must make sure that they have access to appropriate information with which to do so; we need to do much more to inform people about the risk. Just as in my hon. Friend the Member for South Leicestershire’s example of his constituent, I am quite sure that many people who have had fillers—who have gone to have their lips done, like they do—would have no idea that there is a risk of their artery being injected with poison. We need to make sure that consumers are much more aware of that, which is why we are doing so much more in the next six weeks to try to raise public awareness.

We will focus on targeting our messages to women aged 18 to 34, on whom the majority of the treatments are undertaken. I am pleased that we are working with Bauer Media, which publishes Grazia, Closer and Heat, which I hope will be appropriate vehicles to reach that audience. We will make sure that the NHS information is kept up to date and remains a meaningful resource for consumers.