Botulinum Toxin and Cosmetic Fillers (Children) Bill

Laura Trott Excerpts

2nd reading & 2nd reading: House of Commons
Friday 16th October 2020 Commons Chamber

[Laura Trott (Sevenoaks) (Con)]

I beg to move, That the Bill be now read a Second time.

Let us be clear, no child needs cosmetic fillers or botox. However, this is not, unfortunately, how many of our young people feel. Social media exerts a huge pressure on young people to conform to aesthetic ideals, which are simply not attainable without cosmetic surgery or interventions, and this, combined with their increasing availability on the high street and in people’s homes, means that we have an increasing normalisation of cosmetic interventions among the young. These procedures risk ruining young people’s lives.

Alarmingly, this is an unregulated area, so the data that we have on prevalence is very thin, but a survey in 2018 showed that 100,000 under-16s had undergone cosmetic enhancements, the most common of which were fillers. This is worrying not just for the mental health of our young people, but for their physical health, too. We do not expect something that we can easily and very legally get done in the comfort of our own home to be something that can blind us, but, shockingly, that is the case.

For those who are not familiar with fillers and with botox, let me explain: fillers are gel-like substances that can be injected into the lips or the face to add volume and plump the skin. Temporary fillers last eight to 16 months, and there are permanent fillers as well, which have an increased risk of complication. There are currently no restrictions on who can inject fillers into the face. Botulinum toxin, more commonly known as botox, is injected into the skin to smooth lines and wrinkles, and it is not hard to understand the attraction of that. It is a prescription-only medicine, but doctors can delegate responsibility for injecting the botox to anyone at all with no qualifications.

Botox and fillers can be incredibly dangerous. Complications can include, but are not limited to, blindness, breathing difficulties—if it is injected into the neck—infection and the filler moving away from the intended treatment area into other areas of the face. Many people, mainly women, have been left with rotting tissue, lip amputations and lumps. I remind the House that, if any of these complications occurs, the practitioner injecting the substance needs to have no medical training whatsoever, so neither will they be able to deal with the potential complications, nor are they required to have insurance, so they do not have to pay for the very expensive cosmetic surgery that may be required to fix the problem.

[Dr Luke Evans (Bosworth) (Con)]

Does my hon. Friend therefore feel that, when people do run into these problems, the NHS will have to pick up the tab?

[Laura Trott]

My hon. Friend makes an excellent point. It is the NHS that has to pick up the bill for these problems, but it is not the NHS that will always pay for cosmetic surgery to fix them, so young people can be left with lifelong scars as a result of their surgeries, so he raises an excellent point.

The worst of it is that these risks are not theoretical or rare. I stress that this is an unregulated area, so instances of severe complications are not formally documented. However, thanks to brilliant campaigns by many Members of this House, the campaigning organisation, Save Face, and investigations carried out in the media, horrific stories have come to light. There were more than 1,600 complaints to Save Face last year, and it is estimated that 200 people have gone blind following these treatments, but it is the cases of the under-18s that have really stuck with me.

It is worth dwelling on a specific case study, which is representative of the countless stories I have heard. An under-18 female, who I will not name, booked a lip filler treatment after seeing a social media post promoting a discount. When she arrived at the clinic, she applied numbing cream herself to her lips. She was not asked her name. She was not asked details of her medical history. She was not even told what product was being used. She was not told of any possible side-effects. She was not consulted.

The treatment itself took less than 10 minutes. On completion, she was hurried out to pay the final balance. A few days later, she was experiencing significant pain and loss of sensation on the left side of her face. She contacted the person who treated her. She was ignored. Her symptoms became worse. She contacted her GP. She was told she should go and see another practitioner. When she eventually found a reputable local aesthetic healthcare professional, she reviewed her lips and concluded that the filler was compromising the blood flow to the tissue. She nearly lost her lips. This is an under-18 girl who nearly lost her lips through a procedure freely advertised and legally administered with no warnings or regulation whatever. Sadly, that example is not rare enough.

At the opening session of the all-party parliamentary group on beauty, aesthetics and wellbeing’s inquiry into the sector, Rachel Knappier appeared. She suffered from a botched filler, injected by a practitioner without any medical training, which resulted in her needing critical care. She told the APPG that there is

“nowhere for these people to turn to”

when things go wrong. She continued:

“Cheap adverts on social platforms are encouraging young impressionable people to seek an instant change to their appearance…to seek what is portrayed as the image of perfection.”

I could expound at length on the historical lack of oversight on women’s health issues. From PIP breast implants to vaginal mesh, we have simply not seen enough focus on these important issues by Governments over decades. This is a private Member’s Bill, however, and is necessarily limited in scope. I am pleased that the current Minister for Patient Safety, Mental Health and Suicide Prevention and her predecessor, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), have started to change the trend.

[James Cartlidge (South Suffolk) (Con)]

My hon. Friend is making a brilliant speech. She is talking about the scope of the Bill, but will she clarify something? It is not clear to me whether it covers England, or England and Wales or the whole of mainland Great Britain.

[Laura Trott]

I thank my hon. Friend for his intervention. The scope of the Bill is England. It focuses specifically on the lack of protections for under-18s. The absence of a legal age limit for botox and for dermal fillers means that any 15-year-old could walk into a shop and get their lips injected by someone with no qualifications whatever. Despite the proven health risks and implications for psychological wellbeing, young people can legally access invasive cosmetic procedures on the commercial market or in their homes without any requirement for a medical or psychological assessment. Unregulated practitioners are not required to hold insurance and may not have the medical knowledge to manage complications. That cannot be allowed to continue.

The case for change is absolute. It is unacceptable that we allow children to be exposed to life-changing risky procedures with little to no regulation. My Bill would criminalise the administering in England of botox injections and cosmetic fillers to people under the age of 18. There are cases where medical conditions may require such treatment, such as migraines. These treatments could continue if carried out in accordance with the directions of a doctor. However, we must take action to bring fillers and botox procedures in line with other body modifications that carry similar health risks, such as tattoos. The Bill would impose a duty on businesses to ensure that they do not arrange or perform these procedures on under-18s unless approved by a doctor. We can no longer allow the unscrupulous actions of some people to impact on our children’s lives, and those administering the procedures must be held accountable. The most frequent reaction I have received in response to my Bill is, “Surely, that is illegal already.” I join in that disbelief, and this House must now put it right.

[Mr Speaker]

Sir Christopher Chope is missing, so I call James Cartlidge.

--- Later in debate ---

[Laura Trott]

With the leave of the House, I will make some final remarks. There have been some passionate and personal speeches today, and I am very grateful for the support from all parts of the House and from those on the Front Bench. A key thing that has emerged is the impact of social media—a pernicious impact in far too many cases.

My hon. Friend the Member for East Surrey (Claire Coutinho) put it well when she said we have a generation who are the most anxious, the most depressed and with the lowest sense of self-worth. We must do all we can to support our young people. My Bill will deal with some of the symptoms of the problem, but not necessarily the cause. My hon. Friend the Member for Bosworth (Dr Evans) is doing a good job on some of the problematic causes of this issue, and I hope his work is taken forward.

My hon. Friend the Member for West Bromwich West (Shaun Bailey) said that this Bill should only be the start, and he is right. My hon. Friend the Member for Wantage (David Johnston) rightly pointed out that the dangers of unlicensed and unscrupulous providers apply to all ages, not just the young. It is absolutely correct that we need more consultation, as my hon. Friend the Member for Clwyd South (Simon Baynes) pointed out; more accountability, as my hon. Friend the Member for Bosworth pointed out; and minimum qualification levels, as my hon. Friend the Member for Wolverhampton North East (Jane Stevenson) rightly highlighted. I am glad to hear that the Department will be taking registration and licensing forward.

As my hon. Friend the Member for Meriden (Saqib Bhatti) said, the Bill is not an attack on the industry. There are so many providers that are doing this well and are looking after the people they are treating, but we must stop the ones who are not. We must make sure that women—there are men involved as well, but 92% of these procedures are done on women—are protected, and that should be true for all ages.

My hon. Friend the Member for South Suffolk (James Cartlidge) rightly pointed out that we need to be careful about over-regulation, but equally, we must ensure that procedures are safe. We do not expect to go down to our local pharmacy and for the nail varnish to burn our fingers off. Equally, if someone is going to have an invasive procedure, the state should make sure that it is safe.

There was a specific question from my hon. Friend the Member for Totnes (Anthony Mangnall) about enforcement. Local authorities will be able to enforce in their local area, and businesses or providers will be subject to unlimited fines.

The purpose of my Bill is simple. No child needs cosmetic botox or fillers, and such treatments on the vulnerable must be banned. Too many young people’s lives have already been seriously impacted because of cosmetic procedures gone wrong. As my hon. Friend the Member for Wolverhampton North East says, it makes no sense that it is illegal to tattoo a person under the age of 18, but it is not illegal for practitioners to provide these extremely high-risk services to vulnerable and insecure young people.

The Minister rightly set out the Government’s work on the regulation of cosmetic procedures to date, and I thank him deeply for his support. I also place on record my thanks to the Minister for Patient Safety, Mental Health and Suicide Prevention for her help and her work in this area. It has been remarkable and is correcting an oversight that has gone on for too long. We must stop the dangerous and unnecessary non-medical procedures that can ruin children’s lives, and I welcome the Minister’s support today in ensuring that we are now one step closer to achieving that. I commend the Bill to the House.

Question put and agreed to.

Bill accordingly read a Second time; to stand committed to a Public Bill Committee (Standing Order No. 63).