Botulinum Toxin and Cosmetic Fillers (Children) Bill

Laura Trott Excerpts

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

[Ms Dorries]

Thank you, Ms Rees.

The hon. Member for Swansea East has tabled her amendments. I wish again to reiterate the Government’s support for this legislation. On amendments 1 and 2, I should say that the Government are responsible for understanding the impact of any regulatory policy through the completion of a post-implementation review within the first five years following implementation. The review should assess whether the objectives of the regulation have been achieved and are still relevant, the cost of the policy and any wider unintended effects of the policy.

The indicators of the success of this policy would be a reduction in the numbers of businesses offering or performing treatments on under-18s. That may assessed through means such as measuring public, practitioner and stakeholder awareness and experience of the policy, to understand the policy’s reach and effectiveness, and gathering intelligence on the level of enforcement by the police and local authorities.

I was concerned to hear the hon. Lady’s comments about practitioners who were finding reasons and excuses to continue practising. That is something that I know my hon. Friend the Member for Sevenoaks has been made aware of, and we will keep it under review.

[Laura Trott (Sevenoaks) (Con)]

It is honour to serve under your chairmanship, Ms Rees. Before I start, I thank everyone in the room today. This has long been an overlooked area of policy, but with the work of everyone here, perhaps that will not be the case for much longer. As the right hon. Member for North Durham has said, it is a welcome first step.

I pay particular tribute to the work of the hon. Members for Swansea East and for Bradford South, and the all-party parliamentary group on beauty, aesthetics and wellbeing that they lead. The group’s findings have underpinned the substance of the Bill and I thank them for sponsoring it.

I completely agree with the sentiments behind the amendments. It is right that we should restrict these treatments for under-18s to only where it is absolutely medically necessary. The advice I have received is that that is covered in the Bill, inasmuch as UK doctors must be registered and hold a licence to practise with the GMC. The GMC publishes specific ethical guidance that says that doctors performing cosmetic interventions can provide treatment to children only when it is deemed to be medically in the best interests of the patient.

I accept that, as the right hon. Member for North Durham said, in some cases at the moment this is not happening correctly when it comes to botox, but to create a new legal precedent around the wording “deemed medically necessary” would add a layer of complexity, given that it is generally for the GMC to decide what is in the best interests of the patient. As he also mentioned, it would also produce two different authorities—the GMC and the court—which would then opine on the same issue. That could cause confusion.

I understand the thrust of the amendments, but if the hon. Member for Swansea East is content to withdraw them, I will work with hon. Members on some form of strengthened wording, which we can bring forward on Report.

[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.

[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.

[Laura Trott]

Again, I agree entirely that we must ensure providers have proof of age before carrying out treatments. However, I worry that the amendment is too narrow, in that it is for the defendant to establish the steps that they took to evidence proof of age. It is already implicit that that could and should include recording information, but it should not be limited to that. For example, it should be for them to establish the veracity of the documents produced, rather than just recording them.

While I completely agree with the intent of the amendment, I argue that it is not needed on the face of the Bill and would be more appropriately contained in guidance, which I would expect professional bodies to produce when the Bill becomes law. I would like to continue discussions with the hon. Members on the topic.

[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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[Laura Trott]

Thankfully, the future of the GMC is slightly wide of the scope of the Bill, so I will leave those matters to the Minister. However, the right hon. Member for North Durham made the point well that there is widespread abuse by doctors who prescribe botox for cosmetic purposes, particularly for under-18s. It is absolutely right that we are looking to fix that through the Bill, and we will talk further about the wording on it.

The right hon. Gentleman rightly made the case for wider reform of that area, which has not been regulated to the extent that it should have been over the years. The Bill will, I hope, be a first step in addressing that, as we discussed earlier.

Question put and agreed to.

Clause 1 accordingly ordered to stand part of the Bill.

Clause 2

Offence by persons carrying on a business

[Mr Kevan Jones]

I beg to move amendment 4, in clause 2, page 2, line 31, at end insert—

“(c) a person advertises or otherwise promotes the administration, in England, to another person (“A”)—

(i) botulinum toxin, or

(ii) a subcutaneous, submucous or intradermal injection of a filler for a cosmetic purpose, where A is under the age of 18;”

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[Ms Dorries]

As the right hon. Gentleman notes, those matters are not within the scope of the Bill and the Bill will not seek to achieve the points he has made. As I have said before, I will take the comments away and will continue to work on them and review them.

[Laura Trott]

I thank the right hon. Member for North Durham for all his work in this area. On amendment 4, the pressure that young people are put under by social media is undoubtedly a motivating factor behind many of them seeking out these cosmetic treatments. That was discussed at length on Second Reading by the hon. Member for Clwyd South, among others. In many case studies that we have heard, discounts were one of the reasons that a young person went to have one of these treatments.

I note that there is a lot more work going on this area, which is welcome. In January, the Committee of Advertising Practice and the Medicines and Healthcare Products Regulatory Authority issued an enforcement notice to the beauty and cosmetics industry and have started to use monitoring tools to take down posts on social media, which is a welcome development, although obviously we need more.

I completely agree that further work is needed in this area. However, as the right hon. Gentleman rightly notes, it is outside the scope of the Bill. I will be making those points in the debates on forthcoming online harms regulations. I imagine he will be doing the same.

[Mr Kevan Jones]

These were probing amendments. I took the opportunity to get them on the record, as it is important to ensure that we tackle this area. I welcome the Minister’s comments on this being an area that we need to look at further. I know the Department of Health and Social Care does not like to bring legislation forward because it is still suffering from the Care Act 2014—

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[The Chair]

With this it will be convenient to consider clauses 3 to 6 stand part.

[Laura Trott]

Clause 2 sets out a duty on business owners to ensure that substances are not administered to a person under 18. This does not apply to administration by a doctor or regulated healthcare professional. Subsection (1)(b) sets out that a business owner commits an offence if they or someone acting on their behalf makes arrangements for botox or filler to be administered by injection for cosmetic reasons to a person under the age of 18. This will cover, for example, making an appointment, or agreeing to make an appointment by social media. By making it an offence to make arrangements to administer the products covered by the legislation, prosecutions can be brought even when the person aged under 18 does not go on to have the procedure administered because, for example, they changed their mind or there was an intervention by an enforcement body.

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[Mr Jones]

Right. I again put on the record my thanks to the hon. Member for Sevenoaks for bringing the Bill forward. Will the Bill solve all our problems in this sector? No, it will not, but as I say, it is a welcome first step. It also gives us an opportunity to put on the record other concerns, which I know the hon. Lady shares.

This industry—because it is a multibillion-pound industry—is very lightly regulated. When these fillers and botox procedures go wrong, they can cause damage to individuals and costs for the NHS. There are cases of people having to go through expensive procedures on the NHS to put things right before we even mention the cosmetic surgery industry, which costs this country an absolute fortune when operations go wrong and the cost of people’s life-changing conditions have to be met by the taxpayer.

Going right back to when I was chair of public health in Newcastle upon Tyne in the early ’90s, I am reminded a little bit of the same lack of regulation that there was around tattoo parlours. The Government changed that and gave local authorities clear powers. Now, largely, the rules on administering tattoos, for example, are clear. They are enforced by local authorities and the standards are high. To go back to what the Minister said, I agree: I do not want to close the industry down. It has to be about personal choice. If people want some type of what they consider necessary enhancements, that is entirely up to them; but it must be done in a safe and regulated way. I referred to the wild west, and it is like that: there is little control over what is happening.

I think it is five years since the Keogh review recommended increased regulation, and it is now time, with the Bill, which will be a first step forward, to try to get those recommendations put into law. I think that if that proposal came forward there would be no problems about getting cross-party support. I would be a huge champion of such regulations. The issue is not just with fillers and botox, but the broader cosmetic surgery industry. It is about people making informed choices and ensuring that work is done in a safe and effective way. At the moment, the system is in many ways completely unregulated, and regulations that exist are being ignored.

I congratulate the hon. Member for Sevenoaks on bringing the Bill forward, and thank the Minister for how she has responded and taken the issues on board. I think that, although on occasions we have our disagreements, she believes at heart that in the sector in question things should change, and patient safety should come first and foremost for everyone.

[Laura Trott]

Many good points have been made today about the wider work that we need to do in this, but when the Bill goes through it will be the next step towards protecting children, in an area where at the moment they are open to physical and mental scarring for life. I thank everyone who is here today for their work in supporting the Bill, and I thank you, Ms Rees.

Question put and agreed to.

Clause 2 accordingly ordered to stand part of the Bill.

Clauses 3 to 6 ordered to stand part of the Bill.

Bill to be reported, without amendment.

10.23 am

Committee rose.