Botulinum Toxin and Cosmetic Fillers (Children) Bill

Suzanne Webb Excerpts

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

[Simon Baynes]

I strongly agree with my hon. Friend on that score. One of the aspects of this discussion that has been extremely pertinent is the need for consultation. It really seems to me extraordinary that people can undergo such procedures without proper consultation—a point made very eloquently by my hon. Friend the Member for Wolverhampton North East. If someone has proper consultation, they have to refer to the data, as my hon. Friend the Member for Totnes says, and then the procedures start to take place within a structured, controlled environment.

[Suzanne Webb (Stourbridge) (Con)]

Does my hon. Friend agree that one of the problems is that people see these procedures as beauty treatments, when in fact they are medical procedures that bring risks and consequences?

[Simon Baynes]

Yes. I thank my hon. Friend for that intervention. Again, I go back to the point I made at the beginning. As the father of two young daughters, I see the world that they have to inhabit in terms of social media—and inhabit it they do, because it takes up a lot of their life, particularly, as was mentioned earlier, within the context of lockdown, where their ability to see their friends and family is very limited. The whole world of social media has become much more prevalent, so there is a dichotomy between the desire to have the perfect body and the perfect face and what is a very dangerous and difficult intervention. The fact that these interventions have been hitherto unregulated seems quite extraordinary when we actually sit down and read about them, or discuss them in the Chamber.

Another point that has been made is the cost to the NHS of unpicking these problems. The Bill is therefore very important not only in regulating the procedures, but in leading to less work for the NHS when they have gone wrong.

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[Dr Luke Evans (Bosworth) (Con)]

This Friday is a day of joy for me for so many reasons. First, I had my point of order corrected—that is a learning point. Secondly, I am following my hon. Friend the Member for East Surrey (Claire Coutinho), who spoke eloquently. Thirdly, this is the first time since being elected that I am able to speak in this House with no time limit, and I am thoroughly looking forward to it. Fourthly, and through gritted teeth, I have to give credit to my hon. Friend the Member for Sevenoaks (Laura Trott), because I would have brought forward this private Member’s Bill should I have been lucky enough to have been selected in the ballot.

Since entering the House, I have seen, through my work on the Health and Social Care Committee and through many conversations with my hon. Friend, that she is dedicated, thoughtful and absolutely tenacious in getting this Bill through, and rightly so. The Bill is really important and has my full support.

We need to be careful in this debate not to demonise botox and fillers, because they are not the problem. We must remember that they have a use in medicine. As has already been hinted at, botox can be used for migraines, for excessive sweating and to relieve pain by numbing the nerve and stopping the nerve from working. That is why it stops wrinkles, because if it is used in a nerve, that part of the face cannot be innervated, so not so many wrinkles are created.

Fillers have a place as well. My hon. Friend the Member for East Surrey hinted at scarring, but they can also be used for acne. Hyaluronic acid, in the right place at the right time, is really important. We should also make distinctions when we talk about these products. Botox is time-limited and wears off, but with fillers it is a mixture depending on what is used and how it is used. Part of the problem is that often people do not know what kind of filler is going into their face.

My hon. Friend the Member for South Suffolk (James Cartlidge) talked about aspiration and I agree with him. There is a place for these products where people want to improve their body. Countless studies show that plastic surgery or interventions on an aesthetic basis can indeed give long-lasting happiness. Take the example of someone who has their nose corrected or a bump taken out: that can have a devastating effect if it is not dealt with and a really positive one if it is. We must therefore be very careful in this debate to ensure that people can get support when they want it and it is appropriate. A big part of the problem is that we get into this vicious cycle of people thinking incorrectly that having a correction will somehow deal with a flaw that is actually deeper in themselves, be it misplaced anxiety or depression.

[Suzanne Webb]

Does my hon. Friend think that we need to talk about body positivity, starting in schools and colleges, to ensure that people do not feel the need for treatments such as botox? People are trying to go for an unattainable image, and that is of great concern. They can never ever be that person, because the image is doctored by photoshopping or by an injection that paralyses the face and takes away all its natural features. I very much feel that the debate should start with body positivity, and that starts with a family in their house and in schools.

[Dr Evans]

Absolutely, I could not endorse that message of body positivity more strongly. Each of us has a natural way for our body to be, and there is no problem with wanting to improve that. That is part of a healthy message on both eating and exercise.

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[Anthony Mangnall]

That is indeed the case. Importantly, we must not let this be a fad of the time. It has to be something that is thought out. If there is a medical reason for someone undergoing an operational procedure, that is absolutely correct, but we cannot let the whims of social media or the fad or the style of the day dictate how someone might end up living for the rest of their life.

[Suzanne Webb]

Although we talk about it possibly being a fad, is it not more important to consider the fact that we do not know the impact on these young adults of having botox at such an early age? There is also the fact that we should all just embrace our natural features. We will all age, and hopefully gracefully, but if people have botox at such an early age, we do not know the impact that that will have on that ageing process. What they may need in future times is more botox perhaps because of the damage they have done to their face.

[Anthony Mangnall]

I hope that my hon. Friend will take it as a compliment when I say that she is ageing beautifully.

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[Laura Farris]

I am not aware of any case where somebody has, but I am happy to take an intervention on that point. However, focusing on personal injury, we can probably all agree that this is an area of law that is ripe for change, regardless of whether a child has actually died from a complication.

[Suzanne Webb]

Will my hon. Friend give way?

[Laura Farris]

I will proceed for a moment and give way in due course.

Two points about the personal injury element are particularly pertinent. The first is that the very act of injecting filler or botox into a young and developing face has potentially serious medical consequences in and of itself. The second is that if it does go wrong, the impact, not just physically but psychologically, could be so much more serious than for an adult. My hon. Friend the Member for Sevenoaks gave the example of a young 15-year-old girl who nearly lost her lips; imagine the trauma that surrounds that.

The force of the Bill is not just in its creation of an offence of injecting a filler or botox into an under-18-year-old, but in the scope of the defence set out in clause 2(4)—the reasonably onerous requirement for a practitioner to show that they took “all reasonable precautions” and conducted “due diligence” in establishing the age of their patient before they administered the treatment. The Bill does not just have the effect of creating an offence if the practitioner fails to do that; as my hon. Friend the Member for East Surrey (Claire Coutinho) said, by introducing such a regulation, it brings insurance into the frame and creates a right to make a claim for personal injury against a practitioner—a claim for damages should personal injury arise—in a case of this nature.

The second reason why I support the Bill is that it implicitly recognises the undesirable psychological impact of children embarking on invasive cosmetic procedures. This goes so much further than a manicure or a haircut; it is the beginning of a teenager, basically, changing their face. They do it because of a three-pronged assault that they face: from celebrities, from people who participate in reality TV shows, and from social media. I have to say that I think Instagram is particularly pernicious in this regard.

That is why the Bill dovetails so neatly with the ten-minute rule Bill introduced by my hon. Friend the Member for Bosworth (Dr Evans). When they are taken together, they are more than the sum of their parts, because they recognise that young people face a barrage of photographs of women with an unattainable standard of beauty, where the woman herself has probably been doctored and the image certainly has, too. These young people, at a stage in their lives when they are impressionable, vulnerable and at their least assured of their own identities, are fed a tacit message that it is not just desirable but necessary to adhere to that standard of beauty.

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[Suzanne Webb (Stourbridge) (Con)]

I rise to support the Bill, and I thank my hon. Friend the Member for Sevenoaks (Laura Trott) for bringing this important issue to our attention. There have been so many fantastic and important contributions so far.

My support for the Bill is principally due to my concern that young adults perceive these treatments as beauty treatments as opposed to medical procedures that carry risks and side effects, and the fact that damage to their self-esteem has probably brought them to that point. The issue behind this is mental health. What brings someone to the point where they feel that they need an injection in their face to paralyse what is beautiful about them, which is their natural appearance?

I am a huge advocate of body positivity, and my hon. Friend’s Bill contributes to that. My hon. Friend the Member for Bosworth (Dr Evans) probably does not know that if I had a private Member’s Bill that I wanted to introduce, it would be his. I have spoken about it on other occasions. All of this is so important to me, and it goes back to what I was saying: where does the situation start that a young adult feels the need to change their appearance?

Many young adults have body image problems and aspire to a face or a body that they cannot hope to live up to because it was faked on a computer or at the mercy of a needle. They see images of a role model whose face has been frozen in time by paralysing the muscles in their brow or around their eyes to make them look good—less tired, less old and less real. I would love to see a shift in society where there is not the same pressure on us all to be picture perfect.

Listening to hon. Members, I am truly grateful for the time and era in which I grew up. There was no social media or internet. At times there was not even any electricity, because it was the winter of discontent, but we will not go down that route. We did not have reality TV shows. We did not have “Love Island”. We in fact had black-and-white televisions—there are some in this room who will remember that time well.

[Andrew Bowie]

I think my hon. Friend might be misleading the House, albeit inadvertently. I simply cannot believe that she grew up in a time with only black-and-white television.

[Suzanne Webb]

I thank my hon. Friend for that. I wish it were not true, but sadly it is.

All we aspired to was standing in front of a mirror mimicking ABBA—I do not know whether my hon. Friend the Member for Wolverhampton North East (Jane Stevenson) did that. We did not have pressure on us to be anything but ourselves; it is as simple as that. We had Jackie magazine. The images were not doctored in those days. If they were, I would be saddened, but they were not Photoshopped. There was no botox; they were natural images. I hope that I come from a generation that reflects that. We do not feel so much pressure to be something that we are not.

[Dr Luke Evans]

I am glad to have my hon. Friend’s support. I think it is important to realise that fashion, trends and the air of beauty have always been there. The difference is the intensification and the unrealistic aspect of it these days, as opposed to the days of hexamethonium, when women would take drugs that ended up killing them, or indeed of corsets, for example. That is a really important point. It is the intensification and the unreal achievability.

[Suzanne Webb]

I thank my hon. Friend for his comments. That is an important point. People put pressure on us to make us feel that there is a way that we are supposed to look. I am afraid that gentleman often make us feel that way as well. We feel that we need to look a certain way to be attractive. We are attractive for who we actually are. We should just be ourselves. That is the most attractive quality in a person that I can think of.

I have seen written work where botox was debated around a “Should they or shouldn’t they?” argument. My simple question is: why would you? Why would you feel the need to do that?

I had not realised when researching this topic that non-surgical cosmetic treatments, such as botox and dermal fillers, generate over £2.75 billion in the UK and account for 75% of all cosmetic enhancements carried out each year. That is great news on the one hand because it is generating income—fantastic—but when we look at it another way, it is a lot of money focused on cosmetic enhancements. It is the word “enhancements” that starts to ring alarm bells, as does the fact that young adults partake of this practice. I thank my hon. Friend the Member for Sevenoaks for taking time to raise awareness of the impact of botox and dermal filler procedures among all age groups, but particularly those under the age of 18.

When I dug a little deeper, I found that, unlike their surgical counterparts, such as breast enlargement and facelift operations, which have clear and defined laws as to who can undertake the procedures, non-surgical cosmetic injections can be administered by anyone. What struck me most was that it is a largely unregulated industry. I support the wish to see the regulation of this practice enforced by a local authority, which will help to keep children safe from these procedures. It will help to ensure that children grow up to be the person they actually are and, as I said before, to age gracefully.

I thank my hon. Friend for raising awareness of the potential health risks of the procedures, including blindness, infection, scarring and psychological impacts. I also want to say again that we do not know the mental health impact of this and what has brought somebody there in the first place. There must be some damage to one’s self-esteem to think that you need to change your appearance. For me, as I mentioned at the start, that is one of my greatest concerns on this and the growing mental health issue within young adults.

[Jane Stevenson]

I thank my hon. Friend for her recollections of ABBA impersonation; mine was Bananarama, but I follow her lines. Does she agree that, as society has shifted and self-confidence is built on what you look like rather than you as a complete person, we are storing up this mental health crisis for future years? People who are now entering into these cosmetic procedures as they get older will be less able to cope with how they look and less happy with themselves. On the “Love Island” point raised a moment ago, we have seen suicides of those contestants, and it concerns me greatly that if one’s confidence is built purely on what one looks like, this is extremely concerning for one’s mental health.

[Suzanne Webb]

My hon. Friend raises a really important point. It is the fact that people feel so self-conscious, but it is also about how, by embracing who you are, you take the consequences of your actions. We all fail at times—we cannot always look beautiful, and we sometimes make disastrous decisions about what we are wearing and how we look—but that is how we grow and learn, and that is how we become strong. We become strong individuals in our life by learning through our mistakes and so forth. It is about turning up with the wrong frock or the wrong jacket on, putting too much lipstick on, or just looking flipping awful some days. Am I allowed to say “flipping” in here? That is what it is about, and it makes you a strong character. Manufacturing who you are does not make you resilient for life, and I think that is a very important point.

The growth in non-surgical treatments increases the need for consumer protection, and I believe it is important to work with stakeholders to strengthen the regulation of cosmetic procedures, so that only regulated health professionals may administer botox or dermal fillers to under-18s, which may be required for medical reasons. It concerned me greatly when I heard about the impact on and damage to that person. The story was quite heartbreaking.

I know that botox is a treatment option for people who suffer from chronic migraines. It is used in the treatment of a range of medical conditions, including the management of bladder dysfunctions, face and eyelid twitching, painful involuntary neck muscle contractions and severe sweating, as my hon. Friend the Member for East Surrey (Claire Coutinho) has already mentioned. I am pleased that it will be used in these cases, with under-18s being able to access that treatment.

I believe it is important that these procedures remain available where there is an assessed medical need. I think that is key—the assessed medical need. It is not needed for beauty; it is needed only for a medical reason and when provided by a registered health professional. At present, practitioners do not need to be medically qualified to perform those procedures, which is a great concern. I did not realise that that was the case until my hon. Friend the Member for Sevenoaks introduced her Bill. There are no mandatory competency or qualification frameworks related to the administration of those procedures, which is incredibly scary. The potential health risks, which she raised, include blindness, tissue necrosis, infection, scarring and psychological impact.

My hon. Friend has made a really powerful case for the need to prevent under-18s from accessing botox or dermal filler procedures for aesthetic reasons, making the administration of botox and cosmetic fillers by injection to under-18s an offence, and I thank her for doing so. She also wants to establish a regulatory framework for local authorities to ensure that businesses have appropriate safeguards in place to prevent under-18s from using their services. She has 100% support from me for her Bill, which will stop dangerous and unnecessary non-medical procedures that can ruin children’s lives. Let us not forget that. We do not yet know the consequences for a young adult of using botox. We still do not know the consequences for adults of using botox as a beauty treatment.

The Bill also ensures that any treatments that are required are performed by a medical practitioner, which I really appreciate. For me, the most important part of the Bill, in conjunction with the private Member’s Bill introduced by my hon. Friend the Member for Bosworth (Dr Evans), which tackles body dysmorphia and unrealistic images in social media, is the fact that it contributes significantly to promoting body positivity, which I have long championed, and I will continue to do so. That begins at home and at school, and we need to educate young adults and children from the age of one, two, three, four and upwards. They are beautiful as they are. We embrace who we are and what we look like, and that is what makes us stronger in life. Any measures that do that have my unquestionable and unwavering support.