The final item of business is a members’ business debate on motion S6M-14436, in the name of Stuart McMillan, on regulation of the medical aesthetics industry in Scotland. The debate will be concluded without any question being put. I ask those members who would wish to speak in the debate to press their request-to-speak buttons.
Motion debated,
That the Parliament notes the belief that legislation must be introduced to regulate those operating within the medical aesthetics industry because, at present, only clinics that employ healthcare professionals to offer treatments such as Botox and dermal fillers are regulated by Healthcare Improvement Scotland; considers that this means that lay injectors who are not qualified healthcare professionals are not monitored or regulated by any professional body; recognises the reported growth in demand for medical aesthetics, including in the Greenock and Inverclyde constituency, and believes that regulating the sector would help to improve patient safety; acknowledges the reported physical, mental and emotional impact on members of the public who have endured botched experiences at the hands of lay injectors, and the impact that this can have on the NHS, which, it understands, is where people typically turn to for correctional treatment; considers that these treatments should therefore only be offered to people aged over 18, and that patients should be able to expect that the individual offering these treatments is regulated, and welcomes, therefore, the recent announcement by the Minister for Public Health and Women’s Health that the Scottish Government will launch a consultation later in 2024, which, it understands, will include proposals on introducing legislation to regulate the sector in the current parliamentary session.
17:23
I am pleased to lead this members’ business debate on the need for non-surgical medical aesthetics to be regulated. I have been highlighting the topic for several years, as have colleagues on all sides of the chamber. I thank those colleagues who supported the motion to allow the issue to be debated.
The issues arising from the lack of regulation, combined with greater access to non-surgical medical cosmetic procedures, was first raised with me by a constituent, Jill Best, in 2018. I am therefore delighted to welcome Jill and some of her colleagues to the public gallery, and I thank them for coming along.
This debate is about making the industry as safe as possible for patients. It can be argued that, just as with any other purchase, people should, in this area, consider the quality of a product and the person who is selling or administering it. That is especially true when they are considering treatments that involve needles and substances being injected into skin. Understandably, people expect lay injectors to be properly trained and to provide safe, regulated treatments, but that is not always the case. Without regulation, if a procedure goes wrong, there is little chance of holding that lay injector accountable, and the national health service is left to foot the bill for any corrective treatments.
In contrast, if a patient goes to a healthcare professional for the same treatment, that professional will be regulated by Healthcare Improvement Scotland. That means that they are a regulated prescriber and will have obtained medicines from a reputable source. Furthermore, they must have in place safeguards to ensure that the environment in which they are administering the treatments meets health and safety requirements, and that they have policies in place for what happens if a treatment does not go to plan.
In addition, a healthcare professional can rely on their medical training to ensure that a patient is looking for the right type of treatment, following an initial consultation with that patient. Healthcare professionals are also trained to identify whether someone is displaying signs of capacity or mental health issues before making a final decision to carry out any procedure on a patient. If they turn someone away on those grounds, however, the worry and concern is that the person may simply go elsewhere and seek out a lay injector to have the treatment done.
That is only a brief synopsis of the huge range of issues that have been brought to my attention—and, no doubt, to the attention of colleagues on all sides of the chamber—but it is clear to me that regulation of the whole sector is non-negotiable. I am pleased, therefore, that the Scottish Government is looking at bringing in additional regulation. While I know that that has taken longer than anyone would have liked, it is important that we get it right.
As I have learned in recent years, just when the list of all the different types of procedures that are available seems to have been exhausted, another one comes on the market. That shows how adaptable the industry is. We need, therefore, to ensure that regulation is robust while also being flexible enough to cover any new treatments that become available—who knows what the picture will be like in five or 10 years’ time? I appreciate that ministers will want to consult the United Kingdom Government to try to align any policy changes as far as possible across the UK, in order to try to reduce the likelihood of people in Scotland travelling to other parts of the UK for such treatments.
That being said, Scotland has the opportunity to lead the way on the issue. The upcoming public consultation will enable members of the public, as well as healthcare professionals and lay injectors, to have a say on potential regulation. It is important that lay injectors are part of the process and have the chance to feed into any changes that are going to affect them. The industry is not going away any time soon; societal demand shows that it is very much here to stay, so we should make it as safe as possible for everyone. In my view, that is the important thing.
I am aware that lay injectors are undercutting the prices that are being offered by healthcare professionals. If regulation drives up the cost of procedures, that will also act as a barrier and make people think twice about getting a treatment done. However, it is not just about price—the marketing of these products is also a factor in how people access them, and I have had dialogue with the Advertising Standards Authority on that very point. I have seen social media posts in which lay injectors offer treatments for free, or at a discounted price, as they need models. I fear that that leads people to think that these treatments are as simple as getting make-up done. However, make-up can be removed, whereas if a medical aesthetic treatment goes wrong or if the patient does not like it, the after-effects cannot so easily be reversed.
Furthermore, I have seen some lay injectors run online raffles with procedures as a prize. That is very much at odds with the approach that is taken by healthcare professionals, who consult patients before agreeing to offer any procedure. The examples that I have just touched on breach advertising rules. The ASA has told me that, in the past two years alone, it has proactively taken steps to have more than 50,000 online posts for prescription-only medicines taken down.
Evidently, a whole range of policy decisions needs to be considered in order to deliver effective regulation of the medical aesthetics industry. I will continue to highlight those and engage with the Scottish Government and with colleagues on all sides the chamber, and—crucially—also with healthcare professionals, to ensure that the matter is very much progressed.
I look forward to the new consultation, and I encourage anyone who has an interest in this particular issue to get involved in that consultation when it opens. I would like to think that the Minister for Public Health and Women’s Health will, this evening, be able to give some information, or an update, on the consultation. That would certainly help the professionals so that they know what is coming and when, in order that they can encourage others to take part, too.
Fundamentally, we want to ensure that the industry is as safe as possible for everyone across the country, including my constituents in Greenock and Inverclyde. We in Scotland can lead the way, and we have a great opportunity to do so on this particular issue.
We move to the open debate. I remind members that speeches should be up to four minutes.
I also remind those members who wish to speak in the debate to ensure that they have, in fact, pressed their request-to-speak buttons. I am confused, but in any event, I shall move on.
I call Clare Haughey, to be followed by Sharon Dowey.
17:30
I thank you, Presiding Officer, for giving me permission to leave the chamber before the end of the debate. I put on record my entry in the register of members’ interests, as I hold a bank-nurse contract with NHS Greater Glasgow and Clyde.
I congratulate Stuart McMillan on bringing to the chamber this important members’ business debate. In recent years, aesthetic procedures have exploded in popularity, with many clinics popping up on our high streets offering services such as dermal fillers and Botox. While some of those treatments may seem minor, the use of fillers and neurotoxins such as Botox involves medical procedures that can cause serious harm if they are performed incorrectly.
I will share the words of one of my constituents, Suzanne, who owns Pristine Aesthetics. She is a registered nurse, and she runs a regulated clinic in my constituency. She says:
“As nurses we pay high fees to our regulators Health Improvement Scotland, and we work tirelessly to give safe effective care to patients. However we are constantly undermined by people doing short courses to inject people with cheap products purchased online. There is no deterrent, no safety net, or information on this for the public.
As nurses we have high standards and strict protocol on infection control and safe practice. It takes years to train and mould a nurse with the appropriate skill and ethics. The amount of dangerous places in this area is utterly frightening … this is poor unsafe practice.”
Healthcare professionals such as my constituent Suzanne must complete extensive education and clinical training before they can be licensed to perform injections and other procedures. Licensed aestheticians—I knew that I could not say that word properly—who may perform laser treatments, for example, typically complete more than 600 hours at an accredited training centre. However, there is currently no legislation in place to prevent an unqualified member of the public from purchasing materials online, completing a weekend seminar or online course and promoting themselves as qualified to inject clients, regardless of their actual level of knowledge, skill or experience. Worryingly, a 2021 survey of plastic surgeons revealed that 63 per cent of respondents had reported seeing patients with complications, damage and disfigurement after receiving treatments from unqualified injectors.
My constituent’s concerns are reflected in responses to a previous Government consultation on the subject, with almost 98 per cent of respondents agreeing that there should be further regulation of the industry to reduce the risk of physical and psychological harm and the associated cost to the NHS when something goes wrong. As one respondent put it,
“It’s easy to train to deliver these injections, it requires far more expertise to reverse or manage complications. Anyone who cannot manage their own complications should not be delivering these treatments.”
One cosmetic doctor who was interviewed in the press described what she called
“a concerning trend among teenagers to pursue ... ‘tweakments’ to achieve a look that is often completely unrealistic and unattainable”,
driven by “online beauty standards” and filtered images. That chimes with the findings of Girlguiding’s recent “Girls’ Attitudes Survey”, which revealed that over half of girls aged 11 to 21 said that they wished that they looked like they do with social media filters.
In Scotland, there is, effectively, what my constituent has described to me as a “two-tier system” currently in place. Health practitioner services, which are regulated by Healthcare Improvement Scotland, must take into account the physical and psychological wellbeing of the patient or client when considering a course of treatment, including their age. There is currently no ban on under-18s receiving treatments from non-medical prescribers.
The announcement from the Minister for Public Health and Women’s Health that there will be a new public consultation on the topic is an extremely important step towards ensuring that the treatments, which are increasingly popular, are as safe as possible. New regulations will of course have to be introduced with care and consideration, not least to avoid undue difficulties for reputable small businesses and to ensure that unscrupulous providers are not driven underground. The consultation and the continued work of campaigners to raise awareness of areas of concern in the industry will be key to ensuring that regulation will be as comprehensive and effective as possible.
The Scottish Government has stated that it wants to ensure that the procedures
“are delivered from hygienic premises by appropriately trained practitioners, applying recognised standards and using legitimate products.”
Those are sensible goals, which the public should rightly expect to be pursued.
17:35
I thank Stuart McMillan for securing this debate on an important issue that is of real concern to many of my constituents.
Concerns have been raised by medical practitioners that Scotland’s aesthetics regulations are woefully deficient. Every day, vulnerable individuals risk putting their health and their lives in the hands of unqualified laypeople offering aesthetic procedures. Doctors, dentists and nurses are heavily regulated by Healthcare Improvement Scotland, the General Medical Council and other bodies to ensure patient safety, medicine management and insurance coverage. However, laypeople with no professional oversight or competence are free to perform the same high-risk procedures, often in unsafe and unsanitary environments, with little to no accountability when complications arise.
Unqualified and unsupervised individuals are injecting botulinum toxin, or Botox—a prescription-only drug—and dermal fillers into uninformed members of the public with no mandatory insurance or medical oversight. Training courses are unregulated, and some practitioners undergo no formal training at all. There is a wild west element to many treatments.
As Stuart McMillan has noted, there is precious little oversight from any professional body, and the consequences can be severe. It is time that the Parliament looked into the matter, because the treatments seem to be growing ever more popular by the month. Action must take place now, before the situation spirals out of control.
People who undergo shoddy treatment often end up with deep physical and psychological scars from the experience, and we cannot allow that to go on. Although I understand the desire behind the practices and I appreciate how popular some of the treatments have become, it is simply not worth the potential risk to mental and physical health.
The impact goes beyond the individuals who suffer. As Stuart McMillan has said, sub-par regulation is costing our NHS a fortune in time and resources, as our health service needs to step in at a later stage to help those who suffer from a botched treatment. Sometimes, that is correction treatment; other times, the result can be an increased demand for mental health care. In either case, poor practices and the lack of regulation are contributing to the on-going lengthy waiting times in our NHS and are putting medical practitioners under more pressure.
I recently met Lesley Blair, chief executive officer of the British Association of Beauty Therapy and Cosmetology, who highlighted the lack of regulation and standardisation in non-surgical cosmetic procedures. Such treatments are often performed not by medical practitioners but by individuals without proper qualifications, leaving consumers unaware of the risks. Lesley Blair stressed the urgent need for regulation, pointing to the tragic case of Alice Webb, who died following a botched procedure. That shows how vital it is to implement proper oversight as soon as possible. BABTAC also noted consumer surveys revealing that many people falsely believe that the beauty industry is regulated, which only increases the risks involved.
Recently, I had a meeting with the legislation team regarding a bill that would prevent under-18s from receiving such procedures unless advised by a doctor. Such legislation already exists in England. In her winding-up speech, could the minister tell us whether such a measure will be included in her consultation, and could she provide assurances that the Government will move at pace?
I thank Stuart McMillan for bringing the debate to the Parliament. The issue is important and must be examined in more detail. The Parliament has a duty to act to regulate the industry for the protection of people who might suffer from sub-par treatments. I hope that anyone considering a treatment from an unregulated practitioner will think again and exercise caution.
17:39
I am grateful to Stuart McMillan for securing the debate. I whole-heartedly support his motion.
The demand for non-surgical aesthetic treatments such as Botox, dermal fillers and Brazilian butt lifts has surged in recent years. However, too many practitioners are unregulated, which can lead to botched jobs with horrendous side effects. Constituents in East Kilbride have contacted me about the issue.
Many aesthetic procedures require injections, but lay injectors who often have no healthcare qualifications are performing medical procedures without being subject to the same professional standards that apply to regulated clinics. More and more people are seeking such procedures every year, but regulation has not kept pace with that growth. We absolutely need legislation to regulate practitioners who operate in the aesthetics industry. Only clinics that employ registered healthcare professionals are monitored by Healthcare Improvement Scotland, which leaves many providers who do not have relevant formal qualifications operating without sufficient oversight.
At recent events that were held in the Parliament, members heard harrowing stories of patients who have suffered both physical and psychological harm from botched treatments that can lead to infection and disfigurement. The emotional toll for people who are affected can be huge. That also places a huge burden on our NHS, as many of those individuals need correctional treatment when things go wrong. The British Association of Aesthetic Plastic Surgeons estimated that a botched Brazilian butt lift costs the NHS an average of £15,000. It is not right that the NHS has to pick up the pieces due to unregulated and unqualified people offering aesthetic treatments.
At the heart of all this is patient safety. At present, patients who obtain treatment from lay injectors have little comeback when things go wrong. It is clear that we need regulations not only to protect the public and the NHS but to ensure that good practitioners can continue to provide safe cosmetic surgery. With Stuart McMillan and other colleagues, I recently met Jenni Minto, the Minister for Public Health and Women’s Health, to discuss issues with the aesthetics industry. I welcome the fact that the Scottish Government has consulted on the issue, with the result showing that the public overwhelmingly support tighter regulation. I note that the Government is moving the issue forward with key stakeholders, including healthcare professionals and beauty industry representatives, and that there will be further opportunities for the public to feed into the process later this year. The proposals should include strict requirements that only qualified healthcare professionals can administer Botox, dermal fillers and similar treatments. Patients must be able to trust that those who hold the needle have the necessary training, oversight and accountability.
I highlight that many regulated practitioners offer Botox and fillers safely and successfully. People should check out the credentials of a practice before having any aesthetic work done. However, as politicians, we need to step in on regulation. Regulating the medical aesthetics sector is necessary to safeguard the health and wellbeing of the public. I think that members across the chamber will be keen to work together on developing meaningful legislation. I hope that we will be able to deliver that in the next couple of years, so that we can protect patients and restore trust in this rapidly expanding industry.
17:44
I thank the Presiding Officer for allowing me to leave the chamber before the debate finishes.
I, too, congratulate Stuart McMillan on bringing this important issue to the chamber. In France, anyone who wishes to offer medical aesthetic treatment must be registered with the board of the National Chamber of Physicians. In Belgium, practitioners must be doctors, and under-18s must have permission from a parent or guardian before they can have treatment. In Poland, practitioners need to qualify in aesthetic medicine. In Scotland, though, someone who goes on Instagram today will be presented with numerous practitioners who offer aesthetic treatments, very few of whom display medical qualifications and all of whom complete work on very young people.
Such procedures are far from non-invasive. Lip, nose and chin fillers and anti-wrinkle fillers all involve injecting Botox into people’s faces, which can have severe consequences when treatments are botched. A practitioner who does not operate from a medically clean site can cause infections, which means that patients will require further care from our NHS down the line. The treatment can also cause bruising that is much worse than should be normal for such procedures. Nodules can form due to the use of cheap filler, which can cause complications years after a procedure has been completed. This year, there was a story involving 15 women being hospitalised after having beef gelatine injected into them.
Despite those risks, the practice of non-surgical procedures only seems to grow in Scotland. Since under-18s have been banned from having medical aesthetic treatments in England, we have heard reports of more and more children coming to Scotland for injections. That is deeply concerning. I join other members in calling for the provision of such treatment to be limited to those who are over 18. Most such procedures are not conducted by medical professionals. It is possible for lay practitioners to complete training in just one day. No medical body has oversight of the industry. It is therefore clear that we are in a dangerous situation.
I join other members in welcoming the Scottish Government’s launch of a consultation on a proposal to regulate the sector, but it is long overdue. France, which I mentioned earlier, first legislated on the issue in 2009. In 2013, the Keogh report called for improved regulation of the cosmetic industry in the UK. However, the Scottish Government did not even consult on the matter until 2020, when respondents agreed that we needed further regulation. We heard the result of that consultation two years ago. I hope that the Scottish Government’s new consultation will open the door to meaningful progress being made. Too many people who want to improve their confidence are being left with their mental and physical health deteriorating further.
17:48
I thank Stuart McMillan for bringing to the chamber his motion regarding the lack of regulation in the medical aesthetics industry in Scotland. That is a matter of growing concern to me and my constituents, because, all too often, it results in disfigurement and mutilation, mainly of women.
The lack of regulation in the medical aesthetics industry is worrying. It is a rapidly growing sector, with individuals seeking procedures ranging from minimally invasive treatments to major surgical interventions. Even more worryingly, that demand has been accompanied by an alarming rise in the number of unlicensed practitioners, which raises health risks for patients. The lack of adequate regulations poses significant risks to public health and safety.
Bizarrely, only private clinics that employ a regulated healthcare professional who provides a service are regulated. Although some such treatments are performed by qualified healthcare professionals, such as doctors, dentists and nurses, others are administered by people with little or no formal medical training. That extraordinary approach leaves too much room for high-risk cosmetic procedures being carried out by non-regulated, untrained and unskilled practitioners in unregulated premises, which too often leads to patients suffering significant physical and psychological harm.
It alarms me that, for example, anybody in the chamber could take part in an unregulated and often dubious training course and then perform medical procedures on the public. That should serve as a call to action for everybody in the chamber. We need to stop this shambles as soon as possible.
Unregulated clinics do not need to follow the same rigorous health and safety processes as regulated health professionals, which can lead to incidents involving the use of counterfeit products or even the sharing of products with different clients, risking the spread of blood-borne diseases such as hepatitis. That poses a significant health risk to the public, but the lack of regulation is also unfair on the regulated businesses that carry out procedures safely. Reaching high standards comes at a cost, while other businesses are undercutting the competition by risking their patients’ health.
Thankfully, for those who have suffered from botched cosmetic surgery, our NHS is there to help. However, that help comes at a cost at a time when the health service is already under strain. Research from Save Face, a Government-approved register of medical aesthetic treatments, found that, in the case of the 96 per cent of patients who had had complications after cosmetic surgery and were then treated by the NHS, 100 per cent of the failed treatments had been carried out by untrained and unskilled staff. The British Association of Aesthetic Plastic Surgeons estimates that a botched Brazilian butt lift costs the NHS an average of £15,000.
Recent media reports have highlighted cases of botched procedures that have caused permanent damage to people’s faces and bodies. Some individuals have suffered infections, disfigurement and even life-threatening complications. However, in many instances, those who are responsible for performing such procedures face few or no consequences, due to the lack of clear regulation and accountability in the industry.
Other UK nations have already made moves towards regulating the industry, and, if we do not follow their lead, we risk patients border hopping to receive cheap and dangerous procedures in Scotland. We cannot allow that situation to continue. The safety and wellbeing of the public should be of paramount importance, and I therefore welcome the Scottish Government’s planned consultation and hope that we can act on its recommendations as soon as possible to reduce the risk of harm, and before we lose lives.
We must create a framework that protects both practitioners and patients by ensuring a safe and professional aesthetics industry in Scotland. We need to protect our women and our men from unscrupulous exploitation by unqualified and unregulated practitioners.
I call Gillian Mackay, who is joining us remotely, to be followed by Miles Briggs.
17:52
This debate is an important one, and I thank Stuart McMillan for raising the issue in the chamber.
The current situation with regard to the regulation of the medical aesthetics industry in Scotland is untenable. As of today, there are no laws on who can offer such treatments, yet the number of complaints about botched procedures carried out by people with no medical qualifications or in dangerous environments is rising exponentially.
I, along with others, welcome the recent announcement by the Minister for Public Health and Women’s Health that the Scottish Government will launch a consultation later this year to explore legislative proposals to regulate the sector, and I welcome, too, its commitment to doing so within the current parliamentary session. However, although I commend the Government for its position, it is vital that the consultation is followed by robust and swift action.
In the debate, and in conversations around this issue, we should ensure that we never shame or blame those who have sought these procedures.
From 17 January to 30 June 2020, the Scottish Government ran a public consultation on the further regulation of non-surgical cosmetic procedures and proposals to introduce a licensing scheme, and I want to take a moment to highlight the results of that consultation. The consultation report revealed almost overwhelming support for change. Most respondents believed that non-surgical cosmetic procedures should be conducted only by trained, qualified and regulated healthcare professionals, and they also stressed that the physical, psychological or financial risks of allowing unqualified individuals to perform these procedures were far too great. In addition to those views from wider members of the public, regulatory bodies and organisations were calling—and, indeed, continue to call—for more oversight through stricter regulation and/or a comprehensive licensing scheme.
The UK Health and Care Act 2022 introduced enabling powers to establish a licensing scheme for non-surgical cosmetic providers in England. When we look at the experience south of the border, we see that only a small number of local authorities in London, Birmingham and Essex operate their own cosmetic licensing schemes, and they vary in the number and types of treatment that they cover. That said, there are things that we can learn from those schemes when we come to design our own.
For a start, the regulations created under these powers include two separate licences; the powers prohibit people in England from carrying out specified cosmetic procedures in the course of business unless they hold a personal licence and from using or allowing the use of premises for the provision of such procedures unless they have a premises licence. The 2022 act also specifies the high-level categories of cosmetic procedure that will be covered by the licensing scheme, and I believe that we should also set basic standards for training and competencies.
The Scottish Government has previously committed to working with other UK nations on developing proposals for Scotland, and I strongly believe that that is the right path to follow if we are to establish a coherent and robust system for the benefit of the people in Scotland as well as learn from the experiences of other jurisdictions.
Several constituents who are worried about the situation have reached out to me—as others have— and have asked for the matter to be taken seriously and for something to be done urgently. I hope that, in shedding light on some of the dangers, today’s debate means that the Government continues to work to introduce regulations and to ensure and improve public safety. The evidence is clear that, without urgent action, we will continue to see unnecessary harm and further strain on our public health system. Our ultimate goal should be to ensure that all non-surgical cosmetic procedures carried out in Scotland are delivered in hygienic premises by appropriately trained practitioners who apply recognised standards and use legitimate products, and it is my belief that that can happen only through robust regulation.
17:56
I congratulate Stuart McMillan on securing this debate and welcome his constituent Jill Best to the public gallery, along with other campaigners who have joined us in Parliament this evening.
In June, I was pleased to host in the Parliament a cross-party round-table meeting that Stuart McMillan and other members attended and at which we were able to discuss the regulation of invasive cosmetic procedures. I thank the minister and her officials for attending, too. At that round-table event, we heard very clearly the very emotional stories of many people across Scotland whose lives have been impacted by these procedures. We heard not just about the impact of the procedures themselves but about the impact on people’s mental health and the other procedures that they now need to undergo regularly.
Gillian Mackay made a really important point about the motivation for having these treatments. I know from speaking to constituents that, often, they become blind to the reality of what they are doing and, in many cases, what they are receiving. The fact that what they are getting might cost less than treatments using the substances that should actually be used is what really motivates them to have such treatments. Moreover, the social media images that they will have seen of the often fantastic results of these procedures by those advertising them makes people feel that there is a safety net and, as members have mentioned, believe that there is regulation in place.
As other members have said, we have seen these procedures grow and get out of control, and I worry about other potential impacts. For example, in the United States, we are seeing the growth of hangover injection therapy, with people receiving intravenous treatments from friends and others, and we really need to get ahead of all this before it becomes a huge public health emergency in Scotland and across the UK.
The previous UK Conservative Government affirmed its commitment to improving safety, and, since the election, I have written to the new health secretary, Wes Streeting MP, to ask about the Labour Government’s plans to take forward those proposals. In that respect, I very much welcome the Scottish Government’s plans for a consultation. As members across the chamber have said, we are at present seeing individuals with minimal training—sometimes it is only a one-day course, or even just an online course—administering prescription medications, including injectable treatments, and often with an insufficient understanding of the complications involved.
Even more concerning, though, is the prevalence of the use of certain black market products, with poisons being injected into people’s bodies. We simply need to see this as a patient safety concern. As we heard from practitioners and patients at the round-table meeting that I held—and, indeed, as we have heard since—this is rapidly becoming a public health emergency. Those people raise those concerns not because they want that business but because they are picking up the pieces from the impacts on those individuals. That needs to be addressed.
One point that has not been raised in today’s debate but that we also need to recognise is the number of people who seek surgical treatments abroad—for example, for tummy tucks or medical dental surgery—which is otherwise known as health tourism. From speaking to NHS professionals, I know that significant numbers of patients for whom such procedures have failed, or who have had complications abroad or when they have got home, now present to the NHS in Scotland.
I ask the minister whether there has been any progress in recording such cases. We do not have the data on how widespread the issue has become or on its negative impacts not only on individuals but on the NHS, which has to pick up the pieces. I hope that the Government will move forward quickly with the consultation and, what is more important, with actions that can be taken before the end of this parliamentary session.
Before closing, I ask the minister whether the Government will look towards some sort of public health advertising campaign on all that has been raised. It is clear that the issue will not be resolved quickly. Action is taking place, but we need to start raising more concern at Government level and across social media about the implications for people, and to try to warn them against using these procedures.
18:01
I, too, thank Stuart McMillan for bringing the debate to the chamber and for his continued interest in what is a very important subject. I am also hugely grateful for the very helpful and collaborative speeches from everyone today.
I, too, welcome to the Parliament Jill Best and the members of the Scottish medical aesthetics safety group, and I thank them for the awareness raising that they have been working on.
Colin Beattie raised the clear point of significant risk to public health and safety. I have noticed—as have all contributors to the debate—the substantial increase in the number of businesses that offer non-surgical cosmetic procedures such as Botox and dermal fillers. As Miles Briggs said, in June, some of us attended a parliamentary round table on non-surgical cosmetics. I am grateful to Miles Briggs for hosting that event, which gave us an opportunity to hear a powerful account of one person’s experience of a non-surgical cosmetic procedure that went wrong. I completely agree with Collette Stevenson that that was harrowing. I also concur with Miles Briggs’s point that the professionals who attended that meeting came at the issue very much from the perspective of picking up the pieces of work that had gone wrong.
I will touch on the point about Public Health Scotland and the recording of the cases that NHS Scotland has had to treat as a result of such cosmetic work. I have spoken to Public Health Scotland about that and it is exploring further; however, it is a worldwide coding issue, which we need to understand.
I am also mindful of the points that Gillian Mackay and Miles Briggs made about people’s motivation for seeking such treatments. My thoughts will always go out to anyone who may have been harmed by a non-surgical cosmetic procedure. As Gillian Mackay said, we should not shame or blame such people. As Sharon Dowey mentioned, we learned only just last week of the tragic death of Alice Webb, a young mum of five children in Gloucestershire who passed away less than 24 hours after having undergone a cosmetic procedure. My sympathies are with her family.
Many people who undertake such procedures are happy with the results, and there are many responsible practitioners in the medical and beauty sectors, as Clare Haughey and others have outlined. We all want those procedures to be delivered safely by experienced and qualified practitioners, but we know that that is not always the case.
I am grateful to the environmental health officers and public health teams in local authorities who have been working within the powers that they have to address unsafe practice, for instance, by serving prohibition notices. We want to provide a more robust and effective framework to support EHOs, but I also want to provide a framework to support responsible practitioners and give confidence to consumers. We cannot entirely eliminate the risks that are inherent in those procedures. Some are clearly more risky or carry more serious potential side effects than others, but it is appropriate to mitigate those risks.
I remind members that the Scottish Government has made progress in that area. In 2016, we introduced a requirement for independent clinics to be registered and inspected by Healthcare Improvement Scotland. Earlier this year, we expanded that by bringing into the regulation independent services that are provided by pharmacists and pharmacy technicians. Those clinics are the location for a number of non-surgical cosmetic procedures, and consumers can now access them with the confidence that the settings are regulated and inspected by Healthcare Improvement Scotland.
However, as Stuart McMillan and other members have pointed out, there is no regulation of procedures that take place outwith those settings. I agree that that gap in regulation is an issue of huge concern, and the Scottish Government is actively addressing it.
Our consultation in 2020 showed overwhelming support for further regulation. However, some of the comments that we received—on the specific model of licensing that we proposed—were that it was not sufficient to manage the risks for all types of procedures. That is why, at the very helpful meeting with some members on 10 September, I was happy to confirm that I intend to seek public views on more detailed proposals to further regulate the sector. That will build on the previous consultation and the model that we proposed. Work is already under way on that, and we intend to publish the findings before the end of this year. We will ensure that that work is publicised as widely as possible, and I hope that colleagues in the chamber and outwith will do all that they can to support that.
In addition to the consultation, my officials continue to work with the Scottish cosmetic interventions expert group and engage with a range of stakeholders about what regulation might look like. Those stakeholders include healthcare professionals, hair and beauty industry representatives, colleges, environmental health officers and Healthcare Improvement Scotland.
The consultation will be informed by the views of those stakeholders, who have offered valuable advice on the types of procedure that are being carried out, the risks that they carry and the different ways of managing those risks or making the procedures safer.
I will specifically address Foysol Choudhury’s point about age limits. I know that there is an active debate about the appropriate age for procedures to be carried out, and it appears that there is strong support for a minimum age limit for clients. I assure Parliament that our consultation will seek views on age restrictions for procedures in Scotland, as well as the level of training and qualifications that people might need in order to perform those types of procedures safely.
Our ultimate aim is that all non-surgical cosmetic procedures are carried out by appropriately trained practitioners in an appropriate setting, applying recognised standards and using regulated products. As we know, this is a fast-changing sector. Any potential regulation will need to be proportionate, robust and future proofed to capture any emerging procedures. We are working with key stakeholders to get those details right.
I thank Parliament and members for the opportunity to speak in this debate and I commit to continuing to engage with members across the chamber to ensure that we get the regulation right.
That concludes the debate.
Meeting closed at 18:08.Previous
Decision Time