All 4 contributions to the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 (Ministerial Extracts Only)

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Fri 16th Oct 2020
Botulinum Toxin and Cosmetic Fillers (Children) Bill
Commons Chamber

2nd reading & 2nd reading & 2nd reading: House of Commons & 2nd reading
Wed 25th Nov 2020
Botulinum Toxin and Cosmetic Fillers (Children) Bill
Public Bill Committees

Committee stage & Committee Debate: House of Commons
Fri 12th Mar 2021
Botulinum Toxin and Cosmetic Fillers (Children) Bill
Commons Chamber

Report stage & 3rd reading & Report stage & Report stage & 3rd reading
Fri 16th Apr 2021

Botulinum Toxin and Cosmetic Fillers (Children) Bill

(Limited Text - Ministerial Extracts only)

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

(3 years, 5 months ago)

Commons Chamber
Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 Read Hansard Text

This text is a record of ministerial contributions to a debate held as part of the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 passage through Parliament.

In 1993, the House of Lords Pepper vs. Hart decision provided that statements made by Government Ministers may be taken as illustrative of legislative intent as to the interpretation of law.

This extract highlights statements made by Government Ministers along with contextual remarks by other members. The full debate can be read here

This information is provided by Parallel Parliament and does not comprise part of the offical record

Edward Argar Portrait The Minister for Health (Edward Argar)
- Hansard - - - Excerpts

It is always a pleasure to see you in the Chair, Madam Deputy Speaker.

First, as hon. Members will hopefully recognise, I am not my hon. Friend the Member for Mid Bedfordshire (Ms Dorries). I know that she would very much have wished to be here today, given her work with my hon. Friend the Member for Sevenoaks (Laura Trott) on her Bill. She has asked me to say that, as a close contact with someone who has tested positive for covid, she is, as always, doing the right thing and staying away from the House.

I thank my hon. Friend the Member for Sevenoaks for her efforts in bringing forward this Bill today. I know that my hon. Friend, who is the Minister for Patient Safety, Mental Health and Suicide Prevention, has had many positive conversations with her about this issue.

I recognise, given the amount of time that we have been spending opposite each other in debates in recent days, that the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), has picked up on some points that I was already going to pick up on—I suspect that that comes as no surprise. He is right to highlight that this is an issue that unites the House, regardless of party. It is important that I join him in paying tribute to the hon. Members for Swansea East (Carolyn Harris), for Bradford South (Judith Cummins) and indeed to the right hon. Member for North Durham (Mr Jones), who has also taken a big interest in this issue. I also pay tribute to very powerful campaign of The Sun.

Turning to my hon. Friend the Member for Sevenoaks, I know her well and I have known her since before she was a Member of this House. She is always eloquent and effective in her campaigning, and she truly cares about these issues, so it is a privilege to speak in this debate. I also know, from her campaigning, her determination to achieve results and that she always does so. With that in mind, it is a pleasure and, indeed, a relief that, on behalf of the Government, I can offer my wholehearted support for the introduction of an age restriction for cosmetic procedures, and I hope that this Bill—this very important Bill—will receive the wholehearted support of the House.

Let us be clear, this is an ever-expanding multimillion-pound industry and there is more work to be done to ensure that it operates safely. In recent years, there has been a huge rise in the number of people seeking botox and fillers, which has led to an equally large rise in the number of people offering such treatment. The physical and psychological implications of cosmetic procedures are not to be underestimated and need careful consideration. The Bill rightly focuses on protecting young people from receiving botox and fillers until they are able to fully weigh those implications, and I support those aims.

The growth of the cosmetics industry is well documented, and we have seen a fundamental shift in attitudes to cosmetic interventions. It is important to acknowledge the economic and wellbeing contributions of the broader beauty and aesthetics industry. The value of the non-surgical cosmetic interventions market is predicted to rise to over £3.6 billion in the UK by 2021. People have the right to choose what to do to their own bodies, but it is vital that the regulatory framework around the cosmetics industry enables consumers, particularly vulnerable consumers, to make an informed and safe choice.

As my hon. Friend set out, children are currently able to access invasive cosmetic procedures on the commercial market without any requirement for a medical or psychological assessment. Understandably, that has come as something of a surprise to many Members who recognise that they perhaps assumed it was illegal already. I think that my hon. Friends the Members for Wantage (David Johnston), for Newbury (Laura Farris) and for Hyndburn (Sara Britcliffe) alluded to that. There are many reputable and experienced practitioners working in the sector, and this is not an attack on them, but that is by no means universally the case.

It is vital that young people are protected from practitioners who provide botox or fillers for a young person where there is no clinical need on purely aesthetic grounds. We are in danger of mistakenly thinking that having a cosmetic procedure is as straightforward as going to the hairdressers, whereas in reality, as we have heard today, the risks associated with such procedures going wrong are serious and long lasting.

Those risks were set out by my hon. Friend the Member for Sevenoaks and by my hon. Friend the Member for Bosworth (Dr Evans), my constituency neighbour, drawing on his extensive medical experience. My Department has been working to identify where improvements could be made and regulations strengthened to ensure the safety of the most vulnerable consumers. My hon. Friend’s Bill has identified an important area where the safeguards can and should be improved now. My Department is also considering whether further protections should be put in place.

I will make a couple of further points, Madam Deputy Speaker, before drawing my remarks to a close. This is not about making judgments. Young people, as we have heard, are bombarded every day with filtered selfies on social media, influencers and celebrities selling a glamorous lifestyle, which, they suggest, depends on the way someone looks. It is a dangerous and misleading prospectus.

We have heard from many Members today. My hon. Friend the Member for Stourbridge (Suzanne Webb) made her point very powerfully. It is always a pleasure to hear from the hon. Member for West Ham (Ms Brown), who rightly made a typically powerful intervention. She talked about the need for positivity and recognising that everyone is beautiful as they are and the importance of that attitude. The pressure on young people around body image is immense. That is something I saw in my work on eating disorders before becoming a Minister, working with the amazing charity Beat, to which I pay tribute.

The increased accessibility and affordability of cosmetic treatments, alongside that pressure on young people to look a certain way, has perhaps led to a sense of the normalisation of procedures. Our role in government is to support young people in making safe and informed choices and, where necessary, to protect them from the potential harm that procedures can do to their health. We currently place the responsibility to make a considered decision about something seemingly commonplace, but which could have serious consequences for their health, on very young shoulders at a time of physical and emotional development. There are already statutory age restrictions in place for tattooing, teeth whitening and sunbed use, and it makes little sense that there are no similar protections for invasive injectable cosmetic procedures. Alongside the Bill, my Department is exploring a range of options for increased oversight of practitioners, including a system of registration or licensing.

My hon. Friend the Member for Sevenoaks, as I alluded to earlier, highlighted the potential health risks of the procedures covered by the Bill. I will not repeat them, but it is safe to say that I agree with her assessment of which products should be covered by age restrictions. The proposals in the Bill will ensure that the procedures for under-18s are placed firmly within a clinical framework. They permit the procedures to continue under the directions of a doctor and to be administered within a regulated environment for medical purposes.

This Bill is the right thing to do. It represents an important and real step forward, and once again, I congratulate my hon. Friend the Member for Sevenoaks on her important and impressive work and offer the Government’s full support to the Bill.

Botulinum Toxin and Cosmetic Fillers (Children) Bill

(Limited Text - Ministerial Extracts only)

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

(3 years, 4 months ago)

Public Bill Committees
Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 Read Hansard Text Amendment Paper: Public Bill Committee Amendments as at 25 November 2020 - (25 Nov 2020)

This text is a record of ministerial contributions to a debate held as part of the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 passage through Parliament.

In 1993, the House of Lords Pepper vs. Hart decision provided that statements made by Government Ministers may be taken as illustrative of legislative intent as to the interpretation of law.

This extract highlights statements made by Government Ministers along with contextual remarks by other members. The full debate can be read here

This information is provided by Parallel Parliament and does not comprise part of the offical record

Carolyn Harris Portrait Carolyn Harris
- Hansard - - - Excerpts

Thank you, Ms Rees. I am not being presumptuous by sitting in the shadow Minister’s seat; I am merely observing social distancing. I would not presume to elevate myself to such great heights.

I would first like to congratulate the hon. Member for Sevenoaks on having secured parliamentary time to debate this important issue, and I welcome the Bill’s principle of protecting vulnerable young people. The amendments I have tabled are simply intended to improve the Bill. They aim to ensure that no person under 18 years of age receives a non-surgical cosmetic procedure unless it is deemed medically necessary, and medical advice has previously been sought.

As the co-chair of the all-party parliamentary group on beauty, aesthetics and wellbeing, alongside my hon. and dear Friend the Member for Bradford South, I recognise the importance of this Bill and its aim of protecting our young people. The APPG is currently conducting an important inquiry into non-surgical cosmetic procedures, and we have found that all representatives from the beauty industry and beyond are united in supporting a restriction on all persons under 18 years of age.

I am concerned that the Bill, as it is currently worded, would allow registered medical practitioners, as well as regulated health professionals under the direction of a registered medical practitioner, to carry out procedures on any person under the age of 18 without needing to provide medical evidence. I want to be absolutely clear: no practitioner should be exempted from this measure simply because of their qualification level.

It is important to make the case for rare exceptions, as non-surgical cosmetic procedures have uses outside aesthetics: for example, when treating certain muscle conditions such as dystonia, which is a type of uncontrollable muscle spasm. At the beauty, aesthetics and wellbeing APPG session yesterday, on ethics and mental health, it was emphasised by our expert witnesses that medical exemptions must be at the discretion of medical professionals such as psychologists, not left to the devices of the practitioner. One thing I found very disturbing is that we were given evidence by eminent experts in this field who told a story of some medical practitioners seeking excuses to carry out procedures during lockdown that would have justified them being able to practise. I felt that the Minister should know that.

I know that the hon. Member for Sevenoaks accepts the principle of these amendments, and I urge the Minister to consider how to protect vulnerable groups in our society, especially young people who are influenced by social media, peers, and in some cases the industry itself. I know that the hon. Lady will keep us informed about progress, and I urge the Government to make sure that we find a way to protect these young people going forward.

Nadine Dorries Portrait The Minister for Patient Safety, Mental Health and Suicide Prevention (Ms Nadine Dorries)
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It is a delight to serve under your chairmanship, Ms Rees. I pay tribute to my hon. Friend the Member for Sevenoaks for all the hard work and commitment she has put into bringing the Bill forward. She had the delight of being drawn first in the ballot, but the passion and commitment she has shown to this issue, which is close to all our hearts, is second to none.

I thank the right hon. Member for North Durham and the hon. Member for Swansea East. Since I took up this post, the right hon. Gentleman has contacted me, written to me, spoken to me personally, and cornered me in the Tea Room and the corridors to talk to me about this subject many times. I know that he is passionately committed to the subject and the amendments that we are here to talk about. He has been relentless in his pursuit, letter writing and lobbying on the issue.

The hon. Member for Swansea East never rises to speak unless she firmly believes in what she is saying. She is an MP of principle and belief. It is a delight to have her in the House and we are the better for her presence here.

Can I clarify something, Ms Rees? Do you want me to make my comments now or are we going to the hon. Member for Swansea East first?

None Portrait The Chair
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We are going to the hon. Member for Swansea East after you, Minister.

Nadine Dorries Portrait Ms Dorries
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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 Portrait Laura Trott (Sevenoaks) (Con)
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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.

Judith Cummins Portrait Judith Cummins (Bradford South) (Lab)
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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.

Nadine Dorries Portrait Ms Dorries
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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 Portrait Laura Trott
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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.

--- Later in debate ---
Kevan Jones Portrait Mr Jones
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I agree. There are adverts on Amazon in this sector, and treatments offered include fillers, although certain other terms are used. People are not allowed to advertise botox, but they get around that by advertising consultations. In response to the question, many practitioners are not qualified at all and hold no medical qualifications, so how do they get access to botox? They do so because people are signing prescriptions. I fear that a situation may arise in which that practice continues, although it needs to stop.

Another issue is that under the definition the botox can be bought because this is basically a free market, as I see it. A practitioner could then administer the botox to a young person with no regard to that individual’s medical history. A medical practitioner, under the definition, could even be defined as a dentist. That needs tightening up. I do not think that would be onerous for doctors, who are quite rightly prescribing botox injections and other things for perfectly legitimate medical use. Doctors and patients are protected when those uses are laid out.

If I had more faith in the GMC to clamp down, I would be content to leave the situation as it is. I am sorry, but having seen the way the GMC operates, I see that the organisation is not friendly to the complainant or to the patient organisation. It protects the doctor. We took self-regulation away from solicitors, and I have concluded that self-regulation should be taken away from doctors. I did not start with that position, but have come to it.

The Minister promised a Bill on GMC reform in the last Parliament, and one is certainly needed, because frankly, the patient is at a disadvantage in a host of areas, not just this one. It cannot be right that it took my constituent’s case five years to reach the GMC, with huge hurdles to overcome to get there. I hear what the hon. Member for Sevenoaks says, but we should try to tighten things up a bit. The Bill will certainly be improved if we can.

Nadine Dorries Portrait Ms Dorries
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Again, I thank my hon. Friend the Member for Sevenoaks. Many points have been made today and throughout the passage of the Bill that will give us plenty to consider and review.

The GMC publishes guidelines on the ethical obligations of doctors undertaking cosmetic procedures, including guidance on responsible advertising. There is no question as to the GMC’s performance and it being fit for purpose as an organisation. The GMC maintained its track record of meeting regulation standards last year, and it met those standards amid a surge in demand for registration.

The performance review of the GMC for 2018-19 by the Professional Standards Authority, the body that oversees the healthcare regulators, found that good practice was upheld in all 24 standards of good regulation across education, registration standards and fitness to practise. The review confirmed an effective approach to managing a rise in registration applications, progress with the credentialing framework and work to promote fairness in fitness to practise processes.

Kevan Jones Portrait Mr Kevan Jones
- Hansard - - - Excerpts

I hear all that, but I think what needs to happen—I offer this to the Minister—is for her to meet my constituent, Dawn Knight, so she can explain to the Minister the agony that she went through to get justice. The GMC is not user-friendly to patients. The fact of the matter is that, in her case, a doctor was allowed to remain on the register for five years, even though there was clear evidence from multiple women that he had undertaken operations that were, in some cases, life-threatening. Frankly, that is appalling.

Nadine Dorries Portrait Ms Dorries
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The right hon. Gentleman does Dawn great credit by raising that case again, and his words have been noted. He is a tireless advocate. The GMC publishes guidance on ethical obligations for doctors undertaking cosmetic procedures, as it does with all procedures that doctors undertake, which includes guidance on responsible advertising, as I have said. There is another opportunity to continue to raise this matter: I will take his comments away and, as I have a patient safety meeting later today, I will raise them in that forum as well, since this is ultimately a patient safety issue.

Sarah Owen Portrait Sarah Owen (Luton North) (Lab)
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First, I want to say a massive well done and thank you to the hon. Member for Sevenoaks for bringing this important Bill to us and getting it in Committee. The question is not necessarily about the existing guidance, but around the enforcement of that guidance—I think that is what my right hon. Friend the Member for North Durham is saying. It is not just about saying that the guidance is there; we need to see strengthening of that enforcement.

Nadine Dorries Portrait Ms Dorries
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The most I can say at this point—Dawn is a case in point—is that I will take away the comments made by the right hon. Member for North Durham, and I know my hon. Friend the Member for Sevenoaks has also heard them. We will consider those comments. It might be that this matter cannot continue within the scope of the Bill, but we will look to continue it. This does not stop here: my hon. Friend the Member for Bosworth (Dr Evans) is introducing the Digitally Altered Body Images Bill under the ten-minute rule, so there will be another opportunity to raise these points. Within the confines of patient safety, this is an issue that we need to continue reviewing.

Kevan Jones Portrait Mr Kevan Jones
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Will the Minister look at prescriptions for botox as well? There is clearly a market out there and there are medical professionals signing prescriptions and then selling them on, fuelling this market and leading to people who are not qualified giving that botox. Could she look at that?

Nadine Dorries Portrait Ms Dorries
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Of course. I heard that comment in the right hon. Gentleman’s initial remarks. This is a difficult market to police—it is regulated, but it is difficult to police and to know who those practitioners are and where they are selling prescriptions on to. If he knows of any practitioners who are doing that, or is aware of any practitioner who is writing out bulk prescriptions for botulinum toxin and selling them on to other, more ruthless practitioners, or to people who are not even registered to practise, I ask him to please let us know, then we can take that forward.

Kevan Jones Portrait Mr Kevan Jones
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May I suggest another way of doing this? If the Minister speaks to the prescription licensing body, it will know exactly who is signing huge amounts of botox prescriptions, and one possible way to investigate large numbers of botox prescriptions is to ask whether those people can justify what they are doing. If we go online, we see umpteen adverts for botox treatments, and those people who are doing this are not doctors, so where are they getting them from?

Nadine Dorries Portrait Ms Dorries
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Again, the right hon. Gentleman has done his cause justice by raising those concerns and saying what he has in Committee. We will have a look at that.

--- Later in debate ---
Kevan Jones Portrait Mr Jones
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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.

Nadine Dorries Portrait Ms Dorries
- Hansard - - - Excerpts

The right hon. Gentleman has made wide-ranging and important comments. I am not sure it was any easier to speak to the former right hon. Member for Sheffield, Hallam when he was in this place than it is now—there is not much change there—but I thank the right hon. Member for North Durham on all our behalf for his efforts to do so. Outside of the Committee and official channels, he still keeps batting away and trying to get results. We thank him for that.

I believe everyone has the right to make informed decisions about their bodies and our role in Government is to support young people in making safe, informed choices and, where necessary, to protect them from the potential harm that cosmetic procedures can do to their health. This Bill is a really important step on that path and in that process.

On indemnity, the Government passed legislation in July 2014 requiring all practising regulated healthcare professionals to have appropriate indemnity arrangements in place as a condition of registration with the regulatory body and, therefore, their ability to practise. For doctors, those regulations came into force in August 2015. Failure to comply may mean that they are dealt with under fitness-to-practise procedures. That means that all practising surgeons are affected by the legislation, including overseas surgeons practising in the UK. I hope that information helps.

Kevan Jones Portrait Mr Kevan Jones
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I am not against the cosmetics industry. I agree with what the Minister just said—it is about informed choice—but it has to be done safely. I welcome her comments on professionals. The big grey area, which this Bill cannot cover but which needs covering, is those who administer botox and fillers. Most of those people are not medical professionals. They have done “a course” in injections, which in some cases I have seen is just a tick-box exercise. That is the area we need to move on to next—not only who can prescribe, but who can inject these fillers and botox.

Nadine Dorries Portrait Ms Dorries
- Hansard - - - Excerpts

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 Portrait Laura Trott
- Hansard - - - Excerpts

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.

Kevan Jones Portrait Mr Kevan Jones
- Hansard - - - Excerpts

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—

Nadine Dorries Portrait Ms Dorries
- Hansard - - - Excerpts

Nonsense.

Kevan Jones Portrait Mr Jones
- Hansard - - - Excerpts

Well, I was told that by a Minister in her Department. One simple thing we could do is to regulate those who administer these fillers and botox. That would be a huge step forward. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

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

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Clause 5 enables amendments to be made that are consequential on the Bill. Clause 6 sets out the territorial extent of the Bill. The Bill does not impose any requirement on bodies within Scotland, Wales and Northern Ireland that regulate and enforce the supply and administration of botox and cosmetic fillers.
Nadine Dorries Portrait Ms Dorries
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My hon. Friend the Member for Sevenoaks has said everything that needs to be said about these clauses.

Kevan Jones Portrait Mr Kevan Jones
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Are we now debating whether the rest of the clauses stand part of the Bill?

Botulinum Toxin and Cosmetic Fillers (Children) Bill

(Limited Text - Ministerial Extracts only)

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Report stage & 3rd reading
Friday 12th March 2021

(3 years ago)

Commons Chamber
Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 Read Hansard Text Amendment Paper: Consideration of Bill Amendments as at 12 March 2021 - (12 Mar 2021)

This text is a record of ministerial contributions to a debate held as part of the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 passage through Parliament.

In 1993, the House of Lords Pepper vs. Hart decision provided that statements made by Government Ministers may be taken as illustrative of legislative intent as to the interpretation of law.

This extract highlights statements made by Government Ministers along with contextual remarks by other members. The full debate can be read here

This information is provided by Parallel Parliament and does not comprise part of the offical record

Alex Norris Portrait Alex Norris (Nottingham North) (Lab/Co-op) [V]
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I have been reassured by the answers given to the promoter of the Bill, the hon. Member for Sevenoaks (Laura Trott), so I do not intend to support either amendment or delay proceedings any further.

Nadine Dorries Portrait The Minister for Patient Safety, Suicide Prevention and Mental Health (Ms Nadine Dorries) [V]
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I congratulate my hon. Friend the Member for Sevenoaks (Laura Trott) on the outstanding work that she has done in introducing the Bill, and I reiterate the Government’s support for the legislation. I believe that everyone has the right to make informed decisions about their bodies, but our role in Government is to support young people in making safe, informed choices where necessary to protect them from the potential harm that cosmetic procedures can do to their health. The increasing popularity of cosmetic procedures and the pressures on our young people to achieve this aesthetic ideal are well documented, and I believe that the Bill is an important step in putting those necessary safeguards in place.

I acknowledge the intentions behind the amendment tabled in the Public Bill Committee by the hon. Members for Swansea East (Carolyn Harris) and for Bradford South (Judith Cummins) to introduce a medical necessity test on the face of the Bill, and I hope that they have taken assurances from the explanation by my hon. Friend the Member for Sevenoaks of the work that she has done to explore this. The standards set by the General Medical Council already require doctors to consider the best interests of the patient to cover the ethical treatment of under-18s.

It has been an absolute pleasure to work with my hon. Friend to take this step towards greater regulation of the cosmetic procedure industry. I look forward to the Bill’s successful passage through the Lords.

Christopher Chope Portrait Sir Christopher Chope
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Because time is running short, I thank those who have contributed to this short debate, and so that we can move on to Third Reading, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Third Reading

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Nadine Dorries Portrait Ms Dorries [V]
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I have nothing further to say due to the shortage of time. I just reiterate that it has been an absolute pleasure to work with my hon. Friend the Member for Sevenoaks (Laura Trott) to take these steps forward to the conclusion of the Bill, and I commend it to the House.

Alex Norris Portrait Alex Norris [V]
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I add my congratulations to the hon. Member for Sevenoaks (Laura Trott). I know that this has been no mean feat, especially during the current challenging times, and there has had to be a lot of patience, but it has been rewarded today. It is important that we act to protect our young people, especially with the pressures that they face. This is one of those great bits of legislation where I think if we stopped our constituents in the street and asked them about it, they would think it was already like this. This is a common-sense, practical and proportionate way to protect our young people, and we give it our full support.

Botulinum Toxin and Cosmetic Fillers (Children) Bill

(Limited Text - Ministerial Extracts only)

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This text is a record of ministerial contributions to a debate held as part of the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 passage through Parliament.

In 1993, the House of Lords Pepper vs. Hart decision provided that statements made by Government Ministers may be taken as illustrative of legislative intent as to the interpretation of law.

This extract highlights statements made by Government Ministers along with contextual remarks by other members. The full debate can be read here

This information is provided by Parallel Parliament and does not comprise part of the offical record

Lord Bethell Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
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My Lords, I am enormously grateful to all those who have contributed to this lively debate today and pay particular tribute to my noble friend Lady Wyld for sponsoring the Bill, as well as to the honourable Member for Sevenoaks who navigated its passage through the other place. It would also be right to pay tribute to Professor Sir Bruce Keogh for his review of regulations on cosmetic interventions, which was mentioned by many noble Lords and has clearly paved the way for this important Bill. I reassure my noble friend Lord Lansley that his plug for his Private Member’s Bill has been well and truly heard by the Minister.

The Government are pleased to support the introduction of an age restriction for botulinum toxin and fillers. As my noble friend Lady Wyld showed so clearly, the provisions in the Bill will ensure that young people are accorded the highest protections to safeguard their physical and psychological health. There are already statutory age restrictions in place for tattooing, teeth whitening and sunbed use. It makes no sense that there are not similar protections for invasive, injectable cosmetic procedures.

Botulinum toxin, dermal fillers and laser hair removal account for nine out of 10 non-surgical treatments performed in the UK—an astonishing proportion. Analysis by my department last year estimated that as many as 41,000 botulinum toxin procedures may have been carried out on under-18s in 2020 and that more than 29,300 dermal filler procedures may have been undertaken on under-18s in 2017. I support the decision to focus on the treatments covered by the Bill, as introducing an age restriction on botulinum toxin and fillers will protect the greatest proportion of young people seeking a cosmetic procedure at this time.

To practise in the UK, doctors must be registered and hold a licence to practise with the General Medical Council, the regulator of doctors. The GMC publishes clear standards of practice and guidance for doctors, including Good Medical Practice, which covers consent, the treatment of patients aged under 18 years and safeguarding vulnerable patients. On my noble friend Lady Neville-Rolfe’s point on costs, keeping up to date with these provisions is the normal cost of doing business in this area.

The department is working with stakeholders to assess the need for strengthened safeguards around the regulation of providers who offer some of the more invasive non-surgical cosmetic procedures. I completely take on board the points made by the noble Baronesses, Lady Wheeler and Lady Brinton, on the advice given by the excellent Changing Faces charity on the need to protect the surgery that some young people with particular needs may require.

I assure the noble Lord, Lord Addington, the noble Baroness, Lady Walmsley, and others who have asked that the department is working closely with the Medicines and Healthcare products Regulatory Agency to develop our future regulatory regime for medical devices, which prioritises patient safety. As part of this, we will consider whether to bring all dermal fillers and any other relevant procedures into the scope of the device legislation.

Measures in the Bill complement other important work that we are taking forward. I assure the noble Baroness, Lady Massey, and others who asked that public health and mental health messages to our children and young people are key priorities in our long-term plan for the NHS. In addition to the existing funding as part of the long-term plan, the Government recently announced a further £79 million boost to funding for children and young people’s mental health. In addition, in July last year we launched Tackling Obesity: Empowering Adults and Children to Live Healthier Lives.

On the touching comments on body image by the noble Baroness, Lady Bull, I completely agree that we must seek better understanding of the motivations that may be driving consumer demand among young women. We have put in place the first government-led women’s health strategy for England. This will set an ambitious and positive new agenda to improve the health and well-being of women across England. I encourage the noble Baroness, Lady Bull, and all other Peers who have a valuable contribution to make to ensure they hit the end-of-May deadline for evidence.

The Government plan to make a full response to the Independent Medicines and Medical Devices Safety Review report chaired by my noble friend Lady Cumberlege later this year. To ensure that patient voices are heard as we move forward, a patient reference group has been established and is working closely with the department.

On the points made by the noble Baroness, Lady Bull, I note that the House of Commons Women and Equalities Committee recently published the findings of its inquiry into body image. The findings offer insight, and it is disturbing to note that the inquiry’s public survey found that 61% of adults and 66% of children feel negatively or very negatively about their body image most of the time. These figures are even higher for specific groups including women, people with disabilities and transgender people. It is clearly far too high.

These are very personal issues. My noble friend Lady Wyld has spoken of her three daughters and my noble friend Lady Neville-Rolfe spoke of her beautiful granddaughters. I have two daughters of my own and worry daily about the world they live in and their consumption of social media. I should be clear to noble Lords who have raised these points that the Bill before us has a tight focus, and social media is not the target of the Bill. I join my noble friend Lady Mobarik in calling for big tech to do all it can in this area. I reassure noble Lords that the online safety Bill will be ready this year. The legislation will help ensure that children can make the most of the benefits of going online while staying as safe as possible.

The noble Baroness, Lady Wheeler, asked some specific questions about the Bill’s powers. I would be glad to write to her to clarify her questions. In the meantime, I urge noble Lords to resist any temptation to try to improve the Bill through amendments and risk losing it altogether. Time is so tight before the end of the Session.

That leaves me to congratulate my noble friend Lady Wyld and, recognising the encouraging words from the noble Baronesses, Lady Brinton and Lady Wheeler, I offer the Government’s support to this important Bill.