I rise to support new clause 1, which stands in the name of the right hon. Member for Romsey and Southampton North (Caroline Nokes), myself and 18 other right hon. and hon. Members from across the House. I first took an interest in this subject through a constituent, Dawn Knight, from Tanfield in my constituency. Dawn raised issues around the cosmetic surgery industry having been a victim of a particular hospital group. She has been a tireless campaigner in ensuring not only that victims get a voice, but that we press for more regulation.
I join others in paying tribute to the all-party group on beauty, aesthetics and wellbeing for its recent report and to my hon. Friends the Members for Swansea East (Carolyn Harris) and for Bradford South (Judith Cummins) for their work on that report, which highlights what my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders) called the “wild west”. That is exactly what it is: it is a wild west without any regulation. It is a multibillion-pound industry, which is not only putting people at risk, but costing the NHS money.
In April 2013, the Health Secretary at the time—Andrew Lansley, now Lord Lansley—commissioned Sir Bruce Keogh to carry out a review of the regulation of cosmetic surgery. The review came out not only when we were having problems in the sector itself, but when interest was heightened around Poly Implant Prothèse breast implants, which people will well remember. When the review concluded, it explicitly advised the Government to increase regulation of the cosmetic surgery industry to prevent unlicensed treatments and increase patient safety. The review stated that a person having a non-surgical procedure
“has no more protection and redress than someone buying a ballpoint pen or a toothbrush”,
and
“dermal fillers are a crisis waiting to happen.”
As the right hon. Member for Romsey and Southampton North said, that crisis has actually happened already.
I have been campaigning on this issue for a number of years, during which time I have gone through a succession of Health Ministers, all of whom have come back with two points. The first is, “We are going to implement the Keogh recommendations”. But because Ministers were too terrified previously to make any health legislation, they were reluctant to bring those recommendations forward in that way.
The only good news in the area has been private Member’s Bill of the hon. Member for Sevenoaks (Laura Trott), the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021. That legislation was tightly focused—as all private Member’s Bill have to be—and banned botox
injections for under-18s. I congratulate the hon. Member on that work. However, any other regulations have been left unfinished. I have sheaves of letters from former Health Ministers saying, “The Keogh recommendations will be implemented”, but they have not been to date. If we do not do that in this Bill, when will it be done? I doubt that the Department will come forward with a Bill just to implement those recommendations; that is wishful thinking.
There is clearly no regulatory framework in the UK at present for those performing aesthetic non-surgical cosmetic treatments. The area is completely unregulated and lacks any national standards. There is no consumer protection, education, training or qualifications for those administering such treatments. As my hon. Friend the Member for Brent Central (Dawn Butler) said, some people call themselves nurses with no qualifications whatever. There is a huge discrepancy between the standards and qualifications of the training of these people. The other side of the issue, to which I will turn in a minute, is the regulated system, which, frankly, is failing as well.
The right hon. Member for Romsey and Southampton North raised the issue of training. If hon. Members visit any website tonight, they will see huge adverts saying, “Become a dermal filler specialist: training and qualification online within half an hour”—even less time in some cases. The people offering such services have no qualifications whatever, because the qualifications are not worth the paper that they are written on, but these people start carrying out invasive procedures without anybody stopping them. They can do it in a kitchen, or in any area that has not been clinically cleaned and is not of a standard that we would expect for medical procedures. It is a multimillion-pound racket that includes both the people offering the training and those carrying out procedures. It is an increasing issue, which needs to be addressed.
We also need to address the issue of advertising. As I have said before in the House, the Advertising Standards Authority is frankly a complete waste of time. If hon. Members go on any website tonight, or even open the national newspapers, they will see people advertising these services—potentially dangerous procedures—without any qualifications. We might ask, “Why would people have these procedures?” Well, I suggest that everyone reads the Mental Health Foundation’s 2019 report on body image, which shows the increasing pressure on young people.
The right hon. Member for Romsey and Southampton North is correct that this issue mainly affects young women, but it is increasingly an issue for some young men. The pressure of factors such as advertising and photo enhancements lead people to think that there is the perfect individual, but—apart from you, Mr Deputy Speaker—I am not sure that there is. The foundation’s reports highlights the pressure that is put on young people, but particularly young women. If they look at prices for procedures, they end up going to people who are completely unqualified. It is a scandal that there is no legislation to prevent this.
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The Keogh recommendations were published in 2013, Sir Bruce Keogh called for minimum standards. Well, there are no minimum standards or regulation of what should be going on, and that has to be put right. I agree
with the right hon. Member for Romsey and Southampton North that if this new clause is not perfectly crafted—it may well not be—we still need to ensure that there is regulation. I thank the Minister for the meeting we had last week—it took longer to arrange than getting an audience with the Pope, but we finally got it—and for the positive noises he made during the meeting, but I felt that the civil servants were reluctant to have any more regulation. As I said, I can provide the Minister with letters written to me by his predecessors saying that they were recommending the implementation of the Keogh review recommendations; however, we still need to implement them. If the new clause is not acceptable today, we certainly have to ensure that a regulation system comes up during the passage of the Bill.
I want to touch on two other issues. The first is a point raised by the hon. Member for Central Ayrshire (Dr Whitford), about the cost to the NHS. Over the years, I have asked what the cost is to the NHS of putting these procedures right. As the right hon. Member for Romsey and Southampton North said, when things go wrong there is no insurance to cover the individuals and there is no putting things right; that falls to the NHS. I have continually asked whether local NHS trusts keep figures on this, but they do not.
In the cases that Dawn Knight has brought to me—I am sure that it is the same for cases mentioned by the right hon. Member for Romsey and Southampton North—the rectification process involves not only the mental health issues that result from these procedures, but the cost of putting them right, although in some sad cases they cannot be put right. That cost falls on the NHS and the taxpayer. There is no comeback at all on the people who sell the unsafe practices. I therefore tabled an amendment, which was not selected, on collecting data; we need that data.
Finally, I turn to the wider regulation of the sector and the surgical sector. Again, my hon. Friend the Member for Ellesmere Port and Neston said that the sector is a wild west. I always hear from Ministers, “Well, doctors are regulated by the GMC, and you’ve got the Care Quality Commission looking after the private hospitals where these procedures are taking place,” but those bodies are failing. It took my constituent Dawn Knight six years to get a doctor struck off. Self-regulation through the General Medical Council does not work any more. We need to change it if we are to ensure that the patient is not only protected, but can get redress.
The cosmetic surgery industry is a racket. Businesses that are basically marketing companies rather than medical companies can portray themselves as hospital doctors. The doctors are usually brought in—sometimes from abroad, mainly Europe—on a day basis to carry out procedures. In most cases, there is no insurance. The structure behind a lot of the companies is that they tend to have the same directors and go bust very quickly. First call usually goes to the taxman, to whom they owe huge amounts of money, but often they also owe the local authority rates that they have not paid for years. The poor patient has no redress, and those cases come back to the NHS, which picks up the tab for putting them right. My constituent Dawn Knight had surgery on her eyes, and I hate to think what it has cost the NHS to address her ongoing problems.
There are two aims on the non-surgical side, because we have to beef up the regulation as well. I say to the Minister that if we do not get that in this Bill, I am not sure where we are going to get it. If the amendment is not accepted for technical reasons, I and, I am sure, the right hon. Member for Romsey and Southampton North and others, would like to work with him to draft an amendment before the conclusion of the Bill that brings in the regulation that was promised. The evidence is behind it, as is the Keogh review. It will not only give people confidence that procedures have been carried out safely, but drive the cowboys out of the sector, so that they will not be able to practise and harm vulnerable people.