Botulinum Toxin and Cosmetic Fillers (Children) Bill

Part of the debate – in the House of Commons at 11:53 am on 16th October 2020.

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Photo of Justin Madders Justin Madders Shadow Minister (Health and Social Care) 11:53 am, 16th October 2020

I welcome this debate, and I do not intend to take up too much time, as my party supports the Bill, as I think do all Members who have spoken today.

As we know, cosmetic procedures such as botulinum toxin—or Botox, as it is more commonly known—are used to reduce the appearance of wrinkles, and dermal fillers are used to fill out wrinkles and creases in the skin and to fill the cheeks and lips. Those procedures are becoming more and more commonplace. While the effects of the procedures are not permanent—usually lasting three to four months or six to 18, depending on which procedure has been undertaken—it is recommended, as with all cosmetic procedures, that they should be carried out by an experienced and suitably qualified practitioner.

As we have heard, there are a number of associated risks. Although side-effects are rare, in the worst-case scenarios they can include infection, scarring and tissue death, as well as psychological problems. We have heard a number of stories about serious issues and problems arising from these procedures. It is, then, a concern that currently there are no statutory provisions to restrict access to these procedures for children and young people. As has been said, they should be on a par with other appearance-related procedures, such as tattoos and sunbed use, for which there is already a statutory minimum age of 18. The measures in the Bill are necessary to protect young people from the serious consequences of uninformed and unregulated procedures. David Johnston summed up the mood of a number of Members when he said he could not believe that this was not already covered in law.

In 2013, the Keogh review of regulation of cosmetic interventions called for greater protection for vulnerable people, noting that young girls in particular were becoming more concerned about their appearance, as we have heard from several speakers. A Mental Health Foundation study found that 40% of teenagers said that images on social media cause them to worry about their body image. Be Real’s “Somebody Like Me” campaign found that 36% of 11 to 16-year-olds throughout the UK would do “whatever it takes” to look good, including considering surgery. Whatever it takes—what a chilling phrase in this context. Worryingly, Save Face, a national register of accredited practitioners who provide non-surgical cosmetic treatments, has reported increasing numbers of complaints from under-18s who have suffered at the hands of unregulated practitioners.

For too long we have not had the robust, consistent and enforceable standards that we need for these treatments and there has been no accountability for malpractice. The absence of standards leaves practitioners with no support and customers with no guarantee of safety. The Bill is a big step in terms of addressing those issues. I congratulate Laura Trott on bringing the Bill to the House and on her hard work. As we have heard, it is quite a lot of work to get a private Member’s Bill not only debated but passed into law. Her introductory speech was compelling and she made a powerful case about the need for additional safeguards. She was right to say that some of the examples of malpractice that have impacted on women’s health go far beyond today’s discussion, but there are a number of other examples of where things have gone on for too long without intervention.

I wish to recognise the contributions from the other hon. Members who have spoken today. There is clearly a great deal of knowledge and expertise in this debate. Dr Evans in particular gave us a comprehensive overview of the medical aspects of this issue. He was absolutely right about accountability being at the heart of the Bill. Most Members spoke about the pervasive influence of social media in particular and its impact on young people in terms of the pressure that it puts on them. Clearly, that is beyond the scope of today’s discussion, but there is certainly a mood in the House in favour of doing more in that policy area.

While I am talking about Members’ contributions, I wish to pay tribute to the work of the all-party group on beauty, aesthetics and wellbeing, and particularly its co-chairs, my hon. Friends the Members for Swansea East (Carolyn Harris) and for Bradford South (Judith Cummins). The group has been highlighting the lack of age restrictions for these procedures and has also raised concerns about advertising and social media promotion that leaves young people vulnerable and at risk. The group’s inquiry on non-surgical cosmetic procedures is the first to assess the regulation of such procedures and its adequacy. The inquiry has brought together people from across the sector to talk about the lack of robust, consistent and enforceable standards and the all-party group is looking to reach consensus on those issues. The inquiry is still ongoing, but I am sure that when it reports it will be a helpful tool for the Government in respect of future legislation, should any be necessary.

Coming back to the Bill itself, as we know, it is intended to safeguard children from the potential risks associated with these procedures. The Bill prohibits specific cosmetic procedures, commonly known as botox and dermal fillers, being performed on young people under the age of 18 in England for purely aesthetic purposes, although, as I understand it, the procedures will still be available to under-18s through registered health professionals where there is an assessed medical need. The Bill provides that the administration of botulinum toxin and cosmetic fillers by injection on a person of the age of 18 will be an offence and that the person who commits that offence is liable on summary conviction to an unlimited fine. The Bill also imposes a duty on businesses to ensure that they do not arrange or perform procedures on under-18s and that will be enforced by a local authority regulatory regime.

The offence is a strict liability offence, which means that if it is committed by a business, or arrangements are made for the administration of one of the substances covered by the Bill for a cosmetic purpose, it will unfortunately be found guilty automatically. However, a defence of reasonable precautions and due diligence will be available to businesses if they can demonstrate that they took all reasonable precautions and exercised due diligence to require proof of a person’s age before any procedures took place. The Bill, if it becomes law, will also provide that any body corporate that commits an offence, or if one is attributable to the neglect of an officer of the body corporate, then that officer, as well as the body corporate, will be guilty of the offence.

Finally, although the Bill does not create any new enforcement or investigatory powers, it does set out that local authorities can enforce the provisions in the Bill using their powers available under schedule 5 of the Consumer Rights Act 2015. Clearly, these are significant new responsibilities for local authorities. Of course we have expressed concern over the way that councils have had their funding stripped over the past decade, so it does raise questions about how comprehensive the enforcement regime will be. That probably is an issue that this House will return to on many other occasions, but it is not a reason for us to reject the Bill today. I conclude by welcoming what the Bill seeks to achieve, and I wish it a speedy passage through the rest of its parliamentary process.