I beg to move

That this Assembly recognises the need for greater regulation in the use of aesthetic medicines in non-surgical cosmetic procedures; notes that Save Face, a register of accredited practitioners and clinics, received almost 3,000 complaints in 2022 regarding unregistered practitioners; further recognises the potential risk to people if these products are not properly administered, supervised and stored; and calls on the Minister of Health to consider measures, including legislation, to ensure that these products are administered by appropriately trained practitioners.

The Business Committee has agreed to allow up to one hour and 30 minutes for the debate. The proposer of the motion will have 10 minutes to propose and 10 minutes to make a winding-up speech. As an amendment has been selected and is published on the Marshalled List, the Business Committee has agreed that 15 minutes will be added to the total time for the debate.

We tabled this motion in the hope that we can create consensus on the urgent need for greater regulation of non-surgical cosmetic products and procedures in order to improve the safeguarding of the health and well-being of our population, particularly our young people. As many Members will be aware, in the past number of years, there has been a significant rise in the number of people seeking aesthetic procedures such as, but not limited to, botulinum toxin — more commonly known as Botox — and dermal fillers.

There is no doubt that there are huge pressures in society to look good, which can largely be attributed to social media and the content that dominates our young people's social media platforms daily. In the past, aesthetic treatments of that nature were generally seen to be something that celebrities and the more affluent in our society could access, particularly in the US. However, over time, the demand for those treatments has risen exponentially, giving way for more and more people to offer these services, often at a much lower cost.

From the outset, I want to say that I have no issue with aesthetic procedures, and as a woman of a certain age, I fully appreciate that they can help many people to feel good about the way that they look, which can go some way to boosting confidence and self-esteem. Many highly trained practitioners deliver an extremely safe service, using only high-quality products. It is also important to recognise the important use of botulinum toxin and fillers in medical treatments, including, but not exclusive to, the treatment of chronic migraines and excessive sweating, often under the direction of a medical professional.

The genesis of the motion is therefore not to place a ban on those procedures but to ensure proper regulation to mitigate the risks of complications, particularly given the lack of regulation currently in place. Despite the clinical nature of these treatments and the very serious complications that can arise for various reasons, those providing treatments are not currently under any obligation to register with the Regulation and Quality Improvement Authority (RQIA) or any similar body. That is a shocking fact, and even more shocking is that, at present, there is no legislation in the North to protect young people under 18 when accessing treatments, despite the very evident rise in teenagers getting lip fillers and other treatments. Anecdotally, practitioners have told us that children as young as 14 have attempted to access these treatments for purely cosmetic reasons. That is why I welcome the amendment from Diane Dodds and Alan Robinson, which further strengthens our objective to protect our young people from the potential negative side effects of these procedures.

As previously mentioned, more and more people are offering these services, many at a relatively low cost, yet there are serious concerns about the level of training and expertise obtained to enable them to do so. That is not a criticism of those who have undertaken training in good faith. They are not doing anything wrong under the current law. However, when things go wrong — whether a reaction to the product or an error in its administration — they may not always be in a position to provide the necessary aftercare to the client, and that can have many serious implications.

Complications from maladministered injectable aesthetic treatments can range from bruising and skin drooping to anaphylactic shock, permanent blindness, sepsis and, in some cases, even death. Many advanced practitioners in the aesthetics industry have professional qualifications in nurse prescribing, pharmacy, dentistry or medicine and have undergone much more advanced training in the aesthetics field. They have demonstrated from experience the importance of their clinical knowledge in ensuring that they respond effectively and efficiently to complications when needed, which many practitioners without the same level and depth of training would not be able to do.

In a recent case in England, 33-year-old Alice Webb, a mother of five, passed away due to complications from a liquid Brazilian butt lift (BBL) procedure, which involves placing dermal filler in the buttock area. Among advanced medical practitioners, that is known to be an extremely unsafe procedure, and there have been many public calls, dating back to 2023, from industry leaders such as Save Face to ban the use of liquid BBL procedures. It beggars belief that there is no legislation here to determine who can administer those products and procedures. As is highlighted by the examples that I have described, regulations must be put in place urgently.

In England, the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 made it an offence for a person to administer botulinum toxin or a filler by way of injection for a cosmetic purpose to a person under the age of 18 in England. In April 2022, the Health and Care Act 2022 gave the British Secretary of State for Health and Social Care the power to introduce a licensing regime for non-surgical cosmetic procedures in England. Similarly, in the South of Ireland, following an 'RTÉ Investigates' documentary that, earlier this year, provided a covert insight into the scale of illicit practices across Ireland, particularly on a cross-border basis, the former Taoiseach Leo Varadkar indicated that work was ongoing on strengthening regulation of the industry in the Twenty-six Counties. That further emphasises the need for us to act accordingly in the North.

This is a crucial issue that we must get to grips with urgently in the interests of public safety. Making it an obligation to be properly trained and licensed by a relevant regulatory body is about protecting not just people who access treatments but practitioners. I therefore ask the Minister to develop options for essential regulation in the industry and to ensure the introduction of the appropriate oversight and training that is required for those who administer these products. I ask Members to support the motion.

I beg to move the following amendment:

At end insert: "and to make it illegal to administer botulinum toxin (Botox) or a filler, by way of injection, for a cosmetic purpose to a person under the age of 18 in Northern Ireland."

You will have 10 minutes to propose the amendment and five minutes to make a winding-up speech. All other Members who speak will have five minutes.

I very much welcome the fact that the proposer of the motion supports our amendment. When it comes to healthcare, no matter how minor the procedure may seem, safety must always come first. The lens through which any regulation should be looked at is one that focuses on making the industry safer for patients. My party supports greater regulation of the use of aesthetic medicines in non-surgical cosmetic procedures.

The use of injectables such as Botox, dermal fillers and other aesthetic treatments has surged in recent years, with people seeking to enhance their appearance in less invasive ways. However, the rapid growth of the sector has come, unfortunately, with significant risks. Regulation should ensure that providers are properly trained, that the products that are administered are safe, that they are administered within safe levels and that those who administer the products can be held accountable when things go wrong. When those procedures go wrong, they are not easily reversed, and, in most cases, the NHS is left to pick up the pieces. The British Association of Aesthetic Plastic Surgeons estimated that intervening in a botched butt lift could cost the NHS £15,000. It might be easy to administer the products, but, when the procedures go wrong, they are not easy to undo.

The drive for perfection is driven by online trends. I have a 10-year-old who, along with all her friends, is obsessed with her skin and with beauty shops that provide very expensive products. I remember, from when I was her age, 10-year-old girls whose only obsession was with dolls and toys. However, young people are growing up, and they see many others talking openly online about their use of Botox and fillers, which are portrayed as common beauty treatments. The social media era has a lot to answer for.

It must be said that many professionals in the industry would welcome regulation, because their high standard of work is being undermined by individuals who have basic knowledge and limited training and who provide cheap cosmetic products that can be bought online and even from the black market. Quite simply, there are some unqualified individuals who provide poor and unsafe cosmetic practices that have lifelong and devastating consequences that are not just physical but inflict a lifetime of psychological harm. Doctors, dentists and nurses have high standards to follow, but unqualified and untrained individuals are free to carry out procedures that can be life-changing and, on occasion, not for the better. It feels a little bit like the Wild West.

Indeed, Save Face said that 100% of failed treatments were carried out by untrained and unskilled staff. Save Face also stated that it had received a startling 5,000 complaints over the past four years, 70% of which were related to fillers. In October 2021, the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 came into force in England, making it illegal to administer Botox or a filler by way of injection for a cosmetic purpose to a person under the age of 18, but no such law exists in the Province. Under-18s here can have Botox and dermal fillers with no checks on their age. It is concerning that there is no legislation on non-surgical cosmetic treatments for those under 18, yet young people under 18 are banned from using, hiring or buying sunbeds and cannot get a tattoo. There is a gap in regulation. The Health Minister should, therefore, move to introduce a mandatory registration scheme in the Province so that local authorities can work in partnership with the Department of Health to protect public safety. New legislation would enable environmental health teams to regulate the industry throughout the Province.

The consequences of improperly injected Botox or poorly stored dermal fillers can range from adverse reactions and infections to serious complications that require immediate medical intervention. That is not a scenario that we want for anyone. It is, therefore, crucial that steps are taken to ensure that only those who are properly trained and qualified are allowed to administer the products. The Department must regulate the sector in a way that ensures that patients can trust that the procedures will be carried out by professionals who meet the highest standards of safety and care and that no one under 18 can access the treatments in those settings. The Department must ensure that the products are stored and handled in a way that safeguards their effectiveness and reduces the risk of contamination or misuse.

We can no longer have a situation in Northern Ireland where those carrying out treatments such as Botox and fillers are not required to be registered with the RQIA and local authorities have no powers to refuse their registration. My party, therefore, calls on the Minister of Health to review the lack of regulation whereby a practitioner can inject a client with a substance without being registered with the RQIA or their local authority. A registration process would help those considering a cosmetic procedure to make an informed choice. In the meantime, I call on the Health Minister to ensure that his Department increases awareness through campaigns that warn of the public health risks from using untrained individuals to administer such cosmetic products. I trust that the House will support our amendment.

I thank the Sinn Féin Members for tabling the motion and the DUP Members for their amendment. We, in Alliance, are content to support both.

In recent years, we have seen an increase in the use of aesthetic medicines in non-surgical cosmetic procedures as a result of new technologies and products in that field. The procedures, all of which are growing in popularity, include botulinum toxin, more commonly known as Botox; anti-wrinkle injections; cosmetic fillers; chemical peels; and energy-based treatments. They provide a boost to the local economy and are important to small- and medium-sized enterprises. That is especially important as the majority of business owners in the industry are female. According to the British Beauty Council, it is estimated that, in 2022, the cosmetics sector supported a total GDP contribution of £24·5 billion and tax contributions of £6·8 billion to the UK Treasury.

With new procedures come new responsibilities, and the Department of Health here has a responsibility to ensure that any such procedures are safe for the public. In Westminster, the Health and Care Act 2022 gave the Secretary of State for Health and Social Care the power to introduce a licensing scheme for non-surgical cosmetic procedures in England that ensures that people who choose to undergo such a procedure know for certain that the treatment that they are receiving is safe and of a high standard. Such a regulatory framework would be appropriate for Northern Ireland as well. In particular, a licensing scheme would ensure that those who offer specified procedures are suitably trained and qualified, hold appropriate indemnity cover and operate to the highest standards of hygiene, cleanliness and infection control.

The motion notes that the Save Face campaign:

"received almost 3,000 complaints in 2022 regarding unregistered practitioners".

That further reiterates the need for a modern and comprehensive licensing framework. As I mentioned, such a framework was legislated for in England earlier this year, and the Welsh Government launched a consultation on the mandatory licensing of special procedures in Wales. The Scottish Parliament held a similar debate recently. It is concerning that unqualified and unsupervised individuals can handle Botox and dermal fillers for the public without the oversight and insurance policies that we would expect for most other medical procedures. We must act to fill the void in regulating the medical aesthetics industry.

I also welcome the amendment. We will support the call:

"to make it illegal to administer botulinum toxin (Botox) or a filler ... to a person under the age of 18 in Northern Ireland."

It is important, however, to clarify that there are legitimate medical reasons why someone may be injected with Botox. For example, as a treatment to help with hyperhidrosis, or excessive sweating, it is an approved medical treatment that is carried out by professionals in a professional setting. That is an important distinction, which the amendment acknowledges. It states that it should be illegal to administer such procedures:

"by way of injection, for a cosmetic purpose to a person under the age of 18 in Northern Ireland."

Indeed, the motion and the amendment reference another important aspect of the debate, which is the growing pressure of social media. Part of that pressure comes from unethical advertising, with social media posts offering such treatments with little further detail or presenting them as online raffles or other gambling advertising. That connects to a concerning trend on social media of encouraging unrealistic and unattainable beauty standards through, for example, the use of filtered images. That can have a significant impact on young people's physical and mental health, and any regulation of the use of aesthetic medicines should consider the threats posed by social media in that regard.

I thank the Sinn Féin Members who tabled the motion and the DUP Members who tabled the amendment. The issue is important and under-discussed. We encourage the Minister to act by introducing a legislative framework similar to the precedent that we have seen set in England.

The debate is topical and timely, and I thank the signatories to the motion for bringing it to the House.

In recent years, there has been a rapid growth in the popularity — indeed, even a greater normalisation — of non-surgical cosmetic procedures. A number of reasons lie behind the spike in demand. Perhaps one of its biggest drivers, alongside advancements in technologies and treatments, has been the rise of social media. People of all ages, but especially younger people, now effectively carry around with them 24/7 an infinite advertising display in the form of their smartphone. The cosmetic and personal care sector is booming as a result and is now more accessible than ever before. Although, on the whole, that is a positive, because people are absolutely entitled to spend their hard-earned money as they wish, the sector's rapid growth also carries with it risk. Even though treatments may be classified as non-surgical cosmetic procedures, they still entail making changes to people's physical bodies. It is therefore essential that, at the bare minimum, those undergoing such procedures have confidence that the treatments that they are receiving are safe and of a high standard.

Thankfully, the vast majority of treatments are perfectly routine and safe, and the majority of providers are entirely responsible. My party and I, however, are concerned that there has been such growth in the sector, combined with such a prevalence of information online, that some people may be exposed to an unacceptable level of risk. Indeed, as the motion references, there has been an uptick in the number of complaints being made. Regrettably, the figures will include a number of people who have experienced serious complications as a result of treatments and procedures.

Therefore we support the motion. We also support the amendment because we have concerns about the risk to young people and perhaps, sometimes, those whom we would class as children of receiving such treatments.

As was referenced, England has already implemented an age limit and announced a new regulatory framework. I am sure that the Minister and Department of Health will be closely watching the developments in England. No doubt, there will be important learnings for us to take from the changes being made, and, resources permitting, I am sure that the Department here, just like its counterparts across the rest of our nation, will be keen to explore and make progress on the broader issue, because, ultimately, whilst it is important to strike a balance with consumer choice, consumer safety should be what matters most.

The rapidly expanding cosmetic industry and its largely unregulated market are pressing issues that I have been raising concerns about for the past few years. We have all heard horror stories about botched treatments of teenagers — children who are not even legally allowed to buy a pint in a pub undergoing cosmetic procedures that could have life-altering consequences.

In 2022, with limited data available here and in the absence of an Executive, I commissioned a comparative research paper — I thank the Research and Information Service (RaISe) team for their efforts — on non-surgical cosmetic procedures in Northern Ireland, the Republic of Ireland and Great Britain. While the report confirmed many of my suspicions, the dearth of data not just here but across the water is of concern. What is clear is that cosmetic surgery is a lucrative market. The industry in the UK is worth an estimated £3·6 billion. It is no wonder that so many practitioners are diversifying into the field.

The Zoom boom during the pandemic, which saw us all ogling our own images in countless work calls, coupled with social media and the use of online filters, has seen the demand for Botox and fillers skyrocket. I fully understand the positive impact that the procedures can have on people, but people are pitting themselves against impossible standards of perfection. Of course, that is nothing new, but the lack of regulation of licensing and advertising is worrying.

Social media is filled to the brim with influencers promoting the latest on-the-market trends from Barbie Botox to Russian lips. Newsfeeds are filled with posts from individuals testing out a move into those procedures, offering freebie treatments to anyone willing to act as a guinea pig. It is not my intention or that of anyone here to attack the many practitioners and businesses that pride themselves on their high standards; rather, this is about improving the system that they work in.

Registered healthcare professionals performing NSCPs are required to meet the competency standards set by regulatory bodies such as the GMC, but there is no such requirement for non-medical practitioners, regardless of how much or how little training they have received. That creates a Wild West scenario where, essentially, anyone can practise cosmetic procedures without a proper screening process for customers. If you have the cash, you can access the treatment. It leaves individuals under the age of 18 and those with a history of mental health issues such as body dysmorphia completely unprotected under the current system and often unaware of serious and potentially life-altering complications. Therefore, we support the amendment.

It is important to emphasise that, when we talk about botched procedures, we are not referring to just the lack of raised brows or the overdoing of lip filler. The lack of regulation, particularly around hygiene, can have dire, even fatal, consequences, such as sepsis. That not only puts additional pressure on emergency departments and the broader healthcare system but can leave the individual with lifelong physical and emotional scars.

It is clear that government has not kept pace with this booming industry. Worryingly, however, the North will fall even further behind our counterparts elsewhere in these islands, given that the Health Minister has not been in a position to legislate. When I first raised these concerns, there were no active plans for legislative protections. However, since then, the Health and Communities Ministers have expressed to me their willingness to introduce a draft regulatory framework not only for non-surgical cosmetic procedures but for broader regulation of the tattoo and piercing industries.

We urgently need regulation, oversight, better mechanisms for reporting and stricter controls on online advertising to ensure the safety of consumers and prevent the exploitation of vulnerable individuals. That said, any such protections must not harm the livelihoods of the many reputable, conscientious practitioners. We must work with them to create a system that safeguards them and their clients. The industry is not going anywhere; it is here to stay. The Executive need to act now to ensure its safety, rather than wait for disaster to strike.

I support the motion and the amendment. The start of the motion refers to "greater regulation", but the issue is that, in many instances, there is, in practice, no regulation. The regulation of non-surgical procedures and products is effectively absent in Northern Ireland. Premises must register with their local council, but there are no grounds to reject such a registration. Those acting as health professionals must register with the GMC, but those who offer aesthetic or beauty products or procedures have no means of getting a licence, even if they want to, as many do. That carries a significant risk to consumers, about which we have heard, but it is also totally unfair on competent practitioners, as they have no means of formally demonstrating their professionalism and training, apart from with course certificates.

As I mentioned in a public statement on the topic over a year ago, when, frustratingly, we had no means of legislating to deal with the issue:

"Surveys and consultations carried out by the Chartered Institute for Environmental Health in England and by the Scottish Government have shown over 90 per cent of people, including those within the beauty industry, are in favour of regulation and licensing of non-surgical cosmetic procedures in the interests of improved public confidence and consumer safety", as well as, no doubt, in the interests those who wish to provide them competently and safely. At that time, I went on to say that we in Northern Ireland must not be left behind because of our inability to legislate. We now have that ability, yet we are still left behind. I appreciate Mark Durkan's providing an update on what he has been advised; I was not aware of that. This time last year, Scotland had already run a consultation on the topic before the UK Department of Health and Social Care did so for England. Wales is proceeding with similar work. That will likely result in a licensing scheme for providers of procedures such as Botox and dermal fillers. In Northern Ireland, the RQIA has the power to regulate only those who provide laser or intense pulsed light (IPL) cosmetic treatments.

Regulation and licensing would also give us the power to consider two further aspects of the problem here. First, we may wish to raise the age of prohibition to 18, as per the amendment and as has been the case for Botox in England since 2021. I would certainly like to see the Health Committee consult on that. There is also a cross-border element to the matter in that we need to avoid people simply popping across the border to get procedures that may carry significant risk. I am aware that concerns have already been raised in England regarding different regulations or prohibitions in Wales and vice versa.

The second issue concerns the potential prohibition of some procedures altogether, most obviously sunbeds. As a liberal party, we wish to investigate every option short of prohibition, including the improvement and enhancement of public health information. However, the evidence on the overall public health risks of sunbeds is mounting, and countries such as Australia have already moved to outright prohibition.

I very much hope that we will see the issue progressed and investigated by the Health Minister and his departmental officials in order to get us to a position where Northern Ireland at least has licensing and regulation schemes that are similar to those applied elsewhere in the UK. That has clearly been the direction of travel since the start of the decade, and I wish to see no further delay.

I call on the Minister of Health to respond. Minister, you have up to 15 minutes.

Deputy Speaker, with your indulgence, I shall deviate from the motion just for a moment to acknowledge that my counterpart in the Government of Ireland, Stephen Donnelly, the Minister for Health, lost his seat in the general election over the weekend. It is a matter of regret for me, because, over the last six months, we had been building a positive relationship and discussing specifics in terms of service delivery on an all-island basis. I look forward to working with the new Government of Ireland when formed.

To the debate, and I thank the movers of the motion and, indeed, of the amendment. I fully empathise with anybody who has been affected in any way and has suffered harm and injury as a result of accessing non-surgical cosmetic products and procedures that have not been administered appropriately. It is an important issue and one that can impact on vulnerable people, in particular. It needs to be addressed if we are to reduce public harm.

I note the significant volume of complaints that Save Face, which registers accredited practitioners and clinics, received in 2022 regarding unregistered practitioners. I have no doubt that those issues have prevailed since 2022. Therefore, it remains important that action be taken to increase public safety and awareness of what can happen when the procedures are not undertaken safely. In April this year, my Department wrote to Save Face regarding high-risk, non-surgical procedures and treatments on those under the age of 18. We acknowledged the importance of the issue to Save Face at the time, and it is a matter of concern to me that there is no minimum age limit.

To give Members a fuller sense of the concerns from other public bodies around these issues, I can advise that, in recent years, the Department has also been contacted by several local councils on the issue of regulation of cosmetic treatments in Northern Ireland and the introduction of a licensing scheme for non-surgical cosmetic procedures. That is the clear direction of travel in the rest of the UK; indeed, as Members have pointed out, the issue was debated in the Scottish Parliament in October last. My Department therefore recognises the public interest in the area and notes the advocacy by some of the need for statutory regulation. We are aware that the issue of greater regulation is being actively considered by the United Kingdom Government, who have stated a commitment to taking action to address the safety concerns. The new Government are still to set out their position following the consultation in 2023, which was undertaken by the previous Administration.

As Members have heard, in England it is a criminal offence to administer botulinum toxin — Botox — or a filler by way of an injection for a cosmetic purpose to a person under 18, even if they have the permission of somebody who is over 18 years of age. Currently, there is no set minimum age at which a person can avail themselves of the treatments in Northern Ireland, nor is there an age limit in Scotland or Wales. It is essential that people are fully aware and cognisant of the potential consequences before undergoing procedures that could have such long-term effects. The passing in March 2022 of an amendment to the Health and Care Bill gave the Secretary of State for Health and Social Care the power to bring into force a national licensing scheme for aesthetic, non-surgical cosmetic procedures in England. The treatments in question are many and varied and can include things like dermal fillers and other injectables, chemical peels and laser hair removal, to name a few.

I am acutely aware of the wider changing and challenging health and social care service delivery environment, including in relation to cosmetic treatments. Prior to the COVID-19 pandemic, my Department had developed a new draft regulatory policy framework. However, further development work is required. That will include public consultation on a draft policy. As Members will appreciate, the Health and Social Care system across Northern Ireland is working to address a number of the many profound challenges that it is experiencing. That work, regrettably, has been made many times more difficult by the very constrained budget, and my Department is regularly left with no choice but to make decisions in relation to the work that can be delivered within current resources.

In that context, other critical and priority projects are having to progress ahead of the work on the regulatory policy framework and the review of the regulations here. However, I can assure Members that that remains an important issue for me and the Department.

We will continue to engage with DHSC to keep up to date with the proposals and the progress being made throughout the rest of the UK. That will help us to assess how the approach in Northern Ireland should develop. Currently, as I said, the UK Government are yet to respond to the consultation that was undertaken last year by the previous London Administration, and, given the capacity constraints on my Department, which I have mentioned, it is sensible to await the outcome of the UK Government's thinking on the way forward, unless, of course, that thinking is subject to undue delay.

I thank the Minister for giving way. We all fully comprehend the capacity constraints on his Department and the resource constraints therein as well. Given how lucrative the industry is — other contributors have touched on that — does he foresee the possibility of the implementation of a system that would, in effect, pay for itself?

I thank the Member for his intervention. By way of a response, it would be timely to say that it is not the case that nothing is happening on interventions. When it comes to enforcement, we rely on the Human Medicines Regulations (HMR) 2012. I can tell the Member and the House that between 2022 and 2024, my Department's medicines regulatory group conducted 65 focused investigations into the unlawful possession, importation, advertisement or supply of unlicensed prescription medicinal products for use in the non-surgical cosmetic sector. To date, three persons have been successfully prosecuted, and a further four prosecutions are pending. In that period, the medicines regulatory group has issued 24 formal advice and warning letters and has seized over 4,000 units of unlicensed Botox and fillers. Work is under way, but a self-financing proposal is certainly one that I am prepared to take under consideration.

Will the Minister give way?

Will the Minister give way?

I thank the Minister for giving way. You mentioned illegal products and Botox products. Given that you have said that you will keep an eye on what is happening across the water in Britain, I ask that we look at what is happening in the South. The documentary that I mentioned earlier highlighted the black market between the North and South on this island. If legislation and regulation moves at a greater pace in the South, we will be more at risk of greater implications here. I ask the Minister to bear that in mind as well.

I thank the Health Committee Chair for the point, which is well made. I am just making the point that if the UK Government are going to announce their way forward in a reasonable time frame, it is worth looking at that. However, we will, effectively, have to quality-assure that against what is happening on the rest of this island, in the other jurisdiction, in order to make sure that we have as much of a seamless way forward as possible and that there are no loopholes that will jar.

Will the Minister give way?

Yes.

I am sorry: Liz and I spoke at the same time there. First, are the figures that you mentioned UK-wide or are they for Northern Ireland? Secondly, is there a role for councils in the environmental health space in the interim?

I will come to councils in a moment, if I may. The figures are local figures, which come from the Department's medicines regulatory group.

We are working to ensure compliance with existing laws and guidance. Where evidence or information suggests unlawful practice, the HMR are enforced and, as I said, there have been some successes. We are committed to taking decisive action to combat the illegal promotion, supply or misuse of medicines and to alerting the public about the dangers of misuse outside of the regulated supply chain. I am determined that we will remain vigilant and continue to work with key partner agencies in order to monitor the illicit marketplace.

We will continue to take effective action where necessary in order to protect public safety in Northern Ireland. That may involve developing new legislation or reviewing existing legislation in parallel with public health messaging but also considering the issue more widely to assess current responsibilities with a range of organisations — in addition to the RQIA and my Department — such as the councils. That is because some cosmetic services and therapeutic treatments would normally come under council enforcement for health and safety reasons. Then there is the Health and Safety Executive for Northern Ireland (HSENI), which is the enforcing authority when these are carried out under the supervision or control of a registered medical practitioner, and trading standards. Under the Consumer Protection from Unfair Trading Regulations 2008, it is an offence for traders to treat consumers unfairly through misleading actions, misleading omissions, aggressive practices or failing to adhere to the standards of professional diligence.

In summary, I am committed to considering measures to ensure that the products are safe for the people of Northern Ireland who use them and that those products are administered by appropriately trained practitioners. I will therefore continue to make the case for additional resources for my Department in order that, in the interests of public safety, it can respond to the new challenges. I repeat that we will look to see what the UK Government do or do not say in their response to the 2023 consultation and test that against the provisions from the Government of Ireland in order to ensure that we deliver best practice and close off any potential loopholes.

Thank you for that response, Minister. I call Paul Frew to make a winding-up speech on the amendment. Paul, you have up to five minutes.

Thank you very much, Mr Deputy Speaker. I thank the Members who tabled the motion and the Minister for being present to respond to the debate on this important issue.

It is essential that we seek to minimise the chance of vulnerable people being exploited. We need to be confident that treatments are safe and of a high standard. A balance needs to be struck between acknowledging personal consumer choice and protecting the public and building confidence in the safety of the industry.

An increasing number of people describe dissatisfaction with their body image. In some cases, that may be exacerbated by mental health difficulties. The timeline for that issue is not unrelated to the rise of social media and so-called influencers. The number of people who undergo non-surgical cosmetic procedures is increasing. There is a growing number of high-street providers, and the procedures are becoming more normalised. Examples include Botox, anti-wrinkle injections, dermal fillers, chemical peels and energy-based treatments. They are mostly carried out by private providers. Botox injections are not licensed for cosmetic use but can be used off licence. The review of the regulation of cosmetic interventions, which was carried out more than a decade ago, singled out dermal fillers as being "a crisis waiting to happen". The use of anabolic steroids for cosmetic purposes has increased, bringing with it long-term risks of cardiovascular disease and brain changes. Many dangerous procedures are undertaken abroad.

The British Beauty Council reported that the cosmetic and personal care sector contributed £24·5 billion to UK GDP in 2022. People currently have to register to carry out procedures such as tattooing, semi-permanent make-up, piercing and acupuncture. It would be unacceptable if that were not also the case for cosmetic procedures, which have the potential to cause real damage. It is essential that those who carry out such procedures are competent and safe. They need to be properly trained and qualified and should have indemnity cover. Hygiene, infection control and cleanliness must be strictly adhered to. The risks are much greater when the person who carries out a procedure is not sufficiently qualified, uses unregulated products or operates in unsuitable premises. Potential clients need to be certain that practitioners are adequately insured and of the extent of the aftercare that they offer. Save Face provides a UK Government-approved register for medical aesthetic procedures. Members of the public can also have a greater degree of assurance if individuals belong to organisations such as the British Association of Aesthetic Plastic Surgeons or the Joint Council for Cosmetic Practitioners. Save Face received over 150 complaints about Brazilian butt lifts between February and April this year, more than half of which had reportedly resulted in sepsis.

Clear standards and requirements can be established for every type of procedure and could be applied uniformly across the UK. Training needs to be of a good standard and fully accredited. There should be periodic inspections of facilities, with clear standards for infection control. Those inspections should incorporate practitioners who work from home. That is a massive issue in the cosmetic industry: many people who rent premises are disadvantaged by the fact that there are people who work from home. There should be full transparency for consumers about who is licensed and the procedures that they are licensed to perform. There should also be access to a redress scheme. Predatory advertising can use doctored images, and it should be a requirement to make it clear when that is the case.

I will recap some of the contributions. Liz Kimmins related examples of when people lost their lives. She said that it "beggars belief" that there is no regulation. She talked about the situation in the Republic of Ireland and asked the Health Minister to bring forward options for regulation. My colleague Alan Robinson said that "safety must always come first." We support further regulation in this sector. He talked about the cost to the NHS when something goes badly wrong. He also talked about social media pressure, especially on young people, a concern that was echoed in every contribution.

Danny Donnelly talked about the industry, the costs involved, the licensing scheme in England and unethical adverts on social media. Steve Aiken discussed how the rise in demand correlated with the rise of social media. He said that consumer safety should be the most important issue. Mark Durkan said that the unregulated industry —

I am afraid that your time is up.

I will leave it there. Thank you.

I call Nicola Brogan to make a winding-up speech on the motion. You have up to 10 minutes.

Go raibh maith agat, a Leas-Cheann Comhairle.

[Translation: Thank you, Mr Deputy Speaker.]

I thank all the Members who participated in the debate. I thank the Minister for being here — for listening and responding — and Paul Frew for summarising Members' comments.

Sinn Féin tabled the motion because it is clear that the lack of regulation in the non-surgical cosmetic industry is putting lives at risk. These are not abstract numbers or distant problems; these are friends, family members and neighbours who are being harmed when they seek treatments. The facts speak for themselves. As a number of Members said, Save Face reported nearly 3,000 cases of harm caused by unregistered practitioners. Each of those cases represents a person who trusted someone to enhance their appearance but was left with injuries, disfigurement or worse.

Now, we see cases where non-medical practitioners perform what can only be described as life-threatening surgical procedures such as thread lifts and fat-dissolving injections. Those treatments are being carried out in unsafe environments by individuals with no medical training and without proper aftercare. The consequences can be catastrophic: blindness, severe infections, tissue necrosis, permanent scarring and even death are real risks. It is not just happening in distant places; it happens here because our current system allows anyone, regardless of qualifications, to set up shop and start offering treatments without oversight, training or accountability.

The problem is not just about bad techniques or unskilled practitioners. The treatments involve sensitive, medical-grade products that need to be stored and administered with precision. Without proper training, practitioners risk clients' health, safety and trust. When things go wrong, the damage is often irreversible, not just physically but emotionally and financially.

The motion calls for stricter regulation and accountability measures to ensure that only qualified, trained and regulated professionals are allowed to perform the procedures. Voluntary registers like Save Face do excellent work to set standards, but voluntary measures are not enough. We need enforceable laws to make safety the standard, not the exception. We also need to increase public awareness and improve public understanding of the issues. Too often, people are lured by cheap deals that they see on social media or in glossy advertisements. They are unaware of the risks. Many do not know what qualifications they should look for in a practitioner or what questions they should ask. It is our duty to empower the public with the knowledge that they need to make informed, safe choices.

This is not about limiting anyone's ability to choose cosmetic procedures; it is about ensuring that, when people make that choice, their health and safety are protected. It is about protecting lives, preventing harm and creating an industry that operates on trust, professionalism and accountability. I urge colleagues to support the motion. I am glad that so many Members have spoken in support of the motion and the amendment. Together, we can make a meaningful change that protects people across our communities from unnecessary risk and harm.

Thank you for concluding the debate.

Question, That the amendment be made, put and agreed to.

Main Question, as amended, put and agreed to.

Resolved:

That this Assembly recognises the need for greater regulation in the use of aesthetic medicines in non-surgical cosmetic procedures; notes that Save Face, a register of accredited practitioners and clinics, received almost 3,000 complaints in 2022 regarding unregistered practitioners; further recognises the potential risk to people if these products are not properly administered, supervised and stored; and calls on the Minister of Health to consider measures, including legislation, to ensure that these products are administered by appropriately trained practitioners and to make it illegal to administer botulinum toxin (Botox) or a filler, by way of injection, for a cosmetic purpose to a person under the age of 18 in Northern Ireland.

Adjourned at 4.44 pm.