“(c) a person advertises or otherwise promotes the administration, in England, to another person (“A”)—
(i) botulinum toxin, or
(ii) a subcutaneous, submucous or intradermal injection of a filler for a cosmetic purpose, where A is under the age of 18;”
With this it will be convenient to consider new clause 1—Report on preventative measures—
“(1) The Secretary of State must prepare a report on steps that are being, and will be, taken to seek to prevent offences being committed under this Act.
(2) That report must include any steps to prevent the advertising or promotion of the cosmetic use of botulinum toxin and fillers on children.
(3) The report must be laid before Parliament no later than the end of the period of six months beginning with the day on which this Act is passed
Again, this is a probing amendment to get concerns on the record. These issues affect not only under-18s, but people in the wider sector. The amendment deals with the broader issue of the way that the industry has developed. The concern is that botox is a prescription medicine, but if someone were to look at online adverts, they would think it was something that they could just pick up on the street corner. In fact, it can be picked up on the street corner, because the individuals who advertise the injections are not regulated.
Online, people offer home injections, botox parties or injections on premises that are not regulated in any way to ensure that basic hygiene is in place. The other worrying point is that the individuals who carry out the injections are not qualified in any shape or form. There are clear instances when people ask, “Well, what’s the danger?” There are dangers to injecting anything into someone’s body, but particularly in some of the areas in which botox is injected, such as the eyes and other areas. Such injections can lead to nerve damage and quite severe problems, and a medical professional would obviously know not to do them. With someone who is completely unqualified, there is a huge danger that under-18s, and even older age groups, could be affected by those problems.
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.
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.
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.
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.
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.
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—
Clause 2 sets out a duty on business owners to ensure that substances are not administered to a person under 18. This does not apply to administration by a doctor or regulated healthcare professional. Subsection (1)(b) sets out that a business owner commits an offence if they or someone acting on their behalf makes arrangements for botox or filler to be administered by injection for cosmetic reasons to a person under the age of 18. This will cover, for example, making an appointment, or agreeing to make an appointment by social media. By making it an offence to make arrangements to administer the products covered by the legislation, prosecutions can be brought even when the person aged under 18 does not go on to have the procedure administered because, for example, they changed their mind or there was an intervention by an enforcement body.
Clause 3 provides that, if an offence under the Bill is committed with the consent of, or due to neglect of, an officer of a body corporate, that officer, as well as the body corporate, is guilty of the offence. These actions may be undertaken by, or occur due to the neglect of, any executive management team members of the body corporate, or a person who proclaimed or implied that they were acting in such a role.
Clause 4 sets out that local authorities can enforce in their areas the provisions of clauses 2 and 3. Subsection (2) outlines that the Bill does not create any new enforcement or investigatory powers—local authorities are able to use the powers already accorded to them under schedule 5 to the Consumer Rights Act 2015. As these are criminal offences, the police can use their existing enforcement powers to enforce the provisions. However, local authorities have existing powers and experience of registering and enforcing provisions around body modification activities, such as tattooing and sunbed use. Giving local authorities the power to enforce the Bill’s provisions alongside the police provides an additional layer of protection for young people and aims to increase business compliance.
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.
My hon. Friend the Member for Sevenoaks has said everything that needs to be said about these clauses.
Right. I again put on the record my thanks to the hon. Member for Sevenoaks for bringing the Bill forward. Will the Bill solve all our problems in this sector? No, it will not, but as I say, it is a welcome first step. It also gives us an opportunity to put on the record other concerns, which I know the hon. Lady shares.
This industry—because it is a multibillion-pound industry—is very lightly regulated. When these fillers and botox procedures go wrong, they can cause damage to individuals and costs for the NHS. There are cases of people having to go through expensive procedures on the NHS to put things right before we even mention the cosmetic surgery industry, which costs this country an absolute fortune when operations go wrong and the cost of people’s life-changing conditions have to be met by the taxpayer.
Going right back to when I was chair of public health in Newcastle upon Tyne in the early ’90s, I am reminded a little bit of the same lack of regulation that there was around tattoo parlours. The Government changed that and gave local authorities clear powers. Now, largely, the rules on administering tattoos, for example, are clear. They are enforced by local authorities and the standards are high. To go back to what the Minister said, I agree: I do not want to close the industry down. It has to be about personal choice. If people want some type of what they consider necessary enhancements, that is entirely up to them; but it must be done in a safe and regulated way. I referred to the wild west, and it is like that: there is little control over what is happening.
I think it is five years since the Keogh review recommended increased regulation, and it is now time, with the Bill, which will be a first step forward, to try to get those recommendations put into law. I think that if that proposal came forward there would be no problems about getting cross-party support. I would be a huge champion of such regulations. The issue is not just with fillers and botox, but the broader cosmetic surgery industry. It is about people making informed choices and ensuring that work is done in a safe and effective way. At the moment, the system is in many ways completely unregulated, and regulations that exist are being ignored.
I congratulate the hon. Member for Sevenoaks on bringing the Bill forward, and thank the Minister for how she has responded and taken the issues on board. I think that, although on occasions we have our disagreements, she believes at heart that in the sector in question things should change, and patient safety should come first and foremost for everyone.
Many good points have been made today about the wider work that we need to do in this, but when the Bill goes through it will be the next step towards protecting children, in an area where at the moment they are open to physical and mental scarring for life. I thank everyone who is here today for their work in supporting the Bill, and I thank you, Ms Rees.