The need for regulation grows ever more urgent

I found it very concerning to recently read the words of MP Alberto Costa:

Mr Costa, a South Leicestershire MP, recently tabled a parliamentary debate in Westminster Hall on the regulation of non-surgical aesthetic procedures in the UK. While I commend him for raising his concerns, I am not holding my breath for a government response. A two to three-year timescale to propose legislation is simply not good enough; it is wildly unreasonable and illogical. The industry must demand urgent government action.

In 2007, the UK government refused to implement statutory regulation despite the strong recommendations of an expert working group. It would seem that even then, our sector failed to be recognised or respected as a serious branch of medicine. A spokesperson for the Department of Health and Social Care commented:

I find this statement offensive. It would seem that the UK government refuses to accept that aesthetic medicine is a serious branch of anti-ageing and regenerative medicine.

It continues to be a national disgrace that in the UK today, a lay person can legally choose to enter a branch of medicine with no appropriate healthcare qualification and, after a one-day training course, perform medical procedures on patients. In no other area of medicine or any other country is there such an unregulated mess.

Anne Clwyd, Labour MP for Cynon Valley, has a long history of campaigning for higher standards of practice in the cosmetic industry. Her first ten-minute bill on the subject was presented in 1994, 25 years ago. Unfortunately, despite pleas from many organisations and industry leaders, little has changed since then. As a direct result of the government's failure to intervene, women and men continue to face appalling consequences of unregulated healthcare.

In 2013, Sir Bruce Keogh led the now infamous review of the regulation of cosmetic interventions. The report made abysmal reading, and I hold Sir Keogh responsible for the demise of aesthetic medicine and his inclusion of de facto practitioners into a field of medicine, where they had no entitlement to be. We must urge the government to withdraw practicing privileges from the unqualified, unregulated and unaccountable by means of legislation.

So, what justification can the government have for the refusal to bring medical aesthetic treatments under statutory regulation? In my opinion, the government has chosen not to accept that aesthetic medicine constitutes healthcare and that it is a field of professional practice within the realms of traditional medicine. It is pertinent to note that if the government can demedicalise the field of aesthetic medicine, all treatments will become subject to the payment of VAT. This would be a major financial coup for the government, but a huge blow to such an important sector of medicine.

In the absence of statutory regulation, we have voluntary self-regulation. Previous attempts at industry self-regulation have failed. A voluntary register does not have the force of law to ensure that practitioners comply with its requirements. It is a very weak system with which to protect the British public in comparison to statutory law. The first attempt at this came with the Independent Healthcare Advisory service (IHAS)—a government-backed, voluntary quality assurance scheme that managed the ‘Treatments you can trust’ register. This was largely unsuccessful because only a minority of practitioners who were ethically driven to improve patient safety and care bothered to register.

Later came Save Face, a national voluntary register of accredited practitioners who provide non-surgical aesthetic treatments. Save Face are committed to only connecting patients with practitioners who are regulated healthcare professionals who meet best practice standards. The ongoing absence of regulation has undoubtedly led to aesthetic treatments being administered by unscrupulous people who present themselves as trained professionals and put the unwitting British public at risk. Save Face works tirelessly to expose rogue practitioners. The recently televised Kyle Files worked in close partnership with Save face to highlight the challenges the public face when seeking medical aesthetic care. Save Face has Professional Standards Authority accreditation and government recognition as a national register.

The Joint Council of Cosmetic Practitioners (JCCP) launched yet another government-backed voluntary register, but caused some questions among healthcare professionals as a result of the inclusion of the unregulated and unaccountable. However, in response to healthcare professionals refusing to join the register, a turnaround decision was made to suspend entry to non-medics, for now. At a recent stakeholder meeting of the JCCP, concerns were raised about:

The JCCP will be advising the Department of Health and Social Care on a forthcoming awareness campaign about medical aesthetic treatments, which I assume will include who should provide these treatments. The above comments support that the JCCP continues to support the inclusion of those practising within a field of medicine with inappropriate qualifications. What hope do we have of preserving our specialty when those who have the power to influence the government no longer recognise aesthetic medicine as a serious branch of healthcare, and refer to our patients as consumers?

We cannot lay down to this, we have to fight back. The field of aesthetic medicine is close to eradication. I want to call on the hierarchy of our field. We have some extremely powerful and successful influencers among us, but we rarely hear the voices of these people publicly in support of our plight. We all know who the key opinion leaders and ambassadors are; make contact with them, ask for their support. Mr Costa, while I applaud you for raising your concerns, we cannot wait two or three years for the government to propose change. By then, the fight will be over, and aesthetic medicine will be completely demedicalised.