Seòmar agus comataidhean

As I said in my introduction, we have just laid an SSI on the licensing for group 1 of the procedures, and the date set out in that instrument is 6 September 2027. We envisage that, if the bill is enacted, the provisions will come into force then, too. Therefore, on the assumption that the bill will be passed, businesses will have more than a year to comply with the regulations and to ready themselves for them.

There has to be a route map towards full implementation with any new piece of legislation that comes in. I would be content to consider including education for businesses and the general public in the process and to think about whether we need phased implementation.

When we were creating the list of professions that we felt were appropriate to include, we wanted to understand their qualifications in prescribing and whether they understood how to mitigate any negative impact of items that they could prescribe.

I thank the committee for the opportunity to support its consideration of the Non-Surgical Procedures and Functions of Medical Reviewers (Scotland) Bill. I have some opening comments to make about part 1 of the bill concerning non-surgical procedures, and I also have some comments about part 2 of the bill. I hope that you are content for those to be made at a later stage, during the session when you consider evidence on that part of the bill.

I will start by reflecting on the issues that we seek to address through part 1 of the bill. The issue was brought home to me and a number of other members last year at a round-table meeting, organised by Miles Briggs MSP, where we heard some harrowing experiences from people who had been seriously injured after improperly carried-out procedures.

During the past few weeks, the committee, too, has heard evidence about exactly that. Although many Scottish people undergo popular procedures with little thought to potential consequences, the committee, like me, has heard that adverse consequences can include necrosis or vascular occlusion, burns or scarring and, in the worst cases, sepsis, blindness or death. I do not say that to be alarmist or to malign the many reputable providers of those procedures; I say it to remind us all that there are serious risks to the public, which the bill seeks to address.

The bill is robust but proportionate, and it seeks to ensure that those who choose to undergo non-surgical procedures can do so safely. The bill contains substantive provisions that will make the public safer. It does so by making it an offence to provide such procedures to those under the age of 18, which I hope we can all agree is a sensible and important step. It also makes it an offence to provide procedures outwith permitted premises. Permitted premises will be safe, hygienic settings that will be subject to regulatory oversight and from which healthcare professionals will provide or manage services. The involvement of healthcare professionals also supports safe and appropriate prescribing and will enable those healthcare professionals to intervene in the event of complications. If the bill becomes law, it will be an offence for procedures regulated by it to be provided, for example, in the back of a taxi, to be given to teenage children or to be delivered at a fizz and filler party in someone’s home.

Having discussed the main intent of the bill, I will highlight particular issues that might be of interest. I am, of course, happy to address any of the issues in more detail during questions.

I have said a lot about what happens when things go wrong, but I also want to reflect on some of the dedicated and highly trained practitioners, not just in the already regulated medical part of the sector but those in the broader beauty and aesthetics sector. I and my officials have met some of the practitioners who gave evidence to your committee. There is no doubt that many practitioners have invested in their own training and are committed to providing a safe and professional service to their clients. Many of you will have constituents who work in the sector and will know that the businesses are often small and female led. There is room for a thriving non-surgical procedure sector and an important continuing role for non-healthcare professionals in that sector but with some changes to current practice to support safety.

Although public safety is my priority, I have always been clear that we should not put a disproportionate burden on businesses. I am comfortable that the provisions in the bill are the least restrictive means of achieving the bill’s aims. Many experts and respondents to our consultation want to see a more restrictive approach than the one that is provided for in the bill.

In many countries where procedures such as Botox or dermal fillers have been regulated, those may only be carried out by doctors or, in some countries, by doctors, dentists or nurses. However, under our proposals, I consider it appropriate that non-healthcare professional practitioners can continue to provide procedures as long as they do so in permitted premises where services are provided or managed by a healthcare professional. I will come on to training and qualification standards shortly.

I have ensured that procedures are included in the bill only when it is absolutely necessary. Lower-risk procedures that do not require to be undertaken in a setting that involves a healthcare professional will be included in a local authority licensing scheme, akin to the scheme that is in existence for tattooing and skin piercing.

I know that the committee has heard evidence about the importance of training standards for practitioners. I am happy to reconfirm the Scottish Government’s commitment to establishing training standards for procedures that are in the bill. Unfortunately, legislation that sets those standards would engage part 3 of the United Kingdom Internal Market Act 2020. I am happy to discuss that in more detail but, for the time being, I assure the committee that, although the bill does not include such provisions, the Scottish Government is engaging with the UK Government with a view to implementing training standards in a way that will be effective and workable.

The final point in relation to part 1 of the bill is the fact that, last week, a draft order was laid under the Civic Government (Scotland) Act 1982 for the Parliament’s consideration. If affirmed, the order will establish a licensing scheme for low-risk procedures that do not require to be carried out in a setting that involves healthcare professionals and, therefore, do not merit inclusion in the bill. The scheme that will be established by the order and the provisions of the bill are intended to work alongside each other to provide a comprehensive regulatory regime. The order sets a date after which businesses will have to comply with the licensing scheme. I have not previously provided a date on which we intend the offences in the bill to come into force, but I take this opportunity to set out my intention that the bill will come into force on the same day that the licensing scheme becomes operable, which is 6 September 2027.

I look forward to answering the committee’s questions.

We have engaged a lot with small businesses, because we recognise that the regulations will have an impact on certain businesses that are carrying out certain listed procedures, and we have also been speaking to various areas within the business elements of Government to see what support could be provided. There is a bit more work that we can do in that area to consider what support businesses might need—perhaps through, say, the Federation of Small Businesses. Those conversations are on-going, but I do recognise that we have to get the balance right.

My understanding is that Healthcare Improvement Scotland is there to give support.

As I noted in my introductory remarks, each of the four nations has robust procedures. We are taking note of them and operating in a way that provides consistency across the four nations.

One area that I am clear on, which is part of our conversation with the UK Government about the United Kingdom Internal Market Act 2020, is that we need to have a proper standard for qualifications. According to the evidence that was provided to you, the University of South Wales provides a course; we have not yet engaged with it, but we are planning to do so. We also understand that a couple of universities in Scotland are looking to provide better courses—regulated courses—that would help to ensure that the people who offer such treatments have the right training and qualifications.

That may well be a role for the SQA, but it may also be for specific universities.

Currently, the plan is to do it under secondary legislation.