Last April an independent review by Sir Bruce Keogh, the NHS medical director for England, looked into the cosmetic procedures industry across the UK and called for tighter regulation.
The government published its response last week to a mixed reaction. Non-surgical treatments such as dermal fillers, Botox and laser hair removal account for almost 90% of all cosmetic interventions performed and represent 75% of a market said to be worth £3.2bn. It is precisely these procedeures, which can cause lasting harm if administered improperly or incorrectly, that the Keogh review described as a 'crisis waiting to happen' , pointing out that patients are currently protected by the same level of regulation as they would have if buying ballpoint pens and toothbrushes.
The Keogh review called for compulsory registration and better training of all those in the industry, from beauty therapists to breast surgeons. The Royal College of Surgeons will be asked to set standards for the training and practice of cosmetic surgery and Health Education England will also be tasked with a review of training for those administering dermal fillers and Botox injections.
Legislation will be introduced to make it illegal to offer such procedures without that training but Keogh also called for the banning of ‘distasteful’ cut-price deals and plastic surgery as competition prizes, ensuring clinics were adequately insured and giving patients more information about the success rates of surgeons.
By and large, the government response agrees with the majority of these recommendations and measures will be introduced including a registry of breast implants to prevent a repeat of PIP scandal, a review into a system of redress if things go wrong with treatment and a more rigorous consent process. A clamp down on irresponsible advertising will also be discussed with the Advertising Standards Authority.
However, the government will not implement compulsory registration. Although apparently sympathetic to the idea of reclassification of dermal filler products to make them available on a ‘prescription only’ basis, the government response claims this cannot be done due to EU rules. Those two measures were a central plank of the Keogh reforms, supported by several professional bodies including the British Association of Aesthetic Plastic Surgeons.
Rajiv Grover of the British Association of Aesthetic Plastic Surgeons and many surgical professionals remain concerned that anybody will still be able to offer dermal fillers and there will be no central register of who is qualified to administer them:
“Legislators have clearly been paying only lip service to the sector's dire warnings that dermal fillers are a crisis waiting to happen. The refusal to classify fillers as ‘prescription only’ is an opportunity missed”.
Despite those concerns, Sir Bruce Keogh, author of the original review, welcomed the government response, saying he was confident these changes would create a much safer and skilled cosmetic industry which should reassure both consumers and practitioners.
Shelley Nedimovic, a solicitor handling cosmetic surgery compensation claims said:
"These measures may well go some way to reassuring consumers, but do not in any way erode a patient’s right to legal redress if thing go seriously wrong with their cosmetic procedure. Even if the practitioner is ‘fully trained and qualified', the situation remains that if there was a failure to obtain adequate consent, including warnings about the risk involved, or a fault with either the choice of procedure or the way in which it was carried out, you may be able to make a successful compensation claim for loss or injury."