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Cosmetic Surgery (Standards of Practice)

Volume 615: debated on Wednesday 19 October 2016

Motion for leave to bring in a Bill (Standing Order No. 23)

I beg to move,

That leave be given to bring in a bill to make provision about the training, qualifications and certification of medical practitioners conducting cosmetic surgical procedures; to establish a code of practice for the provision of information to patients on the options and risks in relation to such procedures; to make provision about permissible treatments and the advertising of such treatments; and for connected purposes.

I became aware of the scandal around the £3.5 billion-a-year cosmetic surgery industry through a constituent, Dawn Knight, who in 2012 had cosmetic surgery on her eyes at Dolan Park hospital, run by Hospital Medical Group. The surgery was sold to her with a lifetime aftercare package to take care of any complications arising from the procedure. Following the surgery, Dawn was unable to close her eyes, and still, to this day, has to apply artificial tears to her eyes every two hours to stop them drying out. Dawn saw the surgeon who undertook the procedure, Arnaldo Paganelli, who refused to admit there was a problem. When she contacted Hospital Medical Group about the aftercare package, it simply pointed out a clause in her contract that said that treatments could be undertaken only if the surgeon agreed to it. No further help was offered, making a complete sham of the aftercare plan she was sold. As in similar cases, the NHS is now having to pick up the bill for Dawn’s ongoing care. Dawn’s case is not an isolated one. Many others have come forward since the publicity around it.

Although Hospital Medical Group promotes itself as a cosmetic surgery company, along with its associated companies, it is nothing of the sort. Rather, it is a facilities management company, simply providing the facilities where surgery takes place and marketing the procedures. When Dawn complained, she found out that her contract was not with Hospital Medical Group but with the surgeon who performed the procedure, and was told that it was her responsibility to check his General Medical Council registration and insurance. In Dawn’s case, her surgeon was a bankrupt, under-insured individual who was based in Italy and flew into the UK to work for Hospital Medical Group.

Herein lies the problem: at present, cosmetic surgery is not a defined surgical speciality in its own right. As the Department of Health has noted, the training within certain defined specialities such as plastic surgery, ear, nose and throat surgery, and eye surgery includes an aspect of cosmetic training, but no qualification is available for those who perform cosmetic surgery. In fact, the law allows any qualified doctor—they need not even be a surgeon—to perform cosmetic surgery without undertaking additional training or qualifications. My Bill aims to close this loophole. It has the support of the Royal College of Surgeons.

The Government and the Department of Health are aware of this situation. Following the PIP breast implant scandal, the Government asked Professor Sir Bruce Keogh, the then NHS medical director, to undertake a review of the regulation of cosmetic interventions. That review was published in April 2013. It asked the Royal College of Surgeons to establish a cosmetic surgery inter-speciality committee to set standards for cosmetic surgery practice and training, and to make arrangements for formal certification of all surgeons regarded as competent to undertake cosmetic procedures, taking into account their training and experience.

The Department of Health requested the Law Commission to draft legislation, and this was done in 2014. The legislation was widely supported, but the coalition Government failed to enact it, as have the current Government. The Royal College of Surgeons would like only surgeons with appropriate skills and experience to undertake cosmetic surgery. I strongly support that, and I think that most members of the public would do so. To facilitate this, the GMC needs to be given legal powers to formally recognise additional qualifications or accreditations such as those that the Royal College of Surgeons is developing in cosmetic surgery. It should then be mandatory for those offering cosmetic surgery not only to have these but to make it clear to the public that they have them when advertising their services.

This is not the first time I have spoken about this case; I raised it in the House on 20 October 2015. I would like to put on record my thanks to the right hon. Member for Ipswich (Ben Gummer), the then Health Minister, who met me and my constituent, Dawn Knight.

Another area that the Bill aims to address is the marketing of cosmetic procedures. Some of the techniques that are used would be more appropriate for selling double glazing than cosmetic surgery, with its related risks. They include two-for-one offers, along with glossy brochures with no explanation of the potential risks of undertaking the surgery. The whole thrust of the advertising is to sell such procedures without any counselling or advice on whether it is appropriate for an individual to undergo them. Individuals who have already undergone surgery are often bombarded with more adverts, by email or on Facebook, despite the fact that that practice has been reported to the Advertising Standards Agency. Such aggressive marketing needs to be banned and a mandatory cooling-off period introduced once people have signed up to allow them to change their minds. I would go further and include mandatory counselling for individuals before they undertake any such procedure.

I want to address the way in which the companies that sell cosmetic surgery are structured. Dawn Knight responded to an advert from the Hospital Group, but her contract was with a company called the Hospital Medical Group Ltd. If we look at the Companies House register, we see that under the main Hospital Group holding there are eight different companies. In 2012-13, the group’s turnover was £44 million and dividends of some £7.5 million were paid to its directors. In 2016, the Hospital Medical Group was liquidated and its assets were sold to one of its parent companies. Some 80% of creditors on the liquidator’s list are solicitors representing former clients. One suspects that that structure was put in place to avoid any potential for former clients to sue the company for negligence.

With the liquidation, the lifetime guarantee that Dawn was sold is, like those sold to many other people, now completely worthless. Regulation is needed to ensure that guarantees offered on cosmetic surgery can actually be used to get redress. Despite the fact that a large number of women now have no recourse to law, the Hospital Group continues to operate and sell its products. The continuing care of individuals such as Dawn is falling on the NHS, while the group and its associated companies continue to make a profit. Guarantees must be backed up by insurance, so that if a company is liquidated, people can get legal redress.

The Prime Minister, in her speech to Conservative Party conference, said that the state should intervene where the market fails. We have here a classic example of the market not only failing but being used to exploit people, which is ruining their lives and costing the NHS millions of pounds a year. The Government are aware that action is needed in this area, and there is no reason why they should not act.

Question put and agreed to.


That Holly Lynch, Judith Cummins, Claire Perry, Helen Jones, Fiona Mactaggart, Paula Sherriff, Mr Iain Wright, Mrs Anne-Marie Trevelyan and Mr Kevan Jones present the Bill.

Mr Kevan Jones accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 24 March 2017, and to be printed (Bill 77).