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Sunbed Use: Health Implications

Volume 654: debated on Wednesday 13 February 2019

I beg to move,

That this House has considered the health implications of sunbed use.

It is a delight to serve under your chairmanship for the first time, Mr Hosie, and I thank my good friend the Minister for responding to this important debate.

The motion asks the House to consider the health implications of using sunbeds, but I would go as far as calling for a ban. Who needs sunbeds? No one. Many people in the UK believe that they look healthier with a tan, but that could not be further from the truth. Bronzed skin was a trend first popularised by Coco Chanel in 1923, and it has never gone away. From St Tropez to Derbyshire, a suntan continues to be a desired accessory. Over time, people have sought to maintain their tan using artificial means, including the sunbed. In the ’60s, sunbeds were developed for the first time, and in the ’80s they began to be used in large numbers. The industry continued to grow throughout the 1990s and into the 2000s. Today, an estimated 3 million Britons use sunbeds to keep themselves tanned.

According to the World Health Organisation, sunbeds are as dangerous as smoking—many people do not realise that—and in 2009 it classified them as carcinogenic to humans. Worryingly, statistics show that people who have used a sunbed at least once, in any stage of their life, have a 20% higher risk of developing melanoma than those who have never used a sunbed. The first use of a sunbed before the age of 35 increases the risk of developing melanoma by 59%.

The hon. Lady is making an important speech. In all honesty, I think of sunbeds as pernicious death machines. They rely on people’s vanity, but we all have elements of vanity in our lives, so let us not decry that. We should be doing far more. One hundred thousand people get a melanoma every year; it is one of the most pernicious forms of cancer, and 10,000 people die. These are death machines, aren’t they?

Yes. The hon. Gentleman makes an important point, and we must emphasise the fact that sunbeds are killing machines that nobody needs to use. Nobody needs a tan, and as the hon. Gentleman says, this is purely about vanity. We know there is a lot of vanity in the world, but this is a deadly vanity and it is a waste of everybody’s time and money—sunbeds are also expensive.

Dr Andrew Birnie, a consultant dermatologist and dermatological surgeon, supports the World Health Organisation classification of sunbeds as carcinogenic. He notes that

“it has been shown that the biggest cause of melanoma is high-intensity bursts of ultraviolet light on skin not used to being exposed to UV.”

The World Health Organisations has recommended that countries either ban or limit the use of sunbeds. In reality, there is no such thing as a safe tan unless it comes from a bottle or a can. Indeed, one trainee beautician, Kimberley Platt, said:

“I’m a trainee beautician and part of the course is being taught to spray tan. Our course tutors tell us to steer clear of sunbeds, I wonder why. Has anyone ever looked on Instagram at sunbed burn photos? Horrific. It seems as if to burn, either artificially or in the sun, is somehow a funny thing to do. Dealing with skin cancer is not funny though. Think about the cost of treating skin cancer, not to mention the cost of a life.”

Is this particularly an issue in this country because so many people are genetically made for British weather? We have freckles, fair hair and fair skin, which is far more prone to some of the dangers that the hon. Lady mentions.

Again, the hon. Gentleman makes an important point. We are not built for the sun; otherwise we would be black. That is why people in Africa do not have the problems that we have. We tend to go on holiday for a couple of weeks, burn like mad, come back and think it is great, but it is damaging to the skin. One need only look at people who spend a long time either on sunbeds or in the sun. When they get older they look like dried-up prunes, and nobody wants to look like a dried-up prune. People think that they are making themselves look healthier, but they are not; they are deeply damaging their skin, and we must try to persuade the Minister that a ban on sunbed use is the only thing we can do.

Frighteningly, over the past 30 years cases of malignant melanoma have more than quadrupled in the UK, and the scary truth is that it is now the second most common form of cancer in those aged 15 to 34. A melanoma is not easy to treat unless caught early. There are around 15,400 new melanoma skin cancer cases in the UK every year—42 every single day. Every 24 hours in the UK, six people die from a melanoma, and in 2016, 2,285 people died of the condition.

In the United States of America, Europe and Australia, combined sunbed use is estimated to have been responsible for more than 450,000 non-melanoma skin cancer cases and more than 10,000 melanoma cases every year. It is no coincidence that the rise in that aggressive form of skin cancer aligns with the popular use of sunbeds. The current updated body of scientific evidence strongly suggests that indoor tanning significantly increases the risk of melanoma. A large amount of data from observational studies provides enough information to infer that sunbed use causes melanoma, using all the epidemiological criteria for causality.

Dr Nicole Chiang, a consultant dermatologist who treats skin cancer patients on a regular basis, has noted that the risk of melanoma more than doubles when sunbeds are used at a young age of below 35 years. Sunbeds cause three times more DNA damage than natural sunlight, and it has been estimated that 20 minutes on a sunbed could be equivalent to approximately four hours in the sun. Just one sunbed session can increase someone’s risk of developing squamous cell skin cancer by 67%, and basal cell skin cancer by 29%. Even more important is the increased risk of melanoma, which is the deadliest form of skin cancer.

I was concerned to learn that data from Cancer Research shows that more than 25% of the UK’s 3 million sunbed users are unconcerned about the dangers that sunbeds pose. Indeed, I was on the radio today and I heard some people talking about this issue. They said, “Well, so what? It doesn’t matter. It will be okay.” I believe it is important to dispel the fake news, often used in the marketing of sunbeds, that they provide a “controlled” way of getting a “safer” tan. Sunbeds are no safer than exposure to the sun.

A 2008 study published in the journal “Pigment Cell & Melanoma Research”—that sounds like something from “Have I Got News For You”—came to the conclusion that to achieve a tan, the skin must be exposed to ultraviolet radiation, and therefore “safe tanning” is a physical impossibility. It is also important to dispel the myths perpetrated by the sunbed industry about vitamin D benefits from sunbeds. Due to the carcinogenic risk associated with sunbeds, their use cannot be justified. We can take a tablet in the winter to ward off vitamin D deficiencies. A further myth is the idea of the base tan—the dangerous and fanciful assertion that getting an initial tan from a sunbed will protect the skin from the sun. Guidelines from the National Institute for Health and Care Excellence explain that getting a tan provides little protection against later exposure to sunlight, and the resulting skin damage outweighs any later protective effect.

Throughout my time in Parliament, I have focused on the prevention and treatment of skin cancer as a result of personal experience. I have had the privilege of working with a cancer charity, Melanoma UK, which I thank for its support in gathering evidence for this debate. I know only too well the devastating effect that that cancer can have on people’s lives. What is most insidious about melanoma in particular is that it is impossible to treat in its late stages, and it often results in a drawn-out, very painful death. Last year I had my own personal scare. I found a mole, which was malignant. After a tortured three weeks waiting for the results I found out that, luckily, the tumour had not spread—but it was malignant. The fear was magnified by the fact that my own brother died from a melanoma when he was only 54. I have therefore always taken a close interest in that type of cancer and its causes.

My brother went to his GP three times in a year before the GP eventually said, “There’s nothing wrong with you, but I will refer you”—just to get him out of his surgery, I think. By that time it was far too late, and my brother died from his melanoma a few years later; but he was never able to work again, because muscle and lymph glands had to be taken away, so he could not do his job. Neither I nor my brother used sunbeds, but given my experience of the awful disease of melanoma I cannot comprehend why anyone would want to increase their risk of contracting it. Research shows that many people who contract it probably would not have done, if they had never been able to use a sunbed.

I want to refer to some case studies highlighting the horrific effect that sunbed use can have on individuals and their loved ones. I thank the House of Commons outreach team for helping me to collate a vast and wide-ranging response, obtained thanks to the power of social media. I am so grateful to those who participated in the initiative. There were some interesting and informative discussions. I was taken aback by the significant number of responses from people who said they regularly used sunbeds in their youth and today have, or have had, a melanoma. One such lady, Jade Luelle Cope, said that she used sunbeds often between the ages of 15 and 32, and was diagnosed with malignant melanoma at 38. She stated that she does not think that it was a coincidence.

Beverley Chesters passionately advocated a ban. Describing her experience, she said,

“without a doubt these killing machines”—

as the hon. Member for Rhondda (Chris Bryant) called them earlier—

“need to be banned in a heartbeat!”

She used sunbeds in her late teens and early 20s, when

“it was the norm for everyone to walk about with the supposed ‘healthy glow’. How very naive was I. I cannot recall ever any health warnings regarding sunbeds, and yes a pair of goggles given for eye protection and that’s it! Now all these years later I have malignant melanoma, first diagnosed last August…since then I have 2 more separate melanomas, and also waiting for results of 2 further biopsies. I would not wish this horrible disease on anyone. If only I knew then what I know now I would never ever have put myself in that position of risking my life, all for a tan. My body looks like a patchwork quilt.”

Similarly, Vicki Brennan noted that she used sunbeds and now has a malignant melanoma. Tragically, she comments:

“If I knew the statistics back then I would have made an informed decision not to use them, it scares me to think how many people are putting themselves at risk. And as for banality...Tell this to the thousands enduring treatment and those who are dying. You don’t just cut skin cancer out and carry on as normal. Please ban sun beds.”

A lady who came to a meeting that I was chairing had four young children, and was only in her 30s. She knew she was not going to survive, because she had a melanoma. She was going to leave the four young children for her husband to bring up, and they would not know their mother at all because they were so young.

The heartbreaking consequences of melanoma, aligning with sunbed use, were highlighted by Elaine Broadhurst. She said she and her brother used sunbeds as teenagers.

“We had one in our own home. There was no legislation or advice on the dangers. My brother was diagnosed with melanoma and died from it two years ago aged 46, leaving a wife and two young children. I’m convinced that the sunbed use contributed to losing my brother to this deadly disease and that sunbeds should be banned.”

Hundreds of people wrote similar testimonials, which illustrate the huge personal impact that the condition has on people’s lives, and the regret that many feel, having used a sunbed repeatedly and contracted the condition as a consequence. I encourage Members to take the time to read through some of the comments on the House of Commons Facebook page.

It is important to stress that it is clear that the majority of people use sunbeds purely for cosmetic reasons and vanity. The significance and dangers of cosmetic tanning are supported by many case studies and scientific research. It is said that people feel more confident, and sometimes even slimmer, when they are bronzed. However, in reality, over time when people over-use sunbeds their skin can age prematurely, making it look coarse, leathery and wrinkled—prune-like. In the worst-case scenario sunbeds can cause burns, scars and ulcers known as basal cell carcinomas. Dr Birnie observed that there has been rising incidence of the condition in younger people, and especially in women who have used tanning beds in their teens and early 20s. I am sure that that is not the aesthetic that young people craving a tan are trying to achieve.

I am particularly concerned to learn of a trend towards sun tanning addiction, where people use the sunbed for a quick and lasting tan. Some research suggests that as many as one in 50 sunbed users are addicted to them. There are stories of people using a sunbed daily for a long period of time. I was on Radio Sussex this morning and a lady said she had for three years used a sunbed at home for an hour a day. She now has a melanoma. That is excessive use, but lower use is still deadly. Scientists from Germany and the US recently published a study showing that almost 20% of indoor tanning users have addictive symptoms.

I would like high street tanning salons that offer sunbeds to raise awareness of the potential health implications of using sunbeds, as happens with cigarette packets. I understand that the British Association of Dermatologists has explained that many tanning salons fail to provide adequate information. However, I should prefer an outright ban to the use of nasty pictures of people with burns.

There is work to be done outside the legislative reach of Parliament. I would encourage the fashion and beauty industry to take an active role in discouraging the use of sunbeds. I commend initiatives previously adopted by the fashion industry, such as when in 2012 Kate Moss and her then modelling agency, Storm, aimed to raise awareness of the dangers associated with sunbeds, to put heavy tans out of fashion. At the same time directors from 11 UK model agencies including Elite, Premier Model Management, Storm and Next signed up to a zero tolerance policy on sunbed use, to protect new and established models from the health and cosmetic effects of using ultraviolet tanning beds. It would be good to see such work continue and perhaps go further. Perhaps there should be more articles in girls’ and women’s magazines to explain the dangers of tanning in that way. We all know that models are generally young and thin—that is another issue—but they do not need a tan to look beautiful. Twiggy, in the 60s, was pretty beautiful, and she has continued to be. I doubt whether she uses a sunbed.

In 2003 the World Health Organisation responded to the serious public health challenge and published a guidance document on sunbed legislation. Since then, a number of organisations and individuals in the UK have called for an outright ban on the use of commercial sunbeds. We should also look at the practice of selling them privately, because there is then no control over how people use them. The Sunbeds (Regulation) Act 2010 banned the use of sunbeds by under-18s, but many people feel that the ban did not go far enough. It was a start, but only an all-out ban is acceptable. That idea is being explored by our European partners. France’s health watchdog says that the risk of cancer from sunlamps and sunbeds is proven and authorities should act to stop people being exposed to artificial ultraviolet rays. France is one of a number of countries that have already limited their use.

I know that many members of the public support the banning of sunbeds. I was very pleased that Melanoma UK’s recent petition to ban sunbeds in the UK received in excess of 15,000 signatures. While I received a mixture of responses on both sides of the argument from the parliamentary outreach exercise, I was struck by the support from some people in the beauty industry. I am pleased that some individuals in the industry have recognised the dangers of sunbeds and champion the safe alternative of a spray tan.

One such example is Tonina Healey, a beauty salon owner who took the decision to ban the use of tanning beds in her salon and instead has promoted a spray tan. She said:

“I have always been very uncomfortable at the use of sunbeds. I took the decision to stop the use of tanning beds in my salon, I think one of the things that should be of major concern to all salon owners, is the issue of control. I have seen articles relating to tanning addiction and of clients going from salon to salon in order to achieve ‘double’ sessions. No one in the beauty industry can legislate for that and I for one, do not want to invite a lawsuit my way—does anyone in this industry really need that kind of hassle? I do believe that that will come one day, a salon in the UK will be sued when someone develops melanoma. I don’t want that on my plate and I certainly don’t want the illness of a client on my conscience. We trained in beauty to make our clients feel good, not to watch them die horrific deaths. We support a ban.”

Brazil and Australia have already banned sunbeds commercially. Brazil was the first to ban sunbeds in 2009, the only exception being where doctors prescribed their use for health reasons. In the same year, the World Health Organisation classified exposure to UV sunlamps, sunbeds and tanning booths as carcinogenic to humans. Australia followed Brazil’s ban in 2013. Annual rates of malignant melanoma in Australia were 10 times the rate in Europe for women, and more than 20 times for men. Professor Grant McArthur stresses the success of the ban in Australia, saying:

“The Sunbed ban in Australia has been highly effective. We estimate that one unnecessary death per week has been prevented by the ban. The greatest burden of deaths from Sunbeds falls in people aged 20-40. I plead that the UK save their young people by banning sunbeds”.

To conclude, it is my view that there should be an outright ban on sunbeds, and I hope I will receive the support of colleagues in that. While the temptation to achieve that sun-kissed glow is understandable, risking contracting such a devastating disease is not. The unnecessary exposure to UV is nonsensical, and I implore anyone to get a fake tan through a bottle or can, not the sunbed. It seems wrong that people should have the option of damaging their health so greatly, purely in pursuit of cosmetic gratification.

The evidence is clear: for over three decades, deliberate sunbed exposure to UV for cosmetic purposes through sunbeds has been driving up the incidence of skin cancers and driving down the age of their first appearance. I stress again the shocking figures that people who have ever used a sunbed are 20% more likely to develop melanoma later in life than people who have never used one, and those who started using sunbeds before the age of 35 were 87% more likely to develop melanoma than people who have never used a sunbed.

I also believe that action needs to be taken to further raise awareness of melanomas and what causes them, including over-exposure to UV through sunbeds. That action should include providing stronger and clearer warnings about the consequences of sunbed usage. Being aware of the possible consequences of the sunbed should lead to a cultural and generational shift, with people avoiding exposing themselves to UV unnecessarily. It is vital that people are conscious of the impact that this awful condition can have on one’s health and personal life—something that I myself have experienced through my own personal circumstances. Please may we have a ban on sunbeds?

It is a pleasure to serve under your chairmanship this morning, Mr Hosie. I thank my hon. Friend the Member for Mid Derbyshire (Mrs Latham) for securing this important and emotive debate.

Good health is a precious gift, which most of us will hopefully be able to maintain throughout our life by ensuring that we have a balanced diet, take regular exercise and make appropriate lifestyle choices. However, one lifestyle choice that appears not to be beneficial is the frequent use of sunbeds, which give out potentially harmful ultraviolet, or UV, rays.

According to Cancer Research UK,

“sunbeds are no safer than exposure to the sun itself”.

The damage to the DNA in our skin cells builds up over time, possibly resulting in skin cancer, of which melanoma is the deadliest form. NHS research illustrates that people

“who are frequently exposed to UV rays before the age of 25 are at greater risk of developing skin cancer later in life.”

Over the last decade, the number of people diagnosed with melanoma in the United Kingdom has increased by almost half, and it is the fifth most common cancer in the United Kingdom. However, not only have UV rays been linked to the increased risk of developing melanoma, but they may result in premature ageing of the skin, and eye damage may occur if proper and effective eye protection is not applied.

Sadly, some people continue to put body image before their personal health, perhaps inspired by the media coverage of celebrities and models they seek to emulate. That is despite the fact that the risk of cancer is constantly being highlighted by the NHS throughout the UK, with various charities giving the same advice; indeed, the issue was the subject of a debate in the main Chamber only nine days ago.

In recognition of the potential dangers, it is illegal for people under 18 years to use sunbeds at commercial premises, including beauty salons, leisure centres, gyms and hotels. Use is controlled in England and Wales by the Sunbeds (Regulation) Act 2010, and Northern Ireland has passed delegated legislation in the form of regulations, providing a health warning with information that must be imparted to sunbed users. That information explains that those who use sunbeds for the first time before the age of 35 increase their risk of developing malignant melanoma by around a staggering 75%. Scotland has similar but less specific information in the Public Health etc. (Scotland) Act 2008 (Sunbed) Regulations 2009.

In 2009, the Health and Safety Executive was so concerned that it issued revised guidance on sunbed use in the UK. It is clear about the health risks associated with using UV tanning equipment such as sunbeds, sunlamps and tanning booths. However, any legislation is only as good as the enforcement, and that needs to be extremely robust. I would welcome any measures from the Minister that further protect the public from what is in effect a form of self-harm, emanating from the unnecessary pursuit of that perfect appearance. One measure he may wish to consider is raising the age limit from 18 years or consulting on a ban. Equally importantly, however, I ask those using or considering using sunbeds to weigh up the risk that it might present, not immediately but in later life. I said at the start that good health is a precious gift: why, oh why, would we as individuals put that gift at risk?

In closing, it is worthy of note that, properly utilised by experts in the field, and particularly medical staff in the NHS, light rays and phototherapy have a place in the treatment of skin conditions such as psoriasis and eczema, but they are not the same as tanning sunbeds.

It is always a pleasure to serve under your chairmanship, Mr Hosie.

One of the great pleasures of being in Parliament is that I learn new things on a regular basis. I must confess that, prior to coming to this debate, I had, as a peely-wally, fair-skinned, red-headed Scotsman, always avoided the sun and had no experience of sunlamps. It was fascinating to learn about them, and I am grateful to the hon. Member for Mid Derbyshire (Mrs Latham) for securing this debate and for her informative presentation, taking us through the history and many of the health problems. She presented some fantastic statistics, including the fact that sunbeds are used by 3 million people and that they cause three times the DNA damage of sunlight. Her case studies brought home the very human nature of this problem.

There is no doubt that UV rays from sunbeds can damage DNA in skin cells, which, building up over time, can cause skin cancer. The International Agency for Research on Cancer—IARC—accepts that there is enough evidence to show that sunbeds cause melanoma skin cancer, and further states that sunbeds provide no health benefits. That is a fundamental point. It also highlights that sunbed use before the age of 35 significantly increases the risk of melanoma; both earlier speakers used statistics, and the statistics I found last night put the range at 59% to 79% more likely. I do not know the actual figure, and I am interested to hear whether the other Front Benchers have a firmer handle on it. Either way, those figures are frightening.

Those figures are, however, hotly contested by the sunbed industry, which points out that, when professional sunbed use is separated from home use, it has no increased melanoma risk. The industry also highlights the benefits of UVB radiation in treating vitamin D deficiency. While I have no doubt that professional sunbed use will be safer than home use, it is no safer than exposure to the sun. The World Health Organisation classifies sunbeds as a group 1 carcinogen. A WHO director, Dr Maria Neira, says:

“There’s no doubt about it: sunbeds are dangerous to our health”.

I certainly take that warning very seriously.

The Scottish National party recognises the potential harmful effects of sunbed use—or misuse—and has taken action. The Public Health etc. (Scotland) Act 2008, implemented under an SNP-led Government, contains provisions to regulate sunbed use, as well as measures that include prohibiting unsupervised use, banning the use of sunbeds by under-18s and banning the sale and hire of sunbeds to under-18s.

It is imperative that people using sunbeds realise the health implications and risks of doing so, so that they can make an informed decision about their use. The 2008 Act has provisions requiring all sunbed premises to display a health notice visible to anybody entering them and to provide information to customers on the risks, allowing them to make an informed choice.

A Scottish Government leaflet highlights those risks, and reading it earlier in the week gave me my first pieces of information about sunbed use—I have to say that it ticks quite a few of the boxes that would frighten me off ever going on a sunbed, and I encourage the public to have a serious look at it. In addition to the higher risk of skin cancer, it highlights the risk of eye damage—including the higher risk of cataracts if appropriate eye protection is not worn—and of accelerated skin damage, including premature ageing of the skin, which was well covered by the earlier speakers. The leaflet concludes:

“These health risks outweigh any potential benefits in using sunbeds to supplement vitamin D.”

There we have it. There are plenty of warnings about sunbeds, and I will certainly avoid using them. Indeed, I slap factor 50 sun cream on if I walk along Princes Street on a slightly cloudy day. I will leave my remarks at that. I thank hon. Members for an informative debate. I have learned a considerable amount about this issue.

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank the hon. Member for Mid Derbyshire (Mrs Latham) for her passionate and excellent speech and for so bravely sharing her own experience with melanoma, which makes it all the more delightful that she is with us in such fine health this morning. I am very sorry to hear about her brother, but I am pleased that her diagnosis was found early and was successfully treated. I also thank the hon. Members for Ayr, Carrick and Cumnock (Bill Grant) and for Linlithgow and East Falkirk (Martyn Day) for their excellent contributions.

It is fair to say that the health implications of using sunbeds once dominated public consciousness. Almost 10 years ago, when the Sunbeds (Regulation) Act 2010 was introduced by the former Labour MP for Cardiff North and passed by a Labour Government, the health risks that came with using sunbeds were well known and well talked about. I remember a parliamentary reception with celebrities such as Nicola Roberts from Girls Aloud speaking out loud and clear about the dangers of sunbeds.

Roberts spoke as someone in the public eye who felt compelled to be tanned—despite being of ginger complexion and very fair skinned—and to constantly use tanning products. She bravely said that she was coming to a point in her life where she wanted to be her natural colour. However, that was 10 years ago, and we should have come a lot further, but owing to vanity or whatever, everyone still goes in search of that elusive tan. As the hon. Member for Mid Derbyshire says, we do not need a tan; it should not be something that we desire.

The issue has certainly not been talked about in a long time, not least in the House, where between January 2011 and February 2019—more than eight years—the word “sunbeds” has been said only 16 times. It is therefore very welcome that the hon. Lady has brought this issue to the fore once again, because there is a generation of young people who will not really understand the risks of sunbed use. They will not know that the short, high-intensity exposure to UV radiation provided by sunbeds is dangerous and can dramatically increase the risk of skin cancer. Looking tanned might seem desirable when we are young, but I doubt, as the hon. Lady said, that looking aged with skin damage several years along the line will be as desirable. I invoke the dried-up prune analogy once again: we have all seen them on the beaches, haven’t we?

It is important that we get the message about the health risks across to young people, particularly because people frequently exposed to UV rays before the age of 25 are at a greater risk of developing skin cancer later in life. I have to admit that that statistic greatly worries me. I confess that, as a young woman in the 1980s, before we knew what we know now, I used sunbeds, although not as often as some. It was obvious that they could not be that good for me, but I did not realise how bad they were for me. I often used them to get a base tan before going on holiday, because we all believed that we would look after our skin better if we got a base tan before going abroad. As the hon. Lady said, that is a total fallacy. Has the Minister therefore made any assessment of how many young people know the risks of sunbed use, and does he have any plan to address the issue?

All the Government information on sunbed use dates back to 2009 and 2010, despite more relevant information being published since. For example, the WHO published a 2017 report entitled “Artificial Tanning Devices: Public Health Interventions to Manage Sunbeds”. The IARC also assessed UV-emitting tanning devices as “carcinogenic to humans” based on consistent evidence of a positive association between their use and the incidence of melanoma.

As we have heard, melanoma is on the increase in the UK, and it is estimated that the NHS will spend £465 million on treating skin cancer patients by 2025. I pay tribute to charities such as Melanoma UK and MelanomaMe., which was set up in my constituency in 2017 by Kerry Rafferty and Elaine Taylor—I met them in 2017 when opening an awareness event for them in Sunderland—after one of them suffered from melanoma and the devastation it wreaked on her life and body. Charities such as Melanoma UK and MelanomaMe. support patients and their families and raise awareness of skin cancers and the risks of sun exposure and, of course, sunbed use.

The Minister knows how strongly I feel that the Government have an obligation to prevent cancers, and I know he is passionate about doing so. That is why I believe that the Government must look at sunbed regulations again, to assess whether they need to be updated almost 10 years on since they were first published. It must be a priority for the Government to ensure that people know the risks of sunbed use before using them, as well as during and after their use. For example, people are told that smoking is harmful before they take it up, but guidance does not disappear once they have started smoking or even once they have stopped. Even though they may carry on smoking, everyone who smokes will admit to knowing the health risks. We are not at that stage with sunbed use.

It is easy to shrug off health warnings when it comes to sunbed use, because the symptoms of skin damage may not appear for up to 20 years. However, skin damage can have very serious implications, as we have heard, so the warnings must not be shrugged off. The hon. Member for Mid Derbyshire called for a ban on sunbeds across the UK, like in Australia and other countries. Although I can see why she calls for a ban, I feel that we must first allow the Government to look at all the most recent evidence and make an assessment. They should definitely update the regulations if necessary and ensure that younger generations are made aware, at the earliest stage, of the risks of sunbed use.

As I said at the beginning of my speech, this issue was very much in the public consciousness almost 10 years ago, and perhaps it is time to ensure that it is again. I am sure the Minister will take on board all that he has heard this morning, and I look forward to his response.

It is a pleasure to see you in the Chair, Mr Hosie. I thank my hon. Friend the Member for Mid Derbyshire (Mrs Latham) very much. We use the term “hon. Friend” a lot in this place, but she knows that she is my very good friend as well as my hon. Friend. Well done to her for securing the debate.

I was interested to hear the word search statistic from my shadow, the hon. Member for Washington and Sunderland West (Mrs Hodgson). It was very interesting, but not at all surprising. The hon. Lady and I spend a lot of time in Westminster Hall, but this is not an issue that we have covered before, although we have obviously covered cancer a lot. This issue affects so many people’s lives. We heard from my good and hon. Friend about how it has impacted on her family and, as the hon. Member for Washington and Sunderland West said, it was very good to hear that she herself has managed to deal with it successfully.

I do not know about other hon. Members, but sunbeds feel very 1980s to me. As someone who was at secondary school in the 1980s, I thought that they had been left behind there, because we do not hear much about them these days, but it occurs to me that there is a large sunbed salon in my constituency of Winchester. There is a reason why the 1980s came into my mind. Hon. Members may remember an episode of “Only Fools and Horses” called “Tea for Three”. The infamous character Trigger has a niece whom Del and Rodney remember from her much younger years and who comes to stay with Trigger for a period. The niece, Lisa, is now 25 and—well, let’s just say that she has matured into a very attractive young lady. Del and Rodney set out to impress her, both thinking that they have a chance. I remember the episode well, and the reason why it is relevant to the debate is that Rodney decides to lie on the sunbed in the flat at Nelson Mandela House to improve his look for young Lisa and falls asleep. Del then turns up the dial, and Rodney spends the rest of the episode with a bright red face—in many ways. It is interesting that tanning was portrayed in that sitcom as a technique to attract the ladies. It backfired, as everything seemed to, on poor Rodney, but it was interesting how it was used and it explains why I connect sunbeds with the 1980s. As we have heard today, however, sunbeds and their impact are very much current phenomena.

As my hon. Friend is keenly aware, there are huge health consequences from exposure to both natural and artificial ultraviolet radiation. The most significant is of course skin cancer, which we have talked about, but there are other impacts, such as sunburn, which is very unpleasant and uncomfortable, accelerated skin ageing—the “prune” factor that we have discussed—eye inflammation, which my hon. Friend the Member for Ayr, Carrick and Cumnock (Bill Grant) mentioned, and temporary immunosuppression. Importantly, though, there are measures that we all know we can take to reduce the impact of exposure to UV radiation from the sun, such as using sunscreen and seeking shade. Equally, there are many precautions that should be taken when using sunbeds, such as only using a staffed facility that provides guidance to users and limiting regular use of a sunbed. I will come on to those two points. Younger people who use sunbeds are at greater risk, which is why in 2011, regulations were introduced banning the use of sunbeds by under-18s in England and Wales, as we have heard.

Melanoma skin cancer is one of the most common cancers in the UK today. About 15,500 new cases of melanoma are diagnosed each year and more than 2,000 people die every year in the UK from melanoma. In recent years, skin cancer has become much more common in the UK, which is thought to be the result of increased exposure to intense sunlight on holidays abroad. Many people these days can afford foreign holidays, which come with much fun but also many dangers. It is worth noting that more than one quarter of skin cancer cases are diagnosed in people under 50, which is unusually early compared with most other types of cancer. Cancer Research UK estimates that 86% of skin cancers are preventable. I often say in Westminster Hall debates—my shadow will have heard me say this many times—that two thirds of cancers are down to bad luck and one third of cancers are preventable. When we consider the high percentage of skin cancers that are preventable, we realise that this is an area where we can move the dial in the prevention space. That is why I am interested in today’s debate and so grateful to my hon. Friend the Member for Mid Derbyshire for initiating it.

My hon. Friend referred to the many people who would not have skin cancer if they had not used sunbeds. It is difficult to be certain about how many cases of skin cancer are due to sunbed use, as most people will also have had natural exposure to UV from the sun. Obviously, there are a few people who have skin conditions that mean that they must remain 100% covered up or who do not go outside, for other health reasons. It is vital—my hon. Friend made this point very well, as did others—that the public are fully aware of the risk from their overall exposure to UV and how to minimise the risks.

We have not mentioned vitamin D much in this debate. Vitamin D is a hormone that is very important in musculoskeletal health, and vitamin D synthesis is triggered in the skin through exposure to UVB, including from sunbeds. However, we do not advise people to use sunbeds to enhance vitamin D levels, because any beneficial effect of increased vitamin D synthesis is outweighed by the adverse effects that we have heard about in the debate. We recommend alternative sources of vitamin D, such as dietary supplements.

Public Health England, for which I am responsible, discourages the use of sunbeds for cosmetic tanning, and rightly so. Those individuals who have very fair skin, who burn easily in the sun—I think of the hon. Member for Linlithgow and East Falkirk (Martyn Day) when I say that, and it certainly applies to me—or who have had skin cancer previously would be at increased risk and obviously are advised not to use a sunbed. This is the point that the hon. Member for Rhondda (Chris Bryant) made about the race that we are and the part of the world in which we live.

The Be Clear on Cancer campaigns, which Public Health England leads on behalf of the Government, are designed to raise the public’s awareness of specific cancer symptoms, encourage people with those symptoms to go to the doctor, and promote the diagnosis of cancer at an early stage. We are about to roll out the next iteration of the Be Clear on Cancer campaign, about cervical cancer, on which there was a big debate in this Chamber last month, and we have had the campaign on breast cancer in the past. It is fair to say that there is no shortage of applications for the next iteration of Be Clear on Cancer. And often we are limited in what we can do in those campaigns in relation to the impact that people would then be driven into the health service. However, one of the things that I will take away from this debate is that it would be well worth my placing on the radar of the Be Clear on Cancer team melanoma and skin cancers generally for the campaign as we roll it forward. That will hopefully be one positive outcome from the debate.

It is critical—it is important that Health Ministers say this at the Dispatch Box—that people are aware of their skin. They need to be skin aware—in the same way as so many women have, hopefully, been trained to be breast aware—and to seek advice from their GP if they notice any changes, particularly in terms of moles that itch, bleed or change shape. I remember being taught that as a youngster and I wonder whether the younger generation are still as aware of that health message, but Be Clear on Cancer is something that we can look to with hope.

Let me touch on regulation. The Sunbeds (Regulation) Act 2010 came into force in April 2011 in England and Wales, as has been mentioned, to prohibit under-18s from using sunbeds. Restrictions on sunbed use by under-18s also apply in Scotland and in Northern Ireland. Guidance has been provided to support local authorities’ authorised officers in successfully implementing the Act, by providing information on the duties of businesses and how to carry out inspections. The local environmental health departments in England are responsible for monitoring and inspecting sunbed salons everywhere, except those situated in local authority leisure centres, which are regulated by the Health and Safety Executive. It is worth making that distinction.

My hon. Friend the Member for Mid Derbyshire talked about banning sunbeds. Should they be banned? A range of options to minimise the adverse effects of sunbeds has been considered. Public Health England has contributed to the most recent World Health Organisation review, published in 2017, on the public health interventions to manage sunbeds. Banning sunbeds was one option under consideration, but the adverse impacts need to be considered carefully to avoid unintended consequences, such as increased use of home machines—like Del and Rodney had—with more harmful impacts.

We have to be aware of the unintended consequences. One of the unintended consequences of banning the use of commercial sunbeds by under-18s was the opening of a market for home hire of second-hand sunbed equipment and sunbed parties—believe it or not. I have been to many parties in my time, but I have yet to be invited to a sunbed party. The mind boggles—it is probably best to leave it there. My swimming trunks have not had an outing for years, but that is probably for the best. It is vital to equip people with the information to avoid the risks of over-exposure to UV radiation. In this way, we empower individuals to protect themselves from UV sources.

Before I address prevention, diagnosis and treatment, I will respond directly to my hon. Friend’s suggestion that sunbeds should be banned. I think we need to look at the regulations again, as the shadow Minister mentioned. They have not been changed for a number of years. My hon. Friend has brought this issue to this Chamber with great force, intelligence and evidence. Now is a good time because we have published the prevention strategy and we are working on a Green Paper on prevention. I am interested in any and every idea that is related to prevention.

As a Minister, I am often given papers by officials, and stuff to look at and sign off. However, in this process of preparing the Green Paper on prevention I can say to my officials, “I want real blue-sky thinking here. I want you to look out into academia, to see where the really interesting and cutting-edge work is going on around prevention and future prevention.” This Green Paper process is really open-minded and based on open-source planning. If we look at the evidence and think that banning the commercial use of sunbeds, while taking into account the possible unintended consequences, could be part of prevention, I will not rule it out. I absolutely do not rule that out.

Wherever possible, the aim is to prevent skin cancer from developing in the first place. I met Melanoma UK at the Britain Against Cancer conference just before Christmas. It has a fantastic team, who I am sure have been very helpful to my hon. Friend ahead of today’s debate. I am proud to say that Public Health England and Melanoma UK have had great success in raising awareness of the risks, and the actions to take to reduce the risk of exposure to the sun and the use of sunbeds. The Health and Safety Executive plays a vital role in raising awareness through leaflets and posters, reflecting its guidance for tanning salons and their customers about the safe operation of sunbeds. My hon. Friend used many quotes from people who are engaged in this issue. One interesting quote was from the lady who runs a salon and said that she wants people to feel good about coming into her business, and that sending people away with a potentially life-threatening condition is not a good look for any business. That was an important point.

A tan may give you a so-called healthy glow. The hon. Member for Ayr, Carrick and Cumnock pointed to the magazines and the media image: people always have that healthy glow. However, I have never thought of a good tan as a healthy glow. The National Institute for Health and Care Excellence guidance, published in February 2016, is clear that there is no healthy way to tan. The idea that there is such a thing as a healthy tan, as my hon. Friend said in her opening remarks, is a myth. Any tan can increase your risk of developing skin cancer, whether through natural or artificial UV, and getting a tan does very little to protect your skin from the harmful effects of the sun, which is my hon. Friend’s fundamental point.

NICE, NHS England and cancer charities, including Cancer Research UK and Macmillan, are all clear that if you want browner-looking skin, fake tan is the way to go. It is much safer to use a fake tan product on your skin than to sunbathe or use a sunbed. As the expression goes, “Fake it, don’t bake it”. I think that is what they say in the Department of Health and Social Care these days. I do not know whether you are aware of that, Mr Hosie.

I hope that I have covered a lot of the points that have been raised. I hope that I have demonstrated the Government’s commitment—my commitment—to improving outcomes for people in this country living with skin cancer, and the many more who are at real risk of developing this disease. The Government’s ambitions outlined in the long-term plan for the NHS, the Secretary of State’s prevention strategy, and the Green Paper will ensure that we strive to do even better over the next decade. In conclusion, I agree completely with the hon. Member for Linlithgow and East Falkirk that, while we learn a lot in this place, there is a lot of repetition in many of the debates, but that this debate has not been one of those.

I thank the Minister for his thoughtful response. I hope that we can get something in the Be Clear on Cancer campaign and the Green Paper, because that would take us to the next stage. If we can prevent melanomas, it will obviously be a good thing. I thank the hon. Member for Rhondda, who talked about killing machines. Unfortunately, he is no longer in his place, as he has had to become a diplomat, educating the Germans to be diplomatic.

I also thank my hon. Friend the Member for Ayr, Carrick and Cumnock (Bill Grant), the hon. Member for Linlithgow and East Falkirk (Martyn Day), and the Opposition spokesman, the hon. Member for Washington and Sunderland West (Mrs Hodgson), who all made thoughtful contributions. This issue does have a very 1980s feel, as the Minister illustrated with the good example from “Only Fools and Horses”. However, it is still happening.

The Minister said that education is very important. I support a campaign for “Sun Safe Schools” in Mid Derbyshire. We had a broadcaster who died in his early 30s from a melanoma—not from sunbeds. A lot of the money raised for him was spent in schools to make them sun-safe schools, where children learn an amazing little song about slipping on a T-shirt, slapping on a hat and slopping on sunscreen. It educates not just the children, but their parents: keep covered up and keep the sun cream on.

That did not happen in my day. When I was a child, there was no sun factor. We just put on Nivea, got burnt and put on camomile lotion after that. Today, there are options for people and it is important that we educate as many children as possible, because they will educate their parents. I actually challenge builders in the street if I see them without a top on, getting burnt, and ask them if they put on sunscreen. They are very polite, usually, about my intervention.

We need to keep talking about this issue, because I passionately feel that nobody should die from a melanoma. There are familial traits, but we need to educate as many people as possible about sunbed use and over-exposure to the sun, whether on the beach, in the countryside or in the back garden. If the Minister could include it in the Green Paper, it would be an excellent step forward.

However, I would still like not only a ban on sunbeds in commercial premises, but a total ban on the sale of sunbeds in this country. I know that is draconian, and I am not a great “banner” of things, but nobody needs a sunbed—they are not necessary to anybody’s life. I thank the Minister for his thoughtful response. I hope that this has moved the debate forward. Since it is 10 years since anything has happened on this issue, let us hope it is not another 10 years before we move forward again on this particular type of cancer.

Question put and agreed to.


That this House has considered the health implications of sunbed use.

Sitting suspended.