CMO announces better regulation of private cosmetic surgery, UK

Main Category: Cosmetic Medicine / Plastic Surgery
Article Date: 29 Jan 2005 - 7:00 PDT


Facilities should be properly regulated and patients properly informed before cosmetic procedures can be performed.

Chief Medical Officer Professor Sir Liam Donaldson today outlined a series of moves to ensure better training for doctors, better information for patients and a tougher regulatory structure for private cosmetic surgery. Responding to the Expert Group Report on the Regulation of Cosmetic Surgery and The Healthcare Commission's 'Provision of cosmetic surgery in England' report launched today, the Chief Medical Officer said:

"Cosmetic procedures are a rapidly growing area of private healthcare. Many people spend their hard-earned money on these services. Some are disappointed with the outcome but a minority can suffer serious harm or disfigurement. Standards in the cosmetic treatment field must be as high as other areas of health care. We must ensure we properly protect patients' safety by improving the training, regulation and information provided.

"To ensure better training we will be asking the relevant professional bodies to develop specialist training programmes as a matter of urgency for surgeons undertaking cosmetic surgery. Detailed, accredited advice and education materials will be made available for patients and the public by the summer and we will also be working with the Healthcare Commission (the main health regulator) to bring additional cosmetic procedures such as aesthetic fillers and botox facitlities within their regulatory remit by the end of the year.

"People have to be confident that their treatment will be safe, that the medical practitioners who treat them are qualified and competent, and that they have the information they need to make informed decisions. The action being announced today is directed at addressing this."

The Expert Group has found that, while there is no firm evidence of harm to patients under the current arrangements for regulation of cosmetic surgery, this is a growing area with more people wanting to have procedures and new and different procedures being developed all the time, which demands a more robust regulatory structure.

The Department has also committed to:

-- Ensure the facilities where botulinum toxins are injected be licensed with the Healthcare Commission and therefore subject to its regulations

-- Ensure that all cosmetic surgeons and nurses provide to potential and actual patients details of their qualifications, registration, membership of professional organisations, and other medical training and education

-- Ensure current legislation and regulation governing the use of lasers - that every facility defined in the legislation should be registered with the Healthcare Commission - are more consistently enforced. That laser procedures are overseen by a doctor and conducted by appropriately trained and qualified practitioners

-- Ensure that the General Medical Council improves the recording and classification of data about complaints so that comparisons can be made between different medical specialties and procedures.

-- Review the need and scope for additional regulation of aesthetic fillers and in particular any that contain human tissue. The Medicines and Healthcare products Regulatory Agency will work with interested parties, including DTI, and will take into account the likely emergence this year of proposals from the European Commission for the regulation of tissue engineered products.

Sir John Temple, Chairman of the Cosmetic Surgery Inter-Specialty group, said:

"As chair of the inter speciality group we are pleased to have been able to contribute to this report and look forward to being involved in future consultations and work."

Harry Cayton, Director for Patients and Public, said:

"I believe that the recommendations in our report will help ensure that people can make informed choices before undergoing consmetic surgery, and that they can be confident that cosmetic surgery and procedures are well regulated."

Andrew Vallence-Owen, BUPA Group Medical Director said:

"Cosmetic surgery is one of the fastest growing segments of the private healthcare market and patients need to know that their surgeon is not only fully qualified but highly trained and experienced and a specialist in their field. We must establish proper training and accreditation in cosmetic surgery so I urge the profession to urgently address the recommendations in this report.

"Procedures, for instance those using Botox, must be better regulated and we have to get tough with the cowboy operators. Low standards, although only practised by a few, damage patients and give everyone working in this area a bad name."

Related links

Chief Medical Officer

Health Care Commision

Notes to editor

1. A full copy of the Expert Group Report on the Regulation of Cosmetic Surgery and a list of responses to the recommendations made can be found at the link provided:

2. Current regulations for cosmetic surgery are as follows:

Invasive cosmetic surgery is currently regulated by the Care Standards Act 2000. Responsibility of the Healthcare Commission since April 2004

Laser treatment Practitioners are required to register with the Healthcare Commission. Regulated using Independent Healthcare Standards P1-P3 of the Care Standards Act 2000.

Botulinum toxins injections The prescription of botulinum toxins is regulated and they should only be prescribed by a doctor for a named patient. However, botulinum toxins are not licensed for cosmetic use and are therefore only used for this purpose on an off-licence basis.

Aesthetic fillers The injection of cosmetic fillers is not currently regulated. The regulation of filler products is very unclear. Some fillers are classified as drugs or medical devices and therefore are regulated by the Medical Healthcare Products Regulatory Agency (MHRA). Those which contain human tissue are not classified as a medical device and are covered under the General Product Safety Regulations 1994.

3. The Healthcare Commission's 'Provision of cosmetic surgery in England' report can be found at the healthcare commission web site.

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