Although commencement of the bill will rightly be a matter for ministers in the next session of Parliament, my intention is for its key provisions to be commenced on 6 September 2027, which is the date from which the licensing scheme for lower-risk, non-surgical procedures will also take effect. Businesses will have until that date to adjust to the bill’s requirements and, in that time, preparations will be made for the its enforcement and implementation.

I took on board Mr Balfour’s point that some businesses might be concerned that a future minister might bring forward the date for provisions on offences coming into force. I explained why that that was unlikely. However, amendment 35, in my name, puts that beyond doubt by preventing the offence created in section 3—providing a non-surgical procedure outwith permitted premises—from coming into force before that date. I recognise that requiring any earlier date might be unduly difficult for businesses and that any later date would delay operation of the protections in the bill. I hope that that provides assurances to Mr Balfour and that members will support amendment 35.

I urge Mr Balfour not to press his amendments 34 and 36, which would delay the commencement of offences in other parts of the bill for 24 months. That is too long a wait. I also cannot support any provision that would prevent the Government from using regulatory powers until then. The Scottish Government intends to progress work on regulations during that time—for instance, in relation to training or supervision. Mr Balfour is looking to support businesses, but it is in businesses’ interests that work on other regulations can be progressed—for example, under section 5 of the bill—before the creation of offences comes into force, to ensure that businesses have advance notice of requirements.

Amendment 7, in Brian Whittle’s name, raises the important point that transitional provision in connection with the implementation of the bill might be needed. If many businesses register with Healthcare Improvement Scotland at the same time, there could be delays, and it would not be reasonable for businesses that were otherwise compliant to be forced to cease trading or to be criminalised due to an administrative delay. I hope that that will not occur, but, if it does, transitional provision might be required if applications are pending. It is therefore right that the commencement provision in section 20 of the bill be adjusted to provide scope for that protection to be included in commencement regulations, and I thank Mr Whittle for working with me on the amendment.

I ask Mr Balfour not to press amendments 34 and 36, but I urge members to support amendment 35 in my name and amendment 7 in Mr Whittle’s name.

I will just finish my point. The Scottish Government will engage with practitioners and training providers before taking decisions, and I hope that standards can be set at the same level in England and Scotland for the benefit of practitioners.

I am delighted to speak to the general principles of the Non-surgical Procedures and Functions of Medical Reviewers (Scotland) Bill. It is, I believe, an important bill that addresses important safety concerns. It is significant to those who will be impacted by it and to those who have already, sadly, been affected by the lack of regulation in the non-surgical procedures sector to date.

I will start by addressing part 2 of the bill, which makes important amendments to the Certification of Death (Scotland) Act 2011. These amendments extend the right to request an interested person review and update the provisions on authorising cremations and hydrolysis in Scotland when a death has occurred elsewhere in the United Kingdom. These measures ensure that relatives will have more opportunities to request a review and they also update the requirements for authorising cremations and now hydrolysis, avoiding duplication of those processes and reducing delays for families without undermining safeguards.

In considering the remainder of the bill, I want to start by reminding us why the bill came about, just as I did at stage 1. Concerns about cosmetic procedures were first raised more than a decade ago. The Scottish Government took steps and, in 2016, services provided by independent healthcare clinics, which included non-surgical procedures, came under the regulation of Healthcare Improvement Scotland.

Since then, the non-surgical procedures sector has continued to grow. Many people have had positive experiences with responsible and caring practitioners, but, as the sector has grown, so have the stories of people who have been harmed or injured. The regulation of independent clinics left a gap whereby non-clinical settings remained entirely unregulated. In a minority of cases, that has had tragic results.

I thank Alex Cole-Hamilton for his intervention and I note again my disappointment that he has not engaged on the bill with me prior to this stage.

I thank members and their constituents who have tirelessly raised those issues with Government. I hope to hear from some of those members this afternoon, and I hope that those constituents are watching our progress. Most of all, I hope that the bill meets the challenge that they set out for us.

I am also grateful to the members of the Health, Social Care and Sport Committee, the Delegated Powers and Law Reform Committee and the Finance and Public Administration Committee, which have given the bill careful consideration. Their recommendations were balanced and reflective of the need to protect public safety while ensuring that our approach was proportionate and balanced. Likewise, the contributions of members who lodged amendments or who have spoken to me over the past few weeks are very much appreciated. I also thank the members of the bill team. Their determination and dedication to capture every detail required for the bill has been key to ensuring that the right balance has been struck.

The bill will make procedures safer for everyone. It will ensure that all procedures take place in appropriate hygienic settings, where healthcare professionals are involved in the provision or management of services and can assist if there are complications. It will also make it an offence to provide procedures to a person who is under 18. The bill is complemented by the Civic Government (Scotland) Act 1982 (Licensing of Non-surgical Procedures) Order 2026, which establishes a local authority licensing scheme for lower-risk procedures.

I recognise that it is not possible to bring regulations to a fast-growing sector without causing some disruption to the businesses that are already operating within it. That was raised clearly in the stage 1 debate and had been raised with me well before that, too. I assure members that I understand the impact of the bill. I have considered it carefully and, in doing so, I have met currently unregulated businesses and have heard which aspects of our approach are most challenging for them.

In explaining my approach to those concerns, I recall some of Carol Mochan’s comments from the stage 1 debate. In her carefully considered contribution, Ms Mochan stated that

“introducing further restrictions is a necessary step towards improving patient safety”.—[Official Report, 5 February 2026; c 88.]

Many of the amendments today and at stage 2 sought to amend the bill to mitigate the impact of some of the requirements that the bill introduces. I urged members to resist those amendments not lightly but because they weakened aspects of the bill that are necessary to achieve our public safety aims.

Neither the provisions in the bill nor our plans for future regulation go as far as some members would like, and they do not restrict procedures as much as in many European or comparator countries. However, I was not prepared to endorse proposals that I did not think were absolutely necessary. As a result, I believe that the bill that we are voting on today is a balanced one that will achieve public safety aims, especially the protection of under-18s, while protecting the space for a thriving sector.

To Mr Cole-Hamilton’s point, the journey towards a safe, regulated and thriving sector does not end with this bill. I will take this opportunity to set out what I think must come next. In particular, I will set out how the Scottish Government should work with businesses in both the regulated and currently unregulated parts of the sector. Clear information is needed for all businesses. If the bill is successful, officials will host a webinar for businesses before the start of the pre-election period, to explain the bill as amended today and more about what it means. Further information, guidance and advice on seeking support will also be produced.

I expect the Scottish Government to work with businesses and the associated industry in setting training and qualification standards and in considering the requirements of Healthcare Improvement Scotland registration, to ensure that there are no unnecessary hurdles for businesses. I do not know what will be the composition of the Parliament that oversees the implementation of the bill if it is passed, but I am sure that that Parliament will hold the Government to account on all those matters.

Once again, I thank the committees, members, business owners, providers and clients whose input has helped to shape the legislation.

I move,

That the Parliament agrees that the Non-surgical Procedures and Functions of Medical Reviewers (Scotland) Bill be passed.

16:06

I thank all colleagues in the chamber for their constructive comments on part 1 of the bill.

Stuart McMillan is absolutely right: when we are confronted by someone who has been impacted by some procedure, it highlights the change that it has made to some people’s lives. I, too, thank all MSPs who have engaged with me and the bill team.

I welcome the comments on patient safety and on the importance of having the right setting for delivering safe care, which was mentioned by everybody who spoke in the debate. It is crucial that the procedures that are regulated by the bill are delivered in safe, hygienic settings, where providers have support from healthcare professionals and access to emergency medications where required. The bill delivers those safe settings for all procedures. As Carol Mochan says, it will strengthen standards.

I very much thank Dr Gulhane for his engagement on the bill. I have found it incredibly helpful and challenging, and I appreciate the suggestions and proposals that he has made throughout the work on the bill. I also thank Gillian Mackay for her comments and her wider engagement, specifically on cleft palate, and in particular for her comments on under-18s.

I also wish to address the comments that were made by a number of people about the impact on businesses. I was clear in my opening speech that I do not take those impacts lightly, and I am confident that the bill is necessary to protect public safety. Nevertheless, I expect the Scottish Government to continue to work closely with businesses to mitigate the impact wherever possible.

We are proposing to commence offences under the bill in September 2027, giving a good lead-in for all concerned and time for businesses to adapt. I will highlight one very helpful meeting that I had recently, which was hosted by Davy Russell and included some of Fulton MacGregor’s constituents. We discussed the impact of regulation 12(b) of the Healthcare Improvement Scotland (Requirements as to Independent Health Care Services) Regulations 2011, which requires that a suitably qualified healthcare professional will be

“working within the independent health care service whilst service users are present”.

That would include an independent clinic or hospital that falls within the definition of “permitted premises” in section 4 of the bill. I have instructed officials to consider that requirement, and particularly the requirement for healthcare professionals to be on site at all times in relation to businesses that offer a mix of procedures that are regulated by the bill and other beauty treatments or licensable activities. I hope that Brian Whittle and Alex Cole-Hamilton will recognise that the Government is listening.

Colin Beattie talked about establishing a professional body for non-healthcare-professional practitioners. As he commented, that is not something that the Scottish Government can specifically do. However, we would be happy to facilitate introductory discussions between the Professional Standards Authority for Health and Social Care and a representative group wishing to establish a register of practitioners with a view to accreditation in the future.

I thank all members for their contributions. Intervention to regulate a growing and changing sector is not easy, so I have welcomed the support and the constructive challenge that I have received.

I am also grateful for the careful consideration given to part 2 of the bill, even though that has not been the focus of today’s debate. In my time as Minister for Public Health and Women’s Health, public safety has been my absolute priority, and the bill delivers its public safety aims in a proportionate way. I am, again, thankful to Stuart McMillan and others who regularly met me to discuss the impact that the matter has had on their constituents.

As I said in my opening speech, I believe that the bill that we will vote on today is a balanced one that will achieve public safety aims, especially the protection of those under 18, as was noted by Gillian Mackay and Carol Mochan, while protecting a thriving sector. The bill has benefited from contributions from across the chamber and I hope that members of all parties will join me in voting for it at decision time today. I urge the Parliament to support the bill and to pass it into legislation.

I note Ms Mochan’s comments.

Gillian Mackay’s amendment 6 would place a duty on ministers to provide guidance about the provision of procedures. It is appropriate that that amendment focuses on the offences in part 1 of the bill—which are to provide a non-surgical procedure to a person who is under 18 and to provide a non-surgical procedure “outwith permitted premises”—and on the steps that providers would have to take to meet those requirements.

I am grateful to Ms Mackay for working with me and to other members who raised issues on the guidance. I hope that members are content that this single provision on guidance has the flexibility to encompass the topics that businesses want to see in guidance, and I hope that members will support amendment 6.

15:30

Amendment 24, in Sandesh Gulhane’s name, overlaps with amendment 6 to some degree. It would require HIS to publish certain information on the resources that are available to businesses that provide non-surgical procedures. I welcomed my recent discussion with Dr Gulhane on the topic, and I know that he noted my comments about there being resources available for businesses.

As well as the requirement in amendment 6 for the Scottish Government to issue guidance, amendment 24 would place a duty on HIS to publish information about available support, such as the resources from local authorities and Business Gateway, which I highlighted earlier. It is more appropriate for that information to be included in the guidance that is published by the Scottish Government than for it to be a legal responsibility for HIS. I therefore ask Dr Gulhane not to press amendment 24 and ask members to support amendment 6.

At stage 2, I agreed that it was important to provide for a review, so I thank Mr McMillan for his amendment 28. It will strengthen the provisions of section 15A, which was inserted by his amendment at stage 2. It provides for a broad review at a point when it will be possible to fairly assess the bill’s impact.

Given the rapidly changing nature of the sector, the Scottish Government will need to keep the procedures in schedule 1 under review so that the legislation remains effective and proportionate. Amendment 28 will provide an opportunity to review how effective the Scottish Government has been in doing that. It will also require the Scottish Government to assess and report on the operation of part 1, and particularly the impact on businesses and enforcement. I hope that members will support amendment 28.

I am also grateful to Ms Mochan for lodging her amendment 27 and for her support for the bill. Unfortunately, however, amendments 27 and 28 cannot co-exist. All the matters that Ms Mochan has raised should be part of any consideration of the impact on business, which will have to be assessed in a review under amendment 28. I also hope that my response to the amendments in group 5 reassures members, and Ms Mochan in particular, that support for business is at the forefront of the Scottish Government’s mind.

Sandesh Gulhane’s amendments 25 and 26 address enforcement by Healthcare Improvement Scotland. I understand the concerns that were raised at stage 1 about HIS’s capacity to enforce the requirements in the bill, and I know that HIS is alive to those concerns. No legislative requirement is needed to ensure that HIS will be able to implement and enforce the bill. The Scottish Government will work with HIS to ensure that it can deliver what is required. That is critical, and I am happy to have the opportunity to repeat that.

Yes, of course we have done an equality impact assessment.

There are a few points that I wish to make. First, I sympathise with Ms Regan’s intentions. I am sure that she is trying to mitigate what many businesses see as the most challenging part of the bill. Secondly, the requirement for a healthcare professional to be involved is the most important part of the bill. The reasons for healthcare professional involvement being essential to public safety were discussed at stage 2. In many cases, prescriptions will be needed at the outset of a procedure. In other cases, it will be necessary for certain emergency medications to be available on site.

Within the United Kingdom regulatory framework for the sale and supply of medicines, non-regulated settings that deliver non-surgical procedures are not able to routinely hold supplies of prescription-only medicines without the involvement of a suitably qualified healthcare professional.

To say that the involvement of a healthcare professional is necessary is not to denigrate the skills, dedication and experience of other practitioners, who should continue to have a role in the sector. These rules can and should be complementary, ensuring that safe, professional and effective procedures are delivered.

14:45

There are other benefits to the settings that we have selected and to the rule on the involvement of a healthcare professional—for example, that healthcare professionals are subject to regulation by professional bodies.

I turn to the amendments themselves. Amendments 11 and 29 seek to add

“premises managed by a non-healthcare aesthetics professional”

to the list of permitted premises in section 4(1) of the bill. The Scottish ministers would be able to provide registration requirements for these premises in affirmative regulations.

Amendment 14 defines a “non-healthcare aesthetics professional” by reference to particular levels of qualification. Unfortunately, that training does not qualify a practitioner to prescribe medications, nor is it clear that these settings would be able to routinely hold stocks of relevant emergency medications without the involvement of a healthcare professional. These settings do not provide the safety protections required.

Amendments 12, 15 and 30 would provide for a licensing scheme to be established by regulations. Such a scheme is already set to take effect from 6 September 2027 under the Civic Government (Scotland) Act 1982 (Licensing of Non-surgical Procedures Order) 2026. That licensing scheme is appropriate for lower-risk procedures, but I do not believe that the risks of procedures covered by the bill can be adequately mitigated without the involvement of a healthcare professional.

Amendment 13 includes “a non-healthcare aesthetics professional” as one of the persons who may provide or manage services from the premises of a Healthcare Improvement Scotland-registered independent clinic in order for it to be “permitted premises” under section 4(1)(a) of the bill. Amendment 14, as discussed already, defines “non-healthcare aesthetics professional”.

I cannot support these amendments, for the public safety reasons that I have given previously. I also note that section 4(1)(a) interacts with the definition of an “independent clinic” in section 10F(2) of the National Health Service (Scotland) Act 1978. Such a clinic would still need services to be provided by one of the healthcare professionals listed in that section to register with HIS.

With regard to Alex Cole-Hamilton’s support for the amendments, I had hoped to meet him in the lead-up to stage 3. Unfortunately, he was not able to meet me because of his diary commitments.

I also point out that I expect that, in implementing the bill, the Scottish Government will work with businesses in the unregulated part of the sector to ensure that they have access to support and guidance. I understand Ms Regan’s motivations, but I urge her not to press amendment 11 or to move her other amendments, and, if she does, I urge members to vote against them.

Amendments 3 and 4 will build on the helpful provision introduced by Gillian Mackay at stage 2, which specified that regulations under section 5(1) of the bill may make provision for requirements for certain higher-risk groups.

At stage 2, Dr Gulhane raised the need for guidance in relation to mental health conditions, including, in particular, body dysmorphic disorder. While I would expect existing clinical guidance and a healthcare professional’s training on informed consent and shared decision making to be sufficient, I acknowledge that specific additional provision might be helpful. Therefore, I have built on Ms Mackay’s stage 2 amendment to introduce a specific reference to mental health in section 5(3)(e) as a matter on which regulations may be made.

Dr Gulhane’s amendment 16 would require that regulations under section 5(1) must include certain transitional and saving provisions. I agree with his comments on the importance of such provisions. I can confirm that that is already possible under section 18. The amendment is unnecessary and I cannot support it, as the transitional provision that is specified might not always be the most appropriate. The amendment would make it more difficult for ministers to put in place appropriate regulations with the right protections, so I urge Dr Gulhane not to press the amendment.

15:00

Dr Gulhane’s amendments 31 and 32 would provide further specification in the consultation requirements in section 19A, which would apply to any affirmative instruments that are made under the bill. The lists of persons to be consulted are likely to be appropriate in most cases, but I reiterate that even the affirmative powers may be capable of being exercised to make relatively small technical changes or changes that are relevant only to one of the groups that have been listed.

I am concerned that the approach would require consultation with patient organisations, and I am not aware that any such organisations exist representing recipients of the procedures. As a result, it may not be possible to comply with the duty, and I would not want that to prevent us from making necessary regulations in the area or to increase bureaucracy.

Colin Beattie’s amendments 19 to 22 all relate to the principle of supervision. I was pleased to support Fulton MacGregor’s amendment at stage 2 that created a requirement for regulations under section 5(1) to be made specifying training or qualification provisions for persons providing non-surgical procedures within three years of section 3 of the bill being commenced. If it is not practical to do that, a report must be laid before Parliament explaining why. I supported that because of the broad consensus across the Parliament about the importance of establishing training and qualification standards. Supervision is a matter of similar importance and concern, and I am happy to support the amendments that make similar provision. I was appreciative of having conversations with Carol Mochan in that area, too.

Although the timing of training and supervision regulations is not entirely within the gift of the Scottish ministers, I am comfortable with the period that is specified in section 5(5) and the option that is available under section 5(6) for ministers to be held to account if the Government cannot meet those expectations.

I urge members to support amendments 19 to 22 in Colin Beattie’s name and amendments 3 and 4 in mine. I urge Sandesh Gulhane not to press amendment 16 or to move amendments 31 and 32.

Ash Regan’s amendments seek to provide alternatives to the permitted premises that are currently described in the bill. The proposed alternatives would weaken public safety by removing the requirement for a healthcare professional to be involved in those settings.

Due to time constraints, I will not repeat all the discussions that we held at stage 2, but this is a fundamental part of the bill, so there are points that I must make.

We based our estimates on an estimated 1,500 businesses. I point out that this is a non-regulated sector, which is partly why we are bringing in the regulations. However, not all businesses will be impacted, as I will go on to explain.