Chamber and committees

Beyond the bill, what can be done to ensure that international graduates feel welcome here? There has been a lot of anti-migrant rhetoric across the UK recently, and the bill could be seen as adding to the idea of not wanting people to come to this country to work. I appreciate from what the cabinet secretary has said that that is very much not the Scottish Government’s position, so what softer measures can it put in place to ensure that international medical graduates are aware that they are still welcome and that the bill should not put them off coming to Scotland?

To follow up on Sandesh Gulhane’s question, one of the things that we do not talk about is electrical waste in hospitals. The nature of how healthcare is now delivered means that a number of big machines do a lot of work across hospitals, but they often come to the end of their lives either because patient safety issues mean that they are no longer considered safe to keep doing their job or because companies make software updates and machines become redundant as a result of those updates.

What work is being done to reduce the level of electronic waste across the NHS, and how do we ensure that anything that has to go, for patient safety reasons or any other reason, is recycled or repurposed, so that we do not put loads of stuff into landfill?

I think that I was using electronic prescribing as an example of a quite basic thing that we have not achieved yet. Where, in your mind, is the blockage in that respect? Is it a lack of money to do these things? Is it a matter of prioritisation and getting the bigger things rather than the smaller ones over the line? Is it about the cumulative impact?

Given that the committee has concluded a large piece of work on this topic, I would be content to close the petition. However, as there is on-going work in relation to the issue that the petition concerns, we could recommend in our legacy report that, a couple of years into the next session of Parliament, the issue should be looked at again to consider whether any further improvements need to be made.

One of the ideas that we have been talking about for a very long time now is electronic prescribing, which is one of the most basic ways in which we could save something as simple as paper within the NHS, as well as time and all those sorts of things. It is one little idea among a whole load of others that we could be progressing more quickly. What are the barriers to our doing some of those simple things such as electronic prescribing, sustainable medicine disposal and moving to better, greener ways of giving people their medicines through blister packs? Is it a lack of resource? Is it about expertise? Is it because these things need to be done better at a global level? Is it a bit of everything?

Thank you.

Previous First Ministers have provided a clear yes or no as to whether they are against Rosebank, and it would be good for this First Minister to do so.

However, warm words are not good enough when climate destruction is funding illegal occupation, and we must put a stop to that. The First Minister must understand why so many of us are frustrated by the news this week. The National has reported that, following this Parliament’s historic vote last year to boycott, divest from and sanction Israeli companies, the Scottish Government has not commissioned a single briefing from officials on how to implement that action. My colleague Patrick Harvie’s questions on the subject from October remain unanswered 17 weeks later.

Is the First Minister’s Government truly committed to boycotting Israel and supporting the people of Palestine? If so, when will we see action?

In my opening contribution, I want to spend some time reflecting on why we need the bill in the first place.

In March 2024, healthcare professionals warned that Scotland had become the worst country in Europe for unqualified practitioners injecting customers with cosmetic treatments. In its submission, the British Association of Plastic, Reconstructive and Aesthetic Surgeons—that is not easy to say at this time on a Thursday—said:

“The impact on the NHS and public resources is significant. Our members are witnessing an alarming increase in severe complications from procedures performed by unqualified practitioners, many requiring emergency NHS care or even resulting in loss of life.”

Moreover, the Royal College of Nursing highlighted:

“None of the procedures listed in this Bill are without risk and there is a lack of any reliable data on the cost to the NHS of complications arising out of these procedures.”

Although we need to improve the data in order to better understand the full costs, the evidence from clinicians is clear. A survey that was conducted by the Medical and Dental Defence Union of Scotland in October 2024 revealed that 35 per cent of respondents who worked in a medical field in Scotland had treated patients who had needed care following complications that arose from unregulated cosmetic procedures, and 86 per cent thought that the number of patients each year who seek care following complications resulting from unregulated cosmetic treatments had increased.

The proposed ban on procedures for under-18s is particularly important. The Royal College of Surgeons of Edinburgh has said:

“Facial structures continue to develop into early adulthood, and starting these procedures from a young age can have long-term effects. Procedures such as dermal fillers and Botox too young can lead to muscle atrophy and tissue damage and should rightfully only be available to those over the age of 18.”

We do need to protect young people from the damaging long-term effects of cosmetic surgery, but it is also vital, as we have heard from others, that we protect people who are over 18 from side effects. The Royal College of Surgeons lists the serious complications associated with some cosmetic procedures, including

“infections, blocked arteries, necrosis, blindness and stroke”,

and it makes it clear in its submission that the introduction of the bill will

“reduce the likelihood and severity of any risks and complications.”

However, I believe that the bill should be strengthened in that regard, and that duties should be placed on practitioners to inform customers about the risks attached to procedures. I look forward to working with the minister on that.

The committee heard that the bill could have an impact on equality, as it will affect a female-dominated industry and might lead to reduced access to cosmetic procedures in remote and rural areas. The lack of regulation in the industry has led to unsafe practices that disproportionately affect vulnerable groups, but we need to ensure that those who are safely and ethically carrying out these procedures have the ability to adapt to whatever regulation might come in.

There will always be cosmetic tourism, rogue operators and poor standards, but we cannot let them stand in the way of improving patient safety in Scotland. Those kinds of unsafe practices will occur, with or without regulation, so we should ensure that the vast majority of procedures are carried out in a safe, hygienic way in a properly controlled environment. That said, I think that we should still monitor the equality impact of the bill. I strongly believe that the bill will improve public safety for marginalised groups, as all good legislation does, but there could be unintended consequences.

In its submission to the committee, the Cleft Lip and Palate Association warned that access to cosmetic procedures becoming more bureaucratic or costly could act as a barrier

“for those who seek aesthetic enhancement to address cleft-related lip asymmetry, scarring or functional issues. It is important the Bill allows recognised healthcare professionals … working in the cleft pathway to continue to offer safe lip‐fillers or adjunctive therapies under appropriate clinical governance.”

Overall, however, the bill will improve safety for people undergoing non-surgical cosmetic procedures and protect young people under the age of 18. I believe that the evidence for regulation is clear.

16:12

Drilling for oil and gas in the Rosebank oil field is set to tip Scotland over the edge of climate disaster. This week, we also learned that that work will directly fund a company that is complicit in the illegal occupation of Palestine. Campaign group Uplift has obtained legal advice that says that granting permissions for Rosebank could be a breach of the Geneva conventions. The Scottish Government used to have a clear position on that. Under Nicola Sturgeon and Humza Yousaf, it was opposed to Rosebank. Under the current First Minister, no one is sure.

Can the First Minister confirm whether he still stands by Parliament’s commitment to boycotting Israel? If so, does he agree that the Rosebank oil field should not go ahead?

I spoke in favour of regulating the medical aesthetics industry when Stuart McMillan held a members’ business debate on the topic back in October 2024. In his contribution this afternoon, he reflected on how we support those who have made a genuine mistake, including supporting them to improve. Given some of the bad press around these procedures and the potential for practitioners to be demonised for a genuine mistake, we need to make sure that regulation supports improvement across the sector and that opportunities for learning are taken. I hope that that ethos will be at the heart of the regulation, rather than there just being punitive measures.

During its evidence sessions, the Health, Social Care and Sport Committee heard that the bill will create a level playing field, as healthcare professionals already provide aesthetic procedures in HIS-regulated clinics. If the bill is passed, it will ensure that all providers have to meet the same standards. We know that there are and always will be rogue operators. The bill aims to simply ensure that all those who operate in the sector can be held to the same high standards.

In committee, a representative from the industry argued that the cost of treatment has to be considered as well. If what is proposed in the bill becomes a hugely costly exercise for business, the burden of cost will be passed on to the consumer. However, I think that it is important that we do not look to drive down business costs at the cost of patient safety.