Chamber and committees

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

Jim Wallace was one of the founders of devolution. Without him, our Parliament would be a weaker and less ambitious place.

I did not know Jim Wallace on a personal level as well as many others did but, the few times that I met him, he was warm, funny and quick to offer genuine advice to a very new MSP who had a lot to learn. I regret that I have not had the pleasure of working with him or serving in this Parliament with him.

In preparing my remarks, I spoke to colleagues who had worked with Jim. Their view, as has been the case so far across the chamber, was unanimous. They describe an unwaveringly decent and kind person who took Parliament seriously and took Scotland seriously. When he worked, it was with integrity. When he disagreed with colleagues, it was always in a spirit of respect.

Jim was only the second person who was not a Kirk minister to take on the role of Moderator of the General Assembly of the Church of Scotland since the 16th century. Moderator is clearly a non-partisan, party-neutral role. Jim did what he had to do and resigned his membership of the Liberal Democrats for the year of his tenure—it was a commitment on his part that his public service was above party politics.

My co-leader Ross Greer was grateful to know a deeply thoughtful man with an unparalleled commitment to serving Scotland through both politics and the Kirk. His term coincided with Glasgow hosting the 26th United Nations climate change conference of the parties—the COP26 climate summit. That resulted in Ross’s personal highlight of the conference: forming a temporary double act with Jim for a guest lecture at Trinity College Glasgow about faith and small-g green politics. That experience illustrated Jim’s commitment to public service, his love for his country and how his deeply held personal faith influenced his political life.

In this Parliament, we should remember the committed and dedicated voices who came before us and the wonderful legacies that they leave. We should be inspired by Jim Wallace’s work and should try to conduct ourselves in the manner in which he conducted himself. A long-serving Liberal Democrat MSP, Deputy First Minister, acting First Minister and Moderator of the General Assembly, his commitment to public service can never be in doubt. His sudden loss will be keenly felt by colleagues in the Parliament, and I extend our condolences in particular to our colleagues in the Liberal Democrats.

Most of all, I send my condolences to Jim’s friends and family. I sincerely hope that they take comfort in the universal affection and respect that have been expressed by MSPs across all parties.

14:33

I want to be clear that the Greens will not oppose the business motion, but I want to raise the late notice of changes and its wider impact. Over the past few weeks, we have had a series of very late decision times, which have impacted those of us with caring responsibilities or other responsibilities at home. I hope that, as we go through the rest of the session, we will remember that we need to take the decisions in a timely manner and remember the impact that late changes have on everybody across the Parliament.

I thank the cabinet secretary for advance sight of his statement. The creation of the safety and public confidence oversight group is a welcome development, but will the cabinet secretary provide more detail about the group’s membership? He mentioned that there will be active engagement with patients, families, the wider public, staff and whistleblowers, but will he confirm whether there will be patient and staff representatives on the group?

Jim Wallace was one of the founders of devolution. Without him, our Parliament would be a weaker and less ambitious place.

I did not know Jim Wallace on a personal level as well as many others did but, the few times that I met him, he was warm, funny and quick to offer genuine advice to a very new MSP who had a lot to learn. I regret that I have not had the pleasure of working with him or serving in this Parliament with him.

In preparing my remarks, I spoke to colleagues who had worked with Jim. Their view, as has been the case so far across the chamber, was unanimous. They describe an unwaveringly decent and kind person who took Parliament seriously and took Scotland seriously. When he worked, it was with integrity. When he disagreed with colleagues, it was always in a spirit of respect.

Jim was only the second person who was not a Kirk minister to take on the role of Moderator of the General Assembly of the Church of Scotland since the 16th century. Moderator is clearly a non-partisan, party-neutral role. Jim did what he had to do and resigned his membership of the Liberal Democrats for the year of his tenure—it was a commitment on his part that his public service was above party politics.

My co-leader Ross Greer was grateful to know a deeply thoughtful man with an unparalleled commitment to serving Scotland through both politics and the Kirk. His term coincided with Glasgow hosting the 26th United Nations climate change conference of the parties—the COP26 climate summit. That resulted in Ross’s personal highlight of the conference: forming a temporary double act with Jim for a guest lecture at Trinity College Glasgow about faith and small-g green politics. That experience illustrated Jim’s commitment to public service, his love for his country and how his deeply held personal faith influenced his political life.

In this Parliament, we should remember the committed and dedicated voices who came before us and the wonderful legacies that they leave. We should be inspired by Jim Wallace’s work and should try to conduct ourselves in the manner in which he conducted himself. A long-serving Liberal Democrat MSP, Deputy First Minister, acting First Minister and Moderator of the General Assembly, his commitment to public service can never be in doubt. His sudden loss will be keenly felt by colleagues in the Parliament, and I extend our condolences in particular to our colleagues in the Liberal Democrats.

Most of all, I send my condolences to Jim’s friends and family. I sincerely hope that they take comfort in the universal affection and respect that have been expressed by MSPs across all parties.

14:33

I want to be clear that the Greens will not oppose the business motion, but I want to raise the late notice of changes and its wider impact. Over the past few weeks, we have had a series of very late decision times, which have impacted those of us with caring responsibilities or other responsibilities at home. I hope that, as we go through the rest of the session, we will remember that we need to take the decisions in a timely manner and remember the impact that late changes have on everybody across the Parliament.

I thank the cabinet secretary for advance sight of his statement. The creation of the safety and public confidence oversight group is a welcome development, but will the cabinet secretary provide more detail about the group’s membership? He mentioned that there will be active engagement with patients, families, the wider public, staff and whistleblowers, but will he confirm whether there will be patient and staff representatives on the group?

I have a quick question, but the answer to it might not be quick. It is on the support, training and resourcing required to ensure that extending voting rights would be meaningful and not tokenistic, and what form of support would be most important. I will go to Sandra Auld first, because of her experience as a voting member. Sandra, what support do you currently have? If you were doing this again from scratch, what support do you think it would be good for other people to have?

12:15

As we know, the Patient Safety Commissioner has no remit to deal with individual complaints from patients. How do you plan to communicate that clearly to the public and manage patient expectations about your role and the level of support that you can provide?

Everyone has mentioned practical issues that need to be overcome, such as workload, but I am keen to understand whether it is just the practicalities that are the issue here, or whether there is an opposition to lived-experienced voting rights as a principle in itself.