Regulation of non-surgical procedures: equality and Fairer Scotland Duty impact assessment

Key Findings

As non-surgical procedures are unregulated it has not been possible to gather statistical evidence in relation to most of the groups listed above. It is also not a topic that has been examined in any detail, although reports such as GirlGuiding’s Girls' Attitudes Survey 2024 found that “Girls feel under pressure to alter their appearance both online and in real life”. In the absence of any responses to the EQFSDIA questionnaire (with the exception of Scottish Trans, which will be discussed below), the majority of evidence has come from responses to our recent public consultation, which asked specific questions on the perceived impact on people with protected characteristics, people experiencing socio-economic deprivation, children and young people and island communities.

There were no specific comments made in consultation responses to the protected characteristics of disability, sexual orientation, race, minority ethnic or homeless people, looked after children, people involved in the criminal justice system or carers, although there was a general feeling that regulation of non-surgical procedures will promote safety, inclusivity and equitable treatment and will safeguard vulnerable people.

The following comments relating to specific groups were made

• Age: more than half of respondents felt that non-surgical procedures should only be available to people aged 18 and over. Our proposals would help to protect children and young people’s rights to health, safety and wellbeing, prevent exploitation and act in their best interests – a positive impact. A Child Rights and Wellbeing Impact Assessment will be published separately.
• Pregnancy and maternity: pregnant or breastfeeding women would be better protected by guidelines ensuring unsuitable treatments are avoided – a positive impact.
• Religion or belief: regulation of this sector could provide an opportunity (through guidance or training) to foster cultural sensitivity, respecting religious practices and beliefs – a positive impact.
• People experiencing socio-economic disadvantage or from low socio-economic backgrounds: there was some suggestion that those with lower incomes may find it harder to get these procedures if costs increase as a result of regulation – a negative impact.
• People with rare and/or long term health conditions: people with certain health conditions could benefit from tailored treatment consideration – a positive impact.
• People with low literacy/numeracy: clear and accessible information about licensed practitioners can empower individuals, particularly those who may face communication barriers or have limited access to information due to their circumstances, to make informed decisions – a positive impact.
• People in remote, rural and island locations: while regulation would bring fair access to services and safety in island communities, licence fees may prove prohibitive for smaller businesses and there may be a lack of healthcare practitioners for supervision and prescribing – a positive and negative impact. Specific comments on island communities can also be considered relevant for remote and rural mainland communities.

In addition to responses to the public consultation, during our engagement we have also received the following comments:

• Sex: 87% of responses to a consultation for the Business and Regulatory Impact Assessment associated with this policy were from women, which appears to support what we have been told by stakeholders, that this is a female-led sector. Evidence from these responses suggests potential additional costs or annual losses of between £7,000 and £340,000 in order to comply with the proposed regulatory regime, including registration with HIS, alterations to premises, meeting any required training standard, employing a prescribing healthcare professional or reducing the number of procedures which the business can offer. In general there is concern that the proposals for regulation will disproportionately affect women who rely on the flexibility of self-employment within the beauty industry to balance their work with childcare and domestic responsibilities. Investment in businesses, especially in small enterprises, can be tied closely to personal finances and assets. It is not always feasible to change business models, particularly where premises would have to be modified to meet HIS standards or healthcare professional staff would need to be employed. Individuals have invested significant amounts in their businesses and in training and some have many years of experience, having built up good relations with clients. This has a clearly negative impact. We are, however, also aware that many recipients of procedures are female. Data is not collected on this subject, but the view of those with whom the Scottish Government has engaged is that the majority of recipients of non-surgical procedures are female. The proposals may make procedures less accessible, or more expensive for this group, but this group will also be more protected, because women accessing these procedures are likely to be able to do so in a safer and better regulated environment, This shows both a positive and negative impact.
• Gender reassignment: Scottish Trans suggest that it is likely that a higher proportion of trans and non-binary people access these procedures as compared to the general population, and so there may be a disproportionate impact on them in relation to increased costs and less availability of services. In addition, restricting non-surgical procedures to people aged 18 and over will affect young trans and non-binary people who seek these treatments for alleviation of gender dysphoria. However regulation could means that trans and non-binary people accessing these procedures are likely to be able to do so in a safer and better regulated environment. This shows both a positive and negative impact.