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11 Jun 2008 : Column 124WHcontinued
The new byelaws are good news for the people of Mid Sussex because they give environmental health officers the powers they need to protect public health.
We have not received representations from local authorities or practitioners about the effectiveness of the current legislative framework.
My hon. Friend suggested that the byelaws should be more detailed, but they do provide a framework for hygienic practice, and we believe that details of hygienic practice and other matters are better covered in guidance by the Health and Safety Executive on enforcement in respect of skin-piercing activities. The guidance covers the issues that she raised, such as pre-consultation with the client, infection control, cleaning, disinfection and sterilisation, aftercare advice, anaesthetics and enforcement.
As my hon. Friend mentioned, the Department has funded new research by the HPA, which has investigated the prevalence and types of body piercing in those aged 16 and over in England and has estimated the proportion of piercings that result in health complications and the proportion of piercings that result in professional help and advice being sought. As she rightly said, that report is due to be published this Friday. However, after she secured this debate, I asked to see some of its draft findings, and without pre-empting too many of its conclusions, I thought that I would give her a foretaste, given her interest in the matter.
Some of the findings are interesting. The prevalence of cosmetic body piercing, excluding earlobes, but including the upper ear cartilage, in adults aged 16 and over is 10 per cent. Body piercing was more common among women than men and among younger age groups. Nearly half the women aged between 16 and 24 who were surveyed reported having had piercings. Some 33 per cent. of piercings were at the navel, followed by 19 per cent. at the nose, 13 per cent. at the ear, 9 per cent. at the tongue, 9 per cent. at the nipple, 8 per cent. at the eyebrow, 4 per cent. at the lip, 2 per cent. at the genitals and 3 per cent. at some other part of the body.
My hon. Friend may also be interested to know that the anatomical sites used for piercings varied by gender. Among women, the most common piercings were, in order, of the navel, the nose, the ear, the tongue, the eyebrow, the nipple and the lip. Among men, they were the nipple, the eyebrow, the ear, the tongue, the nose, the lip and the genitals. Thus, nipple piercing was the most popular among men but one of the least popular among women, and navel piercing was by far the most popular among women, accounting for more than a third of piercings, and much rarer among men. Some of the findings surprised me, and I am sure that they will surprise a lot of hon. Members and members of the public who, like me, are not au fait with the world of body piercing. Ouch, I said to myself as I read through a lot of that list.
My hon. Friend will also be interested to know that, overall, about 25 per cent. of those pierced reported complications. Among those aged 16 to 24, about 30 per cent. reported complications with piercings and 15 per cent. sought professional help, for example from pharmacists, piercers themselves or GPs. Piercing was much more common in that age group and more likely to have been done in recent years. The most common complications were local infections and bleeding, but serious complications requiring a hospital admission, for example, were extremely rare, at less than 1 per cent. We believe that the research will show that we probably need to do more work to determine the risk of complications and how best they may be avoided.
My hon. Friend expressed her concern about the fact that children can have body piercing done without parental consent, both from the point of view of whether it is appropriate and because of the possible health risks. I emphasise to her that Government policy on the age of consent is the responsibility of the Ministry of Justice, but she will know that the tattooing of minors is controlled by specific legislation. We think that that is appropriate, because of the permanent skin alteration that it involves. However, the piercing of ears and other parts of the body for decorative or cosmetic purposes is lawful. We have taken that judgment because we believe that cosmetic piercing is usually naturally reversible if jewellery is permanently removed from the piercing. There is no statutory minimum age of consent for body piercing or ear piercing. Minors can give valid consent if they are capable of understanding the nature of the act to be carried out. The degree of competence that can be exercised by children depends on the relative maturity of the child concerned as well as upon his or her age.
I understand that some parents feel concerned when their children have body piercing done without their consent. As with many such matters, a lot of the issues involved should be resolved within the family. However, I am advised that it is generally considered good practice by local authorities and by the industry for cosmetic piercing not to be carried out on minors without parental consent. If local authorities receive complaints from parents that that has been done by a particular practitioner, it is open to them to take action using their existing powers. The Health and Safety Executive guidance includes advice on encouraging businesses to adopt a reasonable approach to age of consent issues. Taking a reasonable stance on the age of consent avoids conflict with parents and enhances the reputation of the business. I would helpfully suggest that it also ensures that a business does not run into difficulties with the local authority, which has the responsibilities that I have described.
I am aware that this is a sensitive matter that concerns parents. However, we are concerned that if we introduced a statutory minimum age of consent, we could end up increasing the health risks of cosmetic piercing. Children might be tempted to try to pierce themselves or each other in an unsafe or unhygienic way, or to go to disreputable practitioners. We receive occasional representations on the subject and, as on all matters, keep our policy position under review.
I reassure my hon. Friend that we have a robust legislative framework that provides for local regulation of tattooing and skin piercing businesses. Centrally, the Department assists by providing model byelaws that local authorities can use.
Mrs. Moon: My hon. Friend the Minister has not addressed the issue of qualifications and competency to practice. Will he comment on that in the remaining few minutes and suggest whether the Department has any concerns about it?
Mr. Bradshaw: We are aware of the concerns, and although there are currently no formally recognised qualifications or training courses for body piercing, that is partly because the Government-funded project to develop such standards, of which my hon. Friend may be aware, ended prematurely because of opposition from the industry. We believe that it could have led to the development of formal qualifications.
We believe that progress can most quickly and effectively be made by practitioners, their organisations, industry bodies, training bodies and enforcement authorities working together to agree on suitable standards of good practice and competency. That is the best way forward, rather than our imposing statutory training requirements on the industry.
As I have explained, we recognise that there is concern about the lack of a statutory age of consent for cosmetic piercing, about some of the training standards and about how some local authorities are using our new model byelaws. We keep those matters under careful review and consideration, but we are not persuaded that a statutory age of consent would help. Our concern is that it might have the opposite effect.
Jo Swinson (East Dunbartonshire) (LD): I am delighted to introduce the debate.
I have a vivid memory of one of the first economics lectures that I attended during my time at the London School of Economics. The lecturer, the excellent Morris Perlman, who is sadly no longer with us, made clear to the undergraduates right at the beginning the distinction between money and wealth. Money is pieces of paper or numbers, he said, but the wealth that you have is the sum of all the things that you valueboth the things with a monetary value attached, like your home and possessions, and the things without a price tag, such as relationships, a feeling of security and your health.
It is not just economists. Philosophers, too, contribute to the debate about what we really value. Earlier this year, A. C. Grayling said:
Happiness is the measure of true wealth.
I shall explore how we can measure that wider definition of the nations wealth and the implications that it has for policy making. I shall argue that levels of happiness are important, useful and integral to the concept of quality of life, as other Governments around the world, and even Departments other than the Treasury, acknowledge. I shall argue that happiness can be measured reliably and robustly and that the Treasury can and should do practical things to improve the nations happiness and quality of life.
To raise the rate of sustainable growth, and achieve rising prosperity and a better quality of life, with economic and employment opportunities for all.
I commend the Treasury for including a better quality of life in its aim, but I question whether that is taken as seriously as the growth and prosperity aims. Without quality of life being taken into consideration, growth is meaningless. Gross domestic product grows after natural disasters or oil spills, as the clean-up operation is costly, but it obviously does not follow that such events are desirable. If GDP growth comes as a result of our working longer hours, we may find our quality of life negatively affected. A Department of Trade and Industry study in 2004 found that 87 per cent. of employees said that they would like to spend more time with friends and family. If some of those employees were to cut their working hours to see their family more, GDP would fall. Would that be a bad thing, if that decision enhanced their quality of life?
Research clearly shows that our quality of life is not getting better. The world values survey tells us that, if anything, we as a nation are less happy now than we were in the early 1980s. We can go back further using polling evidence from Gallup, which shows that despite increases in GDP, we are less happy even than in the 1950s. Back in 1968, the late Robert Kennedy said in a famous speech:
There is more to life than GDP.
The debate about the best way for societies to measure progress has continued ever since. The blinkered pursuit of GDP growth on its own can lead to perverse decisions.
We should recognise the limitations of pursuing GDP growth and introduce other measures to capture quality of life.
This idea is gaining momentum. Last week, Ipsos MORI dedicated its summer conference to the subject, under the title, Whos Happy Now? Governments around the world are looking seriously at going beyond GDP, and not just the Government in Bhutan. Earlier this year the French President, Nicolas Sarkozy, commissioned two eminent economists, Joseph Stiglitz and Amartya Sen, to develop alternative measures of progress to GDP that would better reflect peoples well-being. Forty-eight Members from both sides of the House have signed my early-day motion 731, acknowledging static levels of happiness and the need for the Government to measure and address that. The British public agree. In 2006, a BBC-commissioned GfK NOP poll found that 81 per cent. of the British public think that the Governments prime objective should be happiness and not wealth.
As I have mentioned, other Departments are also addressing this issue. In 2002, the Cabinet Office commissioned a paper on the subject, Life Satisfaction: the state of knowledge and implications for government. Although it was not a statement of policy, the paper declared that:
There is a case for state intervention to boost life satisfaction due mainly to evidence of direct impacts on life satisfaction of government activities, together with strong evidence of the dependence of individuals wellbeing on the actions of others.
The paper suggested a range of actions that the Government could take, including at the top of the list:
the use of life satisfaction data to construct quality of life indices.
Following the 2007 UNICEF study of 20 developed nations, in which children in the UK ranked lowest in terms of happiness and well-being, the Department for Children, Schools and Families has introduced SEAL classes, or so-called happiness lessons, in schools. The Department for Communities and Local Government has included subjective well-being measures in its new 2008 national indicators set, which will be used by local authorities to keep track of progress. It is also supporting the Local Wellbeing Project, which is being conducted by the Young Foundation to test practical interventions to improve peoples happiness in three local authority areas in the UK. The Department for Environment, Food and Rural Affairs has started to measure life satisfaction as part of its sustainable development indicators, and it has commissioned a sizeable body of research that highlights ways in which Government action could impact on happiness.
I very much welcome these moves. Many Departments are beginning to take the issue seriously. However, to bring all those activities together and co-ordinate what will otherwise be piecemeal efforts, the Treasury needs to take a lead. Sadly, when I raised this subject with the Chancellor in November 2007, while he waxed lyrical about growth and prosperity, he seemed less than serious when he said:
I am willing to consider a Liberal Democrat happiness index.[Official Report, 29 November 2007; Vol. 468, c. 428.]
I hope that I am wrong, and that the Treasury has an open mind about creating robust measures of quality of life.
If the Treasury is to consider measuring quality of life, quality of life obviously needs to be defined. On 22 February, I asked the Chancellor what definition the Treasury is using, and I received this answer from the Financial Secretary to the Treasury:
Productivity and employment are the key determinants of growth and therefore of living standards. However, a large volume of other data are also important indicators for a broader measure of quality of life, such as those on crime, working hours, social capital, social demography and health.[Official Report, 22 February 2008; Vol. 472, c. 1117W.]
That answer rightly recognises that living standards are not the same as quality of life.
Living standards have certainly increased in recent decades but, as I have said already, quality of life has not. The factors that were listed
crime, working hours, social capital...health
and so on are all important to quality of life, but with such a vague definition, it is not clear how the Treasury can measure overall progress towards its aim of a better quality of life. The answer also misses out how quality of life should be definedthe answer is by asking people. Measuring the subjective well-being of individuals is essential, if we are to know how the quality of life is changing. Asserting that quality of life has increased on a range of sterile indicators is not much use if people do not feel any happier or more satisfied.
Some would argue that happiness cannot be studied or measured accurately. However, science tells us otherwise. Lord Layard, the well respected Labour peer, goes over the evidence that it can be measured at some length in his 2005 book, Happiness: Lessons from a New Science. He is clear that the answers that an individual gives to subjective well-being questions not only match the answers that friends or independent observers would give about their well-being, but also correlate with scans indicating activity in corresponding parts of the brain.
Furthermore, the Governments own sources suggest that a life satisfaction question is both robust and useful. A DEFRA paper published last year, Sustainable development indicators in your pocket, states:
The independent research commissioned by DEFRA concluded that life satisfaction measures should provide reliable information about wellbeing in a policy context.
Of course, just asking people how satisfied or happy they are may be interesting, but it will not help the Government to understand how to enhance quality of life. That is why a range of indicators needs to be developed and correlated over time with the subjective well-being question, so that trends can be established and policies changed accordingly.
There is already a large body of research into the determinants of happiness. A paper commissioned by DEFRA, Review of research on the influences on personal well-being and application to policy making, which was written by Professor Paul Dolan and others in 2006, gives a comprehensive review of the research that has been conducted so far. In particular, the findings on income and work are interesting. The paper states:
The majority of individual level studies find a positive association between absolute income and well-being.
We might assume that to be the case, given that most people tend to try hard to increase their income. However, the paper goes on to say:
The results generally suggest that there are diminishing returns to income i.e. the well-being hit of income falls as income rises.
Beyond a certain point, therefore, policies that prioritise making us richer will not necessarily yield large pay-offs in terms of our happiness.
The Treasury is right to identify employment as a key driver for quality of life, although that is not just about the growth as a result of higher employment, as might be thought. Instead, the same DEFRA paper found that
being unemployed has severe and long lasting negative consequences for life satisfaction and happiness, which cannot be explained only in terms of the loss in income.
The conclusion to be drawn from that is that even when someone who has been unemployed returns to work, they are unhappier than they were before, because the experience of being unemployed increases their feeling of insecurity even while they are in work. I know that, as a Labour Member, the Minister will welcome that finding, which suggests that there should be an even greater focus on ensuring that everyone has a genuine opportunity to work.
Regardless of the level of income, inequality negatively impacts on quality of life. People would rather earn £50,000 in a society where everyone else earns £25,000 than earn £100,000 in a society where everyone else earns £250,000. Therefore, the issue of income inequality is important, so it is especially worrying that according to the Institute for Fiscal Studies and the gini coefficient the gap between the rich and the poor has widened under this Government.
On income and work, it is also important to bear in mind the current personal debt crisis. The evidence shows that while secured debts, such as a mortgage, do not negatively impact on someones quality of life, large amounts of unsecured debt cause a great deal of worry and unhappiness.
Interestingly, the DEFRA paper also points out that, according to the research, commuting is:
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