Previous Section Back to Table of Contents Lords Hansard Home Page


Private and Voluntary Health Care (England) Regulations 2001

9.22 p.m.

Earl Howe rose to move, That an humble Address be presented to Her Majesty praying that the order, laid before the House on 12th December, be annulled (S.I. 2001/3968).

The noble Earl said: My Lords, I beg to move the Motion standing in my name on the Order Paper. In common with most if not all noble Lords who had the privilege of debating the Care Standards Act 2000 during its passage through your Lordships' House, I have been and remain now a firm supporter of the Government's proposals to strengthen the regulation and oversight of independent hospitals. In tabling my Motions for debate this evening, I do not seek in any way to criticise the primary purpose for which the statutory instruments listed on the Order Paper were drafted. My reason for laying these prayers is very specific. It is to voice a strong protest on behalf of a single category of establishment which these regulations will affect. I refer to clinics and beauty salons that operate a particular type of equipment designed to remove unwanted body hair.

There is a type of machine that removes body hair using a technology called intense pulsed light. Intense light is not the same thing as a laser. An IPL machine operates on a principle of administering light to the growing hair, thereby conducting heat to the hair follicle and destroying the cells responsible for the growth of new hair. The technique is painless, non-invasive and extremely safe. It is also, I understand, very effective. While the operator of an IPL system requires training, such training is simple and straightforward. Intense pulsed light hair removal systems were introduced on to the market some two or three years ago and the market for them has grown. There are currently around 1,000 locations around the country that use it, mainly leisure establishments such as hotels, spas and beauty salons.

Although hair removal using this technique is a cosmetic procedure, not a medical one, those establishments that offer it fall within the licensing and inspection regime applicable to full-blown private hospitals. A clinic offering IPL hair removal has no beds, no nurses, no doctors. Typically it is just a small room in which clients are treated with a machine little bigger than a hairdryer. The absurdity of equating such a facility with a private hospital has not, I think, been appreciated in the Department of Health. All the more absurd is it when one considers that other types of hair removal systems such as electrolysis, an invasive procedure, will not be affected by the regulations.

The way in which the IPL sector was brought within the scope of these regulations does not do much credit to the Department of Health. The first consultation paper relating to the National Care Standards Commission was published in July 1999 and was followed by a further document in December 1999 outlining the result of the consultation. At that stage

31 Jan 2002 : Column 443

there was no mention of extending healthcare regulations to the intense pulsed light technique. The Care Standards Bill was silent on the issue.

After the Care Standards Bill received Royal Assent in 2000, there was a further period of consultation with the industry on the proposed standards but there was still no consultation with the main intense light manufacturers or users. Thus in two years, and after several major consultation papers, there was no public mention of the intention to regulate intense light—none, that is, until the eleventh hour when in July 2001 the draft statutory instrument was issued. All of a sudden, establishments using intense light equipment were included within the scope of the regulations. The manufacturers, therefore, had no opportunity to discuss the merits or otherwise of these regulations as they might affect them. Only after the formal consultation process had ended did officials belatedly attempt to consult the sector. Several months ago the noble Lord, Lord Haskins, intervened at ministerial level, but no Minister has to date replied to this approach.

I do not lay Prayers lightly but I have done so in this case because it appears to be the only way of bringing the Minister's attention to a situation that should never remotely have been allowed to arise. I shall not be irresponsible over the order, and there is no question of my calling a Division on it. Nevertheless, I have three concerns which I should be grateful if the Minister would respond to, and of which I have given him prior notice.

The first relates to the need for transitional arrangements to ensure that establishments using intense light machines may continue to do so after the day on which these regulations commence. The commencement order provides for phasing-in arrangements whereby applications submitted prior to 1st April for registration under the Act will be treated as being in compliance with the regulations until the commission has processed the application and made a decision. However, crucially, that concession will not apply to applications submitted after 1st April.

The reason that is important is that in April the single largest trade fair takes place in which IPL machines are sold. The four weeks after 1st April, therefore, will see registration applications reach their peak for the year. If those individuals and businesses who purchase IPL machines at the April trade fair are obliged to wait for six, nine or even 12 months while the National Care Standards Commission gets through the backlog of applications for registering all private hospitals, then I really do not think that that is reasonable or equitable. It may even amount to an unfair restraint of trade. No small business is going to buy such a machine for the first time if it will be prevented from using it for several months. Again, had the sector been consulted at the appropriate time, it could have advised the department of the damaging effect that the regulations, as drafted, are likely to have on their business.

31 Jan 2002 : Column 444

Therefore, I should like an assurance from the Minister that he will give very sympathetic consideration to extending the transitional arrangements so as to enable those who apply to register IPL machines after 1st April to operate them normally until such time as their applications are processed by the commission.

My second concern relates to dual registration. During our debates on the Care Standards Act we established that one of the benefits of having a National Care Standards Commission would be that private hospitals would no longer have to register twice—once with the local authority and once with the health authority. Unfortunately, the belated inclusion of leisure facilities within the Care Standards Act regulations looks set to create a new system of dual registration because many facilities within beauty salons and health clubs already have to be registered with the local authority and will continue to have to be so. Nowhere is that issue addressed in the statutory instrument. I should be grateful if the Minister would give sympathetic consideration to this problem which, again, might well not have arisen had there been proper consultation.

My third main concern relates to fees. There will be three registration fees for IPL establishments: £1,100 for the owner of the establishment where the machine is used; £300 for the registration of the day-to-day manager; and £750 for annual registration of the room in which the machine is located. This adds up to a regulatory bill in the first year of £2,150. Added to these explicit costs will be the implicit costs of complying with both the paperwork and the annual inspection process. It is perhaps one thing for a full-blown private hospital to carry costs of this size. For a small beauty salon providing an intense light machine, often as a marginal service, it will be a considerable and, in my view, disproportionate burden.

But the matter does not end there. The consultation document indicated that the National Care Standards Commission intends to move, in time, towards full cost recovery. This means that within perhaps five years the fees may have doubled from the levels that I have just read out. I am not aware of any clarification by the department or the commission as to whether this kind of uprating of fees will be carried through. There was no published response to this particular aspect of the consultation. Can the Minister give an assurance that the burden of the registration fees on smaller providers will be closely monitored? Can he say whether the NCSC does indeed intend to proceed to "full cost recovery", whatever that means in the context of these very small IPL establishments?

I end by reiterating what I said at the beginning of my remarks. In the context of intense light machines, these regulations have been particularly poorly thought out. Indeed, they seem to me, knowing what I do about the cosmetic treatment concerned—not, I hasten to say, from personal experience—wholly anomalous. Although these regulations will be brought into force as drafted, it is not too late for the Government to look again at the inclusion of intense light technology under the same heading as private

31 Jan 2002 : Column 445

hospitals. I hope that the Minister can give me an assurance that he will carry out such a review at an early opportunity. I beg to move.

Moved, That an humble Address be presented to Her Majesty praying that the order laid before the House on 12th December be annulled (S.I. 2001/3968).—(Earl Howe.)

Lord Clement-Jones: My Lords, I congratulate the noble Earl, Lord Howe, on introducing this Prayer to annul. As the Minister will know, I wrote to him on 16th January in a tenor very similar to the points made by the noble Earl. Obviously this is the best way to get a ministerial assurance; I am still waiting for a reply to my letter. Meanwhile the clock ticks on on a negative instrument.

I shall not repeat the points made by the noble Earl. Suffice it to say that there are real issues here in terms of, first, the lack of consultation with the industry; secondly, the burden of regulation in terms of fees and costs; thirdly, the classification of these businesses as independent hospitals—it is a nonsense that they are so classified in view of the establishments that use these intense light machines—and, fourthly, the whole question of transitional arrangements.

One of the problems for the Minister in replying to the fourth point is that, effectively, the regulation that determines the transitional arrangements, as I understand it, falls under a different order—that is, the Care Standards Act 2000 (Commencement No. 9 (England) and Transitional Savings and Provisions Order) 2001, the date of which has passed. If the Minister can say anything to mitigate that, the industry would be extremely grateful, despite the passing of the regulation.

Two further points were raised by my honourable friend Dr Evan Harris in the Commons debate on this subject, the Hansard for which is not available but the Minister probably has a note of these issues. First, under the regulations—Part III deals with the conduct of healthcare establishments—there appears to be no criterion in terms of inspection for inspectors to observe whether or not the EU Working Time Directive has been complied with. That is not yet in force, as I understand it, but it will be important. It will certainly be extremely important in the NHS, so it will have considerable importance in the independent healthcare sector as well.

Secondly, the Minister will have noticed some of the press coverage surrounding anaesthetists' fees. Because these are not paid for directly by independent hospitals, as I understand it, regulation 7(1)(b) will not cover anaesthetists' fees. The Minister is no doubt aware of the activities of the OFT in looking at possible cartels in terms of consultants' fees. That is very welcome, although I have mixed views about whether or not there should be a schedule of fees. Certainly that is a course adopted by some independent hospitals, but not by others.

31 Jan 2002 : Column 446

I do not want to bowl the Minister too fast a ball. If he cares to write to me, I shall be happy to accept that. Those are the points I wish to make on the regulations.


Next Section Back to Table of Contents Lords Hansard Home Page